MST-Department of Population and Reproductive Health

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Adolescent Friendly Health Services in Level Two Facilities among Public Secondary School Students in Mombasa County, Kenya
(Kenyatta University, 2020) Amuko, Selpha Ongaya
Adolescents’ health is a great determinant of a country’s development since adolescents contribute a large proportion of the population. Sexual and reproductive health problems have been identified in several studies to be a major cause of ill health and even death among young people. These problems demand specialized attention which can be achieved through unlocking access to sexual and reproductive health services to young people through adolescent friendly health services. Despite the adoption of the adolescent friendly health services in all government health facilities, there is still high incidences of teenage pregnancies and HIV infections among young persons aged 15-19 years. The main objective of this study was to assess the adolescent friendly health services in public primary care facilities to adolescents aged 13-17 years attending secondary schools in Kisauni Sub-County, Mombasa, Kenya. The study was conducted to assess the views of secondary school students on adolescent friendly health services in level 2 facilities in Kisauni SubCounty, Mombasa County, Kenya. The study looked at staff characteristics, facility characteristics, interpersonal relationships and their association with students’ perceptions on friendliness of services. A survey was conducted with 313 secondary school going students from two public schools in Kisauni Sub-County, Mombasa County Kenya. Students were selected using a simple random selection process and structured questionnaires used to collect data. Additionally, researchers assessed four public primary care facilities using an observational checklist and Key informant interviews conducted on facility in charges. Relationships between variables were assessed using Chi-Square at 95% confidence interval. Finite correction formula was used to determine the sample size for the study. Kisauni Sub-County was selected purposively. Four public primary health care facilities in the Sub-County were included. Stratified random sampling and simple random sampling methods was used to select participants. Statistical package for social sciences (SPSS) version 23 was used for the analysis of quantitative data. For qualitative data, content analysis was done for open- ended questions responses. Chi-square was used to test the association between the independent and dependent variables of the study. Bar graphs and pie charts were used to present information obtained. The association was deemed statistically significant when the p-value was less than 0.05 at 95% level of confidence. Of all the respondents (n=313), 42% reported the services to be friendly. More than half 65.5% (n 205) of all the respondents thought facilities had appropriate staff to provide adolescent and friendly health services (AFHS) whereas majority 98% of all the respondents reported to prefer staff of same sex and age to offer services to them since they could understand them easily. Media (radio, newspapers) and static advertisements significantly influenced AFHS p - values 0.017 and 0.004 respectively. Less than a half of those who reported friendly services mentioned being aware of services offered in other settings (43.2%(n=32) drop-in centers, 43.7%(n=44) community outreach and 39.2% (n=65) school health programs. Accessing facility by use of vehicle and walking on foot had significant influence on AFHS, p- values of 0.001 and 0.003 respectively. Involvement of other agencies in service review had a significant influence on the friendliness of services, p- value 0.003. The adolescent health services in Mombasa were concluded not friendly. More studies to be carried out on barriers to access. Policy makers and implementers in the health sector found these study findings useful in quality improvement of adolescent friendly health services.
Adoption of Community Hygiene Strategies for Safe Water and Sanitation among Mothers of Underfives in Kitui County, Kenya
(Kenyatta University, 2019-04) Mutie, Lydia Mbeti
Inadequate access to safe drinking water, sanitation and hygiene constitutes a serious global threat to health accounting for approximately 4 billion cases of illness annually. Children under five years in the developing world are most affected, where nearly 1.6 million deaths are recorded annually due to diarrhea alone. This accounts for 15% of all deaths among under fives. Poor sanitation and hygiene practices are among the main factors associated with sanitary diseases. The purpose of this study was to analyze the adoption of community hygiene strategies to safe water and sanitation among mothers of under five year olds in Migwani Division, Kitui County, Kenya. Objectives guiding the study were: to determine adoption of community hygiene facilities for safe water and sanitation among mothers of under five year olds, to examine the prevalence of common sanitary diseases among children under five years old and to assess the influence of community hygiene practices on safe water and sanitation among mothers of under five year olds within Migwani Division, Kitui County. The study adopted a descriptive survey research design. A sample of 94 mothers of children under 5years old, 3 public health officers and 57 community health workers was used for the study. The total number of respondents was 154 and the response rate obtained was 89%. Data was collected using interview schedules, questionnaires and observation checklists. Quantitative data was coded to develop code sheet quantitative data. Qualitative data was thematically categorized and analyzed using Statistical Package for Social Science Version 20. Statistical analysis involved determination of percentages, means, standard deviation and logistic regression. The results of the study show that only 50.6% of the mothers had access to treated piped water with the rest using pond water, stream water or harvested rain water. More than 40% of the mothers used untreated water sourced from open wells, which increased water borne diseases among children. Toilets were observed in 89.9% of the homesteads with 10.1% practicing open defecation. Common sanitation and water borne diseases reported were worms, amoeba, diarrhea, and dysentery. Mothers who used both open well water and stream water were more likely to have children suffer from diarrhea compared to those who used piped water (9. 37 for stream water, 9.42 open wells and 5.42 for piped water-p<0.05). Amoeba prevalence was 82.6% among children whose mothers were using untreated water. Majority of mothers (76.4%) lived more than 10km from water sources therefore forced to use unsafe water. Hand washing at critical times was at 94.4% meaning hygiene awareness was high, evidenced by 61.8% of homesteads with hand washing facilities outside toilets. High level of adoption of safe water and sanitation practices were: Availability and use of toilets, hand washing facilities, hand washing and treating drinking water. Medium level was access to safe water and participation in health programmes. Low adoption was evidenced by prevalence of sanitary diseases and long distances to water sources. Therefore, Community hygiene strategies and practices have great influence on levels of adoption of safe water and sanitation practices among mothers of children under five years old. Recommendations of the study are: community involvement in assessing their health, training of community health workers on concepts of health care and development, change in human behavior in community response towards disease outbreaks and emergencies and poverty alleviation in order to improve adoption of community hygiene strategies for safe water and sanitation.
