Health & Fitness

Tackling non-communicable disease burden in Kenya

health

Summary

  • Whereas the focus has been on infectious diseases - like diarrhoea, pneumonia and malaria - for many years, the Ministry of Health is now grappling with addressing these twin threats.
  • Studies are increasingly providing evidence of patients who have been able to reverse chronic ailments like type two diabetes and hypertension through dietary and lifestyle modifications.

Non-communicable diseases such as diabetes, hypertension and cancer are increasingly affecting many Kenyans and burdening the country's healthcare system.

Whereas the focus has been on infectious diseases - like diarrhoea, pneumonia and malaria - for many years, the Ministry of Health is now grappling with addressing these twin threats.

With NCDs specifically, the costs associated with managing or treating most of the conditions are usually high and way out of reach for many people. For instance, health expenses for cancer treatment, heart disease linked to hypertension and kidney failure caused by diabetes usually take a toll on most people.

The few people covered under private health insurance can get support with expenses, but they too resort to the public sector when limits for their respective insurance covers are reached.

The National Health Insurance Fund (NHIF) has been helpful for the rest of the public that can afford its premiums, which are lower than those charged by private insurance companies.

However, NHIF does not also cover all patients fully for most of these NCDs. Based on assessments done, the medical bills of some people are usually covered partially, forcing them to seek additional support for finances elsewhere.

In as much as treatment and management of NCDs using conventional procedures and medications is important for the survival and well-being of those affected, health experts note that it is high time countries also begin looking at lifestyle medicine that is cost-effective and can address the root causes of various chronic conditions.

Lifestyle medicine involves the use of evidence-based lifestyle therapeutic interventions - focusing on dietary patterns, regular physical activity, restorative sleep, stress management, avoidance of risky substances (like alcohol and tobacco) and positive social connection - to prevent, treat and also reverse chronic conditions.

This is recommended as the ideal first-line defence for tackling the NCDs burden in countries like Kenya. However, health experts lament the lack of funding and enactment of effective policies that can help enhance awareness and empower Kenya to embrace recommended lifestyle changes that will prevent them from getting NCDs.

"Most people don't know that you are what you eat and what you do. The types of food and drinks we consume regularly, our physical activity levels and other factors linked to our behaviours determine to a great extent our health status," notes David Makumi, the vice-chair of the NCD Alliance-Kenya.

Indeed, studies are increasingly providing evidence of patients who have been able to reverse chronic ailments like type two diabetes and hypertension through dietary and lifestyle modifications. As such, these individuals no longer need drugs that they previously relied on for survival.

A recent study, published in the International Journal of Environmental and Public Health, provides more evidence on the significance of these lifestyle medicine approaches to economies and the health sector in general.

According to the study, the reversal of chronic diseases through lifestyle medicine intervention changes could result in significant health care cost savings and economic benefits.

The research, conducted by the American College of Lifestyle Medicine, assessed the health and economic impact of disease reversal through lifestyle interventions that targeted patients with chronic diseases in the United States.

Data for the case studies were self-reported by selected participants and histories were collected through online surveys. People were asked to share their previous diagnosis, lifestyle changes, and cost details for their diet, lifestyle, and health care, both pre- and post-lifestyle change, as well as to participate in follow-up interviews if necessary.

Based on the results of the study, substantial potential cost savings for both the patients and their insurance providers was identified in each case. For an adult male who lost 150 to 200 pounds after committing to a lifestyle change for six months, this included potential savings of $92,000 (Sh9,200,000) in avoided discrete medical costs.

Other examples cited in the study include a cost savings of between $18,000 and $35,000 (Sh1,800,000 and Sh3,500,000) for a potential gastric bypass surgery and a decrease in the annual pharmaceutical costs paid by a participant’s insurer from $19,000 (Sh1,900,000) in 2009 to $122.24 (Sh12,200) in 2015 and 2016 combined.

Another formerly obese participant avoided bilateral knee replacements at a cost of $58,000 to $68,000 (Sh5,800,000 to Sh6,800,000). Participants also reported saving money on grocery bills and heath appointments.

“Our findings are important because accumulated chronic and mental health conditions are responsible for most of the expenses in the health sector. Lifestyle medicine addresses the root causes of chronic disease to restore health with evidence-based treatment rather than the more common disease management approach of our health care system under which costs have soared,” said Dr Micaela Karlsen, the senior director of research at the American College of Lifestyle Medicine.

“Therefore, this case series is a promising foundation for further research into how lifestyle medicine not only benefits a patient’s overall health but makes a positive economic impact on patients and our heavily burdened health care system,” she said.

Dr Padmaja Patel, a co-author of the study and the medical director of the Lifestyle Medicine Centre at Midland Health noted: “We know that chronic disease places an enormous burden on both individuals and our health care system. The current health care quality measures, performance measures and incentive models are tied to a disease management model. They do not serve well for lifestyle medicine providers who focus on disease reversal and remission.”

“We believe this case study provides the justification for these research priorities and hope it will lead to other study designs that further explore the full benefits and value of lifestyle medicine.”

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