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 Understanding Home Delivery Preferences: The Role of SocioEconomic and Cultural Factors in Marsabit County, Kenya(International Journal of Research Publication and Reviews, 2025-08) Sake, Isako Sori; Tenambergen, Wanja Mwaura; Kyalo, Carol KawilaHome 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.Item The Influence of Psychological Contract on Job Satisfaction Among Medical Laboratory Professionals in Selected Public Health Sector Institutions at the National Government, Kenya(Global Social Sciences Review, 2025-06) Nzoka, Peninna Mwongeli; Njoroge, Kezia; Kyalo, Carol KawilaThe 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.Item The Relationship between Integration of Mental Health Services in Primary Health Facilities and Access to Mental Health Services in Kiambu and Makueni Counties, Kenya(International Journal of Research Publication and Reviews,, 2025-01) Musyoki, Milcah Ndinda; Kyalo, Carol Kawila; Njoroge, KeziaWhereas the Kenyan Government has made progressive efforts towards improving mental health services in the country, such as the launch of the mental health policy 2015-2030 and the launch of the mental health action plan 2021-2025, there is still a high unmet need for mental health services in Kenya. The current service statistics indicate that Kenya has 120 psychiatrists. This number is low, given that the Kenyan population is estimated to be over 50 million. Besides, most psychiatrists tend to concentrate in urban areas, making them not easily accessible to the rural populace. Worse still, there is little documentation of mental health services at the county levels at a time when access to health care has been devolved to Counties in Kenya. This study, therefore, examines how integration of mental health services in primary health care facilities can enhance access to mental health care and treatment in Makueni and Kiambu Counties, Kenya. The study adopted a cross-sectional survey design. The target group was healthcare providers from Kiambu and Makueni primary healthcare facilities. The Yamane formula was used to calculate the sample size of 179 healthcare facilities as a unit of analysis. Two health practitioners were selected in each health facility, yielding 358 respondents. Respondents were clinical officers and nurses who directly interacted with patients in primary health facilities. A structured questionnaire was used to collect data from members of healthcare providers. Data collected was checked for completeness, cleaned, coded, keyed in, and stored in the SSPS version 25. A binary logistic model was then fitted into the data. Results of the analysis indicated that the integration of mental health services is a significant predictor of access to mental health services in primary care health facilities in Makueni and Kiambu Counties.Item Factors Influencing Reporting of Medical Errors Amongst Nurses in Pediatric Wards in Three Teaching And Referral Hospitals in Nairobi Kenya(Journal of Nursing and Practice, 2022) Ngivu, Jane N; Kyalo, Carol Kawila; Muiruri, LillianService delivery is among the six health system strengthening pillars by World Health Organization. Successful health services bring about effective, quality, safe, personal and non-personal health care actions or interventions to those who need them, where they need them and when required with minimal resource wastage. Medical error is unintended commission or omission or the failure of an action which was planned which cause, or have potential to cause patient harm. It is a leading challenge in service delivery today and the incidence rates are an emerging international concern. Medical errors are underreported today, yet reporting helps in implementing measures which help prevent recurrence thereby enhancing patient safety and reducing harm and suffering. This study aimed at determining factors influencing reporting of medical errors amongst nurses in paediatric wards in three teaching and referral hospitals in Nairobi Kenya. The specific objectives of the study were to establish if nurses’ knowledge on medical errors reporting influences reporting of medical errors, to establish if management support for medical errors reporting influence the reporting, to establish if medical error reporting systems influence reporting of medical errors and finally to establish if organizational safety culture influences reporting of medical errors, all these, amongst nurses in three teaching and referral hospitals in Nairobi Kenya. The study was cross sectional and utilized both quantitative and qualitative approaches in data collection. The target population comprised of 195 nurses; from Aga Khan University hospital Nairobi, Gertrude’s Children’s Hospital and Kenyatta National Hospital, all in Nairobi Kenya. Sample size was 131 nurses and response rate was 88%. Quantitative and qualitative data was collected from the nurses using a pretested questionnaire. Key Informant Interview Guide was utilized to collect qualitative data from three nurse managers. Data was coded and analysed using SPSS version 25 and presented in form of charts and graphs. Bivariate analysis showed that nurses’ knowledge on medical errors (p < 0.039), management support on reporting (p < 0.031), and medical errors reporting systems (p < 0.002), all had significant association with reporting medical errors in the three facilities. Organizational safety culture however did not, (p = 0.623). This study recommends that nurses’ knowledge and understanding of medical errors be promoted through trainings; starting from college and university levels and later during orientation and in-service. Management to disseminate policies and procedures to staff in their health facilities and ensure the same is well understood and implemented correctly. In addition, feedback about changes put into place based on those errors need to be communicated to staff in a timely manner. Additionally, just culture need to be embraced and cultivated to ensure objective approach to medical errors. Finally, medical error reporting systems to be simplified, made readily accessible and should have capabilities for anonymous reporting.