Part 1
Question 1
According to the World Bank Health expenditure per capita (current US$) report, Kenya’s health expenditure per person is 77.679 USD, which is higher compared to other countries in the region; Tanzania’s is 51.717 USD and Uganda’s is 52.294 USD. Additionally, it is higher than the East Africa’s average of 60 USD.
The World Health Organization recommends a minimum of 36 doctors per 100,000 people which Kenya has not attained seeing that their current rate is at 17 physicians per 100,000 people (Gatura and Mbaluku 2). The number of physicians refers to the people in the country that have graduated from any school or faculty of medicine and are working in the medical field.
Kenya has a ratio of 103.4 nurses for 100,000 population which is lower than the number recommended by the World Health Organization; the organization recommends 250 nurses, doctors and midwives for 100,000 people of the population (Ministry of Health 8).
The Development Partners in Health Kenya is made up of the main donors and partners that support the country. These donors focus on three key diseases, HIV/AIDS, Malaria, and tuberculosis. The funding for these diseases is USD 1.5 to 2 billion dollars (The Global Fund 9). Global fund considers Kenya as a High Impact Country, especially with regards to the HIV/AIDS epidemic. Between 2014 and 2016, the Global Fund has allocated 495 million dollars which is the seventh highest global allocation. As such, Global Fund is about 23 percent of the total aid.
Question 2
The life expectancy for both male and female children has increased by approximately 9 years between 2002 and 2012 while the World Health Organization's average increase was 7 years for the same period of time. In 2012, HIV/AIDS was among the leading causes of death by killing 54.5 thousand people. Today, death as a result of HIV/AIDS is still significantly higher since Kenya was ranked fourth among countries with large HIC epidemics in the world. Other countries that ranked highly included Uganda and Mozambique. Approximately 1.5 million people were said to be living with HIV in 2015 and around 36,000 people died as a result of this disease in the same year. There is a huge gap that needs to be filled in order to address this issue and to reduce the number of deaths as a result of HIV/AIDS.
More than half of the people living with the virus are unaware of their status and there are an approximate 26,000 sero-discordant couples where one partner is HIV-positive and the other is HIV negative and hence a valid estimation that the numbers of infections are bound to increase (Avert). As such, HIV testing and counseling programs are supposed to increase coupled with other targeted testing programs such as door-to-door campaign tests. Also, these efforts should be coupled with preventing mother-to-child transmission, increased condom distribution, and reduced HIV-related discrimination and stigma. More than 60 percent of the country’s HIV response is funded externally while the remaining percentage is funded by private individuals and the Kenyan government. The country has made significant strides in dealing with HIV epidemic, however, its efforts have not matched what should be done for the people living with the disease and to prevent more infections.
HIV/AIDS is one of the diseases that is supported by foreign aid including diseases like Malaria and tuberculosis. Global Fund accounts for 25 to 30 percent of Kenya's funding towards the disease and their contribution is primarily to buy health pharmaceuticals and products, offer training programs and other human resource development programs. The United States remains as the largest donor with approximately 60 to 70 percent of the investment. One of the goals of the Global Fund's strategy is to increase the number of HIV patients on antiretroviral treatment (The Global Fund 11). Based on the revised WHO guidelines, 80 percent of people living with HIV in the country are eligible to receive this kind of treatment.
Question 3
According to the World Health Organization, Kenya has approximately 800,000 deaths as a result of HIV including both adults and children (WHO). http://gamapserver.who.int/mapLibrary/Files/Maps/HIV_deaths_2015.png
According to the World Bank Group, 59 percent of people living with HIV are receiving antiretroviral therapy; the number is higher than other countries in the region with Uganda at 57 percent, Tanzania at 53 percent, and South Sudan at 11 percent (“Antiretroviral therapy coverage (% of people living with HIV)”). http://data.worldbank.org/indicator/SH.HIV.ARTC.ZS?view=map
Approximately 67 percent of pregnant women in Kenya are living with HIV and are receiving necessary antiretroviral therapy to prevent mother-to-child transmission (WHO). The effective Prevention of Mother-to-Child transmission programs includes the provision of antenatal services, HIV testing during a mother's pregnancy, provision of antiretroviral therapy to pregnant women, safe childbirth, appropriate and safe infant feeding among other post-natal services. The Global Health Observatory data repository has provided health centers with guidelines that recommend the provision of antiretroviral treatment to pregnant women and nursing women regardless of their clinical stage or CD4 count (Avent).
