Browsing by Author "Gitonga, Eliphas"

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    Determinants of Focused Antenatal Care Uptake among Women in Tharaka Nithi County, Kenya
    (Hindawi Publishing Corporation, 2017) Gitonga, Eliphas
    Background. The health status of women is an important indicator of the overall economic health and well-being of a country. Maternal health is closely linked with the survival of newborns. For every woman who dies, about thirty others suffer lifelong injuries. Focused antenatal care is one of the interventions to reducematernalmorbidity andmortality. It recommends four targeted visits during pregnancy within which essential services are offered. The aim of the study was to assess the determinants of uptake of focused antenatal care among women inTharaka Nithi County, Kenya. Methods. This was a descriptive cross-sectional survey. Stratified sampling was used to select the health facilities while systematic sampling was used to select the respondents. Chi square, Fisher’s exact test, and logistic regression were used to analyse the data. Results. The level of uptake of focused antenatal care was slightly more than half (52%). The determinants of uptake of focused antenatal care are level of education, type of employment, household income, parity, and marital status of the pregnant women. Conclusion. Despite high attendance of at least one antenatal visit in Kenya, the uptake of focused antenatal care is proportionally low.
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    Determinants of health facility delivery among women in Tharaka Nithi county, Kenya
    (African Field Epidemiology Network, 2016) Gitonga, Eliphas; Muiruri, Felarmine
    Introduction: Kenya records a high maternal mortality ratio 362 maternal deaths per 100 000 live births. Tharaka Sub County has poor transport infrastructure, low levels of socio-economic status and long distances to health facilities. Secondary to these factors, delivering in a health facility is a challenge. Delivering in a health facility is one of the strategies to avert maternal death through skilled birth attendance. The aim of the study was to evaluate the determinants of health facility delivery among women in Tharaka Nithi County. Methods: the study design was descriptive cross sectional survey. Semi structured questionnaires were used for data collection. Stratified sampling was used to select the facilities. Systematic sampling was used to select the respondents. The sample size was 345. Descriptive statistics, chi square, Fishers exact and logistic regression were used in analysis. Results: majority (79%) of the respondents delivered in health facilities. Health facility deliveries were highest (80%) among women aged 20-34 years and among those who attended level 4 facilities for ante natal care (88.3%). Health facility deliveries were lowest among women with five or more births. Health facility deliveries were higher among those who attended at least 4 ante natal visits (87.2%) and having individual birth plans (90%). The likelihood of health facility deliveries was increased by increase in level of education (1.6 times), household income (2.4 times), attending a higher level facility ante natally (1.4 times), birth preparedness (3 times), attending at least 4 ante natal visits (2.9 times) but was decreased by an increase in parity (0.5 times). Conclusion: the determinants of place of delivery are maternal age, level of education, household income, parity, attendance of ante natal care four or more times and birth preparedness.
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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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    Influence of Smartphone Application Reminder Service on Postpartum Contraception among Postpartum Women in Kitui County, Kenya
    (African Journal of Health Sciences, 2025-10) Mwanza, Judith Nzilani; Gitonga, Eliphas; Mugo,Judy
    Background: Low uptake of postpartum contraception remains a significant public health concern, contributing to the rising incidence of unintended pregnancies among postpartum women. This study aimed to establish the influence of smartphone application reminder service on postpartum contraception uptake among postpartum women in Kitui County, Kenya. Methodology: A quasi-experimental study was conducted among 228 eligible participants drawn from two major referral health facilities (Kitui County Referral and Mwingi Central Sub-County Hospitals), which were purposively sampled. Trained interviewers conducted baseline and six-week postpartum interviews with eligible participants, who were recruited through systematic random sampling. The groups were dichotomised into an intervention group, which received the smartphone application (app) reminder and the control group, which did not receive the app reminder. The intervention was a smartphone application with an audio alert in the background, accompanied by a message three days a week. Informed consent and approvals were obtained before the commencement of the data collection process, which was achieved by the use of semi-structured questionnaires. Data were analysed using SPSS version 29. Inferential statistics included chi-square tests and logistic regression, while the Difference-in-Differences (DiD) method was employed to assess the impact of the intervention. Results: Postpartum women with the smartphone app reminder utilised postpartum contraception more (49.1%) compared to those who did not have the reminder (6.1%). Smartphone app reminders increased the likelihood of using postpartum family planning by 8.23 times (OR: 8.23; P=0.000; CI: 14.22-102.41). Conclusion and Recommendations: Smartphone app reminders significantly enhanced the uptake of postpartum contraception among postpartum women. We recommend that smartphone reminders be incorporated into the postpartum care package. The County government should strengthen postpartum contraception and boost capacity at the grassroots to enhance postpartum contraception through smartphone reminder services
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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
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    Socio-cultural factors associated with the uptake of human papilloma virus vaccine among girls aged 9-13 years in Garissa County, Kenya
    (medip academy, 2025-12) Hussein, Risala; Gitonga, Eliphas; Wambugu,Monica
    Background: Cervical cancer remains a major health concern, driven mainly by human papilloma virus (HPV) types 16 and 18. In Kenya, it is the second most common cancer, yet HPV vaccination coverage is still low, with Garissa County at only 2%. Cultural norms, hesitancy, and limited awareness hinder uptake. This study assesses socio-cultural factors shaping vaccination to guide improved interventions. Methods: The study employed a descriptive cross-sectional design. Using systematic sampling, 437 respondents were recruited from public primary schools. Data were collected via questionnaires with informed consent/assent. Ethical approval was obtained from KUERC, and permits from NACOSTI. Statistical package for the social sciences (SPSS) v26.0 was used for descriptive and Chi-square analyses at a 95% confidence level, with results presented in tables and charts. Results: The study found HPV vaccine uptake at 5.7% among girls aged 9–13 years in Garissa County. Most guardians were aged 29–38 years, 92.2% Muslim, and 50.8% had no formal education. Further result revealed key factors reducing uptake includes beliefs that the vaccine causes infertility (p=0.002), myths about its effectiveness (p=0.036), fear of side effects (p=0.001), and perceptions that it encourages promiscuity (p=0.001). Conclusions: HPV vaccine uptake among girls was very low (94.3% unvaccinated). Non-uptake was linked to beliefs about infertility, myths on efficacy, fear of side effects, and concerns about promoting promiscuity. The study recommends targeted education, engagement with religious and cultural leaders, public awareness campaigns, assured vaccine availability, and integration of HPV vaccination into routine services to improve acceptance and reduce the cervical cancer burden.
