RP-Department of Community Health

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Determinants of Cancer Prevention Behaviours among Farmers using Pesticides in Laikipia County, Kenya
(Reviewed International Journal of Medicine, Nursing & Public Health, 2024-10) Taiku, Anne W.; Onsongo, Lister; Elizabeth, Ambani
Cancer is the second leading cause of death worldwide with an average of nine million deaths per year. Available studies have shown a rise in cancer cases from exposure to environmental agents such as pesticides and fertilizers. Despite multiple studies on cancer, empirical evidence on the role of personal protection against exposure to pesticides is lacking especially in the local context. To provide local evidence of personal protection among famers this study sought to establish determinants of cancer preventative behaviors among rural farmers in Laikipia County, Kenya. The objectives of the study were to assess the personal protection practices among farmers, establish demographic characteristics associated with and personal protection practices, determine the association between knowledge and personal protection practices and establish the association between attitude and personal protection practices. A descriptive analytical cross-sectional survey was used in this study. The study targeted small-scale farmers. A sample of 196 farmers was selected using Slovins’ formula. The study employed simple random sampling to choose participants. The data was collected using a structured questionnaire that was administered by the researcher. The study instruments were pretested in Isiolo County, Kenya, for a preliminary evaluation. Data was analyzed using descriptive statistics such as frequencies and percentages. Chi-square tests were also carried out to determine the association between the variables. Logistic regression was also carried out to establish determinants of cancer preventative behaviors. Statistical Package for the Social Sciences version28wasused for analysis. The results showed that majority of the respondents 88.3% (n=173) had poor personal protection practices. Slightly above half 67.3% (n=132) of the respondents were knowledgeable on personal protection. In addition, majority of the respondents 75% (n=147) had a negative attitude towards personal protection. Chi-square analysis showed that age (p<0.01), level of education (p<0.01), land size (p<0.01) and crops grown (p<0.01) were statistically significant. Age (p < 0.001), level of education (p < 0.001), land size (p < 0.001) and attitude (p < 0.001) were predictors in the regression analysis. The study concluded that personal protection practices among farmers using pesticide are poor. Personal protection practices associated with demographic characteristics, knowledge and attitude. The researcher recommended that the county government of Laikipia ought to provide farmers with access to personal protective equipment. In addition, there is a need for targeted education and awareness campaigns to improve knowledge of personal protection practices among farmers.
Factors Influencing Adherence to Anti-Tuberculosis Treatment among Patients Attending Tuberculosis Clinics in Migori County, Kenya
(Journal of Medicine, Nursing & Public Health, 2023) Kerata, Babere Patrick; Gitahi, Mary W.; Iseme, Rosebella A.
Tuberculosis (TB), a disease caused by Mycobacterium tuberculosis, affected 10 million people and claimed the lives of 1.4 million people worldwide in 2018. Poor anti-TB treatment adherence has a number of negative consequences, including increased disease transmission. The incidence rate of tuberculosis in Nyatike sub-county is 209 per 100,000 people, compared to 155 in Migori County. As a result, the primary goal of the study was to identify factors that influence anti-TB treatment adherence among tuberculosis patients attending anti-tuberculosis clinics in Migori County, Kenya. The study employed an analytical cross-sectional study design, with the target population consisting of adult active TB patients (n=) on anti-TB treatment and health care providers (n=) involved in TB Comprehensive care clinic services. Questionnaires, focus group discussions, and key informant interviews were used to collect data, which was then analyzed using chi square and logistic regression techniques. The following factors were found to be associated with patient adherence in the study: HIV co infection (OR=1.152, 95% CI; 0.408,3.691; p=0.029), in which HIV positive patients were 1.152 more adherent than HIV negative participants; using other non-TB drugs (OR=0.418; P= 0.008, 95% CI; 0.157, 1.109), with pill burden being a barrier for adherence to ant-TB treatment; and lack of money to meet Adherence was also found to be influenced by knowledge (OR: 2.856; 95% CI: 1.282, 6.365), P= 0.01). Anti-TB treatment adherence was found to be associated with HIV co-infection, taking other drugs alongside anti-TB patients, and financial constraints. The study's implication is that various factors influence patient adherence to anti tuberculosis treatment.
