Rising NCD burden in Homa Bay: Patients struggle as county investment lags

Homa Bay County is facing a mounting health crisis as non-communicable diseases (NCDs) continue to rise amid limited county investment in prevention and long-term care. The challenge mirrors a growing national trend that has positioned NCDs among Kenya’s most urgent public health concerns.

Across the country, lifestyle diseases including cardiovascular illnesses, diabetes, hypertension, cancers, chronic respiratory diseases, asthma and epilepsy now account for over 50 percent of all deaths reported in health facilities, according to the Ministry of Health. Health experts warn that Kenya is experiencing a silent epidemic fuelled by poor diets, reduced physical activity, increased alcohol and tobacco use, and weak early detection systems.

Despite this national burden, access to NCD care remains uneven. Rural counties like Homa Bay face even deeper challenges as stretched facilities struggle to meet rising demand.

A patient’s daily battle: Martha Aduda’s experience

For Martha Aduda, a diabetic patient from rural Homa Bay, managing her condition requires resilience and sacrifice. She relies on the only two public hospitals, Marindi and Nyalkinyi offering free NCD services in partnership with Médecins Sans Frontières (MSF).

But both facilities are far from her home.

“For me, getting insulin is not just about treatment—it is about survival,” she explains. Long travel distances, transport costs and unpredictable supplies make each clinic visit a gamble.

Nationally, the cost of managing diabetes is heavy. A patient using insulin injections can spend between Ksh 3,000 and Ksh 6,000 per month on treatment in counties without subsidized services. Many low-income families skip doses or ration their insulin, increasing the risk of life-threatening complications such as kidney failure, blindness or amputations.

Martha welcomes the introduction of insulin pens more accurate and less painful than traditional syringes but availability in her village is still inconsistent.

A student’s struggle: Balancing school and diabetes care

Zebrema Akinyi, a secondary school student living with Type 1 diabetes, faces a delicate balancing act between her health needs and studies.

Across Kenya, an estimated 600,000 people live with diabetes, and a growing number of them are under 25 years old. Many school-going children face stigma, frequent hospital trips and the burden of self-management at a young age.

For Zebrema, insulin pens have made dosing simpler and more discreet, easing her time in school. However, she still misses classes whenever her supply runs low or when she must travel long distances for check-ups.

The Ministry of Health acknowledges that NCD services for adolescents remain underdeveloped, with few facilities offering youth-friendly care. This gap forces students like Zebrema to navigate hospital systems designed primarily for adults.

MSF’s community-based drug delivery model where medication is taken directly to patients’ homes has helped, but coverage remains limited compared to national demand.

MSF’s intervention: Bridging a dangerous gap

According to George Wambugu, the MSF Medical Team Leader in Homa Bay, the NCD crisis requires urgent government action.

“Our role is to support, but we cannot replace county systems,” he says.

Nationally, MSF and other humanitarian partners have stepped in due to chronic under-investment in NCD care. Kenya’s health budget allocates less than 15 percent to NCDs despite their rising burden. Most counties spend less than Ksh 50 per person annually on NCD prevention and treatment—far below the World Health Organization’s recommended standards.

According to MSF’s Medical Team Leader in Homa Bay, George Wambugu, the growing NCD burden requires urgent government action. He notes that MSF’s interventions—including free insulin and hypertension medication, the distribution of insulin pens to children and vulnerable patients, home-based drug delivery, training for local clinicians, regular screening and follow-up, and community education on lifestyle modification—are meant to support rather than replace government systems. He warns that without significant county investment, the rising NCD caseload will undermine existing health gains. Wambugu warns that unless counties invest heavily, the NCD crisis will overshadow existing health gains.

A call for stronger county and national involvement

As cases climb, MSF is urging both the Homa Bay County Government and the national government to expand NCD funding, strengthen supply chains and integrate NCD services into primary healthcare.

Kenya’s 2023–2030 National NCD Strategic Plan outlines goals such as scaling up screening, improving access to medicines and reducing premature deaths by 30 percent, but implementation remains slow and underfunded.

For patients like Martha and students like Zebrema, stronger investment would mean consistent insulin supply, more NCD clinics across sub-counties, reduced travel distances, affordable treatment and better long-term health outcomes. Health experts warn that without urgent intervention, NCDs could remain the country’s leading cause of early death for decades, placing enormous strain on families, communities and an already stretched healthcare system.

Without urgent intervention, health experts warn that NCDs could become Kenya’s leading cause of early death for decades to come placing immense strain on families, communities and the already stretched healthcare system.