Ministry bets on home-based care to avert hospital crisis

With hospitals overwhelmed by the Covid-19 pandemic, home-based care for patients is helping manage the crisis, and authorities say they are impressed with the progress.

Health Director-General Patrick Amoth said under home-based care, the government has saved resources and directed them to patients who need critical care.

An asymptomatic patient admitted to a hospital spends at least Sh23,000 in treatment a day, with the bulk of the cost going on personal protective equipment.

A patient with moderate symptoms pays Sh51,000 and Sh71, 000 for patients who are critically ill, he noted. “Home-based care has been very successful because a majority of our discharges are from this programme.”

By Sunday, there were 6,583 patients in home-based isolation and care.

At home, the patient fills a daily monitoring sheet twice a day and sends feedback to the hospital. Medics visit the patient twice in a fortnight to check their blood pressure, any changes in their condition and their temperature difference.

According to the Ministry of Health home-based care guidelines, community volunteers are the communication link between healthcare workers and the household for the duration of the isolation period until the patient’s symptoms have completely resolved. The patient is also provided with a daily monitoring form detailing their temperature and any symptoms they may develop during the 14 days.

Dos

• Place the patient in a dedicated separate well-ventilated isolation room.
• Limit the movement of the patient in the house to minimise time spent in shared spaces such as kitchen and bathroom.
• Limit the number of caregivers — ideally it should be one person who is in good health and has no underlying condition.
• A face mask should be provided to the patient, which should be worn at all times.
• Use dedicated linen and eating utensils for the patient, which should be disinfected with 0.5 per cent bleach immediately.
• Masks, gloves and other waste generated during home-based care should be properly disposed of as infectious waste.

Don’ts

• Visitors should not be allowed in the isolation room. Do not reuse single-use masks.
• Avoid direct contacts with body fluids, especially oral or respiratory secretions.