MST-Department of Population and Reproductive Health

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Risk Factors Associated With Urinary Tract Infections among Pregnant Women Attending Antenatal Care Clinic at Kanyakine Sub County Hospital, Meru County, Kenya
(Kenyatta University, 2023-03) Muthee, Trene Kalimi; Eliphas Gitonga; Joseph Musau
Abstract
Uptake of Modern Family Planning Methods among Women Receiving Spontaneous Post Abortion Care at Kuajok Hospital, South Sudan
(Kenyatta University, 2023) Majok, Samuel Ajiek; Lister Onsongo; Eliphas Gitonga
!mprm{mg women's health and reducing complications related to unwanted pregnancics is crucial, and one effective strategy is promoting modern family planning in the context of spontaneous post-abortion care. In 2019, global estimates indicated that there were 295,000 maternal deaths worldwide, with Sub-Saharan Africa and Southern Asia n_cccunting for approximately 86% of these deaths, and Eastern Africa alone accounting 10lr :fpproximalely 542 maternal deaths per 100,000 births. Each year, more than 44 million women experience complications from spontancous or induced abortions, with around 20 million of these cases being unsafe abortions. South Sudan has the lowest rate of modern family planning uptake at 2.6%, likely due to the volatile humanitarian situation and weak healthcare system in the country, which leaves women and children particularly vulnerable in conflict areas. The main objective of this study was to assess the rate of spontancous post-abortion care (SPAC) and the uptake of modern family planning methods among women at Kuajok Hospital in South Sudan. Specific objectives included determining the uptake of modern family planning methods among women who experienced spontaneous post-abortion, assessing women's knowledge of modem family planning methods, examining women's attitudes towards family planning, and investigating the factors influencing the uptake of family planning among women at Kuajok Hospital. The study followed a cross-sectional descriptive design and involved spontaneous post-abortion women at Kuajok Hospital. The sample size consisted of 276 women, determined using Fisher's formula for sample size calculation. Data was collected through interviewer-administered questionnaires that included both closed and open-ended questions. Simple random sampling was used to select the spontaneous post-abortion women, while purposive sampling was used to recruit healthcare providers as key informants. Data was analyzed using SPSS software (version 23), including Fisher's exact tests to establish relationships between dependent and independent variables. Qualitative data was analyzed thematically. The study found that women in urban and rural areas had different preferences for modern family planning methods. Among the spontaneous post-abortion women, 38.4% preferred modern family planning methods and had sought care at the hospital within the past year. Pills were the most utilized method, chosen by 17.9% of women to manage their family sizes and conception periods, followed by injectable at 8.6%. Male condoms were equally popular, preferred by 11.9% of the population. Female condoms, cervical diaphragms, spermicides, and loop methods were not popular choices among the participants, and none of the patients had used them. The study also revealed that the uptake of modern family planning among women of reproductive age was low. Factors such as age, education level, marital status, and occupation influenced the uptake of modern family planning methods. The study recommends that policymakers and healthcare providers increase awareness about modern family planning methods and implement health education programs to change traditional attitudes towards these methods. Encouraging spousal discussions can empower women to make informed decisions about family planning. The relationship between patients' level of education and their knowledge of family planning methods was found to be statistically significant (X2 = 108.002, p = 091, df=4).
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.
Uptake of modern family planning methods among women receiving spontaneous post abortion care at Kuajok Hospital, South Sudan
(Kenyatta university, 2023) Majok, Samuel Ajiek; Lister Onsongo; Eliphas Gitonga
Improving women's health and reducing complications related to unwanted pregnancies is crucial, and one effective strategy is promoting modern family planning in the context of spontaneous post-abortion care. In 2019, global estimates indicated that there were 295,000 maternal deaths worldwide, with Sub-Saharan Africa and Southern Asia accounting for approximately 86% of these deaths, and Eastern Africa alone accounting for approximately 542 maternal deaths per 100,000 births. Each year, more than 44 million women experience complications from spontaneous or induced abortions, with around 20 million of these cases being unsafe abortions. South Sudan has the lowest rate of modern family planning uptake at 2.6%, likely due to the volatile humanitarian situation and weak healthcare system in the country, which leaves women and children particularly vulnerable in conflict areas. The main objective of this study was to assess the rate of spontaneous post-abortion care (SPAC) and the uptake of modern family planning methods among women at Kuajok Hospital in South Sudan. Specific objectives included determining the uptake of modern family planning methods among women who experienced spontaneous post-abortion, assessing women's knowledge of modern family planning methods, examining women's attitudes towards family planning, and investigating the factors influencing the uptake of family planning among women at Kuajok Hospital. The study followed a cross-sectional descriptive design and involved spontaneous post-abortion women at Kuajok Hospital. The sample size consisted of 276 women, determined using Fisher's formula for sample size calculation. Data was collected through interviewer-administered questionnaires that included both closed and open-ended questions. Simple random sampling was used to select the spontaneous post-abortion women, while purposive sampling was used to recruit healthcare providers as key informants. Data was analyzed using SPSS software (version 23), including Fisher's exact tests to establish relationships between dependent and independent variables. Qualitative data was analyzed thematically. The study found that women in urban and rural areas had different preferences for modern family planning methods. Among the spontaneous post-abortion women, 38.4% preferred modern family planning methods and had sought care at the hospital within the past year. Pills were the most utilized method, chosen by 17.9% of women to manage their family sizes and conception periods, followed by injectable at 8.6%. Male condoms were equally popular, preferred by 11.9% of the population. Female condoms, cervical diaphragms, spermicides, and loop methods were not popular choices among the participants, and none of the patients had used them. The study also revealed that the uptake of modern family planning among women of reproductive age was low. Factors such as age, education level, marital status, and occupation influenced the uptake of modern family planning methods. The study recommends that policymakers and healthcare providers increase awareness about modern family planning methods and implement health education programs to change traditional attitudes towards these methods. Encouraging spousal discussions can empower women to make informed decisions about family planning. The relationship between patients' level of education and their knowledge of family planning methods was found to be statistically significant (X2 = 108.002, p = .091, df = 4).