Knowledge Level of Health Workers on Hand Hygiene, Aseptic Techniques, Isolation and Quarantine Services in Selected Health Facilities in Kiambu County, Kenya
(International Journal of Community Medicine and Public Health, 2022-11) Njuguna, Judy Wanjiku; King’ori, Isabell
Background: The objective of this article was to ascertain the knowledge level of health workers on hand hygiene, aseptic techniques, isolation and quarantine services in selected health facilities in Kiambu County. Methods: A descriptive cross-sectional research design was adopted in Kiambu County and Thika Sub-County was purposively selected. Stratified random sampling was used to draw a sample size of 261 study respondents. Both descriptive and inferential statistics were used to analyze the data. Results: Out of the 261 questionnaires administered, only 178 were accurately, appropriately filled and returned. Chi square was used to test the association between independent and dependent variables at 95% confidence interval. A p value of less than 0.05 (p<0.05) was considered statistically significant. The general knowledge of health workers on IPC was satisfactory with 135 (75.8%) having good knowledge. Knowledge was established to have statistically significant association with nosocomial prevalence (χ2 =49.45, df =2, p<0.001). Conclusions: It was concluded that majority of health workers had good knowledge on hand hygiene and aseptic techniques but in the contrary this was not the case with isolation and quarantine services. This could have been attributed to the fact that there were almost no trainings carried out on isolation and quarantine services and furthermore not all health facilities had the infrastructure for isolation and quarantine required to enforce those services.
Predictors of Cognitive Impairment in Patients with Substance Use Disorder in Kiambu County, Kenya
(2024-06) Mwihaki,Lawrence; Mwanzo,Isaac; Githae, Eunice
Cognitive impairments induced by substance use contribute to poorer treatment outcomes among patients with substance use disorder (SUD). Neuropsychological assessments are often neglected during patient evaluation in SUD treatment programs owing to the fact that they require extensive time for evaluation and are resource intensive. This inattention is likely to compromise comprehensive treatments which would offer better prognosis for such patients undergoing treatment for SUD. The main objective of this study was to determine predictors of neuro cognitive disorders (NCD) in patients with substance use disorders enrolled in rehabilitation centers in Kiambu County, Kenya. A cross-sectional design was adopted and data collected between Oct-23 to Jan 2024, covering a total of 250 patients aged 18-65 years that consented to participate in the study. Consecutive non-probability sampling technique was deployed in the recruitment of the respondents into the study. A self-rated questionnaire was developed for data collection whereas the Montreal Cognitive Assessment (MoCA) Tool was employed in the screening for cognitive impairment. The prevalence of cognitive impairment was 34.8% (Prevalence per primary substance showed alcohol=37%, cannabis=22%, and khat=22%). Age (Coefficient=0.0852, P=0.013 CI= 0.018- 0.152), education (Coefficient=0.0783, P<0.008 CI= 0.021-0.139), and anxiety disorder (Coefficient=0.4286, P<0.001 CI= 0.317-0.540) were found to be significantly associated with neurocognitive disorders at multivariate analysis. This shows that it is important to screen for cognitive impairments during early treatment stages considering the high prevalence rate. This will enhance the choice of treatment course and maximize on treatment outcomes
Effect of Health Education on the Knowledge of Pregnant Women on Iron and Folic Acid Supplements: A Stepped Wedge Cluster Randomized Trial
(Epidemiology & Public Health, 2024-04) Njiru, Haron; Gitah, Mary W.; Njogu, Eunice
Iron deficiency poses a significant public health challenge during pregnancy. However, optimal uptake of antenatal micronutrients is hampered by lack of knowledge. We investigated the effect of health education on knowledge of women regarding antenatal Iron and Folic Acid Supplements (IFAS). In a 9-month trial, antenatal care clinics received a maternal IFAS awareness package, which included education for both health workers and pregnant women and health Information Education and Communication (IEC) materials. The study found that IFAS knowledge improved from 44.8% to 81.1%, a 36-percentage point increase. To enhance IFAS knowledge, hence uptake, the study recommends targeted health education emphasizing IFAS benefits, management of IFAS side effects, along with providing standardized information materials to the clinics.
Prevalence and Socio-Demographic Factors Associated With Hypertension among Rural And Urban Population of Kisii County, Kenya
(IJCMPH, 2021-08) Ondieki, Alex O.; Kimani, Harun M.; Kahiga, Titus M.
Background: Hypertension (HTN) is a major cause of morbidity and mortality worldwide. 9.4 out of the 20 million cardiovascular deaths are due to HTN. HTN has often been described to be more prevalent in urban areas. However, there has been an epidemiologic transition from urban to rural areas which often go unreported or underreported. This gap therefore called for a study to compare the prevalence of HTN burden and assess how socio-demographic factors contribute to HTN development among the rural and urban population. Methods: This study methodology focused on HTN among residents aged 30-69 years, from urban and rural population of Nyaribari Chache sub county, Kisii County, Kenya using a descriptive cross sectional study in which 490 respondents were interviewed. Sampling involved a random sampling technique which entailed household selection. Data was analysed using statistical package for social scientists (SPSS) version 21. Results: The prevalence of HTN for the sampled population was 44.668%. The prevalence of HTN was 44.134% in rural and 43.598% in urban areas. Rural population were more at risk of developing HTN than urban (OR=1.135 and RR=1.072). On general health, those who had ever been told that they had hypertension (p<0.000), ever been told that they had hypertension for the past 12 months (p=0.000) and those who were currently taking hypertension medication (p=0.026) were statistically significant variables. Conclusions: The study concludes that residents in rural population have higher prevalence of hypertension. Further, female respondents, those who are currently married, completed primary school education and were self-employed reported to have a higher prevalence of hypertension.
