ArticleBMJ open2022
Quantifying the indirect impact of COVID-19 pandemic on utilisation of outpatient and immunisation services in Kenya: a longitudinal study using interrupted time series analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of COVID-19 on Maternal Health Service Uptake and Perinatal Outcomes in Sub-Saharan Africa: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- The population-level impact of COVID-19 on maternal healthcare utilization: evidence from the 2022 Kenya Demographic and Health Survey.International health · 2026Article
- The impact of the COVID-19 pandemic on HIV, malaria, tuberculosis and childhood vaccination services in Guinea: an interrupted time series analysis.BMJ global health · 2025Article
- The impact of the COVID-19 pandemic on urban-rural outpatient primary care utilisation in Malaysia: a retrospective time series and spatiotemporal analysis.International journal for equity in health · 2025Article
- Evaluation of the impact of the state of emergency during the COVID-19 pandemic on childhood immunizations in Benguela Province, Angola.Tropical medicine and health · 2025Article
- Economic impact of COVID-19 on patients with type 2 diabetes in Kenya and Tanzania: a costing analysis.BMJ public health · 2024Article
- COVID-19 related disruption and resilience in immunisation activities in LMICs: a rapid review.BMJ open · 2024Review
- Trust in health workers and patient-centeredness of care were strongest factors associated with vaccination for Kenyan children born between 2017-2022.Vaccine: X · 2024Article
- Evaluating the impact of COVID-19 on routine childhood immunizations coverage in Zambia.PLOS global public health · 2024Article
- Impact of COVID-19 on essential healthcare services in Addis Ababa, Ethiopia: Implications for future pandemics.PloS one · 2024Article
- Article
- Resilience of routine childhood immunization services in two counties in Kenya in the face of the COVID-19 pandemic.Vaccine · 2023Article
- The first year of the COVID-19 pandemic in humanitarian settings: epidemiology, health service utilization, and health care seeking behavior in Bangui and surrounding areas, Central African Republic.Conflict and health · 2023Article
- Investigating rapid diagnostic testing in Kenya's health system, 2018-2020: validating non-reporting in routine data using a health facility service assessment survey.BMC health services research · 2023Article
- Pattern of OPD utilisation during the COVID-19 pandemic under the Universal Coverage Scheme in Thailand: what can 850 million records tell us?BMC health services research · 2023Article
- Article
- The impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: A retrospective cohort study.Vaccine · 2023Article
- COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023Article
- The impact of COVID-19 on health financing in Kenya.PLOS global public health · 2023Article
- Impact of COVID-19 on routine childhood immunisations in low- and middle-income countries: A scoping review.PLOS global public health · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveIn this study, we assess the indirect impact of COVID-19 on utilisation of immunisation and outpatient services in Kenya.
designLongitudinal study.
settingData were analysed from all healthcare facilities reporting to Kenya's health information system from January 2018 to March 2021. Multiple imputation was used to address missing data, interrupted time series analysis was used to quantify the changes in utilisation of services and sensitivity analysis was carried out to assess robustness of estimates. EXPOSURE OF INTEREST: COVID-19 outbreak and associated interventions. OUTCOME MEASURES: Monthly attendance to health facilities. We assessed changes in immunisation and various outpatient services nationally.
resultsBefore the first case of COVID-19 and pursuant intervention measures in March 2020, uptake of health services was consistent with historical levels. There was significant drops in attendance (level changes) in April 2020 for overall outpatient visits for under-fives (rate ratio, RR 0.50, 95% CI 0.44 to 0.57), under-fives with pneumonia (RR 0.43, 95% CI 0.38 to 0.47), overall over-five visits (RR 0.65, 95% CI 0.57 to 0.75), over-fives with pneumonia (RR 0.62, 95% CI 0.55 to 0.70), fourth antenatal care visit (RR 0.86, 95% CI 0.80 to 0.93), total hypertension (RR 0.89, 95% CI 0.82 to 0.96), diabetes cases (RR 0.95 95% CI, 0.93 to 0.97) and HIV testing (RR 0.97, 95% CI 0.94 to 0.99). Immunisation services, first antenatal care visits, new cases of hypertension and diabetes were not affected. The post-COVID-19 trend was increasing, with more recent data suggesting reversal of effects and health services reverting to expected levels as of March 2021.
conclusionCOVID-19 pandemic has had varied indirect effects on utilisation of health services in Kenya. There is need for proactive and targeted interventions to reverse these effects as part of the pandemic's response to avert non-COVID-19 indirect mortality.
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