COVID-19 Effect on Perinatal Mortality Trends and Health System Resilience in Kisumu County, Western Kenya
1
1, Tropical Institute of Community Health and Development (TICH), Kisumu, Kenya
2
2, Keele University, Staffordshire, United Kingdom
3
3, University of Sunderland, Sunderland, United Kingdom
4
4 Department of Public Health and Sanitation, Siaya County, Ministry Of Health, Siaya, Kenya
5
5 Department of Medical Services, Kisumu County, Ministry of Health, Kisumu, Kenya
Popul. Med. 2026;8(Supplement Supplement 1):A3159
ABSTRACT
BACKGROUND:
Perinatal mortality remains a major public health challenge in low-resource settings and may worsen during health system disruptions such as the COVID-19 pandemic. Examining facility-level trends provides insight into system resilience and informs strategies to reduce preventable deaths.
METHODS:
This was a retrospective longitudinal study that analyzed routine data from the Kenya Health Information System for 2018–2024, including all deliveries (live births, stillbirths) and early neonatal deaths from two Level 4 hospitals (Nyakach and Katito Sub-County Hospitals). Annual perinatal mortality rates (PMR) per 1000 live births were calculated and aggregated across pre-COVID (2018–2019), during-COVID (2020–2021), and post-COVID (2022–2024) periods. Negative binomial regression models, offset by annual live births, were fitted separately for each hospital to estimate period-specific incidence rate ratios (IRRs) and 95% confidence intervals (CIs), accounting for overdispersion.
RESULTS:
Among 9443 deliveries, 110 perinatal deaths were recorded (Nyakach: 51; Katito: 59). At Nyakach, perinatal mortality increased during the COVID-19 period and declined post-COVID, while Katito showed a progressive decline across periods. Negative binomial regression identified no statistically significant differences in perinatal mortality across COVID-19 periods at either facility, with wide confidence intervals reflecting limited statistical power. Both hospitals displayed heterogeneous PMR patterns, reflecting variable recovery after pandemic-related disruptions.
CONCLUSIONS:
Although period-specific effects did not reach statistical significance, the consistency of temporal trends and wide confidence intervals suggest limited statistical power rather than absence of meaningful variation. These findings point to differences in facility-level resilience and highlight the vulnerability of maternal and newborn services during health system disruptions. Strengthening continuity of emergency obstetric and neonatal care, alongside improved routine data use for monitoring and response, is essential to mitigate preventable perinatal deaths during future public health emergencies.
Perinatal mortality remains a major public health challenge in low-resource settings and may worsen during health system disruptions such as the COVID-19 pandemic. Examining facility-level trends provides insight into system resilience and informs strategies to reduce preventable deaths.
METHODS:
This was a retrospective longitudinal study that analyzed routine data from the Kenya Health Information System for 2018–2024, including all deliveries (live births, stillbirths) and early neonatal deaths from two Level 4 hospitals (Nyakach and Katito Sub-County Hospitals). Annual perinatal mortality rates (PMR) per 1000 live births were calculated and aggregated across pre-COVID (2018–2019), during-COVID (2020–2021), and post-COVID (2022–2024) periods. Negative binomial regression models, offset by annual live births, were fitted separately for each hospital to estimate period-specific incidence rate ratios (IRRs) and 95% confidence intervals (CIs), accounting for overdispersion.
RESULTS:
Among 9443 deliveries, 110 perinatal deaths were recorded (Nyakach: 51; Katito: 59). At Nyakach, perinatal mortality increased during the COVID-19 period and declined post-COVID, while Katito showed a progressive decline across periods. Negative binomial regression identified no statistically significant differences in perinatal mortality across COVID-19 periods at either facility, with wide confidence intervals reflecting limited statistical power. Both hospitals displayed heterogeneous PMR patterns, reflecting variable recovery after pandemic-related disruptions.
CONCLUSIONS:
Although period-specific effects did not reach statistical significance, the consistency of temporal trends and wide confidence intervals suggest limited statistical power rather than absence of meaningful variation. These findings point to differences in facility-level resilience and highlight the vulnerability of maternal and newborn services during health system disruptions. Strengthening continuity of emergency obstetric and neonatal care, alongside improved routine data use for monitoring and response, is essential to mitigate preventable perinatal deaths during future public health emergencies.
| eISSN: | 2654-1459 |
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