RP-Department of Environmental Health

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Child Morbidity and Mortality in Slum Environments along Nairobi River
(Organization for Social Science Research in Eastern and Southern Africa, 2003) Keraka, M.; Wamicha, W. N.
The problem that guided this study was that child mortality and morbidity disparities continue to be observed in the era of improved expansion of the provision of health care services. Some areas have low mortality and morbidity while others such as the slums of Nairobi have high. Various factors may account for this scenario. On the one hand, this would be because of uneven distribution of health facilities. On the other hand, environmental factors may be the major contributors to this high rate of morbidity and mortality. Environmental factors have been analysed in thecontext of socio-economic, socio-cultural and health environments. The aim of this study was therefore to examine the impact of slum environments on morbidity and mortality profile in slum environments along Nairobi River. The main objectives were: first, to assess the influence of environmental factors on child morbidity and mortality, and second, to analyse the influence of the perception and behaviour patterns of slum dwellers on child mortality and morbidity. The data used in this study was collected using in-depth interviews and extensive literature review. The key findings of the study included the fact that poverty is a major factor in child morbidity and mortality. It is because of low-income levels that the families concerned were not able to improve the sanitation that was in turn going to improve the health status of the children. The study therefore recommended that the government should give small loans to slum dwellers, which they can use to start income- generating activities. This can help generate some money that may improve childcare practices.
Road traffic injuries in Kenya: the health burden and risk factors in two districts
(Traffic Injury Prevention, 2012) Bachani, A.M.; Koradia, P; Herbert, H.K.; Mogere, S; Akungah, D. N.; Nyamari, J. M.; Osoro, E.; Maina, W.; Stevens, K.A.
BACKGROUND: Road traffic injuries (RTIs) contribute to a significant proportion of the burden of disease in Kenya. They also have a significant impact on the social and economic well-being of individuals, their families, and society. However, though estimates quantifying the burden of RTIs in Kenya do exist, most of these studies date back to the early 2000s-more than one decade ago. OBJECTIVE: This article aims to present the current status of road safety in Kenya. Using data from the police and vital registration systems in Kenya, we present the current epidemiology of RTIs in the nation. We also sought to assess the status of 3 well-known risk factors for RTIs-speeding and the use of helmets and reflective clothing. METHODS: Data for this study were collected in 2 steps. The first step involved the collection of secondary data from the Kenya traffic police as well as the National Vital Registration System to assess the current trends of RTIs in Kenya. Following this, observational studies were conducted in the Thika and Naivasha districts in Kenya to assess the current status of speeding among all vehicles and the use of helmets and reflective clothing among motorcyclists. RESULTS: The overall RTI rate in Kenya was 59.96 per 100,000 population in 2009, with vehicle passengers being the most affected. Notably, injuries to motorcyclists increased at an annual rate of approximately 29 percent (95% confidence interval [CI]: 27-32; P < .001). The mean age of death due to road traffic crashes was 35 years. Fatalities due to RTIs increased at an annual rate of 7 percent (95% CI: 6-8; P < .001) for the period 2004 to 2009. Observational studies revealed that 69.45 percent of vehicles in Thika and 34.32 percent of vehicles in Naivasha were speeding. Helmets were used by less than one third of motorcycle drivers in both study districts, with prevalence rates ranging between 3 and 4 percent among passengers. CONCLUSIONS: This study highlights the significant burden of RTIs in Kenya. A renewed focus on addressing this burden is necessary. Focusing on increasing helmet and reflective clothing use and enforcement of speed limits has the potential to prevent a large number of road traffic crashes, injuries, and fatalities. However, it is difficult to demonstrate the magnitude of the injury problem to policymakers with minimal or inaccurate data, and this study illustrates the need for national continuous, systematic, and sustainable data collection efforts, echoing similar calls for action throughout the injury literature.
The background, social support and behavioural characteristics associated with health insurance coverage among the older population in Kisii County, Kenya
(2012-07) Nyagero, J.; Gakure, R.; Keraka, M.; Mwangi, M.; Wanzala, P.
