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The COVID-19 pandemic and disruptions to essential health services in Kenya: a retrospective time-series analysis. | LitMetric

The COVID-19 pandemic and disruptions to essential health services in Kenya: a retrospective time-series analysis.

Lancet Glob Health

Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA; Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK. Electronic address:

Published: September 2022

AI Article Synopsis

  • The study examines the impact of the COVID-19 pandemic on essential healthcare services in Kenya, using data from health facilities over various time periods before and during the pandemic.
  • Results show significant declines in multiple health indicators during the pandemic, notably outpatient visits, cancer screenings, HIV tests, and childhood vaccinations, while some areas, like skilled deliveries and diabetes detection, remained stable.
  • Despite a partial recovery in health indicators during the pandemic, a health-care workers' strike further disrupted services, indicating ongoing challenges in accessing essential healthcare.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363041PMC
http://dx.doi.org/10.1016/S2214-109X(22)00285-6DOI Listing

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