Assessment of Adherence to Antiretroviral Therapy among Children below 5 Years of Age in North Kinangop Sub-County, Nyandarua County, Kenya
(Kenyatta University, 2020-01) Musovya, James
Despite the concerted efforts at achieving a 50% reduction in deaths resulting from HIV, a high number of children below the age of 5 years continue to get resistance to first line ART medicines and are second line ARV medication. Efforts to deal with this issue seems not to have taken root in many developing countries, including Kenya. HIV suppression still remains a big challenge in this age bracket with at least one in every six patients failing to achieve the required adherence levels of more than 95% for successful HIV treatment. The net effect is the increase in the AIDS related deaths among the under 5s preventing the country from attaining its SDGs commitment of lowering these deaths by 50% by 2015.The main objective of this study was to assess the adherence to ART among the under 5s in Kinangop Sub-county, Nyandarua County, Kenya. Community based cross sectional study design was used in this study. The study utilized purposive sampling in selecting the hospitals to develop sample frames and Simple random sampling technique to get a sample size of 195 subjects. Researcher-administered questionnaires with open and closed ended questions and Focused Group Discussions (FGDs) were used as the main data collection methods. Collected Qualitative data from FGD interview was translated into a common language and was thereafter typed into MS Word. It was then analyzed manually to fit into the study themes. On the other side, collected Quantitative data gotten from questionnaires used to be checked daily for completeness and was then coded for before it was entered into computer. Similar responses were collected together to form different categories before entering them into computer programme Epi- info version 6 and was then analyzed by version 20 SPSS. This research used univariate, bivariate and multivariate analysis. As for univariate analysis, population distribution by background characteristics was shown. While in bivariate analysis, the association between the dependent and independent variables was showed by cross tabulations then t-test values tested whether or not, the dependent and independent variables association was significant. For multivariate analysis, the study used logistic regression to analyze and determine the effect of explanatory variables has on the dependent variables. ART regimen characteristics had significant association with adherence in this study (t-test=8.7:1df: p=0.000) and were similar to findings by Van Dyke RB, et al., 2009.Duration of medication” and “whether the child was on other medication” were significance as far as adherence is concerned in this study (t-test=4.411:1df: p<0.005) .The higher the level of education, the better the adherence (t-test=7.935:1df: p<.005), however there was no significance in the association between the caregivers’ ability to explain the medication regimen by the names of the drugs it contains and adherence. The study also found that Children who knew why they take ARVS drug had better adherence as opposed to those who did not know disclosure had significant association with adherence/non-adherence outcomes (t-test=10.757:1df: p=0.005). The findings of this study have being shared with the health care facilities involved and a manuscript submitted for publication to a pediatric ART adherence counseling journal for use in hospital and community settings.
Assessment of Awareness of Available Gender Based Violence Interventions among Women of Reproductive Age in Kibera Slums Nairobi
(Kenyatta University, 2021) Wairimu, Wanjohi Bancy; Margaret Keraka; Michel Mutabazi
Dealing with violence against women is key for achieving sustainable development goals (SDG) for equality of gender and empowering women and SDGs 3, 4 and 5. Globally, GBV prevalence accounts for 10-35%. In the year 2014, 45% of Kenyan women aged 14-49 years have reported some form of gender-based violence in their lifetime. About 29% of the women reported to have had experienced it in the previous year. About 16% of these women, reported sexual abuse and 13%, of them had it happen in the previous year. The study assessed awareness on available GBV interventions to women of reproductive age in Kibera. It also identified the types of interventions which were offered to survivors. Descriptive cross sectional study was used (which involved collecting and analyzing both qualitative and quantitative data) and this was conducted in Kibera slums. A sample size of 390 women of the reproductive age was conveniently selected from Kibera which has 13 villages hence 30 women from each village. The respondents were interviewed to obtain the required information using structured questionnaires which had both closed and open ended questions. SPSS version 20 was used for statistical analysis. Chi square tests was carried out to assess awareness of availabile GBV interventions. Descriptive analysis was used. This study confirms that there is a gap between the variable age where the p value is 0.001 which is less than the level of significance of 0.05 where the younger an individual is, the lower the level of awareness on available GBV interventions. The higher the education level, the lower the level of GBV as per the findings where the variable education had a p value of 0.001. The study found challenges in accessing health care for victims of GBV where survivors felt they could not report the perpetrators most of who were the breadwinners hence legal measures was the least taken form of intervention accounting for only 4.3% of the study participants had sought legal redress.Verbal abuse was the most rampant form of abuse accounting for 24.4%. A 49.1% of the interviewees did not seek any help for the abuse faced. About 10% of the interviewees had faced more than two forms of abuse. Sexual abuse accounted for 18.7% which is higher than what had been reported by KDHS in Kenya in the year 2014 which was at 16%. The rape cases were at 3.3% which is a higher number considering this was just done in one slum area in Kenya which when compared to South Africa that reported a prevalence of 11% of rape cases. Affordability of interventions, accessibility, acceptability of legal measures and cultural factors all have a p value of less than 0.05 meaning that these factors affect awareness of the available GBV interventions. Out of the clients interviewed, 28.7% were not aware about any type of interventions offered. The study also found that majority of the cases occurred from their partners or people within the household. Sexual harassment rate was high as well as verbal abuse accounting for 15.4% and 24.4% respectively. The findings of this study if applied will assist in raising awareness on the available GBV interventions in Kibera Slums.
Assessment of Awareness on Vesico-Vaginal Fistula among Women of Reproductive Age in Kawangware Slums, Nairobi City County, Kenya
(Kenyatta University, 2019) Maeri, Jacquelyne Aluoch
Obstetric Vesico-Vaginal Fistula is a reproductive health problem mainly caused by prolonged obstructed labour and delay in seeking emergency obstetric care after delivery. In developing countries such as those in sub-Saharan Africa, obstetric Vesico-Vaginal Fistula continues to cause suffering to a number of women and their families. Women with obstetric fistula not only have to endure the negative physical and emotional impacts of the disease but also social and economic impacts which are also negative. Considering the suffering of families associated with this disease, we set out to investigate community awareness of obstetric fistula especially in areas with poor access to social amenities such as informal settlements. The main aim of this study was to assess the level of community awareness among women of reproductive age in Kawangware Slums of Nairobi City County, Kenya. The study mainly focused on community awareness, knowledge levels, risk factors and attitudes towards Vesico-Vaginal Fistula. The study used descriptive cross-sectional study design. Both quantitative and qualitative data were collected. Quantitative data was collected using questionnaires administered to women of reproductive age while qualitative data was collected using focused group discussion guides. The study targeted 422 adult women aged 18 years and above in Kawangware slums. Systematic random sampling was used to select respondents using a predetermined interval. Every fifth woman who met the inclusion criteria was included in the study. The researcher obtained ethical clearance from the Kenyatta University Ethical Review Committee prior to data collection and a research permit from National Commission for Science, Technology and Innovation. Informed consent was also sought from study respondents. Data was then cleaned and entered into a Microsoft excel datasheet for processing. This was later exported to SPSS version 22.0 for analysis. Descriptive data were presented using frequency tables, graphs and pie-charts. Inferential statistics were done to establish the relationship between variables using Chi-square tests done at 95% confidence interval and p-values of <0.005 considered statistically significant. Qualitative data from focused grouped discussions were triangulated with quantitative data as direct quotes or narrations from respondents. The results revealed that 56% of respondents had low awareness with scores of less than 5. 57% of respondents had low knowledge on occurrence of VVF. Knowledge levels were significantly associated with community awareness (p=0.004). Majority of risk factors were significantly associated with community awareness such as early pregnancy (p=0.001), delayed access to obstetric care (p=0.006) and prolonged labour. 67% of respondents had negative attitude towards Vesico-vaginal Fistula based on Likert scale scores. There were significant statistical association between attitude and community awareness (p=0.010). The study concludes that the respondents from Kawangware had low awareness levels, low knowledge levels and negative attitude towards Vesico-Vaginal Fistula. The findings will be availed to governmental and non-governmental organizations for structuring programs and strategizing on interventions targeting creation of community awareness as well as its prevention and management. These results would also be of use to the Ministry of Health for purposes of health education, policy formulation and implementation with regards to workable short and long-term Vesico-Vaginal Fistula interventions.
