Department of Population and Reproductive Health

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Effect of post-discharge postnatal educational intervention on postnatal practices among lowincome primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment
(Medical Journal, 2024-05) Kamau, Immaculate Wambui; Keraka, Margaret Nyanchoka; Gitonga, Eliphas
Introduction: informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among lowincome primiparas. Methods: quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An intervieweradministered exit questionnaire applied after 6 weeks. Focus group discussions conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. Results: the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks newborn contact and six weeks contact for the dyad. Multi-pronged approaches appreciated. Conclusion: follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
Mortality and Associated Factors among Neonates Admitted at the Karatina Sub-County Hospital Newborn Unit, Nyeri
(East African Medical Journal, 2024-03) Sogoti, T. Y.; Audi, S. A.; Gibuswa, D. M.; Manyega, A. N.; Manoti, N. G.; Rwabukoba, M. J.; Ngugi, A. N.; Wairimu, I. C. W.; Nyamai, L.; Ongecha, F.; Kahiga, T.; Irungu, K.; Gitonga, E.
Background: Neonatal mortality is death within the first four weeks of life. The developing world accounts for 99% of these deaths. Sub-Saharan Africa and Kenya's Neonatal Mortality Rate (NMR) in 2022 was 26.7 deaths and 21 deaths per 1000 live births, respectively. There is need for more data locally and regionally on neonatal mortality. Aim: To determine the cases of mortality and associated factors at the hospital between January 1st, 2019, and December 31st, 2020. Methods: A cross-sectional analytical design using data abstraction forms for data collection was used. The study included 108 neonates. Data analysis was done using the SPSS software version 23. Descriptive statistics, measures of association (p-values and odds ratios), and logistical regression were used to compare variables. Results: The NMR at Karatina Sub-County Hospital (KSCH) Newborn Unit (NBU) was 78 deaths per 1000 neonates. Statistical significance was found between neonatal mortality and parity (p=0.025), gestational age at birth (p=0.039), 5th-minute Apgar score (p<0.0001), and need for resuscitation at birth (p<0.001). Respiratory distress (p=0.003) and respiratory distress syndrome (p=0.016) as morbidities during admission significantly correlated with neonatal mortality. Conclusion: There is a statistical significance between maternal and neonatal factors with neonatal mortality. The Ministry of Health, the Nyeri County Government, and clinicians should undertake measures to minimise these risk factors.
Health System-Related Factors that Influence Retention in Care among HIV Infected Pregnant Women in Narok County, Kenya
(IPRJB, 2024-04) Gakii, Jackline; Menza, Nelson; Maoga, Winfreda Nyamota
Purpose: The aim of the study was to establish the health system-related factors that influence retention in care among HIV infected pregnant women in Narok County, Kenya. Methodology: The study adopted a cross-sectional mixed method design. Purposive sampling method was used to sample the required sample size of 117 HIV infected pregnant women, the participants of the Focus Group Discussions (FGD) and Key Informant Interviews (KII). The study was carried out at Narok County Referral and all the sub-county hospitals in Narok County. A structured questionnaire was used to collect quantitative data. Focus group discussion and KII guides were used to collect qualitative data. Quantitative and qualitative data was analyzed using SPSS version 21 and Nvivo version 14 respectively. Chi square test and logistic regression analysis were used to determine the health system-related factors that influence retention in HIV care. Thematic content analysis was done for qualitative data. The mean age of participants was 30 years (SD=6.48). The study results generated were presented in bar graphs and tables for quantitative data. Results were presented as narrations and triangulated with qualitative data. Findings: This study established that health systemrelated factors (waiting time, health care workers services and ARV availability) influenced retention in care among HIV infected pregnant women. However, only ARV availability had a significant association with retention in care (P<0.001, OR=0.19). The multiple logistic regression was used to predict the influence of grouped variables. Overall, the model was a significant predictor of retention in care. Health system related factors was found to increase the likelihood of being retained in care (OR=5.14), though not significant predictors of retention in care (P<0.34). Unique Contribution to Theory, Practice and Policy: Health system-related factors particularly ARV drug stocks, healthcare workers staffing and timely access of services should be strengthened in order to avert stock outs, minimize waiting time and follow up patients who miss clinic appointments to increase retention among pregnant women in HIV care. Advocate for policy reforms aimed at addressing structural barriers to retention in care, including increased investment in healthcare infrastructure, workforce capacity building, and integration of HIV services within maternal and child health programs. By aligning policy initiatives with the unique needs of HIV-infected pregnant women, policymakers can foster an enabling environment for retention in care, ultimately contributing to the achievement of national and global HIV/AIDS targets.
