According to the findings, a significant proportion of respondents believed that throwing unused medicines in the garbage bin (28%) or flushing them down the toilet (25%) was an acceptable disposal practice.

1.8 tonnes of unused or expired medicines are disposed by Kenyan households annually.

Some of these end up being recirculated and resold to unsuspecting Kenyans, especially in low-income areas. This can have negative health outcomes as expired medications are usually less effective in treating illnesses, and may in some cases be toxic.

You can now safely dispose of your unused or expired medication at any Gertrude’s Children’s Hospital clinic. This will protect you and your loved ones from the illegal recirculation of expired medication, while also protecting our water system and land from contamination. 

The study referred to at the onset emphasized the need for an urgent awareness campaign to educate the public on the significance of safe disposal practices for pharmaceutical waste to safeguard human health and the environment.

Gertrude’s Children’s Hospital together with Ogilvy Africa has embarked on an awareness campaign to change public behaviour around the disposal of pharmaceutical waste.

Read more about the campaign here.

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The initiative is designed to promote awareness on the care of medicine and safe disposal mechanisms to ensure the safe collection and disposal of unused and expired medicines aimed to prevent medical waste from ending up in the hands of the public or contaminating our soil and water systems.

“We are delighted to support Gertrude’s Children’s Hospital in developing this scalable model for safe pharmaceutical waste disposal,” adds Vikas Mehta, CEO Ogilvy Africa. “There is a serious lack of awareness amongst the general public about the health hazard we create every time we throw away old medicines in our garbage cans. DispoSafely is an attempt to bring about systematic behavior change that would protect our environment and reduce public health risks.”

“When we recklessly dispose of pharmaceutical products, we not only contaminate the land and water, but we also risk fueling the dangerous trade of reselling these products to vulnerable communities, thereby endangering both the environment and populations. This initiative is a step forward towards achieving a sustainable and healthier future for all,” said Dr. Robert Nyarango, Chief Executive Officer Gertrude’s Children’s Hospital.

Despite policy guidance on pharma waste disposal, there is a lack of execution in the public domain. The low public awareness of disposal mechanics, lack of infrastructure for collecting and safe disposal of pharma products, high cost of waste management, and dumping of pharma and medical waste into garbage all contribute to the problem.

Recent research in low and middle-income countries show increased availability of unused or expired pharmaceuticals, especially post-COVID.

A study by MDPI suggests that more in-depth research is necessary in Africa. Based on the study conducted in Nairobi, the findings show that knowledge of the safe disposal practices of unused medicines is relatively weak.

“A large percentage of respondents believed that throwing unused medicines in the garbage bin (28%) or flushing them down the toilet (25%) was an acceptable disposal practice. Therefore, there is an urgent need for an awareness campaign to educate the public on the importance of safe disposal practices for pharmaceutical waste to protect human health and the environment,” said the study.

To address these issues, Ogilvy Africa and Gertrude’s Children’s Hospital have developed DispoSafely, a three-pronged program that aims to increase consumer awareness, facilitate the collection and disposal of unused medicines through accredited chemists in Nairobi, and provide social gratification for safe drop-offs. Infrastructure for the safe disposal of unused and expired medicines will also be created.

Commenting on the project, Ogilvy Africa’s Chief Creative Officer, Delna Sethna, said: “As a creative agency, we are always searching for ideas that can truly make a difference in the world.

DispoSafely is one such idea. It is essential that we promote the safe disposal of expired and unused medicines to protect our environment and prevent harmful substances from ending up in our water systems, landfills, or even the black market.

We are honored to be part of this initiative and aim to create a significant impact by promoting a change in behavior on how we dispose of medicines and pharma-waste.”

Through this initiative, Gertrude’s Children’s Hospital and its satellite clinics in Nairobi will be used as drop-off points for unused and expired medicines and pharmaceutical products for safe disposal and incineration.

While the initial rollout will be in Nairobi, Gertrude’s Children’s Hospital and Ogilvy Africa are open to partnering with more organizations from across the country to scale up the safe collection and disposal of pharma-waste.

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The risk of cervical cancer is an existential one, especially among medically underserved populations of the country; this is mainly because of the underutilization of available cervical cancer screening services.

According to the Ministry of Health, about 3,211 women die annually as a result of cervical cancer. More die globally because of what has now come to be known as the ‘silent pandemic.’

