Cancer is the third leading cause of death in Kenya and causes over 27,000 deaths each year (Globocan, 2020). This is despite 30-50% of cancers being preventable through vaccination, risk reduction, screening and early detection which would markedly reduce the burden of cancer (WHO, 2021)
Among Kenyan men, the leading cancers are prostate cancer (21.9 %), oesophageal cancer (8%) and colorectal cancer (8.3%) (Globocan, 2020), most of which are preventable. However, with men having poor health-seeking behaviour due to cultural norms and misinformation, their delayed presentation to health facilities leads to poor prognosis (King-Okoye et al., 2017).
Courtesy of Globocan 2020
The current status of cancer in Kenya underscores the need for robust evidence-based policies that would inform impactful practice in the prevention and control of cancer. The National Cancer Institute of Kenya (NCI-Kenya) is the lead agency that advises the Ministry of Health on priority policy matters relating to the prevention, treatment, and control of cancer. This is achieved through a systematic analysis of all cancer prevention and control activities undertaken by various stakeholders to determine the gaps and make recommendations on the investment priorities for the country.
Furthermore, NCI-Kenya is charged with the responsibility of coordinating prevention interventions, cancer services capacity enhancement, promotion of rights for persons living with cancer, cancer-related research, surveillance & maintaining the national cancer registry to inform policy and practice. This is in line with the aspirations of the Cancer Prevention and Control Act 2012 which highlighted research as a central strategy in all cancer control planning in the country (Cancer Prevention and Control Act Number 15 of 2012, 2012).
One of the ways of improving health-seeking behaviour amongst men is by tackling societal practices through a peer-to-peer approach; an approach that NCI-Kenya and partners have taken in their engagement activities with commercial motorcycle (bodaboda) riders on cancer awareness and the Njuri-Ncheke, the supreme governing council of elders of the Meru people of Kenya in an aim to push for more men to undergo prostate cancer screening.
Taking prostate cancer as an example, the majority of men lack a clear understanding of what the screening entails including undergoing a digital rectal examination. Additionally, it is assumed that any abnormal findings from the screening automatically means a diagnosis of prostate cancer, yet there are other non-cancerous prostate conditions that can be found and managed. The main aim of cancer screening is to look for cancer before a person has any symptoms but often, men seek medical care when the cancer has already established.
Below is an audio file that amplifies the work of NCI-Kenya on the key role of community engagement in cancer prevention and control
Disclaimer: The audio file is in Kiswahili language ( i.e. not translated)
We must acknowledge that one of the strategies for reducing the cancer burden is enhancing cancer awareness in the community and accelerating equitable access to health services, especially at the grassroots level where many patients primarily seek medical services. Many Sub-Saharan countries including Kenya do not have adequate diagnostics capacity such as infrastructure, skilled personnel, and equipment. This results in clients seeking basic cancer services being referred to higher level facilities where the sheer number of patients presents a bottleneck for effective and efficient service delivery. This in turn leads to high drop out of clients in the care pathway. Ultimately delayed diagnosis translates to higher costs to the patient and their families, with cancer patients and caregivers spending an estimated 42% of their annual income on out-of-pocket expenses in Low-and-Middle-Income countries (LMICs) compared to 16% in HICs (Iragorri N 2021)
The National Cancer Institute of Kenya (NCI Kenya) is a state corporation established by the Cancer Prevention and Control Act (No. 15 of 2012). This was in recognition of the need for a more coordinated and multisectoral response to the growing cancer burden in Kenya. The overall mandate of the NCI Kenya is to advise the Kenyan Ministry of Health on cancer response priorities and to coordinate cancer prevention and control activities in Kenya.
Learn more about NCI-Kenya here: www.ncikenya.or.ke
Africa Health Business (AHB) is a Pan-African advisory and consulting firm aiming to increase equitable access to healthcare in Africa. With a focus on the African continent and via private sector engagement, we offer market access and implementation support, serve as a health ecosystem enabler, and provide stakeholder engagement services.
Learn more about AHB here: www.africahb.com
Africa Men’s Health: AHB will be hosting the seventh Africa Health Business Symposium (AHBS VII): Africa Men’s Health under the theme “The role of the private sector in advancing men’s health in Africa.” We are proud to partner with NCI-Kenya and GHCP as we discuss digital health’s key role in advancing men’s health in the region.
Learn more at: www.africahb.com
Iragorri N, de Oliveira C, Fitzgerald N, Essue B. 2021. “The Out-of-Pocket Cost Burden of Cancer Care-A Systematic Literature Review.” Current oncology (Toronto, Ont.), 28(2), 1216–1248.doi:https://doi.org/10.3390/curroncol28020117.
Cancer Prevention and Control Act Number 15 of 2012, (2012).
King-Okoye, M., Arber, A., & Faithfull, S. (2017). Routes to diagnosis for men with prostate cancer: men’s cultural beliefs about how changes to their bodies and symptoms influence help-seeking actions. A narrative review of the literature. European Journal of Oncology Nursing : The Official Journal of European Oncology Nursing Society, 30, 48–58. https://doi.org/10.1016/j.ejon.2017.06.005