A Case Study of Hospital Contraceptive Waste Management Practices in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State
(IJCMPH, 2024-01) Tyotswam, Yanmeer S.; Iseme, Rosebella A.; Makunyi, Eliphas G.
Background: Effective management of hospital waste is a critical component of a hospital’s infection control program and is central to occupational safety for healthcare workers. Thus, this study focused on the assessment of hospital contraceptive waste management practices at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka, Anambra state, Nigeria. Methods: A cross sectional analytical study was carried out among healthcare workers selected using multistage sampling technique in 6 categories of healthcare workers in COOUTH. Data was collected using a pre-tested semistructured interviewer-administered questionnaire and a World Health Organization (WHO) checklist and analyzed using statistical package for the social sciences (SPSS) version 22. Associations and correlations between variables were tested at the bivariate level using Chi-square and t-test. Results: A total of 86 healthcare workers were surveyed. The majority of the respondents were females, nurses with RN qualification. The mean knowledge score of the respondents was 94.8%. The attitude of healthcare workers towards segregation of hospital contraceptive waste at source point was 71% while the usage of gloves in handling hospital waste was 95.3%. The major factor affecting contraceptive waste management practices in the facility was the respondent’s cultural beliefs. The lack of funds to finance standard waste disposal methods was noted to be a significant barrier to optimum waste management practices. Conclusions: This study showed that despite the high level of knowledge of healthcare workers on hospital contraceptive waste management practice in COOUTH, the hospital contraceptive waste management practice is not functioning optimally in Anambra state. Hence, the need to reform the hospital waste management practice to achieve functional results.
Effect of post-discharge postnatal educational intervention on postnatal practices among lowincome primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment
(PAMJ, 2024-05) Kamau, Immaculate Wambui; Keraka, Margaret Nyanchoka; Gitonga, Eliphas
Introduction: informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among lowincome primiparas. Methods: quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An intervieweradministered exit questionnaire applied after 6 weeks. Focus group discussions conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. Results: the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks newborn contact and six weeks contact for the dyad. Multi-pronged approaches appreciated. Conclusion: follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
A randomized controlled study of the effects of targeted health education on uptake of contraceptives among women of reproductive age in Nnewi City, South-East Nigeria
(SAGE Open Medicine, 2024-02-15) Tyotswam, Yanmeer Simeone; Iseme, Rosebella Alungata; Makunyi, Eliphas Gitonga
Objective: There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18–49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi. Methods: Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, a randomized controlled trials design was adopted. A total of 275 women were randomly recruited and allocated into two groups—140 in intervention group and 135 in the control group. Data was collected by trained research assistants using a pretested structured interviewer-administered questionnaire and analyzed using Statistical Package for Social Sciences version 25. The level of significance was set at p < 0.05. Results: At baseline, the level of uptake of contraceptives was similar in both the control and the intervention group (control = 2.48 points; intervention = 2.55 points). Overall, there were no statistically discernible differences between the two groups at baseline. The level of awareness and knowledge on contraceptives as well as the uptake of contraceptives significantly increased in both groups at the end of the study period. A statistically significantly higher increase was noted in the intervention group when compared to the control in level of awareness (t = 3.235; p < 0.05) and uptake of contraceptives (t = 2.628; p < 0.05). Significant positive changes in perceptions of contraceptives were observed more among the intervention group when compared to the control. Logistic regression analysis showed uptake of contraceptives was significantly influenced by occupation, monthly income, source of information, time of first use of contraceptives, level of knowledge on contraceptives as well as the targeted educational intervention. Conclusion: The targeted health educational intervention had a significant and positive effect on the level of awareness and uptake of contraceptives, as displayed in the intervention group. A significant and positive change in perception of contraceptives was also noted among the intervention group in almost all the questions. Certain factors were found to significantly impact the uptake of contraceptives. There is a need for studies with longer follow-up to ascertain sustained impact of health education on uptake of contraceptives. Further studies should be carried out in the other facilities in Nnewi to ensure a better coverage and representation of the target population. Finally, related studies should be carried out among men.