Introduction: Universal health coverage has increasingly become the focus for improved health systems worldwide. In Kenya, the older populations are characterized by low health insurance coverage, resulting in either limited access to quality health care services or catastrophic expenditure on health. This paper seeks to assess the background, social support and behavioural characteristics that are associated with being insured among the older population. Methods: A two level random cluster sampling technique was used to select two rural sites in Kisii County and 1,104 older persons interviewed. The Pearson chi square and the adjusted odds ratio at 95% confidence interval computed in the binary logistic regression was used to analyze the data. Results: Only 5.9% of the older population had been insured. The multivariate regression model found that health insurance coverage was significantly associated with secondary school level of education (p<0.001, AOR 3.68, 95% CI 1.92 7.07), employment history (p=0.002, AOR 2.64, 95% CI 1.43 4.86); being a member of a social welfare group (p=0.002, AOR 3.03, 95% CI 1.51 6.08) and taking of alcohol (p=0.050, AOR 1.85, 95% CI 1.00 3.33). Conclusion: Health insurance coverage remains low among the older population in rural Kenya. Contrary to previous studies, social support such as from the adult children and relatives do not significantly influence being insured among the older population. There is need to enhance the number of older persons who are insured through strengthened sensitization of social support and health promotion.
Trauma Systems in Kenya: A Qualitative Analysis at the District Level.
(SAGE Publications, 2015) Wesson, H.K.; Stevens, K.A.; Bachani, A.M.; Mogere, S; Akungah, N. D.; Nyamari, J. M.; Masasabi Wekesa J; Hyder, A.A.
Injury is a leading cause of death and disability in low- and middle-income countries. Kenya has a particularly high burden of injuries, accounting for 88.4 deaths per 100,000 population. Despite recent attempts to prioritize injury prevention in Kenya, trauma care systems have not been assessed. We assessed perceptions of formal and informal district-level trauma systems through 25 qualitative semi-structured interviews and 16 focus group discussions with Ministry of Health officials, district hospital administrators, health care providers, police, and community members. We used the principles of theoretical analysis to identify common themes of prehospital and hospital trauma care. We found prehospital care relied primarily on “good Samaritans” and police. We described hospital care in terms of human resources, infrastructure, and definitive care. The interviewers repeatedly emphasized the lack of hospital infrastructure. We showed the need to develop prehospital care systems and strengthen hospital trauma care services.
Prevalence of Injuries among High School Students in Kieni West (District) in Nyeri County, Central Kenya
(SCIENCEDOMAIN International, 2015) Warutere, P. N.; Njenga, J.; Mailutha, J. T.; Gatebe, E.; Mwachiro, E.
Background: Injury among high school students has received disproportionately little attention as a public health concern in Kenya. Objective: To establish the prevalence of injuries occurring among high school students in Kieni West District, Nyeri County, Central Kenya. Methods: A Cross sectional study design was adopted where stratified random samples were recruited disproportionately to ensure adequate representation of most of segments of student population. Data was collected from 498 students (n = 294) girls and (n = 204) boys who were systematically randomly sampled from 83 classes from all ten schools in Kieni West district. Participants were asked about injuries they had sustained in the preceding 6 months. The injuries were coded using classification methods derived from International Classification of External Causes of Injuries (ICECI). The existing healthcare facilities and health records in the schools were examined and the principals of the schools were interviewed. Results: A total of 1490 injuries had occurred among the 498 respondents. Boys had higher mean number of injuries per student (3.39±0.65 n = 204) than the girls’ (2.72±0.46, n =294), a difference that was statistically significant (t=12.7, P<0.05, df= 496). The leading causes of injury were falls (31%) and sporting activities (29%). Falls were more common among girls (32%) than among boys and were mainly attributed to slipping and tripping. Boys sustained most of their injuries from sporting activities (32%) particularly from the more impulsive contact sporting activities. However the cause of injury was independent of the gender of the respondents (χ2 = 0.05; P>0.05; df = 4) Conclusion: Injury is a major but largely neglected contributor of disease burden among high school students in Kenya. The leading causes of these injuries- falls and sporting activities- are all preventable. It is important that effective interventions are developed, implemented and sustained to minimize the impact of injury among students. It is further suggested that safety management in schools should be re-evaluated in a bid to improve safety management status in schools.
The Physician-Patient Relationship: A Review of Two Theoretical Approaches and Health Regulation Implications
(Institute of Research Advances, 2016) Yitambe, Andre; Warutere, Peterson N.; Kibaara, Kenneth R.