It is against this backdrop that the World Health Organization (WHO) set aside January as Cervical Cancer awareness month. Throughout the month, WHO and its partners raise awareness on cervical cancer to save lives.

With many women suffering silently due to a lack of knowledge on the disease, access to information is critical to prevent or identify and treat the disease while in its initial stages.

Here is all you need to know about cervical cancer

What causes cervical cancer?

Cervical Cancer is caused by the human papilloma virus (HPV). Certain types of human papillomavirus (HPV) are currently recognized as the central causative factors of invasive cervical cancer. The most common types of HPV that cause cervical cancer are HPV-16 and HPV-18.

Being infected with either strain of HPV does not mean you will automatically contract cancer; your immune system tends to fight off most of HPV infections.

Symptoms of cervical cancer

Due to the alarming lack of awareness and easily accessible screening services, most cervical cancer patients do not know they are infected until the later stages of the disease. This lack of knowledge is a major reason for the increasing number of fatalities across the country.

Most women mistake the signs of cervical cancer to menstruation periods

The key symptoms to look out for include the below

• Pain during urination
• A frequent urge to urinate
• Unusual pain in the pelvis area
• Smelly vaginal discharge
• Unusual bleeding after sex or in between periods

How is cervical cancer screening done and how can I access screening services?

Cervical cancer screening is an important part of routine health care for women. The main objective of screening is to find any evidence of cancerous cells. During the screening, cancer cells can be identified before they spread to other vital organs/parts of the body.

Cervical cancer found at an early stage is usually easier to treat. Treatment becomes difficult as cancer spreads and the stages advance. Screening for cervical cancer and the tests administered to individuals depends on someone’s age and health history.

The National Cancer Screening Guidelines are focused on detection, prevention, and screening as well as equitable access to quality healthcare services.

Cervical Cancer screening services can be accessed at Equity Afia clinics located across the country. The clinics are fully equipped with qualified professionals and state-of-the-art equipment.

In case of detection, healthcare professionals are always on hand to guide you through the treatment process and specialized recovery. You will also be advised on how to prevent possible infection.

What are the stages of cervical cancer?

After diagnosis, it is important that your doctor establishes the cervical cancer stage. Establishing the stage will help the healthcare provider prescribe the right type of treatment for you and manage the disease or provide the needed care towards recovery.

The four stages of Cancer are as below;

• Stage 1 – Cancer has not yet spread to other parts of the body but may already be attacking the lymph nodes.
• Stage 2 – Cancer has not yet reached other body parts but is much larger than at Stage 1. Cancer may be spreading outside the uterus and cervix.
• Stage 3 – Cancer has still not spread to other parts of the body but has spread to the lower part of the vagina or the pelvis.
• Stage 4 – Cancer spreads outside the pelvis area to other organs of the body including lungs, the liver and bones.

Throughout the country, many women are suffering the effects of cervical cancer without even knowing what it is until it is irreversible.

Lack of awareness of cost limitations, and human and health system resource shortages have largely influenced this.

Equity Afia is one of the health facilities stepping up efforts to fight non-communicable diseases by offering quality and affordable healthcare services to all. They are spread throughout the country so make a point to visit one or any of your nearest healthcare providers for an early check.

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The upgrade, which has taken three months to complete, is geared towards providing access to clean and safe water for both drinking and handwashing purposes.

This is important in promoting the prevention of healthcare-associated infections, especially in a facility such as KNH which hosts large numbers of patients, visitors, and staff every day.

Speaking during the event, Managing Director Bayer East Africa Laurent Pierre shared, “ As Bayer East Africa, we are committed to enhancing the quality of life of our communities through different Corporate Social Engagements (CSE) programmes like this one.

“Indeed, the COVID-19 pandemic has proven that the importance of handwashing cannot be overemphasized. We are excited that this project will empower thousands of people who visit KNH daily. Indeed, regular handwashing with soap and clean running water is a vaccine against the spread of many diseases and; handwashing is a win for everyone except the germs“.

“The merits of having clean hands can not be overemphasized. It is the surest and easiest way to keep infection-causing germs from entering our bodies.

“I thank Bayer for the partnership and urge all members of the public who visit KNH to make good use of these facilities,“  Dr. Lydia Okutoyi, the director of health and quality at Kenyatta National Hospital commented.