Predictors of Under-Weight among Children Younger Than 24 Months in Nimule Border Town, Eastern Equatoria State, South Sudan: A Community-Based Cross Sectional Study
(BMC Public Health, 2024) Eriga, Francis; Gulom, Godfrey; Alege, John Bosco
Background Underweight is a public health problem globally, and more severe in South Sudan with wide subregional diferences. In Nimule border town, which represents other border towns in South Sudan, data on underweight among children below two years is unavailable. Thus, this study set out to assess predictors of underweight among children younger than 24 months in Nimule border town, Magwi County, Eastern Equatoria State, South Sudan. Methods An analytical cross-sectional study was conducted in Nimule boarder town targeting 390 children younger than two years. Systematic sampling and simple random sampling methods were used. Data were collected through a researcher-administered questionnaire with both open and closed ended questions. Data was entered in EpiData and then exported into Statistical Package for Social Sciences research (SPSS) version 20 for analysis. Descriptive data analysis was conducted and data were summarized into frequencies and percentages, means with standard deviations, and medians with interquartile ranges. Bivariate analysis was conducted with the Chisquared and Fisher’s exact tests for categorical independent variables, and the student’s t-test for numerical variables. Finally, multivariate analysis was done via logistic regression analysis and results were stated as odds ratios (OR) with corresponding 95% confdence interval (CI). The level of statistical signifcance was set at 5%. Results Out of the total 390 participants, 112 (28.7%) were under weight. The study showed primary (aOR, 0.38; 95% CI, 0.12–1.18; P=0.095) and secondary (aOR, 0.37; 95% CI, 0.12–1.17; P=0.091 levels of education were associated with underweight but not tertiary level of education (aOR, 0.76; 95% CI, 0.21–2.74; p=0.671). Household income of 5000 to 10,000 (aOR, 0.26; 95% CI, 0.10–0.68; P=0.006) and above 10,000 (aOR, 0.11; 95% CI, 0.04–0.28; P<0.001) South Sudanese pounds, supplementary feeding before 6 months (aOR; 0.01; 95% CI, 0.02–0.05; P<0.001) were associated with underweight and irregular hand washing (aOR; 2.17; 95% CI, 1.14–4.11; P=0.018) was associated with increased odds of underweight. Conclusions This study established a high prevalence of underweight. Maternal level of education particularly primary, secondary, higher household incomes in excess of 5,000 South Sudanese pounds reduced the risk of underweight. While irregular hand washing was a risk factor for underweight.
Patients’ Perspectives on Seclusion and Restraint Experience at Mathari National Teaching and Referral Hospital Nairobi City County, Kenya
(EdinBurg, 2024-05) Mwangi, Mary Wanjiru; Kabue, Priscilla; Masika, J.
Mental health research across the world has elicited various perspectives regarding the experiences of seclusion and restraint of mentally unwell, aggressive patients. Despite the need of understanding some of the determinants of seclusion and restraint of mentally ill patients, there has been limited publications particularly in the Kenyan context addressing the experiences of seclusion and restraint on social demographic characteristics of a mentally ill patient, patient, and Institutional factors leading to seclusion and restraint as well as exploring the experiences of the mentally ill patients undergoing seclusion and restraint at Mathari National Teaching and Referral Hospital. The present study therefore aimed to explore patients’ experiences with seclusion and restraint at MNTRH. A phenomenological research approach was adopted and qualitative data was gathered using an interview guide. The study targeted all the patients who had been nursed in seclusion and restraint during admission to (MNTRH) Nairobi City, Kenya. The results revealed that the seclusion procedure at MNTRH was not patient-friendly as they were forced to do it and not provided with the basic needs apart from medication. The interviewees also described two main themes relating to experiences of patients undergoing seclusion and restraint at MNTRH including desirable views of seclusion and restraints and undesirable views on seclusion and restraints experiences. The desirable view on seclusion experiences included that seclusion and restraint provided relief and a less stimulating environment in which they felt safe and secure. Patients were grateful for the constant support and supervision of healthcare providers. However, the undesirable experiences as mentioned by the respondents were that during seclusion and restraint, they experienced abandonment, mistreatment, and neglect. The study concludes that seclusion and restraint is a crucial but contentious treatment that should only be used as a last resort, and steps should be taken to guarantee that patients’ dignity is preserved throughout the seclusion and restraint procedure, as guided by the Mental Health Act 2016. The study recommends that MTRH have the seclusion sessions customized to each patient’s unique cognitive ability and mental condition.