Recent development in the organization of healthcare has impacted on physician and patient relationship. The physician-patient relationship is becoming more and more a universalistic concern. Since Hippocrates, the physician-patient relationship remains the corner stone of medical practice. A number of disciplines have questioned the interaction between physician and patient (from pure sciences and clinical sciences to social sciences). This paper uses a de-centered comparative method to examine how different theoretical approaches shape the understanding of doctor-patient interaction and health regulation implications. In particular, the article looks at two theoretical models: health economics and medical socio-anthropology. The findings show that the difference between the two approaches is based upon the background of each discipline. Nevertheless, there are some similarities. The paper concludes that no theoretical approach is totally privileged to understand the interaction.
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
Associated factors with Puerperal Sepsis among Reproductive Age Women in Nandi County, Kenya
(Mashhad University of Medical Sciences, 2017) Chepchirchir, Maritim Violet; Nyamari, Jackim; Keraka, Margaret
Background & aim: Studies have shown that puerperal sepsis is a major cause of maternal morbidity and the second cause of maternal mortality in the developing world. This study aimed to determine the incidence and management of puerperal sepsis among the women of reproductive age (i.e., 15-49 years) attending to two hospitals in Nandi County, Kenya. Methods: This descriptive, cross-sectional study was conducted on 215 women who were diagnosed with puerperal sepsis and referred to two hospitals in Nandi County. Four health care providers in charge of these patients were also included in the study. The sampling was performed using the purposive sampling technique. The data were collected using a structured interview administered by the researcher. Data analysis was performed through SPSS version 20 using the Chi-square test and logistic regression. Results: According to the results of the study, there was a statistically significant relationship between antenatal care attendance and labor duration (OR=0.35, 95% CI: 0.15-0.80). The mothers who had a short labor were 0.35 times more likely to have attended health care facilities to receive antenatal care as compared to those with a long labor. In addition, the food availability showed a significant relationship with duration of labor (OR=5, 95% CI: 1.8-14.28). The mothers with adequate food were five times more likely to experience a short labor compared to those with food shortage. The results also revealed that there was a lack of knowledge on the etiology of infection in the area under investigation. Moreover, the health care facilities were short of the adequate prerequisites to perform puerperal sepsis awareness both in the clinics and community. Conclusion: The findings of the present study underscored the necessity of supplying funds by the Ministry of Health to raise the individuals’ awareness on puerperal sepsis and provide them with hygiene education in the investigated area. The integration of hygiene education and puerperal sepsis awareness into antenatal care services should be performed as a strategy to prevent and control the infection.
Assessment of the Knowledge on Pre Conception Care among Women of Reproductive Age in Ruiru Sub-County, Kiambu County, Kenya
(International Peer Reviewed Journal and Book Publishing, 2018) Chepngetich, Joyce; Keraka, Margaret; Njagi, Joan
Purpose: The study aimed at determining the knowledge on pre conception care among women of reproductive age in Ruiru Sub-County, Kiambu County. Materials and methods: Descriptive cross-sectional study design was used with a target population of 65,045 women of reproductive age, para one and above in Ruiru sub-county. Simple random sampling method was used to select study participants. A total of 384 women of reproductive age took part in the study. A semi-structured interviewer-administered questionnaire was used to collect data and Focused Discussion groups. Quantitative data from the questionnaire was checked daily for completeness and coded for appropriate computer entry. Thematic content analysis was done for Qualitative data from the FGDs and triangulated during discussion. Thereafter, data was analyzed using SPSS version 20.0 statistical package. Univariate and bivariate data analysis were involved. Chi-square was used to determine the significance of associations between variables. Data finding were then presented using tables, pie charts and bar graphs. Results: There is low level of knowledge on preconception care services among the study participants with a larger proportion who have never heard about the services and not able to name the components of preconception care and the main source of information was obtained from the health workers in the hospitals. Recommendations: Health education of women of reproductive age on preconception care services, its components and importance in the health facilities and institutions of higher learning so that they can have the knowledge on preconception care services hence increasing its utilization. This is because the utilization of preconception care services is influenced by the level of education, occupation and age.
