Abstract
BackgroundThe COVID-19 pandemic and country measures to control it can lead to negative indirect health effects. Understanding these indirect health effects is important in informing strategies to mitigate against them. This paper presents an analysis of the indirect health effects of the pandemic in Kenya.MethodsWe employed a mixed-methods approach, combining the analysis of secondary quantitative data obtained from the Kenya Health Information System database (from January 2019 to November 2020) and a qualitative inquiry involving key informant interviews (n = 12) and document reviews. Quantitative data were analysed using an interrupted time series analysis (using March 2020 as the intervention period). Thematic analysis approach was employed to analyse qualitative data.ResultsQuantitative findings show mixed findings, with statistically significant reduction in inpatient utilization, and increase in the number of sexual violence cases per OPD visit that could be attributed to COVID-19 and its mitigation measures. Key informants reported that while financing of essential health services and domestic supply chains were not affected, international supply chains, health workforce, health infrastructure, service provision, and patient access were disrupted. However, the negative effects were thought to be transient, with mitigation measures leading to a bounce back.ConclusionFinding from this study provide some insights into the effects of the pandemic and its mitigation measures in Kenya. The analysis emphasizes the value of strategies to minimize these undesired effects, and the critical role that routine health system data can play in monitoring continuity of service delivery.
Highlights
The COVID-19 pandemic and country measures to control it can lead to negative indirect health effects
The COVID-19 pandemic has spread to almost all countries and territories worldwide, infecting millions of individuals and causing many deaths [1]
There is evidence that some services were disrupted by the COVID-19 pandemic and the measures put in place by the government to contain it
Summary
The COVID-19 pandemic and country measures to control it can lead to negative indirect health effects. Understanding these indirect health effects is important in informing strategies to mitigate against them. The government of Kenya adopted several strategies to respond to the pandemic (Table 1). These include; closure of borders and a ban on international travel with an exception of cargo, closure of school/learning institutions, ban on social gatherings and meetings, a dawn to dusk curfew, closure of religious places, bars and restaurants, and observance of physical distancing (1.5 m) in spaces where people gather. While other countries imposed strict lockdowns, Kenya opted for a dawn to dusk curfew and only restricted movement in counties considered epidemic hotspots
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