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.

Tom Achoki; Molly K. Miller-Petrie; Scott D. Glenn; Nikhila Kalra; Abaleng Lesego; Gladwell K. Gathecha; Uzma Alam; Helen W. Kiarie; Isabella Wanjiku Maina; Ifedayo M.O. Adetifa; Hellen Barsosio; Tizta Tilahun Degfie; Peter Njenga Keiyoro; Daniel N. Kiirithio; Yohannes Kinfu; Damaris K. Kinyoki; James M. Kisia; Varsha Sarah Krish; Abraham K. Lagat; Meghan D. Mooney; Wilkister Nyaora Moturi; Charles Richard James Newton; Josephine W. Ngunjiri; Molly R. Nixon; David O. Soti; Steven Van De Vijver; Gerald Yonga; Simon I. Hay; Christopher J.L. Murray; Mohsen Naghavi

doi:10.1016/s2214-109x(18)30472-8

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.

Tom Achoki
, Molly K. Miller-Petrie
, Scott D. Glenn
, Nikhila Kalra
, Abaleng Lesego
, Gladwell K. Gathecha
, Uzma Alam
, Helen W. Kiarie
, Isabella Wanjiku Maina
, Ifedayo M.O. Adetifa
, Hellen Barsosio
, Tizta Tilahun Degfie
, Peter Njenga Keiyoro
, Daniel N. Kiirithio
, Yohannes Kinfu
, Damaris K. Kinyoki
, James M. Kisia
, Varsha Sarah Krish
, Abraham K. Lagat
, Meghan D. Mooney

Wilkister Nyaora Moturi, Charles Richard James Newton, Josephine W. Ngunjiri, Molly R. Nixon, David O. Soti, Steven Van De Vijver, Gerald Yonga, Simon I. Hay, Christopher J.L. Murray, Mohsen Naghavi

Massachusetts Institute of Technology
Utrecht University
University of Washington
University of Research Company
Ministry of Health, Kenya
International Center for Humanitarian Affairs
Policy Solutions
Jomo Kenyatta University of Agriculture and Technology
London School of Hygiene and Tropical Medicine
Epidemiology and Demography Department
Malaria Branch
Population Dynamics and Reproductive Health Unit
University of Nairobi
Synotech Consultants
University of Canberra
Royal Children's Hospital
Humanitarian Leadership Academy
Kenya Medical Research Institute
Egerton University
University of Oxford
University of Embu
Centers for Disease Control and Prevention
African Population and Health Research Center

Research output: Contribution to journal › Article › peer-review

65 Citations (Scopus)

Abstract

Background

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.

Methods

We used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.

Findings

The national all-cause mortality rate decreased from 850·3 (95% uncertainty interval [UI] 829·8–871·1) deaths per 100 000 in 1990 to 579·0 (562·1–596·0) deaths per 100 000 in 2016. Under-5 mortality declined from 95·4 (95% UI 90·1–101·3) deaths per 1000 livebirths in 1990 to 43·4 (36·9–51·2) deaths per 1000 livebirths in 2016, and maternal mortality fell from 315·7 (242·9–399·4) deaths per 100 000 in 1990 to 257·6 (195·1–335·3) deaths per 100 000 in 2016, with steeper declines after 2006 and heterogeneously across counties. Life expectancy at birth increased by 5·4 (95% UI 3·7–7·2) years, with higher gains in females than males in all but ten counties. Unsafe water, sanitation, and handwashing, unsafe sex, and malnutrition were the leading national risk factors in 2016.

Interpretation

Health outcomes have improved in Kenya since 2006. The burden of communicable diseases decreased but continues to predominate the total disease burden in 2016, whereas the non-communicable disease burden increased. Health gains varied strikingly across counties, indicating targeted approaches for health policy are necessary.

