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12-Month Substance Use Disorders among First-Year University Students in Kenya
(PLOS ONE, 2023-11) Jaguga, Florence; Mathai, Muthoni; Ayuya, Caroline; Francisca, Ongecha; Musyoka, Catherine Mawia; Shah, Jasmit; Atwoli, Lukoye
Objectives The period of entry into university represents one of vulnerability to substance use for university students. The goal of this study is to document the 12-month prevalence of substance use disorders among first year university students in Kenya, and to test whether there is an association between substance use disorders and mental disorders. Methods This was a cross-sectional online survey conducted in 2019 and 2020 as part of the World Health Organization’s World Mental Health International College Student (WMH-ICS) survey initiative. A total of 334 university students completed the survey. Descriptive statistics were used to summarize the demographic characteristics of the participants. Multivariate logistic regression was used to assess the association between substance use disorder and mental disorders after adjusting for age and gender. Results The 12-month prevalence for alcohol use disorder was 3.3%, while the 12-month prevalence for other substance use disorder was 6.9%. Adjusting for age and gender, there was an association between any substance use disorder and major depression, generalized anxiety disorder, bipolar 1 disorder, intermittent explosive disorder, social anxiety disorder, suicidal ideation, suicide attempt, and non-suicidal self-injury. Conclusion These findings highlight the need to institute policies and interventions in universities in Kenya that address substance use disorders and comorbid mental disorders among firstyear students
Accessibility to Integrated Community Case Management of Childhood Pneumonia Services Among Caregivers in Kisii County, Kenya
(Journal of Advances in Medicine and Medical Research, 2022) Mwambi, Dennis Oroo; . Osero, Justus O. S; Mwanzo, Isaac; Cheboi, Solomon
Pneumonia is the leading cause of childhood illness and mortality worldwide. The number of children under five with pneumonia in Kisii County, Kenya, was 10% compared to the national average of 9% despite the integrated Community Case Management (iCCM) roll out. In order to identify factors associated with caregivers' access to iCCM services, a study was conducted. Materials and Methods: Qualitative and quantitative approaches were used in this descriptive cross-sectional study. Purposive sampling was utilized to choose 10 informants while multistage and random sampling was applied to select 330 caregivers. Thematic content analysis and discourse analysis techniques were used to analyse qualitative data, while Statistical Package for Social Science (SPSS) version 22 was used in quantitative data. Results: Only 33.6% of caregivers accessed iCCM for childhood pneumonia services. In 49% of cases, CHVs was the first point of contact after onset of pneumonia symptoms, with only 31.2% seeking help within 24 hours. 96% of CHVs did not follow the recommended iCCM diagnostic protocols, and only 34.8% prescribed antibiotics. Age (0.011), religion (0.007), and marital status (0.024) were significantly associated with access to iCCM. Business persons were 2.97 times (OR 2.972; CI 1.232,7.167; P= 0.015) more likely to access iCCM than farmers. Caregivers who perceived pneumonia to be severe were 3.03 more likely to access ICCM (OR 3.039;CI 1.703,5.424; P< 0.001) than opposite peers. Respondents who didn't think pandemics affected access were 10% (OR 0.119; CI .058,0.246; P<.0.001) more likely to access iCCM. Conclusion: Access to iCCM was low and Community health volunteers (CHVs) were not the first point of care for pneumonia in children. Evidence of poor performance by CHVs in the areas of diagnosis, treatment, and the administration of antibiotics suggests that iCCM needs more monitoring and oversight.
Across-sectional survey of prevalence and correlates of couple sexual concurrency among married couples in fishing communities along Lake Victoria in Kisumu, Kenya.
(Sexually Transmitted Infections, 2013-10) Mwanzo, I.J.; Kwena, Z.A.; Bukusi, E.A.; Achiro, L.F.; Shisanya, C.A.
