The coronavirus disease 2019 (COVID-19) has spread across the world negatively affecting the world’s population and their livelihoods. It has infected millions and caused devastating effects on the economies of the world. It has caused excess traffic in the healthcare systems worldwide and impacted the social systems. Since the announcement of the first case in Kenya, on 13th March 2021, it has spread rapidly infecting thousands of people and causing many casualties. The virus has infected more than 150,000 people and killed more than 2500 people. The spread of the virus and the measurements taken by the government to protect its people has caused significant changes in both health care and social systems.
After the detection of the first case of coronavirus in Kenya, the government instituted measures and strategies to prevent its spread and the adverse effects of the virus. Some of the measures included, closure of borders and a ban on international travel, closure of schools and learning institution, prohibition of public gatherings, curfews, closure of worship places, social entertainment joints, and institution of public health measures that include social distancing (1.5 meters) and wearing of masks (Barasa et al., 2021). Overall, the Africans are known to be social people who value the importance of communal living. Any interruption in their social norms comes with significant effects and strain, disrupting social cohesion and togetherness.
While the Kenyan economy has experienced a fair share of the strain due to the effects of the pandemic, the healthcare systems have also been threatened and almost crippled down. The surge in the infected cases led to the shortage of amenities like beds, oxygen supplies, and critical care units (Barasa et al., 2020). Besides, due to the fear of getting infected in the corridors of the hospitals, many patients shied away from visiting hospitals and opted for online medical consultations and personalized reviews.
Trends in HealthCare
With the increased coronavirus load in Kenya, there was a reduction in the utilization of outpatient and inpatient care services in the country (Shikuku et al., 2020). This is driven by the fear of infection within the health facilities, with many patients opting for personal private consultations and online specialist services. Many institutions opted to minimize elective procedures and only admit emergency medical and surgical conditions. In addition, there was a reduction in the use of vaccination services, with a decline of approximately 0.77% decline in vaccination coverage (Shikuku et al., 2020). The decline in the number of vaccinations is related to the reduction in the number of outpatient visits.
Notable among the healthcare trends is the adoption of public health measures and ways that reduces the spread of the virus. With the increasing number of coronavirus cases, the government instituted measures that include cessation of movement in some regions, the compulsory wearing of masks in the public, hand washing practices, and social distancing, among others (Barasa et al., 2021). The adoption of these measures has been normalized and many Kenyans have embraced the practice. The majority of Kenyans now wear masks and regularly do handwashing. The handwashing practice has led to a subsequent reduction in diarrheal and other hygiene-related infections. Physical social distancing instituted by the government following WHO’s guidelines is currently being practiced in all public places and social gatherings including, the transport sector.
The increased number of patients in need of critical care services has led to increased investment in the critical care units and services across the country (Wachira & Mwai, 2021). The government and the private sector have increased funding towards the purchase of critical care equipment and the employment of more human personnel to man the units. The national and county governments have had to rethink their priorities and increase their expenditure to source and set up critical care units. Before the onset of coronavirus, there were slightly more than five hundred intensive care units, with many counties having none. Currently, all counties have set up these units and continue to build their capacities to handle more patients in need of critical and high dependency care (Ouma, Masai & Nyadera, 2020). However, the sustainability of these programs remains a mirage as many counties do not have sufficient staff to operate equipment and offer the needed critical services.
To facilitate the process of prevention and control of disease, the government instituted public health emergency response teams to help in the development and implementation of public health policies (Pinchoff, et al., 2021). The national and county government emergency response teams continue to collaborate to improve the emergency preparedness and response capabilities by strengthening the ability to rapidly detect and contain the spread of the virus and the threats it poses to the public. The government of Kenya in collaboration with other partners like the World Health Organization (WHO) and the centers for disease control and Prevention-Africa (CDC-Africa), among others, continues to provide and inform public health policy and practice to manage the pandemic. Before the onset of the corona, the ministry of health and county health departments did not have a concrete policy on the prevention and control of disease (World Health Organization, 2021). Nonetheless, the outbreak of Coronavirus has informed the development of such policies.
The public health institutions continue to build the capacity of their workforce and train future public health leaders in the various departments of health including the clinical, laboratory, program managers. There is a move towards the strengthening of the laboratory systems to ensure testing capacities. In addition, there is an increase in the surveillance and reporting of disease (WHO, 2021). The enhancement of surveillance and reporting of diseases have led to the identification of disease hotspots and the institution of the relevant measures including the latest move in April 2021 to restrict movement in and out of counties of Nairobi, Kiambu, Nakuru, Kajiado, and Machakos. These interventions have proved effective in reducing the positivity rate. With the need for the development of vaccines and rollout, the government of Kenya through the Kenya Medical Research Institutes (KEMRI) increased its funding and resource allocation to facilitate their participation in research (Eckstein et al., 2021). In collaboration with the University of Oxford in the United Kingdom, KEMRI participated in vaccines search and evaluation of their safety, effectiveness as well as ability to elicit a good immune response among the vaccinated group.