“Indeed, these handwashing facilities will further contribute to the prevention of the Covid 19 virus transmission, “ she added.

The World Health Organization (WHO) has rated hand washing as the number 1 method of preventing healthcare-associated infections.

In the latest global survey on the implementation of national infection prevention and control programmes report, WHO highlights the urgent need to reduce inequalities in the availability of good hand hygiene and other infection prevention and control measures between high and lower-income countries.

Bayer launched its first water project at Kenyatta National Hospital back in 2015 in an effort to reduce the spread of diseases in Africa through infections from the hospital to the community and vice versa.

Since almost everyone unconsciously touches their face with their hands several times a day, hand hygiene remains extremely vital in self-protection.

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“This new data suggests that we can fight COVID more effectively by re-focusing our efforts on those who need it most,” said Prof Edwine Barasa, Director at the Nairobi Programme of the KEMRI-Wellcome Trust Research Programme.

“Vaccines work; and ensuring older adults and other at-risk groups receive them quickly is the best way to achieve greater health outcomes and is better value for money. We hope this data helps policymakers across the continent determine how to structure impactful, cost-effective, long-term COVID-19 responses,” he said.

COVID-19 has had a number of negative impacts on the health system in Kenya over the past two years. Between 2019 and 2020, data from the Global Fund to Fight AIDS, TB and Malaria show that the number of malaria cases treated in the country fell by 27%, while HIV testing fell by 37% percent. More than 10,000 fewer individuals were treated for tuberculosis.

The KEMRI-Wellcome Trust research team modelled a broad range of COVID vaccine scale-up scenarios and tested each one for cost-effectiveness and its impact on the spread of the disease.

These forecasts estimate what would happen if vaccine scale-up reached 30%, 50% or 70% of the Kenyan population, under both slow (18 month) and rapid (6 month) scenarios. A no vaccination scenario was modelled as a baseline.

In all cases, the model scales up vaccination to adults over 50 years before extending to the broader population.

Under both the slow and rapid scale-up scenarios, reaching 30% coverage with priority given to adults over 50 averts a substantial number of new infections and deaths – 32 per 100,000 new infections in the 18-month scenario, and 39 per 100,000 in the rapid scenario; as well as ~8,100 or ~9,400 deaths respectively.

Reaching a threshold of 50% and subsequently 70% a would avert an additional ~1,100 deaths under the slow scenario, and an additional ~400 deaths in the rapid scenario.

“The game has changed on COVID-19,” said Justice Novignon, head of the Africa CDC’s Health Economics Unit. “Countries need to re-focus their COVID-19 vaccination programs on the kinds of strategies that will save more lives for less money, especially in settings with overall low risk of severe disease and death and high natural immunity, and constrained resources as is the case in Kenya and Africa more broadly, targeting the elderly and those with risk increasing comorbidities rather than to the whole population. We have to make every last dollar count.”

The research found that scaling-up to 30% vaccine coverage is highly cost effective; while the 50% and 70% scenarios were not, given the lower risk of severe disease and death and high natural immunity due to previous exposure.

The research examined which scenarios saved the most “disability adjusted life years”, or “DALYs”, for the lowest costs. (DALYs are a measure used to standardize health outcomes). A health intervention is cost effective when it saves a DALY for less than the cost of a country’s pre-set cost-effectiveness threshold – in this case, less than $919 per DALY in Kenya.

When interventions cost more than this threshold – as in the case of the 50% and 70% coverage scenarios – it suggests that policymakers should focus on efforts that save more lives for lower costs.

“This critical analysis can help us sharpen our focus as we try and balance COVID vaccination campaigns with other essential health programs,” said Prof Joachim Osur, Public Health Specialist and the Vice Chancellor, Amref International University. “It is time to integrate COVID fully into our regular health system, so we can right-size our COVID-19 vaccine program while also regaining ground against other infectious diseases, such as HIV, TB and malaria.”

In Africa, only 15% of the population has received two vaccine doses and vaccination campaigns have slowed across the continent due to a low demand for doses as well as gaps in the delivery systems needed to roll them out.

Kenya’s campaign began in March 2021, one year after the first recorded case and more than 17 million doses have been administered since then – covering 15% of the total population. Currently the country aims to vaccinate 100% of all adults by the end of 2022.