Utilization and Health Facility Barriers of Sexual and Reproductive Health Services among Female Sex Workers in Nairobi City County, Kenya.
(Kenyatta University, 2022) Bwabi, Beatrice Nangekhe; Jane Kieru; Maurice K’Odhiambo
Female sex workers(FSWS) are categorized as key population due to the high risk they face from their sexual behaviour, stigma from the society and discriminative laws that affect them in seeking preventive and curative health services. Sub Saharan countries report deaths from HIV, unsafe abortion, and unskilled deliveries. Studies in Nairobi county has revealed 25% of female sex workers. The female sex workers who contribute to 5% of reproductive health women are at risk of sexual reproductive health complications because of their weak negotiation power for safe sex and poor health seeking behaviors. The study was conducted in selected hot spots in Nairobi county through a cross-sectional design. The specific objectives included, to determine the influence of socio-demographic characteristics on SRHS utilization among FSWS, to assess the association of knowledge on SRHS and utilization among FSWS, to establish the perception of FSWS on SRHS utilization and to determine barriers faced by FSWS while accessing SRHS in Nairobi County. The self-determination theory was used to probe up internal motivators towards psychological growth among FSWS. Critical Medical Anthropology Theory was used to explain ways in which health services are differentially allocated based on social factors and perceptions. The determination of sample size was conducted through Fisher et al. formulae and attrition rate of 10%, which added to 421 respondents through snow ball sampling. The data collection was done using qualitatively and quantitative methods through structured questionnaires, focused group interview and key informants. The cleaned data was processed through SPSS software v.22. The study established that social demographic characteristics and knowledge have a relationship with sexual and reproductive health services utilization through the Chi-Square test of independence (P=0.01<0.05). The study further established that FSWS had perception towards SRHS utilization through content analysis of focused group interview and likert scale measurement. The perceptions towards utilizing sexual reproductive health services played a big role in seeking of the services by the female sex workers as evidenced by a high average mean (M- 4.22, SD- 0.96). Similarly, the respondents agreed that the rate of SRHS utilization was affected by many barriers, (M- 4.01, SD- 0.938) , poor quality services, lack of time and or inconveniencing clinic schedules. The study recommends that targeted health education on SRHS for FSWs be implemented consistently, sensitization of HCWs on friendly SRHs among FSWs, integration of SRHs among other programs like outpatient and maternal clinic to scale up utilization. To provide information, education and communication materials on SRHS to FSWS.
Uptake of Intrauterine Contraceptive Device among HIV Positive Women at Selected Health Facilities in Nairobi City County, Kenya
(Kenyatta University, 2022) Asava, Diana Navalya; James Otieno Ochieng; James O. Ogutu
The increased maternal and neonatal mortality in Kenya among women living with HIV and AIDS can be attributed to high unmet needs of family planning at 52%. Family planning and use of antiretroviral in sub Saharan Africa and Southern Asia has helped in reducing the maternal and neonatal deaths up to 43% annually. In Kenya there are approximately 1.5 million people living with HIV and 36000 people die annually due to HIV related diseases. Intrauterine contraceptive device as a family planning method reduces unintended pregnancies among women living with HIV AIDS and is 99% effective when used correctly. World Health Organization considers it to be the most effective method of family planning. Despite all the potential benefits, the device is still underutilized. In Kenya the uptake of intra-uterine device in the general population is 3.4% compared to other modern methods. The study therefore aims at assessing the level of uptake of Intra-uterine contraceptive device uptake among women living with HIV/AIDS in selected health facilities in Nairobi City County, Kenya. The findings of this study would help relevant stakeholders in structuring programs and strategize on interventions to improve intra-uterine contraceptive uptake among women living with HIV/AIDS in the Nairobi City County and the country at large. This will discourage reliance on wrong knowledge on IUCD so as to reduce the unmet needs of family planning and reduce unintended pregnancies that crop up in the long run. The study specifically focused on socio-demographic factors, knowledge and barriers associated with intra-uterine device uptake in Nairobi City County. The researcher adopted a cross sectional-descriptive study design to collect data through questionnaires administered with the help of research assistants. A total of 353 participants were interviewed from the selected facilities of Mathare North health Center, Huruma Lions Health Center and Pumwani Majengo Health Center which were purposively chosen. The study used quantitative data collection methods. Systematic random sampling was used to select primary respondents at an interval of 8. Every 8th respondent exiting the family planning clinic was selected for interview until the required sample size was reached in each facility. 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 sought from study respondents while the purpose of the study was explained them. Quantitative data was cleaned and entered into a Microsoft excel database before being analyzed by SPSS version 22.0. Descriptive statistics were presented (using percentages, frequency tables, graphs and pie-charts). Inferential statistics were calculated to establish the association between study variables using chi-square tests done at 95% confidence interval and p-values of less than 0.05 considered statistically significant. The results revealed that only 4.8% of respondents utilized intra-uterine contraceptive device. Socio-demographic factors such as age (p=0.029), number of children (p=0.001), level of education (p=0.009), occupation (p=0.001) and religion (p=0.001) significantly influenced uptake of intra-uterine device. The study established low knowledge levels on intra-uterine device among women living with HIV/AIDS in Nairobi City County. Knowledge levels were significantly associated with uptake of intra-uterine contraceptive device (p=0.047). A number of factors were identified as possible barriers which hindered intra-uterine contraceptive device uptake which included facility reception (p=0.026), provision of information (p=0.002), culture/religion (p=0.004) and spouse allows use (p=0.002). The study concludes that there were low uptake and low knowledge levels on intra-uterine contraceptive device. The study further concludes that socio-demographic factors and other barriers were possible reasons for low uptake of intra-uterine uptake among women living with HIV/AIDS in Nairobi City County. The findings of the study would help relevant stakeholders to sensitize and increase uptake of IUCD among women living with HIV.
