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    Evaluation of consumer food hygiene and safety practices in Households in Langata Sub-County, Nairobi county, Kenya.
    (2014) Abuga, Malkia Moraa
    Food borne diseases comprise a broad spectrum of diseases and are responsible for substantial morbidity and mortality worldwide. It is a growing public health problem in developing as well as developed countries. Food safety at home may result in increased potential for unsafe food handling behaviours and consequential increased risks of illness. In addition, failure to associate the home as a potential location to acquire food borne diseases may be a serious hindrance for implementation of safe food handling behaviours. The home has become a multifunctional setting comprising of many activities that influences the need for and practice of food safety. In Kenya, few documented studies have been undertaken to assess the role played by food handlers in the transmission or control of food borne diseases in various setting, in particular there is scanty information of food safety in the homes. This study aims to evaluate consumer food hygiene and safety practices in the households in Langata Sub-County. This will be a descriptive cross-sectional study targeting consumers who have the sole responsibility of food preparations in the households in Langata Sub- County, Nairobi County, Kenya. The study will seek to establish consumer knowledge; attitude and practices on food hygiene and safety measures in the households and also determine the socio-demographic factors that influence food . hygiene and safety practices in households. A multistage sampling approach will be used. Langata sub-county will be purposively selected. The study will be conducted in all the five wards of the sub-county they include Karen, Soweto Nyayo Highrise, Mugumoini, Langata and Nairobi West. Probability proportionate sampling will be used to get the desired number of households from each ward. Random sampling will be used to select the households in the respective wards. In the households, those responsible of food preparations will be interviewed. A sample size of 387 respondents in Langata sub-county will be used for this study. Data will be collected by use of structured questionnaire and key informative interview. Data will be analysed by SPSS version 20 and presented using tables, graphs while association between variables will be assessed using Chi-square statistic. The findings of the study will be used in health research and development initiatives relating to food safety.
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    Utilization of interventions leading to zero transmission of mother-child HIV/aids among HIV infected women in Narok County, Kenya.
    (Kenyatta University, 2014) Njeri, Nyawira
    Prevention of mother-to-child transmission (PMTCT) has been scaled up to elimination of mother-to-child transmission (eMTCT) to illustrate the global goals of eliminating all new cases of pediatric IllY. This new focus on elimination has been defmed as achieving transmission rates under 5% by use of innovative strategies so as to achieve the MDGs goal by 2015. In Kenya MTCT rate among infants is estimated at 27% at 18 months therefore need to come up with an EMTCT strategies. This study will therefore analyze the various interventions in place geared towards zero transmissions of Mother to child mv/Aids infection in Narok County. This information will be useful to the relevant stakeholders so as to come up with solutions to any issues raised with the goal of achieving elimination of mother to child transmissions. A cross sectional design will be employed in the research .The study will collect data from all the IllY positive mothers attending Maternal Child Health clinics postdelivery. Narok County is in south Rift valley with an estimated population of 850920 according to 2009 census. The County is characterized by poor infrascture resulting to lack of access to health facility, Maasai cultural practices which pose a risk to IllY infection and this leave delivery to be conducted at home by traditional birth attendants. Pretested semi structured questionnaires will be administered to the IllY positive mothers attending the postnatal clinic for the purpose of obtaining primary data upon consenting. Others who will be interviewed are the health care providers, community health workers in community units and mentor mothers by use of interview guided schedules. Purposive sampling technique will be used to obtain mothers with the desired characteristics .. Quantitative data will be analyzed with the aid of the Statistical Package for Social Sciences (SPSS) version 18. Data will be presented using frequencies and proportions. Qualitative data will be collected form the Community Health Workers, health care providers and mentor mothers and categorized into themes based on the study objectives. This study is expected to provide data that will be able to help understand the MTCT practice in Narok County as we move towards zero transmission rates.