The development and increased use of online health platforms like mDaktari and Vezeeta, among other platforms, are attributed to the pandemic. Through these platforms, patients could book their appointments and get treatment from healthcare providers over video conferencing technologies supported by optimized machine learning-based tools (Kapoor et al, 2020). Indeed, with the increased advancements in technology, there is bound to be a rise in the development and use of these platforms for reviews in Kenya’s health sector.
Social changes
The Office of the President, the ministry of health, and the county governments provided measures that touched on the social life of the citizens. These included rules and regulations that suspended social gatherings like weddings, sports, nightclubs, seminars, places of worship, and funerals. These directives also impacted the education and families.
Families have borne the greatest effects of coronavirus in Kenya. Apart from the loss of family members and breadwinners, many families have experienced challenges related to job losses and access to food and basic services. With many firms and enterprises facing existential threats, many families working in the informal sectors have no social protection, and without a means to earn some income, they are not in a position to fend for food to sustain them. For most Kenyan families, the pandemic has affected the food systems in the entire country and exposed their fragility. For the agricultural families, many of them have continued to face scarcity of resources, and malnutrition, poor health, and lack of safety. Additionally, many families have not managed to settle their rents and mortgages and have had to sell their properties to offset rent and afford food.
With the introduction of restrictions of movement, the directive to minimize unnecessary movement, there was a rise in the number of sexual and gender-based violence. With the people being forced to stay at home and imposition of a dusk to dawn curfew, there was a rise in domestic violence against women, men, and children at a rate of 37%, 29%, and 22% respectively (Bhalla, 2020). There was also a high percentage rise in the sexual and gender-based violence outpatient visits within the hospitals and reporting through the national sexual and gender-based violence hotline. For example, in February 2020, 86 cases of gender-based violence were reported through the hotline, but the month of Jun saw 1108 cases of gender-based violence being reported through the hotline (Barasa et al., 2021) The increased cases of sexual and gender-based violence within the families can be attributed to the economic effects of the pandemic and the resultant psychosocial issues.
Before the pandemic, the country had made great strides and progress regarding access to education, with more children, within the rural areas embracing education. However, this learning was disrupted and schools were forced to close down. Students went home with no clear timetable to guide them on when they were to return to learning. As a result, students ended up staying at home for a whole year, thus, their education was negatively affected in several ways. The long stay at home predisposed children to many social and health-related issues.
Notable among the effects of the pandemic is the increase in teenage pregnancies among school-going girls from vulnerable backgrounds (John et al, 2021). In Machakos county, it was reported that over 4,000 girls had been impregnated during the period. This led to great outbursts and responses from the government, and non-governmental institutions citing massive negligence by the community leaders and failure by parents to guide their children. The resultant effects of these pregnancies include girls dropping out of school and stigma from the same society that exposed them to their state. Many children from needy families, especially in the rural and informal settlements, rely on the school feeding program. The fact that their parents continuously struggle to feed them even without the pandemic worsened the situation and left these children without food and led to the worsening of their already fragile nutritional state.
Home-schooling gained popularity with the shutting down of schools. The parents were encouraged to actively participate in learning by providing learning material for children and assist them in the learning process. Media outlets have been airing educational programs for students. Those who could access the internet had an advantage of a variety of resources as well as access to virtual classes.
The ban on social gatherings and the subsequent limitation on the number of people who could attend the social events had an impact on the lives of many personnel. The limitation of the number of people attending weddings and ceremonies disrupted the cultural way of celebrations in Kenya. Many people resorted to online streaming of these events. However, on a positive note, it also came with the economic benefits of reduced expenditures in weddings. The government’s directive regarding the attendance of the death and the undertaking of funeral rites caused a change in cultural practices. The government directives were that burial rites should be attended within 72 hours of death and only a few close relatives were allowed to the burial site (Okal, et al., 2021). As per most Kenyan communities, the burial of the dead is regarded as the last ceremony comprising a series of rites spanning several days. These include night vigils in some communities. With these directives requiring immediate burying of the death, many people were not able to undertake these ceremonies. The fact that conducting funeral rites were to be conducted with a few members meant huge budgets and extravagance, commonly witnessed among the communities has been minimized.
Places of worship, including mosques, temples, and churches among others have had to adapt to the new changes and requirements provided by the government directives. The government of Kenya provided a directive that the places of worship can be only a third full. Many places of worship resorted to offering digital services (Alice et al., 20121). Many churches opted for these digital services as an alternative to the normal face-to-face services. This period marked a greater transition among the church in Kenya, with many churches currently streaming their services through various platforms including Zoom, the use of Google Meet, social media channels like Facebook. The provision of digital service has promoted the ability of individuals to engage in religious practices irrespective of social distancing, and others who would not have stepped foot into the church.
