The Effectiveness of an Integrated Rural Health Care Intervention During the COVID-19 Pandemic Response in Siaya, Kenya: A Prospective Quasi-Experimental Study

Kaseje, Neema; Oruenjo, Kennedy; Kaseje, Dan; Ranganathan, N.; Tanner, Marcel; Haines, Andy

doi:10.2139/ssrn.3798564

SSRN Journal

2021

DOI: 10.2139/ssrn.3798564

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The Effectiveness of an Integrated Rural Health Care Intervention During the COVID-19 Pandemic Response in Siaya, Kenya: A Prospective Quasi-Experimental Study

Neema Kaseje¹,

Kennedy Oruenjo²,

Dan Kaseje³

et al.

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“…Following the intervention, we demonstrated a close to eightfold reduction in COVID-19 cases compared with neighbouring counties; furthemore, we observed a reduction in diarrhoeal cases and upper respiratory tract infections not related to COVID-19 as a result of improved hand hygiene. 3 Unlike other pandemic responses where reductions in the use of essential health services including maternal health services were observed, in Siaya, the use of maternal health services was maintained during the COVID-19 response. 3 The Siaya project success links to three critical assets in Africa: 1.…”

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confidence: 94%

“…3 Unlike other pandemic responses where reductions in the use of essential health services including maternal health services were observed, in Siaya, the use of maternal health services was maintained during the COVID-19 response. 3 The Siaya project success links to three critical assets in Africa: 1. Community-based healthcare (CBHC) with community health workers (CHWs) taking the lead: CHWs link households to the health system.…”

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confidence: 94%

“…2 This view is based on our experience in Siaya, where we implemented an integrated intervention leveraging the community health strategy, youth and digital technology to maximise COVID-19 prevention and optimise the case management of patients with COVID-19 in communities and health facilities. 3 In Siaya (rural Kenya), following a baseline assessment of pandemic preparedness which revealed gaps in COVID-19 training and basic equipment including pulse oximeters, we implemented an integrated intervention that prioritised healthcare worker training in infection prevention and control measures, contact tracing, continued availability and use of essential health services, and case management of patients with COVID-19 in communities and health facilities using pulse oximeters. 3 Youth were involved in promoting digital household visits and data collection.…”

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confidence: 99%

“…3 In Siaya (rural Kenya), following a baseline assessment of pandemic preparedness which revealed gaps in COVID-19 training and basic equipment including pulse oximeters, we implemented an integrated intervention that prioritised healthcare worker training in infection prevention and control measures, contact tracing, continued availability and use of essential health services, and case management of patients with COVID-19 in communities and health facilities using pulse oximeters. 3 Youth were involved in promoting digital household visits and data collection. Following the intervention, we demonstrated a close to eightfold reduction in COVID-19 cases compared with neighbouring counties; furthemore, we observed a reduction in diarrhoeal cases and upper respiratory tract infections not related to COVID-19 as a result of improved hand hygiene.…”

mentioning

confidence: 99%

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Leveraging latent assets to strengthen the COVID-19 response and vaccine roll-out in Africa

Kaseje¹,

Oruenjo

Kaseje

et al. 2021

BMJ Glob Health

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confidence: 94%

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confidence: 99%

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Leveraging latent assets to strengthen the COVID-19 response and vaccine roll-out in Africa

Kaseje¹,

Oruenjo

Kaseje

et al. 2021

BMJ Glob Health

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“…Communities reached by this project had fewer SARS-CoV-2 infections and fewer diarrhoeal and upper respiratory tract infections than neighbouring communities where the intervention did not take place; and the use of essential health services, including maternal health services, was maintained during the intervention. 7 Future steps will aim to scale up similar but locally adapted interventions across sub-Saharan Africa with the ultimate goal of strengthening primary health-care systems.…”

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Global youth advocating for COVID-19 vaccines for all

