Abstract

We examined the impact of coronavirus disease (COVID) mitigation, supply and distribution interruptions on the delivery of long-lasting insecticide-treated nets (LLINs) in Western Kenya. The median monthly distribution of LLINs declined during COVID mitigation strategies (March–July 2020) and during the health worker strikes (December 2020–February 2021). Recovery periods followed initial declines, indicative of a ‘catching up’ on missed routine distribution. Mass community campaigns were delayed by 10 months. These observations offer encouragement for routine net distribution resilience, but complete interruptions of planned mass distributions require alternate strategies during pandemics.

Highlights

  • Sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in 2019 and has impacted health, livelihoods and access to basic services globally

  • Restrictions were relaxed between August and November 2020.2 A second major lockdown was announced on 26 March 2021, following a third wave of increasing coronavirus disease (COVID)-19 test-positivity, reinstating earlier restrictions and the lockdown of travel into and out of Nairobi and four neighbouring counties

  • We examined the impact of health system interruptions on the delivery of long-lasting insecticide-treated nets (LLINs) between March 2019 and March 2021 using temporally and spatially assembled routine health information system data from 62 subcounties that cover eight counties surrounding Lake Victoria in Kenya (Homa Bay, Kisumu, Migori, Vihiga, Siaya, Bungoma, Busia and Kakamega)

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Summary

Introduction

Sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in 2019 and has impacted health, livelihoods and access to basic services globally. Beyond the direct consequences of coronavirus disease 2019 (COVID-19) infection, interruptions in the routine delivery of health services in low- and middle-income countries is predicted to have a large indirect impact on population health.[1]. National COVID-19 mitigation protocols were announced between 22 March and 19 April 2020 that included curfews; mandated wearing of facemasks; closure of schools, higher education institutions, bars, restaurants and places of worship; and bans on international travel and transport (Figure 1A). Between 6 May and 7 June 2020, the capital city of Nairobi and the seaport of Mombasa were placed under lockdown, preventing movement in and out of these urban centres.[2] Restrictions were relaxed between August and November 2020.2 A second major lockdown was announced on 26 March 2021, following a third wave of increasing COVID-19 test-positivity, reinstating earlier restrictions and the lockdown of travel into and out of Nairobi and four neighbouring counties. Health workers returned to their jobs by mid-February 2021

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