Department of Population and Reproductive Health

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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.
Attitude towards Utilization of Family Planning Services among Women of Reproductive Age Living with Disability in Kajiado County, Kenya
(Medip Academy, 2021) Makau, Perrista M.; Keraka, Margaret N.; Kieru, Jane N.; Matoke, Vincent O.; Okari, M. Geoffrey
Background: Family planning refers to practices that allow people to control the number of children and determine healthy spacing and timing of births between pregnancies. Approximately 10 percent of the world's population experience some form of disability. Worldwide, the most vulnerable groups include women with disabilities who highly need contraception most. The objective of this study was to assess the nature of attitude associated with utilization of family planning services among women living with disabilities in Kajiado County, Kenya. Methods: A descriptive cross-sectional study design was adopted with both quantitative and qualitative data collection methods applied. The study systematically sampled 316 women living with disability. Additional information was obtained from Focused Group Discussions. Required ethical clearance and permissions were sought prior to the study. Descriptive data and inferential statistics were analyzed through use of SPSS version 20.0. Results from focused group discussions were triangulated with quantitative data as direct quotes. Results: Only 32.0% of women living with disability utilized family planning in Kajiado County. About 61.2% of them had a negative attitude towards family planning. The nature of attitude (p=0.001) was significantly associated with utilization of family planning. Conclusions: The nature of attitude towards family planning among women with disability in Kajiado County was negative. Approximately 6 out of 10 women of reproductive age with disability had a negative attitude towards family planning. There is need to for policy makers and relevant stakeholders to dispel myths, misconceptions and religious beliefs associated with underutilization of family planning thus changing their nature attitude towards family planning
Awareness of Gender Based Violence Interventions by Women of Reproductive Age in Kibera Slums
(European Centre for Research, Training and Development (ECRTD), UK, 2023) Wairimu, Wanjohi B.; Keraka, Margaret; Mutabazi, Michel
Gender-based violence (GBV) is a major worldwide public health concern which is quite prevalent with domestic violence being voiced as the most common (WHO, 2020). According to WHO (2020), at least 1 in 3 women have experience physical or sexual violence. A study by NCRC (2020) showed cases of gender- based violence in Kenya reported between January and June, 2020 (that is 2,032) are way above the total numbers reported between January and December, 2019 (that is 1,057), representing 92.2% increase and confirming an escalation of incidents (NCRC, 2020). Kibera slum is not spared from GBV cases and other public health issues. A cross-section study was designed to determine the level of awareness of the available GBV interventions among women of reproductive age in Kibera slums and to determine the factors associated with awareness of available GBV interventions offered to women of reproductive age in Kibera slums, the second largest slums in Sub-Saharan Africa. The data was collected with a questionnaire from a sample of 390 interviewees. The findings showed that only 9 (2.3%) which is a small percentage had adequate awareness of the types of interventions that were available for GBV while 112 (28.7%) were not aware of any GBV interventions. The age, education level, occupation, affordability, accessibility, cultural factors, and acceptability of the services were the factors associated with the awareness of available GBV interventions. The study recommended the training of the public and private sectors on the importance of the GBV interventions so as to ensure that the survivors are attended to early enough to curb long- term consequences and that the perpetrators are punished for the vice and there is also a need to raise the women of Kibera slums from low socio-economic status which make them susceptible to and victims of GBV
A Case Study of Hospital Contraceptive Waste Management Practices in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State
(IJCMPH, 2024-01) Tyotswam, Yanmeer S.; Iseme, Rosebella A.; Makunyi, Eliphas G.
Background: Effective management of hospital waste is a critical component of a hospital’s infection control program and is central to occupational safety for healthcare workers. Thus, this study focused on the assessment of hospital contraceptive waste management practices at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka, Anambra state, Nigeria. Methods: A cross sectional analytical study was carried out among healthcare workers selected using multistage sampling technique in 6 categories of healthcare workers in COOUTH. Data was collected using a pre-tested semistructured interviewer-administered questionnaire and a World Health Organization (WHO) checklist and analyzed using statistical package for the social sciences (SPSS) version 22. Associations and correlations between variables were tested at the bivariate level using Chi-square and t-test. Results: A total of 86 healthcare workers were surveyed. The majority of the respondents were females, nurses with RN qualification. The mean knowledge score of the respondents was 94.8%. The attitude of healthcare workers towards segregation of hospital contraceptive waste at source point was 71% while the usage of gloves in handling hospital waste was 95.3%. The major factor affecting contraceptive waste management practices in the facility was the respondent’s cultural beliefs. The lack of funds to finance standard waste disposal methods was noted to be a significant barrier to optimum waste management practices. Conclusions: This study showed that despite the high level of knowledge of healthcare workers on hospital contraceptive waste management practice in COOUTH, the hospital contraceptive waste management practice is not functioning optimally in Anambra state. Hence, the need to reform the hospital waste management practice to achieve functional results.
