Non-Communicable Diseases Risk Factor Surveillance in Kenya: Analysis of Policy Aspects as Barriers of Strategy Design and Implementation

Abstract

Kenya is a developing country currently grappling with a double disease burden. An alarming increase in non-communicable diseases (NCD) threatens to cripple the health system.

As NCDs gain attention, it is becoming apparent that information on their epidemiology and risk factors is lacking. Policies can only rely on non-representative data such as vital registries, facility-level data, and data from small-scale clinical research.

This study aimed to undertake an analysis of the policy aspects of NCD risk factor surveillance for Kenya, to describe hurdles and barriers to creating an NCD risk factor surveillance program, and to suggest a strategy best suited for the Kenyan situation.

A review of policy documents and publications was carried out, and augmented by a field-study consisting of interviews of key stakeholders.

Findings were analyzed using the Walt and Gilson policy analysis triangle. No NCD-specific comprehensive policy document is presently in use; however, one is due for launch later in 2013. No population baseline NCD burden or risk factor data are available; a failed STEPs survey in 2005 is to be repeated in this year. Despite the continued mention of NCD surveillance and its importance in various policy documents, a strategy is yet to be established. Hurdles range from lack of political attention for NCDs, competing interests with other disease priorities, and a lack of an evidence-based decision making culture.

In conclusion, while the implementation of a STEPS survey should succeed in 2013, the establishment of a NCD surveillance program has many hurdles yet to overcome.