Uptake of Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus Interventions among Infected Mothers Attending Health Facilities in Mombasa County, Kenya
(IJCMPH, 2024-04) Musyoka, Jacques Ngumbao; Okwara, Florence Nafula; Yonge, Shadrack
Background: The study was conducted in Mombasa County, Kenya, and aimed at the uptake of Prevention of Mother-to-Child Transmission interventions among HIV-infected mothers attending health facilities. A hospital-based cross-sectional study was used between May 2021 and October 2021, utilizing a self-administered structured questionnaire to collect data. The collected information was then analyzed using SPSS version 17 and STATA version 9.2. Methods: The study utilized a descriptive cross-sectional research design. Results: 84.8% of respondents exclusively breastfed their babies, and 77.3% received antiretroviral drugs (ARVs). Education level, being a housewife, and religion showed statistically significant associations with PMTCT service uptake (p<0.05). Additionally, 53.7% of participants demonstrated awareness of the importance of enrolling in PMTCT intervention services. The study highlighted high levels of knowledge among participants regarding PMTCT interventions, with 89.9% having correct knowledge of ARVs for children, 83.5% understanding the importance of counselling, 77.3% practicing modified infant feeding, and 85% acknowledging the necessity of delivering in a health facility. Knowledge of PMTCT components such as HIV counselling, ARV usage, facility-based delivery, and early diagnosis was significantly associated with the uptake of PMTCT interventions. Conclusions: Utilization of PMTCT services among postnatal HIV-positive mothers was high among postnatal HIVpositive women who embraced the PMTCT interventions. The respondents had average knowledge concerning PMTCT services. This study suggests supporting and encouraging related stakeholders to provide education about MTCT.
Determinants of Moral Distress among Healthcare Providers Working in Oncology Department, Kenyatta National Hospital, Nairobi City County, Kenya
(RJI, 2024-02) Mwenya, Morine N.; Githemo, Grace; Kodhiambo, Mourice; Pharm, M.
Background: This study discusses the prevalence, causes and interrelationships of the causal factors and the coping mechanisms of the HCPs to moral distress in oncology departments. The purpose of the study: A cross sectional study was conducted, using a proportionate stratified sampling method to take in the study sample representative and information was composed using a structured self- administered questionnaire. Descriptive analysis was done where frequencies and percentages were used to sum up grouped data while mean and standard deviation was used to summarize continuous data. Chi-square and Fischer’s exact test were used to investigate the factors associated with moral distress. Binary logistic regression was used to investigate the determinants of moral distress. Level of significance was investigated at 0.05. Statistical package for social sciences was used for analysis. Results: The findings showed that, 56.6%(n =82) of the respondents were male. In investigating age group of study participants, 40.7%(n =59) were aged between 41 and 50 years. Marital status showed that 59.3%(n =86) of the participants were married. In investigating moral distress, that 37.9% (n =55) had no moral distress, 49%(n =71) had mild moral distress while 13.1%(n =19) had severe moral distress. The findings showed that participants with degree, (AOR =0.33, 95%CI:0.14 – 0.85, p =0.001), higher diploma, (AOR =0.22, 95%CI:0.10 – 0.49, p <001) and those with master’s level education, (AOR =0.16, 95%CI:0.04 – 0.51, p =0.010) were less likely to experience moral distress as likened to those with diploma level qualification. Those who had ≤2 years duration of experience (AOR =2.50, 95%CI:1.91 – 6.41, p =0.005). Those who were neutral on assertion that patients’ relatives have unrealistic expectations about them (OR =0.24, 95%CI:0.09 – 0.76, p =0.015), Those who agreed with the statement that patients’ relatives have unrealistic expectations about (AOR =3.88, 95%CI:1.05 – 14.35, p =0.042 and those who disagreed with the statement that there is autonomy in decision making (AOR =4.15, 95%CI: 1.16 – 14.81, p =0.028) were determinants of moral distress. Conclusion and recommendations: The findings have showed that the burden of moral distress is high which warrants the need for healthcare providers to shape focus on their wellbeing. There is need to foster a culture of open communication where healthcare providers feel comfortable discussing moral distress and ethical challenges with colleagues, supervisors, and mentors.
