School of Medicine and Health Sciences
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Welcome to School of Medicine and Health Sciences collection.This collection contains Journal articles published by faculty affiliated to the school.
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Item Determinants of Eight Contacts Antenatal Care Uptake Among Prenatal Mothers in Changamwe Sub-County Mombasa, Kenya(Journal of African Interdisciplinary Studies (JAIS), 2025-05) Swalehe, Bahati Sophia; Njoroge, Kezia; Kawila, CarolineThe 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.Item Determinants of Quality Maternal Care among Women in Garissa County Referral Hospital(INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI), 2025-08) Abdi, Hassan Maryan; Kimemia, Fredrick; Kawila, CarolineThe 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.Item Call Centre Influence on the Delivery of Mental Health Services Among Young People: A Case of One2one Call Centre in Nairobi County(International Journal of Health Sciences, 2024) Kimathi, Mutwiri Robert; Kawila, Caroline; Olouch, MusaPurpose: The purpose of this study was to examine the influence of call centers on the delivery of mental health services among young people in Nairobi County. Specifically, the study aimed to investigate the impact of crisis intervention, round-the-clock availability, resource sharing, and follow-ups on mental health service delivery. Methodology: The study employed a descriptive-cross-sectional research design to assess the impact of call centers on mental health service delivery. The target demographic consisted of healthcare providers affiliated with the one2one Call Centre in Nairobi County. A sample size of 112 respondents was selected using basic random selection methods. Data was collected through the distribution of questionnaires, and Statistical Package for Social Science (SPSS) version 25 was utilized for data analysis. Descriptive statistics such as mean, standard deviation, frequencies, and percentages were employed, along with correlation and regression analysis to evaluate the relationships between research variables. Findings: The study found that crisis intervention, round-the-clock availability, and resource sharing had a positive impact on the delivery of mental health services among young people in Nairobi County. Specifically, crisis intervention strategies were shown to significantly enhance the overall mental health support system, ensuring timely assistance for young individuals in need. Furthermore, maintaining round- the-clock availability allowed service providers to cater to the diverse needs and schedules of young people seeking assistance, thereby improving the overall delivery of mental health services across the county. Unique Contribution to Theory, Practice, and Policy: This study makes several contributions to theory, practice, and policy in the field of mental health service delivery. Firstly, it adds to the body of literature on the effectiveness of call centers in enhancing accessibility and reachability of mental health services, particularly among young people. Secondly, the findings provide valuable insights for healthcare practitioners and policymakers on the importance of crisis intervention, round-the-clock availability, and resource sharing in improving mental health service delivery.Item Factors Influencing Utilization of Health Information System in the Management of Missed Appointments among HIV Positive Patients in Mombasa County(Journal of African Interdisciplinary Studies (JAIS), 2021-10) Mbiya, Odilia Amalemba; Kyalo, Caroline Kawila; Kawila, CarolineA health system requires a well-functioning health information system as it enhances measurement of health outcomes, accountability for resource allocations and assists in arriving at effective health care decisions. An effective health information system captures individual patient data including demographics and data related to clinics on management of population, analysis and reporting of patient risk elements and pinpointing of proactive patients therefore providing reminders where care is delivered. This process of utilizing health information reduces missed appointments, increases retention rate and improves patients’ health outcome .With low retention rates among HIV positive patients, this study aimed at determining the factors associated with the utilization of health information in curbing missed appointments. Utilization of health information involve collection, collation and monitoring in identification of key areas worth addressing within the health structures to direct designing of suitable health mediation to advance health. The research study was guided by the following specific objective to establish infrastructural factors influencing health information utilization. This study utilized descriptive cross-sectional study design using quantitative method of data collection to assess utilization of health information among healthcare workers. The study population for this research was approximately 215 CCC, a sample size of 69 health care workers in three high volume hospitals offering HIV care in Mombasa County (Coast general, Bomu Hospital and Portreitz). Primary data was obtained via questionnaires while secondary data was obtained from hospital records available, the registers, EMR and reports generated. The data was coded and analyzed using the statistical package for social sciences (SPSS). A p-value of less than 0.05 was considered as statistically significant. From the findings, half of the staff had been trained on data management while half was not. All the health facilities used Electronic Medical Records however with unstable local network connectivity. It was also noted that staff supervision was inconsistent and that staff had negative attitude towards data use. There is need for users and utilizers of health information to be trained in all aspects of data to enhance data quality; there is also need to ensure availability of data collection tools either soft or hard. Advocacy for consistent support