Non-communicable diseases in Kenya: economic effects and risk factors
Non-communicable diseases (NCDs) have been on the rise in Kenya over the past decade. However their potential effects on household welfare are unavailable despite strong evidence of economic and social consequences from developed countries. The high expenditures for managing NCDs expose households to risks of financial catastrophe and poverty. Catastrophic expenditures occur when households are forced to dis-save or sell off assets to meet hospital bills or medical care. Although catastrophic expenditures may impoverish households, they enable them to consume essential medical care, thus slowing down the decline in income and labour productivity that is common among NCD patients. However, the patients hardly regain pre-NCD productivity levels even after treatment due to the debilitating nature of most NCDs, this could make catastrophic health expenditures by household on NCDs a poverty risk factor. Using the Kenya household health expenditure and service utilization data collected in 2007, this study uses two stage residual inclusion, control function and instrumental variable approach to investigate the effects of NCDs on household income, contribution of NCDs to household catastrophic spending in Kenya. The main finding is that NCDs have a much bigger toll on household income than the general ailments. While general ailments reduce household income by 13.63 per cent, NCDs reduce income by 28.64 percent. In addition, households with NCDs are 51.35 per cent more likely to incur catastrophic expenditures compared to households afflicted by communicable diseases. The odds of impoverishment are 48.97 per cent higher among NCD households compared to households that suffer from general illnesses. The study further examines the major risk factors for NCDs with a view of unravelling the interventions for addressing the rising prevalence of these diseases. The results show that low intake of fruits and vegetables, cigarette smoking, alcohol consumption and household income are some of the major NCD risk factors. The thesis further explores the role of social interactions in the spread of NCDs, an aspect which has largely been ignored in economics literature. The findings show that social interactions have significant effects on household health. This study recommends that the health care system in Kenya needs to develop mechanisms to promote preventive care for NCDs through control of NCDs risk factors, since preventive health is cost effective than curative health. Effective public policies such as community based routine screening for NCDs are required to address the raising prevalence of NCDs beside individual and household policies. Development of a health financing strategy (social protection and resources pooling) should be a high priority for the Kenya Ministry of Health and development partners.