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Utilization of Preconception Care among Women of Reproductive Age Attending Thika Level Five Hospital in Kiambu County, Kenya
(Kenyatta University, 2025-09) Kamau, Felister Waruguru
Pregnancy, together with other unforeseen health risks could make situations worse during pregnancy, labour, birth, and thereafter. Naturally, women of reproductive age may not be aware of the impact that existing health conditions, health-related actions, and behaviours might have on them and the fetus during pregnancy. Preconception care is provided to women and couples before conception, thus addressing issues that could affect the outcome of pregnancy. Despite this care being available, most women seek care after conception, thereby missing pre-conception care service benefits. The aim of this study was to determine the level of Preconception care utilization and the associated factors among women of reproductive age attending Thika level five hospital. The study design was descriptive cross-sectional, and mixed methods of data collection were used. The dependent variable was utilization of Preconception care, and the independent variables were age, level of education, marital status, occupation, knowledge, social cultural factors, and institutional factors. Quantitative data was obtained through the use of interviewer-administered questionnaires, and qualitative data through the use of a key informant interview guide. The study population was 8950, and the sample size was 316. Systematic sampling was used to select the respondents, while purposive sampling was used for key informants. Quantitative data was analyzed using SPSS version 23 software to obtain descriptive statistics and presented in form of figures, charts, and tables. Qualitative data was categorized into themes, thematic analysis was done, and data was presented in form of narration. The findings of the study revealed that most women of reproductive age (62%; n=196) had utilized at least one form of Preconception care. The level of knowledge was low at 41% (n=129). Those who were knowledgeable were 2.69 times more likely to utilize preconception care (OR: 2.69; 95% CI: 1.647 to 4.407; p-value <0.001). Some social and cultural factors associated with utilization of Preconception care were partner support in decision making on maternal health issues and provision of transport. Those who were not supported with transport were 58% less likely to utilize Preconception care services (AOR: 0.421; 95% CI: 0.239 to 0.744; p-value 0.003). Institutional factors affecting utilization of Preconception care were knowledge deficit among health care providers, long queues (67.4%; n=213) in the hospital, and lack of awareness (50.3%; n=158) on existence of the services. Although utilization of Preconception care was good, the level of knowledge among women of reproductive age was low. Utilization was affected by socio-cultural and institutional factors. There is therefore need to train the health care providers on Preconception care to bridge the knowledge gap and awareness be created among women of reproductive age; human resource and infrastructure issues be addressed to create room for preconception care clinics in order to reduce long queues in the hospital and enhance utilization of preconception care.
Implementation of Primary Health Care Services by Nurses Working in Level 3 Health Facilities in Kiambu County, Kenya
(Kenyatta University, 2025-11) Gitahi, Eunice
Primary health care (PHC) is the foremost interaction instance where necessary medical care is offered to individuals. It dwells on health promotion, curbing illnesses as well as the inherent behavioral and societal factors that contribute to people’s poor health in addition to treating illness and caring for the sick among individuals, families and communities. It is an approach to health that promotes people-centred care guided by the tenets of empowering, community collaboration as well as fairness and equality in the society. The study’s core aim was to evaluate the implementation of PHC services by nurses working in level 3 health facilities in Kiambu County. The study’s precise aims were to ascertain the nurses’ rating of the level of implementation of PHC services in these facilities, to determine their attitude towards implementing PHC services, to establish factors affecting the implementation of PHC services in the said health facilities and to identify perceived areas of improvement in execution of PHC services within the said health facilities. This was an analytical cross-sectional study conducted among 148 nurses working in level 3 health facilities in Kiambu County who were chosen utilizing simple random sampling technique. Using a self-reporting questionnaire, data was gathered. SPSS version 25 was used in probing the data descriptively including varied measures like percentages and frequencies. The chi-square test at 95% CI was utilized for assessing association between predictor and outcome research variables. Results are shown in figures and tables. Appropriate ethical principles were adhered to. The study achieved a response rate of 95.3%. From the findings, majority (91.5%, n = 129) of the nurses rated the level of implementation of PHC services in their work stations as sub-optimal. The nurses had positive attitude towards the implementation of PHC services given that all (100%, n=141) concurred that they perceived provision of PHC services as being critical to attainment of quality healthcare services for all in the country while 99.3% (n = 140) agreed that PHC services constituted an essential foundation for a sustainable health system and health programs in the country. Leading factors that hindered the nurses’ implementation of PHC services included inadequate number of available healthcare personnel - 99.3%; poor or low remuneration of health care providers - 99.3%; poor supply of essential medicine/drugs - 97.2%; unavailability of essential medical equipment - 98.6%; non-functional status of existing medical equipment - 98.6%; poor planning of the PHC programs - 95.7%; lack of or inadequate support to HCPs from the hospital management - 94.3%; significant underfunding of the primary health services - 98.6% and lack of or poor information systems - 98.6%. Nurses working in level 3 health facilities in Kiambu County had positive attitude towards the implementation of PHC services. Several factors, institutional based in nature, did influence the nurses’ implementation of PHC services within the level 3 health facilities in Kiambu County. To further enhance the implementation of PHC services in the county, the leadership of Kiambu County needs to invest on PHC system and programs in the county particularly in the areas of funding of these services, health care personnel staffing and support and ensuring adequate supply of essential medications and adequate availability of essential medical equipment within the health facilities.
