School of Medicine and Health Sciences

Understanding The Socio-Economic Determinants of Family Planning Service Utilization Among Women of Reproductive Age In Eldas Sub-County: A Mixed-Methods Study

Sat, 01 Jun 2024 00:00:00 GMT

Understanding The Socio-Economic Determinants of Family Planning Service Utilization Among Women of Reproductive Age In Eldas Sub-County: A Mixed-Methods Study Mohamed, Sulekha; M’mayi, Consolata; Nyavanga, Eunice This study investigates the socio-economic factors influencing the utilization of family planning (FP) services among women of reproductive age (15-49 years) in the Eldas sub-county. Utilizing a mixedmethods research approach, quantitative data were collected through structured surveys administered to a representative sample of women. Additionally, qualitative insights were gathered through in-depth interviews with key stakeholders. The findings reveal significant associations between various socioeconomic variables and FP service utilization. Marital status and age emerged as contributors, with women aged 36-45 demonstrating higher utilization rates compared to younger age groups, and widowed women exhibiting greater propensity to utilize FP services compared to their married counterparts. Educational background and employment status were also found to be statistically significant predictors of FP service utilization, with educated and employed women demonstrating higher likelihoods of utilizing FP services. Moreover, the number of children, involvement in polygamous marriages, and discussion about birth control with partners were identified as key factors influencing FP service utilization. These findings underscore the importance of addressing socio-economic disparities and promoting educational and economic empowerment initiatives to enhance FP service utilization among women in the Eldas subcounty. Policy and programmatic interventions targeting these factors are recommended to improve reproductive health outcomes and empower women in making informed decisions about their reproductive health.

Understanding Home Delivery Preferences: The Role of SocioEconomic and Cultural Factors in Marsabit County, Kenya

Fri, 01 Aug 2025 00:00:00 GMT

Understanding Home Delivery Preferences: The Role of SocioEconomic and Cultural Factors in Marsabit County, Kenya Sake, Isako Sori; Tenambergen, Wanja Mwaura; Kyalo, Carol Kawila Home deliveries, defined as childbirth occurring outside hospital settings without the assistance of skilled healthcare providers, remain common in some regions despite substantial efforts to improve maternity and newborn health services. This study aimed to assess the influence of cultural factors on the preference for home deliveries in rural Marsabit County, Kenya. A descriptive cross-sectional mixed-methods design was employed, with 396 women participating in quantitative surveys and additional qualitative data gathered from 10 interviews and 2 focus group discussions. Quantitative data were processed using descriptive statistics and logistic regression, while qualitative data were thematically coded. The analysis revealed that the point prevalence of home deliveries among women of reproductive age in Marsabit County was 64.65% (n = 256, 95% CI [59.81%, 69.49%]), with 189 (55.26%) of those who had ever delivered at home reporting between 1 and 3 home deliveries. Additionally, 291 (94.17%) of home deliveries were attended by traditional birth attendants (TBAs), highlighting the significant role TBAs play in maternal health in this community. Cultural beliefs and family influence significantly shaped delivery choices, with family cultural influence reducing the likelihood of choosing a healthcare facility for delivery (OR = 0.47, 95% CI: [0.19, 0.81], p = 0.009). Socio-economic conditions, including higher education levels (OR = 1.854, p < 0.001) and stable employment (OR = 2.776, p = 0.007), were strongly associated with an increased likelihood of facility-based deliveries. The study concluded that an integrated approach addressing cultural and socio-economic factors are crucial for promoting safer delivery practices. Recommendations include integrating TBAs into the formal healthcare system and enhancing communication strategies to build trust in government health programs.

The Influence of Psychological Contract on Job Satisfaction Among Medical Laboratory Professionals in Selected Public Health Sector Institutions at the National Government, Kenya

Sun, 01 Jun 2025 00:00:00 GMT

The Influence of Psychological Contract on Job Satisfaction Among Medical Laboratory Professionals in Selected Public Health Sector Institutions at the National Government, Kenya Nzoka, Peninna Mwongeli; Njoroge, Kezia; Kyalo, Carol Kawila The psychological contract, an implicit agreement shapes employee-employer relationships within organizations. The study investigated the psychological contract's impact on job satisfaction among Medical Laboratory Professionals (MLPs) in Kenya's public health sector. A response rate of 98 (92.7%), for 106 MLPs surveyed with quantitative data analyzed using SPSS version 29. Pearson’s correlation coefficient results indicated that employee obligations, employee entitlements, employer obligations, and delegation were significantly associated with job satisfaction (p<0.001), accounting for 57.7% of the dependent variable's variation, with a model fit of 31.70. Multiple regression analysis revealed that employee obligations (p-value =0.578) insignificantly influenced job satisfaction. Delegation (β = 0.362) had the strongest positive and significant association with job satisfaction, employee entitlements (β = 0.351), and employer obligations (β = 0.253), with employee obligations indicating a negative association. A combination of psychological contract elements (obligations and entitlements) and structural elements (delegation) constitute the key drivers for improving job satisfaction.

