The government is on course to roll out a project integrating testing, treatment and management of Covid-19, Tuberculosis and HIV diseases to the rest of the country.

This is also after a successful pilot project in Kiambu county achieved active contact tracing of patients back to treatment.

Acting director general of Health, Dr Patrick Amoth noted the integrated care has succeeded in several other disease programmes, and is seen as a possible solution to the growing demand for improved patient experience and health outcomes.

“As we continue to strengthen our health systems, we are intentional in sustaining the gains made as we seek to build on the good foundation laid in the pilot project,” he said yesterday during a stakeholder dialogue on how the Covid-19 Integration model has worked.

“This holds the promise for pandemic preparedness,” he said.

Some of the organisations participating in the Covid-19 integration model include; Unitaid, the Geneva-based Global Fund, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), the national and county governments. Unitaid is a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with an emphasis on tuberculosis, malaria, and HIV/AIDS and its deadly co-infections.

Amoth pointed out that one of the high points of the collaboration under the project was the countrywide rollout of tocilizumab, a Covid-19 drug- to manage severe Covid-19 at a time when there was an acute shortage of lifesaving drug in the country.

“Through the project, we piloted the Covid-19 integration in Kiambu county, at the Maternal, Newborn and Child Health (MNCH), TB, and HIV clinics with an aim to optimize care and management of the most vulnerable populations, who are likely to get a severe forms of Covid-19 and/or mortality,” he said.

The fact that women, children and immune-compromised patients with HIV and TB, were more likely to develop severe disease that may lead to death, this model was therefore important to ensure these key populations had their conditions managed in a comprehensive way.

Covid-19 screening

In view of this, Kiambu County Director of Health, Dr Hillary Kagwa says patients have been receiving Covid-19 screening, testing, and treatment services as part of their routine care.

“The integration model looks at the patient holistically by ensuring all conditions are managed in a comprehensive manner,” he said.

The leading causes of morbidity in Kiambu county are identified as respiratory tract infections; gastroenteritis, skin conditions, hypertension, diabetes and rheumatological conditions.

The county’s Covid-19 status shows that 21, 465 total Covid-19 cases with a fatality rate  of 2.57 percent, and 606,306 about 37.3 percent of the proportion of fully vaccinated adults.

“This project also adopted the use of Electronic Medical data ensuring that data is captured in real time for effective patient management and follow-up,” Kagwa pointed out.

The project sought to bridge the gap in evidence around the acceptability, feasibility and effectiveness of existing and upcoming diagnostic tools and treatments.

According to Dr Eliud Mwangi, EGPAF Country Director, Kenya, the project is also meant to promote the implementation of integrated Covid-19 delivery models in health services.

“It will also be instrumental in strengthening the capacity of health systems and platforms and procurement systems; and accelerate regulatory pathways for Covid-19 commodities,” he told journalists.

Mwangi also highlighted that even as the project facilitates strengthening the pandemic preparedness through, the pilot had important lessons that integration is possible and that it works.

The pilot kicked off on October 1, 2021, and expected to be complete by the end of this year. It’s estimated to cost about Sh1.1 billion ($11 million) for three countries; Cameroon, Kenya and Zimbabwe. In Kenya it was piloted in Kiambu County in 29 structured sites and one hub site at a cost of Sh300 million ($3 million).

Novel solutions

According to Unitaid’s Programme Manager, Dr Jackson Hungu since October 2021, the project has been working to accelerate end-to-end access to novel solutions in responding to the Covid-19 pandemic through testing, isolation, care, and treatment approaches adapted to meet the needs of the populace.

“Through the project, there has been significant investment in diagnostic and therapeutic, evidence generation, community and multi-stakeholder mobilization, and strengthening the capacity of healthcare workers for an effective response,” he said.

The project’s key achievements since it was launched has seen the integration in essential health services where 11 percent of those screened were eligible for testing with a 96 percent success rate. An estimated 5 percent of clients tested positive for Covid-19, and 99 percent of positive clients were successfully followed.