Assessment of Community Based Water Supply, Consumption, Utilization and Perceived Sustainability: A Case of Rironi Self-Help Water Project, Kiambu County Kenya
(Kenyatta University, 2020) Ng’aari, Godfrey Njugi
The purpose of the study was to assess the influence of demography, water consumption level, water supply and water utilization on perception of CBWR sustainability at Rironi Self Help Water Project (SHWP) in Kiambu County, Kenya. The study objectives were: to determine the influence of demographic characteristics of project members on perception of CBWR sustainability, to establish the influence of water supply on perception of CBWR sustainability, to establish the influence of water consumption level on perception of CBWR sustainability and to assess the influence of water utilization on perception of CBWR sustainability. The study was guided by the general systems theory by Bertalanffy (1968). The study adopted a cross sectional survey research design. The research was carried out at Rironi, Limuru Central Ward in Kiambu County. Stratified random sampling was used to select nine geographical zones covered by the community based water project. From each zone, random sampling was used to select 297 respondents who participated in the study. The data was analyzed using the Statistical Package for the Social Sciences (SPSS) Version 24. Inferential statistics including Chi-Squares and Spearman Correlations were used to test relationships between variables. The findings revealed that the overall perception of CBWR sustainability was rated as moderate by 11%, high by 54%, and very high by 35% of the respondents. The results of the hypotheses tests showed that demographic characteristics had significant influence on the perception of CBWR sustainability as follows: gender (χ2= =27.117, d.f= 2; p = 0.001), age, (χ2 =31.532, d.f=8; p = 0.001), education, (χ2 =12.135, d.f=4; p = 0.016), occupation (χ2 =23.010, d.f=8; p = 0.003), household size (P=0.001, rs =0.240), duration of residence (χ2 =22.256, d.f=6; p=0.001) and geographical zone (χ2 =113.862, d.f=16; p = 0.001). The water supply and consumption variables that had a statistically significant influence on CBWR sustainability were: availability of secondary sources of water (χ2 =27.428, d.f=4; p=0.001), water disruption in the dry months (χ2 =30.705, d.f=8; p = 0.001), number days water was supplied (P=0.001, rs =0.250) and the volume of water consumed (χ2 =10.919, d.f=4 p = 0.027). However, the mode of water utilization had no significant influence on perception of CBWR sustainability. It was concluded that respondents’ demographic characteristics, amount of water supplied and amount of water consumed had statistically significant influence of the perception of CBWR sustainability. The study recommends the need to consider investment of water infrastructure in the SHWP, implement control measures to ensure that water supply is done equitably in the different geographical zones and reduce the variations in the number of days that water is supplied to members during the dry months. The SHWP should limit the expansion of the water supply coverage to a smaller geographical area. The SHWP members should adopt water conservation measures in order to ensure long term sustainability of community based water resources in the densely populated study region.
Assessment of Newborn Resuscitation Practice by Nurses in Machakos Level 5 Hospital, Machakos County, Kenya
(Kenyatta University, 2020-09) Muli, Musyoki Daniel
The first minute after birth is usually referred to as the golden minute, and the baby should be able to initiate spontaneous breathing, failure to which birth asphyxia ensues. Globally, approximately 5% to 10 per cent of newborns require resuscitation. In sub-Saharan Africa where over one third of all intrapartum related neonatal deaths occur, the rates of skilled attendance at birth are very low. In Kenya neonatal mortality remains at 22/100,000 live births, majority associated with poor resuscitation. This study sought to assess neonatal resuscitation practice among nurses in Machakos Level 5 Hospital, in Machakos County, Kenya. The study aimed at identifying individual, knowledge and health system factors that influences practice of neonatal resuscitation among nurses. The study adopted a descriptive cross-sectional study design. The study population included nurses working in Machakos level 5 hospital in Machakos County. The study sampled 201 nurses involved in neonatal resuscitation who were interviewed. Quantitative data was collected using semi-structured questionnaires from selected nurses through systematic random sampling at a predetermined interval of 2. Every second respondent was selected for interview until the required sample was reached for interviewing. Qualitative data was collected using key informant interview schedules with 6 selected Key Informants. Key informants were purposively selected for inclusion in the study. The researcher sought all required approvals from relevant authorities and ensured study participants gave an informed consent prior to the conduct of the study. Descriptive statistics were calculated using Statistical Package for Social Sciences version 22 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Qualitative data was analyzed using thematic analysis and results triangulated with quantitative data as direct quotes or narrations. To test the association between study variables, Chi-Square tests done was at 95% confidence interval (p<0.05) were used. The study results revealed that 41 per cent of respondents fully practiced neonatal resuscitation. Individual factors such as age (p=0.001), years in current position (p=0.001), highest level of education (p=0.021), training on neonatal resuscitation and performance of neonatal resuscitation (0.001) were associated with practice of neonatal resuscitation. Health system factors such as availability of resuscitation equipment (p=0.001), place of keeping resuscitation equipment (p=0.021) and reference to guidelines (p=0.001) had a significant influence on neonatal resuscitation practice. The study results further revealed that 56 per cent of respondents had high knowledge on neonatal resuscitation. Knowledge level (p=0.001) significantly affected practice of neonatal resuscitation. The study conclude that a significant large number of respondents did not fully achieve neonatal resuscitation despite majority of them being knowledgeable on neonatal resuscitation. The study recommends on job training and seminars on newborn resuscitation towards improving the practice of neonatal resuscitation. The hospital administration should sponsor nurses to specialize in neonatal care and ensure that each department has a team leader to offer mentorship to others in order to reduce neonatal mortality.
Assessment of Safe Sex Practices for Hiv Prevention Among Administration Police Officers in Nairobi City County, Kenya.
