TY - JOUR
T1 - Health disparities across the counties of Kenya and implications for policy makers, 1990–2016
T2 - 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 C.
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
N1 - Funding Information:
Funding provided by the Bill & Melinda Gates Foundation (grant OPP1152504) .
Publisher Copyright:
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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. Funding: Bill & Melinda Gates Foundation.
AB - 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. Funding: Bill & Melinda Gates Foundation.
KW - Administrative Personnel
KW - Global Burden of Disease/statistics & numerical data
KW - Health Policy
KW - Health Status Disparities
KW - Humans
KW - Kenya/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85058717978&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(18)30472-8
DO - 10.1016/S2214-109X(18)30472-8
M3 - Article
C2 - 30482677
AN - SCOPUS:85058717978
SN - 2214-109X
VL - 7
SP - 81
EP - 95
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 1
ER -