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    Nutritional status among the geriatrics in Nyamira subcounty, Kenya
    (Kenyatta University, 2014) Okinyi, Dorcah Kwamboka
    in Kenya, the population of persons aged 60 years end above increased steadily from 1 million in 1989 to 1.9 million by 2009 and is projected to reach about 3 million people by year 2030. Nutritional needs change throughout life and for the geriatrics, these changes may be related to the normal aging pr-oces-ses, medical conditions, or lifestyles in terms of nutritional status (Amella, 2007). This means there is need to develop nutrition policies and guidelines that will aid in maintaining their health status, thus this study aims to determine the nutritional status of the geriatrics in Nyamira Sub-county, Kenya. The study population will include persons aged at least sixty years and are residents in the study area. A sample of 230 participants will be targeted Data will be collected through face to face interviewer administered questionnaire, focused group discussion interview guide where discussions will be conducted in the three divisions. Nutrition assessment will. be carried out using Mini Nutritional Assessment tool, clinical assessment on age-related health problems will be considered and dietary assessment using food frequency questionnaire. Anthropometnc measurements will be taken including height, weight, Mid Upper Arm Circumference and annspan in determining the malnutrition• status of geriatrics. Data will be analysed using descriptive statistics aided by the statistical package for social "Sciences ~SPSS).
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    A standardization model for staffing among medical doctors at hospitals in Nairobi county, Kenya.
    (Kenyatta University, 2014) Kiura, Daniel Munyi
    Across the globe it has been a challenge for Hospital Administrators to accurately estimate the required workforce to cater for patient needs. Various methodologies have been used including Hospital bed capacity to doctor ratio, Population to doctor ratio and policy guidelines. None of these systems have adequately addressed the problem. Irad Ben-Gal et al (2010) proposed a model for determining the required number of doctors in any hospital department by taking into account factors such as average occupancy rates, staff leave, allowances, doctors' duties and patient service levels. This proposal aims to assess how adaptable the proposed model is through replication in a different setting. The study aims to confirm or disapprove the correlation between the time taken to perform direct and indirect patient care activities and the required physician staffing level at four hospitals in Nairobi County, Kenya namely Kenyatta National Hospital (KNH) ,Aga Khan University Hospital, Nairobi (AKUH,N), St. Mary's Mission Hospital(SMMH) and Mbagathi District Hospital (MDH) while taking into account patient occupancy rates. Arising from this study, recommendations will be made for any modifications to the model found necessary. A comparison will be made between the results established using the proposed model and those using the current method of staffing requirement in KNH, AKUH, N, SMMH and MDH A cross sectional survey will be done to establish the current method of determining the required number of doctors in the hospitals under study. The survey will employ use of an orally administered questionnaire to establish the different types of activities that physicians carry out in their daily work and the approximate length of time each activity takes .. The results of the survey will help design the work sampling study. The work sampling will be carried out using an Observation Schedule & Work Sampling Data Collection application tool. The tool will be downloaded onto a Samsung Galaxy 3 android handset or a handset of similar capability. In order to test the Standardization Model, work sampling studies will be carried out on the various factors and variables that affect the work load and required physician capacity. The data collected from the survey will be analyzed and factored into the model so as to derive the required physician staffing level. The data collected will be analyzed using Statistical Package for Social Sciences (SPSS) version 22. Linear regression analysis will be used to correlate the average occupancy rates and the required physician staffing level. Test for statistical significance will be carried out on each variable measured to determine the variable's importance in influencing physician staffing requirement. This study is expected to provide suggested ways of increasing staff utilization of permanent staff, reducing staff burnout and driving lowered cost of employing locum (temporary) doctors
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    Preconception care practice in pregnant HIV infected women in Kiambu county, Kenya
    (Kenyatta University, 2014) Muthoni, Joseph Mwangi
    Preconception care (PCC) is the patient education, evaluation, and management aimed to prevent unplanned pregnancies and decrease the risk of adverse health effects for the woman, fetus, and neonate by optimizing the woman's health and knowledge before planning and conceiving a pregnancy. Importantly, the HIV pandemic makes PCC even more essential due to the additional risks for sexual and vertical transmission of HIV. This study seeks to determine whether PCC is indeed practiced among HIV infected women as a way of fighting the HIV pandemic, besides preventing pregnancy related morbidities and mortalities. The study will be a cross-sectional study in which pregnant HIV infected women who were already enrolled in chronic care by their estimated date of conception will be interviewed on PCC interventions. Besides, clients' files will be reviewed to abstract data on client's condition, stage of HIV disease, CD4 count, and viral load around the conception period because these are the consideration in preconception care practice, yet the patient may not remember. The study will be done in eight Kiambu county facilities that have established comprehensive care clinics namely Kiambu sub-county hospital, Kihara sub-county hospital, Tigoni sub-county hospital, Ruiru sub-county hospital, Nazareth mission hospital, Gatundu sub-county hospital, Githunguri sub-county and Thika sub-county hospital over a period of two months. A sample of 322 HIV infected women will be used. A questionnaire and a checklist will be used to collect data, which will then be analyzed using SPSS. Analysis will involve t-test to compare proportion of women getting preconception care vis-a-vis proportion not getting preconception care. Results will be presented in graphs, tables and charts and the results disseminated to all stakeholders including Kenyatta University and medical superintendents in respective facilities.
