Browsing by Author "Makunyi, Eliphas Gitonga"

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    Birth preparedness among women in Tharaka Nithi County, Kenya
    (2014) Makunyi, Eliphas Gitonga
    It is estimated that in 2008, 358,000 maternal deaths occurred in the world. It is also estimated that in Kenya, 7,700 women die annually due to pregnancy related complications. This translates to approximately 21 women each day or approximately one Kenyan woman every hour. Out of every 10 women, 9 of them receive skilled ante-natal care but only 4 receive skilled birth attendance. The objective of the study was to assess the determinants of birth preparedness among women attending maternal and child health in Tharaka sub-county. The specific objectives were to assess the proportion of women with birth preparedness plans, to assess the socio-demographic, maternal and institutional determinants of birth preparedness. The area of study was Tharaka sub-county and the target population were women who had delivered within two years prior to the study attending maternal and child health clinics. A descriptive cross sectional study was carried out. Data collection was done using interviewer administered questionnaires, focus group discussion guide and key informant interview guide. Tharaka sub-county was purposively selected. Stratified sampling was used to select the facilities while systematic sampling was used to select the respondents. Every 14th client attending maternal and child health clinic was interviewed. The sample size was 345. STATA version 11 was used to analyse the data. Descriptive statistics was used to generate proportions and frequencies while chi square, Fisher’s exact test and logistic regression were used to draw inferences. This study found out that the proportion of women that was prepared for birth was low (20.3%). The aspect of birth preparedness that was identified and planned for by the highest number of women was finances for delivery expenses (74%) followed by place of delivery (68%) while the least was the mode of transport to the facility (35%). The socio-demographic determinants were maternal education (OR=1.5), occupation (OR=3.5), average income (OR=1.6) and marital status (OR=2.2). The maternal determinants were history of still birth (OR=0.2) and attendance of 4 or more ante natal visits (OR=2.2). There were no institutional determinants of birth preparedness with this study. In conclusion, the level of birth preparedness is low. The research recommends to ministry of health to sensitize women of reproductive age on birth preparedness. Birth preparedness should also be improved through quality ANC. The government through relevant agencies should encourage the education of the girl child and put in place strategies to increase the average income of women.
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    Determinants of opportunistic infections among HIV positive patients on HAART at Baptist Medical Centre Ejigbo, south west Nigeria: A cross sectional study
    (Elsevier Ltd., 2026-03) Simeone Tyotswam,Yanmeer; Fredrick Apkaghe,Shawon; Ayobami Adamu; Esomchi, Ikechukwu Chukwudi; Imonikhe, Oisamokhai Kenneth; Mbama, Ernest; Blair Kizza; Mumo, Jeremiah M.; Makunyi, Eliphas Gitonga; Kimani, Eunice W.
    Introduction: Opportunistic infections (OIs) remain a challenge in patients receiving Highly Active Antiretroviral Therapy (HAART) in resource-limited settings. OIs exist more frequently and more severe in people with HIV causing morbidity and mortality even after the era of HAART. This study aimed to identify the determinants and prevalence of opportunistic infections in HIV patients receiving HAART at Baptist Medical Center, Ejigbo. Methods: This was a hospital-based cross-sectional study conducted over a 3-month period in 2022 at Baptist Medical Center, Ejigbo. HIV-positive adults receiving highly active antiretroviral therapy (HAART) attending outpatient clinics were consecutively enrolled based on predefined inclusion criteria. Data on sociodemographic, behavioural, and clinical characteristics were collected using a pre-tested structured interviewer-administered questionnaire. History and presence of opportunistic infections (OIs) were ascertained through clinical evaluation by trained healthcare providers and review of medical records, following standardized diagnostic criteria. Descriptive statistics characterized the study population and prevalence of OIs. Associations between socio-demographic factors and OIs prevalence were initially tested using Chi-square tests. Determinants of OIs were identified via binary logistic regression analysis. All test were carried out at a 95% confidence interval using SPSS version 26.0. Results: Majority of respondents were within the age group of 41–60 years (48.9%), with a mean age of 45 years. The sex distribution was a female to male ratio of (3:1). The prevalence of opportunistic infection (OIs) was 36.8%. The determinants of OIs included a prior history of opportunistic infection (COR = 4.500), alcohol use (COR = 3.400), being on a first-line ART regimen (COR = 3.34), and employment status (COR = 1.953).The most frequent OIs was Oral thrush (candidiasis) (37.7%), followed by Tuberculosis (TB) (23.5%), Pneumocystis pneumonia (9.7%), Toxoplasmosis/Crytococcal infections (1.2%) and Herpes zoster (0.6%). Conclusion: There is a substantial prevalence of opportunistic infections among HIV patients receiving HAART in this setting. These findings emphasize the need to strengthen routine screening for OIs and enhance adherence support str..
