The COVID-19 pandemic and disruptions to essential health services in Kenya : a retrospective time-series analysis
Auteurs & affiliatie
H Kiarie, Marleen Temmerman, M Nyamai, N Liku, W Thuo, V Oramisi, L Nyaga, J Karimi, P Wamalwa, G Gatheca, V Mwenda, LA Ombajo, SM Thumbi, group Essential Health Services Data Monitoring and Evaluation sub-working
Abstract
Background: Public health emergencies can disrupt the provision of and access to essential health-care services, exacerbating health crises. We aimed to assess the effect of the COVID-19 pandemic on essential health-care services in Kenya. Methods: Using county-level data routinely collected from the health information system from health facilities across the country, we used a robust mixed-effect model to examine changes in 17 indicators of essential health services across four periods: the pre-pandemic period (from January, 2018 to February, 2020), two pandemic periods (from March to November 2020, and February to October, 2021), and the period during the COVID-19-associated health-care workers' strike (from December, 2020 to January, 2021). Findings: In the pre-pandemic period, we observed a positive trend for multiple indicators. The onset of the pandemic was associated with statistically significant decreases in multiple indicators, including outpatient visits (28·7%; 95% CI 16·0-43·5%), cervical cancer screening (49·8%; 20·6-57·9%), number of HIV tests conducted (45·3%; 23·9-63·0%), patients tested for malaria (31·9%; 16·7-46·7%), number of notified tuberculosis cases (26·6%; 14·7-45·1%), hypertension cases (10·4%; 6·0-39·4%), vitamin A supplements (8·7%; 7·9-10·5%), and three doses of the diphtheria, tetanus toxoid, and pertussis vaccine administered (0·9%; 0·5-1·3%). Pneumonia cases reduced by 50·6% (31·3-67·3%), diarrhoea by 39·7% (24·8-62·7%), and children attending welfare clinics by 39·6% (23·5-47·1%). Cases of sexual violence increased by 8·0% (4·3-25·0%). Skilled deliveries, antenatal care, people with HIV infection newly started on antiretroviral therapy, confirmed cases of malaria, and diabetes cases detected were not significantly affected negatively. Although most of the health indicators began to recover during the pandemic, the health-care workers' strike resulted in nearly all indicators falling to numbers lower than those observed at the onset or during the pre-strike pandemic period. Interpretation: The COVID-19 pandemic and the associated health-care workers' strike in Kenya have been associated with a substantial disruption of essential health services, with the use of outpatient visits, screening and diagnostic services, and child immunisation adversely affected. Efforts to maintain the provision of these essential health services during a health-care crisis should target the susceptible services to prevent the exacerbation of associated disease burdens during such health crises. Funding: Bill & Melinda Gates Foundation.
Publicatiedatum:
2022
Teamleden:
Link naar publicatie
Bijlages
The COVID-19 pandemic and disruptions to essential health services in Kenya.pdf (open)Gerelateerde publicaties
Olivier Degomme, Emilie Peeters, Hedwig Deconinck, Alban Ylli, Albana Fico, Gentiana Qirjako, Dorina Ttocaj, Sara De Meyer, Kristien Michielsen, Anna Page, Wina Baeha, Kristi Praptiwi, Miranda van Reeuwijk, Beatriz Manuel, Elin C. Larsson, Carmen Ortiz, Bernardo Vega, Monserrath Jerves, Simukai Shamu, Annemiek Seeuws, Anna Galle, Anne Nobels, Ines Keygnaert, Hazel Barrett, Nina Van Eekert, Tammary Esho, Els Leye, Carles Pericas Escale, Samuel Thuo Kimani, Sofie Thielemans, Dara De Schutter, Remi Moerkerke, Louis De Backer, Viola N. Nyakato, Elizabeth Kemigisha, Wei Hong Zhang, Marleen Temmerman, Lina Hu, Shangchun Wu, Kaiyan Pei, Charlotte Neves de Oliveira, Argyro Chatzinikolaou, Eva Lievens
2022 Barriers and facilitators to cervical cancer screening among under- and neverscreened women in Belgium : a qualitative study on community and healthcare providers’ perspectiveBo Verberckmoes, Elien De Paepe, Janne De Vestele, Heleen Vermandere, Ines Keygnaert, Olivier Degomme
2022 Inhoudelijk eindrapport Opleiding seksueel geweld voor de Family Justice Centers & Ketenaanpak Intrafamiliaal GeweldSaar Baert, Lisa Fomenko, Nele Vaerewijck, Lotte De Schrijver, An-Sofie Van Parys, Ines Keygnaert