OBJECTIVE: Sexual concurrency has been associated with HIV infection. Since HIV in sub-Saharan Africa is mostly spread within the context of heterosexual couples, it is necessary that intervention is focused on such couples. We sought to establish the correlates of couple sexual concurrency in Kisumu, Kenya. METHODS: We conducted 1090 gender-matched interviews in 545 couples in a cross-sectional survey. A random sample of fishermen and their spouses from 33 fish-landing beaches along the shores of Lake Victoria in Kisumu were asked to enrol in the study. Couples were separated into different private rooms for simultaneous interviews that documented socioeconomic and behavioural characteristics, and information on number of sexual partnerships in the preceding 6 months and their status. Based on reported concurrency status of the spouses, a couple was categorised as either concurrent when at least one spouse reported a concurrent sexual relationship or non-concurrent. RESULTS: Overall, 32.1% of the men and 6.2% of the women had concurrent sexual relationships in the 6 months preceding the study, resulting in 37.6% of the couples being sexually concurrent. Unmet sexual desire, intra-spousal suspicions of infidelity, male dominance scripts, domestic violence, couples' children and women's age were the correlates of couple sexual concurrency. CONCLUSIONS: Unmet sexual desires, inter-spousal infidelity suspicions, male dominance scripts and domestic violence were the main correlates of couple sexual concurrency in these fishing communities. KEYWORDS: Prevention, Sexual Behaviour, Sexual Networks
Adherence to exclusive breastfeeding among HIV-positive women in Nairobi, Kenya
(Mark Allen Healthcare, 2014-04) Kimani, H.; Koima, Winnie; Mwaniki, Peter
In developing countries, exclusive breastfeeding (EBF) remains the best and safest source of nutrition and a recommended method of prevention of mother-to-child transmission of HIV in combination with use of prophylactic anti-retrovirals. Other feeding options could be detrimental to the infant if the mother cannot afford the recommended replacement feeds and expose the infants to diarrhoeal diseases and malnutrition, which could lead to early mortality. Despite this evidence, EBF ranges from 3.2 to 13% in Kenya. The aim of this study was to identify knowledge, attitude and practice in adherence to EBF among 188 HIV-positive women with children aged 6-12 months in Nairobi, Kenya. This was a descriptive cross-sectional study using quantitative and qualitative approaches. Participants were interviewed using semi-structured questionnaires. In addition, two focus group discussions were conducted and key informants from the health facility were also interviewed. The results showed that 69.1% of women EBF. The following factors influenced adherence to EBF positively: presence of main breadwinner (OR=3.44, P=0.003), food availability (P=<0.001), mastitis (P=0.002), knowledge of mother-to-child transmission of HIV (P=<0.001), being taught about EBF in antenatal and postnatal classes (OR=7.78, P=0.002), expressing breast milk (P=<0.001), disclosure of HIV status to husband (OR=2.46, P=0.007) and relative (OR=2.29, P=0.033). In conclusion, information sharing of mother-to-child transmission of HIV antenatally and postnatally should be strengthened in the health facilities. Additionally, mothers should also be taught how to express breast milk
Adherence To Pulmonary Tuberculosis Treatment In Murang’a County, Kenya
(International Journal of Current Aspects, 2020) Gitonga, Charles Muthui; Nyamari, Jackim; Mugo, Judy
Non-adherence to Tuberculosis treatment is a major barrier for TB control programs because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. Successful treatment of TB involves taking anti TB drugs for at least six months as per the doctors advise. Currently, Tuberculosis has become a resurgent public Health problem in developing countries and is the leading cause of death from any single infectious agent. The purpose of the study was to identify factors contributing to non-adherence to TB treatment amongst pulmonary TB patients in Maragua Sub-County of Murang’a County. The objectives included were to determine the social-economic related, healthcare-related, patient-related and disease and medicine related factors associated with non-adherence of TB treatment amongst patients in Murang’a County. The study was guided by the Health Belief model as the theoretical framework. A cross-sectional survey study design was used. Census method was used and all 270 people were considered. Data was collected using a mixed method approach of interview guides, questionnaires and Focus Group Discussions. A total of 270 adult Pulmonary TB patients, amongst whom 59 (47%) were adherents and 67(53%) non adherents with TB treatment, who received treatment in 2017 and had completed treatment, Community Health workers, and Health Personnel in the TB clinic participated in the study. Data was entered to EPI INFO version 3.5.3 and analysed using Statistical Package for Social Sciences (SPSS) version 22. Multiple logistic regressions was used to identify associations and to control potential confounding variables. Chi Square was used to test independence of categorical variables with p value of less than 0.05 at 95% confidence interval being considered significant. Data presentation was done using figures and tables. From the results of the study only the distance taken to collect drugs in the health facility was found to be associated with non-adherence to TB treatment (n=9 ,13%). The study recommends that measures should be undertaken so as to reduce the non-adherence level to TB treatment by ensuring anti-Tb treatment is accessible to patients at the nearest Health facility from their residence. Additionally, the study proposes that the patients should be sensitized on the importance of adherence to TB drug mediction. Interventions with Health promotion initiatives emphasizing the benefits of treatment adherence should be enhanced in the communities by further large scale multicentred studies and that an enabling environment which is conducive for good patient interactions should be created. The study concludes that there are challenges facing adherence of TB treatment which ought to be addressed. The study, suggests that measures to improve drug adherence such as improving health conditions, increasing the availability of drugs and conducting health educations to the patients is essential in minimizing the drug non-adherence to TB drugs.