Environmental Factors Predisposing Rural Community Members to Tungiasis in Murang’a East Sub County, Murang’a County
(International Peer Revied Journal and Book Publishers, 2018) Wambani, Zablon; Nyamari, Jackim; Kimani, Harun
Purpose: To determine environmental factors predisposing rural community members to tungiasis in Murang’a East Sub County, Murang’a County. Materials and Methods: The study utilized cross sectional descriptive study design. The research adopted systematic random sampling design to identify the households to be studied where a total of 334 households were selected to participate in the study as determined by Fisher et al 1998 formula. The study was carried out in Murang’a East Sub county where household heads or their representatives were interviewed using interview schedule and observation checklist gathered data on environmental factors related to tungiasis. Both descriptive and inferential statistics were used to analyze the collected data. Results: The study found out that Majority of those who had tungiasis were living in temporary houses which had earthen floors. Majority (21%) of the respondents were aged between 20 to 29 years followed by those aged between 30 to 39 years that accounted for 19.2%. Majority (71.3%) of respondents were females while 28.7% were males. 39.5% of them were living in semi-permanent houses, 37.1% were living in temporary houses while 23.4% were living in permanent houses. However, for those who were jigger infested, 83.3% were living in temporary houses and 16.7% were living in semi-permanent houses. 88.6% of households had domestic animals (chicken) out of which 57.7% reported that the chicken slept next to the living house while 36.6% reported that their chicken slept away from the living house. 68.9% of the households’ surrounding was clean. Unique contribution to theory, practice and policy: The study recommends that the county government of Murang’a should consider subsidizing house improvement particularly for those households that experience persistent tungiasis cases
Predictors of Work-Related Musculoskeletal Disorders among Primary School Teachers in Machakos County, Kenya
(International Journal of Prevention and Treatment, 2019) Ndawa, Ancent Ndonye; Nyamari, Jackim Matara; Ireri, Anthony Muriithi
Background: Musculoskeletal disorders refer to a broad range degenerative and inflammatory conditions that affect the joints, muscles, ligaments, tendons, bones, nerves, and the localized blood circulation systems. Despite there being significant literature about musculoskeletal disorders among teachers in other parts of the world, Kenya lags behind in research. The current studies point out to high workloads and stress levels among primary school teachers because of an increase in the teacher-pupil ratio. The objective of this study was to explore the prevalence as well as person and work-related predictors to musculoskeletal disorders among Kenyan primary school teachers in Machakos County. Methods: This study adopted a cross-sectional design to collect data from 302 randomly selected teachers. Data was collected using a questionnaire and an observation checklist. It was analyzed using chi-square and logistic regression analysis and expressed as odds ratio. Results: The prevalence at any site of the body was 85.10% with lower back, knees, neck, and ankles being the most affected body sites at 58.60%, 57.6%, 53.3%, and 53% respectively. The least affected body part was the elbows at 25.2%. The positively associated risk factors were age, teaching for over four hours while standing, teaching for over four hours while sitting, working on a head-down posture, and lack of back support on chairs. MSDs prevented teachers from carrying their normal activities with lower back trouble topping in this respect at 23.8%. Conclusion: Generally, this study reveals that musculoskeletal disorders are very common among primary school teachers in Machakos County, Kenya. Among the recommendations is the need to regulate the number of lessons per teacher, number of pupils per class, and provide chairs and benches for teachers among others.
Diarrhea Risk Factors Associated with Water, Sanitation and Hygiene among the Under Five in Kasarani, Nairobi County
(science publishing group, 2019) Kimani, Humphrey Mbuti; Akunga, Daniel Nyagetiria; Anyango, Stephen Obiero; Ndwiga, Taratisio
Provision of quality water continues to be a challenge in the developing Counties particularly in the informal settlements and Kenya is not an exception. This study assessed diarrhea disease attributable to water, sanitation and hygiene (WASH) among the under five in Kasarani, Nairobi County. The main objective of this study was to establish the association between diarrhea among the under five and Water, Sanitation and hygiene. To achieve this goal Kasarani was categorized into four study environs namely low density high income, Medium density middle income, high density low income and informal settlement low income. Structured questionnaire and hygiene checklist were used as data collection instruments. Association and significant differences between variables were determined using inferential statistics and Chi-square tests. To compare quantitative variables (ANOVA) test was preferred. This study determined that water consumed in Kasarani was a risk for childhood diarrhea (p=0.019). Tap water showed a significantly higher contamination 13.7% than household water container 7.2% for T. Coli Bacteria. The amount of water a household consumed per day was an important risk factor for childhood diarrhea (P=0.001). Overall, Age of a child (P=0.046), water treatment method (P=0.002), method of storage of solid waste P<0.001, quantity and frequencies of water supply (P<0.001) were also found to be the most important risk factors for childhood diarrhea. The study concluded that there was a relationship between childhood diarrhea and water, sanitation and hygiene in Kasarani. The study recommended that Nairobi water and Sewerage Company institute programs that will facilitate adequate and wholesome water supply to HDLI and ISLI residential environs respectively.
