Evidence map›Paper›PMID 30482677›Full record

SynthesisThe Lancet. Global health2019

Health disparities across the counties of Kenya and implications for policy makers, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Tom Achoki, Molly K Miller-Petrie, Scott D Glenn, Nikhila Kalra, Abaleng Lesego, Gladwell K Gathecha, Uzma Alam, Helen W Kiarie, Isabella Wanjiku Maina, Ifedayo M O Adetifa and 20 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors.

Tom AchokiSloan Management, Massachusetts Institute of Technology, Cambridge, MA, USA; Center for Pharmaceutical Policy and Regulation, Utrecht University, Utrecht, Netherlands.
Molly K Miller-PetrieInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Scott D GlennInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Nikhila KalraInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Abaleng LesegoStrategic Information and Learning, University of Research Company, Gaborone, Botswana.
Gladwell K GathechaMinistry of Health, Nairobi, Kenya.
Uzma AlamInternational Center for Humanitarian Affairs, Nairobi, Kenya.
Helen W KiarieMinistry of Health, Nairobi, Kenya.
Isabella Wanjiku MainaPolicy, Planning, and Healthcare Financing Department, Nairobi, Kenya; Institute of Tropical Medicine, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Ifedayo M O AdetifaDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Epidemiology and Demography Department, Kilifi, Kenya.
Hellen C BarsosioMalaria Branch, Kilifi, Kenya; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Tizta Tilahun DegfiePopulation Dynamics and Reproductive Health Unit, Nairobi, Kenya.
Peter Njenga KeiyoroODeL Campus, University of Nairobi, Nairobi, Kenya.
Daniel N KiirithioSynotech Consultants, Nairobi, Kenya.
Yohannes KinfuFaculty of Health, University of Canberra, Canberra, ACT, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic, Australia.
Damaris K KinyokiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
James M KisiaEast Africa Center, Humanitarian Leadership Academy, Nairobi, Kenya.
Varsha Sarah KrishInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Abraham K LagatDepartment of Health Systems and Research Ethics, KEMRI-Wellcome Research Programme, Nairobi, Kenya.
Meghan D MooneyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Wilkister Nyaora MoturiDepartment of Environmental Science, Egerton University, Egerton, Kenya.
Charles Richard James NewtonKenya Medical Research Institute (KEMRI)-Wellcome Trust Collaborative Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK.
Josephine W NgunjiriDepartment of Biological Sciences, University of Embu, Embu, Kenya.
Molly R NixonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
David O SotiEastern Africa Regional Collaborating Centre, African Centre for Disease Control and Prevention, Nairobi, Kenya.
Steven Van De VijverAfrican Population Health Research Centre, Nairobi, Kenya.
Gerald YongaSchool of Medicine, University of Nairobi, Nairobi, Kenya.
Simon I HayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Christopher J L MurrayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Mohsen NaghaviInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA. Electronic address: nagham@uw.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provided comprehensive estimates of health loss globally. Decision makers in Kenya can use GBD subnational data to target health interventions and address county-level variation in the burden of disease.

methodsWe used GBD 2016 estimates of life expectancy at birth, healthy life expectancy, all-cause and cause-specific mortality, years of life lost, years lived with disability, disability-adjusted life-years, and risk factors to analyse health by age and sex at the national and county levels in Kenya from 1990 to 2016.

findingsThe national all-cause mortality rate decreased from 850·3 (95% uncertainty interval [UI] 829·8-871·1) deaths per 100 000 in 1990 to 579·0 (562·1-596·0) deaths per 100 000 in 2016. Under-5 mortality declined from 95·4 (95% UI 90·1-101·3) deaths per 1000 livebirths in 1990 to 43·4 (36·9-51·2) deaths per 1000 livebirths in 2016, and maternal mortality fell from 315·7 (242·9-399·4) deaths per 100 000 in 1990 to 257·6 (195·1-335·3) deaths per 100 000 in 2016, with steeper declines after 2006 and heterogeneously across counties. Life expectancy at birth increased by 5·4 (95% UI 3·7-7·2) years, with higher gains in females than males in all but ten counties. Unsafe water, sanitation, and handwashing, unsafe sex, and malnutrition were the leading national risk factors in 2016.

interpretationHealth outcomes have improved in Kenya since 2006. The burden of communicable diseases decreased but continues to predominate the total disease burden in 2016, whereas the non-communicable disease burden increased. Health gains varied strikingly across counties, indicating targeted approaches for health policy are necessary.

fundingBill & Melinda Gates Foundation.

Indexed as

Administrative PersonnelHealth PolicyHealth Status DisparitiesGlobal Burden of DiseaseHumansKenya

Identifiers

PMID30482677
PMCPMC6293072

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.