By Ngumbo Njoroge
Patients seeking tuberculosis treatment in the private sector pay up to 10 times more than those in the public sector, implying that TB diagnosis and treatment costs in private hospitals represent a substantial economic burden, the health ministry has said. In a tuberculosis patient cost survey, which is the first in Africa, the Ministry said 90 per cent of TB patients were receiving care from public health facilities.
Private for profit or not for profit organizations manage approximately half of all the health facilities in Kenya, implying that private hospitals offer a substantial proportion of healthcare to Kenyans. This aggravates the risk of catastrophe. “Lower expenditure in the public sector is due to subsidies through government that make screening, diagnosis and treatment costs lower,” the survey noted.
It added that the findings should catalyze the strengthening of publicprivate partnership for the provision of affordable TB care in private health care providers. The results of the survey, conducted between June 2016 and January 2017, showed that TB patients and their households incur high costs and a high economic burden due to TB disease, plunging more patients of the infectious disease into poverty.
A person with Drug-Resistant Tuberculosis (TB) spends six times more than those with drug-sensitive TB. Drug-resistant TB patients spend at least Sh145, 000 during treatment while one with drug-sensitive TB spends an average of Sh25, 874. These high costs include medical and non-medical costs related to transport and food support costs associated with seeking and receiving health care and costs related to loss of income despite treatment being free.
The Ministry estimates that TB cure payments led to about three-time increase of patients living below the poverty line from 13 per cent to 31 per cent. According to the survey, some of the costs incurred by TB patients are prohibitive and have had economic burdens on households and worsened levels of income and wealth.
“Even though TB diagnosis and treatment is free, hidden costs incurred by patients and their households may worsen poverty and health. Such costs make TB patients less likely to present for care, complete TB testing, and initiate and adhere to treatment,” Health Cabinet Secretary Sicily Kariuki said.
An estimated 62.5 per cent of patients lost jobs due to TB wherein 9.3 per cent of households’ children disrupted school learning process while 36 per cent experienced social exclusion. Meanwhile, 27.8 per cent used coping strategies such as loans, sale of assets or savings.
Speaking during the launch, Enos Masini, WHO Kenya TB and Malaria Coordinator, said that TB has more than economic effects, as it also comes with high social costs calling on stakeholders to use the survey as proxy to increase access to affordable health care for TB patients as well as vouch for the translation of the survey into a policy. He urged Kenya to increase its domestic investment in Tuberculosis (TB) in order to eradicate the disease. “In the past, TB drugs were provided by foreign donors, but now the government is catering for the medication.
In order to build on the momentum, we are asking Kenya to scale up domestic resources for TB,” Masini added. The survey notes that the number of patients with Drug-resistant TB has been on increase over the years. As of 2017, there were 577 people with Drug resistant-TB. In 2017, the country 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.