COVID-19 Shut Down Prompts Program Evolution
Changes necessitated by measures to slow the spread of COVID-19 have impacted AMPATH’s population health model and created new methods of communication and service delivery.
The majority of the implementation team that partners with the Ministry of Health is working from home but is in close communication with each county Ministry of Health based on the structure of each clinical program.
Distribution of educational materials in Trans Nzoia County. Photo: Kenya Ministry of Health
The Chamas program for maternal child health has successfully reached 85 percent of the more than 2000 women in the program. The team is starting monthly phone calls and regular text messaging with educational messages related to maternal child health as well as COVID-19. Women in the group can also respond via text to communicate within the group. The team is also working with the Ministry of Health to find suitable facilities for women who are delivering babies or experiencing pregnancy complications.
Other microfinance and economic empowerment programs based on group care have also shifted to mobile support and SMS-based communications.
The chronic disease program for hypertension, diabetes and mental health strives to get stable patients to stay at home and communicate virtually with the care program when possible. Every effort is made to obtain a three-month supply of medication for these patients. However, unlike medications for HIV, medications for hypertension and diabetes are not free, so it is difficult for many to afford a three-month supply while also trying to get food when they may not be working in their small businesses.
Educational materials distribution in Kakamega County. Photo: Kenya Ministry of Health
Various strategies are being employed to ensure that patients stay on their chronic disease medications in order to prevent increased deaths from other causes during and following the pandemic. AMPATH provided some subsidies and loans to supply no or lower cost medications. Efforts are being made to keep clinics open for patients who really need them, but volumes are low. While NHIF (insurance) active enrollment activities have been paused, work continues behind the scenes in preparation for resuming promotion when the time is right.
“Economic empowerment may be more in the form of relief just helping people survive for the next 3-6 months,” said Laura Ruhl, MD, interim executive field director for the AMPATH Consortium. “Then we are really going to need to put a lot of emphasis on how we cushion people to help them revive their businesses, improve their incomes and get their kids back in school when this is over,” she continued.