BC-School of Public Health

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Advocacy in Reproductive Health a Kenyan Situation and Reflection
(LAP Lambert Academic Publishing, 2012-11-20) Okello, A. B. M.
Sustained advocacy on sexual and reproductive health in Kenya is of paramount importance in the fight of maintaining the human race and dignity. Advocacy plays an important part in shaping the local policy and funding allocation in reproductive health in Kenya. In recent years the concept of advocacy has grown in importance in civil society organization in shaping policy process in local and international governments and institutions. Advocacy is influencing other people, building support, promoting commitment to issues and directing decision makers towards solutions. Successful advocates usually start by identifying the people they need to influence policies and planning the best ways to communicate with them. They dwell on issues and build persuasive cases. Advocates organize networks and coalitions to create grounds well of support that can influence key decision makers. They work with the media, the third estate, to help communicate the message. Women’s Health Advocacy champions women’s health, rights and development unlike men, women’s health is a complicated issue, which needs a well coordinated approach to solve.
Barriers and Facilitators to Human Immunodeficiency Virus Self Testing among Undergraduate Students in Kenyatta University, Kenya
(Kenyatta University, 2024-10) Muendo, Nicholas Kyalo
Over 36.9 million people worldwide live with HIV, with 21.7 million receiving ART. In Africa, 1.5 million individuals aged 15-24 are affected, with teenage girls and young women being disproportionately affected. KENPHIA Preliminary Report revealed a nationwide HIV prevalence rate of 4.9%, with women having a higher rate of 6.6% compared to men at 3.1%. HIVST aims to increase accessibility to testing services for at-risk populations. The WHO has preapproved three HIV self-testing kits for Kenya, including OraQuick®, Atomo®, and INSTI®. However, only 62% of young individuals are aware of their HIV-positive status, with university students at a higher risk due to risky sexual behaviors and cross-generational relationships. The UNAIDS aims to achieve 95% HIV status awareness by 2030, but current conventional HIV testing has not effectively ensured widespread availability of HIV prevention, treatment, and care. This cross-sectional analytical study targeted undergraduate students, utilizing multi-stage cluster sampling and self-administered questionnaires to collect comprehensive data on their demographic characteristics, HIV testing practices, and factors influencing HIVST uptake. The results revealed that 24.4% of participants had ever used HIVST, with 65.3% having tested for HIV overall. Among those who had tested, 44.6% had last done so more than a year ago, with facility-based testing being the most common method (71.2%). Age and gender were significant determinants of HIVST uptake; females (50.8%) and older students aged 22-25 years had higher odds of using HIVST. Awareness of HIV prevention methods like PrEP was a particularly strong facilitator, with participants aware of PrEP being 2.4 times more likely to use HIVST. Additionally, 69.1% of participants found HIVST kits affordable, though 57.7% reported difficulty accessing them. Social media emerged as the primary source of information for 56.7% of participants, while 86.6% found the instructions on the kits easy to understand. Despite these barriers, 78.4% of participants were confident in interpreting their HIV status at home, and 88.7% agreed that HIVST kits should be made available free of charge in public health facilities. The study underscored the importance of addressing persistent barriers such as stigma, cost, and accessibility to significantly increase HIVST uptake. Key recommendations include enhancing HIV prevention education, leveraging successful media campaigns like "Chukua Selfie," integrating HIVST into campus health services, and tailoring interventions to specific demographic groups such as young adults. The study provided a nuanced understanding of the determinants affecting HIVST uptake and offered actionable strategies to enhance HIV prevention and control efforts among young adults in Kenya
Burden of Childhood Diarrhea from Water, Sanitation and Hygiene: The case of Nairobi city, Kenya
(VDM Verlag Dr. Müller, 2010-07-30) Keraka, M.; Akungah, N. D.; Anyango, O.
