The psychosocial impact of COVID-19 mitigation measures on frontline staff providing sexual health and family planning services in Kenya: a mixed-methods study.

Background: The recognition of the unintended impact of COVID-19 mitigation measures to the availability of sexual and reproductive health (SRH) services led to the initiation of mitigation and health systems support mechanisms within public health facilities by the Ministry of Health (MoH) in Kenya to maintain pre-Covid-19 levels of SRH service provision. These recovery mechanisms however concentrated on policy and infrastructural elements of service provision with limited attention given to the psychosocial impacts of COVID-19 on health care workers (HCWs). This paper examines the psychosocial impact of COVID-19 on front line family planning (FP) and sexually transmitted infections (STI) management HCWs and their coping mechanisms with a view to suggesting ways in which HCWs can be supported during future pandemics.

Methodology: This paper employs a mixed methods approach with quantitative methodology analyzing data on the preparedness of the health sector to maintain service provision levels and qualitative data examining the mental and psychosocial states of HCWs who provide FP and STI health care services within Kenyan public health facilities.

Results: Our main finding was that the psychosocial wellbeing of HCWs was majorly neglected in the government response mechanisms for the pandemic leading to burnout and depression, as well as HCWs absconding their duties in the initial stages of the pandemic, and avoidance of testing and disclosure of status as the pandemic progressed. Some of these mechanisms undermined the mitigation measures by the government and put patients and colleagues at risk of infection by HCWs whose COVID-19 status remained unknown.

Conclusions: We recommend that future responses include mechanisms that address the psychosocial wellbeing of HCWs as a core element of the response for effective management of pandemics. In the case of new and unprecedented pandemics such as COVID-19, it is important that HCWs are provided with accurate and timely information about the pandemic as well as to what is expected of their conduct in service delivery and in the promotion of a culture of risk reduction.