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Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya
  1. Mary Beth Adam1,
  2. Sarah Muma1,
  3. Jecinter Achieng Modi1,
  4. Mardi Steere1,
  5. Nate Cook1,
  6. Wayne Ellis1,2,
  7. Catherine T Chen1,
  8. Arianna Shirk1,
  9. John K Muma Nyagetuba1,
  10. Erik N Hansen1
  1. 1 Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kiambu, Kenya
  2. 2 Pediatrics, Howard Hughes Medical Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Dr Mary Beth Adam; mary.b.adam{at}gmail.com

Abstract

Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-for-profit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike. The volume of patients increased and exceeded the hospital’s ability to respond to needs. There were substantial increases in sick newborn admissions during this time frame and an additional ward was opened to respond to this need. Increased need occurred across all services but staffing and space limited ability to respond to increased demand. There were increases in deaths during the strike period across the paediatric medical, newborn, paediatric surgical and obstetric units with an OR (95% CI) of death of 3.9 (95% CI 2.3 to 6.4), 4.1 (95% CI 2.4 to 7.1), 7.9 (95% CI 3.2 to 20) and 3.2 (95% CI 0.39 to 27), respectively. Increased mortality across paediatric and obstetrical services at AIC-Kijabe Hospital correlated with the crippling of healthcare delivery in the public sector during the national physicians’ strike in Kenya.

  • health services research
  • maternal health
  • paediatrics
  • hospital-based study
  • public health

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Footnotes

  • MBA and ENH contributed equally.

  • SM, JAM, MS, NC, WE, CTC, AS and JKMN contributed equally.

  • Handling editor Seye Abimbola

  • Contributors MBA contributed to the literature search, ethics review submission, creation and review of figures, study design and wrote the first draft of the manuscript. ENH was responsible for the literature review, creation and review of figures, study design and writing of manuscript. All authors gathered data, organised data base, assisted in the interpretation of data, reviewed relevant content, approved the final manuscript and accept responsibility for the integrity of the data.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors alone are responsible for the content of this paper and the views expressed do not necessarily reflect the views of the institutions with which they are affiliated.

  • Competing interests None declared.

  • Ethics approval Kijabe Hospital Ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data from this study are part of Kijabe Hospital patient records and the data are utilised for quality improvement purposes and general audit procedures as outlined in the manuscript. The sharing of de-identified aggregate data from the database could be made available by request with approval from the Kijabe Hospital Ethics committee.

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