National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2021/22 - 2025/26

Objectives

Kenya’s National Strategic Plan for the Prevention and Control of Non-Communicable Diseases (NCDs), covering 2021/22–2025/26, seeks to halt and reverse the rising NCD burden through a comprehensive multisectoral response that reduces suffering, illness and death.[1][2]Its vision is a nation free from the preventable burden of NCDs, while its mission is to secure accessible, affordable, quality, equitable and sustainable NCD care through multisectoral collaboration and partnerships.[3][4]

The Plan responds to NCDs accounting for 39% of annual deaths in Kenya and aims to consolidate gains from the 2015–2020 strategy, address implementation gaps and emerging trends, strengthen population-wide prevention, and improve the health-system continuum of care.[3][1]It supports the national and global ambition to reduce premature mortality from NCDs by one third by 2025, alongside the Sustainable Development Goal commitment to reduce premature NCD mortality by one third through prevention and treatment and promote mental health and wellbeing by 2030.[4][5]

The Plan is guided by equity, universal health coverage, human rights, multisectoral collaboration, evidence, a life-course and people-centred approach, primary health care, integrity, accountability, gender responsiveness, and innovation and technology.[4][6]It covers cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, mental health conditions, violence and injuries, blood disorders, neurological disorders, autoimmune and renal diseases, chronic skin conditions, and oral diseases; it also addresses tobacco, harmful alcohol use, unhealthy diets, physical inactivity, air pollution, environmental toxins and stress.[3][6]

• Strengthen sectoral and multisectoral coordination, leadership and governance for harmonised NCD prevention and response at all levels.[7][8]
• Reduce exposure to modifiable risk factors through policy, legislation, community-based prevention and health-promotion interventions.[7][9]
• Strengthen health-system capacity to provide equitable, quality, accessible, affordable, responsive and sustainable NCD management across the life course.[7][10]
• Enhance advocacy, communication and social mobilisation at national, county and community levels to secure prioritisation, resources and informed community participation.[7][11]
• Promote research and strengthen surveillance, monitoring and evaluation to inform decision-making and health planning.[7][11]

Implementation

The Plan uses a theory of change and logical framework structured around five pillars: multisectoral coordination and governance; reducing exposure to modifiable risk factors; health-system response for NCD management; advocacy, communication and social mobilisation; and surveillance, monitoring, evaluation and research.[12][3]It combines population-wide prevention with integrated prevention, diagnosis, treatment, rehabilitation, palliative care and survivorship services delivered across community, primary, secondary and tertiary levels.[4][10]

Implementation operates through national and county governance arrangements: the Ministry of Health provides policy and technical leadership, while county governments lead health-service delivery.[13]The Ministry of Health Directorate of Non-Communicable Diseases provides national stewardship for policies, guidelines, coordination, monitoring and evaluation, research, data management, resource mobilisation, health-financing prioritisation and workforce development.[14]The NCD Interagency Coordinating Committee provides multisectoral coordination, stakeholder alignment, advocacy, information exchange and technical oversight, supported by a National Steering Committee, national and county health management structures, coordination committees and technical working groups.[14][8]

Delivery requires engagement with line ministries, county governments, civil society, communities, people living with NCDs, development partners, academia, professional bodies, faith-based and community-based organisations, private providers and the private sector.[3][15]The approach also calls for meaningful community participation, protection of marginalised groups, gender-responsive programming, and linkages with related national plans where they have stronger mandates or more comprehensive coverage.[4][16][6]

• Develop and enforce policies on healthy diets, tobacco, alcohol, physical activity, marketing of unhealthy products, environmental pollutants and other modifiable risks.[17][18]
• Deliver prevention through schools, workplaces, community health volunteers, community units, mass media and health facilities; scale up vaccination, screening and individual risk assessment.[9][18][19]
• Integrate NCD education, screening, follow-up and management into community services and lower-level facilities, supported by an essential NCD package within universal health coverage.[20][21]
• Strengthen the workforce through mapping, aligned staffing, specialist sharing, training, career pathways, incentives and expanded competencies for nurses and allied health professionals.[22][21][23]
• Ensure reliable access to essential medicines, supplies, laboratory technologies and assistive devices through list reviews, quantification, pooled procurement, cost-reduction measures and protected county commodity funds.[10][24]
• Establish quality-improvement, telehealth, clinical-guideline, referral and integrated-service frameworks; develop county wellness centres and establish five regional comprehensive NCD centres by 2025.[24][25][26]
• Develop advocacy and communication frameworks, disseminate the Strategy across all 47 counties, integrate NCD action into county plans and insurance packages, and build the capacity of support groups, community resource persons, mobilisers and champions.[27][28][29][30]

Accountability is embedded through a Common Results and Accountability Framework, joint periodic data and performance reviews, annual implementation reviews, a mid-term review, end-term evaluation and annual county support supervision.[31][32]The framework uses 15 high-impact indicators with baselines, 2025 targets and data sources, requires sex- and age-disaggregated data, and draws on the Kenya Health Information System, integrated electronic medical records, disease registries, facility data-quality audits, surveys and annual burden estimates.[33][31][34]