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    Essential newborn care practices among home delivered postnatal mothers with babies 0-28 days from Korogocho slums, Nairobi county
    (Kenyatta University, 2014-11-03) Kiambati, Mugure
    Essential newborn care is designed to improve health of newborns through a set of interventions that should be made available for all births. Essential newborn care would reduce 70% of neonatal deaths. ewborn deaths in Korogocho contribute 33% to Infant mortality in Korogocho slums which is 73.1 per 1000 live births which is higher than any other region in Kenya. This study aims at determining essential newborn care practices among women who deliver at home with babies 0-28 days in Korogocho slums of Nairobi. A cross sectional survey will be carried out in the Korogocho slums .. Target population will be mothers who had delivered at home from Korogocho slums with infants 0-28 days. Purposive, simple random and snowballing sampling methods will be used to get the desired sample size. Eligible women willing to participate in the study will be interviewed using structured interviewer administered questionnaires. Data collected will be analyzed by using SPSS version 17.0 statistical software. Data will be summarized into proportions and means and tests of associations and comparisons done using chi-square and student's t or Mann Whitney U tests respectively. The analyzed data will be presented in tables and charts. Findings from this study will help in the development of programs to promote culturally sensitive and acceptable change in newborn care practices
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    Patterns and determinants of unintentional injuries among children in machakos level 5 hospital
    (Kenyatta University, 2014-11-03) Kibogong, Duncan K.
    Injuries are among the leading cause of death and disability among children worldwide. Approximately 875,000 children die every year as a result of injuries and violence. The definition of a child according to the Convention on the Rights of the Child is someone under the age of 18 years. WHO identifies burns, falls, Road Traffic Injuries (RTIs), poisoning and drowning as the major causes of injuries in childrenalthough unintentional injuries are recognized as a major public health problem globally.Little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Kenya, largely because they have not been effectively counted. The main purpose of the study is to investigate the patterns and determinants of unintentional injuries among the children in Kenya, with specific reference to inpatients of Machakos Level 5 Hospital.Purposive sampling technique will be employed to target children with unintentional injuries admitted in the Machakos Level 5 hospital. Data will be collected using questionnaires and interviews. Data will be analyzed descriptively. The findings will be presented using tables and charts, percentages, tabulations, means and other measures of central tendencies.
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    Uptake of human papiloma virus vaccine among women aged 18-45 yrs in Umoja area of Embakasi sub-county of Nairobi county, Kenya
    (Kenyatta University, 2014-11-03) Mibuku, Fredrick Kairithia
    Cervical cancer kills 270,060 women annually worldwide. III Kenya up to 1655 women die annually. Cervical cancer screening and the uptake of Human Papilloma Virus (HPV) vaccine can result in early detection whereas HPV vaccination can lead to prevention of infection with cancer causing strains among women. Pre-pubertal girls are being targeted for vaccination before their sexual debut although preventive benefits have been documented in older women. Thus, there have been efforts at the local, national and global level to promote cancer screening and to provide information on HPV and promote its uptake in Kenya. Despite these efforts, only 6% of women in Kenya have ever been screened for Pap smear while less than •1% has had HPV vaccine. There are many determinants to the uptake of pap HPV vaccine. Previous studies have identified cost of the vaccine, inaccessibility, lack of awareness, reservations by clinicians as main hindrances to the uptake of the vaccine. This study seeks to determine the factors that influence the uptake of HPV vaccine among women of reproductive age in Umoja Division, Nairobi. Specifically, the study will assess the level of uptake ofHPV among women in selected sites. It will also investigate the experiences of women that have led to their uptake .or nonuptake of the vaccine. Further, the study will identify barriers to uptake of HPV vaccine by women aged 18-45yrs at Embakasi district of Nairobi county, Kenya. The study will use a cross sectional descriptive design. A total of 384 women will be sampled randomly and interviewed to determine if they have had HPV vaccine. Data will be collected using an interview schedule containing closed and. open-ended questions. Data analysis will be done using SPSS computer program
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    Occupational health and safety practices among beauty salon workers in Mukaa sub-county in Makueni county, Kenya
    (Kenyatta University, 2014-10-31) Ngemu, Fredrick Kyalo
