Experts: Stigma could sabotage home care plans

Reuben Mwambingu @reubenmwambingu

Stakeholders in the health sector have raised concerns over growing stigma against Covid-19 patients, saying the trend is a possible impediment to the government’s plan to roll out home-based care for asymptomatic and mildly symptomatic coronavirus patients.

According to guidelines from the Ministry of Health on Monday, where possible, safe home-based isolation and care should be considered for asymptomatic and mildly symptomatic Covid-19 confirmed cases.

Patients eligible for home-based isolation and care first have to be assessed by a health care worker and meet all the criteria, including being a laboratory confirmed Covid-19 case, asymptomatic patients or having mild symptoms of the virus, there must be absence of co-morbidities, and there has to be access to a suitable space for home-based isolation and care.

Host patients

The Ministry of Health states that the decision to care for a patient at home requires careful clinical judgement and should be informed by an assessment of the suitability of the patient’s home environment.

Health care workers must first confirm that the patient is stable enough to receive care at home, appropriate caregivers are available at home, and there is a separate bedroom or isolation space where the patient can recover without sharing immediate space with others.

“If possible, a separate toilet and bathroom facility for the patient, from the rest of the household. Resources for access to food and other basic necessities are available.

The patient and other household members have access to appropriate, recommended personal protective equipment…” the guidelines read in part.

Going by the guidelines, many have argued that it may be practically impossible for most Kenyans residing in the urban settings to meet the criteria for home-based care considering a big percentage of the population in Nairobi and Mombasa, which are the worst hit counties, are in informal settlements.

In addition, the concern of growing stigma increasingly being associated with Covid-19 patients is also being viewed as a stumbling block towards achievement of the new approach.

“For home-based care to succeed, the government has to first address the issue of stigma otherwise the challenge of stigma will hinder the progress.

In Mombasa we have a challenge with stigma because as the situation is for now, people may shun a certain home just because they know it has a positive case,” said Rophus Mwakina, Health Promotion Officer in charge of Changamwe and Jomvu Sub Counties.

Kenya Medical Association (KMA) Coast Branch vice chair Dr Riaz Kasmani said where patients are asymptomatic or mild but their homes can’t meet the criteria, the local community leadership can organise a separate isolation facility to host such patients.

He said it is imperative for communities across the country to understand that anybody can get Covid-19 and that it is not a death sentence.

“We have so many people who have recovered. As per WHO, the cases are increasing across the world meaning soon we will have to live with it,” he added.