Socio-Cultural Factors Influencing Medical Circumcision of Males Performed Voluntarily Uptake in Turkana County
(AJPO, 2024-01) Lokorio, Ekidor Ateyo; Mwanzo, Isaac; Ogweno, Gordon
Purpose: Kenya is amongst six high-burden nations in Africa grappling high HIV infections. Approximately 91.2% of Kenyan men have undergone circumcision. However, male circumcision is not traditionally practiced in Turkana community with male circumcision rates ranging from 5-10%. The study's sought to identify socio-cultural factors Influencing Medical Circumcision of Males Performed Voluntarily Uptake in Turkana County. Materials and Methods: Utilizing a researcher-administered survey, KII schedules, and a FGD guide, data was gathered. 434 males made up the sample size. An analytical cross-sectional methodology was used in the investigation. The data was analyzed with SPSS 22. Results showed that of 374 male participants in the study, 79.9% had undergone circumcision, 77.0% were aged 18-35 years, 94.1% were Christians, and 44.7% were unemployed while 54.8% were married. The overall mean scores of responses for socio-cultural factors, psychosocial factors, socio-economic factors, and information sources factors were 3.230 (neutral), 3.602 (positive), 2.894 (negative) and 3.48 (neutral), respectively. Findings: The study found that sociocultural factors was significant predictors of embracing VMMC. Sociocultural factors were about 0.30 times more likely to increase uptake of VMMC [OR=0.301; 95% CI: 0.081-0.52, P=0.007]. Conclusion: The study recommends that policies addressing main VMMC uptake amongst men in Turkana County should incorporate public participation, traditional leaders and local administrators for societal acceptance. There is need for effective sensitization and advocacy for behavioral change, mobilization and ownership of the initiative by the community. Policies should advocate for local leadership training.
Bacteriological Contamination Level of Foods and Water Sold With Escherichia Coli, Salmonella spp, Staphylococcus Aureus, Coliforms and Vibrio Cholera in Food Establishments in Nairobi City Kenya
(IPRJB, 2024-01) Kinyua, Peter Muriithi; Gicheru, Michael Muita; Mugo, Judy; Gitahi, Nduhiu
Purpose: Food borne illnesses are major health burden leading to high morbidity and mortality. It is a growing public health concerns worldwide resulting from food and water contaminated by pathogenic microorganism, toxins or chemical hazards. It is estimated that 10 to 20% of food borne illness are contracted from food establishments. The main aim was to determine bacteriological contamination levels of foods and water sold with Escherichia coli, Salmonella spp, Staphylococcus aureus, coliforms and Vibrio cholerae in food establishments in Embakasi South Nairobi City County Kenya. Methodology: The study design was descriptive analytical design. The Samples were collected in selected food establishments (Cafeteria, Hotels, Restaurants and food Kiosks) in Embakasi South Sub county Nairobi City County. The study collected 274 samples of food and water randomly sampled and collected using sterile food bags and water bottles within selected establishments and transported to the laboratory in cool boxes packed with ice packs. The samples were analyzed within 6 hours after collection. Microbiological analysis of food and water were borrowed from WHO and bacteriological analytical manual of foods to identify and isolate coliforms, Staphylococcus aureus, Vibrio cholera, Escherichia coli and Salmonella spp. Results: It was found that some foods and water sold and consumed in the selected food establishments was contaminated with food borne microorganisms. Escherichia coli isolated in 137 food samples were at 24.1%, Vibrio cholera at 23.4%, Staphylococcus aureus at 32.8%, and Salmonella spp at 4.4%. Total coliforms detected in 137 samples of water were at 43.8% where 32.8% of them were Escherichia coli. Unique Contribution to Theory, Practice and Policy: The study concluded there was high level of bacterial contamination of foods and water consumed in selected foods establishments. Nairobi City County health officers should enhance regular sampling of foods and water for microbial quality, health education on sources of food contamination at food eateries and establishments to prevent food and water contamination which later lead to food borne illness outbreak.
Relationship between Intake of Energy-Dense Diets and Nutritional Status of Adolescents in Primary Schools in Nairobi City County, Kenya
(AJOL, 2024-03) Muinga, Evelyne Ndunge; Waudo, Judith; Osur, Joachim O.
Background: Energy-dense diets are of low nutrient quality but high energy content and this may have adverse health outcomes, especially in adolescence where the body is transforming from childhood to adulthood. Intake of energy-dense diets is associated with various forms of malnutrition including obesity, overweight, underweight and other micronutrient deficiencies. There is however scanty information about the relationship between the intake of energy-dense foods and adolescents' nutritional status. Aims: This study aimed to establish the relationship between intake of energy-dense diets and the nutritional status of adolescents in Nairobi County. Subjects and Methods: The study was a cross-sectional descriptive research design involving quantitative techniques of data collection. A total of 161 adolescents, 87 females and 74 male aged 10-14 years participated in the study. Cluster sampling was used to select schools in Embakasi South Sub- County. Simple random sampling was used to select adolescents in classes 5, 6 and 7. Data were collected using structured questionnaires, 7-day food frequency questionnaires, and anthropometric measurements. Data analysis was done using; SPSS version 23.0 (quantitative data), ENA for SMART (anthropometric data), Nutrisurvey software (Dietary data) and hypothesis testing (Pearson correlation). Results: The study established a burden of malnutrition among adolescents in Nairobi County (13%) underweight, (5.7%) overweight, (4.3%) severely underweight, and (2.5%) obese. The energy-dense foods which were found to have significant relationship with the nutritional status of the adolescents were: potato chips (r = 0.044, p = 0.045), doughnuts (r = -0.02, p = <0.001), pancakes (r = -0.001, p = 0.762), bhajia (r = -0.014, p = 0.897), cheese (r = -0.107, p-value = 0.660), and Regular soft drink (r = -0.147, p= 0.101. Conclusion: The nutritional status of the adolescents was influenced by the intake of some energy-dense diets and sociodemographic characteristics.