Does Institutional Maternity Services Contribute to the Fear of Childbirth? A Focus Group Interview Study
(Elsevier B.V, 2021) Onchonga, David; Keraka, Margaret; MoghaddamHosseini, Vahideh; ´ Varnagy ´, Akos
Background: The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. Objectives: The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). Methods: This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks’ gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. Results: It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. Conclusion: The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.
Uptake of Modern Family Planning Methods among Women Receiving Spontaneous Post Abortion Care at Kuajok Hospital, South Sudan: A Cross-Sectional Study
(Medip Academy, 2022-08) Majok, Samuel Ajiek; Makuny, Eliphas Gitonga
ABSTRACT Background: Improving women’s health through modern family planning to spontaneous post abortion care is a key to prevent unwanted pregnancy immediately after miscarriage, world health organization indicates that spacing for six months period following miscarriage prevent earlier pregnancy. South Sudan ranks the lowest country with the prevalence rate of 5.5% nationwide. This study helped to uncover the factors contribute to the low uptake of modern family planning options among spontaneous post abortion patients in Kuajok hospital, provide evidence to ministry of health, policy makers and health care providers to improve modern family planning services. Methods: study adopted a descriptive cross-sectional designed and data was collected from spontaneous post abortion patients to determine the prevalence in the study area. Results: Urban and rural have difference choice of modern family planning a total of 38.4% (481) of post abortion women had sort care at the hospital in the past one year revealed that they preferred modern family planning over the other methods. With a total of 17.9% (224) women utilized pills to manage their family sizes, while injectable accounted for 8.6% (108) used of modern family planning among spontaneous post abortion women in that year. The study also noted that male condom was equally popular as a preferred among population at 11.9% (149). Female condoms and cervical diaphragm were unpopular and none patients used them. Conclusions: Ministry of health, policy makers to increase awareness on modern family planning to spontaneous post abortions patients.
Getting Ready for Community Practice: An EvidenceBased Preparation Course for Kenyan Practicum Students
(American Association of Family and Consumer Sciences, 2018-03) VanLeeuwen, Charlene A.; Kathuri-Ogola, Lucy; Weeks, Lori E.; Muriithi, Joan Kabaria
Practicums provide opportunities for students to connect theory with practice through experiential learning and hands-on work experience. While recommended for students in Kenya, there is little research on the practicum experience. This article describes evidence used to prepare students for practicum experiences. Interviews and focus groups (FGs) were conducted with three stakeholder groups in two phases. Findings informed the development of a practicum preparation course that covers topics including (i) becoming a reflective professional and/or practitioner; (ii) articulating practicum learning goals; (iii) mental preparation for demanding field-based situations; and (iv) developing confidence in interpersonal communication. Phase two evaluated the initial impact of the course through FGs and follow-up interviews
Relationship between the Type of Psychosocial Support Available in the Community and Psychosocial Well-Being of Children Affected by HIV And Aids in Kiambu County, Kenya
(IJSSIT, 2019-11) Ashioya, Damaris Shihundu; Kathuri-Ogola, Lucy; Waudo, Judith; Wawire, Koinange
Abstract: Children affected by HIV and AIDS (CAHA) are faced with psychological, social and economic challenges among others. HIV and AIDS has compounded the situation posing more suffering to children whose parents have died of the same. Children affected by HIV and AIDS have been supported in various ways by their extended families and many other organizations. While there are a number of programmes that address the material needs of CAHA, there is less emphasis in assisting these children cope with the distress associated with nursing or living with sick members of the family, witnessing deaths of their parents and suffering the consequences thereafter. The psychosocial well-being of CAHA may be affected because of illness and death of their parents, exploitation, stigma and separation from