Improved cholera control in Kenya: A retrospective analysis of 2017–2019 in Nairobi and Homabay

Abstract

Background: Kenya has recorded at least 38 678 cases and 695 deaths over the last decade, and costing on average $2.2 million annually. From 2014 to 2016, the country experienced one of the deadliest and largest outbreak. However, between 2017 and 2020, there was a decline in the number of reported cases and deaths.

Aim: This study seeks to reveal the investments made post the 2014–2016 outbreak and highlight existing gaps that need to be addressed to stop the resurgence of cholera outbreaks in Kenya.

Setting: The study was conducted in two counties: Homabay and Nairobi.

Methods: We used an observational study. Data were collected from 20 health facilities (involved in cholera control, during the study), 9 key informant interviews (KII) and 6 focus group discussions (FGDs).

Results: We found improvement such as: dissemination of standard operating procedures, aligned reporting system, field epidemiology programme, establishment of a public health emergency operating centre and improved partner coordination. On the other hand, 12 of the selected 20 (60%) facilities had no prior training before government financing and laboratory capacity was sub-optimal: 13 (65%) facilities had no prior training, 16 (20%) had no operational laboratory plan and 10 (50%) had inadequate laboratory test kits and reagents.

Conclusion: This study highlights that Kenya has experienced an improvement in specific core capacities.

Contribution: For Kenya to completely flatten the curve, there is need for more sustainable investment and government’s commitment in health system strengthening.