Socio-Demographic Factors Associated with the Uptake of Community Led Total Sanitation: An Empirical Study among the Residents of Isiolo County, Kenya
(EANSO, 2024-12) Bagaja, Osman Mahad; King’ori, Isabella; Ireri, Anthony
Despite Kenya aiming to achieve 100% ODF status by 2030 and adopting CLTS, about 5.6 million (14%) of the population practice OD. Thus, this study was guided by the research question: What is the level of uptake of community led total sanitation among residents of Isiolo County? The study used a descriptive cross-sectional methodology and conducted among residents of Isiolo Sub-County, Kenya. The study sampled 373 household heads from population of about 21,870 household heads for the study. Systematic random sampling was used to select the participants. An inclusion and exclusion criteria-based period lived in the county and consent to participate in the study were used. Data collection instruments entailed structured questionnaires for households’ heads, key informant interview (KII) guides for opinion leaders, and an observation checklist. The content validity of the tools was assessed by expert from the department of Environmental Health at Kenyatta University. The tools were piloted in Longopito Sub-location with 37 households. Reliability of the tools was assessed using the piloted data through the testretest technique. The paired data sets were correlated, giving R=0.75. The study found an association between demographic factors and the uptake of CLTS in Isiolo county. The uptake of CLTS was found to be low with almost half of the sampled residents lacking latrines. The study concludes there were a number of demographic factors that were significantly associated with the utilization of CLTS including the highest level of education (χ2=66.866, p = 0.001), Occupation (χ2=12.690, p = 0.002), Average monthly family income (KShs) (χ2=43.373, p = 0.012) and number of household members (χ2=6.948, p = 0.044). The study also found that Isiolo County had a low uptake rate for community-led total sanitation. Only three out of ten households in the county uptake CLTS. The study recommends that the County Government of Isiolo should scale up health education programs on community led total sanitation.
Psychological Morbidity among Post-Partum Adolescent Mothers Attending Pumwani Maternity Hospital Nairobi County, Kenya
(IJRESM, 2024) Ireri, Grace
In the recent past, adolescent pregnancy has been on the rise. Estimations indicate that, globally, teenage girls who give birth annually are roughly sixteen million. In countries with few resources, it becomes challenging. Mental health has found a greater concern related to reproductive and sexual health; however, depression-related information in Kenya is limited. This means that more studies on psychological morbidity among teenage mothers are an important area of inquiry. A number of studies from developed countries show a rise in teenage pregnancy and the health consequences to both the teenage mother and the baby, such as anemia, preterm labour, obstructed labour, retardation in intrauterine growth, increased post-partum hemorrhage risk, eclampsia, cephalic pelvic disproportion, sepsis, neonatal death, genital fistula, and the risk of death which contribute to psychological morbidity. The study aimed at assessing predictors of psychological morbidity among postpartum teenage mothers at Pumwani maternity hospital. Descriptive correlation design was the study design whereby 74 postnatal mothers aged between 10 and 19 years who had been admitted in the postnatal wards at Pumwani maternity hospital were recruited through a convenient sampling method. The study used interviewer-administered and self-administered questionnaires in collecting data from those who could read and understand and those who could not read and understand, respectively. SPSS Version 25 was used in verification, coding, and analysis of data. Findings showed that, 51.3% (n =38) were aged between 16 and 18 years, 56.8% (n=42) were single, 60.8% (n=45) had secondary level education with only 12.2% (n=9) had accomplished their education in their respective levels. Out of 74 post-partum adolescent mothers in maternity at Pumwani Hospital, 86.5% (n=64) had psychological morbidity 95% CI: 76.6% - 93.3%. The multivariable analysis established that aged less than 18 years (AOR=11.41, 95% CI:3.08 – 26.23, p=0.004), those who were single (AOR=3.33, 95% CI:1.51 – 21.87, p=0.031) were more likely to have postpartum depression while those who had received care as they wanted were 94% less likely to have depression compared to those who did not receive the care they wanted, (AOR =0.06, 95% CI: 0.01 – 0.67, p=0.022. The prevalence of psychological morbidity is high with age (<18years) and completing highest level of education being significant determinants. Thus, healthcare providers should regularly screen new mothers for depression to help control the burden of psychological morbidity.