Cervical Cancer Knowledge, Awareness and Related Health Behaviours amongst Women of Reproductive Age in Kiambu County, Kenya: A Cross-Sectional Study
(2022-10) Gitonga, Eliphas; Iseme, Rosebella; Mutisya, Redempta; Kodhiambo, Maurice
Background: Data on cervical cancer knowledge, perceptions, screening practices and other relevant health behaviours among women in rural Kenya is limited. Yet understanding this information is a key ﬁrst step in developing evidence-based interventions aimed at addressing the low uptake of screening services and heavy cervical cancer disease burden within Kenya. Consequently, our study sought to assess cervical cancer knowledge, attitude, and practice amongst women of reproductive age within Kiambu County, known for a high cervical cancer disease burden. Methods: This was an analytical cross-sectional study undertaken in April 2022. Data was collected using interviewer-administered questionnaires from 472 females randomly selected from within the community. Data analysis included descriptive statistics (mean values, standard deviations, and frequencies) and logistic regression, using STATA version 13. Results: More than 80% of respondents were aware of cervical cancer though only 54% answered at least half of the knowledge questions correctly. Knowledge of HPV was particularly low, likely because 55% of the study sample stated they had never heard of HPV. Though 89% of study participants deemed cervical cancer preventable, more than 60% had an unfavourable attitude towards cervical cancer screening, deeming the process expensive, painful, and embarrassing. In line with the latter observation, only 20% of our sample had ever been screened for cervical cancer and less than half of this group had undergone regular screening. Notably, knowing a place where cervical cancer screening services are provided had the largest increase in odds of being screened (3.94; 95% CI: 1.08–14.37). Fear of tests and outcomes was also noted to be a prime concern amongst our study participants. Conclusion: A clear message from this study is the need to ensure community members are aware of where to access screening
A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease
(Hindawi, 2018) Iseme, Rosebella A; Mcevoy, Mark; Kelly, Brian; Agnew, Linda; Walker, Frederick R; Boyle, Michael; Attia, John
Bone loss is characteristic of the ageing process and a common complication of many autoimmune diseases. Research has highlighted a potential role of autoantibodies in pathologic bone loss. The confounding effects of immunomodulatory drugs make it difficult to establish the contribution of autoantibodies amongst autoimmune disease sufferers. We attempted to examine the relationship between autoantibodies and bone mass in a population of 2812 elderly participants without clinical autoimmune disease. Serum samples were assayed for a panel of autoantibodies (anti-nuclear, extractable nuclear antigen, antineutrophil cytoplasmic, thyroid peroxidase, tissue transglutaminase, anti-cardiolipin, rheumatoid factor, and cyclic citrullinated peptide). Bone mass was measured using quantitative ultrasound (QUS) of the calcaneus. The relationship between each autoantibody and bone mass was determined using linear regression models. Anti-nuclear autoantibodies were the most prevalent, positive in approximately 11%, and borderline in roughly 23% of our sample. They were also the only autoantibody observed to be significantly associated with QUS index in the univariate analysis (n = 1628; r = −0 20; 95% CI: −0.40–0.00; p = 0 046). However, statistical significance was lost after adjustment for various other potential confounders. None of the other autoantibodies was associated with QUS index in either univariate or multivariate analysis. We are limited by the cross-sectional nature of the study and the low prevalence of autoantibodies in our nonclinical sample.
Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya
(eajhs.eanso.org, 2022) Ngige, Lucy W.; Ndayala, Phoebe D.
