• Kenya

• Kenya

Kenya is missing more than 54% of its 169,000 people estimated to have developed drug-sensitive TB in 2016. During the same year, nearly 89% of its 3,000 people estimated to have developed drug-resistant TB were also missed by the health system.

To find more of its missing people with TB, Kenya is taking a three-prong approach focused on improved TB case detection and diagnosis, enhanced engagement of all care providers, and improved TB care delivery. This strategy will focus on using pay-for-performance and other approaches to motivate health facility management to implement TB case finding activities (systematic TB screening) as routine standard of care for all clients seeking care in supported hospitals. Emphasis is given to pediatric clinics, HIV clinics, out-patients departments and in-patient wards.

Kenya also engages in continuous efforts to use digital chest X-ray as the main screening test for children and other key populations. To optimize the use of GeneXpert as the first TB test of all presumptive TB cases, specimen referral systems are strengthened. In another approach to intensify TB case finding in the private sector, policies and tools will be revised. Moreover, a pay-for-performance cash reimbursement will be established for private health facilities to incentivize rapid uptake of early TB case detection practices.

Kenya is also setting up a County Innovation Challenge Fund (CIC-F). This unique grant mechanism seeks to generate demand and provides two-year financial support to county-specific, innovative interventions from civil society organizations as local solutions for underserved and key population groups. The CIC-F complements the national TB response with empowering community-based organizations to set up tailored responses through active involvement of communities in identifying and addressing barriers towards reducing their local TB case detection gaps.