National Cancer Control Strategy 2017-2022

Objectives

Kenya’s National Cancer Control Strategy 2017–2022 provides a coordinated framework to reduce cancer incidence, morbidity and mortality, improve down-staging and survival, and enhance the wellbeing and quality of life of people affected by cancer.[1][2]Its vision is a Kenyan population with a low burden of cancer, while its mission is to implement a coordinated, responsive cancer-control framework spanning prevention, diagnosis, treatment, palliation and financing.[2]The strategy aligns cancer control with Kenya Vision 2030, the Kenya Health Policy 2014–2030, the national non-communicable disease strategy, the Sustainable Development Goals and relevant global commitments.[3][4]

• Reduce cancer risk through population-based primary prevention addressing tobacco, harmful alcohol use, unhealthy diets, physical inactivity, environmental and occupational exposures, and cancer-linked infections.[5][6]
• Increase equitable access to screening, early detection and quality diagnosis, including screening guidelines, referral and follow-up systems, human papillomavirus and hepatitis B virus interventions, and population-based cervical cancer screening pilots.[6][7][8]
• Strengthen diagnosis, registration and surveillance through imaging, pathology, laboratory medicine, cancer registries, standardised data systems and integrated health-information platforms.[9][10][11][12]
• Provide optimal, setting-appropriate treatment, rehabilitation, palliative care, survivorship and end-of-life support across surgery, systemic therapy, radiotherapy, supportive care and multidisciplinary services.[13][14][15]
• Improve coordination, partnerships, sustainable financing, advocacy, communication, monitoring, evaluation and research across the cancer-control continuum.[16][17][18]

The strategy is organised around five pillars: prevention, screening and early detection; diagnosis, registration and surveillance; treatment, palliative care and survivorship; coordination, collaboration and financing; and monitoring, evaluation and research.[2]It prioritises evidence-based and costed interventions, equity, universal coverage, efficient resource use, accountability, gender sensitivity, cultural appropriateness, rights-based practice and management of conflicts of interest.[19][2]Specific prevention targets include reducing tobacco use and exposure to tobacco by-products to 10% from a 13.1% baseline, unhealthy-diet risk from 94% to 62%, physical inactivity from 46% to 23%, and alcohol consumption from 19% to 13% by 2022.[20][21][22]The strategy also seeks to increase screening from 16% to 25%, reduce down-staging from 80% to 40%, increase access to prevention, screening and early-diagnosis data from 30% to 70%, and reduce cancers associated with infectious agents to 16% from 33%.[23][8][24]

Implementation

Implementation uses an integrated, systematic and multisectoral model across national and county levels, linking risk reduction, screening, diagnosis, treatment, palliative care and end-of-life support.[25][19]The Ministry of Health leads cancer policy, coordination, prevention and population-based screening, technical capacity building, partnership development, resource mobilisation and research promotion, while county governments prioritise cancer control in local health agendas, allocate resources and adapt delivery to county needs.[26][27]The National Cancer Institute Kenya is intended to serve as the technical and regulatory authority for cancer control, including monitoring cancer outcomes, supporting infrastructure, facilitating research and advising the Cabinet Secretary.[28]

• Coordinate implementation through the Ministry of Health, National Cancer Control Programme, National Cancer Institute Kenya, national and county governments, and multisectoral technical working groups, including a dedicated childhood-cancer group.[29][16][30]
• Engage public and private health providers, civil society, faith-based and non-governmental organisations, professional bodies, academia, development partners, patients, families and communities in service delivery, advocacy, accountability, research and psychosocial support.[25][28][31]
• Establish comprehensive regional cancer treatment centres, strengthen tertiary referral centres and county hospitals, and expand accessible surgery, chemotherapy, radiotherapy, hospice and palliative-care services.[15][32][33]
• Develop national clinical, screening, referral, diagnostic, palliative-care, survivorship, procurement, maintenance, quality-assurance and accreditation guidelines and standards.[10][14][34][35]
• Build the workforce through specialised oncology, diagnostic, registry, health-records, palliative-care and community-health training, alongside career pathways, competency-based deployment and retention measures.[10][15][36][37]
• Integrate cancer prevention, screening and early detection with sexual and reproductive health, HIV, immunisation, maternal, newborn and child health, occupational and environmental health, school health and lifestyle programmes.[5][8]

The approach assigns financing responsibilities to the National Treasury for national and county cancer-control activities, systems, infrastructure and regional cancer centres, while the National Hospital Insurance Fund is expected to finance prevention, early detection and organised targeted screening and expand cancer benefits within universal health coverage.[26]Proposed financing measures include county budget lines, a cancer control fund, access to taxation and levy revenues, free cancer care for children below 12 years, increased insurance enrolment, public-private partnerships and measures to improve the affordability of medicines and technologies.[17][38][39][40]No quantified strategy-wide budget, funding allocation or overall financing gap is specified in the supplied material.[27][18]