Maternal Factors Associated with Dietary Diversity Scores of Children aged 6-23 Months in Kwale County, Kenya
(eahealth. org, 2023-08) Chepkirui, Francesca; Osero, Justus; Nyandieka, Lilian; Hitachi, Mami; Kaneko, Satoshi; Wekesa, Norah; Changoma, Juma; Wanjihia, Violet
ABSTRACT Background: Dietary Diversity (DD) is an important component of Infant and Young Child Nutrition (IYCN). Globally, it is recommended that children aged 6-23 months be fed on diverse diets as a public health measure in curbing malnutrition. In Kenya, stunting rates among children below the age of five years is 26% and diversifying of diets is still sub-optimal. The study sought to assess maternal factors associated with dietary diversity scores among children aged 6-23 months in Kwale County, where stunting stands at 29%. Methods: A cross sectional study design was adopted and a random sample of 244 mothers with children aged 6-23 months, residing in locations under Health and Demographic System Surveillance (HDSS) program participated in the study. Results: Mothers aged 17- 68 years were interviewed. Children’s DD scores ranged from 0 to 5 with a mean of 2.2±0.9, only 8.2% of the children met the Minimum Dietary Diversity score (MDDs) of 4 food groups or more in a day. A bivariate regression analysis to determine factors associated with children’s dietary diversity scores showed significant positive relationship with mother’s educational level (r=0.186, P<.000, α=.01), household wealth index (r=0.163, P<.000, α=.01) and the child’s age (r=0.396, P<.004, α=.01). Conclusion: The study concludes that mothers’ level of education, households’ wealth index and child’s age are factors associated with dietary diversity scores of children. Higher dietary diverse scores were observed among older children in the study age categories, from wealthy families and under care of mothers with higher education levels. In the study area however, only 8.2% of children met the minimum dietary diversity score necessitating targeted nutrition education of mothers and implementation of economic development initiatives to boost availability and consumption of diverse diets. A consideration of child age specific interventions will also address nutritional needs and preferences at different stages.
Psychosocial Factors Influencing Medical Circumcision of Males Performed Voluntarily Uptake in Turkana County
(IPRJB, 2023) Lokorio, Ekidor Ateyo; Mwanzo, Isaac; . Ogweno, Gordon
Purpose: Kenya is amongst six high-burden nations in Africa grappling high HIV infections. Approximately 91.2% of Kenyan men have undergone circumcision. However, male circumcision is not traditionally practiced in Turkana community with male circumcision rates ranging from 5-10%. The study's goals were to identify the influences on consensual medical male circumcision acceptance in Turkana County caused by psychological aspects. Methodology: The cross-sectional study was carried out in Loima, Turkana central and Turkana North subcounties between November 2021 to January 2022 with sample size of 434 adult men. Data was collected using both quantitative and qualitative tools. The researcher-administered survey, KII schedules, and a FGD guide. The Statistical Package for the Social Science (SPSS) version 22 was used to analyze quantitative data, whereas qualitative data was analyzed thematically. The results were interpreted at 5% level of significance. Findings: Results showed that of 374 male participants in the study, 79.9% had undergone circumcision, 77.0% were aged 18-35 years, 94.1% were Christians, and 44.7% were unemployed while 54.8% were married. The overall mean scores of responses for psychosocial factors, psychosocial factors was 3.602 (positive). Psychological factors were predicted to increase uptake of VMMC by 0.99 [OR = 0.986; 95% CI: 0.745-1.228, P=0.000]. Unique Contribution to Theory, Practice and Policy: The study recommends that policies addressing main VMMC uptake amongst men in Turkana County should incorporate public participation, traditional leaders and local administrators for societal acceptance. There is need for effective sensitization and advocacy for behavioral change, mobilization and ownership of the initiative by the community.