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The upgrade involves converting the schools’ open pit latrines to closed flushable toilets with a toilet pan. This aims to contribute towards delivering better learning outcomes in Kenya.  

The initiative is part of SATO’s Schools Toilet Enhancement Programme (STEP), which targets upgrading toilets in 144 schools across six countries in Africa, where it has a footprint. The initiative targets reaching over 7.2 million children across the continent. 

According to the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene, Africa lags behind global progress in providing water and sanitation in schools. In Kenya, only half of the schools have basic sanitation facilities with 84 per cent of rural schools without hygiene facilities.

As part of the STEP initiative, SATO has upgraded toilets at Lea Mathare Learning Center, which caters for 100 children from Mathare informal settlement in Nairobi County. The completed toilets were handed over to the school community at the end of the week.

“Besides providing a good learning environment, our innovative and affordable solutions will also enhance the school’s sanitation facilities. Sanitation is the foundation of good health and we need to make deliberate efforts to make this a reality,” said Samuel Langat, Africa Lead for SATO during the ribbon-cutting ceremony at Lea Mathare Learning Center,

Mr Langat explained that STEP takes a holistic approach that not only involves upgrading the toilets in the school and fitting them with SATO solutions, but also benefits the community surrounding the school. The toilets are fitted with SATO’s innovative trap doors that minimise odors and keep flies and other insects away. They also require 80 per cent less water to flush, compared to traditional toilets. 

“These new toilets have greatly improved the children’s learning experience. Previously, we only had one latrine and pupils often had to queue to use it. Now they have more toilets to use and we also have running water,” said Reagan Waithaka, the founder and director of Lea Mathare Learning Center. 

SATO’s Kenya Country Head, Alex Njagi said that besides upgrading the toilets at the school, each of the pupils was also given a SATO Tap, an innovative handwashing station for use at home. Old PET bottles serve as water reservoirs for the handwashing facilities, thus avoiding waste. 

Mr Njagi added: “We are committed to improve the sanitation situation in our learning facilities and are in the process of identifying the schools to enroll into the programme. This is in line with our mission to empower communities around the world who lack access to water and sewerage facilities. We welcome partners from the public, private and not-for-profit sectors to collaborate with in upgrading even more schools’ toilets”. 

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Following the success of the UHC pilot project in 2018, President Uhuru Kenyatta has this afternoon launched the national UHC Scale-Up, an essential delivery under the Government’s Big Four priority agenda.

While welcoming the scale-up, KEMSA Chairperson Mary Mwadime confirmed that the national pharmaceuticals supply Authority had actively participated in the UHC Pilot project and is now ready to facilitate the scale-up to all 47 counties.

Under President Uhuru Kenyatta’s visionary leadership to facilitate access to quality healthcare services to all citizens, KEMSA, among other players in the health sector, she assured are working in concert to improve health outcomes.

Within the national UHC Scale-up commitments, the Government has committed to ensuring 100% access to essential medicines for all Kenyans visiting public health centres. In the last financial year and towards the achievement of UHC, KEMSA procured Health Products and Technologies (HPTs) worth KShs. 35.84 billion, with about 11,500 health facilities managing to draw down 97% of these commodities.

The Authority, Ms Mwadime said, has put in place strategic measures to significantly contribute to the attainment of Universal Health Coverage (UHC) as a strategic delivery partner. “At the UHC pilot stage, we learnt some invaluable lessons that we will apply to facilitate the provision of equitable, affordable and quality health services. KEMSA is a crucial pillar on this journey, and we celebrate the milestone,” she said from Port Reitz Hospital in Mombasa at the launch of the UHC National scale-up programme.

As part of KEMSA’s commitment to supporting UHC delivery, the Authority, Ms Mwadime said, maintains a robust infrastructure and supply chain capacity to guarantee access and delivery of quality HPTs to about 11,500 facilities in the national public health care system.

On his part, KEMSA Acting CEO Mr John Kabuchi confirmed that the Authority had undertaken specific measures to support the national UHC delivery. The measures, he said, include KEMSA policy alignment efforts with the draft UHC Policy 2020-2030 earlier developed to guide the realisation of the UHC. The Authority, he disclosed, is collaborating with players in the public health system, including the Ministry of Health and the National Health Insurance Fund (NHIF) and County Governments to actively ensure supply chain excellence to the remotest parts of the country for essential medicines, among other HPTs.