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.
Influence of Traditional Birth Attendants’ Reorientation and Mother Packs Incentives on Choice of Place of Birth in Marsabit County, Kenya.
(Kenyatta University, 2022) Arero, Christine Bokayo; margaret Keraka; Shadrack A.Yonge
Globally, approximately 295,000 maternal fatalities were witnessed in 2017. About 86% of these reported in Asia and Sub-Saharan Africa. The rate of Skilled Birth Attendant in Sub-African region stood at 59%. Currently, maternal mortality rate in Kenya is 362/100,000 live births. Despite deliberate government interventions to increase hospital deliveries, still a substantial proportion of mothers give birth at home. To address this, Community Based Referral Systems were established by reorienting Traditional Birth Attendants shifting their focus to referring pregnant women to health facilities for delivery. This included provision of mother pack incentives to discourage home deliveries. The study sought to assess influence of community-based referral systems and mother packs incentives on place of delivery choice of among postnatal mothers in the County of Marsabit, Kenya. Specifically, the study focused on influence of community based referral systems, mother pack incentives, and individual and health facility factors linked to place of delivery choice. Analytical study design was adopted which utilized methods of data collection that were qualitative and quantitative. To collect data quantitatively from respondents, questionnaires which were structured helped in this while key informant interview and Focused Group Discussion guides helped in collecting data qualitatively. Respondents for interview were drawn from households picked through systematic random sampling with a 4th internal till attainment of 416 sample size. The recruitment of Focused Group Discussants and Key Informants was done purposively. All the necessary ethical and logistical approvals and informed consent were sought accordingly. Analysis of quantitative data was done by use of version 20 of Statistical Package for Social Sciences. Presentation of data was done by use of graphs, pie-charts and frequency tables. Qualitative data were presented as narrations. Calculation of inferential statistics was done using tests of Chi-Square tests at a confidence interval of 95% and an error of precision of 0.05 to show variable associations. Those variables significant at chi-square were subjected to further logistic regression to determine their relationship to the place of delivery. Results revealed that (233)56.7% of postnatal women in Marsabit County had delivered in health facilities. Skilled birth attendance rate was (241)58.6%. Instant labour pains was the main reason for home delivery at (75)42.1%. Community based referral agents predicted the choice of place of delivery. The person who person introduced women to community referral agents (t=3.879, df=3; p=0.000) predicted choice of place of delivery. Source of information on mother pack incentives (t=2.705, df=5; p=0.007) and receiving mother pack incentives (t=-6.151, df=1; p=0.000) predicted the provision of mother pack incentives on overall, predicted choice of place of delivery. The individual factors such as myths and misconceptions (t=-2.280, df=1; p=0.023), hospital delivery reduces complications (t=-3.987, df=2; p=0.000), hospital delivery time consuming (t=-2.625, df=1; p=0.009), risky to deliver at home (t=-2.999, df=2; p=0.000) and having medical insurance (t=-5.139, p=0.001) predicted choosing a delivery place. The health facility factors such nearness to the facility (t=-5.935, df=2; p=0.000), hindrances of hospital delivery (t=-2.277, df=5; p=0.023) and information provision (t=6.315, df=1; p=0.000) predicted choosing a delivery place. In conclusion, about 6 out 10 deliveries occur at the facility in Marsabit County. Community based referral agents (t=7.677, df=4, p=0.000), mother pack incentives (t=15.643, df=3, p=0.000); individual factors (t=12.785, df=6, p=0.000) and health facility factors (t=13.020, df=4, p=0.000) predicted the choice of place of delivery. The study recommends the Government of Marsabit County and relevant stakeholders to scale-up awareness, coverage and provision of more incentives to encourage hospital delivery.
Utilization of Post-Abortion Contraception among Adolescents in Makueni County, Kenya
(Kenyatta University, 2022) Ngugi, Rachel Njeri; Wacuka Gathigia Njoroge
Correct and consistent use of contraceptives has the potential to reduce the maternal mortality rate (MMR) arising from clandestine abortions by 25-35% and linking post-abortion care (PAC) clients to the family planning clinic in a hospital can reduce the MMR by a further 15%. Despite this, counselling clients on the variety of family planning methods available and allowing them to make informed choice is often overlooked during post-abortion care. Majority of healthcare providers dwell on offering emergency services and removing the retained products of conception and leave out counselling and provision of contraceptives. The main objective of this study was to investigate the utilization of post-abortion contraceptives among adolescents who had received post-abortion care in Kibwezi East sub-county, Makueni County. The specific objectives were to describe the demographic parameters that influence the use of post-abortion contraception, determine the health-care-related factors that influence the use of post-abortion contraception, and assess the impact of contraceptive perception on use. Purposive sampling was employed to identify the facility, and systematic sampling was utilized to choose the study participants in a descriptive, cross-sectional design. Self-administered semi-structured questionnaires were used to collect data. IBM SPSS® 21.0 was used for quantitative data analysis. The significance of the link between the dependent and independent variables was tested using Chi-square values, and the Spearman's Rho test was employed to see if there was any correlation between the variables. Overall, 100 adolescent girls aged 13-19 years (Mean age 17.17 yrs, sd=1.457) who had received post-abortion care at Kibwezi level 4 hospital participated in the study. Findings showed that contraceptive counselling remains an overlooked element of post-abortion care. Only 41% (n=41) of participants were counselled on contraception during their post-abortion care. Contraceptive counselling is an integral part of post-abortion care and in this study, it was found to have a positive correlation with the utilization of post-abortion contraceptives (rs=0.412, p=0.000). The more adolescent girls were counselled on contraceptives, the more likely they were to use post-abortion contraceptives. The level of education, age of the respondents and religion had a significant influence on the utilization of post-abortion contraception (X2=9.511, p-value=0.038), (X2=4.775, p-value=0.0042), (X2=1.828, p-value=0.001) respectively. The study participants perceived that contraceptives had negative side effects (42%) and believed myths that they led to decreased libido and caused infertility (47%) and these were barriers to their utilization of post-abortion contraception. In addition, 10% listed attitude of health care providers as a barrier and a minority of 1% listed spouses as a barrier.44% of study participants had a positive perception of contraceptives while 56 % had a negative perception but this had no significant influence on their utilization of post-abortion contraception (x2=1.813 CI 95% p=0.404). This study concluded that contraceptive counselling remains an important element of post-abortion care but is often overlooked as only 41% of the study participants received contraceptive counselling services and gave recommendations for more research to be done on the impact of sex education on teenage sexual debut age, contraceptive use, and utilization of youth friendly reproductive health services.
