Articles

Personal characteristic and academic help-seeking behavior of basic diploma nursing students in Kenya Medical Training College, Nairobi

2019-01-01T00:00:00Z

Personal characteristic and academic help-seeking behavior of basic diploma nursing students in Kenya Medical Training College, Nairobi Ombasa, Zachary O; Mutinda, Agnes K; Mutungi, Alice Karimi Purpose: This cross-sectional mixed survey sought to describe AHSB of basic diploma nursing students in KMTC, Nairobi, Kenya. The study examined the influence of sources of help, options of help-seeking and personal characteristics on help-seeking behavior. Methods: Data was collected using self-administered questionnaires. Descriptive statistics and inferential statistics (in particular, the chi-square, Fisher’s Exact and binary logistic regression) were derived from the data. All statistical tests of significance were at 95% confidence level. Results: the study revealed that 90.9% (n=160) of respondents were adaptive help seekers, 72.8% (n=126) preferred peers to lecturers and 75.6% (n=133) frequently sought help from fellow students, especially during group discussions. By contrast, 54.6% (n=95) of the respondents approached instructors during class or immediately after lesson; with only 24.6% (n=43) engaging lecturers privately. Adaptive help seeking was positively associated with personal factors of self-efficacy (p=0.034), the notion that the student is of equal worth with peers (p=0.038) and a feeling that help seeking is not a sign of weakness. On binary logistic regression, students who felt that seeking help was a sign of weakness were significantly less likely to be adaptive help-seekers. The study concludes that personal factors are significant predictors of adaptive help seeking behavior of student nurses in KMTC Nairobi. Unique contribution to theory, practice and policy: The research recommends that institutions encourage students to treat peers as people of equal worth; and that seeking help is not a sign of weakness. Moreover, schools should explore ways of increasing help seeking from lecturers, especially in their offices

Factors influencing uptake of antenatal care in Taita Taveta County, Kenya

2019-01-01T00:00:00Z

Factors influencing uptake of antenatal care in Taita Taveta County, Kenya Ndegwa, Mwanyoha Ndegwa; Oluoch, Musa; Kimemia, Fredrick Purpose: The general purpose of the study was to establish factors influencing uptake of antenatal care among pregnant women. Methodology: The study was conducted in TaitaTaveta County, Kenya, which had a population of 338,696, with 81,288 women estimated to be of reproductive age, and 9,823 women estimated to be pregnant per year. The county had a total of 60 public health facilities, including 1 public referral hospital, 3 sub-county hospitals, 18 health centres and 38 dispensaries. The total workforce for the public health facilities was 1000 health care providers, including 300 (30%) nurses/midwives, 25 (2.5%) doctors, and 1750 community health volunteers. Data was collected using structured questionnaires for the mothers (n=381) and key informant interview for the in-charges (n=17). Data was analysed using SPSS, version 23. Chi-square and Spearman’s R tests, and categorical regression were used to determine the relationship between uptake of antenatal care and the independent variables. The results were summarized and presented in form of tables, figures and charts. Findings: Results indicated that antenatal care initiation time (R2 = 0.07) had a weak positive influence on uptake of antenatal care, while skilled health providers’ attitudes (R2 = 0.82), availability of community health volunteers (R2 = 0.78), and availability of skilled health providers (R2 = 0.92) had a strong positive influence on uptake of antenatal care.

Determinants of a functional refferral system in Kisumu County,Kenya. Patient perspective.