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    Utilization of Mobile Phone Short Message Service to Enhance Uptake of Focused Antenatal Care in Tharaka Nithi County, Kenya
    (Kenyatta University, 2018) Makunyi, Eliphas Gitonga
    The Sustainable Development Goals targets a global maternal mortality ratio not greater than 70 maternal deaths per 100 000 live births by 2030. In Kenya, the maternal mortality ratio is high at 362 maternal deaths per 100,000 live births. Focused ante natal care approach recommends four targeted visits commencing before 16 weeks and until delivery. The utilization of focused ante natal care in Kenya, Tharaka Nithi County and Tharaka sub-county is 58%, 56% and 40% respectively. There are few studies on short message reminders on focused ante natal care in rural Kenya. This study examined the influence of short message service in enhancing utilization of focused ante natal care among pregnant women. A single blind randomized controlled trial was carried in Tharaka sub-county of Tharaka Nithi County, Kenya in three facilities that were purposively sampled; Chiakariga, Tunyai and Matiri. The final sample that was analysed was 241. Eligible participants were recruited using systematic sampling with Kth as 5. The subjects were randomly allocated through a computer application to interventional or control arm at a ratio of 1:1. The intervention was three short message reminders which were sent a week before the scheduled appointment date. The study instruments were interviewer administered questionnaires, focus group discussion guide, key informant interview guide and a checklist for desk review. The study period was December 2016 to June 2017. The inferential statistics that were used were t test, chi square, Fisher’s exact, effect size and logistic regression. Qualitative data was thematically organized and reported as narratives. The uptake of focused ante natal care for intervention and control group was 75% and 13% respectively. Short message reminders increased the probability of using focused ante natal care by 19.6 times (OR: 19.6, P<0.001, CI = 10.06 – 38.37). The effect size was very large with Cohen’s D of 1.55. Presence of a risk factor in pregnancy reduced the chances of utilizing focused ante natal care (OR = 0.485, P = 0.016, CI = 0.27 – 0.874). Ante natal profile was completed by 82% of the intervention group while 54% completed in the control group. Being in the intervention group increased the chances of completion by 3.7 times (OR: 3.7, P<0.001, CI = 2.086 – 6.708). Hindrances to attending scheduled visit included forgetting, non-prioritization, busy schedules and long distances with cost implications to the health facility. The benefits of mobile text reminders that were identified were convenience, constant memory, impression of care by the service providers and prioritization of the ante natal care. Negative perceptions on mobile SMS reminders were religious beliefs that they are demonic, that phones can cause cancer and instant deaths. However, there was no influence of socio-demographic, economic, accessibility and phone related variables on uptake of focused ante natal care. In conclusion, mobile phone short message reminders enhance utilization of focused ante natal care. This study recommends that the stakeholders in health should use short message reminders to enhance utilization of focused ante natal care. A further study should be conducted to examine the cost benefit analysis of short message reminders on uptake of focused ante natal care and outcomes of short message reminders in enhancing focused antenatal care.