siblings as well as lack of adult support. The purpose of this study was to examine the relationship between psychosocial support and psychosocial well-being of children affected by HIV and AIDS. This was a cross-sectional survey targeting 3780 children between 10-17 years affected by HIV and AIDS living in foster families from registered CBOs in Kiambu County. Multi-stage cluster sampling was used to select 345 children aged 10-17 years. Key informant interview guides, questionnaires, observation checklist and child drawings were used to collect data. Both quantitative and qualitative data were organized and categorized for analysis. Chi-square and factor analysis were used to test the formulated hypotheses. Qualitative data was transcribed, coded and categorized into themes and words to allow for analysis and presentation. This study showed that there existed a significant relationship between the type of support available in the community and psychosocial well-being of children affected by HIV and AIDS (χ2=7.8207; df =6; p=0.012). This study concluded that there were established relationships between type of support available by the community and psychosocial well-being of children affected by HIV and AIDS. The study recommended that the community/faith based organizations can work together with governments to ensure psychosocial well-being of children affected by HIV and AIDS is addressed through implementation of support systems for children affected by HIV and AIDS while creating awareness and developing efficacious intervention programmes within affectionate environments
The Impact of Experiential Learning Overseas on Kenyan Women Farmers
(University of Georgia, 2023) Shileche, Anne; VanLeeuwen, Charlene; VanLeeuwen, John; Walton, Colleen; Kathuri-Ogola, Lucy
Abstract A multipartner agricultural and nutrition project was implemented in Kenya between 2015 and 2018. This study examined the impact of the international learning and research project on the emotional and civic engagement status of 43 Kenyan women farmers receiving agricultural and nutrition interventions, comparing this group to a control group. Some project women experienced higher emotional worthlessness in the short term but less worry in the long term in comparison to the control group women. Project women also had higher overall civic engagement levels after the 3-year project compared to the control group women. Our results demonstrate that experiential learning has advantages and disadvantages for overseas communities. For community benefits, research and learning projects should be a partnership with community members.
Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya
(eajhs.eanso.org, 2022) Ngige, Lucy W.; Ndayala, Phoebe D.
ABSTRACTThe purpose of the study was to determine whether socio-demographic characteristics of People Living with HIV and AIDS (PLWHA) predicted self-disclosure of HIV seropositivity status in Kenya. A survey was conducted among a random sample of 232 respondents in Nairobi County. Data was gathered through interviews and focus group discussions. The findings indicated that 28.0% of the respondents were male and 72.0% were female. The respondents were aware of their HIV seropositive status for at least one year prior to the study. About half of the respondents (50.9%) had disclosed their HIV seropositive status, while 49.1% had not disclosed. The binary logistic regression established that the socio-demographic predictors of HIV seropositive status disclosure were educational attainment (AOR =1.266; p = 0.001), regular employment status (AOR = 1.691; p = 0.001) perceptions of financial security (AOR = 2.440; p = 0.020) and knowledge of management of HIV (AOR = 3.505; p = 0.001). However, respondents’ sex (p = 0.162), age (p = 0.921) and marital status p = 0.621) were not statistically significant predictors of HIV seropositivity disclosure to sexual partners. This implies that public health programmes should focus on educational interventions, financial security, and training on the management protocols for People Living with HIV and AIDS in order to promote HIV seropositivity status disclosure to sexual partners.APACITATIONNgige, L. W.& Ndayala,P. D. (2022). Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya. East African Journal of Health and Science, 5(1), 73-83. https://doi.org/10.37284/eajhs.5.1.608.CHICAGOCITATIONNgige, Lucy W. & Phoebe D. Ndayala. 2022. “Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya.”. East African Journal of Health and Science5(1), 73-83. https://doi.org/10.37284/eajhs.5.1.608.
