The A to Z of Kenya's health

Access to health facilities

43 per cent of births are delivered in a health facility while 56 per cent are done at home.

Births by older women and those by the higher order are more likely to occur at home.

The proportion of children born at home decreases as the level of education increases; 84 per cent of children whose mothers have no education are born at home compared to 27 per cent whose mothers have some secondary education.

Eight out of every 10 children in North Eastern Province are born at home, compared to one in Nairobi.

Most women in Nairobi who do not deliver in a health facility cite cost as a factor.

Breastfeeding

97 per cent of children in Kenya are breastfed.

Bottle-feeding is also a common practice, with 25 per cent of children less than six months being fed through bottle teats.

Blood Donation

Every three minutes someone in Kenya needs blood.

One out of every 10 people admitted in a hospital needs blood.

Children and mothers use more than 60 per cent of all blood transfused in the country.

It is estimated that Kenya needs at least 380,000 units of blood annually in order to serve the 40 million citizens. Last year donors gave 124,000 units, leaving a shortfall of 256,000 units.

Cancer

Ranked the third highest killer disease in Kenya.

The commonest in adults is Breast at 23 per cent, Cervix at 21 per cent; Prostate at 16 per cent; Oesophagus,  Stomach/Colon at eight 8 per cent; and Kaposi’s Sarcoma at seven per cent.

Every year 22,000 Kenyans are diagnosed with Cancer and 8,000 die from the complication. This is 60 deaths every day or three people per hour.

Diabetes

Its estimated prevalence rate is 4.5 per cent, which translates to about 1.8 million people. Predictations are that this figure will rise to 5.4 per cent by 2025.

The number of children and young people with Type 1 diabetes is on the rise. The estimated prevalence ranges between 2.7 per cent in the rural areas and 12.7 per cent in urban areas.

Lack of access to insulin remains the most common cause of death in children with diabetes in Kenya. The cost of insulin remains as high as Sh1,800 in private pharmacies, whereas in public hospitals the cost is between Sh200 and Sh500.

Eye diseases

The commonest cause of blindness in Kenya is cataract.

Cataract causes blindness in 43 per cent of the patients (107,000 adults).
Childhood blindness is directly linked to poverty and under-five mortality rate. The prevalence of childhood blindness is eight out of 10,000 children.

Refractive error is the leading cause of blindness.

Ebola

In December last year, a woman suspected to have Ebola died at Kenyatta National Hospital. (Last week, the disease broke out in the Kibaale District of western Uganda).

Family planning

This has been lauded as one of the ways that could prevent as many as one in every three maternal deaths by allowing women to delay motherhood, space births, and avoid unintended pregnancies and abortions.

It allows people to attain their desired number of children and determine the spacing of pregnancies. 

Women are more familiar with its modern methods than the traditional ones, the percentage of those in the know being 95.

The most commonly used methods in Kenya are the injectables and pills. One in two married women is using some form of contraception, with modern methods being more frequently used than the traditional ones.

Gonorrhea

In July this year, international researchers announced that a new strain of gonorrhea had developed resistance to antibiotics.

Analysis of the bacterium that causes gonorrhea found a new variant which is very good at mutating.

This has been documented in western Kenya and a restricted area of coastal Kenya.

Studies have confirmed the presence of the drug-resistant strain in selected high-risk populations in Kisumu, Nairobi, Mombasa, and Kilifi. The cause of emergence of this resistance is unclear.

HIV

Its prevalence among women aged 20 to 24 is significantly higher than that of men in the same age group, at nine and two per cent respectively.

Nine out of ten women and women aged 15 to 49 years know that a healthy-looking person can have HIV and know that AIDS cannot be transmitted by supernatural means or sharing food, but a quarter of them say HIV can be transmitted by mosquito bites.

The number of patients on ARVs has increased from 10,000 in 2003 to over 500,000 in 2011; this includes about 43,000 children. 34.2 million people globally live with HIV.

Immunisation

The number of fully immunised children in Kenya has increased in the past nine years from three in five in 2003 to four in five in 2008.

First borns are more likely to be fully vaccinated than those of sixth or higher birth order (84 per cent and 64 per cent respectively).

Urban children are more likely to be fully vaccinated.

87 per cent of children whose mothers had at least some secondary education are fully immunised, compared to children whose mothers have no education at all.

The highest number of children immunised is highest in Nairobi Province at 99 per cent and lowest in Rift Valley at 71 per cent.

