MST-Department of Environmental Health

Permanent URI for this collection

https://repository.ku.ac.ke/handle/123456789/5363

Browse

Recent Submissions

Now showing 1 - 20 of 50
  • Thumbnail Image
    Item
    Safety and Health Management in Selected Kenya Tea Development Agency Factories in Bomet County, Kenya
    (Kenyatta University, 2025-10) Kipkoech, Bett Hillary
    The objective of this research was to establish the safety and health risk management in Kenya Tea Development Agency Factories in Bomet County. The study used cross sectional analytical research design that allowed data collection at one point in time and involved photography, interviews, observation and measurements (air quality and noise) for data collection. The independent variables were classified under individual and system characteristics. Individual characteristics were the demographic variables while system characteristics were the hardware that make up a tea factory. The intervening variables were the system that make up safety and health management system and administration in the factory. The study was undertaken in Bomet County which has eight KTDA tea processing factories. The target population was employees in Tea Factories managed by KTDA. The study population was 1019 workers in tea factories in Bomet County with a sample size of 317 employees. Simple random sampling gave every worker a chance to be included in the study. The Yamane (1968) sample size determination formula was used in the study since the target population was less than 10,000 people. Authorization was obtained from Kenyatta University Graduate School and ethical clearance sought from Kenyatta University Ethical Review Committee while the research license was obtained from NACOSTI. Access to the KTDA Factories was granted by management through the managing director at the head office. Informed consent was sought from workers before participating in the study. Focus Group Discussion guide, interviewer administered questionnaires, noise meter and particulate counter were used for data collection. Data was summarized using descriptive statistics such as mean, frequencies and percentages. The inferential statistics; chi square and binary logistic regression model was used to test association between variables. Qualitative data was grouped according to emerging themes. Data was presented using charts and tables. The prevalence of occupational injuries in the tea factories was 41.3%. In the sampled factories and specific sections, Kapkoros Tea Factory and Withering sections recorded higher mean equivalent noise levels (91.4 dBA and 97.3dBA) above exposure limits (90.0dBA) stipulated under The Factories and Other Places of Work (Noise Prevention and Control) Rules, 2005 while both PM2.5 and PM10 levels in sampled factories were below OEL and generally high at the sorting section (0.34mg/m3 and 1.035 mg/m3) but within the exposure limits specified under The Factories and Other Places of Work (Hazardous Substances) Rules, 2007. The study established that provision of PPEs, workplace occupational audits, risks assessments, occupational trainings and occupational examination of workers were the mitigation strategies employed by the factories in safety and health risks management. Level of education (p=0.0001) and work experience (p=0.0001) were statistically significant socio-demographic characteristics and predicted safety and health risks management. The study recommends the employer to institute tests on the efficiency and adequacy of all safety risk mitigation strategies. The study findings can be used for policy formulation and institutionalize changes when managing OSH risks in Kenyan tea industry.
  • Thumbnail Image
    Item
    Menstrual Hygiene Management Practices among Adolescent Girls with Disabilities in Selected Primary Schools in Wajir County, Kenya
    (Kenyatta University, 2025-10) Jama, Abdiwahit Ahmed
    The beginning of menstruation is a significant occurrence to adolescent girls worldwide. Despite global sensitization on the importance of good Menstrual Hygiene Management (MHM), unhygienic practices and absence of an enabling environment persist. This can have adverse negative effects on adolescents, which are more profound for girls with disability due to their co-morbidities. The study aimed to assess MHM practices among adolescent girls with disabilities in selected primary schools in Wajir County. Specifically, it determined and investigated the influence of socio-demographic factors, attitudes, knowledge and institutional resources on MHM practices. A descriptive cross-sectional study design was employed, targeting all adolescent girls with disabilities from three purposively selected schools using census sampling. Data was collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using descriptive statistics and chi-square tests to determine associations between variables. Statistically significant variables were further analyzed using logistic regression to identify predictors of MHM practice. The required logistical and ethical considerations were adhered to. Results revealed that only 11.9% of respondents practiced good MHM. The socio-demographic characteristics significantly associated with MHMP were severity of disability (p*=0.016), caregiver (p*=0.001), Number of family members (p*=0.029) and Occupation of bread winner (p*=0.001). Nature of attitude (p*=0.029) and level of knowledge (p*=0.037) were also significantly associated with MHMP. In terms of institutional resources, provision of menstrual materials (p*=0.004) and availability of water in school (p*=0.005) showed significant associations. Logistic regression results identified severity of disability (AOR=8.000, p=0.001), caregiver (AOR=4.000, p=0.015), and number of family members (AOR=0.429, p=0.025) as key predictors of MHM. Attitudinal predictors included discomfort in class (AOR=2.428, p=0.002), menstruation-related shame and shock (AOR=5.247, p=0.001), and nature of attitude (AOR=0.160, p=0.016). Knowledge-related predictors included understanding menstruation as a normal experience for girls (AOR=7.417, p=0.001), menstruation as an indicator of reproductive maturity (AOR=6.800, p=0.045), and level of knowledge (AOR=4.206, p=0.028). Among institutional factors, only availability of water in school (AOR=0.085, p=0.021) was a significant predictor. The study concludes that MHM practices are very low among girls with disabilities, influenced by personal, social, and institutional factors. It recommends that stakeholders provide free sanitary products and build sufficient school washrooms to ensure privacy. Community education should address menstruation-related myths and stigma to improve attitudes. MHM education should be scaled up among girls with disabilities, while government and NGOs in the WASH sector should prioritize sustainable water access and support services.”
  • Thumbnail Image
    Item
    Association of Temperature Variations and Health of Workers in Cold Rooms at Jomo Kenyatta International Airport, in Nairobi Kenya
    (Kenyatta University, 2025-11) Bett, Cornelius K.