Social Demographic Factors Associated with Adherence to Treatment among Urban and Rural Tuberculosis Patients in Kenya
(ijmshr, 2020) Mbuti, Humphrey; Mwaniki, Elizabeth; Warutere, Peter; Oguya, Francis; Midigo, Ronnie
Tuberculosis is a Global Public Health concern with serious Economic and Social Burden to the Patient and the Household. Because of the long duration of Standard Treatment there is a Risk of Treatment Default by Patients. The Objective of the Study was to determine the Social Demographic Factors Associated with Adherence to Treatment among the Urban and Rural Tuberculosis Patients in Kenya. The Cross Sectional Study Design was adopted. The Study applied the Multi-Stage Sampling Technique. Random Sampling Method was used to select the TB Clinics that Participated in the Study. Simple Random Sampling according to Probability Proportionate to TB Patient’s Population was preferred to select the Study Participants. Chi-Square Test determined Association between the various Social Demographic factors and the Adherence to treatment while ANOVA Test demonstrated the overall Association of Social Demographic factors and Adherence to TB Treatment. Statistical Significance was evaluated at p<0.05. Descriptive Statistics summarized and described the data. The Study established that Demographic Factors were Associated with adherence to TB treatment. Specifically, Gender, Level of Education, Place of Residence were found to be Significant (P<0.05). Age, Marital Status, Primary Occupation and Household Head were not Significantly Associated with adherence to TB treatment (p>0.05). These Findings will persuade the TB Management Policy towards developing Intervention Programs directed at the Social-Demographic Characteristics of the TB patient for improved Treatment Outcomes.
Levels of ionizing radiations in selected quarries in Nyamira County, Kenya
(Elsevier, 2020) Makori, Kerubo Ruth; Warutere, Peterson Njogu; Nyamari, Jackim; Arika, Wycliffe
It has been shown through a survey by World Health Organization and International Commission on Radiological Protection that certain materials (stones) sourced from quarries and used for the building are radioactive. In Kenya, underground stones which are sourced from embedded rocks are used in construction of most of the permanent buildings, yet Kenya has not adequately radio-profiled sources of building materials to determine whether the construction materials contain radionuclides that emit ionizing radiations yet are used for building. Consequently, Kenyans could be at risk of exposure to high levels of ionizing radiations by living in stone houses that are not radio-profiled. Health problems arise due to subjection to ionizing radiations. The study determined the levels of ionizing radiations in sampled quarries in Nyamira County by using Radiological survey dosimeters to show the radiation readings in milliRoentgen/hr then converted to milliSievert per year and the Global Positioning System device took note of the quarries' geographical positions. The study used Minitab version 17.0 software to establish the statistical differences of degree of exposure in sampled quarries. The sample size for the study was 40 quarries. It was revealed that Q-073 and Q-075 both had the lowest radiation readings of 0.64mSv while Q-079 had the highest reading of 3.46mSv equal to a deviation from WHO approved threshold of -35.71%,- 36.29% and 245.7%, respectively. The results indicated that 89% of the sampled quarries had radiation emissions above the ICRP and WHO standard. However, within Borabu Sub County, only 5 and within Manga Sub-County 4 of the sampled quarries had radiation readings below ICRP and WHO recommended standards of 1mSv/yr. It was exhibited from the study results that there are higher levels of ionizing radiations in quarries going past recommended standards per year hence causing health risk to quarry workers and general public. Therefore, these results could guide in formation of the national construction policies by including regular surveying for the levels of ionizing radiation in building materials as well as in practicing appropriate mitigation strategies.