    The beauty industry is one of the most vibrant industries 111 Kenya with most of its activities being done in small scale. It is a source of livelihood for many young people especially those with tertiary level of education and lower. The industry is regulated by common public health and safety laws but there is no specific legislation or regulations addressing health and safety specifically for the beauty industry. Workers in the industry are represented by the Kenya Union of Hair and Beauty Salon Workers (KUHABSWO) which is not popular with practitioners in the rural areas.Occupational health and safety is of high concern in the industry given the kind of products and chemicals used and the common procedures which all exposes the workers to health risks for which some are not even aware. This study shall be conducted in Mukaa Sub-county with the main aim of assessing occupational health and safety practices among beauty salon workers. Specifically, the study shall seek to determine the prevalence of self-reported occupational health problems, determine OHS compliance, identify factors influencing OHS practices, and determine the level of awareness on OHS and public health issues among beauty salon workers.!t will be a cross-sectional descriptive study. It will be conducted in Mukaa Sub-county which is a majorly rural area with markets and small urban centres. Multistage sampling technique shall be used to select study subjects. Quantitative data analysis shall be done using SPSS version 19 while Qualitative data shall be analysed by content analysis. Data shall be presented in charts and tables. Chi square and logistic regression shall be used to establish relationships. The study findings shall inform policies in occupational health and safety in the beauty industry. Finally, the study findings and recommendations can be applied across the beauty industry in Mukaa Sub-county and Kenya in general in enhancing the lives of the workers in the beauty industry.
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    Utilization of stadardized cervical cancer screening services among health care workers in selected health facilities in Machakos county - Kenya
    (Kenyatta University, 2014-10-30) Nzioka, Agnes Wavinya
    Cancer of the cervix is the second most common reproductive tract cancer among women globally and the leading cause of death in developing countries with large inequalities in utilization of standardized cervical cancer screening services. Standardized cervical cancer screening services utilization among health care workers is equally uneven and rarely documented in developing countries. In Kenya, cervical cancer accounts for 8-20% of all cancer cases and this is projected to double by 2020.Kenya's Cervical cancer screening services coverage is haphazard with standardized cervical cancer screening services only found in designated sites .The main objective of this study will be to assess the utilization of standardized cervical cancer screening services among health care workers in selected health facilities in Machakos County. This study will be descriptive cross- sectional in design. Reconnaissance survey was done to identify health facilities offering standardized cervical cancer screening services in Machakos County.Only 5 out of 157 health facilities offer standardized cervical cancer screening services, All these five health facilities will be selected for the study due to small sample size.Cluster sampling will be done to sample different group/cadres of health care workers in those selected health facilities Random sampling will be used to select individual participants for the study Study population will be female health care workers aged 18-65 years working in the selected health facil ities in Machakos County whereby a sample size of 316 respondents will be randomly selected for this study. Study objectives will be ;to establish the proportion of health care workers utilizing cervical cancer screening services in selected health facilities in Machakos County, to determine individual attributes influence on utilization of cervical cancer screening services among the health care workers in selected health facilities in Machakos County, to establish service provider attributes' influence on utilization of cervical cancer screening services among health care workers in selected health facilities in Machakos County, to find out facility attributes influence on utilization of cervical cancer screening services among health care workers in selected health facilities in Machakos County Inclusion criteria will be health care workers aged 18-65 years working in selected health facilities in Machakos County willing to participate in this study. Exclusion criteria will be eligible health care workers who will be out of the health facility, or terminally ill, at the time of data collection Research instruments to be used will be Self administered questionnaires Qualitative data will be coded appropriately and then categorized as per emerging themes. The quantitative data will be cleaned and coded then entered into SPSS version 17.0 program for data management. The study outcome will be to improve early screening utilization rates and quality of life among female health care workers, and contribute to the body of knowledge. Feedback and recommendations will be given to stake holders to include the hospitals' administration, the health care workers in Machakos County. Research findings will further inform the national program to corroborate the findings of the current study, and work towards planning successful interventions specifically tailored to this population.