    This research sought to determine the connection between fluctuations in temperature and the resulting health effects experienced by staff working in the cold storage facilities at Jomo Kenyatta International Airport (JKIA) in Nairobi, Kenya The specific aims were to determine the most commonly reported health symptoms, assess the relationship between cold exposure frequency/duration and the severity of these symptoms, evaluate the use and effectiveness of protective measures, and explore existing workplace temperature monitoring and occupational safety practices. The JKIA complex in Embakasi and Nairobi County was the setting of this descriptive cross-sectional study which included ten cold-room operating companies. A selection of 293 employees was made through stratified random sampling. The collection of data was done through structured surveys, observation checklists, interviews, and temperature monitoring records, which provided both numerical and descriptive insights. The quantitative data was analyzed using SPSS version 23 and the results were presented in tables. The analysis comprised of descriptive statistics, Chi-square tests, and logistic regression analysis which were used to find out the factors that affect health outcomes. The research showed that among the subjects, 74.2% experienced respiratory symptoms like cough, wheeze, 68.3% had musculoskeletal problems such as pain in joints, stiffness and 53.3% had circulatory symptoms such as numbness and pain induced by cold. The association between the degree and the period of cold exposure and the severity of health issues was particularly strong among the workers, who were those exposed for more than 12 hours daily or for more than three years, where the odds of getting very severe respiratory symptoms were three times higher (OR = 3.62, 95% CI: 1.88-6.96, p < 0.001) and, similarly, for musculoskeletal pain (OR = 2.91, 95% CI: 1.55–5.45, p = 0.001). PPE usage was linked to a reduction in the prevalence of symptoms but only 47% of the workers said they did it all the time, and 28% said they had training. Thematic analysis of qualitative data was considered the main conclusion of the study as it confirmed the quantitative findings and pointed out the major deficiencies in workplace policies, among which were the absence of systematic temperature monitoring and inadequate enforcement of safety regulations in the workplace. The study clearly indicated a dose-response relationship between cold exposure and health problems and therefore it called for a strong safety policy, improved PPE provision, worker training, and the regular monitoring of both the environment and health of the workers. It is a study that has already contributed to the existing knowledge about the cold exposure risks at work and at the same time highlights the necessity of interventions such as those for protecting the health of workers in temperature-controlled areas.
  • Thumbnail Image
    Item
    Effect of Health Education on Costs of Treatment and Household´S Income among Tuberculosis Patients in Kenya: A Randomized Control Trial
    (PAMJ - One Health, 2022-04) Kimani, Humphrey Mbuti; Mwaniki, Elizabeth; Oguya, Francis; Warutere, Peterson
    introduction: directly observed therapy, shortcourse strategy for TB treatment, in combination with patient education has proved to be effective in reducing TB incident than the DOTS strategy alone. Although tuberculosis care for patients is free in Kenya, other expenses associated with the disease during treatment have been known to increase costs at the patient and household level. This study sought to determine effect of health education on costs to treatment and household´s income among tuberculosis patients in Kenya. Methods: the study was conducted between September 2019 and February 2020 in selected public health facilities in Kenya. A cluster randomized controlled trial preceded by crosssectional study was conducted among the TB patients. Four hundred and fifty (450) patients were recruited from the TB clinics by random sampling. Three hundred and seventy-three met eligibility criteria and were assigned into experimental and control groups by simple random sampling. Health education intervention was given to the experimental group and not in the control group. However, all the study patients (experimental and control) received the standard tuberculosis treatment. After six months of treatment the two groups were compared. Results: at the baseline, patients incurred almost similar total treatment costs (experimental (USD 16,071) and control (USD 16,543) groups but after the health education intervention, patients in the experimental group were found to have incurred less cost (USD 59,073) than those in the control group (USD 67,750). The difference was statistically significant (p=0.001). Conclusion: health education was found to impart knowledge to the patient contributing to reduced expenditure while seeking TB care
  • Thumbnail Image
    Item
    Sexual Violence Risks Associated with Shared Sanitation Facilities in Informal Settlements, Nairobi City County, Kenya
    (Kenyatta University, 2025-03) Mwangi, Michael Gaitho
    Sexual violence refers to acts of sexual abuse that include rape, sexual assault, unwanted touching, and sexual harassment that are committed against women and men without their consent. Understanding the context of sanitation-related sexual violence in countries that have inadequate sanitation infrastructure is significant because of the link between the shared sanitation facilities and the well-being of the people living in the informal settlements. Sanitation is a critical element in public health, and effectively considering gender while providing sustainable sanitation and hygiene services, may contribute to improved relationships and attitudes towards the vulnerable population in the community. There is a need for integrated and sustainable innovative strategies to respond to sanitation-related sexual violence. The study used a cross-sectional observational design to examine the sexual violence linked to shared sanitation facilities in the informal settlement of Jua Kali, in Nairobi County. The variables included sexual violence (dependent) and socio-demographic, sanitation-related, and perception factors (independent). A sample of 381 participants, drawn systematically from the population, provided quantitative data through self-administered questionnaires. Instrument validity and reliability were assured through expert review and a pilot test conducted in a neighboring settlement. For qualitative insights, key informant interviews and focus group discussions were conducted and analyzed thematically to identify recurring patterns and contextual factors associated with sexual violence. Data was processed using the Statistical Package for Social Sciences (SPSS) version 26.0, where cross-tabulations were used for analysis. Data was presented in graphical presentations for descriptive statistics. The emerging trends were presented in charts, graphs, and tables. A significant proportion of sanitation-related sexual violence was experienced by female respondents, with 90% of reported cases involving women, compared to 10% involving men. The majority of respondents who experienced sanitation-related sexual violence were Christians (78.4%), and were four times more likely to encounter such violence (OR = 3.641, 95% CI = 1.067-3.972, p = 0.0001). Most respondents, 67.2%, demonstrated willingness to question or challenge the perpetrator’s behaviour, while 15.2% had already done so. The study revealed that respondents who were 30-39 years, 40-49 years, and males were three, two, and one and a half times, respectively more likely to question the behavior of perpetrators. The results indicated significant associations between a number of factors and sanitation-related sexual violence. These factors included long distances (greater than 50 meters) (p=0.030, ꭓ2=5.471, df 1), shared sanitation facilities (p=0.0001, ꭓ2=43.747, df 1), safety at water points (p=0.0001, ꭓ2=11.782, df 1), lighting at sanitation facilities (p=0.001, ꭓ2=11.144, df 1), and non-central sanitation facilities (p=0.001, ꭓ2=12.700, df 1). Thus, it is important for the national and county governments, including the security agencies, to put in place preventive and prompt responses that address incidents of sexual violence related to shared sanitation in the informal settlements.