“KEMSA’s role in the success of UHC is the provision of quality, accessible and affordable Health Products and Technologies sourced from local and international suppliers,” Mr Kabuchi said. He added that “the ongoing efforts to scale up the rollout of UHC are laudable and KEMSA will be at hand to play its facilitative role particularly the competitive sourcing, quality assurance, warehousing and the last mile delivery of essential medicines countrywide.”

Ms Mwadime reiterated that “At KEMSA, we have re-engineered many of our financial management and procurement processes and adopted information technology systems. This is to ensure that we achieve excellence by providing critical assurance of ethical conduct to all our stakeholders.”

All KEMSA business processes are fully automated through the Authority’s Enterprise Resource Planning (ERP), Logistics Management Information System (LMIS) and the KEMSA e-mobile service that facilitate on-time stocks fulfilment to public health facilities countrywide.

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The additional medical centres have been opened in line with Equity Afia’s goal to ensure the sustained improvement of the health and well-being of Kenyans by increasing access to and utilization of quality, affordable and standardized healthcare.

Commenting on the opening of the new facilities, Equity Group Chief Commercial Officer, Polycarp Igathe said, “The Equity Afia network continues to grow and we are happy to play a role in enhancing the quality of healthcare services accorded to Kenyans in all parts of the country. Our medical facilities are comprehensive outpatient healthcare facilities that will offer primary, emergency and specialized care to those we serve. We shall also champion health education through our entire network and leverage the expertise of our medics to promote positive health-seeking behaviour.”

With the opening of the new facilities, Equity Afia, the medical franchise of Equity Group Foundation now has a network of 53 outpatient medical centres distributed across 19 counties in Kenya.

“Our mandate as a primary healthcare service provider is to offer quality and standardized healthcare services to all our clients and at affordable costs. Equity Afia contributes to the attainment of SDG 3 by ensuring that communities within which we operate lead healthy lives and that we promote well-being for all. This is by reducing the financial risk caused by high costs of medical services and increasing access to safe, effective, quality and essential medicines and primary care for all.” added Igathe.

The Equity Afia medical centres, which were first launched in 2015 and have recorded 700,000 cumulative patient visits as of 2021, are managed by trained and qualified Medical Officers and Consultants who are alumni of the Equity Leaders Program (ELP).

The facilities are also well resourced and equipped to offer comprehensive outpatient services including consultation, emergency care, diagnostic services, pharmaceutical services and specialist services including physiotherapy, minor outpatient surgery, nutrition counselling among others.

Also commenting on the opening of the facilities, Equity Afia Kariobangi Medical Officer-In-Charge, Dr. Anthony Kinyanjui said, “Our vision to become a key player and a top-of-mind medical service provider in Kenya is quickly coming to realization. I am delighted that as alumni of ELP, we are working with other health sector players to impact lives positively by championing health education and promotion as well as access to healthcare services through the physical expansion of our network and through offering top of class medical services at affordable rates.”

Located in Ruai at Woodlands Plaza along Kangundo Road, in Kariobangi along Outering Road near Equity Bank, in Lavington on 3^rd Floor Lavington Mall, in Umoja at Moi Drive – opposite PCEA Umoja1, in Nanyuki at Nanyuki Business Centre along Nyeri- Nanyuki Road and in Kerugoya on 1^st Floor Anchor Plaza along Hospital Road, the 6 medical centres are strategically located for ease and convenience of access.

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At the same time, for 59 per cent of respondents, COVID-19 has diminished their confidence in their finances, preventing them from taking the actions necessary to achieve their new goals.

COVID-19 has prompted the affluent in Kenya to become more future-focused when resetting their priorities: more than half have set the goal to ‘to improve my health’ (57 per cent) and to ‘to set aside more for my children’s future’ (57 per cent).

To meet these new goals, the affluent need new strategies to grow their wealth, which often involves more proactive investment rather than just saving cash.

However, their current ‘confidence gap’ has made many increasingly averse to risk, potentially stopping them from putting their money to work through investing or making use of digital tools that simplify wealth management.

