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

Autor: Helen Kiarie, Marleen Temmerman, Mutono Nyamai, Nzisa Liku, Wangari Thuo, Violet Oramisi, Lilly Nyaga, Janette Karimi, Phidelis Wamalwa, Gladwell Gatheca, Valerian Mwenda, Loice Achieng Ombajo, S M Thumbi, Leonard Cosmas, James Kiarie, Khaing Soe, Oliver Munyao, Zipporah Gathiti, Lucy Maina, Adano Godana, Rose Muthee, Brian Onyango, Chirchir Langat, Claudine Wangari, Christine Sadia, Joyce Onyango, Davies Kimanga, Mary Nyangasi, David Otieno, Peter Kamau, Samuel Cheburet, Sergon Kibet, Shikoh Gitau
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Kiarie, H, Temmerman, M, Nyamai, M, Liku, N, Thuo, W, Oramisi, V, Nyaga, L, Karimi, J, Wamalwa, P, Gatheca, G, Mwenda, V & Ombajo, L A & Thumbi, S M 2022, ' The COVID-19 pandemic and disruptions to essential health services in Kenya : A retrospective time-series analysis ', The Lancet Global Health, vol. 10, no. 9, pp. e1257-e1267 . https://doi.org/10.1016/S2214-109X(22)00285-6
LANCET GLOBAL HEALTH
ISSN: 2214-109X
DOI: 10.1016/S2214-109X(22)00285-6
Popis: 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 servicesin Kenya.Methods Using county-level data routinely collected from the health information system from health facilities acrossthe country, we used a robust mixed-effect model to examine changes in 17 indicators of essential health servicesacross four periods: the pre-pandemic period (from January, 2018 to February, 2020), two pandemic periods (fromMarch to November 2020, and February to October, 2021), and the period during the COVID-19-associated health-careworkers’ strike (from December, 2020 to January, 2021).Findings In the pre-pandemic period, we observed a positive trend for multiple indicators. The onset of thepandemic was associated with statistically significant decreases in multiple indicators, including outpatientvisits (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%), andthree doses of the diphtheria, tetanus toxoid, and pertussis vaccine administered (0·9%; 0·5–1·3%). Pneumoniacases reduced by 50·6% (31·3–67·3%), diarrhoea by 39·7% (24·8–62·7%), and children attending welfare clinics by39·6% (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 casesdetected were not significantly affected negatively. Although most of the health indicators began to recover duringthe pandemic, the health-care workers’ strike resulted in nearly all indicators falling to numbers lower than thoseobserved 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 associatedwith a substantial disruption of essential health services, with the use of outpatient visits, screening and diagnosticservices, and child immunisation adversely affected. Efforts to maintain the provision of these essential healthservices during a health-care crisis should target the susceptible services to prevent the exacerbation of associateddisease burdens during such health crises.
Databáze: OpenAIRE
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