Adherence to Standard Management Procedure of Organophosphate Poisoning in Selected Health Facilities in Nandi County, Kenya
(Clinical and Experimental Medical Sciences, 2021) Mbugua, John; Kabiru, Ephantus; Kahiga, Titus
Organophosphate poisoning is a public health problem and an important cause of morbidity and mortality worldwide with over 300,000- 350,000 deaths mostly in developing countries. Incidences of organophosphate poisoning in Nandi County has been on the rise due to widespread and increased access use of organophosphate compounds. The adherence by health care providers in Nandi County is low despite the existence of management guidelines of organophosphate poisoning. Compliance to this guidelines have been proven to improve the quality and outcome of the patient. The study main objective is to determine the level of adherence to the standard management procedure of organophosphate poisoning in selected health facilities in Nandi County. A hospital based retrospective study was carried out on 166 patient records with organophosphate poisoning in Kapsabet County Referral Hospital (87 cases), Nandi Hills County Hospital (49 cases), Kaptumo Sub-County Hospital (14 cases) and Mosoriot Sub-County Hospital (14 cases), Nandi County. Data collected was entered and analyzed using descriptive and inferential statistics. The level of significance was set at 0.05. The study findings indicated that majority of the patients were male (73.3 per cent), married (61.1 per cent), informally employed (85.5 per cent), primary level of education (64.1 per cent) and aged between 18-30 years (56 per cent) who consumed poison with the intention of dying (85.5 per cent). There was a significant association between type of organophosphate poisoning and age (2=148.178, df=4, P0.001), marital status (2=17.059, df=2, P0.001) and literacy level (2=28.767, df=3, P0.001). Management procedures carried out were ABC assessment (96.9 per cent), gastric lavage (65.9 per cent), atropine administration (97.6 per cent) and monitoring of fluids, electrolyte (98.2 per cent), resuscitation (29.4 per cent), skin irrigation (2.5 per cent), emesis (18.5 per cent), administration of activated charcoal (10.7 per cent) and administration of pralidoxime (1.5 per cent).
Aflatoxin Bioaccumulation in Broiler Chicken Meat and Organs from Selected Farms in Nairobi City County, Kenya
(International Organization Of Scientific Research (IOSR), 2023) Chepkosgei, Kirinyet Ruth; Njogu, Warutere Peterson; Nguhiu, Purity; Ojola, Patroba; Kirinyet, Joel; Koskei, Peter; Ndiritu, Alex Karuiru
Background: Food safety is a worldwide concern not only to policymakers but also to the general population. Food is regarded as safe when there is assurance that no damage will accrue from its consumption. Aflatoxins pose a major risk to the health of both humans and animals. Studies on residue levels in broiler chicken are limited in Kenya hence grounded on this knowledge, this study sought to determine aflatoxin residue levels in broiler meat and organs in Nairobi City County. Materials and Methods: The study employed a longitudinal study design for a period of six weeks. A total of 42 broilers were sampled. Samples were analyzed using the LC-MS/MS technique. Data was analyzed using STATA version 12. Tukey Kramer post hoc test was used for comparison of means and statistical significance was determined at 5%. Ethical approval was sought from relevant authorities before commencement of the study and consent was sought from the participants before taking part in the study. Results: Results from the study show that there was a significant association (p<0.05) in AFB1 and Total Aflatoxin levels in the gizzard, liver and muscle per week. AFB1 levels in the gizzard were below the WHO/FAO limit of 5 ppb however they were above the EU limit of 2ppb in week 5 and 6. In the liver AFB1 levels were above the EU limit in week 4, 5 and 6 and above the WHO/FAO limit in week 6.In the muscle AFB1 levels were all below the WHO/FAO and EU limit. Total Aflatoxin levels in the liver were above the EU limit in week 4, 5 and 6 and above the WHO/FAO limit in week 6. In the muscle Total Aflatoxin levels were all below the WHO/FAO and EU limit. Conclusion:The results of the study suggest that there were appreciable levels of aflatoxin in the liver and gizzard hence there is need for continuous surveillance and monitoring of aflatoxin levels in feed by regulatory bodies, county and national government to prevent carry over in meat.