Original language	English
Pages (from-to)	e81-e95
Journal	The Lancet Global Health
Volume	7
Issue number	1
Early online date	25 Oct 2018
DOIs	https://doi.org/10.1016/s2214-109x(18)30472-8
Publication status	Published - 1 Jan 2019

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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PMC6293072Final published version, 5.14 MBLicence: CC BY

Cite this

Achoki, T., Miller-Petrie, M. K., Glenn, S. D., Kalra, N., Lesego, A., Gathecha, G. K., Alam, U., Kiarie, H. W., Maina, I. W., Adetifa, I. M. O., Barsosio, H., Degfie, T. T., Keiyoro, P. N., Kiirithio, D. N., Kinfu, Y., Kinyoki, D. K., Kisia, J. M., Krish, V. S., Lagat, A. K., ... Naghavi, M. (2019). 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. The Lancet Global Health, 7(1), e81-e95. https://doi.org/10.1016/s2214-109x(18)30472-8

@article{8088151fa41642e181167154374bf18b,

title = "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.",

abstract = "BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.MethodsWe used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.FindingsThe national all-cause mortality rate decreased from 850·3 (95\% uncertainty interval [UI] 829·8–871·1) deaths per 100 000 in 1990 to 579·0 (562·1–596·0) deaths per 100 000 in 2016. Under-5 mortality declined from 95·4 (95\% UI 90·1–101·3) deaths per 1000 livebirths in 1990 to 43·4 (36·9–51·2) deaths per 1000 livebirths in 2016, and maternal mortality fell from 315·7 (242·9–399·4) deaths per 100 000 in 1990 to 257·6 (195·1–335·3) deaths per 100 000 in 2016, with steeper declines after 2006 and heterogeneously across counties. Life expectancy at birth increased by 5·4 (95\% UI 3·7–7·2) years, with higher gains in females than males in all but ten counties. Unsafe water, sanitation, and handwashing, unsafe sex, and malnutrition were the leading national risk factors in 2016.InterpretationHealth outcomes have improved in Kenya since 2006. The burden of communicable diseases decreased but continues to predominate the total disease burden in 2016, whereas the non-communicable disease burden increased. Health gains varied strikingly across counties, indicating targeted approaches for health policy are necessary.",

author = "Tom Achoki and Miller-Petrie, \{Molly K.\} and Glenn, \{Scott D.\} and Nikhila Kalra and Abaleng Lesego and Gathecha, \{Gladwell K.\} and Uzma Alam and Kiarie, \{Helen W.\} and Maina, \{Isabella Wanjiku\} and Adetifa, \{Ifedayo M.O.\} and Hellen Barsosio and Degfie, \{Tizta Tilahun\} and Keiyoro, \{Peter Njenga\} and Kiirithio, \{Daniel N.\} and Yohannes Kinfu and Kinyoki, \{Damaris K.\} and Kisia, \{James M.\} and Krish, \{Varsha Sarah\} and Lagat, \{Abraham K.\} and Mooney, \{Meghan D.\} and Moturi, \{Wilkister Nyaora\} and Newton, \{Charles Richard James\} and Ngunjiri, \{Josephine W.\} and Nixon, \{Molly R.\} and Soti, \{David O.\} and \{Van De Vijver\}, Steven and Gerald Yonga and Hay, \{Simon I.\} and Murray, \{Christopher J.L.\} and Mohsen Naghavi",

year = "2019",

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doi = "10.1016/s2214-109x(18)30472-8",

language = "English",

volume = "7",

pages = "e81--e95",

journal = "The Lancet Global Health",

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Achoki, T, Miller-Petrie, MK, Glenn, SD, Kalra, N, Lesego, A, Gathecha, GK, Alam, U, Kiarie, HW, Maina, IW, Adetifa, IMO, Barsosio, H, Degfie, TT, Keiyoro, PN, Kiirithio, DN, Kinfu, Y, Kinyoki, DK, Kisia, JM, Krish, VS, Lagat, AK, Mooney, MD, Moturi, WN, Newton, CRJ, Ngunjiri, JW, Nixon, MR, Soti, DO, Van De Vijver, S, Yonga, G, Hay, SI, Murray, CJL & Naghavi, M 2019, '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.', The Lancet Global Health, vol. 7, no. 1, pp. e81-e95. https://doi.org/10.1016/s2214-109x(18)30472-8

TY - JOUR

T1 - 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.