Jiggers

2.6 million Kenyans are affected by jiggers, resulting in trauma, isolation and low self-esteem.

In March last year, First Lady Lucy Kibaki called for mandatory wearing of shoes by all schoolgoing children. She also urged schools to cement classroom floors.

Central, Western, Coast, Rift Valley and Nyanza provinces are the most affected.

This high rate of jigger infestation is due to poverty, poor housing and sanitation.

Kidney health

Diabetes is one of the leading causes of chronic kidney diseases and may lead to kidney failure.

When a kidney fails, one can get a replacement from three sources; living related donors, living non-related donors and cadaveric donors.

Cadaveric organs are sourced from people who have been declared brain-dead. Permission from relatives is a must.

Lifestyle

At Independence in 1963, the life expectancy was 50 years, today that has gone up to 58.9 years after a drawback in the mid ’80s and late ’90s due to HIV.

Nationally, 12 per cent of Kenyan women are considered thin as they have a mean Body Mass Index less than 18.5.

At the provincial level, the proportion of thin women is highest in North Eastern province at 26 per cent and lowest in Nairobi at eight per cent.

One quarter of women aged between 18 and 49 are overweight, with the highest percentage being in Nairobi at 41 per cent and lowest in North Eastern Province at 11 per cent.

Lifestyle diseases like diabetes, heart disease and cancer are affecting more Kenyans than they did a decade ago.

16 per cent of children under five are underweight and four per cent severely underweight.

Rural children are more likely to be underweight, at 71 per cent, than urban children, at 10 per cent.

Children whose mothers have no education have the highest levels of underweight, at 28 per cent, while children of mothers with some secondary education have the lowest at eight per cent.

Maternal health

99 per cent of all maternal deaths occur in developing countries.

In Kenya, 26 women die daily from avoidable pregnancy-related complications.

Maternal mortality is higher in women living in rural areas and among poorer communities. Sixty per cent of urban women make four or more ante-natal care visits, compared with 44 per cent of rural women.

Nurses

Kenya has 32,941 registered nurses working in 8,006 health institutions.

In the last two decades, nursing has been affected by an exodus for greener pastures abroad, leading to a shortage countrywide.

Britain, the US, Australia, New Zealand and Finland are the preferred destinations.

Obesity

Seven per cent of boys and 17 per cent of girls are overweight or obese because they lead a sedentary lifestyle.

Children from rural Kenya are more physically active than their urban counterparts.

Those in urban centres also spend more time on screen-related activities like playing videogames, on-line chatting, watching television or texting, which is directly related to their bodyweight.

One in every two urban children spends over two hours per week on screen time, compared to one in three children in rural areas.

Pharmacists

Kenya has 3,205 of them who are regulated by the Pharmacy and Poisons Board.

Polio

There was one confirmed case of the wild polio virus type 1 on August 25, 2011 in Kamagambo, Rongo District. A week-long campaign targeted 32 high risk districts of Migori, Homa Bay, Nyamira, Kisii, Kisumu and Transmara.

Quality of care

The numbers of health facilities countrywide have increased from 6,190 to 6,696 in 2009.

Only 13 per cent of health facilities have the basic components to support 24-hour emergency service.

Basic health services are offered as a package by six of every ten health facilities in Kenya.

Government facilities (82 per cent) and NGO-managed facilities (72 per cent) are more likely than faith-based and private facilities to offer any of these basic services.

Stand-alone VCT facilities are least likely to offer outpatient curative services for children, services for adults with STIs, and antenatal care. Infectious diseases, poverty and poor access to health services for pregnant women all contribute to high levels of maternal mortality.

Respiratory infections

Respiratory infections and malaria are the leading causes of illness in Kenya, accounting for 52.7 per cent of the total diseases.

Road Accidents

In 2011, 8,185 traffic accidents were recorded, compared to 9,089 in 2010, which indicates a significant decrease of 904 cases or 10 per cent from the previous year.

2,760 fatal accidents were reported in 2011.

Smoking

The largest proportion of smokers in Kenya are men who use at least three to five sticks per day, at 36 per cent, followed by those who smoke 10 or more sticks per day, at 29 per cent.

Men in Central Province have the highest level of smoking at 30 per cent, whereas those in Nyanza smoke the least, at at eight per cent.

Men with secondary and higher education are less likely to smoke (15 per cent) compared to those who have no education at (20 per cent).

Suicide

There was a 53 per cent increase in the number of suicide cases reported last year from 203 in 2010 to 302 in 2011.