AGC1 Deficiency Causes Infantile Epilepsy, Abnormal Myelination, and Reduced N-Acetylaspartate.
(2014) Otieno, F. G.; Falk, M.J.; Li, D.; Gai, X.; McCormick, E.; Place, E.; Lasorsa, F.M.; Hou, C.; Kim, C.E.; Abdel-Magid, N.; Vazquez, L.; Mentch, F.D.; Chiavacci, R. M.; Liang, J.; Liu, X.; Jiang, H.; Giannuzzi, G.; Marsh, E.D.; Yiran, G.; Tian, L.; Palmieri, F.; Hakonarson, H.
BACKGROUND: Whole exome sequencing (WES) offers a powerful diagnostic tool to rapidly and efficiently sequence all coding genes in individuals presenting for consideration of phenotypically and genetically heterogeneous disorders such as suspected mitochondrial disease. Here, we report results of WES and functional validation in a consanguineous Indian kindred where two siblings presented with profound developmental delay, congenital hypotonia, refractory epilepsy, abnormal myelination, fluctuating basal ganglia changes, cerebral atrophy, and reduced N-acetylaspartate (NAA). METHODS: Whole blood DNA from one affected and one unaffected sibling was captured by Agilent SureSelect Human All Exon kit and sequenced on the Illumina HiSeq2000. Mutations were validated by Sanger sequencing in all family members. Protein from wild-type and mutant fibroblasts was isolated to assess mutation effects on protein expression and enzyme activity. RESULTS: A novel SLC25A12 homozygous missense mutation, c.1058G>A; p.Arg353Gln, segregated with disease in this kindred. SLC25A12 encodes the neuronal aspartate-glutamate carrier 1 (AGC1) protein, an essential component of the neuronal malate/aspartate shuttle that transfers NADH and H(+) reducing equivalents from the cytosol to mitochondria. AGC1 activity enables neuronal export of aspartate, the glial substrate necessary for proper neuronal myelination. Recombinant mutant p.Arg353Gln AGC1 activity was reduced to 15% of wild type. One prior reported SLC25A12 mutation caused complete loss of AGC1 activity in a child with epilepsy, hypotonia, hypomyelination, and reduced brain NAA. CONCLUSIONS: These data strongly suggest that SLC25A12 disease impairs neuronal AGC1 activity. SLC25A12 sequencing should be considered in children with infantile epilepsy, congenital hypotonia, global delay, abnormal myelination, and reduced brain NAA.
The Age Specific Practices and Outcomes in Women Undergoing Unsafe Abortions in Rural Communities of Kenya
(Journal of Medicine and Biomedical Sciences, 2013-05) Osur, J.; Orago, A. S.; Mwanzo, I.; Bukusi, E.
