Setting
Kenya is a low-middle-income country (LMIC) with an estimated population
of 55 million as of 2021, according to world bank data. The population
below the poverty line is estimated at 36.1% as of 2015. Children below
the age of 15 accounts for 39% of the total
population.10-12
Over 80% of the Kenyan population does not have health insurance
coverage. The National Health Insurance Fund (NHIF) is the primary
insurer covering approximately 16 %, while private insurers cover about
1% of the Kenyan population. This leaves most Kenyans paying hospital
bills out of pocket.13 The study was carried out at
MTRH, the country’s second-largest public hospital that offers pediatric
cancer treatment. It is situated in the western part of the country, in
Eldoret town, Uasin Gishu county. It serves a catchment population of
about 25 million people. On average, 240 children were diagnosed with
cancer annually during the period in review. The pediatric oncology unit
has a capacity of thirty-five beds with a bed occupancy of over 200%.
Most patients begin their initial treatment in the general wards before
being transferred to the oncology unit. The children with cancer are
cared for by a multidisciplinary team in collaboration with visiting
pediatric hematology-oncology experts from our twinning partner
institutions in the Netherlands and the USA.