Table 2(suite).
summary of survey findings- Kenyan health system preparedness and adaptation
| Total respondents n=236 | ||||||
|---|---|---|---|---|---|---|
| Survey question | Response | Clinical worker n=98 | Non-clinical worker n=138 | P-value | Chi2 | |
| Kenyan Health System Preparedness and Adaptation | ||||||
| 1 | Did you feel the political decision makers in your country were aware of the risk to frontline workers? | not at all | NA | 23(29) | NA | NA |
| 2 | Did your healthcare workers receive adequate personal protection equipment dependant on their workplace setting? | no | 47(65) | 55(49) | <0.001 | 15.93 |
| 3 | If you were on the frontline (in emergency departments, on respiratory, or ICU wards) taking care of Sars-CoV-2 positive patients, did you receive adequate personal protection equipment (PPE)? | a little + quite a bit | 50(64) | NA | NA | NA |
| completely | 25(32) | NA | NA | NA | ||
| 4 | How would you rate the severity of NCD service disruption (including elective surgery, follow-up clinics, routine care) during the pandemic? | occasional + very often | 44(58) | 55(59) | 0.526 | 0.40 |
| severe | 24(32) | 37(40) | NA | NA | ||
| 5 | Was the provision of individual protection devices adequate or inadequate? | adequate | 16(22) | NA | NA | NA |
| 6 | Were there contingency plans to shield the system in case of an external disruption like COVID-19? | no | 59(69) | 50(50) | 0.003 | 16.10 |
| 7 | Do/did you anticipate an over burden on the NCD services when routine care eventually resumed? | yes | 71(96) | 59(59) | <0.001 | 30.97 |
| 8 | Do/did you have plans for gradual/spaced out resumption of routine care? | yes | 31(39) | 65(64) | <0.001 | 27.84 |
| 9 | Do you plan to evaluate the medical impact of this pandemic on NCDs? | yes | NA | 49(49) | NA | NA |
| 10 | Do you plan to evaluate the social and economic burden of this pandemic on NCDs management? | yes | NA | 59(62) | NA | NA |
| 11 | Is there a plan in place to screen the potential mental health impact of the pandemic? | yes | NA | 52(58) | NA | NA |
| 12 | As those with NCDs are the most vulnerable subgroups of patients, do you plan to target increased prevention, health education programmes towards them? | yes | NA | 37(66) | NA | NA |
| 13 | As those with NCDs are the most vulnerable subgroups of patients, do you plan to target increased outreach initiatives (using volunteers, increased personnel, etc.) and address accessibility (using telemedicine, mobile pharmacies, etc.)? | yes | NA | 50(73) | NA | NA |
| 14 | Would you agree/disagree with the need to ensure that whole populations should have increased health promotion, prevention schemes addressed to them to decrease vulnerabilities and predispositions to NCDs, with the goal of optimizing prognoses in the time of infectious epidemics? | agree | 37(100) | 60(100) | NA | NA |
| 15 | Would you consider using digital health applications for medical information sharing, especially for patients in multidisciplinary care settings? | yes | 34(100) | 44(94) | 0.133 | 2.25 |
| 16 | Would you agree that digital health (eHealth or mHealth) can be integrated into your healthcare infrastructure to better care for your most vulnerable patients in crises such as this? | agree + strongly agree | 38(69) | 47(63) | 0.447 | 0.58 |
| disagree + strongly disagree | 17(31) | 28(37) | NA | NA | ||
| 17 | To better maintain the normal flow of follow-ups and care of your country's NCD patients, how likely are you to depend on telehealth, digital health, mobile health applications? | very much | 36(84) | 37(43) | <0.001 | 21.77 |
| 18 | Taking into account health literacy, access to mobile devices, and financial aspects, would digital health be an option for NCD patients to experience more autonomy over their care? | yes | 50(83) | 70(82) | 0.205 | 3.16 |
| 19 | Did your country's health system cope with the redistribution of resources (both human and economic) at the cost of continuous care of NCD patients? | somewhat | NA | 15(22) | NA | NA |
| 20 | Did you reorient national/regional guidelines and protocols to concentrate services in a setting suited to high-volume, high-acuity care available 24 hours per day? | yes | 27(38) | 38(37) | 0.945 | 0.11 |
| 21 | Was redirecting chronic disease management to focus on maintaining supply chains for COVID-19 an option? | yes | 38(43) | 48(48) | 0.804 | 0.44 |
| 22 | If redirection of chronic care was an option, how successful was it in terms of delivery of care? | met standards | 19(29) | 55(60) | <0.001 | 24.92 |
| 23 | If redirection of chronic care was an option, how successful was it in terms of output? | below standards | 29(53) | 28(44) | 0.01 | 11.03 |
Note: frequency(percentage); p-value from chi2; missing p-value and chi2 due to no comparison group or expected value <5