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    Assessment of the quality of household drinking water in Mbeere south sub-county, Embu county
    (Kenyatta University, 2014-10-03) Njiru, Daisy Mutitu
    Good quality household drinking water is an important determinant of public health in rural communities especially in Africa. The rationale behind protecting drinking water sources is therefore the provision of good quality household drinking water. Nevertheless, recent studies have shown that improved public water supply does not necessarily improve water quality at the point of use. Drinking water quality quickly deteriorates after collection and during storage in the home; and therefore imperative for emphasis on home based water treatment and safe storage. The use of household water treatment and safe storage technologies has received wide recognition in the reduction of diarrheal diseases. This study seeks to evaluate the quality of household drinking water in Mbeere South Sub County, Embu County. To achieve this broader objective, the study will investigate the bacteriological quality of drinking water at the source and at the point of use. The study will also establish water handling and hygiene practices in households as well as household water treatment methods. The study will be a cross sectional descriptive study survey on 192 households drawn from Mwea and Makima divisions as well as microbial water analysis. Two-cluster sampling design will be used. Administrative sub locations will form the clusters. Households will be selected by equal probability systematic sampling from clusters sampled by probability proportional to size procedure. Data will be collected using interviewer administered questionnaires and observational checklists. 112 drinking water samples will be analyzed for total coliforms and Escherichia coli using multiple tube fermentation. Statistically analyses will be conducted by SPSS version 20.Descriptive statistics will be used; cross tabulations, ttest and multivariate logistic regression will be used. The results will be displayed graphically and in tabular form. The findings will provide useful intervention measures to ensure quality of household drinking water in Mbeere South Sub-County. The findings will also contribute to the general body of knowledge in the field of public health. The study will also be informative for future researches on drinking water quality in the area and elsewhere
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    Barriers to effective trachoma control among children aged 1-9 years old in Magadi division, Kajiado county, Kenya
    (Kenyatta University, 2014-10-03) Nyamwaro., Christine Moraa
    Trachoma is caused by Chlamydia trachomatis, a bacterium transmitted by direct spread of infected ocular material from one person to another. The spread of trachoma is by flies (Musca sorbens), fingers and formites. The environmental risk factors that facilitate transmission include dry environment, dirty home environment and discharge (on face, eyes, nose & ears) from the infected individual. Trachoma is a disease of poverty particularly affecting children and their mothers. This disease remains the principal cause of preventable blindness globally. With the establishment of the Global Elimination of Blinding Trachoma by 2020 (GET 2020) goal, the World Health Organization (WHO) has set an ambitious target for country programs. SAFE strategy which is currently recommended and stands for; surgery for trichiasis, antibiotics for active disease, facial cleanliness, and environmental change to reduce tmnsmission targets all key elements believed to be necessary for a short- and long-term intervention program. Even with those things on the ground, the prevalence of trachoma is still high. The study's general objective will be to determine the barriers to effective trachoma control among children aged 1-9 years. The Specific objectives will be to determine socio cultural barriers to latrine coverage and usage in Kajiado County, to explore hygiene practices among caregivers to children 1-9 years old in Kajiado and to determine access and utilization of water by households in Kajiado County. In order to conduct this study, a descriptive cross-sectional study will be conducted. Therefore, 310 children who meet the study criteria will be randomly sampled for study but their mothers or guardians will be the reference persons. Kajiado County is selected because the prevalence rates for infectious and blinding trachoma are 28.1% and 3.3% respectively and WHO defines trachoma as a district wide public health problem when the active infection and blinding trachoma are 10% and 1% respectively. Kajiado County will be sampled using multi stage cluster sampling; sub-location will be the cluster. Sample size will be distributed among the clusters Data will be collected using interviewer administered questionnaire, FGDs and IDIs. Quantitative data will be managed using SPSS version 20 which will be triangulated using qualitative data. Qualitative data will be in vivo coded for thematic mentioned. Data will be analyzed for relationships and exploratory constructs, The study results will be used to by the Ministry of health, AMREF, JCTC and key health sector partners in designing of interventions in the prevention and control of trachoma to strengthen guidance for health policy formulation and emphasize on all the key components of the SAFE strategy.