(kenyatta university, 2023) Kanini, Lilian; Judy Mugo; Casper Masiga
Safe sex behaviors such as monogamous relationship, consistent and correct condom use among sexual partners are important for protection against sexually transmitted infections (STIs) including Human Immunodeficiency virus which continues to be a major global public health issue. Globally, in 2020 about 37.7million persons were HIV-positive with nearly two-thirds of them residing in Sub-Saharan Africa. In Kenya, 1.4 million people are HIV-positive with a prevalence of 4.8%. The study sought to assess safe sex practices towards HIV prevention among Administration police officers in Uhuru camp, Nairobi city County Kenya. The research utilized both quantitative and qualitative data gathering techniques and utilized a descriptive cross-sectional study design. Specifically, it focused on knowledge, attitude and health system factors associated with safe sex practice among administration police officers in Uhuru Camp, Nairobi City County, Kenya. Semi-structured questionnaires were utilized to gather quantitative data, while key informant interview schedules were utilized to gather qualitative data. Stratified and systematic random sampling were utilized to choose participants for interviews at intervals of eight until a sample size of 372 was attained. The choice of key sources was deliberate. The essential ethical and logistical clearances from the appropriate authorities were requested, and participants' informed consent was acquired. With the use of the Microsoft Excel application, quantitative data was analyzed through the Statistical Package for Social Sciences version 20.0 to produce frequency tables, pie charts and graphs. Results from qualitative data were triangulated with quantitative findings using direct quotes or narratives. To determine the relationship (p˂0.05) between variables, inferential statistics were computed using Chi-Square tests with a 95% confidence interval and a margin of error of 0.05. The outcomes were displayed in cross-tabulations. The findings established that 58.2% of Administration Police officers in Uhuru Camp, Nairobi City County did not practice safe sex. The level of knowledge on safe sex practice was at 47.8%. The nature of attitude towards safe sex practice was negative at 54.2%. The level of knowledge (AOR=6.512, 95% CI, 2.773-15.290, p=0.011), fair perceived attitude of healthcare providers (AOR=0.234, 95% CI, 0.121-0.453, p=0.001), getting information from friends (AOR=0.2650, 95% CI, 0.129-0.545, p=0.031) and failure of being treated with privacy and confidentiality deserved (AOR=0.278, 95% CI, 0.124-0.622, p=0.002) predicted safe sex practice. The study concludes that about 6 out 10 police officers in Nairobi City County did not practice safe sex. The level of knowledge was moderate with a negative attitude towards safe sex practice. The predictors of safe sex practice were; level of knowledge, fair perceived attitude of healthcare providers, getting information from friends and lack of privacy and confidentiality during treatment. These results add value to the database of knowledge and would be used as a basis for improvement of HIV prevention among Administration Police officers. The study recommends the National Police Service and Ministry of Health to organize for workshops to scale up awareness on the effects of having multiple sexual partners and encourage police officers to consistently use condoms to increase the chances of practicing safe sex towards HIV. The National Police Service through their respective medical departments to dispel myths and misconceptions through information sessions to improve attitude towards safe sex practice among the police. Further, ensure sexual and reproductive health information is shared through several media on availability of services including counselling on safe sex practice.
Assessment of utilization of postpartum care services among women in Webuye West, Bungoma County, Kenya
(2017-10) Otunga, Claire Luseno
Postpartum care is an important link in the continuum of care for maternal health. The postpartum period is critical because most maternal deaths occur during this time, yet this is the most neglected period for quality care provision. Postpartum Care (PPC) services are essential in the first six weeks extending to six months. When not offered they lead to complications, poor outcomes like morbidity and mortality. The aim of this study was to assess utilization and factors influencing utilization of PPC services among women in Webuye West, Bungoma County, Kenya. The study adopted a descriptive cross sectional design. The study population was all women of reproductive age with living children aged 6-9 months. Six Health Care Workers (HCWs) were key informants. The study composed of a sample of 384 women. The sampling techniques were purposive and simple random sampling. Data collection tools were a semi structured questionnaire, focus group discussions and interview guide. Data was analyzed using Statistical Package of Social Sciences (SPSS) version 20.Statistical analysis was done using Pearson‟s Chi-Square test.On proportion of women utilizing postpartum care services only 33.6% utilized in the required timings and the attendance of mandatory visits was less than 40% which was below the recommended. All the four PPC visits were statistically significant to utilization. On socio cultural factors majority 85.8% of the women reported staying indoors during this period. Majority 55.7% of them had cultural beliefs and practices performed, both being statistically significant to PPC utilization. Religious beliefs and practices too were dependent on use of PPC (X2 p<0.011).On knowledge factors majority 70.6% of the women first knew the services during ANC from HCWs, awareness of first and fourth visits were statistically significant to PPC service use .On health facility factors majority 74.8% of the women reported availability of the basic services and majority 75.9% of HCWs were friendly and helpful. These influenced service utilization. Majority 51.0% paid for services and waited for 31-60 minutes.HCWs availability, friendliness, waiting time and service charges were statistically significant (p < 0.005) thereby influencing PPC utilization .In conclusion the proportion of women utilizing PPC service was low. Utilization of PPC services being statistically significant and dependent on various factors including , staying indoors, religious beliefs and practices , knowledge during ANC , availability of HCW,waiting time, HCWs helpfulness and friendliness and service charge ( p < 0.005). The study therefore rejected the null hypothesis. The study recommends that there is need to increase more awareness on PPC service utilization by HCWs and community volunteers. Community involvement and collaboration of teams to mitigate socio cultural beliefs and practices. The County MOH and facility managers to implement policies on PPC and continuous capacity building that emphasize PPC service utilization and maternal, neonatal, child health (MNCH) integration
Breast Cancer Prevention and Treatment Practices Among Women of Reproductive Age in Bahi District, Tanzania
(Kenyatta University, 2019-06) Mpali, Adela Maria
This study was set to assess the breast cancer prevention and treatment practices among women of reproductive age (15-49yrs) in Bahi Division in Tanzania. It has been observed by research that lack of information of the breast cancer sickness has been a big problem in rural communities in Tanzania. This is attributed to the influence of socio-cultural factors like beliefs and practices such sickness is caused by witchcraft and evil spirits. Despite of the fact that the government of Tanzania has tried to come up with strategies to mitigate the prevalence of breast cancer among women of reproductive age more has to be done by people themselves by changing the beliefs that the disease is a curse. The study is guided by the objective to investigate breast cancer prevention and treatment practices among women of reproductive age in Bahi Division, Tanzania. The study employed cross-sectional survey design utilizing random sampling method to sample study participants. Both quantitative and qualitative approaches were considered in the study. The target population for the study was all the 9600 people which includes reproductive age (15-49) women and community health workers and community extension workers in four community units in Bahi Division. The researcher sampled 370 respondents through Fisher’s model. The data was collected by the use of administered questionnaires as the research instruments. The instrument was validated to check their consistency and reliability by consulting research experts and guidance from the supervisors. A total of 361 questionnaires met the threshold and the data obtained was analyzed using descriptive analysis and results presented in charts, tables, graphs and other relevant statistical presentations. The findings revealed that 51% of the respondents were aware of the disease and that there was a significant level of awareness about both breast cancer programs and breast examinations targeting women of reproductive ages in the area. The study also found that 49.7% of socio-cultural factors had a significant effect on the prevention and treatment of breast cancer disease in the area. The study established that 52.7% of respondents affirmed that there were considerable measures put in place to address breast cancer issues in the area.
