Kenya National Cancer Control Programme (NCCP) FHIR Implementation Guide, published by Digital Health Agency (DHA), Kenya. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/nccpFHIRIG/ and changes regularly. See the Directory of published versions

Background

Background

Kenya's Cancer Burden

Cancer is a leading cause of morbidity and mortality in Kenya. The Kenya National Cancer Registry estimates over 47,000 new cancer cases annually, with breast, cervical, prostate, oesophageal, and colorectal cancers among the most prevalent. Childhood cancers — including Burkitt lymphoma and Wilms tumour — present a significant burden unique to the Kenyan context.

Kenya's cancer mortality rate is high, partly due to late-stage diagnosis and limited access to comprehensive cancer care outside major referral centres such as Kenyatta National Hospital (KNH), Moi Teaching and Referral Hospital (MTRH), and a growing network of county hospitals.

The National Cancer Control Programme (NCCP)

The National Cancer Control Programme (NCCP) is Kenya's coordinated government framework for reducing the cancer burden through:

• Primary prevention — tobacco control, HPV vaccination, cancer risk reduction campaigns
• Early detection and screening — cervical, breast, and colorectal cancer screening programmes
• Diagnosis and staging — strengthening pathology, imaging, and molecular diagnostics
• Treatment — expanding access to surgery, chemotherapy, radiotherapy, and palliative care
• Palliative care — pain management and end-of-life support
• Surveillance and research — population-based cancer registries and clinical data collection

The NCCP operates under the Division of Non-Communicable Diseases (DNCD) within the Ministry of Health, in collaboration with county health departments, national referral hospitals, and development partners.

Digital Health Agency (DHA) Role

The Digital Health Agency (DHA), established under the Kenya Health Policy 2014–2030 and the Kenya Digital Health Act, is the statutory body responsible for coordinating digital health infrastructure in Kenya. DHA's mandate includes:

• Developing and maintaining national health information systems
• Setting interoperability standards for health data exchange
• Managing the Kenya Health Information System (KHIS/DHIS2)
• Publishing and maintaining national FHIR Implementation Guides
• Operating the Kenya National Health Terminology Service (KNHTS)

This NCCP FHIR IG is one of a suite of DHA-published IGs that together form the Kenya National Health Information Interoperability Framework (NHIIF).

Policy and Legislative Context

Social Health Authority (SHA) Integration

The Social Health Authority (SHA) replaced the National Health Insurance Fund (NHIF) as Kenya's universal health coverage insurer under the Social Health Insurance Act of 2023. Cancer treatment is a high-cost SHA benefit package. This IG includes claim and eligibility profiles aligned with SHA's cancer package benefit structure to enable:

• Electronic pre-authorisation for chemotherapy regimens and radiotherapy courses
• Structured itemised claims submission for oncology services
• Real-time eligibility verification before treatment initiation

Relationship to International Standards

This IG aligns with and references the following international standards:

• HL7 FHIR R4 — Base specification for all profiles
• mCODE (Minimal Common Oncology Data Elements) — Conceptual alignment for oncology data elements
• SNOMED CT — Clinical terminology for diagnoses, procedures, and body sites
• LOINC — Laboratory observation codes for staging and biomarker results
• ICD-O-3 — International Classification of Diseases for Oncology, 3rd Edition (morphology)
• ICD-10 — WHO International Classification of Diseases (diagnosis codes)
• CTCAE v5.0 — Common Terminology Criteria for Adverse Events (toxicity grading)

IG	Package	FHIR	Comment
Kenya National Cancer Control Programme (NCCP) FHIR Implementation Guide	fhir.ke.nccp#0.1.0	R4
HL7 Terminology (THO)	hl7.terminology.r4#7.1.0	R4	Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack	hl7.fhir.uv.extensions.r4#5.3.0	R4	Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
FHIR Tooling Extensions IG	hl7.fhir.uv.tools.r4#1.1.2	R4	for example references

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (fhir.ke.nccp.r4) and R4B (fhir.ke.nccp.r4b) are available.