This study aimed to quantify the burden of childhood diarrhea morbidity and mortality of the under five children in Nairobi city using household data and hospital records. The main objective of this study was to estimate the diarrhea disease burden of aged less than five years associated with Water, sanitation and hygiene in Nairobi using available mortality and morbidity information. The study used a cross-sectional, non-interventional approach. For estimating childhood diarrhea disease burden, the study area was categorized into four exposure residential environs differentiated by WASH and SES characteristics. The delineation gave four residential environs namely Informal settlement Low Income Residential Areas (ISLI), High Density Low income residential Area (HDLI), Medium Density High income residential Area (MDHI)and Ligh Density High income residential Area (LDHI). The parameters considered included access to improved water and sanitation and diarrhea (case fatality, incidence rate, incidence duration, and prevalence) so as to calculate Disability Adjusted life Years (DALYs). Also household hygiene knowledge and practice were assessed, sanitary inspections conducted and water samples collected that were analysed for total and faecal coliform counts, turbidity and conductivity. Data obtained were subjected to relevant statistical tools including descriptive statistics, relative risk estimate, regression analysis and multivariate methods. The results of the study show ISLI and HDLI environs were receiving significantly low and unreliable amounts of water (20lcd/person/day) as well as inadequate sanitary facilities. The results also revealed that the microbiological quality of water in ISLI and HDLI residential environs was generally poor due to poor water handling practices and poor sanitary conditions within the surroundings. Overall, household water storage showed a significantly higher contamination (33.2%) than household tap water supplies (4.7%).These factors influence a higher childhood diarrhea burden observed in this study for diarreah the study identified a distinct pattern of childhood morbidity. The annual disability adjusted life years for children under the age of five years in Nairobi study area were approximately 106 DALYS/1000 person years (ISLI=223; HDLI=98; MDHI=56 and LDHI=47). This means that children loose approximately 10% of their quality life to diarrhea with ISLI and HDLI losing 22.3% and 9.8% respectively compared to5.6 and 4.7 per cent for MDHI and LDHI respectively. The diarrhea patterns observed empasised the role of socioeconomic, educational, water supply and sanitation factors on diarrhea morbidity and mortality in Nairobi study area. Some of the most important factors that contributed to diarrhea morbidity were parental education, household water consumption rates household income and access to sanitation facilities. The optimal WASH and SES conditions in this study were for MDHI. There is need therefore to improve children’s living conditions to match MDHI residential environs for children’s diarrhea and health outcomes to be significantly reduced. To this end, multi-stakeholder involvement and strengthening of the institutional mechanism responsible for providing water and sanitation in the city will be key to providing improved access to water and sanitation in the city of Nairobi especially in the ISLI and HDLI residential areas of Nairobi. This should be enhanced by legislating mandatory construction of improved ventilated pit latrines, and provide health promotions on the significance of household hygiene among others.
Health Implications of Urban Livestock Farming on Meat Quality: Assessment of Selected Heavy Metals in Meat Consumed in Eldoret Town, Kenya and Their Health Implications on Consumers
(VDM Verlag Dr. Müller, 2010-02-17) Nyamari, J. M.; Simiyu, Gelas
The main objective of this study was to assess levels of selected heavy metals lead (Pb) and cadmium (Cd) in meat consumed in Eldoret Town, Kenya. This study focused on Liver and Kidney of bovine, since these are depository sites for toxic heavy metals.404 samples of liver and kidney were collected, dried and ground, two grams of dried samples were wet digested using concentrated nitric acid and hydrogen peroxide and the digest was analyzed for Pb and Cd using flame Atomic Absorption Spectrometer - Varian 200 Lead concentrations in liver ranged from 0.01 - 0.33mg/kg, while Cd was 0.001 - 0.17mg/kg. In kidney samples, Pb ranged from 0.01 - 0.33mg/kg, while Cd, ranged from 0.001 - 0.436mg/kg. The maximum concentrations of Pb and Cd found in liver and kidney were from animals samples obtained from urban areas. Most of the samples had concentrations below maximum levels recommended by the WHO / FAO, but considering that relatively higher concentrations were observed in animals from urban areas, there is need to educate public about the dangers of keeping animals for consumption in urban areas, and there is need for To ensure continuous monitoring studies meat is free from heavy metals.
Identification and Characterization of the Microbial Contaminants: of Herbal Medicines in Kenya
(VDM Verlag Dr. Müller, 2011) Nyamari, J. M.; Onyambu, Meshack
With the ever increasing use of herbal medicines and the global expansion of the herbal medicines market, safety has become a concern for both health authorities and the public in many countries. This is because many contaminants and residues that may cause harm to the consumers have been reported. Many are natural such as naturally occurring radioxides, toxic metals, bacteria and fungi. Some arise from past and present use of agents or materials that pollute the environment and subsequently medicinal plants, such as emissions from factories or the residues of certain pesticides. For these reasons, there is currently a global danger to the health and well-being of the people. These risks can be reduced by ensuring that there is enough surveillance of herbal medicines so that those with harmful contaminants and residues above recommended limits do not reach the public. This study therefore was aimed at identification and characterization of the microbial contaminants in herbal medicines sold in Kenyan herbal clinics, Chemists, supermarkets and streets. The microbial loads were established and the contaminants isolated and identified.
Implications of Urban Livestock Farming on Meat Quality: Assessment of Selected Heavy Metals in Meat Consumed in Eldoret Town, Kenya and their Health Implications on Consumers
(VDM Verlag Dr. Müller, 2010) Nyamari, J. M.; Gelas, M.
