SHIF locks out youth in cancer screening cover

Acting Director General of Health Dr Patrick Amoth speaking at an event on March 21, 2024.

Photo credit: Evans Habil | Nation Media Group

Young Kenyans will be forced to foot the costs of screening for four common types of cancer despite making mandatory payments to the new Social Health Insurance Fund (SHIF), posing potential setbacks in ongoing efforts to fight the disease.

A brief on the benefits under SHIF shows that Kenyan men below the age of 40 years and 55 years will pay for screening for colon cancer and prostate cancer respectively, while the scheme will only cover screening for cervical cancer and Human papillomavirus (HPV) for women between 30 years and 50 years.

“Prostate cancer screening will only be covered in males over 55 years, colon cancer screening will only be covered in males over 40 years and screening for cervical cancer will only be covered in women between 30-50 years,” the Ministry of Health says.

Women outside the 30-50 age bracket will foot their screening bills for cervical cancer (popularly known as Pap smear) while those outside the 35-45 age bracket will also pay for HPV testing.

Screening for prostate and colon cancer, which are leading cancers in men by deaths, costs Sh5,000 and Sh40,000 respectively. Female patients pay upwards of Sh5,000 to screen for cervical cancer, which is the leading cause of cancer death among women in Kenya.

Dr Patrick Amoth, the acting Director-General for Health, defended the decision to lock out the youth from the SHIF cancer screening cover, saying the age group is not at risk of the disease.

“For example, cancer of the cervix tends to affect women who are 45 years and above. The average age of sexual debut in Kenya is 17 years and it ordinarily takes 10 years for abnormal changes caused by Human papillomavirus that causes cervical cancer for it to manifest. And from that manifestation to get to overt cancer it takes some time,” he said.

“So it means it does not make business sense to screen a 20-year-old or 25-year-old every year for cervical cancer. One is that they will be able to get an HPV infection and because of their high immunity, they are able to clear it. And even if they develop the cancer it will come 10,12 or 14 years later. So that is the reason for capping. Same is for prostate cancer.”

Cancer is the third leading cause of death in Kenya after infectious and cardiovascular diseases and there are growing concerns of increased cases of the disease amongst young Kenyans.

Locking out the young Kenyans from screening tests covered under SHIF comes despite warnings that cancer cases in Kenya will nearly double by 2040.

The Ministry of Health says overall, Kenya’s population growth, increased urbanisation, and increase in risk factors for cancer will lead to more numbers.

“Going by the current trends, it is projected that there will be an estimated 58,000 new cancer cases in Kenya in the year 2028 increasing to an estimated 95,217 incident cases by 2040,” the ministry says in the National Cancer Control Strategy (2023–2027).

The move compels certain age groups to keep paying for screening tests for cancers and pours cold water on the government’s ambitious universal health coverage, given the additional billions that will be raised from all Kenyan adults under the mandatory membership to SHIF.

All Kenyans aged above 18 will be required to make mandatory contributions to the SHIF, with the billions of shillings collected aimed at paying for primary, secondary, emergency, and chronic healthcare services.

Under the plan, Kenyan workers in the formal sector will from the start of next month part with 2.75 percent of their monthly gross pay while households in the informal sector will cede a similar percentage from the gross income.

Kenyans with no source of income will also be compelled to pay at least Sh300 every month to the SHIF as the State targets a vast funding pool to finance UHC.

According to Ministry of Health data, the annual cancer incidence rate has risen close to 42,116 cases, with 15,566 (male) and 26,550 (female) new cases. The annual mortality is now over 27,092 -- 10,466 males and 16,626 females. The top three cancer cases in women are breast cancer, cervical cancer and esophagus cancer with incidences of 25.6 per cent, 19.7 per cent and 6.1 per cent respectively.

The top three prevalent cancer cases in men are prostate cancer with a prevalence of 21.9 per cent followed by esophageal cancer at 8.7 per cent and colorectal cancer at 8.3 per cent. Medics now say they are noticing a younger demographic who are also testing positive for cancer not only in Kenya but globally.

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