School of Medicine and Health Sciences
Permanent URI for this collectionhttp://41.89.31.6:4000/handle/123456789/315
Welcome to School of Medicine and Health Sciences collection.This collection contains Journal articles published by faculty affiliated to the school.
Browse
2 results
Search Results
Item Influence of Health Referral Systems on Adolescent Sexual and Reproductive Health Service Utilization in Kajiado County, Kenya(Journal of Health, Medicine and Nursing, 2025-01) Aluda, Wilfrida Kadenyi; Mapesa, Job; Njoroge, KeziaAdolescent Sexual and Reproductive Health (ASRH) in Kajiado County, Kenya, is hindered by early marriages, cultural practices, and limited healthcare access. The pastoralist communities face unique challenges, increasing risks like unintended pregnancies and maternal mortality. Despite efforts to improve access, gaps in ASRH service utilization persist. This study examines the influence of referral systems on ASRH service use among adolescent girls in Kajiado County. Methodology: A mixed-method design assessed the influence of referral systems on ASRH utilization among adolescent girls in Kajiado County. Data collection took place from December 2023 to March 2024. Quantitative data from 422 girls were analyzed using SPSS version 26, while qualitative data from 5 FGDs, 15 IDIs, and 15 KIIs were analyzed thematically using NVivo. Findings: Only 15.8% of adolescents used ASRH referral systems. Trust (78.6%), confidentiality (74.2%), and accurate information (71.5%) were key facilitators. Married adolescents were 32.1% less likely to utilize referrals (p < 0.05), and those with primary education were 45.3% less likely (p < 0.01). Positive outcomes included 83.4% reporting improved ASRH knowledge and 79.2% better contraceptive access. Barriers included communication gaps (62.7%) and limited provider awareness. Unique Contribution to Theory, Practice and Policy: The study identifies barriers such as poor communication, limited provider awareness, and socio-demographic disparities hindering ASRH service utilization. Positive outcomes, including improved knowledge and contraceptive access, suggest the potential of effective referral systems. Strengthening trust, confidentiality, and targeting vulnerable groups is crucial for improving ASRH referral pathways. Limitations included the small sample size and limited geographic scope. Keywords: Sexual and Reproductive Health, Adolescent Girls, Health Systems Approach, Service Utilization, Health Systems Management, Public HealthItem Evaluating Quality of Services in Community Differentiated Service Delivery Model. A case of Kakamega county(African Journal of Health Sciences, 2023-12) Owiti, Winnie Sarah; Njoroge, Kezia; Mapesa, JobThe provision of high-quality services is a prerequisite for the successful implementation of community-differentiated service delivery. The service quality influences the clients' satisfaction, perceived value trust in the model and eventual utilization. Evaluating the quality of services in community differentiated service delivery will inform policymakers of existing quality gaps and in turn, this will assist in formulating strategies that will improve service quality and increase utilization. METHODOLOGY This was a cross-sectional study conducted in Kakamega County between September and December 2021 involving 402 participants. using purposive sampling, clients already established on ART were selected and data was collected through a structured questionnaire. Descriptive and inferential statistics were used to analyze data using SPSS version 25. RESULTS The results on dimensions of service quality established a high mean score (4.27) related to client literacy and a low score (2.64) on the package of services. There was a moderate positive relationship between client literacy and package of services (0.641) and a strong positive relationship between package of services and competence of the service provider (0.894). On the package of services (79.9%) of participants reported that ART refill and referral services were available, (12.7%) adherence and psychosocial support, 11.7% and 5% viral load sample collection. Regarding quality, the Freidman test ranged from client literacy (7.84), cost of services (7.79), accessibility (5.71), competence of the provider (4/06) and comprehensive package (2.54). CONCLUSION The study established a service quality gap in the package of services and the competence of the provider. The package of service provided is not comprehensive enough to address the needs of the clients. RECOMMENDATION Policymakers and leaders should re-distribute resources to allow for the training of providers using the differentiated service delivery manual 2023. The dimensions of quality can be reorganized to prioritize the appropriate package of services followed by the competence of lay health providers and lastly client literacy.