Early indirect impact of COVID-19 pandemic on utilisation and outcomes of reproductive, maternal, newborn, child and adolescent health services in Kenya: A cross-sectional study

The paper determined the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in Kenya. Hospital data for the first four months (March-June 2020) of the pandemic and the equivalent period in 2019 were compared using two-sample test of proportions. Despite the global projections for worse indicators, there were no differences in monthly mean (±SD) attendance between March-June 2019 vs 2020 for antenatal care (400,191.2±12,700.0 vs 384,697.3±20,838.6), hospital births (98,713.0±4,117.0 vs 99,634.5±3,215.5), family planning attendance (431,930.5±19,059.9 vs 448,168.3±31,559.8), post-abortion care (3,206.5±111.7 vs 448,168.3±31,559.8) and pentavalent 1 immunisation (114,701.0±3,701.1 vs 110,915.8±7,209.4), p>0.05. However, there were significant increases in FP utilisation among young people (25.7% to 27.0%), injectable (short-term) FP method uptake (58.2% to 62.3%), caesarean section rate (14.6% to 15.8%), adolescent maternal deaths (6.2% to 10.9%) and fresh stillbirths (0.9% to 1.0%) with a reduction in implants (long-term) uptake (16.5% to 13.0%) (p<0.05). With uncertainty around the duration of the pandemic, strategies to mitigate against catastrophic indirect maternal health outcomes are urgently needed. (Afr J Reprod Health 2021; 25[6]: 76-87)

Educators’ perceptions of the early impact of COVID-19 on midwifery training in Kenya: a cross-sectional survey

Background This paper presents a descriptive analysis of the perceptions of Kenyan midwifery educators regarding the early impact of coronavirus disease 2019 (COVID-19) on the continuity of midwifery education. Methods A cross-sectional online survey was conducted among 51 midwifery/clinical medicine educators from 35 diploma training colleges from all eight regions of Kenya. Educators’ concerns and satisfaction regarding the delivery of training during the early phases of the pandemic were expressed as proportions on a three-point Likert scale. Results Of the educators, 76% were extremely concerned about face-to-face teaching during the pandemic; 96% of educators had started delivering virtual teaching (VT), with only 41% being extremely confident in facilitating VT; and 97% were unsatisfied with the measures in place in their institutions to continue face-to-face teaching. Conclusion To minimise the impact of COVID-19 on midwifery education in Kenya, capacity building for VT and mitigation measures for safe in-person training are urgently needed

Impact of routine Newcastle disease vaccination on chicken flock size in smallholder farms in western Kenya.

BackgroundPoultry represent a widely held economic, nutritional, and sociocultural asset in rural communities worldwide. In a recent longitudinal study in western Kenya, the reported mean number of chickens per household was 10, with increases in flock size constrained principally by mortality. Newcastle disease virus is a major cause of chicken mortality globally and hypothesized to be responsible for a large part of mortality in smallholder flocks. Our goal was to determine the impact of routine Newcastle disease virus (NDV) vaccination on flock size and use this data to guide programs to improve small flock productivity.MethodsWe conducted a factorial randomized controlled trial in 537 households: in 254 households all chickens were vaccinated every 3 months with I-2 NDV vaccine while chickens in 283 households served as unvaccinated controls. In both arms of the trial, all chickens were treated with endo- and ecto parasiticides every 3 months. Data on household chicken numbers and reported gains and losses were collected monthly for 18 months.ResultsConsistent with prior studies, the overall flock size was small but with increases in both arms of the study over time. The mean number of chickens owned at monthly census was 13.06±0.29 in the vaccinated households versus 12.06±0.20 in the control households (p = 0.0026) with significant gains in number of chicks (p = 0.06), growers (p = 0.09), and adults (p = 0.03) in the vaccinated flocks versus the controls. Household reported gains were 4.50±0.12 total chickens per month when vaccinated versus 4.15±0.11 in the non-vaccinated controls (p = 0.03). Gains were balanced by voluntary decreases, reflecting household decision-making for sales or household consumption, which were marginally higher, but not statistically significant, in vaccinated households and by involuntary losses, including mortality and loss due to predation, which were marginally higher in control households.ConclusionQuarterly NDV vaccination and parasiticidal treatment resulted in an increase in flock size by a mean of one bird per household as compared to households where the flock received only parasiticidal treatment. While results suggest that the preventable fraction of mortality attributable to Newcastle disease is comparatively small relatively to all-cause mortality in smallholder households, there was a significant benefit to vaccination in terms of flock size. Comparison with previous flock sizes in the study households indicate a more significant benefit from the combined vaccination and parasiticidal treatment, supporting a comprehensive approach to improving flock health and improving household benefits of production in the smallholder setting