Monday, 01 June 2020 07:03

PROVISION OF ESSENTIAL SERVICES DURING COVID-19

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By the end of 26th May 2020, Kenya had recorded 1,348 cases of COVID-19 since the first case was reported in March 2020. Fifty-three people had succumbed to the disease. The Kenyan government led by the President has put in place containment measures related to mobility, physical distancing, targeted mass testing, quarantine and isolation centres among other initiatives. Counties have invested extensively in implementing these measures including re-focusing resources to strengthen the healthcare system to respond to the COVID-19 pandemic.
The COVID-19 transmission mitigation measures e.g. curfew and travel restrictions may ultimately place vulnerable people seeking health care services at greater risk. Analysis of the 2014-2015 Ebola outbreak suggests that the increased number of deaths caused by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures, exceeded deaths from Ebola. Special groups such as pregnant women, children and people living with disabilities, people with chronic illnesses and older people may experience an increased interruption of care caused by COVID-19, leading to high morbidity and mortality in the Country.

Essential services include, but are not limited to:
• Emergency outpatient care- management of injuries
• Critical inpatient services including for emergency surgical procedures
• Emergency surgeries, eye and dental procedures
• Antenatal, Maternity, contraception and postnatal services
• Nutrition -Management of acute malnutrition among children under five and pregnant and lactating women.
• Vaccines and Immunization services
• Child health services including growth monitoring, follow-up for chronic condition and treatment of illnesses commonly affecting children such as malaria
• Monitoring, Provision of medication for chronic non-communicable diseases such as Diabetes, Hypertension and mental health conditions
• Cancer treatment, renal dialysis
• Auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services

County governments have put in places several measures to ensure uninterrupted provision of essential health services. Some of these are highlighted below:

Infection Control and Prevention Measures
• Hand washing points in all health facilities
• Use of sanitizers
• Consistent use of face masks
• Keeping safe distance (at least 2M) in all health care settings
• Reducing visitors to hospitals
• Frequent cleaning and disinfection of surfaces, equipment and floors at health facilities
• Safe disposal of wastes at the health facilities is done. Medical waste is disinfected then incinerated

Reproductive, Maternal, Newborn and Child Health (RMNCH)
• All persons are screened for COVID-19 symptoms (fever, cough, shortness of breath) including temperature check at the entrance to the health facility
• Antenatal Care (ANC) services are offered uninterrupted
• All patients wear masks
• Baseline investigations for co-morbidities are done
• Patient education on both pregnancy and COVID-19 is done
• All clients are evaluated for extended prescriptions where applicable
• Public education on Gender Based Violence (GBV), communication of hotlines for GBV and services for GBV are prioritized
• All children with respiratory tract symptoms are kept at least six feet away from other children
• Children with in-drawing pneumonia are prioritized for COVID-19 testing
• Health workers with respiratory tract illness (regardless of COVID-19 status) are exempted from duties in Newborn Units
• Infants and caregivers coming for immunization services are triaged for possible exposure and appropriately directed to a point of care
• Community Health Workers are deployed to mobilize caregivers to continue seeking immunization services

Nutrition Services
• Caregivers of children who are above one (1) year are encouraged to continue monitoring their children’s’ weight and should they notice that their children are losing weight or adding no weight at all, should visit the nearest health facility for checkup
• Routine screening for malnutrition is continuing at Out Patient Departments (OPD) with strict adherence to Infection Prevention and Control (IPC) procedures and protocols
• Rations per beneficiary are organized ahead of the scheduled distribution
• Extend the number of days are given for Out-patient Therapeutic Care (OTP) services, depending on the usual number of clients and capacity of the health facility (space, available human resource etc.), with an objective of ensuring no contact between clients and crowding at OTP sites
• 4-week OTP rations are provided for children with Severe Acute Malnutrition, and CHVs are assigned for home follow-up

Chronic Illnesses e.g. hypertension, diabetes, HIV
• Continued screening for chronic illnesses is done at health facilities
• Tele-health is done where applicable
• Multi-month drug dispensing when possible
• Models have been adopted that assist service delivery e.g. follow up of clients through mobile phone such as m-shwari
• All patients being evaluated for respiratory illnesses such as Pneumonia, Asthma, COPD, Tuberculosis are also evaluated for COVID-19
• Clients at risk of poor compliance and complications of chronic diseases are enabled to access medication, accompanied by constant follow-ups

Mental Health
• There may be a lot of clients seeking mental health services, in light of the COVID-19 pandemic. There is currently access to telephone counseling through the 719/1190 contact for the general public as well as health workers who are affected by the pandemic. These services are linked to county facilities where emergency psychiatric services are available to clients
• Multi-month dispensing for psychiatric patients where possible

County Governments continue to put more effort in the fight against COVID 19 by refocusing resources and mobilizing more resources from development partners and well-wishers in the Counties. These efforts are meant to ensure that the health system is not overwhelmed by the pandemic. County Governments also continue to encourage residents not to shy from seeking the much required health services for fear of contracting COVID 19 as proper measures have been put in place in all health centres and health workers skilled through training with the necessary skills to deal with the pandemic.

Read 1320 times Last modified on Monday, 01 June 2020 08:01

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