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Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors

Author

Listed:
  • Sujha Subramanian
  • Robai Gakunga
  • Joseph Kibachio
  • Gladwell Gathecha
  • Patrick Edwards
  • Elijah Ogola
  • Gerald Yonga
  • Naftali Busakhala
  • Esther Munyoro
  • Jeremiah Chakaya
  • Nancy Ngugi
  • Nyawira Mwangi
  • Daniel Von Rege
  • Lili-Marie Wangari
  • David Wata
  • Robert Makori
  • Julius Mwangi
  • Walter Mwanda
  • on behalf of the East African Economics and Implementation Group (EAEIG)

Abstract

Introduction: The prevalence of non-communicable diseases (NCDs) is rising in low- and middle-income countries, including Kenya, disproportionately to the rest of the world. Our objective was to quantify patient payments to obtain NCD screening, diagnosis, and treatment services in the public and private sector in Kenya and evaluate patients’ ability to pay for the services. Methods and findings: We collected payment data on cardiovascular diseases, diabetes, breast and cervical cancer, and respiratory diseases from Kenyatta National Hospital, the main tertiary public hospital, and the Kibera South Health Center—a public outpatient facility, and private sector practitioners and hospitals. We developed detailed treatment frameworks for each NCD and used an itemization cost approach to estimate payments. Patient affordability metrics were derived from Kenyan government surveys and national datasets. Conclusions: There is substantial variation in patient costs between the public and private sectors. Most NCD diagnosis and treatment costs, even in the public sector, represent a substantial economic burden that can result in catastrophic expenditures.

Suggested Citation

  • Sujha Subramanian & Robai Gakunga & Joseph Kibachio & Gladwell Gathecha & Patrick Edwards & Elijah Ogola & Gerald Yonga & Naftali Busakhala & Esther Munyoro & Jeremiah Chakaya & Nancy Ngugi & Nyawira , 2018. "Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-16, January.
  • Handle: RePEc:plo:pone00:0190113
    DOI: 10.1371/journal.pone.0190113
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    References listed on IDEAS

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    1. Sima Berendes & Peter Heywood & Sandy Oliver & Paul Garner, 2011. "Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-10, April.
    2. Sanjay Basu & Jason Andrews & Sandeep Kishore & Rajesh Panjabi & David Stuckler, 2012. "Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 9(6), pages 1-14, June.
    3. Racheal Njeri Mwaura & Edwin Barasa & G.N.V. Ramana & Jorge Coarasa & Khama Rogo, 2015. "The Path to Universal Health Coverage in Kenya," World Bank Publications - Reports 23485, The World Bank Group.
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