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Cost Estimate of Delivering
Palliative Care to Children in
Kenya: Policy Implications




Professor Soonman KWON, Seoul
Atia Hossain, GIZ Health Sector Programme


1st National
Non-Communicable Diseases Forum
Republic of Kenya
Naivasha, Aug 24-26, 2011
Organisation of presentation

 Background
 Methodology
 Purpose
 Results
 Policy recommendations
Background:
                     Human Rights Watch in 2010
                     showed that a significant
                     number of children are suffering
                     in Kenya due to the lack of
                     palliative care.



HRW report emphasizes the need to provide palliative care
 and make morphine available to terminally-ill children.


Methodology:
    Literature review
    Interviews with practitioners and stakeholders
Purpose of Costing

 Collect information on relevant costing issues
 related to palliative care of children
 Conduct normative assessment of the cost of
 palliative care (including cost of chemical
 interventions, i.e. provision of morphine)
 Inform Government and Partners about the
 cost and fiscal implications to provide
 palliative care to children in need
Results: Assumptions (I)
                     Total # of children
               (approx) 1.8 – 2.1 million
                                                                 P
                                                                 A
                                                                 L
                                                                 L
                                                                 I
                                                                 A
                                                                 T
                                                                 I
                                                                 V
                                                                 E

                                                               care
               Children (up to 14 years) terminally ill
                      150,000-180,000
2.5% of
Total       Children (up to 14 years) living with cancer
children              150,000-180,000                           50%
           Children (up to 14 years) living with HIV/AIDS   Targeted poor
                      150,000-180,000                          250,000
Results: Assumptions (II)
                                       Morphine +    2,400-
                                       other         2,600 KSh
                                       medicines     per child per
                                                     month

                                    4,650 KSh
                                    per child per
                                    month



  Public health facility
                           Medicines             Consultation

                                    9,300 KSh
                                    per child per
                                    month
                               Private health facility
Results: Cost of Palliative Care
                                                  41.8 bn Ksh



                                27.9 bn Ksh


               13.9 bn Ksh




 7.9 bn Ksh




           Excludes cost of training: 2,224,339Ksh
         for 8-day (5 days in-class & 3 days on-site)
Cost estimates presented is likely to be an
over-estimate of the true (societal) cost of
palliative care in Kenya, because it does not
include the potential savings in overall
health care costs as a result of providing
palliative care.
Policy recommendations

  Palliative care should be seen more from a
            human rights perspective

 Political and financial commitments from the
 government should be the main issue related
 to palliative care, and with focus on:
    Increase public awareness

    Define roles of faith based health care organisations

    Continuous education and raining

    Define roles of morphine provision by nurses
Asante sana!

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Costing of palliative care for children in kenya

  • 1. Cost Estimate of Delivering Palliative Care to Children in Kenya: Policy Implications Professor Soonman KWON, Seoul Atia Hossain, GIZ Health Sector Programme 1st National Non-Communicable Diseases Forum Republic of Kenya Naivasha, Aug 24-26, 2011
  • 2. Organisation of presentation Background Methodology Purpose Results Policy recommendations
  • 3. Background: Human Rights Watch in 2010 showed that a significant number of children are suffering in Kenya due to the lack of palliative care. HRW report emphasizes the need to provide palliative care and make morphine available to terminally-ill children. Methodology: Literature review Interviews with practitioners and stakeholders
  • 4. Purpose of Costing Collect information on relevant costing issues related to palliative care of children Conduct normative assessment of the cost of palliative care (including cost of chemical interventions, i.e. provision of morphine) Inform Government and Partners about the cost and fiscal implications to provide palliative care to children in need
  • 5. Results: Assumptions (I) Total # of children (approx) 1.8 – 2.1 million P A L L I A T I V E care Children (up to 14 years) terminally ill 150,000-180,000 2.5% of Total Children (up to 14 years) living with cancer children 150,000-180,000 50% Children (up to 14 years) living with HIV/AIDS Targeted poor 150,000-180,000 250,000
  • 6. Results: Assumptions (II) Morphine + 2,400- other 2,600 KSh medicines per child per month 4,650 KSh per child per month Public health facility Medicines Consultation 9,300 KSh per child per month Private health facility
  • 7. Results: Cost of Palliative Care 41.8 bn Ksh 27.9 bn Ksh 13.9 bn Ksh 7.9 bn Ksh Excludes cost of training: 2,224,339Ksh for 8-day (5 days in-class & 3 days on-site)
  • 8. Cost estimates presented is likely to be an over-estimate of the true (societal) cost of palliative care in Kenya, because it does not include the potential savings in overall health care costs as a result of providing palliative care.
  • 9. Policy recommendations Palliative care should be seen more from a human rights perspective Political and financial commitments from the government should be the main issue related to palliative care, and with focus on: Increase public awareness Define roles of faith based health care organisations Continuous education and raining Define roles of morphine provision by nurses