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Impact of devolution on the trends of Paediatric Malaria Admissions and Mortality in Homa-Bay County, Kenya- An Interrupted Time Series Analysis

Author: Kodhiambo M.O., Amugune B.K.2, Oyugi J.O.
Is Part Of: Pharmaceutical Journal of Kenya, Volume 23, No. 4 (2018)
Background: Malaria is a leading cause of paediatric admissions, morbidity and mortality. Its burden is borne mainly in the endemic areas, like Homa-Bay in Kenya, which are also the poorest. It is therefore important for the County to prioritize preventing paediatric malaria. Paediatric malaria admission and mortality have recently increased in the lake region unlike the rest of Kenya. It is also not clear whether after devolution was implemented in the year 2013, the trend has changed. The objective of the study was to investigate the impact of devolution on paediatric malaria admission and mortality trends in public health facilities in Homa Bay County.Methodology: A retrospective quasi-experimental study was performed. The study population comprised all public health facilities in Homa-Bay County. We purposively sampled 164 public health facilities from which six-year data on paediatric admissions and mortality was collected. Sub-County level data was obtained on excel from the electronic health records at the County headquarters. Hard copy data from the health facilities were also inspected at the 8 sub-Counties. Data was analyzed by the Interrupted Time Series (ITS) method. Devolution, which was taken as the intervention, occurred around the 36th month of the follow-up period.Results: From January 2013, deaths increased gradually until around the 33rd month when it rose abruptly to nearly 800 then declined to below 200 in the 34th month around the time of devolution. This was followed by a period of stability. Admissions had a similar trend.Conclusions and recommendations: Paediatric malaria admission and mortality rates in Homa Bay increased around the time of devolution. More studies are necessary to assess progress towards universal access to care post devolution.
Keywords: Devolution, paediatric malaria, admissions, mortality, Homa-Bay
Publisher: The Pharmaceutical Society of Kenya
ISSN: 2411-6386