  • Thumbnail Image
    Item
    Visual Comfort of Public Boarding Secondary School Students in Nairobi City County, Kenya
    (Kenyatta University, 2025-03) Magero, Cynthia Vugudza
    Indoor light quality refers to brightness and quantity of illumination in enclosed areas. Technological advancements have enabled artificial and natural light integration in schools. Light quality impacts students’ visual comfort and health. Excessive or insufficient lighting may cause eye strain, light sensitivity, headaches, or musculoskeletal pain. Kenya lacks lighting standards for schools. International standards exist based on facility activities. This study assessed visual comfort among public boarding secondary school students in Nairobi City County, Kenya. Objectives included determining proportion of students reporting visual comfort or discomfort, examining associations between illumination levels and visual comfort, and establishing environmental factors associated with visual comfort. Cross-sectional analytical study design was used. 423 students were randomly sampled from 8 schools. Illumination was measured using a calibrated Benetech GM1010 light meter and compared to ISO/CIE standards. Students’ perceptions were collected through self-administered semi-structured questionnaires and analysed using SPSS. Descriptive analysis involved frequency calculations. Inferential analysis used chi-squares. Findings showed 15% of respondents experienced visual comfort during the day, 13.5% at night, and 12.7% in both. 83.3% experienced at least one visual discomfort symptom. 14 of 38 classrooms achieved recommended illumination at 7:30, 20 at 13:00, and 10 at 18:00. Illumination ranged from 56.71 to 1289.93 lux. There were statistically significant associations between visual comfort and gender (X2(1) = 11.805, p < .05); eye problem (X2(1) = 23.453, p < .05); blinds on windows (X2(1) = 3.982, p < .05); window count (X2(1) = 6.986, p < .05); whiteboard (X2(1) = 5.895, p < .05); and classroom orientation (X2(1) = 4.163, p < .05) during the day; and blinds on windows (X2(1) = 4.212, p < .05); whiteboard (X2(1) = 10.968, p < .05); and seating positions (X2(1) = 17.404, p < .05) at night. The study recommends improving indoor illumination to promote visual comfort in schools.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Utilization of Cervical Cancer Screening Services Among Women Living with HIV/AIDS in Machakos County, Kenya
    (Kenyatta University, 2024-11) Njage, Ruth Kanini
    Cervical cancer (CC) represents a significant health challenge globally, particularly in low- and middle-income countries (LMIC), where it ranks third in incidence and mortality. In Kenya, CC constitutes 20% of female cancer cases and accounts for 15% of cancer-related deaths annually. Women living with HIV/AIDS (WLWHIV) face a higher risk of developing cervical cancer, which adversely impacts their quality of life. Consequently, early screening for cervical cancer among WLWHIV is crucial for timely diagnosis and treatment. This study aimed to evaluate the utilization of cervical cancer screening services among WLWHIV in Machakos County, Kenya. It focused on several specific objectives: identifying socio-demographic factors, assessing knowledge and attitudes toward screening, and analyzing health system factors that influence screening utilization. The study involved 422 HIV-positive women aged 18 to 49 years attending the Comprehensive Care Clinic (CCC) at Machakos County hospitals. Researchers employed a systematic random sampling method, and data were analyzed using the R statistical program, particularly logistic regression to explore variable relationships. Out of 422 participants, 410 women (97%) completed the questionnaire, with an average age of 31.7 years. Screening uptake was notable, with 249 women (61%) having been screened for cervical cancer according to Ministry of Health (MOH) guidelines, while 161 women (39%) had not. Bivariate analysis revealed that age (OR=2.758, P=<0.001) and religion (OR=5.953, P=0.050) were socio-demographic factors linked to screening utilization. Additionally, knowledge and attitudes played a crucial role; women with adequate knowledge of cervical cancer screening had a significantly higher odds ratio (OR=10.210, P=<0.001), as did those who believed in the importance of early screening, even in the absence of symptoms (OR=19.317, P=<0.001). Health system factors also emerged as significant. For instance, WLWHIV motivated by health workers showed a higher likelihood of utilizing screening services (OR=19.317, P=<0.01), as did those who received health education about cervical cancer screening (OR=1.636, P=<0.039). In multivariable analysis, two factors retained a significant association with screening: having adequate knowledge about cervical cancer and its risks, along with the availability of screening services (AOR=3.67, P=<0.001), and the belief in the necessity of screening regardless of symptom presence (AOR=5.460, P=<0.001).In conclusion, the findings highlight that a notable 39% of WLWHIV in Machakos County are not compliant with MOH guidelines for cervical cancer screening. Key factors influencing screening utilization include adequate knowledge of the disease, perceived risks, and belief in the need for screening. To enhance screening rates among WLWHIV, it is essential for the Ministry of Health in Machakos County to implement targeted strategies that promote awareness and education about cervical cancer. Strengthening public health programs focused on WLWHIV can significantly improve knowledge and encourage adherence to recommended screening practices, thereby enhancing early detection and treatment outcomes.
