Covid-19 response in Nairobi: A political settlements approach

Abstract

This paper analyses the response to the Covid-19 pandemic in Nairobi, including measures to treat, prevent and mitigate the impact of the pandemic. It also explores the dynamics among policy actors or the “Covid policy domain” that led to the response and takes a political settlement perspective to examine the broader politics around this response. Methods include key informant interviews conducted between August 2021 and March 2022 and a review of policy documents reports and media sources. This study finds that, despite serious corruption in the Ministry of Health that impacted response effectiveness, the government, with support from civil society, media, the private sector and multilateral institutions, was able to relatively successfully manage the spread of the virus in the capital. However, the failure to mitigate adverse impacts from the Covid-19 response itself led to serious suffering, especially among those living in poverty and women, who faced loss of livelihoods and escalating and gender-based violence. Programmes were set up to address some of the adverse impacts, especially lost livelihoods, as part of a “regenerative strategy” before the upcoming election, but these programmes faced several barriers, including poor service delivery mechanisms and corruption. Some learning from the pandemic is also evident, as the county and national government appeared to make progress on institutionalising community health volunteer programmes. These are vital to extending healthcare to those living in the most deprived circumstances and preparing for public health challenges to come.