Determinants of Eight Contacts Antenatal Care Uptake Among Prenatal Mothers in Changamwe Sub-County Mombasa, Kenya

Thu, 01 May 2025 00:00:00 GMT

Determinants of Eight Contacts Antenatal Care Uptake Among Prenatal Mothers in Changamwe Sub-County Mombasa, Kenya Swalehe, Bahati Sophia; Njoroge, Kezia; Kawila, Caroline The purpose of this study was to assess the determinants influencing ANC uptake among prenatal mothers in Changamwe, Mombasa, Kenya. The study was based the following objective; to assess how quality ANC services influence ANC uptake among pregnant women in Changamwe Sub-County. The study was anchored on the Expected Utility (EU) Theory and Theory of Planned Behaviour (TPB). A mixed-method research design incorporating both qualitative and quantitative approaches was employed. The target population included postnatal mothers attending maternal child health clinics in public health facilities and maternal child healthcare clinic nurse managers as key informants. A total of 370 mothers and 4 nurse managers participated in the study, selected using stratified and simple random sampling techniques. Data collection involved structured questionnaires for mothers and key informant interviews with nurse managers. Descriptive statistics were used to summarize the findings, while correlation and multiple regression analyses assessed relationships between study variables. The results indicated that the quality of ANC services significantly influenced ANC uptake. Specifically, the quality of ANC services was another significant predictor (β = 0.42, p = .003), emphasizing the importance of service quality in encouraging ANC visits. Based on the findings, the study recommends Enhancing ANC service quality through respectful care, skilled provider training, and ensuring reliable supply chains for ANC commodities is also advised. Addressing health need-related barriers by promoting early screening for pregnancy complications and increasing maternal health literacy is crucial. Additionally, re-evaluating the role of community health care workers through targeted training, supervision, and structured home visit and referral frameworks is necessary. Implementing broad community sensitization campaigns to boost awareness and dispel myths surrounding ANC, adopting digital health tools to track ANC appointments and facilitate timely maternal care interventions, and encouraging further research on community health care workers effectiveness in ANC promotion within varied contexts are also recommended. These recommendations underscore a need for multi-level interventions— ranging from household empowerment to service delivery improvements to increase ANC uptake and ultimately reduce maternal and neonatal morbidity and mortality.

Accessibility and Utilization of the Makueni Care Insurance Program in Achieving Uhc in Makueni County

Tue, 01 Jul 2025 00:00:00 GMT

Accessibility and Utilization of the Makueni Care Insurance Program in Achieving Uhc in Makueni County Kisilu, Mary Syontheke; Musyoka, Felistus; Ong’ombe, Musa Oluoch The purpose of this study was to investigate the effect of accessibility on the utilization of the Makueni Care Insurance Program (MCIP) in achieving Universal Health Coverage (UHC) in Makueni County, Kenya. A descriptive research design was employed. The study targeted 128 hospital administrators and departmental heads, 333 healthcare providers across 16 public hospitals, and 132,500 program users. Using the Yamane formula, a sample of 45 administrators and departmental heads, and 99 healthcare providers was selected. In addition, purposive sampling was used to select 40 beneficiaries from each of four public health facilities: Makueni County Referral Hospital, Kalawa Sub-County Hospital, Makindu Sub-County Hospital, and Kibwezi Sub-County Hospital. Data were collected using structured questionnaires designed for program beneficiaries, administrators, and healthcare providers. The data were analyzed using SPSS (Version 26), and a linear regression analysis was conducted to evaluate the relationship between accessibility and the utilization of the Makueni Care Insurance Program (MCIP). The results showed that accessibility influenced the utilization of the Makueni Care Insurance Program (MCIP) (β = 0.167; p-value = 0.001). To enhance MCIP utilization and advance UHC in Makueni County, improve geographical accessibility, increase community enrollment through sensitization, and reduce waiting times by streamlining services and staffing. These steps will strengthen accessibility and drive higher program participation.

