Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic

Abstract

Background Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results Kenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return. Conclusion Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

“…In total, 25 articles were eligible for meta-analysis. Among them, 10 articles assessed the cost-effectiveness of NPIs against COVID-19 [ 14 , 28 - 36 ]. 37 NPIs were included with varying epidemic scenarios.…”

“…A sensitivity analysis was performed by omitting one intervention (Appendix S6, Figure S3 in the Online Supplementary Document ). The pooled INBs were all above 0 and the lowest and highest INBp was observed when the interventions of Adequate PPE utilization [ 36 ] and the combined intervention of health care testing and contact tracing [ 14 ] were excluded. The fail-safe number was 37, indicating that 37 negative studies or interventions might change the current results.…”

Examining the governance arrangements for healthcare worker COVID-19 protection in Kenya: A Scoping Review

“…Chronic underinvestment (70) and inefficiencies (71) in the health sector also meant that the system was less well-prepared to respond to increased demands for HCW protection. This is despite recent assessments showing the value of an investment in HCW protection through measures such as PPE (63).…”

COVID-19 Pandemisi Sırasında Birinci Basamakta Filyasyon Ekiplerinde Çalışanların Deneyimleri

“…Türkiye'de yapılan başka bir çalışmada da, tulum, koruyucu önlük ve N95 maske temininde problem yaşandığı saptanmıştır (Gürer & Gemlik, 2020). Kenya'da yapılan çalışmada, kişisel koruyucu ekipmana yapılan yatırımın sağlık çalışanlarının ölümünü ve COVID-19 vakalarını önleyeceği, sağlık hizmetlerine maddi olarak katkı yapacağı bulunmuştur (Kazungu et al, 2021). Pandeminin ilk zamanlarında sahada görev yapan tüm çalışanlar tulum, N95 maske, gözlük, siperlik gibi kişisel koruyucu ekipmanların tümünü kullanmak istemiş olabilir.…”

“…Ayrıca sahada salgınla mücadele eden ekibe oryantasyon eğitimi, planlı hizmet içi eğitimlerin yapılması, standart bakım planları oluşturulması önemlidir. Bu öneriler literatürdeki çalışmalarda da belirtilmiştir (Liu et al, 2020;Saatçı, 2020;Kazungu et al, 2021;Paksoy & Kotan, 2022).…”