Introduction
Cancer remains a major public health challenge in Kenya, where it is the third leading cause of death and the second leading cause of non-communicable disease (NCD). Kenya records approximately 44,726 new cancer cases and 29,317 cancer-related deaths annually, with breast, cervical, prostate, esophageal, and colorectal cancers being the most prevalent.
Objectives
This study assesses cancer service availability and readiness in Kenya, with a focus on quality of care and rural urban disparities.
Methods
The Ministry of Health conducted the Kenya Quality of Care Health Facility Assessment between February and March 2024. The assessment covered 3,605 health facilities nationwide and looked at structures and processes for cancer health services. The questionnaires were programmed using CSPro survey software and administered on tablet devices. The analysis focused on the availability of tracer cancer services, essential guidelines, treatment protocols, and general cancer readiness indicators, patient safety, disaggregated by cancer type and facility location (rural versus urban). Data were weighted to ensure national representativeness of facilities and levels of care. Stata software (version 17) was used for analysis.
Results
Overall availability of cancer services across assessed facilities was low, averaging 46% (Urban 52%, rural 39%) with only 5% of facilities offering the full package of selected tracer cancer services. Cervical cancer services were the most widely available (93%), followed by breast cancer services (86%). In contrast, prostate cancer services were available in only 32% of facilities, while colorectal and esophageal cancer services were available at 9% and 7% respectively. Cervical cancer screening services were available in 49% of the facilities (Urban 54%, rural 34%). Notably, no rural facilities reported offering radiation therapy. Key quality of care inputs were limited: Kenya National Cancer Screening Guidelines (2018) were available in 34% of facilities (Urban 39%, rural 29%), and National Cancer Treatment Protocols (2019) in only 18%. Average availability of general cancer tracer items stood at 41% (Urban 45%, rural 37%). Only 44% of facilities monitored patient safety incidents (Urban 48%, rural 38%).
Conclusion
The findings reveal substantial gaps in the availability, readiness, and quality of cancer services in Kenya, compounded by pronounced rural-urban inequities. These systemic deficiencies undermine effective cancer prevention, early detection, and treatment. Addressing these challenges requires targeted investments to expand service capacity, strengthen implementation of national guidelines, build a skilled workforce, and reduce geographic inequities. A coordinated approach combining effective
policy implementation and monitoring, strategic resource allocation and continuous national level engagement is essential to improving equitable access to high-quality cancer care in Kenya.