Suchergebnisse

Introduction: Kenya plans to focus on integrating services for non-communicable diseases (NCDs) into existing care platforms as a way of strengthening its health system, reducing redundancies and leveraging existing systems. Mathematical modelling provides a powerful tool to address questions around priorities, optimization and implementation. In this paper we will examine the case for integration of NCDs into HIV care platforms, review examples of how mathematical models have supported policy formulation in Kenya and provide a set of recommendations on the use of modelling in policy development on integration of NCD-HIV services in Kenya. Discussion: In Kenya, NCDs are the second leading cause of morbidity and mortality after HIV/AIDS and has been shown to be higher in people living with HIV. Integration of care services has shown to have generated advantages for both provider and user, be cost-effective, practical and achieve rapid coverage scale-up. The National Strategy for Prevention and Control of Non-Communicable Diseases 2015-2020 emphasizes integration of NCD with HIV care; their shared chronic nature means a majority of the programmatic and operational approaches and infrastructure developed for HIV programs could be used for NCDs, especially in resource-constrained settings. However, the vertical nature of current disease programs, policy financing and operations operate as barriers to NCD integration in Kenya. Modelling has successfully been used to inform health policy in Kenya across a number of disease areas and in a number of ways, including i) estimating current and future disease burden to set priorities for public health policy interventions, ii) forecast the requisite investments by government, iii) comparing the impact of different integration approaches, iv) performing cost-benefit analysis for integration, and v) evaluating health system capacity needs. Conclusions Modelling can and should play an integral part in the decision-making processes surrounding the scale-up of NCD-HIV integration in Kenya. Successful use of modelling to inform policy will depend on several factors including policy makers' comfort with and understanding of models and their uncertainties, modelers understanding the policy questions, funding opportunities and building local modelling capacity to ensure sustainability.

Background In response to a growing cancer burden and need for improved coordination among stakeholders in Kenya, the US National Cancer Institute and the Kenya Ministry of Health collaboratively hosted a stakeholder meeting in 2014 which identified four priority areas of need (research capacity building, pathology and cancer registries, cancer awareness and education, and health system strengthening) and developed corresponding action plans. Methods Surveys were conducted with participants to collect input on the progress and impact of the 2014 stakeholder meeting. Findings Of 69 eligible participants, 45 responded from academia, healthcare institutions, civil society, government, and international agencies. Of the four technical focus areas, three have continued to conduct working group meetings and two have conducted in-person meetings to review and update their respective action plans. Accomplishments linked to or enhanced by the meeting include: Kenyan and international support for expansion of population-based cancer registries, increased availability of prioritized diagnostic tests in selected regional referral hospitals, a greater focus on development of a national cancer research agenda, strategic planning for a community education strategy for cancer awareness, and improved coordination of partners through in-country technical assistance. Interpretation The Stakeholder Program has successfully united individuals and organizations to improve cancer control planning in Kenya, and has enhanced existing efforts and programs across the country. This model of partners working in parallel on prioritized track activities has supported development of long term coordination of cancer research and control activities sustainable by the Kenyan government and Kenyan institutions.

Background In response to a growing cancer burden and need for improved coordination among stakeholders in Kenya, the US National Cancer Institute and the Kenya Ministry of Health collaboratively hosted a stakeholder meeting in 2014 which identified four priority areas of need (research capacity building, pathology and cancer registries, cancer awareness and education, and health system strengthening) and developed corresponding action plans. Methods Surveys were conducted with participants to collect input on the progress and impact of the 2014 stakeholder meeting. Findings Of 69 eligible participants, 45 responded from academia, healthcare institutions, civil society, government, and international agencies. Of the four technical focus areas, three have continued to conduct working group meetings and two have conducted in-person meetings to review and update their respective action plans. Accomplishments linked to or enhanced by the meeting include: Kenyan and international support for expansion of population-based cancer registries, increased availability of prioritized diagnostic tests in selected regional referral hospitals, a greater focus on development of a national cancer research agenda, strategic planning for a community education strategy for cancer awareness, and improved coordination of partners through in-country technical assistance. Interpretation The Stakeholder Program has successfully united individuals and organizations to improve cancer control planning in Kenya, and has enhanced existing efforts and programs across the country. This model of partners working in parallel on prioritized track activities has supported development of long term coordination of cancer research and control activities sustainable by the Kenyan government and Kenyan institutions.