It’s easy to think that tackling national health crises should be the government’s remit. But the reality is that the involvement of the private sector can make a key difference in a country with inequitable distribution of resources – problems acknowledged in the government’s 2017 Health Sector Strategic and Investment Plan.
Helping to protect your staff from the country’s biggest health threats makes good business sense. Not only will it give you a healthier, more productive workforce, it will also help keep your health insurance costs low, attract high-calibre staff and foster loyalty among employees.
Let’s take a look at the five top health challenges affecting Kenyans today – and how you can look after your workforce.
The current health picture
Over the course of the 1990s, life expectancy in Kenya plummeted due to the impact of HIV. Thankfully, the situation is now improving, and the average age of death for both men and women has now risen above 1990 levels. However, we have slipped further behind the global average, with women dying nearly seven years earlier at 67 and men nearly six at 63.
According to the latest official figures, from 2013, HIV is still the leading cause of both health loss and death in Kenya. In both rankings, the top five causes are HIV, lower respiratory infections (LRIs), diarrhoea, tuberculosis (TB) and stroke. Here we’ll take a look at why these health problems are so prevalent in Kenya, what’s already being done to improve the situation and how your company could make a difference.
According to the latest official figures, from 2013, HIV is still the leading cause of both health loss and death in Kenya.
HIV/AIDS: The first case of HIV in Kenya was diagnosed in 1984 and by the mid-1990s it had become one of the leading causes of death in the country. Unlike in some countries where HIV has mostly affected certain demographics, in Kenya the impact has been huge and population-wide, with more women affected than men.
Kenya’s AIDS epidemic reached its peak in 2005. By 2013, the number of people dying as a result of HIV-related illnesses had more than halved, thanks to increased early-stage diagnosis and antiretroviral treatment. Antiretroviral drugs have also dramatically decreased the number of babies born with HIV.
But despite these improvements, recent figures show that 146,700 new cases of HIV were detected in 2014, compared with 60,000 in 2005. So the battle still goes on. It’s estimated that there are 1.6 million people living with HIV in Kenya today.
Lower respiratory infections and diarrhoea: In 1990, diarrhoeal diseases were the top cause of health loss – referred to as disability adjusted life years (DALYs) – in Kenya. They slipped into second place in 2000, replaced by HIV/AIDS, and by 2013 they had dropped into third place, behind LRIs.
The rates of health loss due to both diarrhoeal diseases and LRIs, such as pneumonia, have fallen nearly 50% since the 1990s, though they are still a major cause of illness and death among children under five.
There are strong links between respiratory infections in young children and both poor nutrition and poor household air quality, which may result from fuel used for indoor cooking.
Diarrhoea most often results from a bacterial or viral infection, which may be caused by poor hygiene and, in particular, dirty water.
The situation is exacerbated by the poor provision of health facilities in remote areas, which means some children don’t have access to even basic healthcare. Across the country there is only around one nurse per 1,000 people and the concentration is particularly low in rural areas.
TB: This highly contagious bacterial disease is easily spread through the air. Despite widespread inoculation of babies, TB became more common during the 1990s, as HIV made more people vulnerable to infection. However a national TB strategy saw efforts to detect and treat the disease increase. In conjunction with efforts to tackle HIV, deaths from TB fell nearly 40% between 2000 and 2013.
However a national survey carried out in 2015 suggested that while 82,000 people were diagnosed with and treated for TB that year, the actual number of new infections was much higher. And although interventions to manage TB among people living with HIV have been successful, it appears that there is a large burden of the disease among the wider population.
A national survey carried out in 2015 suggested that while 82,000 people were diagnosed with and treated for TB that year, the actual number of new infections was much higher.
Since 2015, people diagnosed with HIV in Kenya have routinely been prescribed with the TB-fighting antibiotic isoniazid to prevent its onset.
Stroke: Unlike Kenya’s other top health concerns, strokes come under the category of non-communicable diseases (NCDs), which are becoming increasingly prevalent in developing countries. This can be attributed both to the reduced health impact of infectious diseases and a rise in unhealthy lifestyle habits such as inactivity, unhealthy eating, smoking and drinking excessive alcohol. In Kenya the burden of NCDs is growing steadily and progress in tackling them has been slow so far.
The government now has a strategy in place to tackle the rising tide of NCDs, through prevention as well as cure.
Other important health issues
Unfortunately, the death rate for new babies is still relatively high and declining very slowly. The proportion of babies dying during the first seven days of life has hovered around 20 per 100,000 live births since 1990. This represents a major concern.
Thankfully the death rate for children between the ages of one and five has declined sharply since 2000, mainly thanks to progress tackling malaria and HIV.
Taking a proactive approach to your employees’ health
Here are a few ideas to consider.
Provide staff and families with private medical insurance: It’s becoming increasingly common for companies to protect the health of their most precious asset – their people – with private medical insurance. But by extending the coverage to include partners and dependants, you will be able to have a much more far-reaching impact. After all, if an employee’s children are sick, this is likely to increase risk of absenteeism as well as concentration and productivity issues while they are at work.
This level of protection will help to secure the loyalty of your employees and make it easier to attract the best people to join your team, so you could find the investment is repaid many times over. A good insurance adviser will be able to recommend a product to suit your needs and secure a competitive price for you.
Consider providing maternity cover: The costs associated with giving birth in a private hospital nearly doubled between 2008 and 2016, and the National Hospital Insurance Fund contribution will fall well short of covering them in most cases, possibly encouraging some women to skip vital routine check-ups with potentially disastrous consequences. Good pre- and post-natal care can make a huge difference to the health of both pregnant women and their babies, helping to detect treatable but potentially serious conditions early on.
Few employers in Kenya currently offer maternity cover, so introducing this will make you stand out from the crowd as a good and supportive employer, helping you to attract – and retain – top talent.
Plus mother-friendly policies such as the provision of childcare facilities and an on-site mother’s room can help women continue to breastfeed exclusively for the first six months, as recommended by the World Health Organization (WHO).
Encourage HIV testing: HIV is still associated with high levels of stigma in Kenya, which can lead to discrimination. This can put people off being tested, delaying vital treatment that will help them manage their condition and stay in relatively good health. Consider offering voluntary, confidential HIV testing and support, with access to treatment for those affected.
Promote healthy lifestyle choices: You can take a stand against the rising tide of non-communicable diseases by helping your employees avoid the habits that can lead to their development. Through a simple workplace wellness scheme you can encourage staff to be more active, eat better, give up smoking and cut back on alcohol.
Through a simple workplace wellness scheme you can encourage staff to be more active, eat better, give up smoking and cut back on alcohol.
These simple changes could make a huge difference to their wellbeing in the long term, helping to cut their risk of obesity, cardiovascular disease, cancer and diabetes as well as stroke.
Offer health talks: Enlisting health professionals to visit the workplace and give talks about various health issues, from nutrition to hygiene, infectious diseases, vaccinations and aspects of children’s health, can help educate staff to avoid illnesses and keep their families well.
Support innovative health initiatives: Kenya is currently benefiting from a wealth of initiatives aimed at tackling some of its many health challenges. Some of these are run by charities or other not-for-profit organisations, while others are run by commercial businesses or public-private partnerships.
Why not consider supporting one of these initiatives by making a donation or investment? This is a great way to demonstrate that you’re a socially responsible organisation, which could help you secure loyal customers as well as employees.
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