Financial toxicity of cancer in Kenya: What can be done?

One in every 1,000 people in Kenya is likely to fall prey to cancer. This incidence is expected to rise by 70 percent in the next two decades, and the mortality is expected to be disproportionately higher compared to other countries, due to the ill-preparedness of our healthcare system. However, if detected early, cancer can be effectively treated. The likelihood of encountering one of cancer’s causative agents is quite high given their wide breadth. These possible risk factors could range from low-nutritional diets, to tobacco, to exposure to the sun’s harsh rays of light.

In a disease narrative, curative solutions are likely to dominate over the counterpart preventative options. In the event that preventative options are explored, eating a healthy diet and being active would surface as suggestions. The underlying hypothesis is that such healthy habits would bolster one’s immune system to help keep diseases at bay.

Curative solutions work on the same foundation; artificial addition of substance into one’s body to boost one’s immune system, and aid the fight against diseases.

The main difference however, is the financial burden to the individual. Preventative solutions are considered more cost effective and could avert up to 50 percent of cancer cases today .

Policy interventions in support of preventative solutions will be of benefit to the society. Not only will this enlighten the society and protect them from the disease, but also shield them from financial strains that are characteristic of the disease occurrence.

Cancer care is an expensive affair. Its treatment can set back the patient by up to Sh 7 million. Kenya is fortunate to have a wide array of prepayment mechanisms that could be used to meet such costs. But to what extent? NHIF, the most pervasive insurance scheme in terms of number of principal members, covers up to Sh900,000 of cancer related treatment costs. Private insurance companies have varied upper limits but are typically capped at Sh1 million.

Assuming a breast cancer patient has both covers, she is left with the burden of raising 70 percent of her costs from out of pocket means, in order to access quality of cancer care treatment.

These out of pocket means would result in the breast cancer patient digging deeper into her already stretched pockets, selling off part of her property and running fundraising campaigns, all in a bid to raise these funds.

It is recommended that no more than 15 - 20 percent of total health expenditure (THE) should be met through out of pocket payments in order to prevent pushing individuals and households into poverty.

In Kenya, about 30 percent of health care costs are met out- of -pocket (OOP), an increase from the 27 percent reported by World Bank in the year 2016.

This could be due to a double whammy situation where external funding and government investment into healthcare have not only been on a decline, but have also fallen below the recommended levels, forcing citizens to pay for healthcare through out-of-pocket means.

This constrained fiscal space is evidenced by the poor performance against generally accepted indicators.

Waruguru is a Corporate Finance Specialist at E&K Consulting Firm. Bonareri is a Business Analyst at the same firm.