http://apps.who.int/gho/data/node.main.627?lang=en
HIV prevalence in Kenya is both generalized and concentrated with the epidemic being traced in the general population while at the same time being said to be very high in certain populations such as sex workers, people injecting drugs, and men who have sex with men (National AIDS Control Council 4). http://www.unaids.org/sites/default/files/country/documents/KEN_narrative_report_2014.pdf
Question 3
The graph above shows the leading causes of death in Kenya from 2005 to 2015 (IHME). As seen, some diseases have changed their position on the chart while others have reduced significantly in percentage. However, over this period, HIV/AIDS has remained the number one cause of death in the country. This chart matches the data that has been evaluated and analyzed in other questions and above all it supports the claim that the country’s efforts to reduce or deal with the disease do not match the needs. As such, HIV has remained the number one cause of death despite the country’s significant spending to reduce the number of infections and provide care to the people living with the disease. From this chart, it is clear that more needs to be done in order to match these needs.
Question 4
HIV/AIDS remains as a great epidemic that is affecting many developing countries like Kenya. From the data analyzed, it is evident that the country is receiving a significant amount of aid from other international organizations and countries. However, there is a disconnect between the programs established and their significance in improving the HIV situation in the country since the data shows that the efforts being put in have not matched or met the needs that the country has regarding this epidemic. However, the most surprising part of this research is that the high prevalent areas are in certain regions of the country. The western part of Kenya including Homabay, Siaya, and Kisumu counties are the most affected by the epidemic with rates of 25.7, 23.7, and 19.3 percent respectively (Kodi). While the least infections are in Marsabit, Tana River, and Wajir parts with 1.2, 1, and 0.2 percent respectively. Such data raises the question of the concentration of the programs in urban areas or the misallocation and mismanagement of funds in some areas. Also, it raises the question whether such data is accessible and known to the Kenyan government and whether they plan on aligning their funds and HIV-related programs to match and cater to the high prevalent areas.
Works Cited
Avert. “HIV and AIDS in Kenya.” Avert, 14 Dec. 2016, https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/kenya. Accessed 14 Jan. 2017.
Gatura, Gatonye and Turudy Mbaluku. “Kenya Decades Away From Getting Better Healthcare.” The Standard, 22 February 2013, p. 2. Retrieved from http://www.internewskenya.org/summaries/internews51530d99375f5.pdf
Global Health Observatory data repository. “Prevention of mother-to-child transmission Data by country.” World Health Organization, 2016, http://apps.who.int/gho/data/node.main.627?lang=en. Accessed 14 Jan. 2017.
Kodi. “HIV Situation in Kenya.” Open Data Blog, n.d., http://blog.opendata.go.ke/hiv-situation-in-kenya/. Accessed 14 Jan. 2017.
Ministry of Health. Kenya Nursing Workforce Report: The Status of Nursing in Kenya, 2012. Ministry of Health, 2015. Retrieved from http://www.health.go.ke/wp-content/uploads/2015/09/Kenya%20Nursing%20Workforce%20Report.pdf
National AIDS Control Council. Kenya, A. I. D. S. Response Progress Report 2014: Progress towards Zero. UNAIDS, 2014. Retrieved from http://www.unaids.org/sites/default/files/country/documents/KEN_narrative_report_2014.pdf
The Global Fund. Audit Report: Global Fund Grants to the Republic of Kenya. The Global Fund, 2015. Retrieved from http://www.theglobalfund.org/documents/oig/reports/OIG_GF-OIG-15-011_Report_en/
The World Bank Group. “Health expenditure per capita (current US$).” World Bank Group, 2014, http://data.worldbank.org/indicator/SH.XPD.PCAP?end=2014&start=2014&view=map. Accessed 14 Jan. 2017.
The World Bank Group. “Antiretroviral therapy coverage (% of people living with HIV).” World Bank Group, 2015, http://data.worldbank.org/indicator/SH.HIV.ARTC.ZS?view=map. Accessed 14 Jan. 2017.
World Health Organisation (WHO). “World: Estimated Adult and Child Deaths from AIDS, 2015- By WHO Region.” World Health Organization, 2016, http://gamapserver.who.int/mapLibrary/Files/Maps/HIV_deaths_2015.png. Accessed 14 Jan. 2017.
