Deaths due to Non-Communicable Diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Of the 40 million annual global deaths due to NCDs, 75% occur in Low- and Middle-Income Countries (LMICs). As in other LMICs, the majority of the population in Kenya receives only episodic care. As such, the Emergency Department (ED) is a primary entry point to the healthcare system, and patients accessing care in the ED may not otherwise do so. A significant proportion of ED presentations are NCD-related such as acute coronary syndromes, strokes and asthma exacerbations. These conditions require timely and effective management in order to mitigate long-term effects of disease. In addition, the ED is an important site for identifying patients at risk for complications such as patients with undiagnosed/ untreated hypertension. Despite the volume of NCD care occurring in EDs, there is lack of data regarding the ability of EDs in LMICs to respond. In 2018, the Emergency Medicine Kenya Foundation conducted Project 47, which was a national, cross-sectional study of EDs in the 47 counties of the country. Two validated World Health Organization (WHO) tools were used, which assess infrastructure, human resources, supplies and other key factors for effective emergency, surgical and critical care. The assessment was successfully completed in a nationally representative sample of EDs in Kenya, an unprecedented feat in Africa, and the dataset includes key indicators pertaining to NCD care. The objective of our study is to assess capacity for NCD care using results from the Project 47 study. Our findings will be directly translated to clinical guideline, intervention, and policy development to improve acute and emergent NCD care in Kenya. They will also have direct implications throughout East Africa whose residents regularly seek care in the country. Finally, it will provide essential primary data to support development of NCD care across Africa.
The Emergency Department (ED) is a principal source for healthcare in Low- and Middle-Income Countries given lack of infrastructure for primary care and other barriers to care. A significant proportion of ED presentations are Non-Communicable Disease (NCD)-related such as acute coronary syndromes, strokes and asthma exacerbations, all of which require timely and effective management. The objective of our study is to assess capacity for NCD care in a national dataset of Kenyan EDs, and to do a Geographic Information Systems analysis to provide mapping data on access to this care.