2019-01-01T00:00:00Z

Determinants of a functional refferral system in Kisumu County,Kenya. Patient perspective. Nango, Wilbert Otieno; Mwangi, Eunice Muthoni; Oluoch, Musa Purpose: Most referral health facilities are faced with challenges ranging from congestion of patients at these health facilities, strained/ limited resources (both human and material) to deal with the voluminous patients, slow rate of service delivery to the patients which normally results in compromised quality of medical care provided to the patients. The study therefore aimed to find out the determinants of a functional referral system in two high level health facilities; Jaramogi Oginga Odinga Referral Hospital (JOOTRH) and Kisumu County Referral Hospital (KCH). Methodology: A cross sectional study was conducted using a quantitative approach to data collection. Three hundred and thirty eight out-patient clients were systemically selected to participate in the study. Data was collected using Individual questionnaire. The collected quantitative data were coded and analyzed using the SPSS 25.0 Computer program. The quantitative data were then analyzed using the descriptive statistics and logistic regression models. Results: The research findings revealed that there is a positive significant correlation between primary health facility characteristics (r = 0.474**; P<0.000).It also revealed that there is a positive significant correlation between receiving facility characteristics (r = 0.475**; P<0.000) to a functional referral system. Further Multivariate analysis also revealed a significant association between referral health facility characteristics and a functional referral system, (β3 = .425, P =.000).The results further revealed that there was a negative significant association between receiving health facility characteristics and a functional referral system, (β4 =.-0.156, P < .000). Unique Contribution to Theory, Practice and Policy: The County government of Kisumu should supply adequate drugs and equipment’s to attract more patients seeking medical care services to the primary level facilities. Quality of services offered and general cleanliness at the primary health facilities should also be improved to boost patient’s confidence in them. Key Words: Functional Referral System, health facilities; Jaramogi Oginga Odinga Referral Hospital (JOOTRH) and Kisumu County Referral Hospital (KCH).

Factors influencing Healthcare Waste Management System in Machakos County, Kenya

2019-07-01T00:00:00Z

Factors influencing Healthcare Waste Management System in Machakos County, Kenya Mwania, Michael Musango; Oluoch, Musa; Kimemia, Fredrick Machakos County health facilities have poor healthcare waste segregation, treatment and disposal practices; patients, health workers including waste handlers and the general population are exposed to risks of needle stick injuries and infection of HIV/AIDS and Hepatitis B&C. All population is exposed to risks associated with furans, dioxins and heavy metals released to the environment through open and crude burning of healthcare waste. World Health Organization recommends supporting and strengthening a health system based on six health system building blocks that includes quality service delivery. The study focused on strengthening the service delivery pillar of health systems in which good health services are expressed as both personal and non-personal quality care, through addressing aspects of safe healthcare waste management (HCWM) herein viewed as non-personal services that directly or indirectly affect patient, health workers and the general population health. The purpose of this study was to determine factors affecting HCWM system in Machakos County. Specific objectives were to determine the healthcare waste management process, health Managers role, human resource factors, and how healthcare waste management policy implementation affect HCWM system in health facilities in Machakos County. Methods: We used survey research design. A sample size of 120 respondents was drawn using both stratified random and purposive sampling techniques. Data was collected using questionnaires and an interview guide. Results: The findings showed that the role of health managers (β2 = .436, P < .001), human resource factors (β3 = .065, P < .002), and healthcare waste management policy implementation (β4 = .275, P < .001) influenced management of healthcare waste system. Conclusions: Health managers’ role had the strongest positive and significant influence on HCWM. Recommendations: i) adoption of safe technologies for treatment and disposal of healthcare waste, ii) refresher trainings on HCWM to all healthcare staff on existing HCWM policies in Kenya, iii) provision of adequate budget to procure enough HCWM commodities, iv) provision of adequate personal protective equipment to all health staff, and v) vaccination of health staff against Hepatitis B.

Status of Health workers Knowledge on Maternal and Neonatal Health related to Service Delivery in Makueni County

2019-07-01T00:00:00Z

Status of Health workers Knowledge on Maternal and Neonatal Health related to Service Delivery in Makueni County Kasanga, Bernard; Muthoni, Eunice; Oluoch, Musa Globally, new born mortality remains unacceptably high. Neonatal mortality accounts for 60% of infant mortality rate in Kenya. In Makueni County, 1 in 22 children does not live to his or her first birth day. This unacceptable high mortality is despite existence of cheap and tested interventions which could reduce up to 70% of current deaths. Evidence of mismanagement of clients in the County health facilities has raised concerns whether health workers attending to mothers and neonates are knowledgeable. The purpose of this study was to determine health worker knowledge on maternal and neonatal health related to service delivery in Makueni County. Specific objectives were to determine prenatal care, preeclampsia and postnatal care knowledge among primary care givers and how it relates to service delivery. Methods: we used a cross sectional research design. A total of 163 health workers selected through simple random sampling were involved. Data was collected using a structured questionnaire and observational checklist. Results: On prenatal care, majority of health workers 89(54.6%) had good knowledge (X2 =45.1 p<0.05). Practice didn’t conform to guidelines since 30.3% and 69.7% of antenatal mothers didn’t have full history taken and general physical examination done respectively. On pre-eclampsia, majority of caregivers (78, 49.4%) had poor knowledge while on postnatal care 53(32.5%), 58(37.4%) and 132 (80%) had good knowledge in new-born care, management of neonatal infections and young infant feeding respectively. Conclusions: The study concluded that health workers were not following guidelines and lacked adequate knowledge in management of pre-eclampsia, newborn care and neonatal infections. Recommendations: The study recommends the following to Makueni County health managers (i) to have refresher course, targeted continuous medical education and standard operating procedure on management of pre-eclampsia (ii) to strengthen supportive supervision and ensure guidelines are adhered to (iii) to retrain workers on new-born care and management of neonatal infections

