The psychosocial impact of COVID-19 mitigation measures on frontline staff providing sexual health and family planning services in Kenya: a mixed-methods study.
Okwaro F, Mohiddin A, Temmerman M • Reproductive health • 2025
The psychosocial wellbeing of HCWs was majorly neglected in the government response mechanisms for the pandemic leading to burnout and depression, as well as HCWs absconding their duties and avoidance of testing and disclosure of status.
Key Findings
Results
Psychosocial wellbeing of healthcare workers was largely neglected in Kenya's government pandemic response mechanisms.
Recovery mechanisms initiated by the Ministry of Health concentrated on policy and infrastructural elements of service provision.
Limited attention was given to the psychosocial impacts of COVID-19 on healthcare workers.
The neglect of psychosocial wellbeing was identified as the study's main finding.
The study focused on frontline family planning (FP) and sexually transmitted infections (STI) management healthcare workers in Kenyan public health facilities.
Results
Healthcare worker psychosocial neglect led to burnout and depression among frontline SRH service providers.
Burnout and depression were identified as direct consequences of neglected psychosocial wellbeing during the pandemic.
These outcomes were observed among HCWs providing FP and STI health care services within Kenyan public health facilities.
The study used qualitative data to examine the mental and psychosocial states of these HCWs.
Both quantitative and qualitative (mixed-methods) approaches were used to capture these outcomes.
Results
Healthcare workers absconded their duties in the initial stages of the pandemic.
Absconding of duties was identified as a behavioral consequence of poor psychosocial support during the early pandemic period.
This behavior was linked to the neglect of HCW psychosocial wellbeing in the government response.
This finding emerged from qualitative data examining HCW mental and psychosocial states.
Results
Healthcare workers avoided COVID-19 testing and disclosure of their status as the pandemic progressed.
Avoidance of testing and non-disclosure of COVID-19 status were identified as coping mechanisms adopted by HCWs.
These behaviors were described as undermining government mitigation measures.
HCWs whose COVID-19 status remained unknown put patients and colleagues at risk of infection.
This pattern emerged in later stages of the pandemic, in contrast to duty absconding which occurred in initial stages.
Background
COVID-19 mitigation measures had unintended negative impacts on the availability of sexual and reproductive health services in Kenya.
The Ministry of Health initiated mitigation and health systems support mechanisms within public health facilities to maintain pre-COVID-19 levels of SRH service provision.
The study examined FP and STI management services specifically.
Quantitative methodology analyzed data on the preparedness of the health sector to maintain service provision levels.
The recognition of these unintended impacts prompted the initiation of recovery mechanisms.
Conclusions
The study recommends that future pandemic responses include mechanisms addressing HCW psychosocial wellbeing as a core element.
Authors recommend psychosocial wellbeing support be treated as a core element of pandemic response for effective management.
For new and unprecedented pandemics, HCWs should be provided with accurate and timely information about the pandemic.
HCWs should also receive clear guidance on expected conduct in service delivery and promotion of a culture of risk reduction.
These recommendations are framed as applicable to future pandemics beyond COVID-19.
What This Means
This research suggests that when Kenya's government rolled out its COVID-19 response to protect sexual and reproductive health services, the mental and emotional wellbeing of the frontline health workers providing those services was largely overlooked. While policies and physical infrastructure received attention, the psychological toll on nurses, clinicians, and other staff providing family planning and STI services was not adequately addressed. As a result, these workers experienced burnout and depression, and some simply stopped showing up to work during the early pandemic period.
As the pandemic continued, the study found that some healthcare workers began avoiding COVID-19 testing and did not disclose their infection status to colleagues or supervisors. This research suggests these behaviors were coping responses to an environment where workers felt unsupported and feared the consequences of a positive test. Critically, this put both patients and coworkers at risk of unknowing exposure to COVID-19, effectively undermining the very public health measures the government had put in place.
This research suggests that any future pandemic response plan should treat the psychological and emotional support of healthcare workers as a fundamental component — not an afterthought — of the overall strategy. Providing workers with clear, timely, and accurate information about a new disease, along with explicit guidance on professional conduct and safety, may help prevent the kinds of avoidance behaviors observed here. The findings are particularly relevant for low- and middle-income settings where healthcare worker shortages mean that each worker's presence and performance has an outsized impact on community health outcomes.
Okwaro F, Mohiddin A, Temmerman M. (2025). The psychosocial impact of COVID-19 mitigation measures on frontline staff providing sexual health and family planning services in Kenya: a mixed-methods study.. Reproductive health. https://doi.org/10.1186/s12978-025-02089-9