Kenya has been advised to ensure health systems are resilient to outbreaks and can continue offering key services in cases of eventuality.
This is after research by health experts African Institute for Development Policy (AFIDEP) found the country’s health systems have low resilience to disease shocks.
The research findings were published in the BMJ Public Health, an international, open access and peer-reviewed journal.
The team, led by Senior Research and Policy Analyst at AFIDEP Michael Give Chipeta analysed the resilience of health systems in in Kenya and Ethiopia.
The team analysed the impact of Covid-19 on maternal healthcare usage in the two countries.
They focused on subnational levels to identify healthcare disruption hotspots that require targeted interventions and help policymakers prioritise resources to accelerate progress.
The researchers used monthly Health Management Information System (HMIS) data to track changes in healthcare access at sub-national levels in Ethiopia and Kenya during the pandemic.
They compared service usage before and during the pandemic, using interrupted time series and analyses to evaluate the pandemic’s impact on healthcare usage trends.
They also performed geospatial mapping of the affected regions to identify hotspots.
They found that epidemics such as COVID-19 could undermine progress towards sustainable development goals (SDGs) on maternal and child survival.
According to the report, despite the directive that expectant mothers be allowed to leave their houses and go to health facilities to access delivery care during the COVID-19 period, they however had challenges with transportation to health facilities during the curfew.
The preventive measures imposed by the government did not only affect health service delivery but also minimised patient-healthcare workers' interaction, especially mothers, for fear of infection by Covid-19.
“Our analyses reveal that the lockdowns and fear of the disease may have reduced access to Antenatal Care (ANC) and Skilled Birth Attendance (SBA),” Chipeta says.
At the onset of the Covid-19 pandemic, the government issued a 30-day lockdown as a mitigation measure to Covid-19 transmission, accompanied by a curfew.
Initially, movement had been restricted between 7.00 p.m and 4.00 a.m. but was subsequently extended to 9.00 p.m. to 5.00 a.m.
The research found that there were significant changes in the number of women seeking antenatal services in several Kenyan counties during the pandemic, with disruptions noted in the two counties.
“Our analysis highlights the low resilience of subnational health systems to shocks, underscoring the need to strengthen healthcare systems,” the report says.
The team recommends evidence-based research which they note is essential in identifying hotspots and supporting targeted interventions to achieve the SDGs and improve maternal and child health outcomes.
The data comprised monthly subnational level data for the 47 counties in Kenya and 12 regions in Ethiopia from 2016 to 2021.
The period from March 2020 to October 2021 was operationalised as the reference Covid-19 period (20 months) and from July 2018 to February 2020 (20 months) as the pre-Covid-19 period.
The World Health Organisation advises that there should be a high priority placed on essential obstetric care during the pandemic and that care should not be interrupted or neglected, as this could result in higher morbidity and mortality.