On March 11, 2020, the World Health Organization (WHO) declared coronavirus 2019 (COVID-19) a global pandemic. The WHO estimates that 10 % of the global COVID-19 clinically diagnosed cases are among health workers with over 10,000 of the infected health workers coming from 40 African countries (1). Health care workers have been reported to have 11.7 times the risk of testing positive for COVID-19 compared to the general community (2). This increased risk of infection has been primarily attributed to a lack of adequate personal protective equipment (PPE) (3, 4).
Although existing evidence indicates that the type of PPE may determine the level of protection against COVID-19 infection among healthcare workers (5), there is a consensus for the consistent use of PPEs (a surgical mask, gloves, eye protection and a gown) when providing care for COVID-19 patients (2, 6). Providing PPE to healthcare workers is, therefore, a critical component of the response to the COVID-19 pandemic (7, 8).
Countries are experiencing PPE shortages for frontline health care workers. PPE availability is affected by increased demand, global supply chain disruptions resulting from interventions to control the pandemic (9), challenges with ensuring rational use, ensuring supplies are preserved for areas with the greatest need, and lack of accountability in delivering PPE supplies to the frontline. This is despite the growth in local manufacturing of PPE in many countries and gradual improvements in international supply chains (10).
Ensuring healthcare workers are protected from COVID-19 infection is paramount especially in those countries with low healthcare worker numbers in absolute and relative terms (11). These same countries will experience greater strain on their ability to manage cases of COVID-19.
Kenya is a lower-middle-income country with 13.8 health care workers per 10,000 population in 2016. There is a steady pipeline of human resources for health development mainly from non-university tertiary level institutions (12, 13). The workers are employed in both public and private sectors with dual practice common (14). Public sector employment is mainly through county governments who are the main providers of public health services (15). Private sector employment is through not-for-profit and for-profit organizations and sole proprietorships (16). Healthcare workers are inequitably distributed with urban areas attracting and retaining more. There are challenges with the effective management of public sector workers contributing to repeated episodes of industrial action in recent years (17).
Kenya reported 3,068 infections and 32 mortalities among healthcare workers as of 11th January 2021 (18). This represents 3.1% of total infections as of this date. Anecdotal evidence identifies the availability of PPE as a key contributor to these infections. Concerns about the availability of PPE in Kenya have led to industrial unrest among healthcare workers (19). The impacts of continued infection of healthcare workers are likely to be severe but are yet unknown. This paper seeks to quantify the costs and cost-effectiveness of availing adequate PPE to healthcare workers in Kenya and the resulting return on investment at a societal level.