Unsurprisingly, the effects are bleak.
During the 2013-2014 Ebola outbreak in West Africa, the number of people taking care of their physical health and that of their children decreased significantly. This has led to an increase in deaths caused by malaria, HIV and tuberculosis (TB). The figures were similar to or, in some cases, higher than the total number of deaths caused by Ebola virus disease.
The COVID-19 pandemic appears to have followed the same worrying trajectory, at least in Kenya. We look at how the pandemic has influenced the use of various exercises in this East African country. Our particular study aimed to assess which exercises were resistant to formula interruptions and which were most vulnerable.
We collected county-level knowledge aggregates per month for 17 signs in the Kenya fitness data formula over 4 time periods. These were the run-up to the pandemic (January 2018 to February 2020), two pandemic periods (March to November 2020 and February to October 2021), and the physical care workers’ strike from December 2020 to January 2021. The signs pointed to 4 categories:
We combined this data with Google and Facebook data on human movements in Kenya during the pandemic, as well as Ministry of Health data on daily COVID-19 cases. We have taken note of curfews and other movement restrictions to ensure this is taken into account.
We found that the pandemic and similar attack through physical care personnel disrupted fitness services. Outpatient clinics, screening and diagnostic services, and immunization of formative years were affected.
These findings are a valuable tool to help health governance and other stakeholders better prepare for long-term pandemics and ensure that essential sports facilities continue to operate as often as possible, even sometimes.
Worrying declines and some points
Outpatient visits, screening and diagnostic services, and immunization during the formative years are most affected.
The onset of the pandemic was associated with a significant reduction in outpatient visits (29%), cervical cancer screening (50%), and the number of HIV tests performed (45%). Reported cases of TB (27%), high blood pressure (10%), and vitamin A supplementation (9%) were also minimized. They have been motivated by partial closures, stay-at-home orders and movement restrictions, discouraging patients and parents from seeking non-emergency services.
At the beginning of the emergency, when little was known about COVID-19, the Ministry of Health issued rules aimed at minimizing overcrowding in hospitals, in its component by cutting visits to non-urgent clinics and surgical procedures. This would likely have reduced outpatient visits in addition to spreading concerns about contracting the disease in hospitals.
For outbreaks like Ebola, concerns about contracting the virus in fitness services have been shown to impair access to other fitness services.
Access to antiretrovirals has been as affected as other services. This may be due to a replacement policy in the national programme to combat AIDS and sexually transmitted infections that allows for the distribution of antiretroviral drugs for several months. This reduced the need for regular clinic visits.
We also detected fewer reported cases of pneumonia and diarrhea in children. It’s unclear whether this is similar to a step forward in hand-related hygiene or a decrease in contact between children when schools closed. It may also be a relief to report due to an update in Physical Care Seeking Behavior brought on by the pandemic.
The accumulated concern in visits to gyms comes from cases of sexual violence, which have increased by 8%. Gender-based violence is linked to stress, uncertainty, social isolation and movement restrictions.
There were promising knowledge points. Rates of professional deliveries per pregnancy as well as for antenatal care (care pregnancy) have been resilient. They have remained strong both early on and during the pandemic.
There are several conceivable reasons for this. Permits have been issued to pregnant women to stop at gyms during curfew hours. An ambulance system, Wheels of Life, has been designated in Nairobi to transport pregnant women during curfew hours. Strict rules have also been issued for services related to the continuity of reproductive and maternal health services. And many pregnant women remained determined to give birth in the hospital because they had arranged prenatal care and delivery before the pandemic.
Towards the later stages of the pandemic, signs of peak fitness began to recover. But the strike of fitness workers minimized all signs to figures lower than those observed at the beginning or the period before the strike, with the exception of the number of denounced. TB instances that increased slightly to 0. 3%.
recommendations
It doesn’t make much sense to look to improve an essential gym when a pandemic has already begun. Preparation is key. Kenya will have to, with datasets like ours, among other tools, identify facilities that are vulnerable in times of crisis. They will then need to be improved so that human life is protected before and after a physical emergency.
The health government should also expand and disseminate rules to health care officials on how to better manage facilities and get out of a crisis. Better coordination and communication between national and county departments is also crucial.
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