supervision to facilitate data utilization; this would improve the staff attitude on data capture, demand and use.Item Opportunities and Challenges for HIV/AIDS and Non-Communicable Diseases Integration: A Systematic Review of Different Models of Integrated Care(Public Health Research, 2021-06) David, Njuguna K.; Ombiro, Oren; Kawila, CarolineIt is evident that HIV and Non-Communicable diseases (NCD) programs often intersect. However, HIV services are stand alone and decentralized making it attractive to patients in peripheral facilities, and retaining them in care. In contrast, NCD care is provided using a centralised model, with the majority of care provided by hospitals. Patients have limited access and commonly present late with symptoms of complications. Therefore, HIV/NCD integration would strengthen the health systems capacity to address the full range of needs for HIV patients, at both the population and individual level. This systematic review explores the pertinent opportunities and challenges for HIV/NCD integration in comparison to different models of integrated care. Twenty studies with some conducted in America, Africa and Asia that heavily relied on primary data and implied that HIV/NCD integration increases the utilization of healthcare services and improve health outcomes were examined. Three studies reported increased utilization and improved outcomes through a population-based model of integrated care, however, reported challenges with linkage to care, loss to follow up and low levels of male involvement. Seventeen studies reported on individual models of integrated care which translated into impressive health outcomes including efficiency gains in staffing, increased coverage, improved medication adherence, and high rates of retention in care. One study reported on a case management approach that was found to be more effective when supporting integrated services for depressed HIV patients. The review findings show that intense efforts are needed to improve male involvement, invest in point of care technologies, reduce the return visit rates and provide streamlined care to reduce the loss to follow up for individual-based models of integrated care. There is diversity in integration models combining HIV and NCD services, and they have the potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts.Item FACTORS RELATED TO QUALITY DATA WHICH DETERMINE HE ALTH INFORMATION UTILIZATION IN MAKING DECISION AMONG HEALTHCARE MANAGERS IN MOMBASA COUNTY, K ENYA(2020) Otieno, Moses Ochieng; Muiruri, Lillian; Kawila, CarolinePurpose: This was a study based on Health Info rmation Systems pillar. T he st udy sought to explore factors related to quality data which influence health information utilization in making decision among healthcare managers in Mombasa County . Methodology: This was a Descriptive Survey Study design whe re desired data was obtained from selected respondents by semi - structured questionnaires. The research targeted a total of 303 healthcare managers in Mombasa County which comprised of 21 County Health Management Team (CHMT) members, 56 Sub - county Health Ma nagement Team (SCHMT) members from the four sub - counties, 43 facility In - Charges from the 43 public health facilities and 183 Heads of Departments (HODs). A sample size of 91 healthcare managers was used in the study . This was 30% of the target population and were randomly selected. A response rate of 98.9% was achieved . Descriptive and Inferential analysis was done. Data was analyzed with SPSS version 23. Findings: R esults revealed that quality data factors (β 4 = 0.298; t = 4.079; p < 0.01) w ere significant predictors of health information utilization in making decision among healthcare managers in Mombasa Coun ty . These results imply that improvement in these variables (data accuracy , completeness and timelin ess) will enhance health information utilization. How these variable s are accomplished influence the level of health information utilization in making decision . Unique contribution to theory, practice and policy: When the study recommendations are impleme nted, there will be assured q uality data which will assist in coming up with the design of disease prevention, interventions and to monitor and evaluate the progress made on the measures put in place. By doing so, the study will have validated the theory o f Evidence Based Healt h Information System by Carbone, (2009), on which the study was anchored. Quality data is, therefore, not only crucial in securing health status description, service coverage, and performance, but also inspires confidence in the HIS a mong healthcare manag e rs. The study recommends that the MOH introduce s HMIS as a subject in the pre - service curriculum of all healthcare cadres in order to improve HIS . Mombasa County Government should ensure t hat quality data is generated (with regards to accuracy, completenes s and timeliness) at all levels of the health systems for purposes of accountability and more importantly its utility to improve healthcare programs, to survive and prosper in the current dynamic healthcare environment .Item The Role Of Health Information System Towards The Achievement Of Uhcin Maternal Care: A Case Of Coast General Teaching & Referral Hospital(Researchjournal's Journal of Public Health, 2021-07) Awadh, Zahra Mbarak; Njoroge, Kezia; Kawila, CarolineThe role of Health Information System is fundamental to achieving the goals of Universal Health Coverage. An integrated information system must be in place to generate good quality information to informed-decisions, and monitor progress towards these goals. This study sought to determine the role of the health information systems in the attainment of UHCin maternal healthcare within Mombasa. The study objectives were the determination of the role of quality assurance in free maternal care under UHC, to establish the role of data management in maternal care under UHC, determination of the role of system resources in achieving UHC maternal care, and the evaluation of the role of technical competency of healthcare workers