How best can Kenya strengthen its health policy to improve non-communicable disease care at the primary health care level?

Abstract
Background: Kenya faces a growing burden of non-communicable diseases (NCDs), which account for over 50% of hospital admissions and 55% of in-hospital mortalities. Despite their prevalence, integrating NCD care into primary healthcare (PHC) remains a challenge due to infrastructural limitations, funding shortages, and policy gaps. This study investigates how Kenya’s health policy can be strengthened to enhance NCD care delivery at the PHC level.
Methods: A qualitative, descriptive design was employed, incorporating stakeholder interviews, document reviews, and thematic analysis. Using Kingdon’s framework and Bardach’s eightfold path for policy analysis, data from key stakeholders—including policymakers, healthcare providers, and patients—were collected from three counties in Western Kenya. NVIVO software was used to identify themes and patterns related to barriers, facilitators, and opportunities for improving NCD care.
Results: Findings highlight systemic challenges, including inadequate healthcare worker training, poor dissemination of policies, resource shortages, and cultural barriers. Stakeholders underscored the need for increased funding, consistent access to essential medications, community outreach programs, and enhanced collaboration between the national and county governments. Integration of NCD care into PHC was identified as a critical priority to address these gaps effectively.
Conclusions: Strengthening NCD care at the PHC level requires policy reforms, sustainable financing, enhanced training for healthcare workers, and multi-sectoral partnerships. Recommendations include developing county-specific NCD frameworks, fostering public-private collaborations, improving community-based initiatives, and expanding health worker capacity. These actions align with Kenya’s health policy goals and the global agenda for universal health coverage (UHC).

Keywords: Bardach’s framework, health policy, Kenya, Kingdon’s framework, non-communicable diseases, policy analysis, primary healthcare.