Status of Care for Diabetes and Hypertension in Four Counties in Kenya

Background: Cardiovascular diseases (CVDs) are a major cause of death from non-communicable diseases (NCDs) in Sub-Saharan Africa, accounting for over 50% of hospital admissions in Kenya. The Kenya CVD National Guidelines aim to standardize care, enhance early diagnosis, and improve community awareness. This paper reports baseline findings from a project disseminating these guidelines. Methods: A mixed-method cross-sectional study was conducted in 70 public health facilities across Kirinyaga, Marsabit, Kilifi, and Elgeyo Marakwet counties, selected based on the ongoing interventions to improve diabetes and hypertension management. Data collection involved healthcare workers’ (HCWs) surveys and patient file reviews that were analyzed using descriptive statistics. Results: All counties reported the availability of equipment and supplies for CVD care, but not all facilities had the necessary materials. Awareness and education activities focused on diabetes and hypertension rather than on heart disease and stroke. All counties offered screening and treatment for hypertension and diabetes and relied heavily on patient books for data recording. Besides Marsabit, all counties provided similar services for heart disease and stroke. HCWs demonstrated medium to high knowledge and confidence regarding CVD management, with generally positive attitudes. However, hypertension screening was inconsistent across facilities, and patients’ blood pressure was not routinely monitored. Conclusion: While health education and screening for diabetes and hypertension are present, challenges include inadequate focus on heart disease and stroke, limited equipment, and poor record-keeping. Solutions involve enhanced training, improved drug availability, better data management, and dissemination and use of national CVD guidelines for the management of patients.