Maintaining care delivery for non-communicable diseases in the face of the COVID-19 pandemic in western Kenya

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has disrupted health systems worldwide, gravely threatening continuity of care for non-communicable diseases (NCDs), particularly in low-resource settings. We describe our efforts to maintain the continuity of care for patients with NCDs in rural western Kenya during the COVID-19 pandemic, using a five-component approach: 1) Protect: protect staff and patients; 2) Preserve: ensure medication availability and clinical services; 3) Promote: conduct health education and screenings for NCDs and COVID-19; 4) Process: collect process indicators and implement iterative quality improvement; and 5) Plan: plan for the future and ensure financial risk protection in the face of a potentially overwhelming health and economic catastrophe. As the pandemic continues to evolve, we must continue to pursue new avenues for improvement and expansion. We anticipate continuing to learn from the evolving local context and our global partners as we proceed with our efforts.

Understanding the treatment burden of people with chronic conditions in Kenya: A cross-sectional analysis using the Patient Experience with Treatment and Self-Management (PETS) questionnaire

“…These are areas where targeted approaches can potentially make a substantial difference to people, through for example, outreach services such as group medical visits as previously trialled in Western Kenya [45,46]. Recent efforts in the study region saw the piloting of tele-medicine services using community health workers and peer support as 'clinician-extenders' during the COVID-19 pandemic to maintain and PLOS GLOBAL PUBLIC HEALTH improve access to NCD care [47]. Such approaches provide a useful starting point for the further development of NCD programmes in the region.…”

Factors Influencing the Implementation of Remote Delivery Strategies for Non-Communicable Disease Care in Low- and Middle-Income Countries: A Narrative Review

“…Since COVID-19 poses increased risk to people living with NCDs, they have been recommended to minimize interactions with others, including with health services [ 14 , 15 ]. Thus, health care providers, including humanitarian actors, have had to adapt NCD service delivery to ensure continuity, while minimizing face-to-face patient contact [ 16 , 17 ]. Anecdotally, adaptations to reduce facility-based attendance (referred to here as “remote” care), have included use of e-health, community-based strategies, and adaptations to medicines dispensing.…”