Male Participation in Utilization of Antenatal Care Services Among Their Spouses in Selected Manufacturing Industries in Nairobi City County, Kenya.
(Kenyatta University, 2021) Jelagat, Kirui, Nancy; Margaret Keraka
Male participation in utilization of antenatal care services is critical in the uptake of maternal health care services and improvement of pregnancy outcomes. Provision of Ante Natal Care is essential for pregnant women as one of the pillars of safe motherhood. Despite high antenatal care attendance of 96%, the proportion of Skilled Birth Attendance was still low at 62% which is far below the 90% target by 2015. In developed countries the maternal deaths stood at 12 per 100 000 live births compared to 362 per 100,000 in Kenya. This study therefore sought to explore male participation in utilization of antenatal care services among their spouses in selected manufacturing industries in Babadogo, Nairobi City County Kenya. The study specifically focused on male awareness on antenatal care components, socio-cultural factors, health facility factors and employer related factors influencing male participation in utilization of antenatal care services. This study adopted a cross-sectional descriptive study design to collect quantitative data. The study respondents were sampled using systematic sampling with a predetermined interval of 2. A total of 266 respondents were recruited for interview with the aid of the human resource registers in selected manufacturing industries. The researcher sought all required approvals from relevant authorities and obtain informed consent from research participants prior to the conduct of the study. Data collected after Logistical and Ethical approval, was cleaned, coded and entered into Microsoft excel then exported into SPSS for analysis. Descriptive data was analyzed using Statistical Package for Social Sciences version 22.0 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Inferential statistics were calculated using Chi-Square tests done at 95% confidence interval and a margin of error of 0.05 to establish the association between study variables. The results of this study revealed that 34.0% of male respondents participated in antenatal care services in Nairobi City County despite 56.0% accompanying their wives to antenatal care. Psychosocial support to partners was the main motivation to participating in antenatal care. Most of socio-cultural factors such as antenatal care utilization is a women affair (p=0.041), embarrassed to accompany wife or partner (p=0.036) and it is the mother-in-law‟s responsibility to accompany women to ANC were significantly associated male partner participation in utilization of antenatal care services. 57.5% of respondents were moderately aware on antenatal care services. The level of awareness (p=0.001) was significantly associated with male partner participation in utilization of antenatal care services. Most of the health system factors such as distance to the nearest health facility (p=0.024), cost of accessing antenatal care (p=0.001), attitude of health providers (p=0.001) and friendly waiting bay were significantly associated with male partner utilization of antenatal care services. Employer factors such as amount of workload (p=0.001), terms of employment (p=0.017) and provision of payments during paternity leaves were significantly associated with male partner participation in utilization of antenatal care services. The study concludes that the rate of male partner participation in utilization of antenatal care services in selected manufacturing industries in Nairobi City County was low. The study further concludes that the respondents were moderately aware on the antenatal care services in Nairobi City County. These results would be useful to policy makers and other stakeholders to scale up early and proper antenatal care, encourage women to give birth under the care of a skilled birth attendant, provide resources to pay for the services and to help identify and seek heath care in cases of post-partum complications
Knowledge Level on Sexual and Reproductive Health Rights Among Youths With Disability in Selected Centres of Kisii County, Kenya
(Kenyatta University, 2022) Obaga, Christine Kwamboka; Margaret Keraka
Youth with disability often face obstacles and challenges in regards to exploring and exploiting their potential as sexual beings. This in turn deprives them of their human rights comprising of their sexual and reproductive health rights and may internalize various sexual assumptions and attitudes regarding their sexuality. The intent of this study was therefore to assess the level of knowledge on sexual and reproductive health rights among youths living with disability in selected disability centres in Kisii County, Kenya. The study specifically focused on socio-demographics, awareness and health system characteristics associated with level of knowledge on reproductive health rights. The study embraced a cross-section descriptive study design employing both the quantitative and qualitative data collection methods. The study aimed at a representation of 130 respondents who were randomly extracted from the study population using folded pieces of paper. The respondents selected were proportional to the number of youths with disability in Gianchere Special School, Kisii Special School and Association for the Physically Disabled in Kenya, Kisii branch. All necessary ethical and logistical considerations were sought from relevant authorities before the study was conducted. Quantitative data was gathered using structured questionnaires given to respondents through well trained research assistants. Qualitative data was collected using key informant schedules and focused group discussion guides. Statistical Package for Social Sciences version 22.0 was used in analyzing quantitative data. Descriptive statistics were used to present quantitative data in form of frequency tables, percentages, pie charts, and bar graphs. Qualitative data from focused group discussion sessions and key informants were triangulated with quantitative data