The National Cancer Control Strategy (2023-2027)

Objectives

Kenya’s National Cancer Control Strategic Plan 2023–2027 sets a coordinated, responsive and patient-centred framework to reduce cancer incidence, illness and premature mortality, while improving the quality of life and experiences of people living with cancer by 2028.[1]Its vision is a nation free from the preventable burden of cancer, and its principal goal is to reduce premature cancer mortality by one third by 2028.[1]The strategy implements the Kenya Cancer Policy 2019–2030, aligns with universal health coverage and primary health care, and is informed by disease burden, risk-factor prevalence, equity, feasibility, effectiveness, cost-effectiveness and locally appropriate priorities.[2][3][4]

• Deliver equitable prevention, early detection, accurate diagnosis, timely treatment, palliative care, survivorship support, rehabilitation and end-of-life care across the full cancer-control continuum.[5][6]
• Reduce modifiable risks through tobacco and alcohol control, healthier diets, physical activity, immunisation, environmental and occupational risk reduction, and action on social determinants of health.[7][8][9]
• Organise implementation around five key result areas: prevention and early detection; imaging, pathology and laboratory medicine; treatment, palliative care and survivorship; advocacy, partnerships, coordination and financing; and strategic information, registration, surveillance and research.[7][6]
• Expand screening, early diagnosis and linkage to care, prioritising cervical, breast, colorectal and prostate cancers, which account for 43.1% of new diagnoses and 36.9% of cancer deaths in Kenya.[10]
• Meet defined prevention and outcome ambitions, including reducing tobacco use to 6.5% and alcohol use to 10% by 2028, reaching 90% human papillomavirus vaccination coverage by 2030, and increasing childhood cancer survival to 60% by 2030.[10][9][11]
• Ensure accessible, comprehensive, affordable and timely multidisciplinary cancer management, including surgery, systemic therapy, radiotherapy, nuclear therapy, transplantation, palliative care, survivorship and rehabilitation.[12]
• Strengthen sustainable financing, governance, regulation, health workforce capacity, essential medicines and technologies, research, data systems and financial protection as enabling conditions for cancer control.[8][3][13]

Implementation

Implementation uses a multisectoral, participatory and iterative model that integrates cancer prevention, control and management within health systems, particularly through primary health care, community services and linked referral pathways to county and national facilities.[7][2][3]The Ministry of Health, through the National Cancer Control Programme, leads implementation and progress tracking, while national and county governments, public and private providers, faith-based institutions, professional bodies, civil society, patient groups, academia, regulators, industry and development partners contribute to delivery.[7][14][15]

• Coordinate national action through the Non-Communicable Diseases Intersectoral Coordinating Committee and Cancer Technical Working Group, and coordinate county implementation through multisectoral technical working groups led by County Non-Communicable Diseases Coordinators.[14]
• Assign the National Cancer Control Programme responsibility for policy and guideline development, technical support, county capacity building, supportive supervision, advocacy, partnership coordination and oversight of the Monitoring, Evaluation, Accountability and Learning framework.[16][14]
• Enable the National Cancer Institute of Kenya to advise on treatment and care priorities, regulate cancer facilities and standards, support research and data quality, maintain and link the cancer register with national information systems, build capacity and establish a national cancer centre of excellence.[14]
• Require county governments to integrate cancer interventions into annual work plans and integrated development plans, establish county cancer control programmes, provide infrastructure, equipment, commodities and qualified personnel, and collect and report cancer data.[15][17][18]
• Deliver prevention and screening through health facilities, schools, workplaces, community health workers, mobile clinics, self-care approaches and digital systems, while strengthening referral, client navigation, specimen tracking and follow-up.[19][20][21]
• Expand diagnostics through national standards, quality assurance, accreditation, referral networks, imaging, pathology, laboratory medicine, interventional radiology, genomic testing, telepathology, teleradiology and interoperable radiology and laboratory information systems.[22][12][23]
• Strengthen treatment capacity through multidisciplinary teams, workforce development, five additional comprehensive regional cancer centres, strengthened national referral hospitals, telehealth, electronic oncology systems, palliative-care integration and patient navigation.[11][24][25]
• Mobilise resources through county budget lines, public financing, health-insurance benefits, mixed financing, levies and sin taxes, development-partner engagement, public-private partnerships, philanthropic contributions, local manufacturing and pooled procurement.[13][17][26]
• Operationalise the Monitoring, Evaluation, Accountability and Learning framework using process, output and outcome indicators, annual monitoring, mid-term, end-term and impact evaluations, data-quality audits, service audits, cancer registries and dissemination of findings.[27][28][29]
• Track selected 2023–2030 targets, including cervical screening coverage from 42% to 70%, breast screening from 1% to 30%, palliative-care access from 2% to 50%, high-quality population-based registration coverage from 5% to 20%, and cancer expenditure from 0.8% to 10% of the total health budget.[27]