  • Thumbnail Image
    Item
    Compliance with Tuberculosis Infection, Prevention and Control Guidelines among Healthcare Workers in Kibera, Nairobi City County, Kenya.
    (Kenyatta University, 2024-04) Wangari, Janeffer Muthoni
    Tuberculosis is one of the major occupational hazards recorded among healthcare workers, not just in Kenya but globally due to their consistent and routine exposure. This is especially true among the nurses and laboratory workers who are regarded as high-risk groups for both Latent Tuberculosis Infection (LTBI) as well as active TB, among the profession cadre. From the studies done within Kenya and globally, it has been proved that the risk of infection among Health Care Workers (HCWs) compared to the general population is three times more with poor implementation administrative control cited as the major cause according to World Health Organization (WHO). The study was aimed at producing baseline data that would be used to create awareness on existing morbidity within the community hence lead to prevention and control measure being put in place. This too shall contribute significantly to the Sustainable Development Goal (SDG) indicator of ‘End TB 2050’. The study sought to assess the compliance to TB IPC among HCWs in Kenyatta National Hospital and Mbagathi District Hospital. The study sample was 406 participants from KNH and Mbagathi hospitals. Out of the 406 questionnaires distributed, 98.0% (n=398) were completed, accurately filled and returned. A total of 36 nurses, 4 laboratory staff participated from Mbagathi with 328 nurses and 30 laboratory staff from KNH. Statistical Package for Social Sciences version 22.0 was used to analyze the descriptive statistics. Thematic analysis was employed to analyze qualitative data and triangulated with quantitative data either as narrations or direct quotes. The Chi-Square tests were done at 95% confidence interval and results with p-values of less than 0.05 (p<0.05) were considered significant. This helped identify the relationship between various variables. Moreover, Pearson’s correlation too was done to show the strength of the association. The study findings revealed that the socio-demographic factors that significantly influenced respondents’ compliance to the laid down TB IPC guidelines included the number of years worked (P=0.043) and salary received per month (P=0.003). Further, the HCWs generally had a high level of knowledge on TB with low score observed on TB prevention aspect. On compliance, the administrative aspect of control measure was noted as inadequate contrary to what was filled in the questionnaires. The study further revealed that those with a fair attitude were more likely to comply with TB IPC guidelines than their counterparts. Thus, knowledge and attitude levels were significantly associated with compliance to TB IPC guidelines (P=0.000). In conclusion, there is a dire need to offer continuous medical education to HCWs despite their tight schedules with an emphasis on TB prevention. Moreover, the hospitals managements should ensure that appropriate policies such as compensation policy, incentive program, TB screening and HIV/AIDS testing and treatment that is staff-friendly are formulated and implemented to boost the attitude of the HCWs.
  • Thumbnail Image
    Item
    Participation of Community Health Care Workers in Enhancing Long-Acting and Reversible Contraceptives in Married Women in Kilifi County, Kenya
    (Kenyatta University, 2024-06) Mbatah, Jared Adams
    Community health workers (CHWs) play a vital role in enhancing the utilization of long-acting and reversible contraceptives (LARCs). Since CHWs serve as trusted sources of information and support within their communities makes them instrumental in enhancing the utilization of LARCs among married women and contributing to improved maternal and reproductive health outcomes. Kenya faces significant challenges in ensuring widespread access to and utilization of LARCs among married women despite the proven benefits of these contraceptive methods in preventing unintended pregnancies and improving maternal and child health outcomes. The study assessed the participation of Community Health Workers (CHWs) in enhancing the utilization of long-acting and reversible contraceptives (LARCs) among married women in Kilifi County, Kenya. The study was guided by the following specific objectives; To determine the level of knowledge of CHWs in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To establish the health and community support systems available for the CHWs in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To evaluate the health and community systems barriers that hinder the participation of CHWs in in enhancing utilization of LARCs among married women in Kilifi County, Kenya; To investigate the resources available for CHWs that can enhance their participation in promoting utilization of LARCs among married women in Kilifi County, Kenya. The study was anchored on the Health Belief Model (HBM). A descriptive research design was adopted, employing both qualitative and quantitative data collection methods. Interviews, surveys, and focus group discussions were conducted with CHWs, healthcare providers, and community members to gather insights into their experiences, perceptions, and challenges related to LARC promotion. The study was conducted in selected Sub–County hospitals in Kilifi County. The study population was 246 CHWs working in Kilifi County. Study participants will be selected through purposive sampling. The study used structured questionnaires to collect quantitative data. The study also conducted focused group discussions and key informant interviews. Data collected was organized and entered into SPSS Version 24. This was then presented through tables, charts and narratives. Logistic regression was used to assess the levels of association. The strength of the association was measured using a 95% confidence level. The study findings revealed that level of knowledge of CHWs, community support systems, resources available for CHWs did enhance utilization of LARCs among married women in Kilifi County, Kenya. It was concluded that participation of CHWs enhanced utilization of LARCs among married women in Kilifi County, Kenya. Overall, the study findings underscored the importance of equipping CHWs with adequate knowledge, resources, and support to effectively promote LARC utilization among married women in Kilifi County. Addressing the identified barriers and implementing the recommendations can contribute to improving reproductive health outcomes and empowering women to make informed choices about their contraceptive needs.