ABSTRACTThe purpose of the study was to determine whether socio-demographic characteristics of People Living with HIV and AIDS (PLWHA) predicted self-disclosure of HIV seropositivity status in Kenya. A survey was conducted among a random sample of 232 respondents in Nairobi County. Data was gathered through interviews and focus group discussions. The findings indicated that 28.0% of the respondents were male and 72.0% were female. The respondents were aware of their HIV seropositive status for at least one year prior to the study. About half of the respondents (50.9%) had disclosed their HIV seropositive status, while 49.1% had not disclosed. The binary logistic regression established that the socio-demographic predictors of HIV seropositive status disclosure were educational attainment (AOR =1.266; p = 0.001), regular employment status (AOR = 1.691; p = 0.001) perceptions of financial security (AOR = 2.440; p = 0.020) and knowledge of management of HIV (AOR = 3.505; p = 0.001). However, respondents’ sex (p = 0.162), age (p = 0.921) and marital status p = 0.621) were not statistically significant predictors of HIV seropositivity disclosure to sexual partners. This implies that public health programmes should focus on educational interventions, financial security, and training on the management protocols for People Living with HIV and AIDS in order to promote HIV seropositivity status disclosure to sexual partners.APACITATIONNgige, L. W.& Ndayala,P. D. (2022). Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya. East African Journal of Health and Science, 5(1), 73-83. https://doi.org/10.37284/eajhs.5.1.608.CHICAGOCITATIONNgige, Lucy W. & Phoebe D. Ndayala. 2022. “Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya.”. East African Journal of Health and Science5(1), 73-83. https://doi.org/10.37284/eajhs.5.1.608.
Does Institutional Maternity Services Contribute to the Fear of Childbirth? A Focus Group Interview Study
(Elsevier B.V, 2021) Onchonga, David; Keraka, Margaret; MoghaddamHosseini, Vahideh; ´ Varnagy ´, Akos
Background: The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. Objectives: The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). Methods: This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks’ gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. Results: It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. Conclusion: The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.
Effect of post-discharge postnatal educational intervention on postnatal practices among lowincome primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment
(Medical Journal, 2024-05) Kamau, Immaculate Wambui; Keraka, Margaret Nyanchoka; Gitonga, Eliphas
Introduction: informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among lowincome primiparas. Methods: quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An intervieweradministered exit questionnaire applied after 6 weeks. Focus group discussions conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. Results: the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks newborn contact and six weeks contact for the dyad. Multi-pronged approaches appreciated. Conclusion: follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
Effect of post-discharge postnatal educational intervention on postnatal practices among lowincome primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment
(PAMJ, 2024-05) Kamau, Immaculate Wambui; Keraka, Margaret Nyanchoka; Gitonga, Eliphas
Introduction: informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among lowincome primiparas. Methods: quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An intervieweradministered exit questionnaire applied after 6 weeks. Focus group discussions conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. Results: the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks newborn contact and six weeks contact for the dyad. Multi-pronged approaches appreciated. Conclusion: follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
Enhancing Household Livelihood Outcomes through Resilient Agri-Food Systems among Small-Scale Farmers in Kitui County, Kenya
(East African Nature and Science Organization, 2022) Rufo, Boniface Munene; Njuguna, Christine W; Muiruri, Samuel Muigai
The practice of resilient agri-food systems, especially in arid and semi-arid areas, is considered key to attaining sustainable livelihoods. Changes in climatic conditions have forced small-scale farmers to develop adaptive capacities related to food security. This study was done in Nguni ward Kitui County involving 246 small-scale farmers, two focus groups discussion, and four key informants. The sampled participants had practiced resilient agri-food systems for the last five years from the time of data collection. A gender dynamic was established after 71.5% of the respondents were found to be female and 28.5% male. More females practiced resilient agri-food systems but did not own productive assets like land. A statistically significant relationship between resilient agri-food systems and household livelihood outcomes was determined where the probability value was less at a 95% confidence level (0.01<0.05). Further analysis showed a positive association between household income and sex χ2=9.551 where p (0.008) was less than 0.05. In conclusion, resilient agri-food systems practices such as conservation agriculture positively influence the household livelihood outcomes like diversification of livelihoods, reduced prevalence of human, crop, and livestock diseases, and improved ability to cope with shocks and trends. The study recommends the provision of incentives, insurance, and social safety nets to encourage small-scale farmers to practice resilient agri-food systems.