Predictors of Unsafe Abortion among Women Seeking Postabortion Care at the Nakuru County Referral Hospital, Nakuru County Kenya
(IAJHMN, 2023) Nyakambi, Samuel Nyachwaya; Mwanzo, Isaac; Osur, Joachim
Unsafe abortion is common all over the world but is more prevalent in developing countries especially Africa. Kenya is one of the developing countries, where unsafe abortion is a common occurrence and it significantly contributes to maternal mortality in the country. Even when it has not been properly quantified in sub-Saharan Africa, studies in Kenya show that for many years’ unsafe abortion has caused many maternal deaths. Nakuru County is the fourth in the country on maternal mortality. In the referral hospitals there has been increased admission due to induced abortions many of them unsafe. The main objective of this study was to establish the predictors of unsafe abortion among women in Nakuru County. The specific objectives sought to establish if demographic factors influence the choice for unsafe abortion, to determine the extent to which women’s knowledge on reproductive health affect the choice of unsafe abortion and to determine how socio-cultural factors influence women’s choice for unsafe abortion in Nakuru County. The study was conducted at the Nakuru County referral hospital among women seeking post-abortion care (PAC) services. The study employed a mixed method design comprising cross-sectional survey, focus group discussions and key informant interviews. The sample size of the respondents was one hundred and Eighteen (118) selected to fill questionnaires using systematic sampling from the admission and out-patient registers. In addition, twelve community healthcare workers (CHVs) were selected for a Focus Group Discussion using simple random sampling. The study used purposive sampling to select four healthcare workers who work at the Post- Abortion Care units of Nakuru County Referral Hospital for interviews. Trained healthcare professionals were recruited as research assistants, who after training administered the semi-structured questionnaire and conducted the focus group discussion. The researcher conducted the key informant interviews. The data was then cleaned, coded, entered and analyzed using statistical package for social scientists (SPSS) version 25. The study found that age group, marital status, education level and monthly income influenced the choice of unsafe abortion among women in Nakuru County. However, it was found that religion, ethnicity, livelihood and residence of the women do not influence the choice of unsafe abortion among women in Nakuru County. The study found that Reproductive Health knowledge had statistically significant effect on unsafe abortion as evidenced by a t-statistic of 9.423 and p<0.905. The study established that socio- cultural factors do not affect the choice of unsafe abortion among women in Nakuru County. This is evidenced by t=6.258 and p<0.05. The study recommends legal measures are taken against healthcare workers both in public and private health facing helping young girls to procure abortion unless it is to save their lives. The study recommends use of provision measures that deter pregnancy even in the use family planning products, educating young girls and women on risk of abortions and encouraging girls to keep their pregnancy to full term. Health education is encouraged in the community as well as in schools by all health care workers on use of family planning is also recommended. The findings of this study may be used to develop policies & design program interventions to alleviate the problem of unsafe abortion.
Uptake of Electronic Medical Record System by Health Workers in Selected Public Hospitals in Kiambu County, Kenya
(EANSO, 2023) Ndemi, Caroline Kabura; Otieno, George O.; Rucha, Kenneth
Electronic Medical Records (EMRs) are now exerting a more significant impact on healthcare industry than before. The objective of this study was to find out how public hospitals in Kiambu County were providing health care services using the health information technology. A simple random sampling technique was employed to select 359 participants who met the inclusion criteria out of the entire population of health workers in Kiambu county public facilities. Data was collected using structured and semi structured questionnaires. The study found that majority of respondents were using EMRs during the time of the study. Most of the respondents with internet connectivity utilized the EMRS. Further analysis showed that internet connectivity was 5.3 times more likely to utilize EMRS. The study found that most respondents aged between 40-44 years were utilizing EMRS followed by 30-34 years and 20-24 years. Additionally, more male healthcare workers were utilizing EMRS. Healthcare workers’ who perceived patients' information as secure while using electronic medical record system were more likely to utilize EMRS. Although most healthcare workers disagreed that EMRS takes less time retrieving patient information, the respondents who indicated that the speed in retrieving patient's information was very good were three times more likely to utilize electronic medical record system. Hospital having a power backup system in place or not did not influence the overall uptake of EMRS. The study revealed that at least 89.6% of the healthcare workers utilizing EMRS disagreed that they had adequate knowledge and skills on EMRS operation, this was not significantly associated with uptake of EMRS. In conclusion, most health facilities in Kiambu County are utilizing EMRs with the Ministry of Health at the national and county government required to facilitate continuous training for health workers to promote EMR uptake.
Uptake of Indoor Residual Spray as a Malaria Vector Control Strategy among the Residents in Migori County, Kenya
(IJCMPH, 2023-10) Odira, John; Gitahi, Mary W.; Orago, Alloys S. S.
Background: Globally unexpected 219 million malaria cases occurred in 2021, with 90% of these cases happening in the WHO Africa region and unexpected 435,000 malaria transmissions worldwide, with children less than five years being the most-at-risk (61%) of malaria infections (World Malaria Report, 2021). In 2019, IRS coverage was 94.6%. This was reason enough to assess contributing factors leading to not reaching targeted 100% of the households mapped despite massive resources. Methods: The study adopted analytical cross-sectional design. The study area was Migori County (Awendo, Uriri, Rongo, Suna East, Suna West and Nyatike sub counties) where IRS had been implemented in four sessions. The study period November 2021 to April 2022. The respondents sample size was determined using Cochran (1963) for a single population of 1,000 households. The respondents were randomly selected villages from purposively selected Migori County. Kenyatta University Ethics Review Committee and NACOSTI provided ethical clearance. Quantitative data analyzed using SPSS version 2.6 and thematically for qualitative data. A Chi-squared test used to compute statistically significant differences between independent variables at p value <0.05. Results: Some 249 (90%) of the respondents confirmed their houses were IRS- covered while 32 (10%) of the houses were not sprayed because they were not informed in advance (p value <0.000). Conclusions: Using the Chi-squared test of significance the spray operators` arrival time for IRS activities affected the respondents daily calendar of events significantly (p=0.013, <0.05) resulting into respondents’ non-participation and unmet targets.

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