Perceptions of Kenyan adults on access to medicines for non-communicable diseases: A qualitative study

• Published in: PloS one 2018-08, Vol.13 (8), p.e0201917-e0201917
• Main Authors: Onyango, Monica Adhiambo, Vian, Taryn, Hirsch, Isabel, Salvi, Devashri D, Laing, Richard, Rockers, Peter C, Ashigbie, Paul G, Wirtz, Veronika J
• Format: Article
• Language: English
• Subjects: Adult; Adults; Analysis; Breast cancer; Buying; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Chronic diseases; Chronic illnesses; Costs and Cost Analysis; Diabetes; Diabetes mellitus; Diagnosis; Drugs, Essential; Family income; Forecasts and trends; Health care; Health care services accessibility; Health facilities; Health Services Accessibility; Heart diseases; Households; Humans; Hypertension; Income; Initiatives; Kenya; Life expectancy; Low income groups; Medicine; Medicine and Health Sciences; Mortality; Noncommunicable Diseases - drug therapy; Noncommunicable Diseases - epidemiology; Patients; People and Places; Perception; Public health; Public sector; Qualitative Research; Respiratory diseases; Social aspects; Social Sciences; Statistics
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0201917

In Kenya, noncommunicable diseases (NCDs) account for 27% of all deaths. Adult Kenyans have an 18% chance of dying prematurely from cancers, diabetes, cardiovascular diseases or chronic respiratory diseases. A Novartis Access Initiative is making medicines available to treat cardiovascular diseases, diabetes, chronic respiratory diseases, and breast cancer in 30 countries, including Kenya. Little is known about patients' perceptions of access to medicines for NCDs in Kenya. The study objective was to understand patients' perceptions of access to medicines; as well as barriers and facilitators at the household, community, and healthcare system level. A baseline qualitative study was conducted in eight of 47 counties as part of an evaluation of the Novartis Access Initiative in Kenya. The 84 patients interviewed through a household survey had been diagnosed and treated for an NCD. Although medicines at government facilities were free or cheaper than those sold in private pharmacies, the availability of medicines presented a constant challenge. Patients often resorted to private pharmacies, where NCD medicines cost more than at public facilities. Participants with an NCD took their health seriously and strove to get the medicines, even under difficult circumstances. Buying NCD medicines put a strain on the household budget, especially for the lower-income participants. Some actions to overcome affordability barriers included: borrowing money, selling assets, seeking help from relatives, taking on extra work, buying partial dosages, leaving without the medicines, or resorting to non-medical alternatives. In conclusion, access to NCD medicines is a major challenge for most adults in Kenya. As a result, they engage in complex interactions between public, private facilities and pharmacies to overcome the barriers. The government should ensure well-stocked public sector pharmacies and subsidize prices of medicines for lower-income patients. Integration of industry-led access to medicine programs may help governments to obtain low cost supplies.