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 C. 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 & 10 others 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

Research output: Contribution to journalArticle

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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. Funding: Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)e81-e95
JournalThe Lancet Global Health
Volume7
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

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Kenya
Administrative Personnel
Health
Life Expectancy
Uncertainty
Mortality
Parturition
Unsafe Sex
Hand Disinfection
Sanitation
Quality-Adjusted Life Years
Maternal Mortality
Health Policy
Malnutrition
Statistical Factor Analysis
Communicable Diseases
Global Burden of Disease
Water
Wounds and Injuries

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Achoki, Tom ; Miller-Petrie, Molly K. ; Glenn, Scott D. ; Kalra, Nikhila ; Lesego, Abaleng ; Gathecha, Gladwell K. ; Alam, Uzma ; Kiarie, Helen W. ; Maina, Isabella Wanjiku ; Adetifa, Ifedayo M.O. ; Barsosio, Hellen C. ; Degfie, Tizta Tilahun ; Keiyoro, Peter Njenga ; Kiirithio, Daniel N. ; Kinfu, Yohannes ; Kinyoki, Damaris K. ; Kisia, James M. ; Krish, Varsha Sarah ; Lagat, Abraham K. ; Mooney, Meghan D. ; Moturi, Wilkister Nyaora ; Newton, Charles Richard James ; Ngunjiri, Josephine W. ; Nixon, Molly R. ; Soti, David O. ; Van De Vijver, Steven ; Yonga, Gerald ; Hay, Simon I. ; Murray, Christopher J.L. ; Naghavi, Mohsen. / 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. In: The Lancet Global Health. 2019 ; Vol. 7, No. 1. pp. e81-e95.
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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. Funding: Bill & Melinda Gates Foundation.",
keywords = "Administrative Personnel, Global Burden of Disease/statistics & numerical data, Health Policy, Health Status Disparities, Humans, Kenya/epidemiology",
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 Barsosio, {Hellen C.} 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",
note = "Copyright {\circledC} 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.",
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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, HC, 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

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

In: The Lancet Global Health, Vol. 7, No. 1, 01.01.2019, p. e81-e95.

Research output: Contribution to journalArticle

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 - Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. 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

VL - 7

SP - e81-e95

JO - The Lancet Global Health

JF - The Lancet Global Health

SN - 2214-109X

IS - 1

ER -