as direct quotes or narrations from respondents. Inferential statistics were computed using Chi Square tests to establish the association between study variables at 95% confidence interval (p<0.05). The results revealed that 55.9% of respondents had low knowledge level towards reproductive health rights. It was revealed that 59.1% of youths living with disability in Kisii County were conscious of their sexual and reproductive health rights. Awareness (p=0.012) and number of reproductive health rights mentioned (p=0.018) were significantly associated with level of knowledge on sexual and reproductive health rights. Majority of socio-demographic factors such as marital status (p=0.001), degree of disability (p=0.001), having children (p=0.001), type of education involved in (p=0.030), breadwinner (p=0.001) and breadwinners’ occupation (p=0.001) were significantly associated with level of knowledge on reproductive health rights. Majority of health system factors such as attitude of healthcare providers (p=0.001), provision of information (p=0.012), unfriendly physical infrastructure (p=0.001), disability being a hindrance and ever utilized sexual and reproductive health services (p=0.019) were significantly associated with level of knowledge on reproductive health rights. The study concluded that majority of socio-demographic factors significantly influenced knowledge level, that there was low knowledge level on sexual and reproductive health rights in the disability centers, this was despite there being high level of awareness and finally that most of the health system factors significantly influenced the level of knowledge on sexual and reproductive health rights. These findings would inform policy on reproductive health issues thus increase knowledge and awareness levels consequently improving the rates of utilizing reproductive health services among youths with disability. This provides room for adoption of appropriate strategies to ensure sexual and reproductive health rights among youths with impairment are protected.
Utilization of Selected Reproductive Health Services among Adolescent Mothers in Meru County, Kenya
(Kenyatta University, 2022) Muriuki, Sabera M.; Syprine A. Otieno; Joan N. Njagi; Judy Mugo
Reproductive health is “a state of complete physical, mental, emotional and social well-being and not merely absence of disease or infirmity, in all matters relating to the reproductive system and to its functions. Despite efforts from Ministry of Health relevant partners to provide the highest attainable health for all, adolescents continue to face reproductive health challenges such as; STI/HIV, teenage pregnancy, unsafe abortion and harmful practices, for example female genital mutilation. This affects adolescent‟s career progression, childbearing age and increases risk of reproductive health problems in future. Utilization of reproductive health services (RHS) could save many adolescents from the numerous sexual and reproductive health problems. Little has been documented about the levels of utilization of reproductive health services by adolescent mothers in Igembe South Sub County. The purpose of this study therefore was to determine the level of utilization of reproductive health services by adolescent mothers in County, Meru County. The study adopted a descriptive cross-sectional design using pretested questionnaires. The study population was adolescent mothers who had delivered within twelve months prior to the study. Sample size comprised of 234 adolescent mothers and 10 key informants. A pretest of research tools was carried out at Kimongoro location. Data analysis was done by use of thematic content and quantitative data presented by use of percentages and frequencies distribution tables. For inferential quantitative analysis, a partial binary logistic regression model was fitted to determine demographic, socio cultural and health facility predictors of utilization of reproductive health services in Igembe South sub-County. Adjusted Odds Ratios were evaluated for significance by considering the 95% Confidence Interval or the p. value for the Z statistic generated. Ethical clearance was sought from the Graduate School, Kenyatta University Ethical Review Committee, and National Commission for Science Technology and Innovation (NACOSTI), Meru County director of public Health, County director of education and County commissioner. The results showed that utilization of the selected reproductive health services by adolescent mothers was high (above 70%). In this study, majority of the adolescent mothers attended antenatal services at least once. However, the proportion attending the clinic at least 4 times according to the recommendations of the WHO was below the findings of the Kenya demographic survey report which reported that more than half of all pregnant mothers had visited the clinic four or more times. More than 80% of the adolescent mothers reported to have delivered their babies in health facilities. An adolescent mother who is not married was less likely to seek reproductive health services than married ones (AOR =0.51, p=0.033). Level of education and socio-economic status as well as the person adolescents live with, influence utilization of contraceptive services in the area. The study found that a Muslim adolescent was 74% less likely to attend antenatal services compared to a Christian adolescent (AOR= 0.262, 95% CI (0.132 to 0.51, p<0.001) The researcher recommends that primary school curriculum should include sexuality education to ensure factual information is passed to teenagers at primary level. The Ministry of Health to waive user-fee for reproductive health services to ensure all adolescents can access them. The information generated from this study may be a useful contribution to the current knowledge on adolescents‟ reproductive health management and policy development by the Government of Kenya.
Level of Knowledge and Utilization of Fortified Maize Flour By Primary Food Shoppers in Mathare, Nairobi County, Kenya
(Kenyatta University, 2022) Nassir, Hussein Samira; Eunice Njogu.
