Abstracts

Financing, Policy Gaps and Opportunities in Diabetes and Hypertension Care: Insights from Kenyan Counties

Not scheduled

20m

Oral NCD Health Financing and Policy

Speaker

Damaris Sertoi (Focus Projects and Research Organization (FOPRO))

Description

Background: Diabetes and hypertension are among the leading non-communicable diseases (NCDs) in Kenya, yet financing and policy implementation remain inadequate at the county level. Examining budget allocations and policy adoption highlights gaps and opportunities to strengthen sustainable NCD governance.

Methods: A cross-sectional baseline survey was conducted across all 47 counties (March–June 2024), involving 229 county health leaders: Chief Officers of Health (27), Directors of Health (33), NCD Coordinators (45), Pharmacists (47), Health Records Officers (32), and Community Strategists (45). Data were collected through semi-structured and in-depth interviews to assess budget allocations, prioritization of NCDs, awareness, and implementation of the national NCD strategy, and county-level financing mechanisms for NCDs.

Results: Across 47 counties, 18/27 (67%) leaders ranked hypertension and diabetes among their top five priority conditions. However, only 7/27 (26%) reported allocating more than 10% of health budgets to NCDs, 9/27 (33%) allocated less than 10%, and 11/27 (41%) could not specify. Primary-level facilities were underfunded and heavily dependent on partners. Most leaders (85%) were aware of the Kenya National NCD Strategy, but only 10/33 (30%) had begun implementation. While 91% of counties included NCDs in annual work plans, only 79% reflected them in budgets. Qualitative findings showed budget execution was hindered by delayed disbursements, allocations that existed “on paper” but not in practice, and dilution of NCD funds within broader PHC budgets. Emerging opportunities included lobbying assemblies to secure NCD allocations; partner-supported outreach, training, and procurement of commodities; and integrating diabetes and hypertension activities into broader PHC programs.

Conclusion: Despite growing recognition of NCDs in county plans, financing remains inadequate and inconsistent. Opportunities exist through earmarked funding, stronger accountability, strategic partnerships, and integration into broader PHC. Aligning county budgets with the national NCD strategy can transform gaps into sustainable pathways for action, ensuring NCD prioritization becomes actionable rather than aspirational.