  • Thumbnail Image
    Item
    Occupational Safety Culture in Devki Steel Mills Limited in Athi River, Machakos County, Kenya
    (Kenyatta University, 2023-01) Amol, Daniel Aluora
    Workers in Devki Steel Mills Limited are exposed to several hazards and as a result, an average of three workers go on sick leave monthly due to occupational incidents. The management sought to reduce these incidences using a leading indicator through Safety Culture. Determining the safety culture at Devki Steel Mills Limited was the main objective of this study. Independent variables considered were artefacts, espoused values and basic assumptions while the dependent variable was occupational safety culture. The study made use of an analytical cross sectional design. The study population was 800 permanent employees from which a sample of 260 respondents were selected through the stratified sampling technique. The study used an interviewer administered questionnaire and observation checklist to collect primary data. Key informant interviews were conducted to further elaborate on basic assumptions. Pre testing of the research tools was undertaken to ascertain that the tools were reliable and the resulting data was valid. The data was analysed through inferential statistics by aid of the SPSS version 24.0 software. Tables and charts were used to present the analysed data. This data was interpreted using a safety culture assessment tool provided by Worksafe New south Wales (NSW). The tool categorised an average score that lies between 0% and 49% as Poor, 50% and 74% as Average and above 75% as Good. Of the twenty five artefacts investigated, nineteen were observed. This resulted in a score of 76% which showed that the workplace made good use of safety artefacts. The study analysed the aspired values of the organisation using attributes of safe work procedures, Policies, Injury Management, Return to work and communication. With an average score of 42.9% the organisation scored poorly on upholding the aspired values. For Basic Assumptions, the study analysed attributes of Reporting Safety, Training, Supervision, Management Commitment and Safety prioritisation. The average score of these attributes was 39.3 % resulting in a poor rating for basic assumptions for safety in the organisation. The Pearson’s Correlation was used to deduce the factors that promoted safety culture. The results of the correlation were: management commitment to safety,51.2%, training and supervision, 49.8%, consultation of workers, 49.1% , reporting safety incidents, 45.1%, safe work procedures, 43.2% and injury management & return to work with a score of 38.9%. The study therefore concluded that: (i) the artefacts were installed for regulatory compliance, (ii) A lot of the stated values were not practiced as evidenced by the poor perception amongst respondents (iii) The study also concluded that workers' attitude towards safety in Devki Steel Mills Limited was improving but a lot more should be done in the areas of Induction, Training, Updating safe work procedures and increased resources allocated to safety programs. From the sum average of the first three objectives, the Worksafe NSW Tool ranked the organisation as having an Average safety culture with a mean score of 52.7%, (iv) From the Pearson’s correlation, the most important attribute in building a good safety culture was Management commitment to safety with injury management as the least important. The study recommends that: (i)the organisation incorporates care based artefacts in addition to the existing compliance based ones, (ii)Workers opinions on safety matters be sought through a clear communication channel between management and workers, (iii)the company should provide consistent training on workplace safety and raise awareness of the risk and dangers associated with the tasks performed and (iv) the management should be seen to promote safety through proactive measures as this will demonstrate to workers that the organisation is committed to their safety.
  • Thumbnail Image
    Item
    Uptake of Voluntary Medical Male Circumcison Services and Associated Pyschosocial and Knowledge Based Factors among Men in Turkana County, Kenya
    (Kenyatta University, 2024-04) Lokorio, Ekidor Ateyo
    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 rarely 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 socio-cultural variables, psychological aspects, social-economic variables, and knowledge-driven factors. Utilizing a researcher-administered survey, KII schedules, and a FGD guide, data was gathered. 434 males made up the sample size. 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. The study found that psychological factors, socio-cultural factors, socioeconomic factors, and information sources were significant predictors of embracing VMMC. Sociocultural factors were about 1.522 times more likely to increase uptake of VMMC (AOR= 1.522); p=0.034]. Psychological factors were predicted to increase uptake of VMMC by 1.544 (AOR= 1.554; p=0.028). Social economic factors were predicted to increase uptake of VMMC by 1.068 (AOR = 1.068; p=0.018). Information sources were predicted to increase uptake of VMMC by 1.622 (AOR= 1.622; P=0.013). Thus, this led to the rejection of all the research null hypothesis and the study concluded that socio-cultural, social-economic, psychosocial, and knowledge-based information sources have a positive and significant influence on uptake of VMMC in Turkana County. Additionally, this research recommends that the County Executive Committee members for Health services and sanitation in Turkana County should develop campaigns that respect and integrate local customs, traditions, and religious beliefs, emphasizing how VMMC aligns with these values. They should also train and mobilize peer educators who can relate to the community, sharing accurate information and subjective experiences to dispel myths and misconceptions. The study also advocates for additional educational programs at different educational levels in schools where tailored information about VMMC benefits and HIV/AIDS education will be made easily accessible and comprehensive to all groups of male students. Policymakers in the county government should also advocate for the local leadership to be adequately trained so that they can mobilize communities, sensitize, and educate them about behavioral change and the importance of VMMC.