Outcomes of Livelihood Diversification among Agro-Pastoral Households in Laikipia County, Kenya
(jpid, 2021) Irungu, Martin Waithaka; Kabaria- Muriithi, Joan; Njue, Jane Rose
Abstract Purpose: The purpose aimed to investigate livelihood diversification strategies and livelihood outcomes among agro-pastoral households in Laikipia North Sub-county, Kenya. Methodology: The study adopted a cross sectional survey design where a sample of the population was selected, and from these individuals, data was collected to help answer the research questions. A total of 422 households were systematically sampled. Data were collected using two instruments; household interview guides and key informant interview guide. Data analysis was done using SPSS (version 20) computer software program. Frequency tables, pie charts and bar graphs are used to present the findings of the study. Descriptive statistics were presented using maximum, minimum, mean, percentage, and standard deviations. Significance correlation between descriptive variables was tested using Chi square test and Spearman correlation coefficient at 0.05 level of significance. Results: The findings of the study revealed that there was a response rate of 90.3% with more than half of the respondents being household heads. The average number of years the respondents had lived in the area was 43. The researcher sought livelihood strategies pursued in the past, presently and enumerated the reasons for disparity where it existed. Climate change was cited as a major cause of disparity at 40.7% followed by increased levels of education, changing land use and need to increase income and availability of market in that order. Assets (physical, financial and social) were found to have a significant influence on livelihoods outcomes. Challenges the respondents faced however was found to have no significant influence on the livelihood outcomes (χ=1.017, df =1, p=0.313). Finally, there was significant relationship between the adopted livelihood strategies and livelihood outcomes (χ2 =14.730, df =1, p=0.000, r=-0.197). Unique contribution to theory, practice and policy: The government should strengthen Cooperative Development and Trade and Industry to the ward level. Such efforts will enhance the formation and effective running of cooperative societies as well as equip local community members with skills of running profitable businesses.
University students as Outreach Youth Champions in Enhancement of Food Security: Challenges and Lessons from the Enhancing Community Food Security through Outreach Youth Champions (EFSOYC) Pilot Project
(PAC UNIVERSITY, 2021) Kathuri-Ogola, Lucy; Kabaria-Muriithi, Joan; Irungu, Martin; Muchiri, Stephen; Murathe, Stephen; VanLeeuwen, Charlene A.
Abstract - The Enhancing Community Food Security in Urban and Rural Areas through Outreach Youth Champions (EFSOYC) pilot project focused on promoting agri-social enterprise initiatives targeting highly food insecure farming households in Kenyan communities. In pursuit of Sustainable Development Goal (SDG) 2, the project sought to leverage the potential of youth, specifically university finalist students, as Outreach Youth Champions (OYCs), to drive food security efforts in their local communities through highly innovative and participatory initiatives. The pilot project deployed sixteen (16) competitively selected OYCs to urban and rural communities to promote sustainable activities along the agricultural value chain through training on effective agri-social enterprise practices, initiating agri-social-enterprises, and farmer saving groups/cooperatives, and championing value addition strategies. The 16 participating OYCs underwent three weeks of intense training in preparation for implementing agri-social enterprise in three Kenyan counties - two semi-arid areas and one urban area for seven months. Initiatives included; shade nets, sack vertical gardening, soil-less farming (hydroponics) as well as food storage and preservation projects, specifically solar cold rooms and food dryers. Approximately 187 households benefitted from the OYCs initiatives, which promoted innovative, sustainable food security practices, improved livelihoods, and capacity building through training. Implementation challenges were related to team formation, mobility in project sites, and community engagement. Lessons learned related to the strength in pairing the novice entrepreneurs, adaptability and resilience of youth, and the value of adopting a participatory approach throughout the project to enhance community engagement for project ownership and sustainability. Despite the challenges experienced in the pilot EFSOYC project, adoption and integration of the OYC model as a graduate transition pathway from institutions of higher learning to the labor market is a plausible option in Kenya and beyond
Factors Associated With Cohabitation among University Students in Nairobi, Kenya
(Universidad Nacional Aut{\'o}noma de M{\'e}xico, Instituto de Investigaciones Sociales, 2011) Muriithi, Joan Kabaria; Ngige, Lucy W; Mugenda, Olive M
Cohabitation is emerging as an important factor in mate-selection in many societies in Kenya. This study focused on cohabitation among university students in Nairobi. The objectives included: determining the prevalence of cohabitation and establishing the relationship between students’ attributes, family background and social factors and cohabitation. Methodology was guided by Brofenbrenner’s ecological model of human development. A survey of 176 students from one public university in Kenya was conducted. Results showed that the prevalence of cohabitation was 27.4%. The significant factors that influenced cohabitation included fathers’ occupation (p = 0.016), mothers’ occupation (p = 0.029), parents’ residence (p = 0.000), family income (p = 0.000) and peer influence (p = 0.000). However, the factors of students’ age and sex were not significantly related to cohabitation. Implications for family life education, reproductive health and strengthening of students’ guidance and counseling services were included.