Unsafe Abortion is common among young women. It is not however known whether the young women decide on their own to terminate the pregnancies, whether the methods they use are similar to those of older women, and whether the outcomes of their unsafely procured abortions are different from those of older women. This study therefore set to establish the age specific practices and outcomes of unsafe abortion. It was a cross-sectional survey and the setting was Siaya County, Kenya in East Africa. A sample of 320 women aborting unsafely and reporting to health facilities for completion of the process and management of complications were interviewed to determine their reproductive health profiles, decision making process for unsafe abortion, unsafe abortion methods they had used and outcomes making them seek healthcare. The study found that 76% of women aborting unsafely were between 10 and 24 years with 62% being nulliparous. 84% of them had undesired pregnancy. Younger women were likely to consult with a variety of people before making a decision to abort unsafely. Women with wanted pregnancy and aborting unsafely were likely to be of a younger age. The younger person was also more likely to use a wide variety of unsafe abortion methods resulting in more complications. Overall
Analysis of Cost Associated with Treatment of Road Traffic Injuries among Victims at the Kenyatta National Hospital Nairobi City Kenya
(IJRISS, 2022) Lipule, Zablon.anyenda; Yitambe, Andre; Rucha, Kenneth
Background; Previous studies have pointed out that road traffic injuries (RTIs) as a leading cause to fatalities of over one million victims globally per year which bears negative impact on health, economy and development of the society as a whole. Furthermore, young men and women at their most economic age group have been identified as the most vulnerable group to road traffic injuries (RTIs) resulting to mortality and very severe morbidity due disability. However, there is little or no published evidence on healthcare resource allocations and utilization after RTIs, especially in developing countries that include those in Africa. Objective: The main objective of this study was to analyze the total hospital cost related to RTI (Road traffic injury) victims admitted for a period of 3 months. The study demonstrated effects of direct and indirect medical cost , productivity loss and hospital length of stay on total cost of road traffic injuries of RTI victims at KNH. Methods: This was a cross sectional study design done at the Kenyatta Hospital Nairobi, surgical wards and Accident & Emergency. A sample (n=124) consisted of new victims admitted to the Hospital due to RTI from January 25th 2019 to 24th April 2019., this was two thirds of the sample size at 74% respondent rate who gave consent and all ethical approvals granted. The data collection of direct and indirect medical cost was by data extraction tool, testing of the tools was done at the surgical ward. Productivity loss of the victims was calculated by use of Work Productivity and Activity Impairment Questionnaire (WPAIQ). SPSS version 22 was applied and descriptive statistics to show frequencies and Percentages for categorical variables (victim’s unique individualized characteristics). Multi Linear Regression Model Test was used test the relationship between the independent and dependent variables. Results: The study results indicated that direct cost factors (laboratory cost, A&E Charges and Diagnostic Cost) (X1: β1 =.199, P<. 047), (X3: β3 =.469, P< .037), and (X4: β4 =.029, P< .048) had a significant influence on the overall cost of treatment of RTI victims seeking treatment at the KNH, there was no significant relationship between Bed Charges (X2: β2 =.117, P>.689) and the cost of treatment of RTI victims seeking treatment at the KNH. The findings of the study also indicated that Y= 7.949+.001X1+0. 458X2+0. .239 X3+ 0. .305X4+e where a .199 change in direct cost, .117 changes in indirect cost, .469 change in total productivity cost and .029 changes in duration of stay in hospital influenced a unit change on the cost of treatment of RTI victims seeking treatment at the KNH. Most distribution of injuries was lower limbs at 51.6% Conclusion & Recommendation: The study concludes that Road traffic accident is an economic burden to individual, family and country at large. The study recommends, need for an awareness on importance of National Hospital insurance fund (NHIF) as a universal health coverage fund for people at an affordable cost, there is need to reduce the indirect cost of treatment associated indirect cost of treatment, support to from one person or two further increasing productivity time associated with the injury. Further motion study on cost analysis will give a detailed insight on these area of study.
Anopheles larval abundance and diversity in three rice agro-village complexes Mwea irrigation scheme, central Kenya
(Malaria Journal, 2010) Mwangangi, J. M.; Shililu, J.; Kabiru, Ephantus W.; Muturi, E. J.; Muriu, S.; Jacob, B.; Mbogo, C. M.; Githure, J.; Novak, R. J.
BACKGROUND: The diversity and abundance of Anopheles larvae has significant influence on the resulting adult mosquito population and hence the dynamics of malaria transmission. Studies were conducted to examine larval habitat dynamics and ecological factors affecting survivorship of aquatic stages of malaria vectors in three agro-ecological settings in Mwea, Kenya. METHODS: Three villages were selected based on rice husbandry and water management practices. Aquatic habitats in the 3 villages representing planned rice cultivation (Mbui Njeru), unplanned rice cultivation (Kiamachiri) and non-irrigated (Murinduko) agro-ecosystems were sampled every 2 weeks to generate stage-specific estimates of mosquito larval densities, relative abundance and diversity. Records of distance to the nearest homestead, vegetation coverage, surface debris, turbidity, habitat stability, habitat type, rice growth stage, number of rice tillers and percent Azolla cover were taken for each habitat. RESULTS: Captures of early, late instars and pupae accounted for 78.2%, 10.9% and 10.8% of the total Anopheles immatures sampled (n = 29,252), respectively. There were significant differences in larval abundance between 3 agro-ecosystems. The village with 'planned' rice cultivation had relatively lower Anopheles larval densities compared to the villages where 'unplanned' or non-irrigated. Similarly, species composition and richness was higher in the two villages with either 'unplanned' or limited rice cultivation, an indication of the importance of land use patterns on diversity of larval habitat types. Rice fields and associated canals were the most productive habitat types while water pools and puddles were important for short periods during the rainy season. Multiple logistic regression analysis showed that presence of other invertebrates, percentage Azolla cover, distance to nearest homestead, depth and water turbidity were the best predictors for Anopheles mosquito larval abundance. CONCLUSION: These results suggest that agricultural practices have significant influence on mosquito species diversity and abundance and that certain habitat characteristics favor production of malaria vectors. These factors should be considered when implementing larval control strategies which should be targeted based on habitat productivity and water management.
