Kelvin Mokaya, NAYA Advocate.
Some significant gains have been made in Kenya towards reducing some risk factors for NCDs. The most commendable gains have been made in control of alcohol and cigarette consumption through an increase in taxes and enactment of legislation targeting to control the use of these products. Restriction of access to clubs and pubs as well as a strict implementation of the Traffic Act that controls driving while drunk has in the past reduced alcohol consumption in Kenya. In terms of cigarette smoking, warnings of the harmful effects of the practice on cigarette packets, and banning both smokings in public places and tobacco advertisements have been implemented.
Major gaps remain in control of unhealthy diets, environmental and household pollution and physical inactivity. In the Kenyan health sector, as in other low and middle-income countries, the approach to prevention and treatment of these chronic diseases is largely unstructured. A ‘global framework for action to improve the primary care response to chronic non-communicable diseases’ has been proposed with highlights on key areas to structure such as a discussion of policy options. These include identification and addressing modifiable risk factors, screening for common NCDs and diagnosing, treating and following-up patients with common NCDs using standard protocols. Some of the specific approaches recommended include case-finding in primary health care services attendees, standard diagnostic and treatment protocols, reliable drug supply, and a strong reliable monitoring and evaluation system.
Some challenges, however, still exist in the implementation framework and they have somewhat eroded some of these gains. These, if not addressed systematically, could result in an increase in the use of cheaper and more harmful alternative products. Regarding treatment of NCDs, investments in infrastructure such as modern equipment for screening and treating NCDs and training of health care workers to manage these conditions is ongoing. In a bid to improve data availability on NCDs, efforts are underway to define some key indicators to monitor the progress on control of NCDs, and a number of regional cancer registries have been established. This would include indicators to measure progress towards increasing the impact of primary care interventions on chronic NCDs.