RP-Department of Environmental Health

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Browsing RP-Department of Environmental Health by Author "Gitonga, Eliphas"

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    Determinants of Unmet Family Planning Needs among Women of Reproductive Age between 15 and 49 Years in Siaya County, Kenya
    (Pan African Medical Journal, 2025-07) Ameso, Ruth Anyango; Gitonga, Eliphas; Owaka, Isaac Ogweno
    Introduction: unmet need for family planning is still a major public health issue, impacting maternal and child health outcomes. In Kenya, 14% of women desire to avoid or delay a pregnancy but are not using contraceptives. Unmet need differs across counties, with Siaya having a high unmet need at 21% despite the target to eliminate unmet need for family planning. This study sought to establish determinants of unmet family planning needs among women of reproductive age (WRA) between 15 and 49 years in Siaya County, Kenya. Specifically, the study sought to address three specific objectives: to determine the level of unmet needs among WRA, socio-demographic characteristics of WRA, assess the level of knowledge on family planning and to determine attitudes towards family planning among WRA. Methods: the study presents findings from the baseline phase of a larger quasi-experimental study design. It utilized a mixed research design. The study adopted the World Health Organization's 30 by 30 2-stage cluster sampling method. The FANTA sample size formula was applied to arrive at 724 respondents. A total of 728 women of reproductive age participated in the study. The study included sexually active WRA, married women, or women in a companion. The study targeted over 67,023 women already in such unions and sexually active, which served as the sampling frame for the study. The current study, being a baseline study, results after the health education intervention will be presented in another study. Results were presented in tables and figures. Ethical guidelines and procedures upheld during the study included informed consent, voluntary participation of participants, confidentiality, data security measures, assent for the minors, and usage of research licenses and approval from the ethics from the school. Data analysis was done using IBM SPSS version 28.0. The statistical analysis was undertaken in two steps: bivariate analysis and multivariate analysis. Results: a total of 728 women of reproductive age participated in the study. The majority (45.2%) of the women were aged 25 to 34 years. Results showed that most (64.0%) of the women demonstrated a high level of knowledge, scoring 80% or above. However, only 2.7% had a low level of knowledge, with aggregate scores below 50%. The majority (75.5%) of the women had a positive attitude, with 24.5% having a negative attitude. The prevalence of unmet need was 52.7%. The proportion of unmet need was significantly more (COR = 1.61; 95%CI = 1.19 - 2.19; p = 0.002) among women with a low or moderate level of knowledge on family planning compared to those women with a high level of knowledge. Women aged 15 to 24 years were 3.43 times more likely to have unmet need for family planning compared to those aged 35 to 49 years (COR = 3.43; 95%CI = 2.23 - 5.26; compared to those women with a positive attitude. Conclusion: the study concludes that social-demographic factors such as education, age, or economic activity significantly influenced the unmet needs for family planning. Knowledge significantly influenced the unmet needs for family planning, where WRA with lesser knowledge were more likely to experience unmet needs. Lastly, Attitudes such as perceived harm of using contraceptives and stigmatization from their use significantly increased the odds of unmet family planning needs.
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    Individual Risk Factors for Exposure to Pesticide among Small Scale Coffee Farm Workers in Kirinyaga County, Kenya
    (2024-01) Mutegi, Winjoy Kageni,; Nyamari, Jackim M.; Gitonga, Eliphas
    According to the population census of 2019, about 70% of the Kenyan population is rural. Most of whom depend heavily on rainfed agriculture under unstable climate conditions. This is also the case in Kirinyaga County where majority of the coffee farmers are small scale farmers who rely on the crop for income generation activities that require the use of pesticides to increase yields. The overdependence on pesticides has resulted in overuse and exposures of pesticides and uninformed mixing of pesticides in an effort to manage the low labor costs and meeting output needs and requirements at end of the harvest which has resulted consequently in poor health of farm workers. The main objective of this study was to establish the incidence of occupational acute pesticide toxicities among small scale coffee farm workers in Kirinyaga, determine the levels of perception and behavior of smallscale farmers regarding occupational usage of pesticide and determine the factors associated with occupational acute pesticide toxicities in relation to small scale coffee farm workers. The study utilized a descriptive cross-sectional study design. The study sampled a population of 399 respondents who were randomly selected in the five wards in Kirinyaga central sub county namely Mutira North and South, Kanye-ine, Kirinyaga central and Inoi wards. An electronic based semi-structured questionnaire using KOBO Toolkit, observational checklists and plates were used in data collection. Data analysis was done using the statistical package for social sciences SPSS version 25.0. The relationship between independent and dependent variables was determined using chi-squared tests. Significant risk factors were analyzed using logistic regression and expressed as odds ratios. The study established that the incidence risk for acute pesticide poisoning symptoms was 52.3% with the most common symptoms being headaches (95.7%), diarrhea (98.8%), skin rashes (88%), staggering (81.9%) and dizziness (81.9%). The perception levels that were found significant in line with acute pesticide poisoning were those of effect to human health (p=0.031) and environment (p=0.027). Additionally, perceived failure to use safety equipment increased potential for Acute pesticide Poisoning(p=0.041)(OR= 2.199) .statistically significant individual risk factors identified were worker characteristics of drinking alcohol( OR= 0.033)and eating during pesticide application (OR= 0.537); socio-demographic characteristics of gender(OR=0.035), level of education (OR=0.024) and employment status(OR= 0.011); the safety practices of wearing PPEs(OR= 1.305), taking a systemic shower (OR= 0.537). A farm worker who washed hands was 2.042 times less likely to exhibit symptoms of APP. Hospital staff reported they had no means in terms of equipment and technical expertise to identify pesticide poisoning symptoms. Nevertheless, cases of Acute Pesticide Poisoning were hardly reported at health facilities among farmers because of the common nature of symptoms with other common illnesses. This study concluded that there is a high incidence risk among small-scale farmers for occupational APP. The varying individual risk factors and perceptions are indicative of the need for a multi- disciplined approach to training to help minimize adverse effects associated with pesticide exposure and to encourage approaches already in use that can minimize the harmful effects of pesticide use in coffee production.
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    Skilled Birth Attendance among Women in Tharaka-Nithi County, Kenya
    (Hindawi Publishing Corporation, 2017) Gitonga, Eliphas
    Background.Theburden of maternal mortality is concentrated in sub-Saharan Africa with an estimation of 500 000 deaths annually. In 2012, about forty million births occurred without a skilled attendant in developing countries. Skilled birth attendance improves maternal and newborn survival. The aim of this study therefore was to establish the level of skilled birth attendance and the associated factors. Methods. A cross-sectional survey was carried out using structured questionnaires as tools of data collection. Systematic sampling was used to select the respondents from the facilities that were stratified. The dependent variable was skilled birth attendance. Descriptive statistics were used to generate proportions and percentages while chi-square and Fisher’s exact tests were used to draw inferences. Association was significant if 𝑃 < 0.05. Results. The level of utilisation of skilled birth attendance was 77%. Skilled birth attendance was noted to be associated with age, level of education, average family income, parity, distance to the health facility, timing of initiation of antenatal care, level of facility attended during pregnancy, and birth preparedness status. Conclusion. The level of skilled birth attendance among women in Tharaka-Nithi County, Kenya, despite being higher than in some counties, requires improvemen