Appreciating the Essence of Post Natal Care Services from Mothers’ Perspective in Kiambu, Kenya
(Sciencedomain International, 2017) Njoka, Nancy Mugure; Otieno, George Ochieng’; Mwaniki, Peter; Cheboi, Solomon Kemoi
Introduction: The first 42 days after delivery is a critical period in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. The government of Kenya has recommended that all mothers and newborns receive three postnatal (PNC) checkups this period. These are; within 48 hours before discharge from post-natal ward, at 2 weeks and again at 6 weeks. Nonetheless, uptake of postnatal services particularly visit two remains low. For instance 25% of mothers in Kiambaa Sub County access PNC at two weeks. Study Design: A cross sectional descriptive study design was conducted among 399 mothers to determine the factors that influence utilization of PNC services. Study Area and duration: This research was undertaken in Kiamba, Kiambu County between August and September, 2013. Original Methodology: This was a mixed qualitative and quantitative study. Simple random sampling was used to select participating administrative units and respondents selected systematically. Sample size distribution was by probability proportionate to size. Quantitative data was analyzed using Stata version 13, while qualitative data was analyzed manually based on themes. Results: Utilization of PNC services was at 45.1%. Over half (53%) of the respondents made their first PNC post-delivery visit after 14 days, 11% and 36% within 7 and 14 days respectively. The health care workers had informed only 15 % of the women, to attend the PNC services. College education (OR=12.292, p<0.001); high household wealth status (OR=3.6211, p<0.001); formal employment (OR=2.705, p=0.008); delivery at a private facility (OR=2.9269, p< 0.000) and high knowledge of PNC services (OR=2.2307, p=0.008) were synonymous with utilization of PNC services. Perceived good quality of care (OR=5.2607, p< 0.000), and a positive attitude (OR=3.6507, <0.000) were other determinants. Conclusion: Uptake of postnatal care services remains a challenge among mothers and is predicted by several overt and covert constraints. Quality of delivery services and providers respective care practices were key predictors. Nevertheless, close to half of the women sought postnatal care at least twice in the post-natal period. The services were mainly accessed at or after 6 weeks. The timing of first PNC, post- delivery visit varies. Uptake of PNC visit two remains low.
Aspirations versus Reality: Exploring Factors Affecting Meaningful Youth Participation in Sexual and Reproductive Health and Rights Programme in Rural Kenya
(East African Nature and Science Organization, 2021) Evelia, Humphres; Ndayala, Phoebe; Page, Anna; Wafula, Charles O; Westeneng, Judith; Kuya, Johnstone; Chesire, Faith
This paper presents the results of an implementation research of a pilot intervention, mainstreaming meaningful youth participation in a health care management system in Western Kenya with the aim to address adolescent sexual and reproductive health and rights (SRHR). This qualitative case study included 29 key informant interviews and 13 focus group discussions conducted in five community health units across four counties. The results demonstrate positive attitudes towards the principle of youth participation, yet, also a mismatch between the aspirations of young people to be active decisionmaking agents and the actual roles and responsibilities assigned to them. This paper further identifies factors that inhibit and enable effective youth participation at multiple levels; individual (such as education, discipline, migration, gender); organisational (such as guidelines and structures, financial support, and political interference) and societal (norms seeing SRHR as taboo and young people as unequal to adults), and formulates recommendations to address these.