Monitoring & Evaluation

The 2023–2030 Monitoring, Evaluation, Accountability and Learning framework provides the national architecture for data-driven implementation across the cancer-control continuum. It aligns with Ministry of Health monitoring and evaluation policy, combines process, output and outcome indicators, assigns roles and responsibilities, and incorporates data use, knowledge management and continuous quality improvement.[27]

• Track a main indicator for each key result area through the Common Results and Accountability Framework and ministry-level monitoring.[27]
• Measure progress against selected 2023–2030 baselines and targets: cervical cancer screening coverage from 42% to 70%; breast cancer screening from 1% to 30%; human papillomavirus vaccination from 58% to 90%; treatment of cervical pre-cancerous lesions or invasive cervical cancer from 26% to 90%; childhood cancer survival from 20% to 60%; palliative-care access from 2% to 50%; and high-quality population-based cancer-registration coverage from 5% to 20%.[27]
• Monitor colorectal cancer screening, advanced-stage cancer detection, time from diagnosis to treatment initiation, access to safe and effective essential medicines and treatment, and the cancer budget as a share of the total health budget.[27]
• Conduct annual, mid-term, end-term and impact evaluations; prepare implementation reports; convene review forums; and disseminate findings to stakeholders.[28][29]
• Coordinate annual monitoring and evaluation through the Non-Communicable Disease Interagency Coordinating Committee and the National Steering Committee on Non-Communicable Diseases.[16]

Strategic information, registration, surveillance and research form a dedicated key result area. The National Cancer Control Programme is responsible for coordinating implementation, supporting counties and facilities, while the National Cancer Institute-Kenya supports cancer-data quality, regulation, research and cancer-register linkages with national health information systems.[30][16]

• Strengthen population-based registries in Nairobi, Eldoret and Kisumu and establish registries in Nakuru and Mombasa to reach at least 20% population coverage, consistent with International Agency for Research on Cancer recommendations.[29]
• Harmonise population-based and hospital-based registration, linking registries with the Kenya Health Information System, electronic medical records, screening systems and death-registration data.[31][32][33]
• Publish, validate and externally review annual national cancer burden reports, and track annual registry compliance with standard operating procedures and data-quality audits.[32]
• Conduct scheduled data-quality audits at least 10 times annually, undertake supportive-supervision visits and service audits, and integrate cancer continuous quality improvement into the Kenya Quality Model for Health.[28]
• Use dashboards and electronic systems to track screening clients, product availability, forecasting, consumption, pharmacovigilance and oncology-service performance.[21][34][35][36]

Accountability mechanisms include county cancer-control programmes, annual county cancer reports, quarterly Cancer Technical Working Group meetings and reports to national coordination structures, regular technical and thematic committee meetings, service audits, laboratory accreditation and external quality assurance.[37][38][23]

Priority surveillance and quality gaps include late-stage diagnosis, reported for 70% of cancer cases, uneven pathology provision across about 10 counties, and population-based registry coverage of approximately 11% against an ideal 20% benchmark.[39][31]

Costing & Financing

Financing is positioned as a core cancer-control function, combining national and county public financing, Universal Health Coverage benefit packages, development-partner support, public-private partnerships, philanthropy, levies and sin taxes, local manufacturing, procurement mechanisms and community social-financing initiatives.[17][26][40]

• Increase the cancer budget from a baseline of 0.8% to a target of 10% of the total health budget.[27]
• Establish county cancer-control programmes, incorporate priorities into county integrated development plans and annual work plans, and allocate and ring-fence county budget lines.[17][26]
• Expand public financing through the Universal Health Coverage benefit package, chronic disease funding, improved insurance coverage and enhanced diagnostic reimbursement.[13][26][40]
• Mobilise resources through joint funding round tables, donor identification, funding proposals, public-private partnerships, business and philanthropic engagement, lease and concession arrangements, and collaboration with international non-governmental organisations.[17]
• Use pooled or national and regional procurement, framework agreements, access programmes, local manufacturing and tax exemptions to improve availability and affordability of cancer medicines, technologies and commodities.[41][34][26]
• Support childhood cancer care through differentiated Universal Health Coverage packages, procurement of essential medicines and social-protection arrangements for patients and families.[40]
• Increase excise taxation on tobacco towards 70% of retail price and consider increased or differential taxes on alcohol, sugar-sweetened beverages, trans fats and unhealthy foods and drinks.[42][43]

Financial constraints remain substantial: public health expenditure is estimated at 2.2% of gross domestic product, while out-of-pocket payments account for one third of total health expenditure.[41]Inadequate financial resources prevented implementation of the planned colorectal cancer screening pilot and public-health surveillance frameworks under the 2017–2022 strategy.[44]Kenya must also prepare for domestic financing of human papillomavirus vaccination following transition out of GAVI support from 2023.[45]

The extracts identify financial support for strategic-plan development from CDC/PEPFAR, BD, AstraZeneca and FIND.[7]They do not specify a total implementation budget, monetary allocations by activity or county, unit costs, quantified funding gaps, financing timetable or economic assumptions.[27][26][40]