Not quite yet: Stakeholder perspectives on health economic evidence use in Non- Communicable Disease priority setting in Kenya

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Abstract
Background Reversing the rising trend in the burden of non-communicable diseases (NCDs) in Kenya requires the implementation and scaleup of prevention and control interventions. Health economics can help to inform priority setting processes by comparing the costs and outcomes from alternative interventions. However, there is limited research regarding the role played by health economic evidence in NCD priority setting in Kenya. This study explored the perspectives of Kenyan stakeholders regarding the use of, and barriers affecting the uptake of health economic evidence in NCD priority setting in Kenya. Methods We conducted sixteen comprehensive interviews with Kenyan stakeholders engaged in NCD policy, management and research. The study participants comprised officials from the Ministry of Health at national and county levels, representatives from civil society organisations, the private sector, health economists, and researchers. We applied an inductive thematic approach in coding and data analysis. Results The study found a limited and inconsistent uptake of health economic evidence for informing NCD decision making, which was described as fragmented, ad hoc, and peripheral. Investment cases and cost analyses were the most commonly applied forms of economic evidence. Key barriers to increased uptake included the low prioritisation of health economic evidence within decision-making processes, misalignment between health economic research outputs and policy priorities, and limited capacity to conduct and interpret economic analyses. The scarcity of locally relevant, high-quality economic data also emerged as a major impediment to the reliability and credibility of health economic evidence. Conclusion Despite growing recognition of its value, health economic evidence remains inconsistently integrated into NCD decision-making in Kenya. Addressing gaps in prioritisation, capacity, data availability, and alignment between research and policy needs may strengthen the systematic and sustained use of health economic evidence to support effective NCD policy and resource allocation. Analysts should involve the relevant stakeholders while designing and generating health economic evidence to improve uptake.

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