Nyeri's chronic disease burden

Two out of three people in Nyeri die of a non-communicable disease, according to data from the county health department.

The diseases, which have been attributed to lifestyle choices such as unhealthy diets, physical inactivity and excessive alcohol consumption, are also responsible for 55 per cent of hospital admissions. Cancer, diabetes, hypertension and asthma are the main ones afflicting Nyeri residents.

The prevalence of diabetes in the county is estimated at 6.4 per cent (triple the national prevalence) while that of hypertension is estimated at eight per cent.

The Nyeri County Referral Hospital reports 700 new cancer cases annually. Other risk factors that have contributed to the high rate of lifestyle diseases in Nyeri include tobacco use, being overweight and obese and psychological factors such as stress.

MOST AFFECTED GROUP

Non-communicable diseases account for 44 per cent of all deaths in the county, and men are the most affected, with 55 per cent of them succumbing to lifestyle diseases. Although the ailments are a challenge across the eight sub-counties, the highest rates of death are recorded in Nyeri Central, Mathira and Othaya. The most affected age group is residents above the age of 40.

In Kenya, non-communicable diseases account for 50 per cent hospital admissions and 55 per cent of deaths, according to data from the Ministry of Health. In 2017, cancer was the third leading cause of death, having killed 16,953 people; while heart disease killed 4,786 Kenyans, according to data from the latest Economic Survey. .

Nyeri is keen on prevention and reduction of non-communicable diseases risk factors from before conception, through pregnancy, infancy, childhood, adolescence and adulthood. The World Bank is funding the construction of walking and cycling lanes at a cost of Sh232 million to boost physical activity among residents as a way of reducing their risk. The county also plans to realign bus parks in Nyeri town, so that they are a distance away from offices, to further encourage walking and help reduce cases of lifestyle diseases.

ALARMING RATES

Given the alarming rates of lifestyle diseases in the county, Nyeri was chosen as one of the four counties that will pilot universal health coverage starting Thursday, when UHC will be launched officially.

The county acknowledges that lifestyle diseases such as heart attack, strokes, cancer, chronic respiratory diseases and diabetes, are a threat to the workforce due to premature death, reduced productivity and added cost of living due to disability or unexpected/extra health costs.

Apart from more physical activity through walking, Nyeri is also counting on engaging community health volunteers, to drive prevention by offering targeted preventive services from door to door.

The county has 2,510 community health workers, 90 per cent of whom have been trained on non-communicable disease management.

They have been trained to screen for diabetes and hypertension and various health indicators associated with chronic ailments.

One of the main prevention strategies for non-communicable diseases is a healthy diet. The Nutrition Association of Kenya recommends dietary modification to include consumption of unsaturated fats, and more fruits, vegetables, legumes, nuts and whole grains, while reducing the consumption of unhealthy fats, sugar and salt.

“The time has come to curb the rising cases of non-communicable diseases through nutrient profiles of the commonly consumed foods as well as taxing sweetened beverages more,” said Nutrition Association of Kenya Chair Henry Ng’ethe.

NUTRIENT PROFILING

Nutrient profiling is the science of categorising foods according to their nutritional composition so as to use them to prevent disease and promote health.

Nutrient profiles on food labels can help consumers understand the composition of the foods they eat, something Mr Ng’ethe says can help solve the challenge of consumers making uniformed food choices, which then put them at risk of lifestyle diseases, if they choose to eat unhealthy foods.

Even as the county works to bring down the rates of lifestyle diseases through various measures, challenges such as staff shortage, limited access to drugs and essential equipment and lack of awareness on non-communicable disease risk factors, abound. Moreover, there are no resources allocated to lifestyle diseases.

“Patients are not able to get the drugs they need constantly as expected. We also have a deficit in personnel with expertise in managing non-communicable diseases,” said a county health worker who asked for anonymity for fear of reprisals, as she is not authorised to speak to the press.

The official noted that the county is currently not employing health workers, and only 25 doctors and nurses have been trained on diabetes and hypertension management. Only one doctor is stationed at the palliative unit that handles more than 30 patients a day.

Moreover, the machines necessary for diagnosis and follow-up are not adequate, thereby increasing the financial burden on patients, who have to seek diagnostic tests in private facilities.

Nyeri County: Health at a glance

Population:

693,558 (2009 census)

0 to 14 years: 34%

15 to 64 years: 60%

65+ years: 7%

NHIF coverage:

31% (in 2015)

Health workers to population ratio

Doctors: 1 per 5,000

Doctors: 11 per 100,000

Nurses: 64 per 100,000

Clinical officers: 16 per 100,000

Health facilities

Total: 333

County referral (Level 5): 1

Sub-county facilities (Level 4): 3

Health centres (Level 3): 18

Dispensaries (Level 2): 75

Nursing home: 1

Hospice: 1

Mission hospitals: 3

Private hospitals: 3

Private clinics: 228

Prevalent diseases:

Malaria, urinary tract infections, skin diseases

Govt health spending:

Sh2,574 per person (in 2015)