Micronutrient malnutrition has a potentially huge public health implication hence it is very vital to treat and prevent it in the shortest time possible. Fortification of food has been lauded as a safe and effective means of preventing micronutrient deficiency. In spite of the attempts made by the Government of Kenya to fortify food, micronutrient malnutrition is still a public health concern. This is evidenced by the increasing cases of disorders for instance, iodine, vitamin A and iron deficiency anemia characterized by stunting and wasting among other features of general poor health among children. Little has been documented about the level of knowledge of fortified foods and its utilization in Kenya's urban areas, especially among the urban poor. The purpose of the study was to explore the knowledge and utilization of fortified maize flour among Mathare residents in Ruaraka sub-county, Nairobi County. Primary food shoppers were selected from Mathare valley in Nairobi County because it is the second largest recognized slum in Nairobi, it is classified as a worse off slum category with high poverty index, increased malnutrition with poor and low access to social amenities such as water, sanitation and health services. The study adopted a cross-sectional research design with qualitative and quantitative methods of data collection, analysis and presentation. Research administered questionnaires and key informant interview guides were used to collect information from the participants. Cluster sampling was used to target 318 households in Mathare Valley. Random sampling was used to select villages and the households were selected using systematic random sampling method. The data generated from pretested questionnaires for both primary food shoppers and shopkeepers was edited, organized and coded. Data was analyzed using SPSS version 21. The data was summarized using descriptive statistics such as frequencies, mean, percentages and standard deviation. The significance level was P < 0.05, the association between variables was established using binary logit. The mean age of primary food shoppers was 33 years, 66% were married and the average income was 3,000-5,000 Kenya shillings. Slightly above half 55%, of the primary food shoppers knew about fortification but only 25% understood its meaning. Fortified maize flour was consumed by more than 80% of primary food shoppers hence it was widely accepted though utilization frequency was low. In conclusion factors that were significantly associated with utilization of fortified maize flour included; knowledge on fortified maize flour (p=0.00), household size (p=0.005), preference of fortified maize flour (p=0.000) and level of fortification knowledge (p=0.002). Availability and price were ranked as the most important factors that influence utilization of fortified maize flour at 58% and 55% contrary nutritional value was ranked the least important at 37%. The findings showed that hospitals were among the least considered sources of fortification information and suggests The Human Nutrition and Dietetics unit in the ministry of health should increase and maintain awareness on fortification.
Utilization of Partograph among Nurses and Midwives in Selected Facilities, Makueni County, Kenya
(Kenyatta University, 2022) Muthusi, Urbanus Mutiso; Mokua Gladys N; Macharia Stephen
The partograph, a graphic recording of progress of labor and salient conditions of the mother and fetus, has been used since 1970 to detect labor that is not progressing normally, to indicate when augmentation of labor is appropriate and to recognize cephalopelvic disproportion long before labor becomes obstructed. Early detection of abnormal progress of labor and the prevention of prolonged labor would significantly reduce the risk of postpartum hemorrhage and sepsis, and eliminate obstructed labor, uterine rupture and its sequelae. In comparison to high-income countries, maternal mortality is a severe health issue in low-income countries. This primarily affects low-income nations in Sub-Saharan Africa and Southeast Asia, where maternal mortality account for nearly all of the deaths. The use of partograph in labor management is recommended by the World Health Organization (WHO). This allows for quicker decision-making and life-saving measures. Factors that influence partograph use in Makueni County are unknown. The purpose of this study was to determine the level of partograph usage in the selected facilities in Makueni County. This was a descriptive cross-sectional study that used quantitative and qualitative methods. A data abstraction tool was utilized to obtain data from partographs retrospectively for the quantitative investigation. Individual interviews with 46 nurses and midwives working in the maternity wing were used to gather qualitative data. SPSS version 20.0 was used to analyze the data. To summarize the data and indicate the scope of partograph use, frequency tables were employed. The Chi-square test was used to determine the relationship between the independent and outcome variables. The significance level was set to 0.05. The Phi and Cramer's V tests were used to determine the strength of the relationship. The analysis of qualitative data was done in grouped themes. The interviews were verbatim transcribed and examined with content analysis. From the findings of the study both fetal and maternal outcomes were linked to partograph use. The study found that method of birth had a significant association with fetal monitoring (fetal heart rate (p=.000), liquor (p=.002), and moulding p=.021)), labor progress monitoring (descent (p=.001), contractions (p=.000) and cervical dilatation (p=.001)) and referral monitoring at α = 0.05. The study also found significant association between fetal outcome and contraction (p=.014), gravidity (p=.000), parity (p=.000), fetal heart rate and moulding (p=.021) at α = 0.05. Most midwives partially filled the partograph. The study further concluded that there exists a significant association between maternal, fetal outcomes and labor progress with partograph completeness in Makueni County. The study therefore recommends increased support supervision to ensure proper partograph use. The number of midwifery care-providers should also be increased to improve efficiency in maternal and child care. Regular and structured ongoing trainings on partograph use should be part of the policy framework to build capacity of the midwives and improve maternal and fetal outcomes.
Risky Sexual Behaviour among Masinde Muliro University of Science and Technology Undergraduate Students in Kakamega County, Kenya
(Kenyatta University, 2022) Aroka, Margaret Dorothy Adhiambo; Joan Kabaria-Muriithi; Priscilla Kabue
Healthy sexual reproductive behaviour is a key driver for healthy sexual lifestyle not only for youths but for all human populations. Absence of healthy sexual reproductive behaviour contributes to high cases of mortality and morbidity due to unintended pregnancy leading to unsafe abortion, which result in chronic ill health and psychological stress. Risky Sexual Behaviour (RSB) related to different forms of sexual orientations as heterosexuality, homosexuality, and bisexuality among undergraduate students exposes them to serious consequences. They may have severe HIV and AIDS and Sexually Transmitted Infections (STIs). The research objectives were; to establish the prevalence of risky sexual behaviour, to assess the health seeking behaviour arising from exposure to risky sexual behaviour, to identify the external environmental factors that influence sexual behaviours and to explore the relationship between sociodemographic characteristics and risky sexual behaviour among undergraduate students attending MMUST in Kakamega County. A quantitative cross sectional survey was done between October and December 2018 using self-administered structured questionnaires. The population of study was undergraduate learners from Masinde Muliro university of Science and Technology. Sample of 386 participants was chosen from the population through stratified random sampling technique. Validity of the data collection tools was ascertained using expert opinion while test-retest technique applying Cronbach’s Alpha Coefficient of reliability was computed. Data was analyzed through descriptive and inferential statistics with the help of the Statistical Package for the Social Sciences (SPSS) version 28 for windows. Descriptive statistics involved the use of mean, mode, standard deviation, frequency, and percentage. Pearson's correlation and ANOVA were utilized to show the relationship between the independent variable (sociodemographic characteristics) and the dependent variable (Risky Sexual Behaviour (RSB)). According to results of the study, 40.9% of students had penile-vaginal or unprotected penile-vaginal sex during the three months prior to the research. The results also showed a significant association between sociodemographic features and risky sexual behavior among MMUST learners. Considering the research results, it was concluded that risky sexual behavior is widespread among MMUST undergraduate risky. This study also had a conclusion that sociodemographic characteristics played a significant role on the risky sexual behavior of MMUST undergraduates. After the study, the government was recommended to work with universities to develop policies to strengthen current information education and communication. This raises young people's awareness of the consequences of dangerous sexual behavior and encourages behavioral changes in university students.
