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Healthcare and Socio-economic Impacts of COVID-19 on Patients with Diabetes in Selected Counties in Kenya, GECO-Kenya

Kenya, , 2021 - 2023
Health and Well-Being (HaW)
Gershim Asiki,MD,Phd
Last modified November 26, 2024 Page views 38558 Documentation in PDF Metadata DDI/XML JSON

Identification

IDNO
DDI-KEN-APHRC-GEGO-2021-v1.0
Title
Healthcare and Socio-economic Impacts of COVID-19 on Patients with Diabetes in Selected Counties in Kenya, GECO-Kenya
Subtitle
GECO-Kenya
Country
Name Country code
Kenya KEN
Abstract
Background

The COVID-19 pandemic has resulted in socioeconomic hardships and disrupted healthcare for people with type 2 diabetes (T2D) particularly in sub-Saharan Africa. The project aims to explore the experiences of people with T2D and healthcare providers on managing T2D during COVID-19.

Methods
This is a mixed methods cross-sectional study which will be delivered through five interrelated work packages (WPs). In WP1 we will administer questionnaires (N=500) and in-depth interviews (N=30) to T2D patients to explore their experiences of healthcare access, and T2D self-management, socio-economic challenges and knowledge, attitude and practices related to COVID-19 in rural and urban Kenya. WP2 will use a desk review and field research on individual and societal economic burden of T2D. WP3 will explore the perspectives of local healthcare providers (N=30) on T2D management during COVID-19. WP4 will analyze policy landscape using desk review and key informant interviews to identify policy gaps and action for T2D during the pandemic. WP5 will synthesize evidence from WPs1-4 to develop policy recommendations and health education messages for T2D management during COVID-19 using a multi-stage participatory process. Quantitative analysis will determine differences between rural and urban settings using descriptive statistics and a hierarchical modelling using WHO framework on social determinants of health and wellbeing will be employed to explore factors associated with care disruption. A thematic content analysis will be used for qualitative data. For policy analysis Walt and Gilson's policy triangle framework, will be used.

Version

Version Date
2021-09-16
Version Notes
N/A

Scope

Keywords
Keyword
COVID-19
Type 2 Diabetes
Socioeconomic impact
Healtcare access
Self management
Rural and Urban Kenya
Healt prividers
Health education
Economic burden
Social determinant of health

Coverage

Geographic Coverage
National: The study was conducted across four counties in Kenya: Nairobi, Kiambu, Nyeri, and Vihiga.
Unit of Analysis
Individula;
-People with type 2 diabetes (T2D) in rural and urban areas of Kenya.
-Healthcare providers managing T2D patients.
Universe
The survey covered all individuals diagnosed with type 2 diabetes (T2D) receiving care at selected health facilities in Kenya, including both urban and rural residents, as well as healthcare providers involved in the management of T2D patients.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
Gershim Asiki,MD,Phd a. African Population and Health Research Center (APHRC)
Producers
Name Affiliation Role
Richard Sanya, MBChB, MMed, PhD a. African Population and Health Research Center (APHRC) Co-Investigator
Shukri Mohamed, PharmD, MPH, PhD a. African Population and Health Research Center (APHRC) Co-Investigator
Maurine Ng’oda, BSc, MPH a. African Population and Health Research Center (APHRC) Co-Investigator
Lyagamula Kisia, BSc a. African Population and Health Research Center (APHRC) Co-Investigator
Sally Mtenga, PhD Ifakara Health Institute (IHI) Work Package Associate
Grace Mhalu, PhD Ifakara Health Institute (IHI) Work Package Associate
Prof. Cindy Gray, PhD University of Glasgow Work Package Associates
Prof. Francis Mayer, MD, PhD University of Glasgow Work Package Associate
Christopher Bunn, PhD University of Glasgow Work Package Associate
Elenor Gieve, PhD University of Glasgow Work Package Associate
Muhuyi Erick, BSc a. African Population and Health Research Center (APHRC) Data Documentation specialist
Bonface Ingumba, a. African Population and Health Research Center (APHRC) Data Governance Officer
Funding Agency/Sponsor
Name Abbreviation Role
National Institute for Health Research NIHR Funder

Sampling

Sampling Procedure
500 patients with T2D were recruited from health facilities across four counties (Nairobi, Kiambu, Nyeri, Vihiga). The sample was selected based on existing patient databases from these facilities, ensuring representation from both urban and rural populations.
Deviations from the Sample Design
N/A
Response Rate
The sample size was adjusted for non-response by oversampling by 30%, leading to a total sample size of 500.
Weighting
N/A

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date Cycle
2021-09-16 2023-02-28 18 months
Mode of data collection
Face-to-face [f2f]
Supervision
Enumerators were organized in teams that included experienced research assistants. Each team had supervisors overseeing data collection. The main roles of the supervisors included ensuring data quality and adherence to protocols. There was no specific mention of upper management visits to the field.
Type of Research Instrument
The questionnaires were the T2D patient experience and Healthcare providers perspective questionnaires.

