The Economic Survey 2021 shows that the number of registered deaths in 2020 was the lowest in five years. The common narrative has been that we lost more people due to the pandemic. 

While 184,185 deaths were recorded in 2020, 191,495 people died in 2019.  Of course there could be some criticism of this data, amid concerns of an undercoat of undeclared Covid-19 deaths. It could also be argued that this number just reflects registered deaths but not all deaths. Let’s however note that Kenya maintains good records as most burials are conducted after a permit is secured from the local administration.

To what extent can the lower death rate be related to public health interventions instituted in 2020 to mitigate the pandemic? While we don’t have a specific study for Kenya, we can relate to a global research on “the trajectory of Covid-19 pandemic and hand-washing adherence: findings from 14 countries”, published on the BMC Public Health journal. 

The findings reveal that the indicators of the trajectory of the Covid-19 pandemic, were associated with adherence to handwashing. Essentially, the study posits that higher numbers of total cases of and total deaths from Covid-19 were related to lower levels of handwashing adherence. This underscores the critical role of handwashing as a cost-effective public health intervention in reducing the disease burden and ultimately related deaths.

To understand the Kenyan context, we can look at the diarrhoeal case load reported in health facilities in 2021. The Economic Survey 2021 data shows that diarrhoeal diseases, the leading cause of child deaths, dropped out of top 10 child morbidity statistics in 2020. It shows that the total number of cases of diarrheal diseases reported in health facilities decreased by 26.33 per cent in 2020. 

Is the marked improvement in handwashing practices, especially hand washing at critical times, a factor in the reduction of diarrhoeal-associated deaths? 

An in-depth research on behaviour change during the pandemic is required to make the aforementioned associations.

Apart from handwashing, other public health and social measures can be lauded for limiting the spread of the virus. Last year the government through the Ministry of Health and other stakeholders stepped up access to clean water, soap and handwashing facilities. As our hands are a critical vector in transmitting microorganisms, handwashing with soap and water is the first line of defense against infection. 

Communication and branding efforts boosted a coordinated national campaign – Komesha Corona by the Ministry of Health – which saw the relaying of public health messages on handwashing, not only through traditional channels but also through social media. 

What about the role of community health workers? Essential in low-resource settings, CHWs were critical in outreach, prevention awareness, and home-based care. As frontline health workers, they played a critical role in hygiene behaviour change and adoption of healthy habits at the households and community level by ensuring the information reached the households and demonstrated good hygiene practices.

Community social capital has contextual benefits for collective action, which in many cases, played a crucial role in advancing the message and practise of handwashing. In one of Mombasa’s informal settlements – Bangladesh – community members organised themselves to enforce Covid-19 protocols. In the early days of the pandemic, people not only adhered to, but enforced handwashing and social distancing. Here, the networks, norms and trust that enable cooperative behaviour, influenced communal ability to adhere to prevention measures.

— The writer works for Practical Action