Author Archives: Naya

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Non-Communicable Diseases Epidemic

Non-Communicable Diseases Epidemic

Category : Naya , Naya Blog

Kelvin Mokaya, Youth Advocate.

A number of factors, including rapid urbanization, globalization, and aging of the population all contribute to the growing NCD burden in Kenya, but many NCDs are largely preventable by changing unhealthy behaviors. The four major NCDs (cardiovascular diseases, cancers, chronic lung diseases, and diabetes) share four key risk behaviors: tobacco use, harmful use of alcohol, lack of exercise, and an unhealthy diet.  These are all behaviors that are typically initiated or solidified during adolescence or young adulthood and set the stage for NCDs later in life.

According to the World Health Organization (WHO), 70% of premature deaths in adults worldwide are as a result of behaviors that begin in adolescence. While these risk behaviors are still relatively low among youths in Kenya as compared to youths in other regions, their prevalence is increasing.

Therefore, a window of opportunity exists for the Ministry of Health now to address the four key risk behaviors in its large and ever-growing youth population to reduce the NCD burden in the coming decades. Scaling up proven, cost-effective interventions that discourage unhealthy behaviors and promote healthy ones can significantly shift the course of the costly NCD epidemic in the near future. Doing so now will also help Kenya meet some of the Sustainable Development Goals and improve the chances of achieving greater economic growth and development.

 


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Strides Made by The Kenyan Government to Tackle Non-Communicable Diseases

Strides Made by The Kenyan Government to Tackle Non-Communicable Diseases (NCDs)

Category : Naya , Naya Blog

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.


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URBANIZATION ON NON-COMMUNICABLE DISEASES

Urbanisation on Non-Communicable Diseases (NCDs)

Category : Naya , Naya Blog

Kelvin Mokaya, Youth Advocate

Rapid economic and social change, together with urbanization and globalization in Nairobi, are leading to a shift away from healthier, traditional diets to those filled with sugar, sodium, and saturated fat. Increased availability and consumption of commercially prepared and highly processed foods and sugary beverages contribute to overweight and obesity and to various NCDs. The food industry targets children and youth in an effort to influence their taste preferences and encourage brand loyalty that can continue into adulthood.

Aside from poor diets, a lack of sufficient exercise is also increasing the risk of developing NCDs. According to the International Study of Childhood Obesity, Lifestyle and Environment conducted in Nairobi in 2012, among 9-11-year-old students in primary schools, less than 10 percent of girls and less than 20 percent of boys got sufficient levels of physical activity. This has been defined as engaging in at least 60 minutes of moderate-to-vigorous physical activity every day. Over half of the students reported using motorized transportation to and from school every day.

Rapid urbanization in Kenya has significantly reduced the levels of physical activity required for work or transportation. It has also given rise to environmental factors such as heavy traffic, poor air quality, and crime that can make it difficult to be active outside. Lack of access to safe, well-lit sidewalks and parks and other spaces for recreation can also prevent youth from getting enough exercise.

Exercise has multiple other benefits including reducing the risk of developing mental health conditions, such as anxiety and depression that are common among young people. Physical activity among youth is also typically associated with lower levels of other NCD risk behaviors such as tobacco and alcohol use. Appropriate physical activity is a valuable tool in therapeutic regimens for the control and rehabilitation of cardiovascular disease, coronary artery disease, hypertension, congenital heart disease, peripheral vascular disease, obesity, chronic obstructive pulmonary disease, diabetes mellitus, musculoskeletal disorders, end-stage renal disease, stress, anxiety, and depression, etc.

Regular physical activity, independent of other factors, reduces the probability of coronary artery disease and early death. The Ministry of Health should endorse fitness programs in all sectors, which will result in decreased health-care costs.


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Strategies in Curbing

Strategies in Curbing NCDs

Category : Naya , Naya Blog

Kelvin Mokaya, NAYA Advocate.

