How can countries maximise their resources to identify COVID-19 outbreaks and prevent the spread of this evolving disease? In Kenya, USAID’s Tupime Kaunti project demonstrated that using data to coordinate interventions can make a vital difference in fighting infectious diseases. Lillian Mageto, the Chief of Party of the recently wrapped up five-year long project, reflects on how the team pivoted to address COVID-19 and what they learned along the way.

The project, which launched in 2016, shifted in real time to support local governments in addressing the emerging COVID-19 pandemic. “The aim for Tupime Kaunti was to strengthen county health systems for HIV, malaria, and reproductive health programming,” Mageto explains.

“As much as there was pivoting along the way, the purpose remained the same despite the expansion to other disease and geographical areas. The overall goal of improving sector-wide measurement and evaluation systems for decision making and accountability was attained.”

From the start of the pandemic, the Tupime Kaunti project technically supported three counties to put in place their emergency operations centre functional, leverage on the skills built among the officers to bolster local government’s data analysis skills for COVID-19 surveillance and control. As a result, governments in the three partner counties were empowered to make rapid decisions to address outbreaks and slow the spread of COVID-19 in Kenya.

Tupime Kaunti Pivoted to Help Counties in a Crisis

When Kenya reported its first case of COVID-19 in March 2020, it was clear to Mageto that the government didn’t have adequate funding to address it. “The allocated resources the county governments and the national level Ministry of Health were not sufficient to deal with this fatal disease and needed a lot of investment to combat it in a short time,” she explains.

Since Tupime Kaunti had been supporting strategic health information for three and a half years and had strong relationships with both the county and sub-county health management teams, the team was well-prepared to pivot, and pivot quickly to address the emerging threat of COVID-19. She adds that due to a reduction in funding at the end of the project’s first year, the team had learned how to do more with less.
Mageto notes that she almost considers COVID-19 a blessing for the project.

“It tested the capacities and the systems we helped put in place. The health care workers who were trained on data management came in handy to capture and provide quick analytics for use during the day-to-day response,” she explains.

“The strategic information work we did for COVID-19 helped strengthen our overall outcomes in the sense that it tested the resilience of the monitoring and evaluation systems that we put into place.”

From May to December 2020, the Tupime Kaunti project focused on strengthening the counties’ capacity to support emergency operations centres for management and response to the pandemic; generating county-level epidemic intelligence to tailor short- and medium-term plans; and mobilising resources for a public health approach to case management.

In Migori County, which borders Tanzania, Tupime Kaunti trained government officers on how to use a Geographic Information System (GIS) to analyse and map COVID-19 hotspots. As a result, the county’s monitoring and evaluation unit began including maps in their daily situation reports and weekly factsheets for the county health leadership to review. These enhanced visualisations led to informed and targeted decisions to stop outbreaks and advocate for resources.

“We have been able to use the COVID-19 data by Tupime Kaunti to seek supplementary funds through the county assembly,” notes Migori County Executive Committee Member in Charge of Health Dr. Iscar Oluoch. “County assembly members started taking the situation seriously when we presented data to them, and they allocated more funds towards mitigation measures.”

Nakuru County, one of the most populous areas in Kenya, was able to reduce the number of COVID-19 cases with analytics and financial support from Tupime Kaunti. The project worked closely with the county epidemiologist and county health records information officer to consolidate the data on all COVID-19 cases and then use the data to generate county-specific maps.

The maps highlighted where confirmed cases were identified, treated, and quarantined. Additionally, they revealed that a high number of people required isolation services and home-based care compared to the space available in the local health facilities.

The highly populated Kakamega County lacked a coordinated rapid response structure prior to the pandemic. The County Rapid Response Team, with the support of Tupime Kaunti and other USAID partners, visited hospitals earmarked as COVID-19 treatment centres in four sub-counties and uncovered that all of the sub-counties had different coordination and response approaches to the pandemic despite the national government’s proposed coordination system for addressing COVID-19.

Tupime Kaunti helped set up the requisite multisectoral, multi-partner coordination mechanisms at the county and sub-county levels to ensure efficiency in the COVID-19 response operations and streamlined all response activities across the 12 sub-counties.

Adapting to COVID Prepared Counties to Address Future Pandemics

These success stories of data use and improved coordination are not merely short-term gains for Kenya’s health system. New skills in data analysis and visualisation, particularly in GIS mapping, are currently being utilised to generate GIS maps for all health sector data. The Tupime Kaunti project helped counties co-create work plans, document coordination structures, conduct data quality reviews, and monitor response plans.

As Mageto adds, all of these actions can be applied to improving the overall health sector in the long run. “The skills, experience, and coordination gained by these counties during the pandemic in Kenya will easily translate into other disease areas, helping prevent future outbreaks of COVID-19 or even other novel illnesses.”

“It feels good to complete a project,” she adds. “The sense of accomplishment of getting to the finish line was epic. We had a tagline for the final year of ‘finishing strong’ and this is what kept the team together until the last day.”

A five-year strategic information health project, Tupime Kaunti worked with county governments from 2016-2021 to strengthen measurement, learning, and accountability systems to provide high-quality health data for program planning, policy development, and decision-making. The project supported 12 counties to increase the availability, analysis, and use of high-quality data. For more information, contact info@thepalladiumgroup.com.