Influence of training on performance of nursing officers, in Nyeri County, Kenya

2019-01-01T00:00:00Z

Influence of training on performance of nursing officers, in Nyeri County, Kenya Ongori, Jeremiah M.; Oluoch, Musa; Adoyo, Maureen A. Purpose: The management of human resources in healthcare institution is essential to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Training and development is most effective in motivating and retaining high quality human resources within healthcare organization. This study therefore sought to establish the influence of training on the performance of nursing officers, in Nyeri County, Kenya. Methodology: This study adopted a cross sectional descriptive research design. The respondents constituted all nursing staffs and managers in Nyeri County Public Health facilities and at the County Director’s Office. Stratified random sampling was used to come up with a sample of 248 respondents. Data was collected using questionnaire. Descriptive statistics were used in the analysis of data with the help of SPSS. Chi-square analysis was used to establish relationships. Findings: The study found that training of nurses was conducted but there was a limitation in the diversity of approaches used. There was a significant relationship (χ2= 34.500, df=12, p=0.001, v=0.422) between training and the performance of nursing officers, in Nyeri County. The study concluded that training influences the performance of nursing officers, in Nyeri County, Kenya. Specifically, the lack of adequate training is a drawback in service delivery. Unique contribution to theory, practice and policy: The study recommends that training programs in the health sector should therefore be reviewed in order to employ more techniques in the training of nurses.

Relationship Between Structural Arrangement and Provision of Primary care Quality: A Case of Health Centers in Nakuru County, Kenya

2019-08-01T00:00:00Z

Relationship Between Structural Arrangement and Provision of Primary care Quality: A Case of Health Centers in Nakuru County, Kenya Kandagor, Amos Kipngetich; Wanja, Mwaura-Tenambergen; Mwangi, Eunice Muthoni Introduction: Healthcare is a fundamental need, its availability and comprehensiveness helps in making people’s life better and productive. Delivery of quality care requires an efficient system with adequate capacity of well trained and motivated health workforce, good infrastructure, good leadership and governance and effective system for financing primary care. This study aimed at finding out the relationship between structural arrangement and provision of primary care quality in Kenya and majorly focused on the public health centers in Nakuru County. Methods: The study used census research design. A total of 102 respondents comprising technical health workers were included in the study. Data was collected using closed and open ended questionnaire and was analyzed using SPSS. Descriptive analysis was used to profile the characteristic of the respondents. Mean standard deviation and correlation was used to perform analysis of the extent to which each independent variable was considered significant in influencing provision of quality primary care service. Findings: Adequate infrastructure led to an increase in provision of primary care quality in health centers (r=0.453, P<0.001), while increased employee capacity improved provision of primary care quality (r=0.365, P<0.001). Sufficient fund and effective financial management improved provision primary care quality (r=0.567, P<0.001) and effective governance improved provision of primary care quality (r=0.613, P<0.001). Conclusion: The results show that good infrastructure, sufficient funds, high staff capacity, transparency and accountability improved primary care service delivery. Good structures lead to good processes and ultimately good health outcome. Provision of equipment’s to perform the necessary work, adequate allocation and timely release of funds to health centers, career progression and continuous professional development, institute staff retention measures and frequent auditing of assets and liabilities and report made public.