  • Thumbnail Image
    Item
    Quality of Drinking Water from Masinga-Kitui Water Supply System in Kitui County, Kenya
    (Kenyatta University, 2023-06) Mulwa, Angeline N.; Akungah Daniel Nyagetiria; Jackim M. Nyamari
    Abstract
  • Thumbnail Image
    Item
    Pesticide Exposure among Farmers in Trans-Nzoia County, Kenya
    (kenyatta university, 2023) Oyaro, Bikwendo Kevin; Jackim M. Nyamari; Joseph Musau
    Kenya as a country relies on agriculture to sustain its economy. Agriculture contributes up to 33% GDP. The quality and quantity of agricultural produce is dependent on the use of different pest controlling mechanisms such as pesticides. The use of pesticides exposes farmers to health complications resulting from contact with chemicals through the application and handling. The main objective of this study was to determine pesticide exposure among farmers of Kwanza sub-county in Trans-Nzoia County. The specific objectives were; to determine the exposure rate of farmers to pesticides, to assess the level of knowledge, determine practice associated with handling pesticides, finding out the perceived health effects and determining the significant risk factors associated with pesticide exposure. To achieve its specific objectives, the study employed a cross-sectional study design. The study used purposive sampling to select participants from Kwanza subcounty and stratified random sampling was employed to pick the participants from within the four elective wards. The study involved 323 participants who filled semistructured questionnaires as a data collection tool. In addition to the use of semi- xi structured questionnaires, FGDs and observation checklist was also used to collect data. Data was analyzed using SPSS version 22. Confidence interval used to prove exposure proportion, likert scale and a chi square test of independence to determine levels of knowledge and practice, Odds Ratio was used to show the association among variables (Sociodemographics and pesticide exposure). Qualitative data was analyzed and presented thematically according to the study objectives. The proportion of farmers exposed was 61% which was within range of CI calculated (51.6% and 70.4%). The socio-demographic factors income (1.66), gender (2.26), age (1.38) and education (4.02) were found to be strongly associated with pesticide exposure due to their OR values being above 1 and chi square test for independence being below P<0.05. Knowledge and practice were below the P<0.05 indicating significance and showing good knowledge and practice that is above average. The study established that farmers in Kwanza sub-county in Trans-Nzoia County employed standard practices when handling pesticides. The Gastro intestinal Tract was found to be the primary medium of acute exposure to pesticides among the farmers. The study found out that farmers’ knowledge of pesticides increased with high education level and training. On practice, the study established that training offered and level of education of individuals is effective in reducing exposure. The study concluded that farmers of Kwanza sub-county in Trans-Nzoia County had basic knowledge on the best practices to handle pesticides but lacked the necessary finances to implement. Thus, it is recommended that farmers in Kwanza sub-county needed to explore financial platforms to help on financial constraints. Furthermore, emphasis on avoiding contamination to reduce the occurrences of acute toxicity while on the farm should be implemented via sanitation practices. Additionally, it’s also recommended that regular monitoring and evaluation of practices when handling pesticides should be done to further increase on the practices of pesticide handling.
  • Thumbnail Image
    Item
    Determinants of Dehydration among Children Under Five Years with Acute Diarrhea Attending Mbagathi Hospital in Nairobi City County, Kenya
    (Kenyatta University, 2023-11) Muriu, Mary Wanjeri; Judy Mugo; Redempta Mutisya
    Diarrhea in the developing countries is the second death causing infection among children below five years of age. Millions of these deaths are caused by dehydration which is the most frequent and dangerous complication of diarrhea. Identification of determinants of dehydration among under five years old would help in predicting the children with acute diarrhea who are likely to die due to dehydration. The aim of the study was to establish predictors of dehydration among under five years old seeking treatment for acute diarrhea at Mbagathi County hospital in Nairobi county, Kenya. The specific objectives were to determine the socio- demographic characteristics of primary care givers (PCGs) and child associated with dehydration in under five years old with acute diarrhea attending Mbagathi county hospital, to identify the social- cultural beliefs of PCGs which are associated with dehydration in under five years old with acute diarrhea attending Mbagathi county hospital, to establish whether there was an association between the PCGs level of knowledge in diarrhea management and dehydration in under five years old with acute diarrhea at Mbagathi county hospital and to determine whether there was an association between the prior actions taken by PCGs to manage the acute diarrhea at home and dehydration in children under five years at Mbagathi county hospital. The study applied a hospital based unmatched case- control analytical design with mixed method approach. Purposive sampling was used to select 110 cases and 110 controls who met the inclusion criteria at a ratio of 1:1. The study participants were interviewed using a structured questionnaire. The same sampling method was used to select PCGs to participate in focus group discussions (FGDs). Qualitative data was thematically analyzed by Nvivo software then transcribed and coded into themes. Quantitative data was analyzed using SPSS Version 25. A mixed effect logistic regression model was used to evaluate the association between the predictors of dehydration. The results of the logistics regression analysis are presented in terms of odd ratios (OR) and the corresponding 95% confidence intervals (CIs). The socio demographics characteristics of PCGs in cases and controls were almost similar in terms of proportion in both groups. The characteristics of child demographics were also almost similar in both groups. In univariate analysis the variables that were statistically significant at cut off p< 0.2 were then offered to the multivariable model. Findings from the adjusted multivariate model the variables that were statistically significant were highest level of education at p< 0.05 and initiation of zinc supplement at home immediately diarrhea started p<0.05. After adjusting for duration of diarrhea, results of the logistic regression showed that the variables median age of the PCGs at p<0.01 and initiating zinc supplement at home immediately diarrhea started at p< 0.02 were significant predictors of dehydration among children below five years. In conclusion there is risk of developing diarrhea- associated dehydration among children under five years with acute diarrhea attending Mbagathi hospital mainly in young mothers with low education and also due to delay in initiating zinc supplement when children develop diarrhea. Recommendation was that there is need for more focused health education on diarrhea management in young mothers and health promotion activities at the community level so as to sensitize the community and dispel myths and misconceptions on causes and management of diarrhea.