Assessing Long-Acting and Permanent Family Planning Methods Uptake among Women of Reproductive Age in Kilifi Sub-County, Kilifi County
(IJRIS, 2014-11) Mambo, S.N.; Oyore, J.P.; Obare, F.O.
Family planning is the intentional prevention of conception through use of the various available devices, sexual practices or surgical procedures and medications followed in order to deliberately prevent or reduce likelihood of pregnancy. Family planning methods comprise modern methods (short acting methods and long-acting and permanent methods (LAPM) and traditional methods. This study focused on the Long acting/Permanent methods (IUCD, Implants and sterilization) which have comprised a very small percentage of the methods used by women over the years. Kilifi district has a bigger population which is rural, with a quarter of the population twenty five percent being WRA. Kilifi district contraceptive prevalence rate (CPR) currently stands at twenty three percent, however, the LAPM share of this is not known. The aim of the study was to assess the determinants of uptake of long acting/permanent methods of family planning among the women of reproductive age in Kilifi sub-county of Kilifi county, Kenya. Cross sectional exploratory study was used which was employing both qualitative and quantitative designs. The study was done in public health facilities only where ten percent of the total facilities in the sub-county were randomly selected: Kilifi district hospital, Bamba sub district hospital and Vipingo health centre were selected. A total of three hundred and fifty respondents drawn from the three facilities were sampled: 150 respondents from KDH; 120 respondents from Sub-district hospital and 80 respondents from the health centre. Two phases of data collection were used where in phase one, data was collected through client-exit interviews using questionnaires administered to WRA visiting family planning clinic at the three health facilities that were selected for the study between October 2011 and June 2012. Phase two involved conducting key informant interviews (KIIs) with the service providers which was done around the same time. Uptake of LAPM among the respondents WRA in Kilifi was found to be forty percent (40%). The major socio-cultural and demographic factors that were found to determine uptake of LAPM of family planning were age, education level, marital status, intention to have more children, partner support, LAPM previous knowledge and use, as well as the previous source of these methods. Major health facility determinant was found to be the mode of transport to facilities. Other barriers to LAPM uptake as indicated by key informants were partner approval, myths and perceptions, commodity stock outs and shortage of trained personnel.
An Assessment of Health Provider Related Factors Influencing Utilization of Health Facility during Child Birth by Women Aged 15-49 Years in Matinyani Sub-County in Kitui County
(International Peer Reviewed Journal and Book Publishing, 2018) Maingi, Nancy Nyambura; Keraka, Margaret
Purpose: This study was aimed at identifying health provider related factors influencing utilization of health facility during child birth by women aged 15-49 years in Matinyani Sub- County in Kitui County. Methods: It was a facility- based study conducted in Matinyani Sub county where 376 women and 6 health facilities were included. It was a descriptive cross-sectional study. The variables tested were utilization of health facility during child birth and provider related factors. Data collection was done using focused group discussions guide, interview schedule guide, observation and analysis was done using SPSS version 17. Chi test was used to show association between the variables. Results: Majority of health workers were trained on FANC but not trained on comprehensive RH. Unique contribution to theory, practice and policy: All health workers to be educated on drug storage to avoid expiry hence wastage of drugs.
An Assessment of Knowledge, Utilization, and Perceptions On Antenatal Care Services among Women in Nimba County, Liberia
(Stratford, 2022) Smythe, Edwina; Kabiru, Ephantus; Osero, Justus O.S
Liberia registers an exponential mortality rate in developing Sub-Saharan countries in Africa. Inadequate utilization of antenatal care is a leading cause of the higher infant mortality rates recorded in Liberia. Thus, this study seeks to assess knowledge and socio-demographic factors that thwart the utilization of ANC services among women between 15 and 49 years in Nimba County, Liberia. The study applied quantitative and qualitative research design. A sample of 167 was selected using a systematic sampling technique. The SPSS Software Version 23.0 was used to analyze the data collected statistically. Results indicated that 54.5 % of the sample were between 15 – 25 years. Socio-demographic characteristics such as age (χ 2= 0.902), df= 3, P= 0.825), were not significant with ANC attendance and the level of knowledge was significant (χ 2=5.653 df =1 P=0.017). Further, 150 women in the sample had adequate knowledge of ANC services. The high level of knowledge among respondents was significant (χ 2=5.653 df =1 P=0.017) with ANC attendance. In addition, 83.8% attended ANC services, and 77.8% delivered their babies at health centres. One of the noticeable challenges cited by respondents in this study was the distance to facilities with 64%. Most people were knowledgeable about ANC services, which affected their decision to utilize ANC services, while demographic factors were not significant. However, the study has established inadequate medication and distance to the nearest facility foiled the utilization of ANC services. Therefore, this study recommends that the government ensures that rural Liberia’s health facilities are equipped with medicines and accessible and aggressively conducts civic education or campaigns to create awareness about the ANC services
Assessment of Patient Satisfaction and Perception of Quality of Antenatal Care Services Among Pregnant Women Attending Antenatal Clinics at a Secondary Health Care Facility in Anambra State, Nigeria.