Clinical Phenotypes Associated with Preterm Births at Jaramogi Oginga Odinga Teaching and Referral Hospital In Kisumu County, Kenya
(Kenyatta University, 2019-06) Juma, Edwin Omondi
Preterm birth is a global health problem. It is the leading cause of child and neonatal mortality globally including Kenya. Preterm birth is the birth occurring before 37 completed weeks of gestation. In Kenya, preterm birth is the leading cause of neonatal mortality as it contributes to 35% of deaths among the neonates while Kisumu County is among the county’s leading with child under-five mortality rate at 133 deaths per 1000 live births. The main objective of this study was to identify the clinical phenotypes associated with preterm birth in JOOTRH in Kisumu County. It was a cross sectional study based on women who had a preterm birth alive or stillbirth at JOORTH in Kisumu County. Purposive sampling technique was used to select 178 respondents who met the inclusion criteria. Interviewer administered questionnaire was used to collect both qualitative and quantitative data. Data was analyzed by computer software SPSS version 23; descriptive statistics was used together with inferential statistics (Chi-square and Fisher’s Exact test) to help in the identification of the statistical significance of any association between the variables. A p value of < 0.05 was used. Bivariate analysis was utilized to measure the strength of associations. Data presented by use of frequency tables and narrative description. Ethical clearance was sought from Kenyatta University Ethics and Review Committee, permit sought from NACOSTI, consent and assent from the respondents. Results showed that maternal age (p=0.011) to be statistical significant with preterm births. Clinical phenotypes based on maternal, fetal and placental conditions; preeclampsia/eclampsia (p=0.016), extrauterine infections which includes malaria, UTI and HIV (p=0.030), severe maternal conditions that includes DM, anaemia, cardiac disease, hypertension prior to pregnancy and TB (p=0.001), multiple gestations (p=0.013), fetal anomaly (0.048), IUGR (p=0.049), antepartum stillbirth (p=0.046) and APH/early bleeding that include placenta previa and placenta abruption (p=0.025) were all significantly associated with preterm births. On bivariate analysis between clinical phenotypes and preterm births, all except multiple gestation (p=0.416) and APH (p=0.660) remained statistically significant. All clinical phenotypes (maternal, fetal and placental conditions) were significantly associated with preterm births. All clinical phenotypes except multiple gestations and APH/early bleeding remained statistically significant after bivariate analysis. The study recommends the use of Barro’s classifications system of clinical phenotypes to phenotype all preterm births in JOOTRH. Early identification of maternal, fetal and placental conditions identified in this study to be associated with preterm births by adopting Barros’ phenotyping of preterm births as a strategy to help prevent the occurrence of PTBs and eventually reduce neonatal deaths and under-five mortality
Compliance to Prenatal Iron/Folic Acid Supplementation and Associated Barriers among Pregnant Women Attending Antenatal Clinic in Machakos County, Kenya
(Kenyatta University, 2021) Musyoki, Stephen Matata; Joseph Thigiti; Gilbert Munyoki
Iron nutrients plays a very critical role in body. Iron and folate nutrients are availed during expectance period so as cater for the high demand when one becomes pregnant to ensure sufficient supply of such elements to both baby and expectant mother. Therefore, the general objective of this research is to determine the barriers that controls compliance to iron/folate nutrients amidst expectant mothers in Machakos county. The specific goals were to determine maternal social demographic factors influencing adherence to IFAS supplementation, obstetric related factors and health facility related factors influencing adherence level to usage of IFAS. An illustrative sampling research design was used in three sub-county hospitals found in Machakos county to sample 200 expectant mothers whose years of age was between 18-49 years. The facilities that were used were selected randomly from seven sub-counties hospitals within Machakos County while the mothers were systematically and randomly sampled. Morisky medication compliance scale questionnaire was employed to estimate compliance of iron/folate. Data gathering was achieved by help structured questionnaire. Statistical package software (SPSS version 24) was employed to analyze the data. The kind of relationship that existed between study variables was determined by use of logistic regression. The strength of association between these variables was established using odds ratio, with 95% confidence interval. Bar charts and tables played the role of visual presentation of the data. Three focus group discussions with health unit managers and administrators were held out. The data from these discussions was sorted and themes that appeared were reported. Results: Most of the participants fall under age bracket of 21-40 years. A few respondents were above 40 years. 84 % were in marriage whereas 76 % of them had made it to secondary school. Above 50% of the sampled expectant mothers were involved in casual work while 69% received family support during expectant period. Among the socio-demographic factors of the participants, family support and level of literacy of the expectant women were significantly connected with adherence to iron and folate supplements at p value <0.05. Maternal knowledge on consequences of low haemoglobin levels, source of information about the consequences and perceived benefits of taking the supplements were significant predictors of iron and folate supplement compliance. This was improved when the supplements were given in combined form. Provision of health education in pregnancy especially counseling on nutritional value of supplementing iron stores in the body and how to manage side effects of iron and folate supplements were significantly associated with compliance to iron and folate supplements. Also, availability of the supplements during antenatal visits was associated with compliance to the supplements. Past experience of the mothers’ especially previous history of anemia, current haemoglobin level and bad obstetric history of the mother were found to increase compliance to the supplements. The time of initiating the antenatal clinics, number of antenatal clinics attended and current gestation were also found to be significant predictors of compliance to iron and folate supplements. Recommendation: The government of Kenya, through the County government of Machakos, to develop policies on procurement and distribution of combined iron and folate supplement. This will promote availability of the drugs and improve compliance to the supplements
Consumption Patterns of Tea, Iron and Ascorbate-Rich Foods and Iron Status among Women of Childbearing Age in Nandi County, Kenya
(Kenyatta University, 2021-05) Nyakundi, Patrick Nyamemba; Juliana Kiio; Ann Munyaka