Demographic Study of Ionizing Radiation Exposure of Quarry Workers in Some Selected Quarries in Nyamira County, Kenya
(Environmental Health Insights, 2020) Makori, Kerubo Ruth; Warutere, Peterson Njogu; Nyamari, Jackim; Arika, Wycliffe
Cumulative effects of exposure to ionizing radiation results in oxidative-induced damage and genetic mutations that are prerequisites for many pathologies including cancer. An understanding of term “ionizing radiation,” its injurious effects and mitigation measures is therefore, imperative. The present study aimed at investigating the awareness of the term “ionizing radiation,” its injurious effects and preventive measures among quarry workers within Nyamira County, Kenya. An analytical cross-sectional study design was adopted and data collected through administration of questionnaires. The results revealed that majority of the sampled quarry workers indicated inadequacy in understanding the term “ionizing radiation,” its injurious effects and preventive measures against ionizing radiation exposures. However, it was noted that level of education and working experience of quarry workers positively correlated with the understanding of the term “ionizing radiation,” injurious effects and intervention approaches against ionizing radiation exposures irrespective of gender and age. Therefore, there is need for stakeholders to build capacity on ionizing radiation, its effects, and preventive measures against exposures to ionizing radiation among the quarry workers and the general public.
Risk Factors Associated with Artisanal and Small-Scale Gold Mining in Rosterman, Kakamega, Kenya
(Scientific & Academic Publishing, 2020) Makokha, Winnie Rabera; Nyamari, Jackim Matara; Makau, Isaac K.
Occupational injuries, though preventable, have been described as a major public health problem. In artisanal and small-scale gold mining (ASGM), little is known about the risk factors to injuries. In 2018, we examined injuries and the potential risk factors among ASGM workers in Rosterman, Kakamega County, Kenya. A descriptive cross-sectional survey was conducted and three hundred and thirteen (313) ASGM workers were interviewed regarding their occupational injuries experiences over the preceding 1 year. Data was collected using structured interviewer administered questionnaires with the aid of open data kit (ODK) platform. Injury rates were estimated at 44.7 injuries per 100 person years. The most affected body parts were hands, upper and lower limbs at 62.14%, 30% respectively. The risk factors associated with injuries included; having an alternative source of income (p=0.027), an individual personal safety culture (p=0.021) and use of hammer or mallet as tools (p=0.022). In conclusion, injuries are prevalent among ASGM workers with several body parts being affected, the upper limbs being the most commonly affected. The study also demonstrated that there are various risk factors associated with injuries in ASGM. In view of those findings, the study recommends that injury prevention should be made a priority in ASGM intervention programs in order to reduce the burden of occupational injuries and also sensitize the workers on the risk factors they are exposed to.
Influence of Short Message Service Reminders on Utilisation of Focused Antenatal Care Among Women in Rural Kenya: A Randomised Controlled Trial
(AFRICAN Journal of Midwifery and Women’s Health, 2020) Gitonga, Eliphas; Nyamari, Jackim; Warutere, Peterson; Wanyoro, Anthony
Background/Aims The short message service is a part of mobile health, which is defined as medical and public health practices that are supported by mobile devices, such as mobile phones, personal digital assistants, and other wireless devices. Mobile health has documented positive outcomes on other health services, including focused antenatal care. The focused antenatal care model emphasises quality of care rather than quantity of antenatal visits, and the World Health Organization recommends a minimum of four targeted antenatal visits. This study examines the influence of short message service reminders on utilisation of focused antenatal care in rural Kenya. Methods This was a randomised controlled trial with 118 respondents in each of two study arms, intervention and control, conducted in Tharaka Nithi, Kenya. The study group were pregnant women attending their first antenatal care visit in Tharaka subcounty health facilities. The intervention was three short message service reminders a week before the scheduled visit. Structured questionnaires were used to collect baseline and exit interviews. The chi-square test and logistic regression were used to check associations between uptake of antenatal care and participant characteristics at 5% significance level. Results Three quarters (75%) of the respondents in the intervention group completed the four targeted antenatal visits, whereas only 10% of respondents attended the required four visits in the control group. None of the sociodemographic variables were found to have any association or influence on focused antenatal care attendance. Short message reminders increased the chances of attending the recommended visits by 27 times (P<0.001). Conclusions Short message service reminders have a positive influence on utilisation of focused antenatal care. This research paper recommends that policymakers and health managers use short message service reminders to increase the uptake of focused antenatal care.