Factors Associated With Cohabitation among University Students in Nairobi, Kenya
(Universidad Nacional Aut{\'o}noma de M{\'e}xico, Instituto de Investigaciones Sociales, 2011) Muriithi, Joan Kabaria; Ngige, Lucy W; Mugenda, Olive M
Cohabitation is emerging as an important factor in mate-selection in many societies in Kenya. This study focused on cohabitation among university students in Nairobi. The objectives included: determining the prevalence of cohabitation and establishing the relationship between students’ attributes, family background and social factors and cohabitation. Methodology was guided by Brofenbrenner’s ecological model of human development. A survey of 176 students from one public university in Kenya was conducted. Results showed that the prevalence of cohabitation was 27.4%. The significant factors that influenced cohabitation included fathers’ occupation (p = 0.016), mothers’ occupation (p = 0.029), parents’ residence (p = 0.000), family income (p = 0.000) and peer influence (p = 0.000). However, the factors of students’ age and sex were not significantly related to cohabitation. Implications for family life education, reproductive health and strengthening of students’ guidance and counseling services were included.
Factors Associated with Malaria, Intestinal Helminths, and Their Coinfection among Pregnant Women Attending ANC in Kanduyi Sub-County, Kenya
(IJIRAS, 2021) Omanyo, Peter Wanyama; Keraka, Margaret; Wanyoike, Peter Kamau; Kikuvi, Charlotte; Kebira, Anthony
Malaria and intestinal helminths are the most prevalent parasite diseases among children under five and pregnant women in impoverished countries, especially in Sub-Saharan Africa (SSA). They can induce anemia in pregnant women, and this can have significant repercussions for the kid as well. When malaria and intestinal helminth infections coexist, the symptoms and pathology might be more severe. The study adopted mixed methods for data collection and 423 pregnant women were interviewed and data analyzed using SPSS version 26. Bivariate analysis was conducted to examine possible associations between predictor variables and independent variables. This was done using Pearson’s Chi Square. Association was considered significant when p-value is less than 0.05. Results indicated that Age (p=0.012), marital status (p=0.014), use of insect treated mosquito nets or repellents (p=0.033) and malaria chemoprophylaxis (p=0.0001) were significantly associated with malaria infection. Hand washing before meals (p=0.041) was significantly associated with intestinal helminths infection. Age (p=0.019), education level (p=0.017), hand washing before meals (p=0.031) and malaria chemoprophylaxis (p=0.0001) were significantly associated with coinfection. Malaria infection (p=0.015), intestinal helminths (p=0.039), and their coinfections (p=0.022) were significantly associated with anemia severity. In conclusion, the prevalence of anemia was high among pregnant women. The prevalence of malaria, intestinal helminths infection, and their coinfections was low. Malaria chemoprophylaxis, use of insect treated mosquito nets, and hand washing before meals was associated with malaria, intestinal helminth, and their coinfection.
Functionality of Elderly Persons: A Comparison Between Institutionalized and Non – Institutionalized Elderly Persons in Nairobi City County, in Kenya
(Science Publishing Group, 2018) Mugo, Judy Wairimu; Onywera, Vincent; Waudo, Judith; Otieno, Ochieng George
This study compared the Functionality of Institutionalized elderly persons and that of the elderly persons living with their family and or community members using the Modified Barthel Index. Two hundred and seventy elderly men and women who met the inclusion criteria were sampled, 135 from 4 Institutions namely Mji wa Huruma, Nyumba ya Wazee Ruaraka, Kariobangi Cheshire home and Mother Teresa in Huruma and 135 from Gumba, Kariobangi, Huruma and Kawangware divisions. Data were coded and entered using EPI Info version 9 and were analyzed using SPSS version 17. There were more totally dependent elderly at Institutions (13.6%), compared to 3% who were Non-institutionalized. The majority of those who were able to independently go in and out of their house and in and out of bed or wheel chair were living in the Institutions of the elderly. There were no gender differences in performing ADLs. More men than women were found to have pressure sores and bed sores. The study will reference for similar studies in Kenya and other parts of the world and prompt tertiary institutions of learning to design new training programs and review existing programs to address the Functionality needs of the growing population of Elderly persons.
