Influence of health‐insurance access and hospital retention policies on childhood cancer treatment in Kenya

Abstract

Children with NHIF at diagnosis had significantly lower chance of abandoning treatment and higher chance of survival. Childhood cancer treatment outcomes could be improved by interventions that prevent treatment abandonment and improve access to NHIF. Hospital retention of patients over unpaid medical bills must stop.

Abandonment of childhood cancer treatment in Western Kenya

“…This is very unusual compared with previous studies where abandonment predominantly occurs at diagnosis or in the very first weeks of treatment 8 11 20. This delayed abandonment is mainly a result of hospital policies in Kenya where patients are retained until their hospital bill is either paid or waived 12 24–26. In practice this means that initially nearly all patients receive medical care.…”

“…The most important reason for childhood cancer treatment failure in the Moi Teaching and Referral Hospital (MTRH) in Western Kenya is abandonment of treatment whereby 54% of all families prematurely stop prescribed treatment 12. Insight into the reasons of families to abandon treatment is urgently required and will guide interventions aimed at avoiding abandonment.…”

Financial catastrophe, treatment discontinuation and death associated with surgically operable cancer in South-East Asia: Results from the ACTION Study

“…In general, however, health insurance status has been found to be associated positively with uptake and compliance with treatment in cancer. 13,14 ASEAN encompasses a range of low-and middleincome countries with heterogeneous health systems and varied levels of health insurance and social security coverage (Table I). Malaysia and Thailand have achieved universal coverage, whereas Indonesia, the Philippines, and Vietnam have achieved >50% population coverage.…”

Factors influencing time to diagnosis and treatment among pediatric oncology patients in Kenya

“…This is one of the areas that the government and other stakeholders should focus on given that we have previously shown that having insurance also reduces risk of abandonment and improves survival. 28,29 More than half of families reported use of alternative treatment before coming to MTRH. Use of alternative treatment resulted in significantly longer patient delay as well as diagnosis delay.…”

“…29 While parents had valid reasons for using alternative treatment it shows that time is lost before they seek care in a conventional health facility. More community education would alleviate this though the challenges associated with accessing health-care in Kenya need to be addressed as well.…”