County Health Leadership Practices and Readiness for Noncommunicable Disease Services in Kenya

Paul Wekesa; Kevin Owuor; Cheryl Beers Cullen

doi:10.5334/aogh.2673

County Health Leadership Practices and Readiness for Noncommunicable Disease Services in Kenya

Annals of Global Health

Volume 88 (2022): Issue 1

By: Paul Wekesa , Kevin Owuor and Cheryl Beers Cullen

Open Access

|Jul 2022

Abstract

Background: Premature mortality from noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services.

Objective: This study investigated any relationship between leadership practices and readiness for NCD services.

Methods: This correlational study investigated any relationship between leadership practices at the county level and readiness for NCD services in Kenya using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between leadership practices (annual work planning, therapeutic committees, and supportive supervision), and NCD readiness (county readiness score).

Findings: The findings indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009).

Conclusion: Health leaders should ensure that leadership practices that have a predictive relationship with NCD readiness, such as therapeutic committee activities and supportive supervision visits, are implemented appropriately. Further, county health leaders should pay particular attention to the implementation of these leadership practices at nonpublic and Tiers 2, 3, and 4 health facilities that had lower NCD readiness scores.

References

World Health Organization. Global Health Estimates 2019: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2019; 2020.
Search in Google Scholar Back to article
Allen LN, Feigl AB. Reframing non-communicable diseases as socially transmitted conditions. Lancet Glob Heal. 2017; 5(7): e644–e646. DOI: 10.1016/S2214-109X(17)30200-0
Open DOI Search in Google Scholar Back to article
Pearce N, Ebrahim S, McKee M, et al. The road to 25 × 25: how can the five-target strategy reach its goal? Lancet Glob Heal. 2014; 2(3): e126–e128. DOI: 10.1016/S2214-109X(14)70015-4
Open DOI Search in Google Scholar Back to article
Ralston J, Reddy KS, Fuster V, Narula J. Cardiovascular Diseases on the Global Agenda: The United Nations High Level Meeting, Sustainable Development Goals, and the Way Forward. Glob Heart. 2016; 11(4): 375–379. DOI: 10.1016/j.gheart.2016.10.029
Open DOI Search in Google Scholar Back to article
Kozelka EE, Jenkins JH. Renaming non-communicable diseases. Lancet Glob Heal. 2017; 5(7): e655. DOI: 10.1016/S2214-109X(17)30211-5
Open DOI Search in Google Scholar Back to article
Zou G, Decoster K, Mcpake B, Witter S. Renaming non-communicable diseases. Lancet Glob Heal. 2017; 5(7): e656. DOI: 10.1016/S2214-109X(17)30218-8
Open DOI Search in Google Scholar Back to article
Bollyky TJ, Templin T, Cohen M, Dieleman JL. Lower-income countries that face the most rapid shift in noncommunicable disease burden are also the least prepared. Health Aff. 2017; 36(11): 1866–1875. DOI: 10.1377/hlthaff.2017.0708
Open DOI Search in Google Scholar Back to article
Peck R, Mghamba J, Vanobberghen F, et al. Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: A cross-sectional survey. Lancet Glob Heal. 2014; 2(5): 285–292. DOI: 10.1016/S2214-109X(14)70033-6
Open DOI Search in Google Scholar Back to article
Geldsetzer P, Ortblad K, Bärnighausen T. The efficiency of chronic disease care in sub-Saharan Africa. BMC Med. 2016; 8–11. DOI: 10.1186/s12916-016-0675-6
Open DOI Search in Google Scholar Back to article
Ali MK, Rabadán-diehl C, Flanigan J, Blanchard C, Narayan KMV, Engelgau M. Systems and capacity to address noncommunicable diseases in low-and middle-income countries. Sci Transl Med. 2013; 5(181): 1–5. DOI: 10.1126/scitranslmed.3005121
Open DOI Search in Google Scholar Back to article
Moucheraud C. Service readiness for noncommunicable diseases was low in five countries in 2013–15. Health Aff. 2018; 37(8): 1321–1330. DOI: 10.1377/hlthaff.2018.0151
Open DOI Search in Google Scholar Back to article
Achoki T, Miller-Petrie MK, Glenn SD, et al. Health disparities across the counties of Kenya and implications for policy makers, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Heal. 2019; 7(1): e81–e95. DOI: 10.1016/S2214-109X(18)30472-8
Open DOI Search in Google Scholar Back to article