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    Treatment compliance among primary hypertensive patients attending selected hospitals in Nairobi county, Kenya
    (2014-08-13) Mburugu, Purity; Osero, O.J.S.; Warutere, P. N.
    The ultimate aim of any prescribed medical therapy is to achieve certain desired outcomes in the patients concerned. However, despite all the best intention and efforts on the part of the healthcare professionals, these outcomes might not be achievable if the patients are non compliant. Hypertension is a common condition affecting nearly one billion people worldwide. It also remains one of the most important preventable causes of premature morbidity and mortality in the world. However, compliance with treatment is often sub-optimal, especially in developing countries. Treatment with appropriate medication is a key factor in the control of hypertension and reduction in associated complications. Compliance to hypertensive treatment remains fundamental in reducing risks of ischemic and hemorrhagic stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. The main objective of this study is to determine the level of treatment compliance among primary hypertensive patients attending selected hospitals in Nairobi. It is a facility based descriptive cross-sectional study which will be conducted in three hospitals in Nairobi County which were selected by simple random sampling that is Mbagathi District Hospital, St Mary's Hospital and Mater Hospital. The study population will be selected using systematic sampling and will comprise of patients with primary hypertension who are aware of their status and have been on medication for at least one month. Data will be collected using semi-structured questionnaires, focus group discussion and key informant interviews. The collected data will be cleaned, coded and stored. Quantitative data analyzed using SPSS version 20. Descriptive analysis will be done using frequencies, means and SD. Chi square will be used to test association of variables. The outcome measure of this study is the level of treatment compliance among primary hypertensive patients attending selected hospitals in Nairobi County.
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    Menstrual hygiene management among adolescent girls in primary schools in Mashuru division, Kajiado county
    (2014-08-13) Korir, Eleen; Okwara, F.; Okumbe, Mukolwe Gaudencia
    Globally, approximately 52% of the female population (26% of the total population) is of reproductive age (Sara et al, 2012) and most of these women will menstruate each month for between two and seven days. Menstrual hygiene and management (MHM) is an issue that is insufficiently acknowledged and has not received adequate attention in Water, Sanitation and Hygiene (WASH) and reproductive health sectors in developing countries. The relationship of MHM with and impact on achieving many Millennium Development Goals (MDGs) is rarely acknowledged. It is documented that a large number of girls miss school. On average a girl miss 4-5 days of school per month, due to lack of sanitary pads and underwear, combined with inadequate sanitary facilities in their schools (GCN and MOE, 2006). Poor practices coupled with lack of knowledge is responsible for a significant proportion of school absenteeism, seclusion from social activities, illness and infection associated with menstruation among adolescent school girls in developing countries (Water Aid, 2009). The main objective for this study is to assess menstrual hygiene management among adolescent girls in Mashuru division, Kajiado County. The specific objectives will be: to establish the level of knowledge of menstrual hygiene management among adolescent girls; to identify the menstrual hygiene management practices among adolescent girls; to identify cultural factors influencing menstrual hygiene management among adolescent girls and to assess school based interventions on menstrual hygiene management that can be implemented and sustained in Mashuru division. This study will help identify the gaps and recommendations on menstrual hygiene management in schools. A cross-sectional descriptive study design will be conducted and purposive sampling will be used to identify the study area based on specific considerations such as the nomadic lifestyle. Simple random sampling will be used to identify the primary schools in the division. Stratified sampling will be used using classes as strata followed by systematic random sampling to select the adolescent girls to participate in the study. The study will include 313 randomly selected adolescent girls in classes 4-8 from 14 schools that will be selected randomly in Mashuru division. The research instruments that will be employed include interviewer administered semi-structured questionnaires, focus group discussions as well as key informant interviews and observation checklists. Statistical Package for Social Sciences (SPSS) version 17.0 will be used during data analysis. Chi-Square will be computed to establish the association between dependent and independent variables and binary regression to identify predictors. Measures of central tendency such as mean, mode and median will be computed. Cross tabulation will be done to establish the relationship between the variables. The level of significance will be defined as p-values less than 0.05. The research findings will be presented using tables, pie charts and bar graphs.