Factors influencing demand for healthcare insurance:A study of jua kali workers in Nairobi

2013-01-01T00:00:00Z

Factors influencing demand for healthcare insurance:A study of jua kali workers in Nairobi Nalebeson, Mugubi Robert N.; Odhiambo-Otieno, George W. Health systems are a means to achieving better health outcomes for all. However, where patients depend largely on out of pocket (OOP) payments to access health services, there is often lack of care for those who cannot afford. This study aimed at establishing the fac¬tors influencing the demand for health insurance among Jua Kali workers in Nairobi. This was a cross-sectional research study involving mixed approach (simple random, purposive sampling, qualitative and quantitative methods) involving 130 Jua Kali workers from Associations/Cooperatives and 258 Jua Kali workers from non-organized groups; key informants from NHIF and the Department of Micro and Small Enterprise Department and was. The study was conducted between January to March 2012 within Pumwani Division in Nairobi County. Findings indicated that 113 (29.1%); 21.1% members of Jua Kali association and 11.8% individualJua Kali workers out of 388 were enrolled in NHIF while 262 (67.5%) were not enrolled in NHIF. Inadequate Knowledge of NHIF benefit and the KShs. 480 upfront NHIF premium payment were the main contributing factors to non-enrolment of262 (67.5%) of Jua Kali workers. 42.3 % individual Jua Kali and 6.1 % members of association with a monthly income less than KShs. 9,000 did not enrol in NHIF. To enhance more enrolment of Jua Kali workers, the study recommends that NHIF should design strategies that target the younger, low income and Jua Kali workers with low level of education with key information on health insurance benefits and the benefits of enrollment in NHIF , establish satellite pay¬ment offices within Jua Kali working zones to bring services closer to them, apply KShs. 160 per month instead of KShs. 480 and enhance networking and engage Jua Kali association as strategic partners for the purpose of motivating Jua Kali workers enrollment. P 159-173

Haematological and serological findings in Cercopithecus aethiops(African green monkeys) with Cyclospora infections in Kenya

2013-01-01T00:00:00Z

Haematological and serological findings in Cercopithecus aethiops(African green monkeys) with Cyclospora infections in Kenya Nguhiu, Purity N.; Wamae, Claire N.; Magambo, Japheth K.; Yole, Dorcas S. Cyclospora,is a common cause of gastroenteritis in humans resulting in protracted life threat¬ening diarrhoea in immunocompromised patients worldwide.Cyclospora infections have been reported in African green monkeys. The objective of the study was to determine the haema¬tological and serological parameters in African green monkeys with Cyclospora infections.A cross-sectional laboratory based study was done at Institute of Primate Research, Nairobi, from March 2008 to June 2009. Thirty three African green monkeys comprising of 10 male adults, 7 female adults, 3 male juveniles and 13 female juveniles were analysed for blood cell counts using a haematological analyser and screened for Cyclospora by ELISA. The red blood cell counts decreased in all study animals with mean decline of 1.2-1.5 (x 106/µl). The white blood cell counts varied among the study animals with highest increase among female adults from4.3-7.1 to 5.4-8.8 (x 103 /µl) and a decrease among the male adults from 3.9-8.7 to 1.5-5.3 (x 103/µl). Positive antibody responses to Cyclospora were observed in 20 of the study animals with highest mean optical density (OD) values of 0.816 ± 0.100 observed among the female juveniles and lowest among the male juveniles at mean OD value of 0.646 ± 0.055. In conclusion, Cyclospora infections triggered both cellular and humoral responses in the African green monkeys. P 122-131

The Caves of Mount Elgon and Their Sandfly Fauna David K

2011-01-01T00:00:00Z

The Caves of Mount Elgon and Their Sandfly Fauna David K Sang, David K. A survey of the Kenyan side of Mount Elgon revealed numerous caves which were found harbouring phlebotomine sandflies. Among the morphologically identifiable males of rwo species of the genus Phlebotomus, sub-genus Larroussius were indistinguishable females, a proportion of which were infected with promastigotes of Leishmania. The suspected vector of this parasite, Phlebotomus pedifer was found predominant in a relatively low altitude escarpment belt at l 750- l 900m, and represented over half of the identified male sandflies detected from the slopes of Mount Elgon. These male sandflies were associated with females infected with Leishmania and those which bit man. At intermediate and higher altitudes, the caves harboured mainly P.elgonensis and were associated with river valleys and major promontories. The escarpment which is a proven focus of cutaneous leishmaniasis was approximately 257 sq km and 10% of the study area, and took the form of a narrow, elongate cliff along the entire southern slopes of the mountain. Details of the distribution of caves on the slopes of Mount Elgon and their sandfly fauna are presented. P 98-103