World Health Organization. Non-Communicable Diseases Progress Monitor 2022; 2022. DOI: 10.1016/B978-0-7020-5101-2.00062-5
Open DOI Search in Google Scholar Back to article
World Health Organization. Global Health Estimates 2015: Death by Cause, Age, Sex, by Country and by Region 2000–2015; 2016. https://www.who.int.
Search in Google Scholar Back to article
Phillips-Howard PA, Laserson KF, Amek N, et al. Deaths ascribed to non-communicable diseases among rural kenyan adults are proportionately increasing: Evidence from a health and demographic surveillance system, 2003–2010. PLoS One. 2014; 9(11): 1–29. DOI: 10.1371/journal.pone.0114010
Open DOI Search in Google Scholar Back to article
Devleesschauwer B, Havelaar AH, Maertens de Noordhout C, et al. Calculating disability-adjusted life years to quantify burden of disease. Int J Public Health. 2014; 59(3): 565–569. DOI: 10.1007/s00038-014-0552-z
Open DOI Search in Google Scholar Back to article
Ministry of Health – Kenya. National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2021/22–2025/26; 2021. www.health.go.ke.
Search in Google Scholar Back to article
Some D, Edwards JK, Reid T, et al. Task shifting the management of non-communicable diseases to nurses in Kibera, Kenya: Does it work? PLoS One. 2016; 11(1): 1–9. DOI: 10.1371/journal.pone.0145634
Open DOI Search in Google Scholar Back to article
Barasa EW, Cleary S, Molyneux S, English M. Setting healthcare priorities: A description and evaluation of the budgeting and planning process in county hospitals in Kenya. Health Policy Plan. 2017; 32(3): 329–337. DOI: 10.1093/heapol/czw132
Open DOI Search in Google Scholar Back to article
Waithaka D, Tsofa B, Kabia E, Barasa E. Describing and evaluating healthcare priority setting practices at the county level in Kenya. Int J Health Plann Manage. 2018; 33(3): e733–e750. DOI: 10.1002/hpm.2527
Open DOI Search in Google Scholar Back to article
Ministry of Health Kenya. Guidelines for the Establishment and Operationalization of Medicines and Therapeutics Committees; 2020.
Search in Google Scholar Back to article
Deussom R, Mwarey D, Bayu M, Abdullah SS, Marcus R. Systematic review of performance-enhancing health worker supervision approaches in low- and middle-income countries. Hum Resour Health. 2022; 20(1): 1–12. DOI: 10.1186/s12960-021-00692-y
Open DOI Search in Google Scholar Back to article
Ministry of Health. Kenya Stepwise Survey for Non Communicable Diseases Risk Factors 2015 Report; 2015. http://health.go.ke.
Search in Google Scholar Back to article
Hall V, Thomsen R, Henriksen O, Lohse N. Diabetes in Sub Saharan Africa 1999–2011: Epidemiology and public health implications. A systematic review. BMC Public Health. 2011; 11(1): 564. DOI: 10.1186/1471-2458-11-564
Open DOI Search in Google Scholar Back to article
International Diabetes Federation. Global Diabetes Scorecard: Tracking Progress for Action; 2014. https://www.idf.org.
Search in Google Scholar Back to article
Malloy P, Boit J, Tarus A, Marete J, Ferrell B, Ali Z. Providing palliative care to patients with cancer: Addressing the needs in Kenya. Asia-Pacific J Oncol Nurs. 2017; 4(1): 45. DOI: 10.4103/2347-5625.199073
Open DOI Search in Google Scholar Back to article
Topazian H, Cira M, Dawsey SM, et al. Joining forces to overcome cancer:The Kenya cancer research and control stakeholder program. J Cancer Policy. 2016; 7: 36–41. DOI: 10.1016/j.jcpo.2015.12.001
Open DOI Search in Google Scholar Back to article
Menon S, Van Den Broeck D, Rossi R, Ogbe E, Mabeya H. Multiple HPV infections in female sex workers in Western Kenya: Implications for prophylactic vaccines within this sub population. Infect Agent Cancer. 2017; 12(1): 1–8. DOI: 10.1186/s13027-016-0114-5
Open DOI Search in Google Scholar Back to article
Ochwoto M, Kimotho JH, Oyugi J, et al. Hepatitis B infection is highly prevalent among patients presenting with jaundice in Kenya. BMC Infect Dis. 2016; 16(1): 1–14. DOI: 10.1186/s12879-016-1409-2
Open DOI Search in Google Scholar Back to article
Onyango MA, Vian T, Hirsch I, et al. Perceptions of Kenyan adults on access to medicines for non-communicable diseases: A qualitative study. PLoS One. 2018; 13(8): 1–12. LK – http://sfx.umd.edu/hs?sid=EMBASE&issn=19326203&id=doi:10.1371%2Fjournal.pone.0201917&atitle=Perceptions+of+Kenyan+adults+on+access+to+medicines+for+non-communicable+diseases%3A+A+qualitative+study&stitle=PLoS+ONE&title=PLoS+ONE&volume=13&issue=8&spage=&epage=&aulast=Onyango&aufirst=Monica+Adhiambo&auinit=M.A.&aufull=Onyango+M.A.&coden=POLNC&isbn=&pages=-&date=2018&auinit1=M&auinitm=A. DOI: 10.1371/journal.pone.0201917