Kaseje¹,

Walcott²

2021

The Lancet

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globally there were more than 212 million confirmed COVID-19 cases and more than 4 million deaths from COVID-19. 1 Current infections are driven by SARS-CoV-2 variants circulating in largely unvaccinated populations. [2][3][4] As of Aug 24, 2021, the global distribution of more than 5 billion COVID-19 vaccine doses reveals gross disparities in vaccine access: the EU and North America received 727 million and 547 million doses, respectively; Asia received 3 billion doses; South America received 336 million doses, while Africa received 93 million doses, translating into a vaccine coverage rate below 1%. 5 Richer countries continue to secure and hoard vaccines leaving lowincome and middle-income countries behind.Although not often highlighted, youth have had an important role in COVID-19 response efforts during the pandemic. The Global Shapers Community, a group of young changemakers spread across 450 hubs around the world, convened a group of more than 250 community members in over 60 countries who drove engagement between Fortune 500 companies, government officials, and members of multilateral entities, including WHO, involved in COVID-19 response efforts. 6 This early call to action allowed the community to formulate responses to local challenges through global best practices and insights. Furthermore, the grass-roots nature of the community allowed for prompt distribution of trusted, accurate information through a global campaign called #PreventionOverPanic. This campaign aimed to simultaneously encourage risk-mitigating activities and respond to pervasive levels of anxiety related to the pandemic. After the success of this initial effort across 70 countries, the community sought to deepen its impact by launching and supporting projects aimed at tangible outcomes globally. To date, these projects have assisted nearly 2 million beneficiaries, raised over US$500 000, and distributed over 1 million items of personal protective equipment, benefiting communities globally.Similarly, the Forum of Young Global Leaders (YGL), a community of 1400 members and alumni of 120 nationalities, leading initiatives across multiple sectors including business, technology, arts, government, and health, organised projects aiming for systems change. For example, a YGL led project in Siaya, Kenya, worked

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The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review

Kaseje,

Ranganathan,

Magadi

et al. 2024

Global Health Action

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Background Rural community health workers [CHWs] play a critical role in improving health outcomes during non-pandemic times, but evidence on their effectiveness during the COVID-19 pandemic is limited. There is a need to focus on rural CHWs and rural health systems as they have limited material and human resources rendering them more vulnerable than urban health systems to severe disruptions during pandemics. Objectives This systematic review aims to describe and appraise the current evidence on the effectiveness of rural CHWs in improving access to health services and health outcomes during the COVID-19 pandemic in low-and middle-income countries [LMICs]. Methods We searched electronic databases for articles published from 2020 to 2023 describing rural CHW interventions during the COVID-19 pandemic in LMICs. We extracted data on study characteristics, interventions, outcome measures, and main results. We conducted a narrative synthesis of key results. Results Fifteen studies from 10 countries met our inclusion criteria. Most of the studies were from Asia [10 of 15 studies]. Study designs varied and included descriptive and analytical studies. The evidence suggested that rural CHW interventions led to increased household access to health services and may be effective in improving COVID-19 and non-COVID-19 health outcomes. Overall, however, the quality of evidence was poor due to methodological limitations; 14 of 15 studies had a high risk of bias. Conclusion Rural CHWs may have improved access to health services and health outcomes during the COVID-19 pandemic in LMICs but more rigorous studies are needed during future pandemics to evaluate their effectiveness in improving health outcomes in different settings and to assess appropriate support required to ensure their impact at scale.

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The Effectiveness of an Integrated Rural Health Care Intervention During the COVID-19 Pandemic Response in Siaya, Kenya: A Prospective Quasi-Experimental Study

Cited by 3 publications

References 21 publications

Leveraging latent assets to strengthen the COVID-19 response and vaccine roll-out in Africa

Leveraging latent assets to strengthen the COVID-19 response and vaccine roll-out in Africa

Global youth advocating for COVID-19 vaccines for all

The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review

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