MoH directs counties to adopt integrated model in fight against diseases

Acting Director General of Health, Dr Patrick Amoth. [Brian Kisanji, Standard]

The Ministry of Health has directed County Governments to implement integrated strategies for testing, treating and management of infectious diseases.

The three key infectious diseases to be included in the integration strategy include Covid-19, Tuberculosis (TB) and HIV/AIDS.

In a circular, Acting Health Director General, Dr Patrick Amoth, said the integrated strategy is essential in testing and treatment of diseases, using the Covid-19 model.

"Integration of outpatient departments, HIV Clinics, TB and respiratory clinics, Non-Communicable Diseases units and Renal units will therefore enhance service delivery," reads a section of the circular written by Dr Amoth.

With the model, testing for the treatment of diseases will be handled at the primary level by having patients, tested, and managed at the hospital level.

The model of integration is to be implemented at a time when HIV/AIDS and TB are still ranked top killer diseases in Kenya, alongside malaria according to the 2022 Kenya Demographic Health Survey (KDHS).

The ministry's directive of adoption of an integrated strategy comes five months after its commitment to roll out the programme.

In the circular, Dr Amoth noted that integration will also help optimise the test and treatment pathway for Covid-19.

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Kenya reported her first case of Covid-19 in March 2020 and applied an integrated strategy to manage and treat the disease at the community level.

At least 5, 700 deaths and 343,000 cumulative infections have been reported in the country.

Amoth said the ministry has worked towards adapting the best strategies for the management of Covid-19 based on scientific evidence, adding that targeted Covid-19 screening and testing in priority groups for both symptomatic individuals and high-risk populations is key to achieving timely case management and reducing mortality and morbidity.

"The purpose of this circular is to provide guidance in the implementation of the test and treat model for Covid-19 in health facilities to reduce the risks of severe health outcomes related to Covid-19 infection," said Amoth.

Ordering and reporting of diseases and data under the integrated system will be through the Kenya Health Information System (KHIS) in the TB medicine reporting tool which has integrated Covid-19 therapeutics and allocation of the product through the TB allocations tool monthly.

Once the reporting is done in KHIS, the Antiviral will be allocated through an allocation tool based on the facility consumption.

The integration strategy is also thought to be key for pandemic preparedness.

Some of the organisations participating in the Covid-19 integration model include Unitaid, Global Fund, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), and the national and county governments.

On her part, Dr Virginia Gitau, Project Lead, Catalytic Covid Action Project at EGPAF, the integration programme has been instrumental in addressing the goal of Universal Health Coverage (UHC) through the provision of holistic patient-centred services.

"Systematically integrating COVID-19 services into TB, Maternal and Child Health (MCH), and HIV clinics can lead to more efficient and cost-effective programs.

This is by increasing the use of health services -- improving people's access to Covid-19 testing services, reducing facility-related stigma around contracting Covid-19 and improving surveillance of the virus among the vulnerable population, and avoiding added complexity of TB care through counselling on COVID prevention measures," said Dr Gitau.

The integrated strategy, she said also minimises incomplete referrals of positive patients.