Assessing the Effect of the COVID-19 Pandemic on Community Health Services: A Pre-post Analysis.

Abstract

Following COVID-19 containment measures, healthcare service utilization was expected to decline, including in Kenya, across all healthcare tiers. We investigated the impact on community-level health indicators before and during the pandemic. This pre-post study examined community health utilization in 2019 (pre-pandemic) and 2020 (pandemic year) from March to December. Normality was assessed using the Shapiro-Wilk test, followed by Mann-Whitney U or Welch t-tests as appropriate. During the pandemic, facility deliveries (159.2 ± 39.0 vs 496.4 ± 288.2; +237.96%, P = .0232) and ANC referrals (191.0 ± 55.3 vs 630.1 ± 287.2; +229.89%, P = .0008) increased significantly. Child immunization referrals also rose (57.3 ± 11.7 vs 350.2 ± 259.3; +511.17%, P = .0060), while diarrhea treatments in children declined (59.2 ± 47.6 vs 9.2 ± 6.7; -84.46%, P = .0001). Diabetes referrals increased (108.7 ± 65.3 vs 319.5 ± 310.2; +211.15%, P = .035). Households with handwashing facilities saw a non-significant rise (78073.7 ± 16367.9 vs 118457.9 ± 90291.8; +51.73%, P = .3527). Community-level prevention and promotion programs persisted and were enhanced, due to increased fiscal and training support. Even amid crises, community health strategies can adapt and thrive with proper training and funding.