Tuberculosis

Kenya is rated 13 in the 20-TB high burden countries, with more than 100,000 new cases reported in 2011.

It is projected that at least one million children will die of TB in the next five years.

According to WHO’s Global TB Report 2009, Kenya had approximately more than 132,000 new TB cases and an incidence rate of 142 new cases per 100,000 people.

Last year, Kenya reported 106,083 cases of TB, a decrease of four per cent in cases reported in 2009.

Typhoid

The number of typhoid cases reported countrywide in 1965 was 11, compared to the more than 1.75 million cases reported in 2008. This is attributed to water scarcity and contamination at the source or in transit, and the emergence of slums.

Ulcers

Four times as many peptic ulcers arise in the duodenum — the first part of the small intestine, just after the stomach — as in the stomach itself. About four per cent of gastric ulcers are caused by a malignant tumour, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign.

Vasectomy

Last year, 3,652 vasectomies were done, compared to the 246 recorded between 1987 and 1991.

In 1988, for example, only 35 per cent of men and 20 per cent of women in Kenya knew about vasectomy.

Only three per cent of couples worldwide use vasectomy as their primary contraceptive method, even though it is permanent, safe, and cost-effective and the only long-acting contraception available for men.

Water in health facilities

Three out of every five hospitals, 45 per cent of health centres and 60 per cent of clinics reported having a regular water supply.

Maternity facilities (57 per cent), hospitals (58 per cent) and clinics (59 per cent) are more likely than other facility types to have a regular water supply.

Health centres (45 per cent) and dispensaries (35 per cent) are less likely to have  a regular water supply. However, some health facilities have been shut down for lack of this basic commodity.

On Wednesday, 18th July 2012, The Health ministry closed Cheptais District Hospital due to lack of water.

The hospital serves more than 200 patients daily. Patients from Cheptais and the lower areas of Mt Elgon, who were discharged, sought treatment at Kapsokwony and Sirisia district hospitals, more than 20 kilometres away.

X-ray

The training of radiography in Kenya was started in 1951 in Kisumu by the then Colonial Government at Port Florence and has over the years matured into a diploma course in diagnostic radiography at the Kenya Medical Training College.

Only 47 radiographers have acquired specialised degrees in Radiotherapy, Computerized Tomography-CT, Magnetic Resonance Imaging-MRI, Ultrasound, and Nuclear Medicine among others.

Doctors have warned that more lives will be lost if public hospitals are not equipped with enough diagnostic equipment.

Yellow fever

Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients.

There is no cure for yellow fever abd vaccination is the most important preventive measure against it.

There was not a single case yellow fever in Kenya last year.

It is compulsory to receive yellow fever innoculation prior to your entry into Kenya. The inoculation must be done at least 10 days before departure.

Zoonotic diseases

This refers to diseases that can be passed from animals, whether wild or domesticated, to humans.

Kenya has been categorised as one of the hotspots of human-animal infectious diseases and emerging disease outbreaks.

Many zoonotic diseases affect the productivity of both wildlife and livestock. These include diseases such as the meat-borne helminth diseases, and bacterial diseases such as anthrax, brucellosis, tuberculosis, salmonellosis, and clostridial infections. Viral diseases include rabies and Rift Valley fever.

More than two million people a year are killed by diseases globally that spread to humans from wild and domestic animals.

Sources of data

2008/2009 Demographic Health Survey
http://tinyurl.com/clzha2y

2010 Kenya Service Provision Assessment
http://tinyurl.com/cty497j

Kenya Cancer Association
http://kenyacancer.org/

International Livestock Research Institute
http://tinyurl.com/cuq8ozr

Malaria Indicator Survey 2010
http://tinyurl.com/cxmwnj5

Kenya National Bureau of Statistics
http://www.knbs.or.ke/

Kenya National AIDS/STD Control Programme
http://nascop.or.ke/

The National AIDS Control Council NACC
www.nacc.or.ke/

Ministry of Public Health and Sanitation
http://www.publichealth.go.ke/

Ministry of  Medical Services
http://www.medical.go.ke/

2012 Economic Survey
http://www.knbs.or.ke

Facts and Figures of Kenya 2012
http://tinyurl.com/d8j3fov

Kenyatta National Hospital
http://knh.or.ke/

World Health Organisation
http://tinyurl.com/ch2rwbc

Diabetes Management Information Centre
http://dmi.or.ke/