  • Thumbnail Image
    Item
    Compliance to Occupational Safety and Health Practices among Workers in Flower Farms in Embu County, Kenya
    (kenyatta university, 2023) Barongo, Bevalyne Gechemba; Peterson Njogu Warutere; Isaac K. Makau
    The Kenyan flower sector has experienced significant growth since the early 1980s. However, limited studies have been conducted on the provision of occupational safety and health services to employees in this industry. This study aimed to assess the compliance level with occupational safety and health practices among workers in flower farms in Embu County, Kenya. Specifically, the research evaluated risk identification and assessment practices, compliance with workers' health surveillance, and the awareness of safety and health among flower farm workers in Embu County. The study was guided by the Systems Theory of Accident Causation and Domino Theory. A descriptive cross-sectional research design was employed, isolating dependent and independent variables to determine the extent and frequency of their relationships. The study population consisted of employees working at Fides Kenya Ltd farm in Embu County. The sample size was calculated using the Slovin's formula based on the study population, and respondents were selected through stratified random sampling. Structured questionnaires, an observational checklist, focus group discussions (FGDs), and key informant interviews (KIIs) were used to collect quantitative and qualitative data. Statistical Package for the Social Sciences (SPSS) was utilized for data analysis, employing percentages, means, standard deviations, and Pearson's Product Moment Correlation to assess the influence of independent and dependent variables. The study revealed a strong, significant positive correlation between risk identification and assessment practices and compliance with a safe work environment (r=0.799, P=0.001<0.01). Additionally, the surveillance of workers' health showed a strong, significant positive influence on compliance with occupational safety and health practices in flower farms in Embu County (r=0.711, P=0.021<0.05). Moreover, the degree of awareness of safety and health exhibited a strong, significant positive correlation with compliance of occupational safety and health practices (r=0.721, P=0.037<0.05). In conclusion, the study found a high level of risk identification and assessment practices, contributing to improved compliance with occupational safety and health practices among workers in flower farms in Embu County, Kenya. Additionally, the existence of a health surveillance program was identified, preventing diseases and illnesses and further enhancing compliance with occupational safety and health practices among workers. The results also indicated a high level of employee awareness of safety and health, leading to improved compliance with occupational safety and health practices. Based on the findings, it is recommended that management in flower farms in Embu County should ensure the participation of all employees in the application and review of OSH risk identification and assessment practices in accordance with Section 6 of the OSHA 2007. Additionally, implementing periodic and post-employment medical examinations for all workers is advised to comply with the Medical Examination Rules 2005. Furthermore, flower farm management should provide training programs that address new risks, such as changes in machinery or materials, to ensure compliance with Section 99 of the OSHA 2007.The results of this study are essential and can be utilized by policy makers, the county government, and the national government to streamline OSH implementation within the flower industry
  • Thumbnail Image
    Item
    Cyanotoxins Exposure and Attributable Health Effects among Residents of Tharaka-Nithi County, Kenya
    (Kenyatta University, 2022) Wakhungu, Dickson Wekesa; Daniel Akunga; Peterson Warutere
    Access to safe domestic water remains a challenge in many rural community and water scarce areas. One key challenge is cyanotoxins in surface water that has been known to cause serious health effects among people using these sources. The main objective of the study was to determine health effects attributable to cyanotoxin exposure among residents of Tharaka-Nithi County. The study employed Analytical cross-sectional study design in which quantitative data was collected. Interview schedules were main subject ways of data collection from the household heads while water samples for cyanotoxins and physicochemical characteristics were subjected to laboratory analysis. Simple random sampling was used to select 6 water sources. Treated pipe water and residents using it were the control point. The number of households sampled was proportionate to the number of the households in the particular area which were subjected to systematic random sampling technique during data collection. Household heads or any other dependable adult present in the household at the time of interview and were willing to participate were illegible for participation. Those excluded in the study are those who met the inclusion criteria but were absent during the sampling or unwilling to participate. A household to start with was randomly picked and the calculated interval followed in a chosen direction until the required number of households was reached. Data was analyzed using SPSS version 21 and presented using tables and bar graphs. Majority (54.40%) of the respondents were of age 46 and above years. Majority (54.93%) of respondents had primary level of education. Majority (48.53%) of respondents earn less than KShs 10000 per month. Majority (36.59%) of the respondents with more than one disease symptoms related to cyanotoxins use water with high level of cyanotoxins (3.6μg/L). Two sources of water were found to have significant level of cyanotoxin (3.6μg/L and 2.3μg/L) above WHO recommended value (1μg/L). The physicochemical characteristics were found to be high in sources with detected cyanotoxins: -Total nitrogen (7.01mg/l); total phosphorous (2.16 mg/l); pH (9.8); turbidity (21.2 NTU) and temperature (27.6oC). Chi-square test showed that the level of income had significant influence on the selection of the water source while the age and level of education had no significant influence on selection of water source. Pearson correlation found that cyanotoxin levels in the water source influenced the disease symptoms related to cyanotoxins and physicochemical characteristics influenced the cyanotoxin levels in water source. The findings of this study exposed the situation on the ground on health effects related to cyanotoxins and cyanotoxins levels in water sources and hence a wake-up call to the Public Health Officer and other Sub-County authorities on safety of the water sources. It also alerts the residents on the level of cyanotoxins in water they use and effects of using such water sources.
  • Thumbnail Image
    Item
    Evaluation of Work-Related Health and Safety Risks Associated with Hairdressers in Nairobi City County, Kenya.
    (Kenyatta University, 2022) Chebet, Koskei Winnie; Peterson Warutere; Bernard B. O. Awuonda
    Hairdressers work towards changing or maintaining a person’s image. They are exposed to awkward posture, prolonged standing, long working hours and chemical hazards capable of causing adverse health effects. They are at high risk for safety and health risks which have not been well elucidated. This study sought to evaluate the safety and health risks associated with hairdressers. Specifically, it investigated whether salon designs, ergonomic risk factor and hairdressing tasks have impact on hairdressers’ health and safety. The study used descriptive cross-sectional and analytical design. Systematic random sampling was used to select salons and hairdressers. Closed and open-ended questionnaires were distributed to 286 hairdressers who consented to participate in the study. Observation checklist, WISHA caution checklist, thermometer, light meter and noise level meter were used to collect data in the sampled salon. To determine the impacts of salon deigns, ergonomic risk factors and hairdressing tasks on the health and safety of hairdresser, data were analyzed descriptively and with regression analysis. The findings indicate that the space in most salons in inadequate. The average space for salons is 7.22M² and that most (68.5%) hairdressers work for long hours (11-12 hours). It was also established that few salons (5.48%) have adequate amount of light and that 8.22% salons have high temperatures. Results also showed that aprons are the most used PPEs by hairdressers. It was revealed that manual handling of salon equipment and awkward posture cause musculoskeletal disorders among the hairdressers. Their odd ratios impacting health and safety of hairdressers were 2.706 and 2.728 respectively. All hairdressing tasks were done on awkward positions. The study revealed that hairdressing salon designs; space, affect the lighting and temperatures affect the health and safety of hairdressers. The hours off work and minimal or no breaks also have negative impacts on the health and safety of hairdressers. The study recommends the enforcement of the enacted legislation by the ministry of health and regular provision of hairdresser-based information on ergonomic risks to minimize the health and safety risks in the industry.