in UHC. This study realized that quality assurance, data management, system resources and technical competency influenced the achievement of UHCin maternal healthcare at CGTRH, with system resources being the significant factor in the achievement of UHCin maternal healthcare at CGTRHItem Determinants of Reporting Rates for HIV Test-kits; A Case of Meru County(International Journal of Computer Applications, 2021-09) Gathii, Paul; Kawila, Caroline; Muiruri, Lillian: Many health organizations including Ministry of Health through Kenya Medical Supplies Authority have adopted reporting rates as a measure for improving health service delivery in terms of ensuring the availability of health commodities and product supply. Uninterrupted health commodity supply is determined by ensuring commodity reports are uploaded into District Health Information System 2 platform which is a national system for consolidating consumption data. It is this data that the national allocation committee uses to quantify HIV test kits required by facilities on quarterly basis. Methods: The study embraced quantitative research design where quantitative approach was used. The study target population was 260 Healthcare workers in Meru County to assess the role or the factors that affect the reporting rates of HIV test kits. The study used purposive sampling technique to sample the respondent’s i.e. Health care workers who are responsible for consolidating facility level HIV test kits reports in Meru County Therefore the sample size was 260 health care workers. The study used semi structured questionnaires and data extraction sheet to collect the data. Majority were familiar with the recommended data reporting tools (MOH 643). Results: Majority 153(, 61.2%) were familiar with the recommended reporting tools (MOH 643) (x2=101.76, p<0.05) slightly more than half of the Healthcare workers were regularly trained in the recommended data reporting tools (MOH 643 tool) 145, (58.0%) (x2=6.4, p<0.05). Approximately 101(40.4%) that recommended data reporting tools(MOH 643) is adequate in capturing the consumption data of the HIV test kits (x2=77.67, p<0.05). Most respondents indicated that the trainings were not useful compared to a third indicated that the trainings were useful.. The respondents agreed to the statement that they were aware of HIV test kits policies that are in place and the agreed that the policies were helpful at their work. The respondents agreed that they had a supervisor whom they report to in the course of their work and that their supervisor was not always available for consultation. There was strong positive relationship that was significant (p<0.05) between reporting rates and availability of the reporting tools (rho=.693, p<0.05) while a strong positive relationship existed between reporting rates and availability of Standard operating Procedure (rho=.814, p<0.05) and a strong relationship between the reporting rates and human capacity (rho=.896, p=054) and support supervision (rho=-.407, p=.053). Conclusion: presence of enough staffs, availability of Standard Operating Procedure, supportive supervision all affects reporting rates for HIV testing kits. The coefficient of determination obtained from the model was .663 and this indicated that the regression model explained only 66.3% of the factors that affected the reporting rates on consumption data of HIV test kits in the countyItem Organizational determinants of health information utilization in making decision among healthcare managers in Mombasa County, Kenya(Journal of Health, Medicine and Nursing, 2020) Otieno, Moses Ochieng; Muiruri, Lillian; Kawila, CarolinePurpose: This was a study based on Health Information Systems pillar. The objective was to examine organizational factors which influence health information utilization in making decision among healthcare managers in Mombasa County. Methodology: This was a Descriptive Survey Study design where desired data was obtained from selected respondents by semi-structured questionnaires. The research targeted a total of 303 healthcare managers in Mombasa County which comprised of 21 County Health Management Team (CHMT) members, 56 Sub-county Health Management Team (SCHMT) members from the four sub-counties, 43 facility In-Charges from the 43 public health facilities and 183 Heads of Departments (HODs). A sample size of 91 healthcare managers (30% of the target population) was used in the study with a response rate of 98.9% being achieved. Data was analyzed with SPSS version 23. Findings: Results revealed that organizational factors (β2 = 0.233; t = 4.552; p < 0.01) were significant predictors of health information utilization in making decision among healthcare managers in Mombasa County. These results imply that improvement in these variables (Feedback mechanisms, Supportive supervision and Resource availability on Health Information Systems) will enhance health information utilization in making decision. Unique contribution to theory, practice and policy: Implementation of the study findings will ensure that healthcare organizations have systems and infrastructure for improving interpersonal relationship among healthcare workers and managers, providing clear guidelines and defining roles and responsibilities related to HIS thus improving evidence-based decision making. When this is done, the study will have validated the theory of Evidence Based Health Information System by Carbone, (2009), on which the study was anchored. This theory further explains that there is need for a “catalyst” which is responsible for ensuring that the overall clinical care task is performed. Organizational factors are some of the catalysts referred to in the theory that when looked into will ensure an improved health outcome. The study recommends that the Ministry of Health (MOH) introduces Health Management Information Systems (HMIS) as a subject in the pre-service curriculum of all healthcare cadres in order to improve Health Information Systems (HIS) and facilitate proper prioritization of health needs, interventions and proper resource allocation