Mental health support is vital in the treatment journey of patients with chronic illnesses, to help them cope with the burden of managing the illnesses and other related socio-economic afflictions. Medical experts warn that some of the severe mental health conditions such as psychosis and schizophrenia could also come as a result of poor management of such diseases as epilepsy, when patients are not provided with proper treatment and psychosocial support.

Since June 2017, MSF has been running a program in Embu County that focuses on testing models of care for non-communicable diseases (NCDs) within existing primary health facilities. The project – run in 11 health facilities – involves MSF staff mentoring Ministry of Health (MoH) medical staff in the care and management of NCDs. Results are shared with other organisations working on NCDs to try to increase access to care for these conditions elsewhere. MSF currently focuses on hypertension, diabetes, asthma, chronic obstructive pulmonary disease (COPD) and epilepsy.

The core model of this pilot program was informed by the gaps identified in the management of NCDs in the primary healthcare facilities – from community health levels to level three in the public healthcare system – which lacked some capacity to manage patients with these conditions. Most of these patients had to be referred to higher facilities, which were often far from their homes, which meant that they had to spend a lot of time and money to reach the facilities, yet with these medical conditions they need more frequent visits to the facilities than others.

The model has shown that equipping primary health facilities, consequently bringing health services closer to patients’ home, and equipping staff with skills and supplies means more are able to easily access healthcare services, hence reducing the distance and costs linked to travel to Level 5 hospital (County Referral Hospital). This also eases the congestion at the apex hospital allowing medical teams to focus on more severe cases.

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