Supervision Challenges Encountered During Kenyan University Students’ Practicum Attachment
(IISTE, 2015) Ogola, Lucy Kathuri; Vanleeuwen, Charlene; Muriithi, Joan Kabaria; Weeks, Lori E; Kieru, Jane; Ndayala, Phoebe
There is little published research that examines the supervision experience of field attachment supervisors in Kenya. In this study, we identify the challenges encountered by field supervisors during student field attachments with community organizations. Fifteen organizations that had hosted third year students from the Department of Community Resource Management and Extension (CRM&E) at Kenyatta University during their practicum attachment were sampled using purposive and convenience sampling. Data was collected using faceto-face key informant interviews with field supervisors (n=15). Data was analyzed using NVivo10 software for qualitative analysis. Thematic analysis resulted in the identification of key themes related to clarity of learning objectives for students and the supervision challenges encountered by field supervisors during practicum. Key findings indicate that the supervisors largely lacked a clear understanding of practicum expectations and the academic preparation of students in the Community Resource Management and Extension program. The main supervision challenge is largely on orienting students to community based field work so as to enable them link theory to practice. These results can be helpful for any academic program to improve the field attachment experience of university students and the community organizations hosting the students. A better understanding of the challenges that field supervisors’ encounter is fundamental to the enhancement of the practicum experience of university students since the requisite and appropriate support can be provided to the host organizations. Subsequently, the students will be more likely to optimize the intended benefits of the practicum as a result of the host organizations enhancing the quality of field-based learning.
Women Survivors’ Perceptions on Susceptibility Factors to Intimate Partner Violence
(Center for Promoting Ideas, USA, 2017) Joan, Kabaria Muriithi; Lucy, Ngige W; Elishiba, Kimani N
Intimate Partner Violence (IPV) is a form of gender based violence that has become rampant with women being most vulnerable. This paper analyzes the perceptions of women survivors on their susceptibility to IPV with regard to individual and cultural underpinnings. The paper is premised on a study conducted in two shelter homes in Nairobi and Nakuru, Kenya. By employing a survey design, 230 respondents participated. Data was collected through interviews, focus group discussions and document analysis. Quantitative analysis was done using Statistical Package for Social Sciences (SPSS) while the qualitative data was analyzed thematically. The paper observes that individual and cultural factors contribute to the perpetuation of IPV. The paper demonstrates higher levels of education of the woman and comparatively lower levels of education of the man as well as differences in economic ability as significant predisposing factors to IPV. The authors recommend that stakeholders need to re-think IPV and focus on dealing with the root cause – power plays at the cultural level.