Ensuring that youth receive the correct information about the health impacts of their behaviors is important to help youth make healthy decisions. Many young people today have unprecedented access to information and the capacity to act on that information in shaping their own lives and determining their own health status. For example, the Ministry of Health launched an anti-tobacco mass media campaign in 2014 titled, “Smoking Kills—Quit Now”. It broadcast messages on radio and television about the adverse health effects of smoking tobacco. The Ministry of Health also disseminated informational posters in schools, universities, and other public institutions to create awareness.

Young people can contribute in several ways to prevent NCDs. By using new media, young voices can provide a novel perspective on NCD prevention and control by sharing targeted messages on key risk factors and interventions. Young people can engage with different communities and share information about NCDs.

Schools’ managerial bodies can also play an important role. For example, the school curriculum in Kenya is currently being revised to increase the level of physical activity children gets during school time, but a major challenge has been the tendency of many schools spending the physical education time on other academic subjects.

Now is the time for Nairobi County, under the NCD unit in collaboration with the Ministry of Health, to implement a full range of prevention strategies, i.e. prioritize NCDs, reduce risk factors, support research and development, monitor trends and determinants of NCDs, strengthen the health system and national capacity, which will build positive health behaviors and reduce NCD risk behaviors among youth. Successfully implementing such strategies require coordination, creative thinking, collaboration across sectors, and involving young people.

Also important is filling critical information gaps by regular NCDs’ data collection efforts, and conducting policy and program evaluations to help identify the most-effective interventions for Kenya. Averting the premature onset of NCDs will enable youth to reach their full potential, increase productivity, decrease future health care costs, and contribute to further economic growth and development.

Youth centers and existing health services targeting youth, such as sexual and reproductive health services and HIV/AIDS services, can also incorporate NCD services, such as counseling and screening for NCD risk behaviors, to reach a wider cross-section of youth with the services necessary to reduce risk behaviors. School-based information programs on the importance of staying away from alcohol and tobacco have also been found successful in some settings.


Diabetes

Diabetes

Category : Naya , Naya Blog

Mariah Akinyi, Youth Advocate.

Extreme fatigue, feeling very thirsty, blurry vision, cuts and bruises that are slow to heal, feeling very hungry (even though one is eating), itchy skin, red and/or swollen gums, numbness or tingling especially in the feet and hands, are just but a few of the symptoms that accompany individuals who diabetes has gotten the better part of them. Doctors around the world have described diabetes as a group of metabolic diseases in which the patient has a high blood glucose (blood sugar), either because the insulin production is inadequate, or because the body’s cells do not respond properly to insulin or both. Insulin is the hormone that regulates the level of sugar in the blood i.e. it helps to keep the blood sugar level from getting too high or too low and is produced by beta cells of the pancreatic islets. Diabetes, just like any other Non-Communicable Disease (NCD), can cause great discomfort to the victim and deprive them of their happiness as the normal operations of the body will be affected.

There are three types of diabetes that are known; Type 1 diabetes, Type 2 diabetes and Gestational diabetes. Under Type 1 diabetes, the body does not produce insulin. Patients with this type of diabetes will need to take insulin injections for the rest of their life. Under Type 2 diabetes, the body does not produce enough insulin for proper function, or the body cells do not react to insulin. Most of the cases of diabetes worldwide are of Type 2. Gestational diabetes affects females during pregnancy. These are mostly women with very high levels of glucose in their blood and their bodies are not able to produce enough insulin to combat the blood sugar levels.

In as much as all people are at risk of developing diabetes, some are at much higher risk than others. These include obese and overweight individuals whose weight leads their bodies to produce chemicals that can destabilize the body’s metabolic functions. Those who are usually inactive and continually take the wrong diet are also at the risk of developing diabetes and especially Type 2 diabetes.

Type 1 diabetes is untreatable and it is unfortunate that patients affected by it have to live with it for the rest of their lives. Type 2 diabetes can be controlled by exercising a lot, controlling one’s body weight and taking in the right diet especially fruits and vegetables.

