1st National TB patient cost survey launched
One person with Drug Resistant Tuberculosis (TB) spends at least Sh145, 000 during treatment while one with drug sensitive TB spends Sh 25,874.
The high costs include medical and transport costs associated with seeking and receiving healthcare and costs related to loss of income despite treatment being free.
Some of the costs incurred by TB patients are prohibitive and have had economic burdens on households and worsened levels of income and wealth.
In the first ever national TB patient cost survey in Kenya, TB payments have led to an increase in the proportion of patients living below poverty line from 13.9 percent to 31.1 percent.
Speaking on Wednesday during the launch of the survey at a Nairobi hotel, Health Cabinet Secretary (CS), Sicily Kariuki said the ministry is working towards ensuring that TB is included in the NHIF benefit package and that all households affected by TB are linked to existing social protection and food security programmes.
“As part of government effort to reduce the cost of seeking health care, Government is in the process of scaling up health insurance enrolment,” she said.
In a speech read on her behalf by the Director of Medical Services, Dr. Jackson Kioko, the CS said it is sad that 62.5 percent of Drug resistant TB patients lost jobs due to TB and 9.3 percent of TB affected households had their children’s education interrupted, according to the survey.
“There is need therefore to develop policies and laws that aim at eliminating the discrimination in work place of people with TB disease and ensure job security during and after treatment,” she said
This, Kariuki added will minimise loss of income during TB treatment and ensure children’s schooling is not interrupted.
The CS said the government will ensure that TB patients do not incur any diagnostic and treatment costs by looking into providing cost-free chest x-ray services.
“ We are working towards improving sample referral mechanisms so as to reduce transport costs for TB patients, ensure availability of services, by defining comprehensive essential package for health for all Kenyans and this will be extended to the TB patients,” Kariuki said
The CS noted that with this in place, the government can achieve one big target of the End TB strategy ‘zero catastrophic costs to TB patients and their households’ by 2020.
The Parliamentary Health Committee Member and Chair of TB caucus in Kenya and Africa, Stephen Mule asked the ministry to ensure that the parliamentary committee on health gets thecopy of the survey so that they can be able to make policies, and deliberate on how it’s going to be implemented.
“We, as a committee are ready to play our role in the implementation of this survey, “he said, but noted that the main challenge that such reports have, is that they gather dust on the shelves with no action.
He added that there are normally very good policies made, but not implemented under the social protection and this needs to be strengthened.
“We are planning in parliament to soon introduce a legislation to bring all cadres under the social protection in one umbrella so that they can run from one basket and not by different ministries,” the Matungulu MP said.
He asked the ministry to liaise with NHIF to ensure that all TB patients are covered during their treatment.
According to the survey, only 13.6 percent of TB patients are covered by NHIF during their treatment and for those who were enrolled, insurance did not protect them from incurring catastrophic costs.
Eunice Mailu from National Tuberculosis, Leprosy and Lung Disease (NTLD) Programme said between 27.1 percent and 53.7 percent of TB affected households experienced food insecurity due to TB.
She explained that most of them ended up poor because they had to incur expenses ending up taking loans, sale of assets, and use of savings.
“Households affected by TB incurred severe socio economic consequences with 27.8 percent using coping strategies such as loans and even 36 percent experiencing social exclusion,” she said.
Mailu said there is need to enhance TB specific social protection measures, linking TB affected households to food security programmes, and also include them in NHIF programme.
“The TB epidemic mainly affects the young people of ages 15-34yrs which are the most economically productive age groups,” she said adding that the high costs of treatment create barriers to access and adherence to medication, thereby increasing the risk of disease transmission.
Mailu explained that the survey was carried out in 30 counties with about 1,353 respondents out of which 1,071 were Drug Sensitive TB while 282 had Drug Resistant TB.
“Our survey was Health Facility-Based, Data was electronically collected and patient’s demographic data obtained from the health facility records,” she said
In 2017, Kenya reported and treated 85,188 TB patients, among them 7,771 children, making Kenya one of the countries with the highest burden of the disease.
The number of Drug resistant TB have been on increase over the years, as of 2017, there were 577 people with DR-TB reported and are currently on treatment.
Currently TB diagnosis, medicine and nutritional support are offered free in all government and faith based health facilities. In private sector TB treatment is subsidised by provision of free anti TB medicine.
By Wangari Ndirangu