The National Cancer Control Strategy (2023–2027)

Objectives

The National Cancer Control Strategy 2023–2027 provides a roadmap for implementing the Kenya Cancer Policy 2019–2030 through a coordinated, people-centred and equitable cancer-control framework. Its vision is a nation free from the preventable burden of cancer, and its mission is to reduce cancer incidence, illness and premature deaths while improving the experience and quality of life of people living with cancer by 2028.[1][2][3]The overarching goal is to reduce premature cancer mortality in Kenya by one third by 2028.[4][3]

• Reduce preventable cancer risks through action on tobacco, alcohol, unhealthy diets, physical inactivity, overweight and obesity, environmental and occupational exposures, and cancer-associated infections.[4][5][6][7]
• Expand vaccination, screening, early diagnosis, referral and linkage to care, prioritising cervical, breast, colorectal and prostate cancers for population-level screening or early diagnosis.[3][8]
• Strengthen accessible, timely and quality-assured imaging, pathology and laboratory medicine services for biopsy, staging, treatment planning, follow-up, research and planning.[9][10]
• Improve treatment, palliative care, survivorship, rehabilitation and reintegration through multidisciplinary, patient-centred services across the continuum of care.[1][11][12]
• Advance advocacy, partnerships, coordination, financing, strategic information, registration, surveillance and research as cross-cutting pillars.[4][13]

The strategy is aligned with the Kenya Cancer Policy 2019–2030, Kenya Palliative Care Policy 2021–2030, National Non-Communicable Diseases Strategic Plan 2021/22 to 2025/26 and Universal Health Coverage Policy 2020–2030.[14][15]Its values include community and survivor involvement, sustainability, improved financial, geographical and social access, patient-centred care, evidence-based innovation, equity and inclusivity.[3]

Key quantified ambitions include reducing tobacco use from 13.3% to 6.5% and alcohol use from 19% to 10% by 2028; reaching 90% human papillomavirus vaccination coverage among eligible girls by 2030; achieving at least 60% childhood cancer survival by 2030; and expanding high-quality population-based cancer registry coverage to 20% of the national population.[5][8][12][16]

Implementation

Implementation uses an integrated health-system approach centred on primary health care, universal health coverage, decentralised county delivery and referral links to specialised services.[14][15][17]The Ministry of Health, through the National Cancer Control Programme, leads policy implementation, technical support, capacity building and annual monitoring, while the National Cancer Institute-Kenya provides policy advice, accreditation standards, regulation and cancer-data support.[16][18]

• Coordinate national action through the Non-Communicable Diseases Intersectoral Coordinating Committee, Cancer Technical Working Group and National Steering Committee on Cancer Prevention and Control.[4][19]
• Support county governments to establish cancer control programmes, integrate interventions into county plans and budgets, provide infrastructure, commodities and qualified staff, collect cancer data and build multisectoral partnerships.[19][20][21]
• Deliver services through community health, primary care, county referral and national referral levels, using hub-and-spoke networks, centres of excellence, patient navigation, telehealth and interoperable digital systems.[22][17][2][23]
• Strengthen workforce capacity through pre-service education, in-service training, mentorship, fellowships, professional accreditation and workforce-sharing arrangements between counties.[12][24][25]
• Improve commodity access through forecasting, pooled procurement, framework agreements, local manufacturing, supply-chain monitoring and collaboration with the Kenya Medical Supplies Authority.[24][26][27]

The delivery model combines public institutions, county governments, health facilities, professional bodies, civil society, communities, survivors, caregivers, private providers, development partners, research institutions and faith-based organisations.[3][19][20]Communities are intended to participate in prevention, health-seeking, insurance enrolment, patient support and stigma reduction, while survivors are engaged as cancer-control champions.[26]

The Monitoring, Evaluation, Accountability and Learning framework covers the full cancer-control continuum and uses process, output and outcome indicators, defined responsibilities, data-use arrangements and knowledge management.[21][28]Planned mechanisms include annual implementation monitoring, mid-term, end-term and impact evaluations, Service Quality Audits, Data Quality Audits, annual cancer burden reports and integrated cancer registration and health-information systems.[16][18]Key indicators include screening and vaccination coverage, treatment initiation and completion, access to essential medicines and palliative care, childhood cancer survival, cancer budget share and population-based registry coverage.[28]

