Medical experts want Kenya Government to puts its money in caring for the less sick Covid 19 over those in critical care units.
“Kenya will achieve better value for money if it prioritizes investments in essential care before investments in advanced critical care,” the Kenya Medical Research Institute (Kemri) has advised the Government.
A team coordinated by Dr Edwine Barasa (pictured), head of KEMRI Wellcome Trust Research Programme, Nairobi, says this is the best choice in the face of limited resources.
Since the pandemic outbreak, Kenya, the experts say has been struggling to invest in improving both essential and critical Covid 19 care but failing in both.
“This is indeed what we have observed in Kenya, with challenges in availability of essential care that includes oxygen and critical care persisting one year since the onset of the pandemic,” says the study.
Their findings, the team says show that it is more cost-effective to start by prioritizing investments in plugging gaps in essential care before investing in plugging gaps in advanced care.
Covid 19 patients in Kenya are classified as the: asymptomatic and moderate receiving home care; severe who get essential care within general hospital wards and critical patients in intensive care units.
Patients progressing to critical care the study shows are generally fewer, older with comorbidities and lower rates of survival despite the advanced and expensive care required.
On the other hand severe patients are likely to recover with standard or essential care hence saving more lives at a lower cost.
However since the government is struggling unsuccessfully to improve both essential and advanced critical care, the experts had weighed in on what should be prioritized.
“If, as it is evident, the Kenyan government is unable to fill capacity gaps in both essential and advanced critical care, where should they start?” asked the team.
The preprint posted on medRxiv on Monday (24th August 2021) says most logical is to invest in essential care patients attending general hospital wards.
Justifying this conclusion, the team says investments in critical care are way too high for a struggling economy while investing in essential care is likely to save more lives.
The team which analyzed data of 2,288 patients hospitalized with Covid 19 says the proportion of those needing critical care is small, 14 percent, compared to 86 per cent requiring essential care.
Further, outcomes for advanced critical care are poor with only 39.6 percent recovering. “These factors combine to make an investment in essential care the most cost effective,” says the study.
But the team warns against doing nothing about the situation as this may lead to more deaths.
“Maintaining the status quo may mean a large proportion of patients that need essential critical care miss it, and hence transition to critical care, which is more costly in money and lives.
In January Dr Barasa, was profiled in the prestigious Science journal for his exemplary work in Covid 19 and health insurance.
He was described as belonging to a generation of young African research leaders now stepping forward.
This is a fresh breath of air at a time Kenya’s medical research data and interpretation are being treated with caution and skepticism.
By Gatonye Gathura