Juttla Prabhjot Kaur, Kimani Bernard, Kamita Moses, Kariuki Teresia, Wachira Naomi, Odongo Alfred Owino, Mwancha-Kwasa Magoma
School of Medicine, Faculty of Health Sciences, University of Nairobi, Nairobi County, Kenya.
Department of Health, County Government of Kiambu, Kiambu County, Kenya.
Inquiry. 2025 Jan-Dec;62:469580251338681. doi: 10.1177/00469580251338681. Epub 2025 May 26.
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 or Welch -tests as appropriate. During the pandemic, facility deliveries (159.2 ± 39.0 vs 496.4 ± 288.2; +237.96%, = .0232) and ANC referrals (191.0 ± 55.3 vs 630.1 ± 287.2; +229.89%, = .0008) increased significantly. Child immunization referrals also rose (57.3 ± 11.7 vs 350.2 ± 259.3; +511.17%, = .0060), while diarrhea treatments in children declined (59.2 ± 47.6 vs 9.2 ± 6.7; -84.46%, = .0001). Diabetes referrals increased (108.7 ± 65.3 vs 319.5 ± 310.2; +211.15%, = .035). Households with handwashing facilities saw a non-significant rise (78073.7 ± 16367.9 vs 118457.9 ± 90291.8; +51.73%, = .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.
在实施新冠疫情防控措施之后，预计包括肯尼亚在内的所有医疗层级的医疗服务利用率都会下降。我们调查了疫情之前和期间对社区层面健康指标的影响。这项前后对照研究考察了2019年（疫情前）和2020年（疫情年）3月至12月期间的社区医疗服务利用率。使用夏皮罗-威尔克检验评估数据正态性，随后根据情况进行曼-惠特尼检验或韦尔奇检验。在疫情期间，机构分娩（159.2±39.0对496.4±288.2；增长237.96%，P = 0.0232）和产前保健转诊（191.0±55.3对630.1±287.2；增长229.89%，P = 0.0008）显著增加。儿童免疫转诊也有所上升（57.3±11.7对350.2±259.3；增长511.17%，P = 0.0060），而儿童腹泻治疗有所下降（59.2±47.6对9.2±6.7；下降84.46%，P = 0.0001）。糖尿病转诊增加（108.7±65.3对 319.5±310.2；增长211.15%，P = 0.035）。拥有洗手设施的家庭数量有不显著的增加（78073.7±16367.9对118457.9±90291.8；增长51.73%，P = 0.3527）。由于财政和培训支持增加，社区层面的预防和促进项目得以持续并得到加强。即使在危机期间，通过适当的培训和资金投入，社区卫生战略也能够进行调整并蓬勃发展。