  • Thumbnail Image
    Item
    Utilization of Continuum of Care and Prevalence of Puerperal Sepsis among Postnatal Mothers in Kericho County, Kenya
    (Kenyatta University, 2022) Kipkirui, Beatrice Chelangat; Margaret Keraka; Josephat Nyagero
    Maternal and infant mortality is a critical issue that has been a herculean challenge to governments all over the world and especially in less developed nations. The continuum of care is reportedly one of the major strategies of addressing this challenge. This study sought to put into perspective the various factors that influence the continuum of care (COC) practices and how the said practices influence occurrence of puerperal sepsis among postnatal mothers. The specific objectives included to determine the prevalence of puerperal sepsis amongst PN mothers, to determine the utilization of COC amongst postnatal mothers, to determine the factors affecting utilization of COC; and to determine COC association with puerperal sepsis. Literature on the contributing factors, continuum of care practices and occurrence of puerperal sepsis was reviewed, critiqued and research gaps outlined. A cross-sectional research design and a mixed approach were adopted. Positivism paradigm guided the study. The study variables included maternal factors, and health facility-related and occurrence of puerperal sepsis. The study was conducted in Kericho County where participants were postnatal mothers and health care workers. A sample of 385 postnatal mothers and8 postnatal mothers was considered by the study. A structured questionnaire and focus group discussion guide were used as tools for data collection. The tools were pretested with the view of assessing their validity and reliability. The collected data were analyzed using the Statistical Package for Social Sciences tool. Descriptive and inferential statistics were used in the analysis. Pertinent logistical and ethical issues were considered. The findings indicated that in reference to adherence to the compliant of care practices, the mothers preferred to give birth at health facilities (95.2%). This notwithstanding, the completion of the continuum of care was not realized by the mothers in Kericho County. Although affordable, some mothers were deterred from seeking necessary continuum of care services from health facilities due to staff inadequacy and lengthy distance. The continuum of care practices was found to explain 83.1% variability in the occurrence of puerperal sepsis. It was also indicated that the effect of the continuum of care practices on occurrence of puerperal sepsis was statistically significant at p<0.001. The study concluded that the surveyed mothers did not complete the continuum of care since only a few attended ANC with majority opting to deliver at health facilities and attend PNC. Puerperal sepsis occurred while the mothers were at home not in the hospital. It is recommended that there ought to be more awareness on matters reproductive health in order to encourage more mothers to embrace the continuum of care practices through home visiting and postnatal follow ups by the healthcare providers.
  • Thumbnail Image
    Item
    School Hygiene Promotion Approaches and their Influence on Pupil’s Hygiene Practices in Public Primary Schools in Dagoretti, Nairobi City County, Kenya
    (Kenyatta University, 2021) Kathuni, Styvers Kirimi; Daniel Akunga; Esther Kitur; Sammy Letema
    Hygiene promotion in schools is an area of focus for public health practitioners in a bid to mitigate spread of water, sanitation and hygiene related diseases. There exist several hygiene promotion approaches that can be used in similar or different situations. Research indicates that selection and application of different approaches yields varied outcomes. The absence of clear guidelines on selection of hygiene promotion approaches, as is the case in Kenya, can lead to varied adoption of hygiene practices. The objective of this study was to examine the influence of hygiene promotion approaches on pupil’s hygiene practices. The study sought to establish the proportion of pupils practicing safe hygiene practices and the hygiene promotion approaches being employed by public primary schools in Dagoretti North and South Sub Counties in Nairobi City County. The study applied a descriptive cross-sectional design. Eligible schools in the study area had a population of 14,505 pupils and probability proportional to size was used to distribute the sampled 384 pupils across the schools. Questionnaires were administered to pupils with the aim of collecting data on hygiene knowledge and practices. Questionnaires were also used to collect data on selection of hygiene promotion approaches from 32 school health teachers. Pupil’s demographic data was collected from school head teachers. Five key informant interviews were conducted with Nairobi City County public health and education officers and a non-governmental organization staff. Observation checklists were used to triangulate information on hygiene practices by pupils. The data collected was entered and analyzed using Statistical Packages for Social Scientists to determine association and significant differences between variables through Chi-Square and Fisher’s exact tests. For comparison of quantitative variables, one-way analysis of variance test was used. Results indicate that 95.6% of the pupils practiced hand washing at critical times, 98.7% used the toilet while 85.4% safely disposed solid waste. The study reveals that water, sanitation and hygiene in school approach is implemented by 31.3% of the school health teachers. There is a significant relationship between school health clubs approach and hand washing at critical times (p=0.04) and proper solid waste disposal (p=0.02). One way analysis of variance established that there is a statistically significant difference among hygiene promotion approaches and pupils hygiene knowledge, F(5, 162) = 6.41, p <0.05 ƞ²p = 0.076. Majority of the school health teachers (62.5%) noted that the school’s management support to a particular approach was the major factor influencing selection of the approach. There is a significant relationship between selection of an approach due to the factor that non-governmental organization or government officers came with the approach and a combination of school health clubs, Water Sanitation and Hygiene in schools and No Strings approaches (p=0.02). The study concludes that different hygiene promotion approaches have potential to influence hygiene practices and in particular, hand washing at critical times and proper solid waste disposal amongst pupils in public primary schools in Dagoretti. The study recommends formation of school health clubs and involvement of school’s management in selection and implementation of hygiene promotion approaches.