The main objective of this study was to assess levels of selected heavy metals lead (Pb) and cadmium (Cd) in meat consumed in Eldoret Town, Kenya. This study focused on Liver and Kidney of bovine, since these are depository sites for toxic heavy metals.404 samples of liver and kidney were collected, dried and ground, two grams of dried samples were wet digested using concentrated nitric acid and hydrogen peroxide and the digest was analyzed for Pb and Cd using flame Atomic Absorption Spectrometer - Varian 200 Lead concentrations in liver ranged from 0.01 - 0.33mg/kg, while Cd was 0.001 - 0.17mg/kg. In kidney samples, Pb ranged from 0.01 - 0.33mg/kg, while Cd, ranged from 0.001 - 0.436mg/kg. The maximum concentrations of Pb and Cd found in liver and kidney were from animals samples obtained from urban areas. Most of the samples had concentrations below maximum levels recommended by the WHO / FAO, but considering that relatively higher concentrations were observed in animals from urban areas, there is need to educate public about the dangers of keeping animals for consumption in urban areas, and there is need for continuous monitoring studies to ensure meat is free from heavy metals
Indigenous Behavioral Health in Eastern Africa
(Wiley, 2013-08-12) Wasanga, C.; Mathews, J. R.
In Africa, the number of traditional healers far outnumbers Western-trained doctors by as much as 10:1. In fact, it is estimated that 80% of rural health needs in Kenya are met by traditional healers. This is due in part to long-held traditions in African communities and in part due to the lack of Western-trained medical practitioners. Given the low physician:patient ratio, it is important for Western-trained practitioners to understand and collaborate with traditional healers. With the onset of the HIV/AIDS pandemic in Africa, there is even greater utilization of traditional healers. Recognizing this fact, the World Health Organization published a traditional medicine strategy proposing national policies to ensure quality care by traditional healers.
Lifestyles in an Era of AIDS : Women Migrant Workers Sexual Behaviour Patterns
(VDM Verlag Book Publisher, 2010) Mweru, M.
Participation of Community Health Care Workers in Enhancing Long-Acting and Reversible Contraceptives in Married Women in Kilifi County, Kenya
(Kenyatta University, 2024-06) Mbatah, Jared Adams
Community health workers (CHWs) play a vital role in enhancing the utilization of long-acting and reversible contraceptives (LARCs). Since CHWs serve as trusted sources of information and support within their communities makes them instrumental in enhancing the utilization of LARCs among married women and contributing to improved maternal and reproductive health outcomes. Kenya faces significant challenges in ensuring widespread access to and utilization of LARCs among married women despite the proven benefits of these contraceptive methods in preventing unintended pregnancies and improving maternal and child health outcomes. The study assessed the participation of Community Health Workers (CHWs) in enhancing the utilization of long-acting and reversible contraceptives (LARCs) among married women in Kilifi County, Kenya. The study was guided by the following specific objectives; To determine the level of knowledge of CHWs in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To establish the health and community support systems available for the CHWs in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To evaluate the health and community systems barriers that hinder the participation of CHWs in in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To investigate the resources available for CHWs that can enhance their participation in promoting utilization of LARCs among married women in Kilifi County, Kenya. The study was anchored on the Health Belief Model (HBM). A descriptive research design was adopted, employing both qualitative and quantitative data collection methods. Interviews, surveys, and focus group discussions were conducted with CHWs, healthcare providers, and community members to gather insights into their experiences, perceptions, and challenges related to LARC promotion. The study was conducted in selected Sub–County hospitals in Kilifi County. The study population was 246 CHWs working in Kilifi County. Study participants will be selected through purposive sampling. The study used structured questionnaires to collect quantitative data. The study also conducted focused group discussions and key informant interviews. Data collected was organized and entered into SPSS Version 24. This was then presented through tables, charts and narratives. Logistic regression was used to assess the levels of association. The strength of the association was measured using a 95% confidence level. The study findings revealed that level of knowledge of CHWs, community support systems, resources available for CHWs did enhance utilization of LARCs among married women in Kilifi County, Kenya. It was concluded that participation of CHWs enhanced utilization of LARCs among married women in Kilifi County, Kenya. Overall, the study findings underscored the importance of equipping CHWs with adequate knowledge, resources, and support to effectively promote LARC utilization among married women in Kilifi County. Addressing the identified barriers and implementing the recommendations can contribute to improving reproductive health outcomes and empowering women to make informed choices about their contraceptive needs.
Prescribed Diets in HIV Malnourished Children
(Lambert Academic Publishing, 2012-07) Agina, B.M.O.; Masinde, L.A.; Okwara, F.
The role of good nutrition in mitigating the effects of HIV/AIDS is well documented but little is known about the effectiveness of prescribed diets in malnourished HIV infected children. This book is a result of a study on the effectiveness of Insta Food by Prescription (FBP) and also addresses the challenges encountered in delivering FBP to HIV malnourished children. It highlights fundamental issues that should go along with prescribed diets such as; general sanitation and personal hygiene, training of caregivers, age of caregiver, relationship between the child and caregivers, family planning, medical and child care, food security and stigma among others. The study was carried out at Lea Toto Program, a set of outpatient clinics of Nyumbani Children’s Home, founded by the late Fr. Angelo D’Agostino in 1992. The program mostly serves the slum suburb of Kangemi, Nairobi, Kenya and its adjacent areas. Most patients showed improvement after being put on Insta FBP. For better results, addressing malnutrition in HIV infected children should entail an integrated programme that addresses nutrition as well as socio demographic and economic factors.

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