Twenty-one percent of women of childbearing age (WCA) in Kenya are iron deficient. Iron deficiency poses a variety of adverse effects on cognition, quality of life, behaviour, and emotion, and productivity. Tea consumption within 1-hr before/after meals reduces iron bioavailability. Tea is a commonly consumed beverage in Kenya. Tea has been reported to be taken with meals in Nandi County. However, information on consumption patterns of tea, iron- and ascorbate-rich foods and their influence on iron status among WCA is scarce. The current study investigated consumption patterns of tea, iron- and ascorbate-rich foods on iron status among WCA in Kapsabet Ward, Kenya. The study adopted a cross-sectional analytical design. The Ward was divided into 8 villages and systematic sampling was used to sample a total of 160 respondents proportionately from villages. A researcher-administered, semi-structured-consolidated questionnaire was utilized to gather data on socio-economic and demographic characteristics and tea consumption practices of respondents. Consumption patterns of iron- and ascorbate-rich foods were assessed using a modified 7-day Food Frequency Questionnaire. Venous blood (2ml) was drawn from participants, haemoglobin levels were determined using “Mission® Plus” and serum ferritin (SF) and C-reactive proteins (CRP) analysed using “Elegance Amplified Enzyme-Linked Immunosorbent Assay”. Data were entered into SPSS and demographic and socio-economic characteristics, and consumption of tea, iron- and ascorbate-rich foods data were analysed using descriptive statistics. Logistic regression was conducted to establish the association between tea, iron- and ascorbate-rich foods consumption, socio-economic and demographic characteristics, and iron status. Confounding variables including consumption of food with high phytate levels, milk and milk products, recent major blood losses, iron bioavailability levels, and parasitic infections were controlled for during analysis. Most of the respondents were young (15-24 years) (53.8%), single women (57.5%), with a mean age of 24.7 years, and belonged in households earning < Ksh. 10,000 (38.1%) and budgeted 34.0% of their income for food. Majority of the respondents (90.6%) consumed tea/coffee and mainly (54.5%) taken 2-3 times a day at quantities of 2-4 cups (250 ml) daily (42.1%). They mainly infused tea for >5 minutes, at a moderate tea strength (64.1%), and taken within 1-hr before/after meals. Respondents infrequently consumed meat (61.3%), sardines (61.9%), oranges (54.4%), and fortified breakfast cereals (94.4%) but frequently consumed kale (76.3%) and beans (50.6%). The prevalence of anaemia (Hb <12 g/dl), iron deficiency (SF <15 μg/l or SF 15 - 30 μg/l & CRP >5mg/l) and iron-deficiency anaemia (iron deficient and anaemic) were 86.2%, 36.9% and 32.5% respectively. Two dietary patterns were derived by principal component analysis (PCA). Respondents with high consumption of PCA component_1 foods (sardines, meat, terere, mangoes, oranges, and porridge) (AOR= 4.851, p = 0.021) were 5 times more likely to have normal iron status than those with low consumption. Respondents with a high household budget for food (AOR= 1.237, p = 0.012) were 23.7% more likely to have normal serum ferritin levels than those with a low budget for food. However, respondents were 4 times more likely to be iron depleted with high overall consumption of tea (AOR= 4.065, p = 0.001). Iron status of WCA was positively predicted by high consumption of iron- and ascorbate-rich foods and a higher relative budget for food but inversely predicted by high intake of tea. WCA and other risk groups should limit their tea consumption or take tea more than 1-hr before or after meals for better outcomes in iron status.
Correlates of Pregnancy Related Complications in Mandera East, Mandera County, Kenya
(Kenyatta University, 2021) Issakow, Abdi Maalim; Margaret Keraka; Peterson Warutere
Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age worldwide. About eight hundred women die from pregnancy or childbirth-related complications around the world every day. In most low-income countries, high maternal mortality of women (462 per 100,000) of reproductive age is attributed to pregnancy-related causes. In Kenya, Mandera County contributes the highest burden of maternal mortality ratio 3795 per 100,000 live births; therefore, this study sought to determine factors influencing complications in pregnancy among women in Mandera County, Kenya. Specifically, the study examined health facility attributes, maternal characteristics, and socio-cultural drivers that reinforce complications in pregnancy. This study employed a descriptive cross-sectional study design utilizing quantitative and qualitative data collection methods among 350 respondents seeking maternal health service in health facilities in Mandera County. Stratified, simple random, and proportionate sampling techniques were used to sample health facilities and respondents. An interviewer-administered questionnaire during data collection. Quantitative data were analyzed using SPSS version 20. Frequencies and percentages were used to describe data. Chi-square and fisher‟s exact test were used to test the association between the dependent and independent variables. Data were considered significant at p<0.05. Findings illustrate that Anaemia (28%), vaginal discharge (13 %), miscarriage (9%), lower limb oedema (24%), and haemorrhage (17%) were the prevalent complications during pregnancy. Laceration (39.1%) anaemia (22.8%), and haemorrhage (19%) were the reported forms of complications during delivery. Spontaneous delivery was the preferred mode of delivery among respondents. Sepsis (56.5%), Haemorrhage (25.9%), and stillbirth (10.9%) were the prevalent complications after delivery. Data shows that the median number of Antenatal visits was three and one for a postnatal visit. Slightly more than half of the respondents (54.4%) were satisfied with staff attitude. At least 87.2% of respondents in the study had undergone female genital mutilation, and the majority of participants attested that their communities supported early child marriage. Inferential analysis shows that complications during pregnancy were associated with age (p=0.026), household income (p=0.05) time-taken to the health facility (p=0.02). Complications during delivery were associated with average waiting time (p=0.02) and perceived staff attitudes (p=0.021). Complications after delivery were associated with time taken to health facilities. In conclusion, anemia, vaginal discharge, and haemorrhage were the prevalent complication during pregnancy, delivery, and the postpartum period. Antenatal and post-natal care visits were optimally low. This study recommends concerted efforts to emphasize the need to sensitize women of reproductive age to identify common obstetric danger signs and symptoms and other stakeholders on the importance of maternal and child health. There is a need to document incidence and prevalence of maternal morbidity at the health facility level to inform decision-making regarding the quality of maternal health services. The County health department needs to increase the number of health facilities within the county to enable access to Maternal health services to reduce the time -taken to access health facilities.
