Description
Background:
Non-communicable diseases (NCDs) present a significant health challenge in Kenya, especially in underserved rural areas with limited access to continuous, integrated care. Traditional models often overlook the social and economic factors influencing health outcomes. The AMPATH BIGPIC Milo Family Care Program, launched in 2016 in Bungoma County, adopts an innovative, community-driven approach that combines health service delivery with microfinance, agribusiness, and community empowerment to holistically address NCDs.
Objective:
To describe the design, implementation, and outcomes of this multi-sectorial integrated care model for NCD prevention and management in rural Kenya.
Methods:
This program utilizes the Find-Link-Treat-Retain (FLTR) framework to tackle hypertension, diabetes, and mental health disorders. Microfinance groups act as access points to enhance care and economic resilience. The BIGPIC clinical team delivers care and medication to disadvantaged patients across 38 community care sites. Community Health Promoters (CHPs) and Group Empowerment Service Providers (GESPs) support screening and economic initiatives. Outcomes from 2016 to April 2025 are assessed across health, social, and economic dimensions.
Results:
By April 2025, 6,569 individuals were screened, identifying 2,354 cases of hypertension, diabetes, and mental health conditions. Of these, 1,742 were linked to care, with 1,221 receiving portable care quarterly. Medication delivery improved adherence for 90 patients per quarter. Thirty CHPs were trained in health screening, while 87 GESPs supported 320 microfinance groups with 7,600 members. Community stakeholders contributed Kshs 600,000 in loans and Kshs 3.5 million in agribusiness grants. By August 2024, WASH trainings improved hygiene practices, 4,800 individuals joined NHIF, and over 6,300 attended health literacy forums to reduce stigma and enhance awareness.
Conclusion:
The AMPATH BIGPIC program demonstrates a scalable model integrating health, finance, and agriculture to deliver person-centered NCD care in rural Kenya. This approach addresses clinical and socioeconomic drivers of health, advancing sustainability and Universal Health Coverage goals.
| Country | Kenya |
|---|---|
| Organization | Academic Institution |
| Position | Program Manager, Ampath's Bigpic Care Program |
