Community Health Access Program (CHAP) & Bristol Myers Squibb Foundation

Need

Isiolo and Tharaka Nithi are two of 47 counties in Kenya that transverse the arid and semi-arid regions of Eastern Kenya with an estimated population of 143, 294 and 365,330 respectively (Census 2009). The inhabitants belong to Borana, Meru, Turkana, Samburu, Pokot, Tharaka and Somali ethnic groups that are predominantly pastoralists. They live in remote and difficult environments with limited access to health services. Accessibility is hampered by poor infrastructure, insecurity (cattle rustling and competition for water and pasture), fights among the inhabitants with neighboring counties, and the counties’ geographical proximity to Somalia and Ethiopia. Marginalization of the communities has resulted in high poverty levels coupled with limited access to health care services.

In Isiolo, 39.7% of women between the ages of 15-49 have had no formal education compared to men in the same age group reported at 11.4%. Early marriages and female genital mutilation are widely practiced. Isiolo County has 1 referral hospital and 27 health facilities with a doctor population ratio of 1:143,000 compared to the national average of 1:10,000. Kenya is experiencing an increase in non-communicable diseases (NCD and cancer accounts for 7% of the overall national mortality and is considered the second leading cause of NCD related deaths in Kenya (WHO–NCD 2014). Among Kenyan women, breast, cervical and esophageal cancers are most common. Data indicates that breast cancer occurs in 34 women per 100,000 population while cervical cancer is reported at 25 cases per 100,000. Up to 40% of global cancers are preventable through interventions that modify associated risk factors. Currently there are no cervical cancer interventions that address screening and treatment in Tharaka Nithi. Community based cervical cancer interventions have not been established in the proposed project area.