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 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 50percent 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 Sh7 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 Sh 900,000 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 fund raising campaigns, all in a bid to raise these funds.
It is recommended that no more than 15 -20 per cent 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. For instance, whereas research recommends $86 as the minimum general government health expenditure (GGHE) per capita needed to promote universal health care (UHC), latest evidence shows Kenya’s GGHE per capita stands at $24 – falling far short of this threshold and Africa’s average. Similarly, GGHE as a proportion of GDP is a generally used threshold to assess commitment of a government to promote UHC. Whereas 5 percent is the recommended minimum threshold for this indicator, Kenya invests less than 2 percent of its GDP in health, further precluding its achievement of universal health coverage (UHC).
The limited fiscal space for health in Kenya drives the high levels of OOP which in effect, exposes households to catastrophic health expenditure and impoverishment. By the year 2030, at least 2 million Kenyan households will be impoverished by OOP for health should the current health financing situation prevail.
There is so much that can be done to ensure the number of cancer incidents in Kenya goes down, including vaccines and other technologies that are being discovered day in day out by scientists and doctors. Bottom line is, raising cancer awareness and advocating for prevention through a reduction in exposure to risk factors will go a long way in ensuring the mortality rates drastically reduce from the current levels.
Cancer continues to claim many lives and as it stands, if nothing is done, many families will continue to succumb to the disease. The government has an obligation to increase its fiscal allocation towards prevention and treatment of cancer, as well as facilitating the provision of alternative financial protection mechanisms to cushion those already diagnosed with the disease.
Waruguru is a Corporate Finance Specialist at E&K Consulting Firm and Bonareri is a Business Analyst at E&K Consulting Firm.