According to the World Health Organization (WHO), the prevalence of diabetes in Kenya is estimated to be at 3.3% and by 2025 it is predicted to rise to 4.5%. Diabetes is a threatening factor in the country and so the government should ensure that a proper funding structure is put in place in our hospitals for effectively combating the disease. People should also be educated on proper feeding habits in order to keep diabetes at bay.


Financing and Performance of Non-Communicable

Financing and Performance of Non-Communicable Diseases (NCDs)’ Programs

Category : Naya , Naya Blog

Kelvin Mokaya, NAYA Advocate.

Broadly speaking, African governments do not spend enough on health care. While governments pledged in 2001 through the Abuja Declaration to commit 15 percent of their annual budgets to public health spending, only a few countries have actually achieved the target. Within health care spending, funding for NCDs is even less of a priority. Governments are underspending on health.

Donor funds are mainly directed towards supplementing the public health sector funds including funds to fight HIV, tuberculosis, malaria, and NCDs among others. The rest of the gap is filled by private companies, a local foundation, and other unspecified sources.

Health professionals and practitioners have mentioned that paying for NCD advancement and maintenance is an investment; thus, necessitating rise of health awareness programs targeted on managing the diseases.

Additionally, there is strong evidence in the reduction of finances required to implement health awareness programs if NCDs medication could be used more rationally.

Health promotion, prevention, and early treatment would greatly reduce some of the costs related to NCDs care and treatment. Therefore I call upon the National Government to allocate funds that will specifically tackle NCDs’ care and treatment.

Nevertheless, awareness creation on promotion and advocacy efforts should be targeted at the financial allocation of more resources ensuring original NCDs brand medicines are availed to further lower the proportion of direct costs related to NCDs.


lung cancer

Tobacco and Noncommunicable Diseases

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Category : Naya , Naya Blog

Tobacco smoking is projected to cause up to 71% of the lung cancer deaths globally. Nevertheless, it is responsible for 10% cardiovascular diseases and 42% for respiratory diseases. It also contributes to 14% NCDs related deaths globally between the people of ages 30 and above. According to the World Health Organization, recent findings indicate that about 8billion sticks of cigarettes are smoked in Kenya annually. In Kenya young people of the ages 15 and above have smoked tobacco, an equivalent of 11.6% of adults, this according to the Global Youth Survey.

The rate of tobacco use among young people is alarming with 12.8% boys and 6.7% among girls. Kenya Global Youth Survey indicates that between 2001 and 2007 the toll of smoking amid school going young people stood at 77.8%. Tobacco is a risk factor for 6 out of the 8 leading causes of death among people aged 30 years and above, however, it is important to note that among the risk factors for NCDs, tobacco is the most leading preventable risk factor. Currently, 7 out of 10 active smokers have tried to stop smoking, in the past one year whereas 9 among 10 current smokers want to stop smoking.

It’s important to note again that tobacco use has a persistent addiction among its users thus making it difficult to stop. This has therefore resulted in a rapid growth in the burden of NCDs in Kenya today. The Framework Convention on Tobacco Control is a treaty that Kenya is committed to so as to establish policies to regulate tobacco use.

To reduce the NCD burden and tobacco use, the government has a responsibility to adopt and implement fully the FCTC policies by ensuring adoption of tax and price measures to lessen tobacco use, banning tobacco sponsorships, promotions and advertisements.

 

Ricky Samuel.


Noncommunicable diseases

Non-communicable diseases; The Kenyan Context

Category : Naya , Naya Blog

Kelvin Mokaya, NAYA Advocate.

NCDs are responsible for reducing productivity, curtailing economic growth and trapping the poorest people in chronic poverty in the country. The probability of dying too young from an NCD in Kenya is 18%, according to the World Health Survey. NCDs contribute to over 50% of inpatient admissions and 40% of hospital deaths, which dominates healthcare budgets in Kenya (WHO, 2014). The social, economic and physical environments in Kenya afford our population much lower levels of protection from the risks and consequences of NCDs as compared to the developed countries.