Factors Associated with Health Seeking Behaviour for Reproductive Tract Infections among Young Street Females in Eldoret, Kenya
(Kabarak Journal of Research & Innovation, 2021) Chepchirchir, V MARITIM; WANYORO, Anthony; NYAMARI, Jackim; MAINGI, John; ABALLA, Lillian; KIMANI, Eunice
Reproductive tract infections (RTIs), among young women is a public health concern, especially in developing countries like Kenya. When a reproductive tract infection occurs, urgent treatment should be done to avoid short- and long-term consequences. However, few studies have evaluated factors associated with RTIs and healthcare seeking behaviors especially, among young street women in low and middle-income countries. This study aimed at determining the factors associated with healthcare seeking behavior for RTI infections among young street females in Eldoret town in Kenya. Descriptive cross-sectional study design was used. The study participants were young street females aged between 10-24 years. The independent variables were age, education, occupation, marital status, and healthcare associated factors such as distance to the facility, and health care perspectives on reproductive health were assessed. Informed consent was obtained from participants while assent was obtained from guardians for minors and persons in charge of street families. A total of 77 young street females were enrolled. Those aged ≤15 years were 10 (13%) while those aged ≥ 20 years were 48 (62.3%). The study established that participants aged between 16 to 19 years were less likely to report having had an RTI compared to those aged between 20 to 24 years (95% CI; 0.216 (0.070-0.671), p=0.006). Majority had heard of RTI (62, 80.5%). Out of the fifty respondents (65%) who reported having ever experienced RTI in their lifetime, 36 (72%) sought treatment for the illness with 46 respondents (94%) seeking treatment after two days post-onset of symptoms. Additionally, the main first points of seeking treatment were pharmacies (21, 43%) and health facilities (25, 51%). The study findings show there’s a high burden of RTIs among young street females in Eldoret.
Compliance to Occupational Safety and Health Practices among Workers in Flower Farms in Embu County, Kenya
(Full Length Research, 2021) Gechemba, Barongo Bevalyne; Warutere, Peterson Njogu; Makau, Isaac K
The implementation of occupational safety and health in workplaces is of significance in improving safety working condition in horticultural sector in Kenya. The main objective of the study was to assess the level of compliance to occupational health practices among flower farm workers in Embu County, Kenya. Specific objectives were to determine risk identification and assessment practices among flower farms in Embu County, Kenya, to determine the level of compliance on surveillance of worker’s health among flower farms in Embu County, Kenya and to determine the degree of occupational safety and health awareness among flower farm workers in Embu County, Kenya. A descriptive crosssectional research design was used. The study population was 859 comprised of employees working in flower farms in Embu County. A sample size of 300 selected through stratified random sampling. Structured questionnaires, observational checklist, FGD and KII were also utilized to collect data. Data analysis was done using descriptive statistic technique and inferential analysis technique Pearson’s Moment Correlation and regression. The study revealed that there is a strong, significant positive correlation between OSH Risk identification and assessment practices and compliance with Safe Work Environment (r=0.799, P=0.001<0.01). The study established that Surveillance of workers’ health had a strong, significant, positive influence on compliance with occupational Safety and health practices in Flower farms in Embu County (r=0.711, P=0.021<0.05 ). Further, the study established that the degree of awareness on safety and health has a strong, significant and positive correlation with Compliance of Occupational Safety and Health practices (r=0.721, P=0.037<0.05. The study concluded that there was a high level of risk identification and assessment practices thus improving the level of compliance with OSH practices in the flower farms in Embu County. The study concluded that there exists a health surveillance program indicating compliance to OSH practices in the flower farms in Embu County. From the results, there was high level of employee awareness on safety and health among the workers a predictor of level of compliance with OSH practices in the flower farms in Embu County.
Perceptions of caregivers on immunization in Ntungamo district, Uganda
(Medip Academy., 2021) Topher, Byamukama; Keraka, Margaret M.; Gitonga, Eliphas
Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district. Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square. Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group. Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively.

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