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    The intervening role of community-based health education in reducing unmet family planning needs among women of reproductive age 15 and 49 years in Siaya County, Kenya
    (Pan African Medical Journal, 2025-10) Ameso, Ruth Anyango; Gitonga, Eliphas; Owaka, Isaac Ogweno
    Introduction: unmet family planning needs remain a significant health challenge. In Kenya, 14% of women have an unmet need. In Siaya County unmet need is 21% among the women, and this is high. This study seeks to determine the intervening role of community health education on the reduction of unmet needs among women of reproductive age in Siaya County. Methods: the study employed a quasi-experimental design with non-randomized, geographically distinct clusters. Assignment to the intervention and control arms was based on geographic allocation to avoid contamination into an intervention group that received structured health education for six months, and a control group, which did not. Data were collected at two time points (baseline and end line). The design enabled a difference-indifferences analysis to determine changes in outcomes between the groups over time. The FANTA formula by Robert Magnani determined the sample size of 1,448 respondents for the study. The WHO 30 by 30 two-stage cluster sampling method was used to sample the number of women of reproductive age. Data analysis was done using IBM SPSS version 28.0, with both bivariate and multivariate analyses conducted. Unmet needs for family planning were modeled using a generalized linear mixed-effects model (GLMM). Results: one thousand four hundred and forty-seven (1447) women of reproductive age (WRA) were interviewed at baseline and end line. There was a 17.1% increase in high family planning (FP) knowledge and a 12% rise in positive attitudes in the intervention, and a decline in the control group. Despite an increase in unmet need for FP in both study arms, the rise was lower in the intervention (6.7%) compared to the counterfactual (20.8%). The intervention had a protective effect against worsening of unmet need (aOR=0.31, 95% CI=0.10-1.00; p=0.051). This effect had borderline statistical significance (p=0.051). Family planning (FP) uptake decreased in the control group by 11.3% but increased in the intervention group by 6.6%, with (aOR=2.42, 95%
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    Utilization of HIVTesting and Counseling Services by Teenage Pregnant Girls in Selected Health Facilities in Kilifi, Kenya
    (EdinBurg Peer Reviewed Journals and BooksPublishers, 2025-03) Mramba, Caroline Lillo; Kimani, Harun Mbugua; Gitonga, Eliphas
    Despite worldwide advancements in health, many countries still face challenges regarding population health, chiefly due to the HIV/AIDS pandemic. AIDS-related illnesses are a leading cause of death among females aged 15-49, with younger individuals at a higher risk globally. HIV Testing Services (HTS) are crucial for managing AIDS, yet few youths are aware of their HIV status. A study in Kilifi found that out of 1,912 teenagers tested for HIV, 1,041 were enrolled in ART. This study aimed to determine the utilization of HIV testing and counseling services by pregnant teenage girls from selected health facilities in Kilifi County.An analytical cross-sectional study design was employed to assess HTS utilization among pregnant girlsaged 13-19. Data were collected using a standard questionnaire from 250 participants, with categorical variables reported as counts and percentages. Chi-square wasused to determine practicesassociatedwith utilization of HIV testing and counselingserviceswas conducted usinglogistic regression models. Timely utilization of HTS within the recommended 12 weeks of pregnancy was reported by 81 (32.4%). Factors affecting timely HTS utilization included living more than 5 km from the facility (chi-square=16.5, P<0.001), source of income as casual or salaried employment (chi-square=11.4, P=0.02), and awareness that one should be tested while pregnant, which was linked to lower odds of timely HTS use (COR 0.36 (95% CI 0.14–0.90), P=0.03). The study concludes that teenage pregnant girls did not utilize the HTS within the recommended period of 1sttrimester (32.4%) as per the MOH guidelines in Kenya. There were missed opportunities for testing for HIV bringing a gap in achieving 100% testing at the ANC level. This conclusion could be attributed to factors such as income and distance to the facilities as being a contributor tothe low utilization of HTS.