In Developed countries, the population often benefits from Governments’ policies and plans to reduce the exposure to risk factors for NCDs. Hence, strengthening the capacity of individuals and populations to make healthier choices and follow lifestyle patterns that follow good health. Insufficient action will result in significant socioeconomic drag for our country, which is just emerging as a low middle-income country and an additional burden for the health system that it can ill afford.

As a country, we should ensure that all parts of government and society respond to the challenges of NCDs. Health gains can only be achieved much more readily by influencing public policies in sectors beyond health than by making changes in health policy alone. We need to identify opportunities for linking the promotion of NCD prevention and control into existing programs in both the health sector and other sectors such as education, labor, and urban development. Lastly, we have to place a stronger emphasis on protecting people from the exposure to highly processed foods and beverages containing large amounts of fats, salt and sugar and raising awareness among the population.


Youth are Key in Tackling the NCDs in Nairobi

Category : Naya Blog

Establishing healthy behaviours among young people in Nairobi County could help stem a looming regional epidemic of non-communicable diseases like cancer, diabetes, cardiovascular diseases, and chronic respiratory conditions. Non-communicable diseases (NCDs) are already responsible for a good number of deaths in the County. Based on current trends, the World Health Organization projects that NCDs will become the leading cause of death in the African region by 2030, surpassing AIDS and other conditions that predominate today.

The four main risk factors for NCDs are tobacco use, alcohol abuse, unhealthy diet, and insufficient exercise – behaviours that are often established in early adolescence and young adulthood and which set the stage for NCDs later in life. Focusing on youth is critical in the country because of its large and growing number of young people. Kenya as a country is among the leading countries in Africa with the youngest population. Research indicates that youth in some African countries are already predisposed to the risk factors and this is likely to rise furthermore throughout the African region unless the Nairobi County government, through the national government, allocates financial resources to combat this.


Quality healthcare is the extent to which health services provided to individuals and patient populations improve desired health outcomes.

Effective Programming for Non-Communicable Diseases (NCDs)

Category : Naya , Naya Blog

Kelvin Mokaya, Youth Advocate.

The Global Opportunity Report (2016) notes that most times, NCDs are prevalent across the country though there may be regional variations.

Quality healthcare is the extent to which health services provided to individuals and patient populations improve desired health outcomes. Effective NCD prevention and control is a high priority on the global health and development agenda. In line with this, World Health Organization (WHO)  continues to support countries to develop and strengthen National Multi-sectoral NCD policies and plans; move towards time-bound targets and indicators; identify and act on priority risk factors and strengthen health systems for NCD management especially in primary care (WHO, 2014).

The high prevalence of NCDs requires immediate attention. The rise in the burden of NCDs has resulted in financial constraints resulting in a struggle in service delivery. Preventable risk factors lie mostly on fully understanding how the NCDs come about. The prevalence ranges between earning groups and differs with gender (WHO, 2014).

A plan of action, therefore, should include effective and efficient covering of all parts of a country in a phased manner giving highest priority to the areas with high prevalence or highly affected yet with a low level of available and required NCD services. It is thus important that Kenya not only limits the NCD awareness programs to cancer and diabetes but cover cardiovascular diseases and chronic respiratory diseases in an integrated manner. Knowing that both effective NCD awareness and communication are essential for the promotion and preservation of public health will be a major milestone in the emergence of hard-tackling Non-Communicable Diseases.

To continually carry out NCD awareness projects, it is essential that services including programs especially for the disadvantaged poor remain effective and efficient to address different vulnerabilities and risks. While developing the Kenya NCDs and guidance law, an emphasis was laid in developing interventions to work with organized difficulties that see NCD prevention and control at both the national and national government level (Kenya National Strategies for NCDs 2015 – 2020). For NCD awareness programs to work, the guidelines should be based on the powerful clinical results.

The answer lies with the Ministry of Health to ensure that there are effective health awareness programs which involve changing behavior at multiple levels. To reverse, there is a need to understand and use the mechanisms which have been largely used to empower individuals to make healthy options. These include the Health Belief, Self-Efficacy, Social reading and Self-elevations models.