Monitoring and evaluation are to build on existing information systems, cancer registries, routine data, national surveys and research.[27][18]Planned mechanisms include electronic data collection and transmission, integration of registry variables into the District Health Information System, mandatory cancer notification, unique patient identifiers, annual progress reports, quality assurance, technical-working-group oversight and reporting obligations for public and private diagnostic and treatment centres.[10][31][18][41]The strategy calls for a detailed monitoring and evaluation plan and evaluation protocol covering needs, questions, methods, effectiveness measures, activities and outcomes; however, it does not provide a complete consolidated indicator framework or reporting timetable in the supplied text.[27][18]

Monitoring & Evaluation

The strategy establishes monitoring, evaluation and research as a core pillar, supported by cancer registration and surveillance, health-information systems, quality assurance and accountability arrangements across national and county implementation.[2][10][27][18]It provides a framework for routine data collection, evaluation of interventions, research dissemination and reporting on implementation progress, although it does not present a single consolidated indicator framework or complete reporting timetable.[27][18][42]

• Develop a high-level monitoring and evaluation framework, detailed implementation plan and evaluation protocol covering needs, questions, methods, effectiveness measures, activities and outcomes.[27][18]
• Produce annual progress reports on implementation, processes and outputs, and generate regular reports across the strategy’s five pillars using routine and research data.[27][18][43]
• Strengthen cancer registries and surveillance through a national registry network, standardised International Agency for Research on Cancer tools, International Classification of Diseases for Oncology compliance, electronic data collection, mandatory reporting arrangements and integration with existing health-information systems.[10][11][41][12]
• Use registries and surveillance data to measure cancer incidence, mortality, prevalence, survival and disease trends, informing patient follow-up, research, planning and resource use.[9][10]
• Strengthen the Health Management Information System and link standardised cancer-risk indicators, registry variables and pathology information with national information systems.[6][26][10][44]
• Implement quality assurance and continuous quality-improvement programmes for diagnostic imaging, pathology, laboratory medicine, cancer registration and surveillance.[10][31][34][35][45]
• Monitor cancer-service delivery through health-management information-system indicators, cancer-centre accreditation, treatment and referral standards, and measures of service quality, patient outcomes and quality of life.[14][15][46][47]
• Assign accountability roles to counties for coordination, monitoring and evaluation, to National Treasury for monitoring results associated with cancer-control resources, and to civil society for social accountability and advocacy.[26][28][17]
• Support ethical oversight through ethical review committees that advise on research ethics, safeguard standards and compile annual information on cancer research.[26][28]
• Track specified prevention targets, including reducing tobacco use to 10% from a 13.1% baseline, unhealthy diets to 62% from 94%, physical inactivity to 23% from 46%, alcohol consumption to 13% from 19%, screening coverage to 25% from 16%, down-staging to 40% from 80%, and cancer-data access to 70% from 30% by 2022.[20][21][22][8][24]
• Measure delivery through indicators covering trained personnel, reporting facilities, registry coverage, guideline adoption, diagnostic accreditation, cancer-treatment infrastructure, communication activities, research publications and partnership activity.[48][34][11][32][30][49]

Costing & Financing

Financing is a strategic pillar and the strategy seeks sustainable, coordinated funding for prevention, screening, diagnosis, treatment, palliative care, survivorship, research, infrastructure and information systems.[1][16][17]It prioritises costed interventions and calls for strategy costing during implementation planning, but does not provide a Kenya-specific total budget, activity-level allocations, quantified funding gap or detailed costing methodology.[25][19][27][18]

• Assign National Treasury responsibility for funding national and county cancer-control activities, systems, infrastructure, regional cancer centres, and monitoring results associated with resources provided.[26]
• Assign the Ministry of Health responsibility for implementing most cancer-related budget measures, mobilising resources and strengthening partnerships.[26]
• Use the National Hospital Insurance Fund to finance prevention, early detection and organised targeted screening, expand cancer-related benefits and support universal health coverage.[26][17]
• Advocate sustainable financing through county budget lines, a cancer control fund, broader taxation and levies, access to relevant levy revenue, tobacco-tax allocations and fiscal measures on sugary drinks, refined sugars and unhealthy foods.[5][17][50][51][38][39]
• Provide free cancer care for children below 12 years as a proposed universal-health-coverage financing measure.[17][38]
• Mobilise additional resources through the National Cancer Institute Kenya, civil society, private-sector partners, cancer registries, development partners and public-private partnerships.[28][52][31]
• Improve affordability of cancer medicines, diagnostics, equipment, supplies and technologies through supply-chain partnerships, subsidies, essential-medicines-list inclusion and use of idle private-sector capacity.[31][15][53][39][40]
• Undertake cost-benefit and cost analyses of prevention, screening, early diagnosis and treatment interventions, including patients’ potential financial burden, to inform an essential package of non-communicable disease and cancer-control services.[54][55][56][57]
• Recognise inadequate registry funding and operational costs, alongside shortages of personnel and equipment, as constraints requiring workforce, equipment-maintenance and partnership responses.[9][10]
• Note an international business-as-usual estimate of US dollars 1.5 trillion in cumulative economic losses for low- and middle-income countries during 2011-2025, and an estimated additional US dollars 20 billion annually for an essential intervention package.[3]