Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-for-profit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike. The volume of patients increased and exceeded the hospital’s ability to respond to needs. There were substantial increases in sick newborn admissions during this time frame and an additional ward was opened to respond to this need. Increased need occurred across all services but staffing and space limited ability to respond to increased demand. There were increases in deaths during the strike period across the paediatric medical, newborn, paediatric surgical and obstetric units with an OR (95% CI) of death of 3.9 (95% CI 2.3 to 6.4), 4.1 (95% CI 2.4 to 7.1), 7.9 (95% CI 3.2 to 20) and 3.2 (95% CI 0.39 to 27), respectively. Increased mortality across paediatric and obstetrical services at AIC-Kijabe Hospital correlated with the crippling of healthcare delivery in the public sector during the national physicians’ strike in Kenya.

In Kenya, cancer is the third leading cause of death. The African Inland Church Kijabe Hospital (AICKH) is a level 4 missionary hospital. The hospital serves the Kenyan population in many areas, including cancer care, and some of these services were affected during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to leverage a recently established hospital-based cancer registry of patients treated at AICKH between 2014 and 2020 to describe the cancer cases and patient referral patterns seen at AICKH during the COVID-19 pandemic in 2020. A cross-sectional retrospective survey was conducted through medical records abstraction in the surgery, breast clinic, palliative care and pathology departments. A total of 3279 cases were included in the study, with females accounting for 58.1% of the cases. The top-three cancers overall were breast (23.0%), oesophagus (20.5%) and prostate (8.6%). There was a minimal increase in the number of cancer cases in 2020 (1.7%) compared with 2019, with an increase of 19.3% in 2019 compared with 2018. In conclusion, AICKH is one of the few hospitals in Kenya where a large number of cancer patients seek healthcare, and referral of cancer cases changed in 2020, which may be due to the COVID-19 pandemic. Future efforts can leverage this registry to determine the impacts of cancer diagnosis and treatment on survival outcomes.

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