AU - Achoki, Tom

AU - Miller-Petrie, Molly K.

AU - Glenn, Scott D.

AU - Kalra, Nikhila

AU - Lesego, Abaleng

AU - Gathecha, Gladwell K.

AU - Alam, Uzma

AU - Kiarie, Helen W.

AU - Maina, Isabella Wanjiku

AU - Adetifa, Ifedayo M.O.

AU - Barsosio, Hellen

AU - Degfie, Tizta Tilahun

AU - Keiyoro, Peter Njenga

AU - Kiirithio, Daniel N.

AU - Kinfu, Yohannes

AU - Kinyoki, Damaris K.

AU - Kisia, James M.

AU - Krish, Varsha Sarah

AU - Lagat, Abraham K.

AU - Mooney, Meghan D.

AU - Moturi, Wilkister Nyaora

AU - Newton, Charles Richard James

AU - Ngunjiri, Josephine W.

AU - Nixon, Molly R.

AU - Soti, David O.

AU - Van De Vijver, Steven

AU - Yonga, Gerald

AU - Hay, Simon I.

AU - Murray, Christopher J.L.

AU - Naghavi, Mohsen

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.MethodsWe used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.FindingsThe national all-cause mortality rate decreased from 850·3 (95% uncertainty interval [UI] 829·8–871·1) deaths per 100 000 in 1990 to 579·0 (562·1–596·0) deaths per 100 000 in 2016. Under-5 mortality declined from 95·4 (95% UI 90·1–101·3) deaths per 1000 livebirths in 1990 to 43·4 (36·9–51·2) deaths per 1000 livebirths in 2016, and maternal mortality fell from 315·7 (242·9–399·4) deaths per 100 000 in 1990 to 257·6 (195·1–335·3) deaths per 100 000 in 2016, with steeper declines after 2006 and heterogeneously across counties. Life expectancy at birth increased by 5·4 (95% UI 3·7–7·2) years, with higher gains in females than males in all but ten counties. Unsafe water, sanitation, and handwashing, unsafe sex, and malnutrition were the leading national risk factors in 2016.InterpretationHealth outcomes have improved in Kenya since 2006. The burden of communicable diseases decreased but continues to predominate the total disease burden in 2016, whereas the non-communicable disease burden increased. Health gains varied strikingly across counties, indicating targeted approaches for health policy are necessary.

AB - BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.MethodsWe used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.FindingsThe national all-cause mortality rate decreased from 850·3 (95% uncertainty interval [UI] 829·8–871·1) deaths per 100 000 in 1990 to 579·0 (562·1–596·0) deaths per 100 000 in 2016. Under-5 mortality declined from 95·4 (95% UI 90·1–101·3) deaths per 1000 livebirths in 1990 to 43·4 (36·9–51·2) deaths per 1000 livebirths in 2016, and maternal mortality fell from 315·7 (242·9–399·4) deaths per 100 000 in 1990 to 257·6 (195·1–335·3) deaths per 100 000 in 2016, with steeper declines after 2006 and heterogeneously across counties. Life expectancy at birth increased by 5·4 (95% UI 3·7–7·2) years, with higher gains in females than males in all but ten counties. Unsafe water, sanitation, and handwashing, unsafe sex, and malnutrition were the leading national risk factors in 2016.InterpretationHealth outcomes have improved in Kenya since 2006. The burden of communicable diseases decreased but continues to predominate the total disease burden in 2016, whereas the non-communicable disease burden increased. Health gains varied strikingly across counties, indicating targeted approaches for health policy are necessary.

U2 - 10.1016/s2214-109x(18)30472-8

DO - 10.1016/s2214-109x(18)30472-8

M3 - Article

SN - 2572-116X

VL - 7

SP - e81-e95

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 1

ER -

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.

Abstract

UN SDGs

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