Malaria and Intestinal Helminths Coinfections and Anemia Severity among Pregnant Women Attending Antenatal Clinic in Bungoma County, Kenya
(Kenyatta University, 2022) Omanyo, Peter Wanyama; Margaret Keraka; Anthony Kebira
Malaria and intestinal helminths infections are the most prevalent parasitic infections in developing countries, especially in Sub-Saharan Africa (SSA) affecting children under five years and pregnant women. These infections during pregnancy may lead to anemia which may often cause maternal and perinatal complications. The coinfections of malaria and intestinal helminths may cause considerable health effects leading to more severe clinical symptoms and pathology than in mono-infection situations. Kanduyi Sub-County in Bungoma County Kenya is the malaria-endemic zone where these parasites are also prevalent. A hospital-based descriptive cross-sectional study targeting the pregnant women attending antenatal clinic at government health facilities in Kanduyi Sub-County was conducted between September and November 2019. This study was aimed at determining the prevalence of anemia, malaria, and intestinal helminths coinfections and factors associated with the severity of anemia among pregnant women. Data was collected using both quantitative methods. A multi-stage sampling approach was used to get a quantitative sample. Data were analyzed using SPSS version 22.0 and descriptive data were presented using tables and bar graphs. Chi-square statistics were used to test the association between the variables. Logistic regression was used to determine the association between malaria and intestinal helminths coinfections and anemia severity. The prevalence of anemia was 56.3% while malaria, intestinal helminths, and coinfection were 35.5%, 23.6%, and 9.9% respectively. Age (p=0.012), marital status (p=0.014), use of insect treated mosquito nets or repellents (p=0.033) and malaria chemoprophylaxis (p=0.0001) were significantly associated with malaria infection. Hand washing before meals (p=0.041) was significantly associated with intestinal helminths infection. Age (p=0.019), education level (p=0.017), hand washing before meals (p=0.031) and malaria chemoprophylaxis (p=0.0001) were significantly associated with coinfection. Malaria infection (p=0.015), intestinal helminths (p=0.039), and their coinfections (p=0.022) were significantly associated with anemia severity. In conclusion, the prevalence of anemia was high among pregnant women. The prevalence of malaria, intestinal helminths infection, and their coinfections was low. Malaria chemoprophylaxis, use of insect treated mosquito nets, and hand washing before meals was associated with malaria, intestinal helminth, and their coinfection. Malaria, intestinal helminths infection, and their coinfection was found to be associated with anemia severity. The study recommended that pregnant women should be advised on early initiation of antenatal clinic attendance, get iron supplements and dietary counseling to prevent anemia. Provision of malaria chemoprophylaxis and insect treated mosquito nets should be issued to all pregnant women to protect them from malaria infection. All pregnant women attending antenatal clinics should be screened for intestinal helminths infection through routine stool tests and anti-helminths therapy should be provided to prevent intestinal helminths infection. Offer health educate pregnant women on risk factors associated with malaria and intestinal helminth infection. Prompt treatment of pregnant women who have malaria and intestinal helminths infection.
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
Reproductive Health Rights Awareness among Women of Reproductive Age 15-49 Years in Pumwani Maternity Hospital- Nairobi City County, Kenya
(Kenyatta University, 2022) Mogire, Janet Nyaboke; Judy Mugo; Pacificah Okemwa
Women’s health status is compromised not only by lack of knowledge of medical related issues but also by a breach in women’s reproductive rights. The status of women’s health is affected by multifaceted social, biological and cultural factors. These are interrelated and can only be addressed in a comprehensive way by creating awareness. The study focused on reproductive health rights awareness among women of reproductive age in Pumwani Maternity Hospital. The study aimed at assessing the reproductive health rights awareness among women of reproductive age attending the services. The study specifically focused on the influence of socio-demographic factors, health system factors and attitude towards awareness on reproductive health rights among respondents. The study adopted a cross-sectional study design with quantitative and qualitative data collection methods. A total of 189 respondents were sampled using systematic random sampling method and interviewed. The target population included women attending antenatal, family planning and post-natal clinic services. The researcher ensured all Ethical and Logistical requirements were met before embarking on data collection. Informed consent was sought from study participants and the purpose of the study was explained to respondents. Data was coded, cleaned and entered into Microsoft excel spread sheets and later exported to the statistical package for social sciences version 21.0 for analysis. Descriptive statistics were presented in frequency tables, graphs and pie-chats. Inferential statistics were analysed using chi square tests to show the association between study variables at 95% confidence interval and p-values of less than or equal to 0.05 considered significant. The study found out that 59.8% of respondents were aware of their reproductive health rights. Majority of socio-demographic factors such as age (p=0.024), highest level of education attained (p=0.003), marital status (p=0.001) and parity (p=0.003) were significantly associated with awareness on reproductive health rights. With regards to health system factors, there was an association between reproductive health related counselling (p=0.002), affordability of reproductive health services (p=0.001), source of advice on contraceptive usage (p=0.001) and awareness on reproductive health rights. About 55.6% of respondents had a negative attitude towards reproductive health rights and there was a significant statistical association between attitude (p=0.001) and awareness on reproductive health rights. The study concludes that majority of the respondents were aware of their reproductive health rights even though their attitude was negative among women seeking reproductive health services in Pumwani Maternity Hospital in Nairobi City County. These findings shall inform policy makers in health care on reproductive health issues thus increase reproductive health rights awareness.
