Fig. 5

Schedule of SAIA monthly visits that were completed by the supervising sub-county implementer during Stage 2 follow-up, from February 2020 to January 2021. Green indicates when visits did occur and red indicates that a supervising sub-county STI or RH coordinator did not visit the clinic. This visit schedule reflects the context in Mombasa County at the time of the study. In February 2020, before any COVID-19 cases were reported in Kenya, the sub-county Coordinators completed supervised hand-off visits with study staff. In March 2020, the COVID-19 pandemic reached Kenya, and restrictions were put in place that impacted government-run services. Beginning in July, normal operations returned to a certain extent, and SAIA supervision visits resumed. However, the healthcare worker go-slow began in October 2020, followed by a full healthcare worker strike beginning in December 2020 that lasted through the end of the study and resulted in disruption of study activities.