Adherence to Healthy Timing and Spacing of Pregnancy among Women of Reproductive Age (15–49 Years) in Kilifi County, Kenya
(Kenyatta University, 2025-11) Supaki, Esther Kadzo
Healthy timing and spacing of pregnancy refer to a tactic of planning families that enables delaying, limiting or spacing pregnancies. Globally, about 25% of births occur with shorter intervals and about 21million underage pregnancies and 12 million underage births are reported yearly in developing countries with most of them from Sub-Saharan Africa. In Kenya 2 out of 10 girls less than 18 years are either pregnant or have given birth. In Kilifi County, about 19.6% of births do not adhere to the 24 months birth-interval being and report about 28.6% teenage pregnancies. The study aimed at establishing factors associated with adherence to healthy timing and spacing of pregnancy (HTSP) among reproductive age women in the County of Kilifi. The study’s specific objectives were to determine the proportion of women adhering to healthy timing and spacing of pregnancy, level of knowledge, socio-demographic, socio-cultural and accessibility factors associated with adherence to HTSP. The research adopted an analytical descriptive cross-sectional design of study using quantitative data collection methods. The study was done in two selected sub-counties with respondents picked systematically at a specified interval of 3. A sample size of 293 women of reproductive age selected from households with children less than 24 months of age from villages in Sokoke Ward in Ganze and Tezo Ward and Kibarani Ward in Kilifi North sub-counties respectively. All the required approvals from relevant institutions were obtained and signed consent from respondents. Quantitative data were collected utilizing semi-structured questionnaires from women of reproductive age (15-49 years). Data was analyzed and managed through the Statistical Package for Social Sciences (SPSS Version 29.0). Presentation of results was through graphs, tables and charts. Chi-Square tests were used to perform inferential statistics at a confidence interval of 95% and an error of precision allowed at 0.05 to predict variable associations. Logistic regression analysis was done to ascertain the strength of the relationship between variables. The results revealed that 60.1% of respondents adhered to the WHO recommended HTSP. About 69.4% pregnancies occurred on or after 18 years, 67.1% within the recommended 24-month inter-birth interval and 58.9% had pregnancies 6 months after a miscarriage or abortion. Approximately 42.3% of respondents had above average knowledge on HTSP. The predictors of HTSP were; socio-demographic variables such as age (AOR=6.47, p=0.001) and marital status (single; AOR=0.43, p=0.025; divorced/widowed/separated; AOR=0.1, p=0.001); socio-cultural variables such as feeling embarrassed talking about HTSP (AOR=0.3, P=0.007), early marriages (AOR=1.16, P=0.013) and many children being a sign of marriage stability and acceptance (AOR=1.34, P=0.035) and accessibility variables such as availability of family planning (AOR=0.28, P=0.001) and perceived experience with healthcare providers (AOR=0.37, P=0.023). The study concludes that about 4 out of 10 women of reproductive age in Kilifi County did not adhere to the recommended HTSP. The study recommends the Ministry of Health and relevant stakeholders to provide educational programmes on delaying sexual debut to curb early pregnancies, emphasize on use of FP especially among sexually active single, divorced and separated women; provide and scale up health education and sensitization activities focusing on adherence to interbirth-to-pregnancy interval, delaying first pregnancy to at least 18 years and at least 6 months after a miscarriage or abortion; empower community health workers to conduct outreaches emphasizing on the methods and benefits of observing HTSP to improve their overall knowledge; interventions to influence cultural beliefs affecting reproductive health decisions of women focusing on discouraging early marriages and having many children and provide mobile clinics to reach more women in remote areas and concentrate on regular continuous medical education sessions to increase availability and access to family planning services and perceived experience with healthcare providers thus improved adherence to HTSP.