Gender, Underweight and Dietary Practices among Male and Female Adolescents in Pastoral Community, Kenya
(Research Square, 2021) Munga, Judith; Kiige, Laura; Maina-Gathigi, Lucy; L'Parnoi, Peter; Lengewa, Catherine Mesianto; Kiplamai, Festus; Kariuki, Esther
Background: Many boys and girls in developing countries transition to adolescence undernourished, making them more vulnerable to disease and mortality. Growth during adolescence is faster than any other period of life leading to increased requirements for both macro- and micronutrient. High vulnerability to undernutrition has been expressed more on adolescent girls despite similar stage of growth for both males and females. This necessitates more information on gender influence on undernutrition and dietary practices especially in resource poor environments with rich cultural practices such as pastoral Samburu community in Kenya.
Getting Ready for Community Practice: An EvidenceBased Preparation Course for Kenyan Practicum Students
(American Association of Family and Consumer Sciences, 2018-03) VanLeeuwen, Charlene A.; Kathuri-Ogola, Lucy; Weeks, Lori E.; Muriithi, Joan Kabaria
Practicums provide opportunities for students to connect theory with practice through experiential learning and hands-on work experience. While recommended for students in Kenya, there is little research on the practicum experience. This article describes evidence used to prepare students for practicum experiences. Interviews and focus groups (FGs) were conducted with three stakeholder groups in two phases. Findings informed the development of a practicum preparation course that covers topics including (i) becoming a reflective professional and/or practitioner; (ii) articulating practicum learning goals; (iii) mental preparation for demanding field-based situations; and (iv) developing confidence in interpersonal communication. Phase two evaluated the initial impact of the course through FGs and follow-up interviews
Health Facility Factors Influencing the Implementation of PTBI during the Provision of Intrapartum and Perinatal Care in Embu County
(Edith Cowan Peer Reviewed Journals and Book Publishers, 2023) Ndwiga, Edith Wamuyu; Keraka, Margaret; Kodhiambo, Maurice
Purpose: The objective of the study was to establish the health facility factors (HFF) influencing the implementation of PTBI during the provision of intrapartum and perinatal care in Embu County Methodology: The study used a cross-sectional design. Random sampling technique was used to determine the sample size of 94 HCP, while the Purposive sampling technique was used to sample 24 client files (a quarter of the sample size) and 5 Key informants. The study was conducted in three hospitals in Embu County, Kenya. Questionnaires and document review guides were used to collect quantitative data and Key informant interview (KII) guides were used to collect qualitative data. Data analysis was done using SPSS version 21, descriptive statistics; Chi squires, Fisher’s test, and binary logistic model. Qualitative data were categorized into themes. Data findings were presented using tables and charts. Results: The findings in this study revealed that the majority of HCP in the maternity unit who agreed with the statement that adequacy of HFF influences implementation of PTBI were associated with the low implementation of PTBI as compared to those who disagreed. On the other hand, those HCP who agreed that there was adequate HFF were also associated with the low implementation of PTBI as compared to those HCP who disagreed. The findings further revealed there were inadequate staff, transport, and finances while drugs and equipment were adequate. The former three are important aspects in the implementation of PTBI and their inadequacy may lead to the low implementation of PTBI. In addition, this study also revealed that the highest number of respondents reported HFF affects the implementation of PTBI to a large extent as compared to those who reported moderately and low extent respectively. Respondents’ responses were echoed by the 5 KIIs of whom, four reported that the level of implementation is affected by HFF to a moderate and large extent respectively. Unique contribution to theory, policy and practice: In addition, the study recommends the county government consider improving HFF by; providing facilities for KMC, improving transport facilities, recruiting more skilled staff, and increasing funding in the field of midwifery/reproductive health to enhance the implementation of PTBI. Adequate funding will enhance staff recruitment, maintenance of transport, and timely procurement of drugs and equipment. Consequently, promoting the implementation of PTBI. Keywords: Health Facility Factors influencing implementation of PTBI during provision of intrapartum and perinatal care in Embu County
Health System-Related Factors that Influence Retention in Care among HIV Infected Pregnant Women in Narok County, Kenya
(IPRJB, 2024-04) Gakii, Jackline; Menza, Nelson; Maoga, Winfreda Nyamota