The T2D patient experience questionnaire assessed the patients expereince, acess to healthcare, self-management practices and the challenges they faced during and before COVID-19. The healthcare providers questionnaire assessed the view on how the healthcare managed the patients with type 2 diabetes, the challenges and strategies employed.

The questionnaires were written in English and Swahili to accomodate the linguistic diversity of the respondents.

The questionnaires were developed based on the standard model questionnaire for chronic disease management, adding elements from previous studies on diabetes care. The process was reviewed by stakeholders and feedback was provided on the draft version. The questionnaires were piloted prior to the main study to ensure clarity and relevance.

All questionnaire and module are provided as external resources.

Data Processing

Cleaning Operations
Data was collected electronically using the SurveyCTO program. After each interview, the data was synchronized to the APHRC servers. Data quality checks included spot checks and automated routines to ensure completeness and consistency. There was no specific mention of hot deck or cold deck techniques used for data editing.
Other Processing
N/A

Data Appraisal

Estimates of Sampling Error
N/A

Data access

Contact
Name Email URI
African Population and Health Research Center(APHRC) datarequests@aphrc.org https://microdataportal.aphrc.org/index.php/catalog
Conditions
Data access agreement
The representative of the Receiving Organization agrees to comply with the following conditions:

1. Access to the restricted data will be limited to the Lead Researcher and other members of the research team listed in this request.
2. Copies of the restricted data or any data created on the basis of the original data will not be copied or made available to anyone other than those mentioned in this Data Access Agreement, unless formally authorized by the Data Archive.
3. The data will only be processed for the stated statistical and research purpose. They will be used for solely for reporting of aggregated information, and not for investigation of specific individuals or organizations. Data will not in any way be used for any administrative, proprietary or law enforcement purposes.
4. The Lead Researcher must state if it is their intention to match the restricted microdata with any other micro-dataset. If any matching is to take place, details must be provided of the datasets to be matched and of the reasons for the matching. Any datasets created as a result of matching will be considered to be restricted and must comply with the terms of this Data Access Agreement.
5. The Lead Researcher undertakes that no attempt will be made to identify any individual person, family, business, enterprise or organization. If such a unique disclosure is made inadvertently, no use will be made of the identity of any person or establishment discovered and full details will be reported to the Data Archive. The identification will not be revealed to any other person not included in the Data Access Agreement.
6. The Lead Researcher will implement security measures to prevent unauthorized access to licensed microdata acquired from the Data Archive. The microdata must be destroyed upon the completion of this research, unless the Data Archive obtains satisfactory guarantee that the data can be secured and provides written authorization to the Receiving Organization to retain them. Destruction of the microdata will be confirmed in writing by the Lead Researcher to the Data Archive.
7. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the Data Archive will cite the source of data in accordance with the citation requirement provided with the dataset.
8. An electronic copy of all reports and publications based on the requested data will be sent to the Data Archive.
9. The original collector of the data, the Data Archive, and the relevant funding agencies bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
10. This agreement will come into force on the date that approval is given for access to the restricted dataset and remain in force until the completion date of the project or an earlier date if the project is completed ahead of time.
11. If there are any changes to the project specification, security arrangements, personnel or organization detailed in this application form, it is the responsibility of the Lead Researcher to seek the agreement of the Data Archive to these changes. Where there is a change to the employer organization of the Lead Researcher this will involve a new application being made and termination of the original project.
12. Breaches of the agreement will be taken seriously and the Data Archive will take action against those responsible for the lapse if willful or accidental. Failure to comply with the directions of the Data Archive will be deemed to be a major breach of the agreement and may involve recourse to legal proceedings. The Data Archive will maintain and share with partner data archives a register of those individuals and organizations which are responsible for breaching the terms of the Data Access Agreement and will impose sanctions on release of future data to these parties.
Citation requirement
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download

Metadata production

Document ID
DDI-KEN-APHRC-GEGO-2021-v1.0
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC DDI Documentation
Date of Production
2024-09-02
Document version
Version 1.0 (September 2024)