PHD-Department of Community Resource Management and Extension

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Browsing PHD-Department of Community Resource Management and Extension by Subject "Kenya"

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    Evaluation of street children rehabilitation programmes in Uasin Gishu district, Kenya
    (2011-07-19) Wakhu-Wamunga, Florence M.; Ngige, L.W.; Tumuti, D.W.
    The purpose of this study was to evaluate the street children rehabilitation programmes in Uasin Gishu District with the aim of providing information that can be useful to policy makers in the area of child welfare. The objectives of the study were to: (i) Determine how the programmes were initiated, (ii) Establish the context in which the street children rehabilitation programmes operate, (iii) Establish the resources used in the rehabilitation process, (iv) Determine the strategies used to rehabilitate the street children, (v) Evaluate the extent to which programme objectives had been achieved, (vi) Assess the social impact of the rehabilitation programmes on the street children community and the larger community of Eldoret town. Stufflebeam's improvement - oriented model of evaluation was adapted for the study. The naturalistic / pluralistic research design was used for the study. Both quantitative and qualitative modes of inquiry were employed in the research. The sample constituted 223 respondents. Data were collected by means of interviews, questionnaires, focus group discussions, spot observations and document analysis. Data were analysed using both quantitative and qualitative approaches. The results showed that the three centres were initiated and established by foreign missionaries with the aim of providing shelter, food, clothing, education and health care to street children in surrounding towns. Majority (53.3%) of the children in the centres were teenagers who had left home at a very early age. Sugoi home had no children below the age of 10 years. The main reason why these children had been on the streets was poverty which was a consequence of ethnic clashes of 1992. The management of the centres employed staff from the local community on contract. Staff turnover was quite high with an average time of 1.7 years spent at the centres. The staff had no skills in handling children in need of special protection. Rescue Centre had volunteers who came to teach children craft skills. All the centres had set rules and routines the children had to adhere to. This helped instil a sense of responsibility. Education therapy was employed in all centres. The character of street children and the character expected of them at the institutions determined the way the children were handled by staff. The staff had improper attitudes towards the children. They handled the children like delinquents in a correctional centre. The children were also involved in religious activities for there spiritual development. At Bindura and Sugoi centres, the children were involved in manual and farm work. Despite all the work that was going on at the centres, there was no monitoring of progress made by children. The strategies employed at the centres can be classified as interpersonal cognitive problem solving skills and behavioural social skills training. The centres had made some achievements in that the basic physiological needs of the children were met and, there was observed positive behaviour change in the children. The children were disciplined, clean and trustworthy. There are those who had been employed in various places while others had become evangelists and musicians. Some children from Rescue Centre had been assigned to others homes, reintegrated back into their families, or adopted. The centres had made some achievements in that the basic physiological needs of the children were met and, there was observed behaviour change in the children. The local community had also developed a change of attitude towards street children. They made donations towards the centres and gave volunteer service. Despite the achievements made, the centres still faced a lot of challenges such us inadequate funds and facilities, unskilled employees, lack of guidelines on rehabilitation, dependency syndrome from poor parents, increase in the number of street children and runaways. It is recommended that the government provides financial funding human resources for the running of these institutions
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    Influence of Provider Initiated Calls on Uptake of Cervical Cancer Screening in Kirinyaga County, Kenya
    (Kenyatta University, 2021) Monicah, Wambugu W.; Margaret Keraka; Anthony Wanyoro
    Every day women die from cervical cancer in the world with majority of deaths occurring in developing countries like Kenya. In Kenya, cervical cancer screening uptake is low at 3.2% for all women (GLOBOCAN 2018), below the 25% projection by National Cervical Cancer Prevention Program. Kirinyaga County like the rest of Kenya has no effective reminder mechanism to enhance uptake of cervical cancer screening. This study examined the influence of provider-initiated call reminders on uptake of cervical cancer screening. Using a single blinded randomized controlled trial study design; „two-stage‟ random sampling was used to select eligible women from a sampling frame of 19572 within four randomly selected Wards of Kirinyaga Central sub-county. Participants were randomly allocated to the control (received placebo calls) and intervention (received call reminders) arms at a ratio of (1:1). The data collection tools were interviewer administered questionnaires, Key informant guides and a checklist .The intervention was three provider initiated calls that contained; five education points on cervical cancer, reminder to attend screening and answers for two questions on cervical cancer and screening. Thematic content was used to analyze qualitative data. Categorical variables were summarized using descriptive statistics to proportions and frequencies while measures of central tendency were used to summarize continuous variables. Inferences were drawn using logistic regressions to determine factors associated with uptake of cervical screening and effects of the intervention. The final sample analyzed was 173. The mean ages of participants was 40.4 ± 9.4, majority had attained secondary education 57.4% and were of a low economic status 78.4%. Only 14.6% of women aged 25 years and above at baseline had ever been screened for cervical cancer and only 6.04% were on the recommended regular screening schedule. Participants who attended cervical cancer screening at end line were 67% from the intervention arm and 22.4% from the control arm. Provider initiated call reminders increased the probability of uptake of cervical cancer screening by 11 times (OR 11.04; CI 95% 8.56-26.89; p<0.001). There was a significant mean difference in perception on cervical cancer before and after the call reminders; perceived susceptibility(t=8.46,df=86,p=0.001); seriousness, (t=8.93,df=86,p=0.001);perceived benefits (t=8.13,df=86,p=0.001); barriers (t=3.46,df=86, p=0.001) in the intervention arm. There was also a significant mean difference of knowledge level on cervical cancer before and after intervention p<0.001 in the intervention arms. On the multivariate analysis, increased knowledge on cervical cancer increased chances of screening uptake by up to 7.09 times (OR 7.09; CI 95%3.72-11.95; P<0.001). High perception of being susceptible to cervical cancer increased the chances of screening uptake by up to 4.26 times (OR 4.26 P<0.0001). Forgetting was the major reason participants gave for not attending the scheduled screening. This study concluded that, many women residing in the study county had not been screened for cervical cancer despite being at risk. Calling those women to remind them to attend screening had potential to increase uptake of screening. Knowledge and perception on cervical cancer increased after using call reminders. The management of Kirinyaga County and the Ministry of Health should adopt a reminder system like the provider initiated calls in order to enhance cervical cancer screening uptake. Further studies should be conducted on the number of voice calls necessary for an optimal attendance for cervical cancer screening; national enrollment into routine screening and pathway analysis of factors associated with enrollment into routine screening.