A lot more needed to improve heart disease care in Kenya
A heart patient undergoes surgery at the Kenyatta National Hospital in Nairobi. PHOTO | SALATON NJAU
What you need to know:
Innovations in Delivery of Cardiac Care, served as a stocktaking event as well as discussions on the way forward in delivery of cardiovascular health
The Kenya Cardiac Society and the Pan African Society for Cardiologists (Pascar) last month hosted a regional gathering in Mombasa bringing together cardiologists, cardiothoracic surgeons and health workers.
The conference, themed Innovations in Delivery of Cardiac Care, served as a stocktaking event as well as discussions on the way forward in delivery of cardiovascular health.
Like other health statistics, the numbers on the cardiology side aren’t reassuring. First, cardiologists and heart specialists are very few and concentrated in cities and big towns.
Secondly, the availability of hospitals with facilities capable of handling complex cardiac cases is low: there are just six cardiac catherisation labs in the country against an estimated 500,000 potential users.
Of these, only one public lab functions. The number of facilities able to handle cardiac surgery stands at less than 15, specialist cardiothoracic surgeons are also a rare breed in the country.
Local cardiologist Prof Elijah Ogolla noted that heart disease accounts for more than half of mortalities in the higher age groups (above 50 years).
Poor management of heart disease and conditions such as chronic kidney disease worry health system planners.
Of note also is the cost of managing heart disease. By virtue of their chronicity, they account for longer hospital stay than say infectious diseases.
Also, the cost of managing them is higher compared to chronic infectious diseases. The cost of managing myocardial and cerebrovascular accidents, or heart attack and strokes, is out of reach for many Kenyan patients both in terms of facilities and cost.
Other associated complications like renal dialysis and transplants, both end points of poorly controlled cardiovascular disease, are also expensive with average costs running into millions of shillings forcing most patients to resort to fund-raising.
As discussed by one of the presenters, public health officials hold a key role in potentially reducing such costs. Preventable causes of cardiac disease in children, such as rheumatic heart disease, can be addressed through public health initiatives at lesser cost to the health kitty.
This also applies to hypertension, diabetes and kidney disease where early detection and better management are key to averting progression of the diseases.
However, a key constraint in initiating this timely and quality interventional management is lack of equipment. There is need to decentralise both equipment and personnel to deal with these cases.
Earlier the intervention
The cost of treating a heart attack after one hour and after 12 hours are different: the earlier the intervention the lower the eventual expenditure and the better the outcome.
In all what still lacks is a business model that links expensive equipment and medication needed to spread these services to counties.
Fortunately, many patients can now afford to pay for the treatment. Those who cannot can be persuaded to take up insurance so they can benefit from health services.