School Connectedness and Its Effects on Student’s Discipline in Public Secondry Schools in Tharaka-Nithi County, Kenya
(Kenyatta University, 2025-11) Wachira, Isaac Kiiru
Schools are fundamentally designed to foster personal and social growth among
students, yet this objective is often undermined by indiscipline which has become a
major challenge in many public secondary schools in Tharaka-Nithi County.
Persistent indiscipline has not only hindered academic achievement but has also led
to significant financial burdens to families, stemming from both lost instructional
time and damage to school infrastructure. This study set out to examine the effect of
school connectedness on student discipline in public secondary schools in Tharaka
Nithi County, Kenya. The investigation focused on four key dimensions: teacher
support, peer group networks, commitment to education, and the physical school
environment. The research was anchored in Invitational Theory, which posits that
cultivating inviting and supportive school environments through people, places,
programs, processes, and policies can meaningfully shape student outcomes.
Employing a convergent-parallel mixed methods design, the study integrated both
qualitative and quantitative approaches. The total population encompassed 51,363
students, 2,737 teachers, and 154 principals across the county’s public secondary
schools. From this, a sample of 400 students, 200 teachers, and 40 principals was
selected using systematic random, stratified, and purposive sampling techniques.
Data collection instruments included questionnaires for students and teachers and
structured interview schedules for principals. Cronbach’s Alpha showed strong
reliability for both student (0.831) and teacher (0.731) tools. Quantitative results
were processed through descriptive and inferential statistics, while qualitative input
was thematically examined. All four school connectedness aspects were found to
meaningfully shape student discipline. Specifically, teacher support (F(2, 389) =
5.694, p = .004), peer networks (F(2, 389) = 35.672, p = .000), commitment to
education (F(2, 389) = 81.571, p = .000), and the physical environment (F(2, 389) =
141.691, p = .000) each emerged as significant predictor. Collectively, these factors
explained 57.5% of the variance in student discipline (R² = 0.575, F = 130.93, p =
.000), with the physical environment exerting the strongest influence. The study
concludes that student discipline is closely linked to the degree of school
connectedness. Supportive teachers, constructive peer relationships, strong student
engagement, and an orderly school environment collectively foster positive
behaviour and self-regulation. The research recommends that educational
policymakers and school leaders prioritize teacher-student relationship building,
implement peer mentoring initiatives, promote comprehensive student engagement,
and maintain safe, friendly and inviting school environments. This study presents
evidence on how various aspects of school connectedness affect discipline, offering
a practical guide for nurturing well-managed and supportive school environments in
Kenya.
Efficacy of Deltamethrin Incorporated Polypropylene Storage Bag Against Sitophilus zeamais and Prostephanus truncatus on Maize Seed Quality in Kitale, Trans Nzoia County, Kenya
(Kenyatta University, 2025-10) Tegei, Eric Maghas
Seed storage structures have a great influence on the quality of the stored certified maize seed. However, the conventional method of storing the certified maize seed has been found to be ineffective as the levels of insect-pest infestation, damages or losses, and overall quality of the stored seed over a period of time depend on the kind of storage structure used. The purpose of this study was to determine the effectiveness of deltamethrin-incorporated polypropylene Storage Bag against storage insect pests on maize seeds in Kitale, Trans Nzoia County, Kenya. The study was operationalized with a Completely Randomized Design (CRD) in a factorial arrangement with four replications for each treatment, namely, Deltamethrin Incorporated Polypropylene bag, paper pack, non-dressed polypropylene bag, and jute bag. The study was carried out under ambient temperature conditions (Average 18.60C) and bimodal rainfall (900mm to 1400mm) for thirty-two weeks. Data for each treatment was collected in terms of foreign matter generated to evaluate commodity damage, dead and live insects to assess bag efficacy, moisture content for bag robustness, weevil-damaged seed for bag suitability, and seed germination for bag effect on seed quality. The findings revealed that both the type of packaging material and pesticide treatment had a substantial influence on the seed quality and protection of maize seeds during storage. Additionally, the results indicated that the choice of storage bag and the application of pesticide played a crucial role in controlling insect infestation and reducing susceptibility to weevil damage. Furthermore, the study established that seed moisture content and germination performance were significantly affected by the type of packaging material and pesticide treatment used, emphasizing their importance in maintaining maize seed viability and overall quality during storage. The study found that deltamethrin-incorporated polypropylene storage bags were highly effective in preserving maize seed quality in Kitale, Trans Nzoia County, Kenya. These bags significantly reduced insect infestation, maintained optimal seed moisture levels, minimized weevil damage, and enhanced seed germination throughout the storage period.