Original Research

Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya

Mwaleso Kishindo, Jemima Kamano, Ann Mwangi, Thomas Andale, Grace W. Mwaura, Obed Limo, Kenneth Too, Richard Mugo, Ephantus Maree, Wilson Aruasa
African Journal of Primary Health Care & Family Medicine | Vol 15, No 1 | a3889 | DOI: https://doi.org/10.4102/phcfm.v15i1.3889 | © 2023 Mwaleso Kishindo, Jemima Kamano, Ann Mwangi, Thomas Andale, Grace W. Mwaura, Obed Limo, Kenneth Too, Richard Mugo, Ephantus Maree, Wilson Aruasa | This work is licensed under CC Attribution 4.0
Submitted: 24 October 2022 | Published: 29 September 2023

About the author(s)

Mwaleso Kishindo, Academic Model Providing Access to Healthcare, Eldoret, Kenya
Jemima Kamano, Academic Model Providing Access to Healthcare, Eldoret, Kenya; and School of Medicine, Moi University, Eldoret, Kenya; and Division of Non-Communicable Disease, Ministry of Health, Nairobi, Kenya
Ann Mwangi, Department of Mathematics, Physics, and Computing, Moi University, Eldoret, Kenya
Thomas Andale, Academic Model Providing Access to Healthcare, Eldoret, Kenya; and Moi Teaching and Referral Hospital, Eldoret, Kenya
Grace W. Mwaura, Academic Model Providing Access to Healthcare, Eldoret, Kenya; and Moi Teaching and Referral Hospital, Eldoret, Kenya
Obed Limo, Academic Model Providing Access to Healthcare, Eldoret, Kenya
Kenneth Too, Academic Model Providing Access to Healthcare, Eldoret, Kenya
Richard Mugo, Academic Model Providing Access to Healthcare, Eldoret, Kenya
Ephantus Maree, Division of Non-Communicable Disease, Ministry of Health, Nairobi, Kenya
Wilson Aruasa, Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in place to ensure greater access and affordability to non-communicable disease (NCD) management services.

Aim: This article aims to examine outpatient management services costs for patients with diabetes and hypertension attending public primary healthcare facilities.

Setting: The study was conducted in Busia and Trans-Nzoia counties in Western Kenya in facilities supported by the PIC4C project, between August 2020 and December 2020.

Methods: This cross-sectional survey included 719 adult participants. Structured interviewer-administered questionnaires were used to collect information on healthcare-seeking behaviour and associated costs. The annual direct and indirect costs borne by patients were computed by disease type and level of healthcare facility visited.

Results: Patients with both diabetes and hypertension incurred higher annual costs (KES 13 149) compared to those with either diabetes (KES 8408) or hypertension (KES 7458). Patients attending dispensaries and other public healthcare facilities incurred less direct costs compared to those who visited private clinics. Furthermore, a higher proportionate catastrophic healthcare expenditure of 41.83% was noted among uninsured patients.

Conclusion: Despite this study being conducted in facilities that had an ongoing NCDs care project that increased access to subsidised medication, we still reported a substantially high cost of managing diabetes and hypertension among patients attending primary healthcare facilities in Western Kenya, with a greater burden among those with comorbidities.

Contribution: Evidenced by the results that there is enormous financial burden borne by patients with chronic diseases such as hypertension and diabetes; we recommend that universal healthcare coverage that offers comprehensive care for NCDs be urgently rolled out alongside strengthening of lower-level public healthcare systems.


Keywords

out-patient costs; non-communicable diseases; catastrophic healthcare expenditure; primary healthcare; comorbidity.

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics

Total abstract views: 1118
Total article views: 1031

 

Crossref Citations

1. Predictors of hypertension among diabetic patients in the Ejisu municipality of Ghana
Florence Brenyah, Charles Apprey, Jacob K. Agbenorhevi, Felix C. Mills-Robertson
F1000Research  vol: 13  first page: 202  year: 2024  
doi: 10.12688/f1000research.146555.1