Description
Introduction:
Kenya is experiencing a rising burden of hypertension (HTN) and type 2 diabetes (T2DM). Community-based screening and linkage to care improve access to prevention and treatment. This study estimated the long-term costs and impacts of strengthening integrated community-based active case finding for HTN and T2DM at primary care level in Western Kenya from a societal perspective.
Methods:
Data from the Primary-health integrated care for four chronic diseases (PIC4C) project informed an individual patient simulation model of costs and health outcomes for 100,000 individuals over a 50-year horizon. Strengthened case finding was compared with usual care, with parameters for the latter derived from published literature and the Kenya Demographic and Health Survey 2022. Risks of cardiovascular disease (CVD) complications were estimated using WHO CVD risk equations.
Results:
The intervention was cost-saving compared with usual care, with lower total discounted costs (KES 35.5 billion vs 35.7 billion), representing savings of ~KES 129 million. DALYs were also reduced (284,964 vs 285,269), with ~305 DALYs averted across the simulated cohort. This translated into a lower cost per DALY (KES 124,708 vs 125,027). The intervention increased numbers screened and treated and reduced CVD complications. Subgroup analyses suggested greater benefits among younger adults and individuals with T2DM, who experienced substantial DALYs averted at low incremental costs. Results for individuals with HTN alone were more variable, indicating the need for tailored implementation strategies.
Conclusion:
Strengthening integrated community-based active case finding for HTN and T2DM in Western Kenya is a cost-saving strategy that improves outcomes and reduces the long-term burden of CVD complications. These findings support prioritisation of integrated NCD interventions within Kenya’s primary health care system to deliver sustainable and equitable health gains.
| Country | Kenya |
|---|---|
| Organization | Academic Institution |
| Position | PhD student |
| Received a Grant? | Yes |
| If yes, give grant details | Wellcome Trust Doctoral training Program in public health economics and decision science |