(Magna Scientia, 2021) Chigozie, Joseph Ezeoke; Onyeka, Chukwudalu Ekwebene; Tyotswam, Simeone Yanmeer; Chioma, Favour Ekwebene; Chigbo C, hisom God’swill; Eleje, George Uchenna
Introduction: Prenatal care is an important component of maternal care worldwide more so in sub-Saharan Africa. Methodology: This work is a cross-sectional descriptive study carried out among 170 pregnant women attending antenatal clinic in health facilities in Ekwulobia, Anambra state. Convenience sampling technique was used in this study. The study instrument was a semi structured interviewer administered questionnaire which was developed according to the objectives of the study. In this study we evaluated patient waiting time, pregnancy outcome, quality of care, attitude of staff and facility neatness as parameters for measuring patient satisfaction, we also evaluated quality of service, attitude of staff, proximity to ANC centre, waiting time and cost as determinants of ANC use. Result: The study showed a demonstration of good knowledge of ANC and its importance in maternal and child health, 65.6% were aware of first trimester has the most appropriate time for ANC booking. A high level of satisfaction was recorded among the participants, 65.6% rated the ANC services as very good and 30.3% rated the service as good. Conclusion: Pregnant women in rural areas in eastern Nigeria receive quality and accessible antenatal care services and majority of the women are satisfied with the quality of service. Efforts to improve maternal and child health status in Eastern Nigeria is yielding fruit especially in rural areas. It is recommended that similar studies studies be conducted in other parts for the country to discover the conditions of ANC use and i effects and compare the factors that influence ANC use
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.
Assisted Partner Services (APS) among Patients Attending HIV Comprehensive Care Clinic in Kenya: Randomized Controlled Trial (RCT)
(International Journal of Medical Science and Health Research, 2018) Kimani, Harun; Bukusi, David; Maingi, Peter; Macharia, Peter; Otieno, Felix A.; Muiruri, Peter; Farquhar, Carey
Introduction: Assisted Partner Services (APS) for HIV involves interviewing HIV infected individuals about their sexual partners and then locating these partners to offer HIV testing and inform them about the exposure. Several studies have shown APS to be effective and acceptable among newly diagnosed individuals, however few have studied APS among individuals with chronic HIV infection. Methods: HIV-infected individuals receiving care at Kenyatta National Hospital Comprehensive Care Center (CCC) were randomized to community versus health facility based notification. Index case in the Health facility arm were offered standard of care which is contract testing where they were encouraged to bring their partners for testing. In the community arm which was the intervention arm, the index cases were offered immediate assisted partner notification where health advisers consented the index cases for their partners to be confidentially contacted and tested for HIV. Smart phone tablet with a Open Data Kit questionnaire was used to collect data. The two approaches were compared using the ODDS Ratio with 95% confidence intervals and the results given below. Results: Index cases randomized to health facility arm were 201 while 218 index cases in the community arm of whom 262 (62.5%) were women and majority aged between 40-49 years 87 (39.9%). The community based assisted partner notification yielded 1 partner per index and among these 113 partners were traced (51.8%) and 101 partners were HIV tested (89.3%). Of those tested, 35 of 101 were HIV-positive. When compared to facility passive referral, there was a 2.6-fold increase in partner testing with 58 (28.9%) of 201 testing for HIV in the health facility arm (Odds ratio [OR] 2.65; 95% confidence interval [CI]: 1.77, 3.98 p<0.001). Discussion or conclusion: Community based partner tracing has high potential of reaching HIV exposed partners of a HIV infected index case. It is acceptable to both index cases and their partners and enables health workers provide services that enable partners to be enrolled into care.
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.

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