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Adaptability, Scalability and Sustainability of Mhealth Projects Performance in Low and Medium-Income Countries: A Systematic Review
(Global Press Hub, 2026-03) Mutula, Martin Wambua; Sang, Paul
Mobile health (mHealth) initiatives have immense potential to revolutionize healthcare service delivery in terms of accessibility, quality, and outcomes in low- and middle-income countries (LMICs). However, the progress of mHealth initiatives in LMICs is often marred by the challenge of "pilotitis," wherein successful pilots do not result in scalable or sustainable mHealth initiatives. This independent study paper is an attempt at conducting an in-depth systematic review of recent literature (2020-2025) to explore the various interrelated factors that affect the adaptability, scalability, and sustainability of mHealth initiatives in LMICs. The overall objective is to explore the various barriers and facilitators that affect the long-term performance and institutionalization of mHealth initiatives. For the systematic review, a desktop systematic review methodology was conducted by searching various prominent databases like PubMed, Scopus, and Web of Science to retrieve relevant peer-reviewed articles and systematic reviews on mHealth initiatives, scalability, and sustainability in LMICs. The results have identified a number of key challenges that can affect the scalability and sustainability of mHealth projects. These include a lack of infrastructure such as a stable electricity supply and a lack of good internet connectivity, the cost of mobile data communication, a lack of digital literacy among healthcare professionals, and a lack of compatibility with existing healthcare information systems. The study thus underscores the need to move beyond technology-focused strategies to health systems strategies in the design and implementation of mHealth interventions. Flexibility in accommodating local contexts has thus been identified as a key factor that influences the sustainability of mHealth interventions. As a result, the study has made several recommendations, including the use of context-sensitive evaluation approaches, such as the HOT-FIT-BR model, to move beyond pilot interventions to sustainable mHealth in LMICs
Executive Remuneration Structure and Corporate Firm Value Among 25 Index Listed Firms at the Nairobi Securities Exchange, Kenya
(International Academic Journal of Economic and Financial Research, 2026-03) Omondi, Elvis Owino; Aluoch, Moses Odhiambo
Purpose: This study examined the effect of executive remuneration structure on corporate firm value among the 25 Index listed firms at the Nairobi Securities Exchange. The research aimed to determine how fixed remuneration, shortterm incentives, and long-term incentives influenced firm value, considering the moderating role of financial leverage. Methodology: The study adopted a quantitative research design to examine relationships between executive remuneration components and firm value. The target population comprised firms listed under the Nairobi Securities Exchange 25 Share Index over a five-year period from 2018 to 2022. Secondary data were obtained from annual reports and financial statements of the listed companies. Data were analyzed using Econometric Views (EViews) software, applying descriptive statistics, correlation analysis, and panel regression. Findings: The findings indicated that longterm remuneration components had a positive and statistically significant effect on firm value. Conversely, fixed remuneration, short-term incentives, and other executive perks were not statistically significant in explaining variations in firm value. Financial leverage was found to significantly moderate the relationship between executive remuneration and firm value, with higher leverage increasing firm risk and weakening the positive influence of long-term incentives. Unique Contribution to Theory, Practice and Policy: The study contributes to corporate governance literature by providing empirical evidence on the effectiveness of executive remuneration structures in enhancing firm value in emerging markets. Practically, it reveals the importance of emphasizing long-term incentive schemes in executive compensation packages. From a policy perspective, the findings offer insights to regulators such as the Capital Markets Authority and corporate remuneration committees.
Antimicrobial Activity of Zinc Oxide Nanoparticles and Allium sativum Extract against Pathogenic Escherichia coli and Staphylococcus aureus Isolates
(EA Health Research Journal, 2026-02) Mwachofi, Fromence Nyambu; Mwangi, Anthony; Macharia, Catherine; Nyamache, Anthony Kebira
Background: The increasing trends in antimicrobial resistance (AMR) have continued to pose a global public health
concern. This rapid emergence and spread of antimicrobial resistance have necessitated the exploration of innovative
approaches to combat microbial infections. This study investigated the potential of enhancing antimicrobial properties
through the synergistic effect of zinc oxide nanoparticles (ZnO NPs) and Allium Sativum (garlic) extracts against Escherichia
Coli and Staphylococcus aureus Methods: Zinc oxide nanoparticles (ZnO NPs), were synthesised using the sol-gel method and later synergised with extracts of Allium sativum. Formation of ZnO NPs was confirmed using X-ray diffraction (XRD), Fourier Transform Infrared
Spectroscopy (FTIR) and UV-visible spectrophotometry methods. Similarly, these methods were also used in formed
Allium Sativum extracts as well as in ZnO NPs and garlic acid combined product. The antimicrobial activity of the nanoparticles against Staphylococcus aureus and Escherichia coli isolates were determined using Kirby Bauer disc and well diffusion methods.