Determinants of access to skilled birth attendants by women in Galkacyo District, Somalia
(Kenyatta University, 2018-02) Mohamed, Suleiman Yusuf
ABSTRACT Globally over half million women of reproductive age (15-49 years) die every year as result of pregnancy and childbirth complications, and 300 million women endure from debilitating injuries. The lack of availability and access to basic and obstetric emergency care is a major cause of the high levels of maternal mortality and morbidity in Somalia. Barriers to accessing skilled birth attendant services are many as reflected, in Somalia only one out of 6 women receive the appropriate care. WHO report states during 2011, 55.5%, of pregnant mother preferred to deliver at homes instead of health facilities and the availability and accessibility of traditional birth attendants influenced their choices. The main objective of this study was to investigate the determinants of access to skilled birth attendants by women in Galkacyo district, Somalia. The specific objectives were to determine the proportion of women accessing to skilled birth attendants, to investigate demographic characteristics, socio-cultural practices, and socio-economic factors that influence access to skilled birth attendants by women in Galkacyo district, Somalia. This study was descriptive cross-sectional. The study was conducted in Galkacyo district, Puntland, Somalia. The target population of this study was women of reproductive age (15-49 years).In this study administered questionnaires was used to collect data from the respondents while key informants interview was done to find overall picture on access to SBAs. Purposive sampling was used to select key informants. Convenience sampling was used in this study to select 384 respondents who met inclusion criteria. Informed consent was obtained from the study participants. SPSS version 20 was used for data analysis. After entry, cross tabulation was done followed by chi square statistics to get the independent variables that were significantly associated with access to skilled SBAs. Logistic regression was used to generate odds ratios on the variables that were significant at chi square level. Information generated was then presented in forms of text, tables and graphs. Qualitative data was analyzed using content analysis based on key themes generated from the objectives. This study found that low proportion of women (27%) had access to skilled birth attendants in Galkacyo district, Somalia (27%) of respondents delivered with assistance of skilled birth attendants. The following factors were significantly associated with access to skilled birth attendants in the study area: Respondents level of education (OR=10.11; 95% CI: 4.8 – 21.28; p<0.001). Marital status (OR=0.23; 95% CI: 1.11 – 0.46; p<0.001). Husband's level of education (OR=4.99; 95% CI: 2.285 – 10.90; p<0.001). Decision maker about delivery (OR=0.15; 95% CI: 0.03 – 0.66; p=0.012).Respondent's occupation(OR=3.17;95% CI=1.52-6,62; P= 0.002). Husband's occupation (OR=2.69; 95%CI: 1.02-7.09; P=0.046). Household's monthly income(OR=0.20; 95%CI: 0.11-0.37,P<0.001). This study recommends that there is need to upgrade educating young girls, so that they enable to make informed choice for their health outcomes. To overcome socio-cultural practices influencing access to SBAs, MOH should increase community health education. Women should be economically improved as to enable them access to higher quality of services including delivery care, more jobs should be created for women.
Determinants of Antenatal Care Attendance among Women in the Reproductive Age at Guriel District, Somalia
(Kenyatta University, 2020-09) Omar, Fardowsa Mohamed
Worldwide it is estimated that 303,000 of maternal deaths occurred in 2015.It is also estimated that in Somalia the maternal mortality rate is 669 deaths per 100,000 live births. Infect one out every 12 women dies due to pregnancy-related issues and one every nine Somali children dies before one year. Antenatal care attendance at four times in Somalia is 24 %. Seventy nine percent of women deliver at home, and twenty-four percent of them delivery with skilled assistance .The major contributors to worsening maternal and neonatal mortality rate in Somalia are low awareness of the importance of antenatal care and inadequacy of subsidized ANC services. Most pregnant women are at greater risk for obstetric fistula due to the three delays. Antenatal care is the most important health intervention to reduce maternal and child mortality and morbidity, through complication readiness and preparing an individual birth plan. The main direct causes of maternal deaths in Africa are: postpartum hemorrhage (27.1%), hypertensive disorders of pregnancy (14.1%), complications of unsafe abortion (7.9%), obstructed labor (9.6%), and sepsis. The main objective of the study was to explore determinants of antenatal care attendance among women of reproductive age in Guriel, Somalia. The specific objectives were to determine the socio-demographic factors, economic factors, accessibility factors and level of awareness influencing ANC attendance. The study used descriptive cross-sectional community-based survey with structured questionnaires. The Study used systematic random sampling, the administered questionnaire was used to collect the primary data from the respondents, Data analyzing of quantitative raw data from questionnaires was coded and entered using SPSS 22.0 data entry program. The statistical mode such as chi-square test was used to test the relationship between the variables, and to test null hypothesis. In the study, estimated mean age was 28 years. The study concluded that most socio-demographic factors influenced ANC attendance. In the study marital status, education level, and parity showed significant statistical association with ANC attendance. The study findings showed that most economic factors played significant role in determining ANC attendance among respondents. The study results revealed that accessibility of health facilities was important to ANC attendance. Distance to health facility, cultural acceptability played significant role on ANC attendance. The study revealed that ANC attendance for the district was low according to the WHO standards and this explains the high maternal and infant mortalities recorded in the district. The research concludes that level of awareness on ANC services was high but unfortunately this did not contribute to increasing the rate of ANC attendance
Determinants of Contraceptive Choices among HIV Positive Women of Reproductive Age Attending Comprehensive Care Centre at Kitale County Referral Hospital, Kenya
(Kenyatta University, 2016-03) Cheruiyot, Edward Kiplagat
Family planning is an important aspect of primary health care. In order to improve the efficacy of available contraceptive methods, it is of importance to identify factors influencing women’s choice of contraception. In Kenya, like many other sub-Saharan countries, prevention of unintended pregnancies among HIV positive women as a strategy for PMTCT has been neglected. This has resulted in a large population of HIV positive women who have a substantial degree of unmet need for family planning, estimated at 60% in the 2007 Kenya Aids Indicator Survey. This study focused on exploring the various determinants of contraceptive choices among HIV positive women of reproductive age seeking services at comprehensive care centre, Kitale County Referral hospital, Trans Nzoia County. The specific objectives for this study were to determine the knowledge levels, to determine the types of modern contraception used and to assess the factors that influence contraceptive choices among HIV positive women of reproductive age attending comprehensive care centre at Kitale County Referral Hospital. This was a cross-sectional descriptive study of 357 randomly selected HIV positive women where both quantitative and qualitative information was collected. The research instruments used were a questionnaire, key informant interview guide and a focus group discussion guide. The data was analyzed using Statistical Package for Social Sciences (SPSS V.20). Statistical techniques including Chi square, and logistic regression were used in the analysis. P<0.05 was considered significant. The findings showed that more than half of HIV positive women 182 (52.1%) were using hormonal modern contraceptives. Controlling for occupation, age, religion, access to contraceptives and facing challenges were significant determinants of contraceptive choice (p<0.05). Those below 30 years were less likely to choose non-hormonal contraceptives compared to those 30 years and above (OR; 95%CI: 0.341; 0.195-0.598). Those affiliated with catholic religion were 2 times more likely to choose non hormonal contraceptives compared to Protestants (OR; 95%CI: 2.226; 1.192-4.158). Those accessing contraceptive at the CCC were 11 times more likely to choose non-hormonal contraceptives compare to those accessing from other places (OR; 95%CI: 11.265; 2.914-43.551). Those experiencing challenges in accessing contraceptives were 6 times more likely to choose non-hormonal contraceptives compared to those not (OR; 95%CI: 6.246; 1.410-27.673).In conclusion,choice of contraceptive was strongly related to age, religion, access and challenges. There is need for the Governmental and nongovernmental organizations, health facilities and other stakeholders to ensure availability, accessibility and sustained advocacy for use of appropriate contraceptive methods. This will guarantee contraceptive commodity security and sustained demand for contraception among HIV positive women of reproductive age. There is also need for researchers to investigate husbands’ perception and acceptance towards contraceptive use by their partners