The ‘confidence gap’ is greater among the emerging affluent

The emerging affluent have disproportionately suffered a loss of confidence, with 61 per cent reporting less confidence compared with 24 per cent of HNW individuals. That means those lower down the wealth spectrum, still establishing their finances, stand to lose out more if they do not have the support to rebuild their confidence.

For the affluent across the wealth spectrum in Kenya, the three most common factors impacting their confidence were ‘volatility in financial markets (38 percent), ‘fear of poor returns on investments (37 percent) and ‘insufficient information about specific investment opportunities (32 percent).

Retirement is at risk

A late start to retirement planning, combined with the pandemic-induced confidence gap, leaves a significant proportion of affluent consumers at risk of a shortfall for their retirement. In Kenya, 17 per cent of people do not currently save/invest for retirement. For those that do, ‘investment income’ (62 per cent) and ‘cash savings’ (38 per cent) are the most common expected sources of income. At the same time, 45 per cent plan to retire before the age of 65 and 22 per cent have set a new goal to retire early. This shows a disconnect between current actions and future expectations if a confidence gap is holding them back from investing.

A pro-active approach can help the affluent regain control

Globally, almost all (94 per cent) of investors who had tried more than five new investments or investment strategies reported being happy with their finances.

Whether it is diversifying into new asset classes, new investment strategies to rebalance their portfolios, or exploring sustainable investing, the survey revealed that more hands-on investors are happier with their finances.

This trend is mirrored in Kenya, where 95 per cent of those who have made five or more changes to their portfolios following the pandemic are happier with their finances.

Paul Njoki, Head of Wealth Management, Standard Chartered, said: “Saving in cash will not cover longer lifespans and new priorities, so it is essential for the affluent to invest for the long term. They need to take charge of their finances and build diversified investment portfolios to meet their new goals, including a comfortable and timely retirement. If they do not act now, they may stand to miss out.”

He added: “Affluent consumers across the wealth spectrum can benefit from professional advice to help them manage their finances. We hope this report raises awareness of the risks posed by the confidence gap and are committed to helping by offering personalised advice and convenient digital access to the wealth management solutions most suited to their goals.”

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The grant will support Kenyan counties in establishing engagement mechanisms that result in a common understanding of priority maternal and child health challenges and possible solutions.

Additionally,  the fund will support counties to implement co-creation workshops to develop fit-for-purpose investment cases that are grounded on local ecosystem capabilities and acceptance.

Dr Francis Wafula, the Director of Open Phences and a Senior Lecturer at the SBS Institute of Healthcare Management, expressed gratitude for the funding, emphasizing the team’s intention of supporting counties to establish joint learning and co-creation mechanisms that deliver investment cases that are more focused on improving lives and less on who owns the health system inputs.

“Public-private partnerships remain contentious and contested in healthcare for two reasons. First, we have rarely involved the entire ecosystem – including community members – in the design and execution, and second, we haven’t put enough emphasis on understanding weaknesses in models and building on the lessons, including being frank enough about what doesn’t work well,” Dr. Wafula observes.

“Fair and transparent collaborations can help Africa leapfrog development. The Open Phences Hub is fully committed to contributing to that vision – unified ecosystems systems that are solely focused on meeting the social and health needs of the community,” he added.

Starting January 2022, the Hub will work with national and county governments to promote open, transparent and mutually beneficial engagement. Four counties of Homa Bay, Kiambu, Kisumu and Trans Nzoia will benefit from the first phase.

Kenya dealt fairly well with the Covid-19 pandemic, thanks to its ability to mobilize non-state actors for support. However, the mobilization was mostly ad hoc, exposing the absence of structured engagement and collaboration mechanisms between the public and private sectors.

Open Phences was created to democratize public-private engagement, collaborations, and partnerships in healthcare across Sub-Saharan Africa.

The Hub brings together a diverse pool of health systems champions with a common vision – unified health systems that harness individual strengths of ecosystem actors and channel them towards the public good.

The RISA (Research and Innovation Systems for Africa) programme aims to strengthen research and innovation ecosystems in Africa, with funding from two separate FCDO programmes – SRIA for research ecosystems and ATIP for innovation ecosystems. The awarded RISA funding is managed by Chemonics Kenya and will be implemented until 31 March 2024.

Parts of this article was adapted from the Strathmore Business School website.

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