Results: The average size of ZnO NPs in the present study is 40.96nm with a percentage crystallinity of 58.30%. The minimum inhibitory concentrations (MIC) of ZnO NPs ranged from 5 to 0.312 mg/ml. The antimicrobial assay of both
ZnO NPs and crude Allium Sativum extracts showed a concentration-dependent effect. The zones of inhibition for ZnO NPs ranged from 18mm to 20mm±2.5, crude Allium Sativum extracts 8mm to 14.2mm±2, while the synergistic effect of ZnO NPs and crude Allium Sativum extracts was more effective with zones of inhibition ranging from 40mm±2 and 42mm±3.5 against Enteropathogenic Escherichia coli and Staphylococcus aureus, respectively. Antimicrobial assays revealed that the drug combination exhibited a significantly enhanced inhibitory effect against tested isolates by 35%
with reduced minimum inhibitory concentrations (MICs) by 50% compared with individual treatments.
Conclusion: Our findings confirm the promising use of zinc oxide nanoparticles (ZnO NPs) in treating pathogenic
Staphylococcus aureus and Enteropathogenic Escherichia coli (EPEC) bacteria that zinc oxide nanoparticles (ZnO NPs) could be a possible alternative antibiotic. These results highlight the powerful potential of combining nanotechnology
with natural products as alternative antimicrobial agents.
Firm Characteristics and Financial Stability in The Insurance Sector: A Critical Review of Literature
(2026-03) Nyamai, Jonathan Sila; Jagongo, Ambrose
This study underscores a systematic review of the extant literature examining the relationship between firm characteristics and financial stability. The review was theoretically anchored in the buffer theory of capital adequacy, efficiency theory, market power theory, and stakeholder theory, which collectively provide complementary perspectives on how internal firm attributes influence resilience and risk exposure. Adopting a systematic literature review methodology, the study synthesised empirical and conceptual contributions addressing the nexus between firm-specific factors and financial stability outcomes. The findings indicate that a significant relationship has consistently been identified between firm size and financial stability. Larger firms are frequently associated with greater diversification opportunities, improved access to capital markets, and enhanced capacity to absorb shocks, thereby strengthening their stability profiles. Accordingly, firm size emerges as an important determinant of financial resilience within the reviewed literature. Similarly, substantial empirical evidence supports a significant association between capital adequacy and financial stability. In line with the buffer theory, higher levels of capital serve as a protective cushion against unexpected losses, reducing insolvency risk and enhancing institutional soundness. The capital position of an institution is therefore widely regarded as fundamental to its long-term stability. With respect to liquidity, the literature also establishes a significant relationship with financial stability. Liquidity, reflected in the availability of cash and near-cash assets to meet short-term obligations, plays a critical role in mitigating funding risk and maintaining operational continuity. Firms with stronger liquidity positions are generally better equipped to withstand adverse financial conditions. Finally, the review identifies a significant association between operational efficiency and financial stability. Efficient resource allocation, cost management, and productivity improvements contribute to enhanced profitability and reduced vulnerability to external shocks. Collectively, these findings underscore the multidimensional nature of financial stability and highlight the importance of firm-specific characteristics in shaping sustainable financial performance.
Strategy Implementation Practices and Organizational Performance of Coast Water Works Development Agency Mombasa County, Kenya
(Stratford Peer Reviewed Journals and Book Publishing, 2026-03) Katana, Emmanuel Wara; Waithaka,Paul
The assumption used for strategy implementation is that if an organization’s actual performance meets or exceeds the goals of an organization’s strategic plan, then that organization has successfully implemented its strategy. The following objectives were identified in this research as the reasons used to influence the implementation practices of Coast Water Works Development Agency’s strategy in relation to organizational performance in Kenya. The resource allocation, organizational structure, organizational culture, and organizational leadership were the objectives for the following. Theories used to guide the study were Resource-based view theory, Management by Objectives, 7-S model of McKinsey, and Goal path theory. 67 senior staff members were targeted demographically to study the implementation of a research design of a descriptive, which will help it achieve its objective. The sample contained 32 participants who made up 48% of the total population. They conducted their pilot study with their measurement instrument as it was implemented to a subset of their sample population, 10 participants, in order to have an idea of how accurate and consistent their instrument is. 'Stratified sampling' was the method used to approach this study. Primary data purchases were made through a structured questionnaire via the help of a ‘5-point Likert scale’. Researchers collected both numbers and written responses with both short answer and multiple option questionnaires. This analysis depended on statistics that allowed us to understand the data from first principles and also created explanations using SPSS software. We opted to use Multiple Regression for analysis. The analysis part of the meeting made use of pie charts, bar graphs and tables. Based on the study, organization structure, organization culture and leadership’s part in managing resources all influenced the results of the Agency. The agency should accordingly be recommended to optimize its resource allocation practice and develop a systematic tool for evaluating and ranking resource requirements. The study also suggested that the agency stay well defined organizationally and encourage a highly defined organizational culture that is consistent with the agency’s mission and values. Effective leadership was also emphasized, and it was recommended that the attention be spent on leadership development programs. The agency is finally advised to evaluate and document strategy implementation used, which includes performance appraisals and operational cost review. Further research was suggested for other possible factors, including stakeholder engagement and technological integration, in the public sector institutions.