Determinants of Quality Maternal Care among Women in Garissa County Referral Hospital

Fri, 01 Aug 2025 00:00:00 GMT

Determinants of Quality Maternal Care among Women in Garissa County Referral Hospital Abdi, Hassan Maryan; Kimemia, Fredrick; Kawila, Caroline The determinants of quality maternal care among women in Garissa County Referral Hospitals are multifaceted and can be attributed to a combination of individual, structural, and systemic factors. The general objective of this study was to examine the determinants of quality maternal care among women in Garissa County Referral Hospital. The specific objectives include to examine how physical factors and accessibility contribute to quality maternal care among women in Garissa County Referral Hospital. The study was guided by the Social Cognitive Theory and Social Action Theory. A descriptive research design was employed. The target population consists of 314 employees at Garissa County Referral Hospitals, with a sample size of 63 participants, determined using Yamane's formula. Data collection involved the administration of questionnaires and key informant interviews. The collected data was analyzed using the Statistical Package for Social Sciences (SPSS). The findings from this study suggest the study emphasize the significant role of physical accessibility in determining maternal health outcomes, especially in areas like Garissa County, where geographical, infrastructural and social factors significantly hinder access to timely maternal healthcare. The results of a binary logistic regression analysis conducted indicated Physical Accessibility, Is Not Statistically Significant Predictors, Although Access and Staffing scores were included in the model, their coefficients were not statistically significant (p > 0.05): Access: B = 0.010, p = 0.873. The study concludes Geographic isolation, poor infrastructure, lack of emergency services and limited transport options all contribute to delays in seeking maternal care, which increases the risk of maternal complications and deaths. Among the recommendations policies aimed at providing financial support, such as subsidized healthcare services or maternal healthcare insurance schemes, could significantly improve access to care for women from low-income households.

Capacity Building as a Predictor of Service Provision among Community Health Promoters in Nandi County, Kenya

Mon, 01 Sep 2025 00:00:00 GMT

Capacity Building as a Predictor of Service Provision among Community Health Promoters in Nandi County, Kenya Chebet, Risper; Vundi, Susan; Kimemia, Fredrick Capacity building is increasingly recognised as a cornerstone for strengthening community health systems, particularly in underserved regions where Community Health Promoters (CHPs) play a vital role in bridging the gap between households and formal healthcare services. This study examined the role of capacity building in enhancing the effectiveness of CHPs’ service provision in Nandi County, Kenya. The research adopted a descriptive design and targeted 1,567 CHPs across six sub-counties, from which a stratified random sample of 306 was drawn. Data were collected using a structured fivepoint Likert scale questionnaire that was pretested in Uasin Gishu County to ensure reliability and validity. A total of 287 responses were obtained, yielding a 93.8 percent response rate. Descriptive statistics indicated that although many CHPs had received some form of training, gaps persisted in the consistency, adequacy, and relevance of these capacity-building initiatives, which in turn affected their ability to deliver services effectively. Inferential analysis using Pearson correlation showed that capacity building had a statistically significant positive relationship with service provision (r = 0.518, p < 0.01), while regression analysis confirmed that capacity building was the strongest predictor among all facilitators, explaining a substantial portion of the variance in CHP performance outcomes. CHPs who accessed regular training, mentorship, and learning resources demonstrated greater confidence, improved efficiency, and stronger engagement with their communities. The findings underscore that beyond financial incentives, supplies, and job security, sustained investment in capacity building remains the most critical enabler of community health service delivery. The study concludes that institutionalising structured and continuous professional development programs for CHPs is essential for equipping them with the skills to respond to evolving health challenges, foster innovation, and build trust between communities and health systems. Policymakers and stakeholders are therefore urged to prioritise capacity building as a strategic pathway toward achieving universal health coverage in Kenya and similar context

Influence of Performance Planning on Health Workers Performance at Public Hospitals in Nairobi County Kenya

Fri, 01 Aug 2025 00:00:00 GMT

Influence of Performance Planning on Health Workers Performance at Public Hospitals in Nairobi County Kenya Okaka, Anjichi Jane; Njoroge, Kezia; Kimemia, Fredrick Effective performance management is crucial for delivering health services. It is a key component of the healthy workforce pillar in health systems, contributing significantly to optimal healthcare outcomes. By evaluating and enhancing employee performance, performance management systems help healthcare organizations maximize the contributions of healthcare professionals towards expected health outcomes. Performance planning is a vital part of performance management systems. It is a strategic process that ensures organizational goals are achieved through collaboration with staff. This involves setting SMART goals by both employers and employees and creating a plan to achieve these goals. The study aimed to investigate the impact of performance planning on the performance of medical staff in public hospitals in Nairobi County, Kenya. The goal was to understand how performance planning within performance management systems affects health workers' performance. The study was based on goal-setting theory. A cross-sectional descriptive survey design was used. Stratified random sampling method was used to recruit 594 health professionals from Mama Lucy, Mbagathi, and Makadara Hospital. 17 physicians, 201 nurses, and 21 clinical officers were sampled. Pretest study was conducted to evaluate validity and reliability of the research tool, with internal consistency measured using Cronbach's alpha coefficient. Primary data was collected through self-administered questionnaires. SPSS was used to code and analyze raw data. Inferential statistics and descriptive methods were employed for data analysis. Regression model was used to explore the relationship between independent and dependent variables. Results were presented using frequencies, means, standard deviations, and percentages. Findings indicated that clear job descriptions, setting SMART goals, and employee motivation significantly influenced health workers' performance. The study highlighted the importance of reliable plans, offering consistent evaluations, constructive feedback, and employer support. The research suggests, hospitals can enhance patient care quality by fostering a culture of accountability, recognition, and motivation, leading to improved performance.

