PHD-Department of Home Economics

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    Application of community participation paradigm in the care of children orphaned by HIV and AIDs in Kibera Division, Nairobi, Kenya.
    (Kenyatta University, 2004-11) Akunga, Alice Bonareri
    Literature reviewed indicates that community care programmes have been initiated to support children orphaned by HIV and AIDS. These children suffer from various problems, including loss of family, depression, malnutrition, lack of access to education and healthcare; loss of property and inheritance; abuse and increased exposure to HIV and AIDS. However, there is no information on gender relationship in their needs, care, and problems faced. There is also no information on community participation in the care programmes assisting orphaned children, and the success of these community programmes in meeting orphan needs. Neither is there any information on the relationships between the orphans being supported by these community care programmes and those without any support, issues that this study sought to address. This study applied community participation paradigm in community care programmes providing care to HIV and AIDS orphans in Kibera Location, Nairobi, Kenya. This paradigm emphasizes and strengthens the role of the community in community programmes. It emphasizes that involvement of the community members in planning and implementation of these programmes enhances ownership and therefore leads to success of these programmes. The study is also supported by the double ABCX model, which describes factors that account for differences in family capability to achieve a new level of balance at both the individual family and the family-community level over time after a situation affecting the family occurs. The study therefore sought to establish community participation in care programmes, as well as the success of these programmes in meeting the needs of orphans. A random sample of 219 orphans and caregivers (55 from a community care programme and 164 not under the programme); 11 community leaders and 13 community care programme leaders in Kibera Location, Nairobi, was surveyed using interviews and focus group discussions. The findings of this study showed that orphan needs for food, clothing, medical care, shelter, education and psychosocial support are not adequately provided for. Findings further showed that the orphans experienced a number of problems, including hunger, inadequate shelter and clothing; being overworked, beaten and quarrelled. The results further indicate that very few caregivers were involved in community care projects. For instance, only 5% of caregivers were involved in planning the activities of community care programmes, while only 2.7% are involved in decision-making. Additionally, very few (17.3%) of caregivers were involved in carrying out activities of the community care programmes, which mostly involves reaching out to orphans and offering home based care and support. At the same time, only 6.8% of caregivers made contributions towards supporting community care programmes. Overall, 56.2% of the caregivers felt that community care programmes were not sufficiently meeting orphan needs, hence.not successful, while only 8.2% felt that the programmes were successful in .meeting needs of orphans. The rest, 35.6%, felt that the needs of orphans were fairly sufficiently met. There were significant relationships between gender of orphans and assistance required in school fees, with more girls requiring support in school fees. Significant relationships were also observed between orphans in and out of the project and problems of hunger, inadequate clothing and being overworked. The majority of orphans out of the project were overworked. Correlation results show success of community care programmes and, the number of orphans, support provided, needs and problems of the ophans and problems experienced by caregivers. Community participation variables also showed significant relationship with success of community care programmes. The study findings further show that the number of HIV and AIDS orphans and number of problems experienced by caregivers are predictors of success of community care programmes. Based on the findings of this study, there is a need for programmes designed to assist orphans to have an integrated approach towards assisting orphans, thereby striving to XVI provide for all their needs adequately and checking against any abuses. There is also a need to design programmes to support caregivers and communities affected particularly those without any assistance. In addition, it is important to involve the communities and in particular caregivers in the activities of the community care programmes. It is also important to establish home based care support programmes, establish orphan support networks and advise and encourage parents who are infected with IllV and AIDS to engage and discuss with their children about their future.
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    School-Based Physical Activity, Its Correlates and Efficacy of Interventions among Learners with Physical Disabilities in Kenyan Special Secondary Schools
    (Kenyatta University, 2021) Gaita, Njenga Daniel; Lucy-Joy Wachira; Edna Thangu
    The WHO rates physical inactivity as the fourth global risk factor for mortality. Children and youth with disabilities are twice at risk of inactivity and sedentary lifestyles concomitant with related comorbidities. This necessitates evidence-based physical activity (PA) promotion strategies implementable in schools where these individuals spend most of their time. This two-phased study aimed at assessing the PA behaviour and its correlates and the effectiveness of selected school-based PA promotion interventions among learners with physical disabilities in Kenyan special secondary schools. Phase 1 was a cross-sectional descriptive survey among a census sample of 650 learners. The learners’ PA behaviour, attitudes towards PA, satisfaction with use of assistive mobility devices (AMDs) and the influence of PA on their health-related quality of life (HRQoL) was assessed using the Youth Activity Profile, the Negative and Positive Attitude scales, the Assistive Device User Satisfaction tool and the Paediatric Quality of Life Inventory (PedsQLTM) respectively. Phase 2 of the study was a three-arm cluster randomised test among 45 purposively sampled learners using manual wheelchairs for mobility. It assessed the effectiveness of PA literacy, peer mentoring and adult mentoring in promoting PA. Changes in PA were ascertained by assessing the arm strength and cardiovascular endurance of the participants. Data was collected using the handgrip dynamometer, the 10-m wheelchair ride test and subsequently analysed using General linear mixed model (fixed and random effects) at p ≤ 0.05. The effectiveness of the interventions was also assessed using focus group discussions which were analysed thematically. Results from phase 1 established that the learners were more physically active than sedentary during a school-day. Engagement in PA was higher during out of school-times compared to school-times. Learners participated in more unstructured and unsupervised PA during out of school-times. The study also established potential for PA in recess, lunchtime and PE lessons. Using Univariate Analysis of Variance regression tool, the study established that attitudes towards PA largely influenced the leaners’ PA behaviour (p<0.001, ƞ2 = 0.045), an influence that transcended gender, the use of AMDs and learners’ class level. Further, the study established that PA behaviour positively predicted HRQoL (p<0.001, ƞ2 = 0.044). Results of phase 2 showed that the PA promotion interventions increased engagement in PA among learners who used manual wheelchairs. These learners also reported improved independence and quality of life. The study concluded that learners with physical disabilities were relatively physically active and were likely to engage in more PA during out of school-time. It concluded that their PA was likely to be influenced by their attitude toward PA more than by other selected correlates. The study also concluded that their PA was likely to improve with interventions that target enabling, predisposing and reinforcing factors of PA behaviour. It thus recommends implementation of strategies which enhance predisposing, enabling and supporting determinants of PA in all school-times.