Influence of Food Taboos and Beliefs on Anaemia among Pregnant Women in Isiolo County, Kenya
(Kenyatta University, 2021) Agustino, Sora Gonjobo; Judith Kimiywe; James Ogutu
Over ages, different cultures all over the world has imposed certain rules and regulations regarding food consumptions a phenomenon that has significant impact on individuals health. For instance, a pregnant mother requires significant additional calorie and nutrients requirements. This particular group together with the breastfeeding mothers requires a balanced diet to supplement them with necessary nutrients and to avoid nutritional stress. Unbalanced diet and insufficient nutrients to this group particularly in remote areas has significant disadvantageous impacts on expectancy and birth results. The communities that live in Isiolo County are so fond of preserving their culture, beliefs and traditions. A part of these cultures dictates on food consumption. They are rules and regulations that dictates on do’s and don’ts as far as food is concerned. These beliefs have ignorantly posed adverse risk to particularly pregnant mothers and the child. The main objective of this study is to evaluate some of the food prohibitions and beliefs during pregnancy and their impact on anaemia for expectant mothers living in Isiolo County. The research employed an illustrative sampling research design. Isiolo County is subdivided into three sub-counties; that are Isiolo, Garbatulla and Merti. Therefore three clusters of the study population were created based on these particular sub-counties where cases of anaemia among maternal mothers has been reported to be very nationally. Reports from Kenya Demographic Health Survey of 2014 indicate that 4% of the population in Isiolo County is made up of expectant mothers. Numerically this number stands to be approximately 5733, which is used as study population in this research. From this population, a sample of 374 participants was drawn which was distributed among the three sub-counties. Both qualitative and quantitative data was gathered by trained research assistants SPSS version 23 statistical research was employed to analyze this particular information. Data presentation was in form of illustrative statistics. To determine the association between variables, correlation coefficients were employed. The qualitative data that was collected by focus group was analyzed by help of content analysis technique. The results that were obtained from this research established that there are high cases of anaemia in Isiolo County (68%). Various factors contributed to this scenario of high cases but the main causes was established to be ignorance among the community living in this region on this particular topic (r=0.68, f=56.56, p=0.00). The foods that were prohibited were mostly animal products that included; Fish, organ meat, chicken meat and chicken eggs. There was a positive relationship between food taboos and beliefs with prevalence of anaemia in pregnancy. We recommend the ministry of health and other stakeholders to formulate strategies that focus on lowering the anaemia prevalence in pregnancy, increasing pregnant women’s nutritional knowledge and demystifying the misconceptions about the food taboos.
Spousal Verbal Communication Patterns on Reproductive Tract Infections among Married Women in Kiambu County, Kenya
(Kenyatta University, 2021) Ndung’u, Gladys Wangui; Judy Mugo; Justus Ngatia
Reproductive tract infections (RTIS) adversely affect the reproductive health of both women and men. However, the consequences are widespread and devastating among women. Limited information is available about spousal communication on reproductive tract infections among women in Kenya. This study was designed to investigate factors influencing spousal verbal communication on reproductive tract infections, determine the level of knowledge of the common symptoms and treatment practices in spousal communication on RTIs and assess spousal verbal communication patterns on RTIs among married women in Thika Sub-County, Kenya. This study used a cross-section design. A total of eight reproductive health personnel participated as key informants. Using structured questionnaires, a simple random sampling was employed to collect data from 422 married women with RTIs and attending Thika Reproductive Health Unit. The findings from this study reported that the secondary level of education and urban residence were independent predictors of spousal communication among married women in Thika Sub-County, Kenya (p<0.001). The odd ratio of spousal communication in the tertiary level of education was 4.482 times greater than that of the primary level of education on RTIs. Besides, the odds ratio of spousal communication among respondents who resided in the urban areas was 2.816 times greater than those who resided in the rural areas on RTIs. The urban residence as well as the secondary and tertiary levels of education were also significant predictors of good spousal communication on RTIs (p<0.05). The women who knew the symptoms of RTIs were more likely to verbally discuss with their spouses than who had no knowledge on the same (57.7% vs. 35.5% p = <0.05). The respondents who used condoms were more likely to communicate with their partners on the symptoms of RTIs than those who did not (58.3% vs. 43.7%; p<0.05). Most of the respondents who sought treatment communicated with their partners on RTIs at 55.6% as opposed to those who never sought treatment at 38.9% (p<0.05). The highest proportion of women who abstained communicated with their partner compared to those who never abstained (60.3% vs. 45.3%; p<0.05). There was an association between spousal verbal communication patterns on RTIs, residence and level of education (p<0.05). In conclusion, tertiary education and urban residence were independent socio-demographic predictors of spousal communication on RTIs among married women in Thika Sub-County. Besides, there was an association between spousal communication on RTIs with knowledge, use of condoms, sex abstinence and seeking treatment. The residence and level of education were significantly associated with the spousal communication patterns on the RTIs. This study recommends fostering open and effective communication between spouses allows partners to voice out their concerns and worries about reproductive health issues. This ensures co-operation in seeking treatment and strategizing on preventive measures.

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