Open DOI Search in Google Scholar Back to article
Oti SO, van de Vijver S, Gomez GB, et al. Outcomes and costs of implementing a community-based intervention for hypertension in an urban slum in Kenya. Bull World Health Organ. 2016; 94(7): 501–509. DOI: 10.2471/BLT.15.156513
Open DOI Search in Google Scholar Back to article
Siddharthan T, Ramaiya K, Yonga G, et al. Noncommunicable diseases in East Africa: Assessing the gaps in care and identifying opportunities for improvement. Health Aff. 2015; 34(9): 1506–1513. DOI: 10.1377/hlthaff.2015.0382
Open DOI Search in Google Scholar Back to article
van de Vijver S, Oti S, Cohen Tervaert T, et al. Introducing a model of cardiovascular prevention in Nairobi’s slums by integrating a public health and private-sector approach: the SCALE-UP study. Glob Health Action. 2013; 6(1): 22510. DOI: 10.3402/gha.v6i0.22510
Open DOI Search in Google Scholar Back to article
Nturibi EM, Kunda J, Kamau EW. Thematic frames underpinning asthma and chronic obstructive pulmonary disease research in Kenya. African J Respir Med. 2016; 12(1): 3–10. http://www.africanjournalofrespiratorymedicine.com/articles/september_2016/AJRM-128(Mugambi).pdf%0Ahttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed17&NEWS=N&AN=614251260.
Search in Google Scholar Back to article
O’Neill K, Takane M, Sheffel A, Abou-Zahr C, Boerma T. Monitoring service delivery for universal health coverage: the Service Availability and Readiness Assessment. Bull World Health Organ. 2013; 91(12): 923–931. DOI: 10.2471/BLT.12.116798
Open DOI Search in Google Scholar Back to article
Spiegel DA, Droti B, Relan P, Hobson S, Cherian MN, O’Neill K. Retrospective review of Surgical Availability and Readiness in 8 African countries. BMJ Open. 2017; 7(3): 1–9. DOI: 10.1136/bmjopen-2016-014496
Open DOI Search in Google Scholar Back to article
Wakaba M, Mbindyo P, Ochieng J, et al. The public sector nursing workforce in Kenya: A county-level analysis. Hum Resour Health. 2014; 12(1): 1–16. DOI: 10.1186/1478-4491-12-6
Open DOI Search in Google Scholar Back to article
Makinde OA, Azeez A, Bamidele S, et al. Development of a Master Health Facility List in Nigeria. Online J Public Health Inform. 2014; 6(2). DOI: 10.5210/ojphi.v6i2.5287
Open DOI Search in Google Scholar Back to article
Bonita R, Magnusson R, Bovet P, et al. Country actions to meet UN commitments on non-communicable diseases: A stepwise approach. Lancet. 2013; 381(9866): 575–584. DOI: 10.1016/S0140-6736(12)61993-X
Open DOI Search in Google Scholar Back to article
Allen L, Cobiac L, Townsend N. Quantifying the global distribution of premature mortality from non-communicable diseases. J Public Heal (United Kingdom). 2017; 39(4): 698–703. DOI: 10.1093/pubmed/fdx008
Open DOI Search in Google Scholar Back to article
Atun R, Davies JI, Gale EAM, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017; 5(8): 622–667. DOI: 10.1016/S2213-8587(17)30181-X
Open DOI Search in Google Scholar Back to article
Beaglehole R, Bonita R, Horton R, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011; 377(9775): 1438–1447. DOI: 10.1016/S0140-6736(11)60393-0
Open DOI Search in Google Scholar Back to article
Wong CA. Connecting nursing leadership and patient outcomes: state of the science. J Nurs Manag. 2015; 23(3): 275–278. DOI: 10.1111/jonm.12307
Open DOI Search in Google Scholar Back to article
Vasan A, Mabey DC, Chaudhri S, Epstein HAB, Lawn SD. Support and performance improvement for primary health care workers in low- and middleincome countries: A scoping review of intervention design and methods. Health Policy Plan. 2017; 32(3): 437–452. DOI: 10.1093/heapol/czw144
Open DOI Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.5334/aogh.2673 | Journal eISSN: 2214-9996

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Language: English

Submitted on: Sep 5, 2019

Accepted on: Jun 15, 2022

Published on: Jul 22, 2022

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Noncommunicable diseases,

service readiness,

leadership practices,

county,

Kenya

© 2022 Paul Wekesa, Kevin Owuor, Cheryl Beers Cullen, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 88 (2022): Issue 1