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    Effect of perceived stigma on health related quality of life growth curve for newly diagnosed HIV postive adults in Nairobi, Kenya
    (2014-08-12) Kinuthia, Gichuhi; Kabiru, Ephantus W.; Orege, P. A.; Muia, D. M.
    Health related quality of life (HRQOL) is an assessment of how an individual's quality of life may be affected by a disease, disability or a disorder. HRQOL is a patient reported outcome that quantifies the extent to which of one's physical, emotional, and social well-being are affected by a medical condition or treatment. The desired HRQOL is conceptualized as the optimum levels of mental, physical role functioning and social functioning. It is distinct from quality of life as a whole, which would also include adequacy of housing, income and perceptions of immediate environment. Low HRQOL has been shown to negatively affect morbidity and mortality in both acute and chronic health conditions. Therefore improvement of HRQOL in management of diseases would also improve the final outcome and extend life expectancy. About 70% - 80% of HIV infected persons have low HRQOL. HIV is a highly stigmatized disease with 50%-80% of HIV patients reporting HIV related stigmatization further lowering their HRQOL. Counseling for HIV related stigma is currently not included National AIDS & STI Control Program's (NASCOP) protocol for HIV management. The aim of this study is to quantify the magnitude and strength of the effect of HIV stigma on HRQOL growth curve in newly diagnosed HIV adults in Nairobi County, Kenya. The study will be a prospective longitudinal cohort design with four repeated measures of HRQOL taken at enrollment, 3rd 6th and 9th months for each participant. The study population will be consecutive newly diagnosed HIV infected persons, aged 18 years and above in 10 out of 85 randomly selected Comprehensive Care Centers (CCC) in Nairobi County and enrollment will stop when the sum of participants equals the estimated sample size. The sample size of 288 is estimated to give 90% power to detect any change in effect with 95% confidence however 20% participants will be added to guard against loss of this power in case of inevitable losses during the follow up. WHOQOL-HIV BREF and PLWHA [HASI-P] instruments will be used to measure HRQOL and HIV stigma levels respectively. The participants' biomarker data will be extracted from their medical files. The data will be entered into the computer using EPIDATA 3.l™ then transferred to STATA-13™ for data management and descriptive statistics. Confirmatory factor analysis and HRQOL growth curve within multivariate structural equation modeling framework will be done with Mplus" 7.2. The results from this study are expected to give evidencebased guide for inclusion of counseling in management of patients with HIV infection to improve their HRQOL since low HRQOL is associated with high nonadherence antiretroviral therapy, hospitalizations, morbidity from opportunistic infections, and overall mortality. Identification of the particular HIV stigma domains affecting the HRQOL growth curve will also guide in designing a tailor made psychotherapy-counseling module for HIV patients.
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    Prevalence and Response to Needle Stick Injuries among Health Care Workers of Kenyatta National Hospital, Nairobi County, Kenya
    (2013-12-28) Njihia, A.W.; Osano, J. O.; Warutere, P. N.
    Needle stick injuries are occupational hazards which are quite prevalent among HCW who are pillars of Health care systems. The injuries can easily cause blood born infections such as HBV, HBC, and HIV. The diseases have worse outcomes which include long term illness, disability and even death. Health Care Workers optimal health is essential for efficient delivery of health services. The overall objective of this study is to determine the prevalence and response to needle stick injuries among Health Care Workers working at KNH. The study design will be descriptive while data will be collected by quantitative and qualitative methods. The Target population will be 1394 HCW who perform invasive patient procedures while the sample size will be 331 HCW. Data will be collected using self-administered structured questionnaires and Focused Group Discussion for a period of one (1) month. Data will be collected, examined daily for completion, coded, entered in to computer and analysed using SPSS version 20.0. Chi Square will be used to test association and relationship independent and dependent variables. Findings will be presented in Frequencies of various parameters, proportions, pie charts, tables and graphs. The expected benefits of the study findings will be to identify gaps in prevalence and response to NSI. Recommendations on Documentation and ways of addressing the gaps will be developed and the findings disseminated to the hospital management and concerned HCW.