Influence of Storage Practices on Vaccines Availability in Public Health Facilities in Kisii County, Kenya

Fri, 01 Aug 2025 00:00:00 GMT

Influence of Storage Practices on Vaccines Availability in Public Health Facilities in Kisii County, Kenya Kegesa, Emily Moraa; Vundi, Susan.; Monda, Jonathan Vaccine stock outs remain a significant challenge in public health systems, especially in low- and middleincome countries, where fragile health infrastructure and logistical inefficiencies undermine routine immunization programs. These stock outs disrupt vaccination schedules, expose populations, especially children—to vaccine-preventable diseases, and ultimately compromise health outcomes. In Kenya, repeated vaccine shortages have been reported across counties, often linked to poor cold chain management, insufficient maintenance of storage equipment, and inadequate inventory practices. This study aimed to assess the influence of storage practices on vaccines availability in public health facilities in Kisii County, Kenya. A descriptive cross-sectional design was employed, targeting 131 healthcare workers from all 131 public health facilities offering immunization services in the county. A census approach with purposive sampling was used to identify vaccine handlers. Data were collected using researcher-administered questionnaires and an observation checklist, and analyzed using SPSS version 26.0. Descriptive statistics summarized storage practices, while linear regression assessed the relationship between storage practices and vaccine availability, with statistical significance set at p < 0.05. The findings showed that while functional refrigerators were available in 90.6% of the facilities, availability of freezers (15.4%) and cold boxes (29.1%) was limited. Monthly physical counts were routinely done (mean = 3.57), but many facilities lacked routine maintenance plans and trained cold chain personnel (means = 2.90 and 2.71 respectively). Regression analysis revealed a strong positive relationship between storage practices and vaccines availability (R = 0.734, β = 0.734, p < 0.001), with 53.8% of the variability in availability explained by storage practices (R² = 0.538). The study concludes that strengthening cold chain infrastructure, training staff, and implementing structured maintenance plans are essential to improving vaccine storage and preventing stock outs. It recommends budget allocation for cold chain improvements and adoption of standard operating procedures to enhance vaccine availability and health system responsiveness in immunization delivery.

Influence of Hospital Infrastructure On Quality Healthcare Service Provision at Kenyatta National Hospital

Thu, 01 May 2025 00:00:00 GMT

Influence of Hospital Infrastructure On Quality Healthcare Service Provision at Kenyatta National Hospital Olinyo, Diana Chebet; Kariuki, Caroline Kawila; Mwangi, Eunice Muthoni Quality healthcare service provision is pivotal for achieving Sustainable Development Goals, particularly in national referral hospitals like Kenyatta National Hospital, Kenya. This study aimed to identify determinants influencing quality healthcare provision at KNH, focusing on human resources, infrastructure, system optimization, and health financing. This paper focuses on the influence of hospital infrastructure on quality healthcare service provision at Kenyatta National Hospital. A descriptive crosssectional design was employed, targeting 5,779 healthcare workers with a stratified random sample of 374. Data were collected using pre-tested questionnaires, achieving an 88.2% response rate (n=330). Reliability was confirmed with Cronbach’s α=0.811. Descriptive statistics revealed a high level of agreement regarding the influence of infrastructure, with mean scores exceeding 3.0. Inferential analysis showed a significant positive relationship between hospital infrastructure and quality care (r=0.445, p<0.01). Furthermore, logistic regression identified infrastructure as the strongest predictor of quality healthcare service provision (β=0.593), with the model explaining 66.8% of the variance (Cox & Snell R²=0.668). The findings underscore the pivotal role of hospital infrastructure investment in enhancing service quality at KNH. The study recommends prioritizing infrastructure upgrades as a strategic pathway to improve patient care outcomes and operational efficiency.