A Psychosocial Intervention to Reduce Gender-Based Violence and Antepartum Depressive Symptoms in Pregnant Women in Kisumu County, Kenya: A Quasi-Experimental Study
(Pan African Medical Journal and African Field Epidemiology Network (AFENET), 2018) Mutisya, Redempta Kalekye; Ngure, Kenneth; Mwachari, Christina
Introduction: Gender-based violence during pregnancy and its associated adverse health effects are disproportionately higher in developing countries like Kenya where screening for and management of gender-based violence is currently not part of routine antenatal care. This study assessed the effect of a psychosocial intervention on gender-based violence and antepartum depressive symptoms in pregnant women. Methods: This quasi-experimental study compared gender-based violence and antepartum depression scores of 288 pregnant women in the two arms; one exposed to a psychosocial intervention and another receiving usual antenatal care. We used analysis of covariance to estimate the intervention effect and Chi-square to test the equality of proportions. Results: The difference between the psychosocial intervention and the usual antenatal care group in the total intimate partner violence and physical violence scores was a significant, with small effect sizes of partial eta = 0.196 and 0.305 respectively. The two arms did not differ in terms of the proportion of women reporting other acts of gender-based violence by intimate and non-intimate partners post-intervention. The intervention group had significantly lower mean depression scores compared to the usual care group, post-intervention, with a medium effect size of 0.500. Conclusion: This intervention aimed at reduction of gender-based violence and improvement of mental health of pregnant women is promising. Primary health care facilities in resource-constrained settings can take advantage of local capacity to deliver focused non-specialized psychosocial support to pregnant women experiencing violence.
A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease
(Hindawi, 2018) Iseme, Rosebella A; Mcevoy, Mark; Kelly, Brian; Agnew, Linda; Walker, Frederick R; Boyle, Michael; Attia, John
Bone loss is characteristic of the ageing process and a common complication of many autoimmune diseases. Research has highlighted a potential role of autoantibodies in pathologic bone loss. The confounding effects of immunomodulatory drugs make it difficult to establish the contribution of autoantibodies amongst autoimmune disease sufferers. We attempted to examine the relationship between autoantibodies and bone mass in a population of 2812 elderly participants without clinical autoimmune disease. Serum samples were assayed for a panel of autoantibodies (anti-nuclear, extractable nuclear antigen, antineutrophil cytoplasmic, thyroid peroxidase, tissue transglutaminase, anti-cardiolipin, rheumatoid factor, and cyclic citrullinated peptide). Bone mass was measured using quantitative ultrasound (QUS) of the calcaneus. The relationship between each autoantibody and bone mass was determined using linear regression models. Anti-nuclear autoantibodies were the most prevalent, positive in approximately 11%, and borderline in roughly 23% of our sample. They were also the only autoantibody observed to be significantly associated with QUS index in the univariate analysis (n = 1628; r = −0 20; 95% CI: −0.40–0.00; p = 0 046). However, statistical significance was lost after adjustment for various other potential confounders. None of the other autoantibodies was associated with QUS index in either univariate or multivariate analysis. We are limited by the cross-sectional nature of the study and the low prevalence of autoantibodies in our nonclinical sample.
Influence of Capital Structure on Sustainability of Community Water Projects
(2018) Solomon Muriungi Mburung’a
The purpose of this study was to investigate the influence of capital structure on sustainability of community water projects. The objective of the study was to investigate influence of capital structure (equity financing-community‟s contribution; debt financing; grant financing-donor funds; and water tariffs) on sustainability of community water projects. The study adopted a cross-sectional descriptive survey design and data was collected using questionnaires, interview schedules and observation schedules. Both descriptive and inferential statistics were used in analysis. The study established that, there was significant but moderately weak positive relationship between equity financing (community‟s contributions) and level of sustainability of community water projects. In addition, there was a weak negative relationship between grant financing and level of sustainability of community water projects. Hence, increase in grants reduces the levels of sustainability of a community water project. None of the projects utilized any debt finance such as loans in their capital structure. Finally, there was a significant moderate positive relationship between water user fee and sustainability of community water projects. The study recommends that, communities should give more of their own resources while donors should, either reduce or insist on refund for funds donated to improve sustainability of community water projects.

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