Total implementation requirements are costed at Kenya shillings 49.2 billion for 2023–2027, based on annual coverage growth of 3.5% to reach 45% by 2028, annual downstaging of 2–3%, and a projected 5–10% improvement in stage-specific five-year survival.[29]Resource mobilisation includes national and county budget advocacy, excise taxation, a Chronic Disease Fund, public-private partnerships, donor engagement, corporate social responsibility and community social-financing approaches.[30][21][31]

Monitoring & Evaluation

The strategy establishes a Monitoring, Evaluation, Accountability and Learning framework to oversee implementation across prevention and early detection; diagnostics; treatment, palliative care and survivorship; advocacy, partnerships and financing; and strategic information, registration, surveillance and research.[32][13][28]It combines routine monitoring against defined indicators with periodic evaluation, accountability, learning, data use and continuous quality improvement.[33][16]

• Monitor process, output and outcome indicators across the cancer-control continuum, including screening, vaccination, diagnosis-to-treatment initiation, medicine access, treatment completion, childhood cancer survival, palliative-care access, cancer financing and registry coverage.[4][28]
• Track key targets, including 70% cervical screening coverage, 30% breast and colorectal screening coverage, 90% human papillomavirus vaccination, 90% treatment coverage for cervical pre-cancerous lesions or invasive cervical cancer, 60% childhood cancer survival, 50% palliative-care access, 10% of the health budget for cancer, and 20% population coverage by high-quality population-based cancer registries.[28]
• Conduct annual monitoring, mid-term, end-term and impact evaluations, and share findings with stakeholders through the designated non-communicable disease coordination and steering structures.[16][18]
• Strengthen cancer intelligence through population-based and hospital-based registries, integrated oncology databases, interoperable electronic medical records, cancer screening repositories, the Kenya Health Information System and the Electronic Community Health Information System.[34][16][35][36]
• Publish annual cancer burden reports, undertake Service Quality Audits and Data Quality Audits, audit registry processes, and incorporate findings into continuous quality improvement under the Kenya Quality Model for Health.[16][37][38]
• Use technical working groups, county focal points, coordination meetings, dashboards, service audits, quality assurance, accreditation and supportive supervision as operational accountability mechanisms.[39][40][41][42][43]

Previous-strategy evaluation found that 28% of planned interventions were fully implemented, 65% were under implementation and 7% had not commenced.[44][45]Cancer registration coverage was reported at approximately 11% of the population, against the International Agency for Research on Cancer ideal of 20%, reinforcing the need to expand registries.[33]

Costing & Financing

The strategy is costed using the World Health Organization economic costing model, with total implementation requirements reported as Kenyan shillings 49.2 billion for 2023–2027.[29]Detailed five-year tables report total implementation costs of Kenyan shillings 49,221,600,090, including programme, clinical and capital costs.[46]Costing assumptions include annual service-coverage growth of 3.5% to 45% by 2028, annual downstaging of 2% to 3%, and a 5% to 10% improvement in stage-specific five-year survival.[29]

• Allocate reported five-year costs of Kenyan shillings 17,584,026,570 to clinical services, Kenyan shillings 6,627,731,200 to programme costs and Kenyan shillings 7,425,815,750 to capital costs.[46]
• Increase annual total costs from Kenyan shillings 7,309,944,450 in Year 1 to Kenyan shillings 12,899,477,840 in Year 5.[46]
• Prioritise public funding according to disease burden, equity, feasibility, effectiveness, cost-effectiveness, affordability and value for money.[26][47]
• Mobilise resources through national and county budget processes, excise taxation, the Chronic Disease Fund, new taxes, corporate social responsibility, public-private partnerships, development partners, philanthropy and community social-financing approaches.[30][21][31]
• Ring-fence county cancer budget lines, include cancer in county plans and annual work plans, and expand health insurance coverage for screening, diagnosis, treatment, palliative care and survivorship.[48][33][20]
• Address documented constraints from insufficient and unsustainable financing, limited insurance coverage and fiscal pressure, which prevented implementation of the colorectal screening pilot and planned public-health surveillance activities under the preceding strategy.[45][49]

The framework targets an increase in cancer financing from 0.8% to 10% of the total health budget.[28]Public health expenditure was estimated at 2.2% of gross domestic product, while one third of total health expenditure was financed through out-of-pocket costs.[39]The supplied sections do not quantify a funding gap or identify committed funding sources for the full costed requirement.[29][46]