Many social events including entertainment events have negatively impacted the lives of event planners, musicians, disk jockeys, and the owners of entertainment sites. As a response, many artists opted to conduct online shows for their fans and keep them entertained at their homes. Thus, these people have been forced to enhance their digital presence to boost their survival in the market and for the sustainability of their families.
In summary, the COVID-19 pandemic has changed the way people live and interact in many ways. The healthcare system across the world has been weakened and the healthcare workers are forced to work under risky working conditions. Kenya is not an exception. The government has instituted public health measures and strengthened the public health capacities, disease surveillance, and response. Moreover, there has been an enhancement and promotion of collaboration and research. Vaccination has been started and it is currently continuing across the country. The use of online platforms for consultation is taking shape.
The onset of the pandemic has negatively affected many families disrupting the source of livelihoods and loss of income and lack of access to food. Many children have had their school calendar disrupted and exams postponed. closure of schools led to people embracing home-schooling. However, some students from needy families and without good internet access stagnated in their villages and some girls suffered the fate of teen pregnancies. In addition, their restriction of social gatherings has led to changes in socio-cultural practices in conducting funerals and weddings. Additionally, the religious denominations have to readjust their programs to meet the government demands.
References
- Alice, S., Reuben, K., Gabriel, C. M., & Salimin, A. H. (2021). Effects of Covid-19 Pandemic on Religious Activities and Faith of Worshippers in Kenya; A Case Study of Narok Town, Kenya. Journal of Studies in Social Sciences, 20.
- Barasa, E., Kazungu, J., Orangi, S., Kabia, E., Ogero, M., & Kasera, K. (2021). Assessing the Indirect Health Effects of the COVID-19 Pandemic in Kenya. Center for Global Development. Forthcoming at https://www.cgdev.org/publication/assessing-indirect-health-effects-covid-19-pandemic-kenya
- Barasa, E., Mothupi, M.C., Guleid, F., Nwosu, C., Kabia, E., Araba, D., Orangi, S., Muraya, K., Gitaka, J. and Marsh, K., (2020). Health and socio-economic impacts of physical distancing for COVID-19 in Africa. KEMRI-Wellcome Trust Research Programme and African Academy of Sciences.
- Bhalla, N. (2020). Kenya orders probe into rise in violence against women and girls during Pandemic. Reuters: Nairobi, Kenya.
- Eckstein, L., Rid, A., Kamuya, D., & Shah, S. K. (2021). The essential role of DSMBs in ensuring the ethics of global vaccine trials to address COVID-19. Clinical Infectious Diseases.
- John, N., Roy, C., Mwangi, M., Raval, N., & McGovern, T. (2021). COVID-19 and gender-based violence (GBV): hard-to-reach women and girls, services, and programmes in Kenya. Gender & Development, 29(1), 55-71.
- Kapoor, A., Guha, S., Das, M. K., Goswami, K. C., & Yadav, R. (2020). Digital healthcare: The only solution for better healthcare during the COVID-19 pandemic?. Indian Heart Journal.
- Ngwacho, A. G. (2020). COVID-19 pandemic impact on Kenyan education sector: Learner challenges and mitigations. Journal of Research Innovation and Implications in Education, 4(2), 128-139.
- Okal, B. O., Benard Otieno Kodak, D., Yakub, A., & Okello, J. (2020). Implications of Coronavirus (Covid-19) on the Stability of the Luo Cultural Funeral Ceremonies in Kenya.
- Ouma, P. N., Masai, A. N., & Nyadera, I. N. (2020). Health coverage and what Kenya can learn from the COVID-19 pandemic. Journal of Global Health, 10(2).
- Pinchoff, J., Austrian, K., Rajshekhar, N., Abuya, T., Kangwana, B., Ochako, R., Tidwell, J.B., Mwanga, D., Muluve, E., Mbushi, F. and Nzioki, M., (2021). Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements. BMJ open, 11(3), p.e042749.
- Shikuku, D. N., Nyaoke, I., Gichuru, S., Maina, O., Eyinda, M., Godia, P., Nyaga. L. & Ameh, C. (2020). Early indirect impact of COVID-19 pandemic on utilization and outcomes of reproductive, maternal, newborn, child, and adolescent health services in Kenya. medRxiv.
- Wachira, B. W., & Mwai, M. (2021). A baseline review of the ability of hospitals in Kenya to provide emergency and critical care services for COVID-19 patients. African Journal of Emergency Medicine.
- World Health Organization. (2021). COVID-19 weekly epidemiological update, 9 March 2021.