By Clifford Akumu

The Kenyan Government has been advised to ensure health systems are disease outbreak-resilient and to future-proof them against poor service delivery likely to dent maternal and child health outcomes.

This is according to a newly published research report by experts from the African Institute for Development Policy (AFIDEP) in the BMJ Public Health, an international, open access and peer-reviewed journal, titled Assessing the impact of COVID-19 pandemic on maternal healthcare usage: evidence from routine health data in Kenya and Ethiopia.

The team, led by Michael Give Chipeta, Senior Research and Policy Analyst at the AFIDEP says that such epidemics as COVID-19 could undermine progress towards sustainable development goals (SDGs) on maternal and child survival.

At the height of COVID-19, for example, Kenya imposed strict curfews and lockdown rules to prevent the spread of the disease. The Government banned international flights, closed schools, and banned large social gatherings including mass prayer meetings, public rallies and large weddings and funerals.

In addition to this, the Government issued a 30-day lockdown as a mitigation measure to COVID-19 transmission. This was accompanied by a curfew that initially restricted movement between 7.00 p.m. and 4.00 a.m. but was subsequently extended to between 9.00 p.m. and 5.00 a.m.

Despite the directive that expectant mothers be allowed to leave their houses and go to health facilities to access delivery care during emergencies, they had challenges with transportation to health facilities during the curfew and thus, the preventive measures imposed by the government did not only affect health service delivery but also minimized patient-healthcare worker 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),” said Michael.

He said the team analyzed COVID-19’s impact on maternal healthcare usage in the two countries, focusing on sub-national levels to identify healthcare disruption hotspots that require targeted interventions and help policymakers prioritize 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 then 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.

The results showed significant changes at sub-national levels. ANC declined in several Kenyan counties during the pandemic, with disruptions noted in the two counties.

“Our analysis highlights the low resilience of sub-national health systems to shocks, underscoring the need to strengthen healthcare systems,” said researchers.

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 Novel Coronavirus disease, commonly referred to as COVID-19, was declared a public health emergency of international concern by the World Health Organization (WHO) on 30th January 2020 and declared a global pandemic on the 11th March of the same year. However, due to reduced rates of infection and deaths globally, the disease is no longer a public health emergency of international concern.

Other team members included Maame Brayie Peterson, Ruth Vellemu, Sahra Mohamed, Themba Mzembe, Chimwemwe Chifungo and Prof Nyovani Janet Madise who also is the head of the Malawi office of the AFIDEP.