Determinants of physical violence on married women by spouses in Kandura sub county, Murang’a County, Kenya
(Kenyatta University, 2018-10) Jonathan, Redempta Ngina
Despite the many efforts put in place globally, regionally and at national level to reduce and eliminate Physical Violence against married women, this violence is still prevalent. It is one of the major forms of oppression against women. The aim of this study was to investigate the determinants of Physical Violence on married women by their spouses within the age of 18-45 years and above in Kandara Sub County, Murang‟a County, Kenya. The study objectives were to determine the socio-demographic characteristics of married women experiencing Physical Violence, to establish the socio-cultural factors influencing experience of Physical Violence on married women by spouses, to identify forms of Physical Violence perpetrated against married women by spouses and to identify the coping strategies adopted by married women experiencing Physical Violence. The Radical Feminist Theory by Hollace Graff, (2012) guided the study which was used to conceptualize the underlying factors that aggravate Physical Violence on married women by spouses. The study applied cross-sectional survey research approach to gather data from 111 married women experiencing Physical Violence and 11 state and non-state actors. Data collection tools included an interview schedule for married women experiencing Physical Violence and key informant interview for the chiefs, selected religious leaders from Anglican Church of Kenya (ACK) and Catholic churches, and law enforcers who included the police officers within the area of study. Secondary data was obtained from the records kept in the chief‟s office and police abstracts from the police station in the area of study. Qualitative data was sorted and analyzed thematically based on the objectives while quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) using both descriptive and inferential statistics. Findings from descriptive statistics revealed that slightly more than a third (34.2 %) of the married women aged between 25-31 years were the most physically violated by their spouses. Findings from inferential statistics showed that the determinants of Physical Violence were; married women‟s level of education (p=0.029), number of children (p=0.027), age of the spouse (p=0.043) and occupation of the spouse (p=0.048). The socio-cultural determinants of Physical Violence were: witnessing inter-parental violence by the married women (p=0.032), dowry related violence (p=0.036), spouse‟s use of alcohol, drugs and other substances (p= 0.045) and retrogressive traditional norms and beliefs (p= 0.001). Significant coping strategies adopted by married women: were running away from marital home (p= 0.039), reporting to the chief (p=0.002), sharing with married women‟s friends (p=0.028) and seeking help from hospital (p=0.038). The study concluded that PV against married women is a grave social and economic vice that requires a practical role of state, non-state actors, community members and active participation of both the married women and their spouses so as to address it. The study recommends the need to intensify awareness and sensitize people on Physical Violence against married women by spouses through seminars, workshops, group counselling, mass media, print media and social media networks by state and non-state actors, religious leaders and the community. In addition arms of government dealing with Gender Based Violence should strengthen their practice on the existing policies. The result of this would be elimination of Physical Violence on married women by spouses.
Determinants of Post Caesarean Section Wound Sepsis among Postnatal Mothers at Kenyatta National Hospital, Nairobi City County, Kenya
(Kenyatta University, 2019-09) Chelimo, Agneta; Arodi, Washington; Makworo, Drusilla; Mugo, Judy
Determinants of Unmet Need for Contraception use among Hiv-Positive Women in Kwale County, Kenya
(Kenyatta University, 2022) Mumbo, Edward M; Redempta Mutisya; Alice Ondigi
Prevention of unplanned pregnancies is one of the four approaches in the prevention of MTCT of HIV. Even with the constant availability of modern contraceptives in the health facilities, 352 known HIV-positive women attending Comprehensive Care Clinics (CCC) services in Kwale County conceived in 2018, risking an increased rate of vertical transmission of HIV. The main objective of the study was to understand the use of contraception by HIV-Positive clients of childbearing age and find out the possible factors for their unmet need for contraception in Kwale County. The study aimed to determine the contraceptive prevalence among HIV-positive, to establish the socio-demographic, socioeconomic, health facility, and sociocultural factors that are associated with the unmet need for contraception use among HIV-positive women of childbearing age in Kwale County. The study targeted all HIV-positive women of childbearing age attending comprehensive care clinic services in Kwale County and officers in charge of CCCs. The study had 347 clients that were sampled using a systematic random sampling technique, while thirty-three (33) in charge of CCCs were purposefully selected as KIIs. An analytical cross-sectional research design was used. Trained research assistants were used to collect data in the selected CCCs using semi-structured questionnaires. Further information was obtained by reviewing the clients’ notes in the health facilities. To take care of any inconsistent entries, pre-analysis data cleaning was done and wrongly captured data, missing information, outliers, and repetition were checked. Microsoft Excel was used for data cleaning. STATA 16 was used for the data analysis. The descriptive analysis involved frequency distribution tables, and calculations for mean, middle, and prevalence estimates. Inferential statistics were both bivariate and multivariate. Fisher's exact test was used to test for the relationship between independent variables and unmet FP needs. The statistically significant variables (p-value < 0.05) during bivariate analysis were then subjected to a multivariate logistic regression model to identify the independent variables associated with the unmet need for family planning. The outcome variable was coded “0” for “FP need met” and “1” for “unmet FP need”. Odds Ratios (OR) were computed. Qualitative data from the KIIs were synthesized and emerging themes were grouped according to their similarities and differences. The study revealed a 78.9% Contraceptive prevalence rate (95% CI 74.3; 82.9), while the unmet need for contraception use among HIV-positive women in the County was 21% with 18% and 3% with unmet need for limiting and spacing respectively. In the multivariate analysis, sociodemographic, health facility, and socio-cultural factors were found to be independently associated with the unmet need for family planning among women of reproductive age living with HIV in Kwale County. Among the demographic characteristics that independently influenced FP use are age, marital status, and the clients’parity. Demographic factors: Age 45-49 years OR=9.95, 95% CI[1.4-63.2, P= 0.014] was found to be 10 times more likely to have unmet FP need as compared to age 25 to 34 years OR 0.569,95% CI [0.165-1.964, P=0.372]. Being widowed increased the probability of unmet FP needs, OR 6.5, 95% CI [2.003-21.415, P=0.002]. Being a grand multipara was associated with a reduced unmet need for contraception, X2=, 7.9921 p=0.018. Sociocultural attributes:- Intimate partner disclosure of HIV state , OR 0.262, 95% CI [ 0.01-6.686, P= 0.006], awareness of FP methods OR 0.02, 95% CI [0.052-0.773, P= 0.02] and independence to use Fp were associated with reduction in unmet need for contraceptive use. Health facility characteristics that have influenced the unmet demand for contraception among HIV-Positive women were lack of integration of FP services in CCCs, no stocking of FP commodities in the CCCs, Lack of FP services reporting and documentation tools, and inadequate space in the CCCs. The study concludes that HIV-Positive women of reproductive age in Kwale County had an unmet need for contraception use. The study recommends that the department of health services should invest in clients and community education on the importance of FP use, raise more awareness of FP services among HIV-positive women, promote male involvement and partners disclosure, Promote programs to empower women in FP decision-making, & facilitate the integration of FP in all the CCCs.