Purpose: The aim of the study was to establish the health system-related factors that influence retention in care among HIV infected pregnant women in Narok County, Kenya. Methodology: The study adopted a cross-sectional mixed method design. Purposive sampling method was used to sample the required sample size of 117 HIV infected pregnant women, the participants of the Focus Group Discussions (FGD) and Key Informant Interviews (KII). The study was carried out at Narok County Referral and all the sub-county hospitals in Narok County. A structured questionnaire was used to collect quantitative data. Focus group discussion and KII guides were used to collect qualitative data. Quantitative and qualitative data was analyzed using SPSS version 21 and Nvivo version 14 respectively. Chi square test and logistic regression analysis were used to determine the health system-related factors that influence retention in HIV care. Thematic content analysis was done for qualitative data. The mean age of participants was 30 years (SD=6.48). The study results generated were presented in bar graphs and tables for quantitative data. Results were presented as narrations and triangulated with qualitative data. Findings: This study established that health systemrelated factors (waiting time, health care workers services and ARV availability) influenced retention in care among HIV infected pregnant women. However, only ARV availability had a significant association with retention in care (P<0.001, OR=0.19). The multiple logistic regression was used to predict the influence of grouped variables. Overall, the model was a significant predictor of retention in care. Health system related factors was found to increase the likelihood of being retained in care (OR=5.14), though not significant predictors of retention in care (P<0.34). Unique Contribution to Theory, Practice and Policy: Health system-related factors particularly ARV drug stocks, healthcare workers staffing and timely access of services should be strengthened in order to avert stock outs, minimize waiting time and follow up patients who miss clinic appointments to increase retention among pregnant women in HIV care. Advocate for policy reforms aimed at addressing structural barriers to retention in care, including increased investment in healthcare infrastructure, workforce capacity building, and integration of HIV services within maternal and child health programs. By aligning policy initiatives with the unique needs of HIV-infected pregnant women, policymakers can foster an enabling environment for retention in care, ultimately contributing to the achievement of national and global HIV/AIDS targets.
The Impact of Experiential Learning Overseas on Kenyan Women Farmers
(University of Georgia, 2023) Shileche, Anne; VanLeeuwen, Charlene; VanLeeuwen, John; Walton, Colleen; Kathuri-Ogola, Lucy
Abstract A multipartner agricultural and nutrition project was implemented in Kenya between 2015 and 2018. This study examined the impact of the international learning and research project on the emotional and civic engagement status of 43 Kenyan women farmers receiving agricultural and nutrition interventions, comparing this group to a control group. Some project women experienced higher emotional worthlessness in the short term but less worry in the long term in comparison to the control group women. Project women also had higher overall civic engagement levels after the 3-year project compared to the control group women. Our results demonstrate that experiential learning has advantages and disadvantages for overseas communities. For community benefits, research and learning projects should be a partnership with community members.
Individual Attributes Influencing Cervical Cancer Screening Services in Selected Health Facilities in Machakos County
(science publishing group, 2018) Nzioka, Agnes Wavinya; Akunga, Daniel Nyagetiria; Wanyoro, Anthony Karanja
In Kenya, 51.2% of estimated women population of 11 million aged 15 years and older are at risk of developing cervical cancer. Research shows that screening a woman even once between the ages of 35 and 40 years reduces her lifetime risk of cervical cancer by 25–36%. However, the effective cervical cancer screening in developing countries is as low as 18.5%. Low levels of utilization of Cervical Cancer Screening Services (CCSS) among health care workers have been documented. This study sought to determine the utilization of cervical cancer screening services by healthcare workers (HCWs) in selected health facilities in Machakos County. It was also thought imperative to determine individual HCW attributes influencing utilization of cervical cancer screening services in selected health care facilities in the county. The study adopted a descriptive cross-sectional study design involving 271 female health workers drawn from all the level 4 and level 5 facilities within the county. Respondents were stratified according to level of facility and according to their cadres. Data was collected via self-administered questionnaires and a facility assessment tool. Data analysis used SPSS version 21. Association was subjected to binary logistic regression. Only 25% of HCWs had utilized cervical cancer screening services. HCWs who had certificate (OR = 0.05, p-value < 0.01), diploma (OR = 0.04, p-value < 0.01) and degrees (OR = 0.09, p-value = 0.01) were less likely to utilize CCSS as compared to HWCs who had attained graduate studies or higher. Also health workers aged 30 years and below (OR = 0.12, p-value = 0.01) and those aged between 31 and 40 years (OR = 0.30, p-value = 0.05) were less likely to utilize CCSS as compared to healthcare workers who were aged more than 50 years. The study recommends establishment of tailor-made sensitization programs on young female health care worker aimed at increasing their uptake of CCSS services among these group.

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