The Strategy is costed using Activity-Based Costing and the One Health Model, with a total financing requirement of Kenya Shillings 377.2 billion over the planning period; Kenya Shillings 361.1 billion, or 95.7% of the total, is allocated to the health-system response pillar.[35][36]Available resources were estimated at Kenya Shillings 20.8 billion, leaving a funding gap of approximately Kenya Shillings 356.4 billion, or 94% of total requirements.[37]Resource mobilisation includes budget advocacy, engagement with the National Treasury and assemblies, sin-tax advocacy, donor proposals, private-sector partnerships, National Health Accounts participation and annual resource tracking.[16][38]

Monitoring & Evaluation

The Strategy establishes a comprehensive monitoring, evaluation, accountability and learning system to track implementation, outcomes and resource use across non-communicable disease prevention and control. It combines a Common Results and Accountability Framework, routine health-information systems, surveys, registries, research, periodic reviews and multisectoral performance dialogue.[31][33][39]

• Use fifteen high-impact indicators within the Common Results and Accountability Framework, with baselines, 2025 targets and identified data sources.[33]
• Track indicators across risk-factor reduction, disease management, screening, immunisation, injuries, mortality, service availability, treatment coverage, resources, expenditure and patient outcomes.[40][39]
• Produce weekly surveillance reports, monthly facility reports, quarterly health-data reviews, annual performance reports and expenditure returns, alongside periodic surveys and assessments.[39]
• Conduct annual reviews from 2021 to 2025, a mid-term review, an end-term evaluation and annual county support supervision, increasing supervised counties from 10 in 2021 to 47 in 2025.[32]
• Apply joint periodic data and performance reviews with aligned reporting tools, implementation tracking for review recommendations, and evidence-informed policy dialogue involving health stakeholders.[31]
• Strengthen surveillance through integrated electronic medical records, disease-specific registries, standardised data tools, population surveys including the STEPwise approach to non-communicable disease risk-factor surveillance survey, annual burden estimates and facility-level data-quality audits.[41][34]
• Disaggregate collected, analysed and reported data by sex and age to support gender integration.[31][33]
• Use the Kenya Health Information System, the cancer registry, disease-specific tools, surveys and defined data flows from lower levels to national level, while improving completeness, accuracy, electronic-record integration and data use for policy.[42]
• Monitor governance and implementation through stakeholder databases, committee minutes, county reports, the NCD Navigator, the Non-Communicable Disease Intersectoral Coordination Committee portal, National Health Accounts and policy or legal records.[43][44][45]
• Conduct annual resource-tracking and accountability assessments, publish annual non-communicable disease expenditure reports and include non-communicable diseases in the National Health Accounts process.[8][9][44]

Accountability is intended to operate through performance reporting, transparency, public participation, leadership structures and accountability to government, funding partners and communities for resource use, service delivery and health outcomes.[4][6]The Strategy identifies responsibilities for divisions, facilities, facility managers, the Division of Surveillance and Epidemiology, the Non-Communicable Disease department, counties and other stakeholders, although the supplied extracts do not provide all indicator definitions or accountability sanctions.[39][14]

Costing & Financing

The Strategy uses Activity-Based Costing, a bottom-up input-based method linking unit costs, quantities and input frequencies to activities, outputs, objectives and the overall budget.[35]Where quantification reports were unavailable, it uses the One Health Model, strategic targets, published unit costs and expert interviews to estimate intervention costs.[35]The total resource requirement is Kenya Shillings 377,183.3 million over the planning period, with the health-system response pillar accounting for Kenya Shillings 361,097.8 million, or 95.7% of the total.[36]

• Estimate commodity requirements at Kenya Shillings 320,440.7 million over the planning period, including major costs for cardiovascular disease and diabetes, cancers, injuries and epilepsy.[46]
• Estimate available financial resources at Kenya Shillings 20,777.1 million, comprising Kenya Shillings 8,167.7 million from domestic sources and Kenya Shillings 12,609.4 million from external sources.[37]
• Identify a funding gap of Kenya Shillings 356,406 million, equivalent to 94% of the total requirement, and indicate that potential additional resources may come from donors, the private sector and households.[37]
• Prioritise advocacy, communication and social mobilisation at a cost of Kenya Shillings 1,243.2 million, including Kenya Shillings 822.4 million for commemorating World Non-Communicable Diseases health days.[47]
• Ring-fence county non-communicable disease commodity funds, quantify and cost health products and technologies, and pursue cost-reduction agreements and pooled procurement.[24][10]
• Increase the planned proportion of total health expenditure allocated to non-communicable diseases from a 6.5% baseline in 2015 to 31.5% in 2025.[48]
• Increase the proportion of government allocation devoted to non-communicable diseases from a 48% baseline in 2020 to a 60% target in 2025.[33]
• Mobilise resources through Ministry of Health and county budgets, National Treasury and assembly engagement, sin-tax advocacy, donor proposals, public-private partnerships, private-sector engagement, insurance coverage and community mobilisation.[16][15][49]

Non-communicable diseases are associated with a reported 28.6% reduction in household income and catastrophic expenditure.[50]Interventions to mitigate this impact are estimated to require 17% of total health expenditure, equivalent to United States Dollars 11.97 per person annually and almost three times current non-communicable disease expenditure.[51]Available-resource estimates rely on secondary data, including Ministry of Health budget commitments and assumptions about future annual contributions.[46][37]