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 Adoption of Computerised Health Information System Focusing on Kenya’s Health Facilities(Journal of Biology, Agriculture and Healthcare, 2016) Githiom, Samuel; Muiruri, Lillian; Osuga, BenAlthough the benefits of information technology are clear adapting new information systems to health care has proven difficult globally and rates of use have been limited. With the challenge of inadequate health workers and low quality of service delivery, Information Communication Technology is essential to ensure availability of Information to multiple users and multiple settings. It is also important for Integration of variable types of data media, data legibility, reduced medical errors, complete and quality data. It also enable structured data entry, accurate calculation of processes, provision of tools for decision support and data based analysis. Although Kenya as a developing country has invested in Information Communication Technology with the aim of improving patient care, all indications have shown slow adoption of technology in healthcare industry. Therefore it is important to focus on means of hastening adoption of HIS in order to enhance service delivery in the health sector and hence effective service delivery for Kenyan peopleItem Utilization of Service Charters in Public Hospitals in Kenya: A Case of Thika Level 5 Hospital, Kiambu County(International Journal of Scientific and Research Publication, 2016-06) Masese, Charles Onyambu; Tenambergen, Wanja Mwaura; Muiruri, LillianService delivery in government health facilities in Kenya still faces multiple challenges. These challenges can still be identified ten years down the line since the introduction of Service Charter. The objective of the study was to assess how the service charter utilization would influence health service delivery in Thika Level 5 Hospital (TL5H) in Kiambu County. Cross sectional study design was employed. Quantitative data was collected using questionnaires. A sample size of 156 technical employees of TL5H and patients participated in this study. Collected data was edited, coded, and entered into the computer using the Statistical Package for Social Scientists (SPSS v 23). The respondents strongly agreed that the hospital charter content is not viewed annually creating unfriendly services (mean 1.73, SD 0.97), (mean 1.74, SD 0.997) indicated the respondents strongly agreed that the service charter is not clearly understood by the majority of patients informing them of their rights when seeking services. The respondents disagreed that the hospital management is always active in monitoring performance and playing the oversight duty according to the SC (mean 2.19, SD 1.20) on whether failure to utilize the service charter may lead to deterioration of quality and equity of healthcare, the respondents agreed (mean 2.05, SD 1.54). Most of the respondents strongly agreed there is availability of support for the service charter (Mean 1.72, SD 0.93), while the respondents also indicated that the waiting time has not improved despite the availability of service charter (Mean 2.98, SD 1.09). The study also established that there was uncertainty in the amount of waiting time in TL5H (Mean 1.775, SD 0.91). The channels used for communication were not clear (Mean 1.993, SD 1.12) while the communication at TL5H does not ensure clarity on issues (Mean 1.9, SD 1.07) while the respondent agreed on communication at TL5H was not always done to get commitment from staff (Mean 1.923, SD 1.047) and there was inadequate open communication of most issues at TL5H (Mean 1.846, SD 1.075). The study recommends that 1) TL5H should improve the contents of the service charter to make it clear, to ensure that the patients fully understand the contents, 2) there should be proper monitoring of the members of staff to ensure that the service charter is fully implemented to minimize the amount of complaints by patients, 3) the service charter contents should be embedded in the organization culture to ensure that is fully and properly implemented to the satisfaction of the service users.Item Human resource capacity for information management in selected public healthcare facilities in Meru County, Kenya(Pan African Medical Research, 2015-04) Kiilu, Elizabeth Mueke; Okero, Dominic Charles; Muiruri, Lillian; Owuondo, Pacific AkinyiIntroduction: Reliable health information is essential for decision making in the healthcare system. Information management in Kenya was considered the weakest area under the Health Information System pillar mainly due to inadequate health workers capacity. The study therefore aimed at assessing health workers skills and current training needs for information management in the selected healthcare facilities. Methods: Cross-section research design was adopted and both purposive sampling technique and censuses were used to establish the study participants. Analysis was done using SPSS version 20 and results were presented in tables, charts and graphs. Results: It was established that capacity building was usually undertaken through on-job trainings i.e. 85.1% (103) health workers had on-job training on filling of data collection tools and only 10% (13) had received formal classroom training on the same. Further, only 9.1% (11) health workers had received information management training while 90.9% (110) had not received such training. Health workers demonstrated below average skills on information management i.e. only 17.4% (21) could check for data accuracy, only 16.5% (20) could compute trends from bar charts and only 16.5% (20) could transform the data they collected into meaningful information for use. Conclusion: The researcher recommended that healthcare facilities management teams develop a competency based framework for defining the desired skill mix for information management and have a yearly Training Needs Assessment for assessing training needs for information management among the health workers.Item Organizational Factors Influencing the Adoption of the District Health Information System 2 in Uasin Gishu County, Kenya(International Journal of Medical Research & Health Sciences, 2018) Kuyo, Richard Ole; Muiruri, Lillian; Njuguna, SusanBackground: Sound and reliable information is the foundation of decision-making across all health system building blocks that include service delivery, health workforce, health information, medical products, vaccines and technology, financing, leadership, and governance. This study is built on health information system pillar. Objectives: To determine the organizational factors influencing the use of DHIS2 in Uasin Gishu County. Methods: Study was conducted in Uasin Gishu-Sub County health facilities. A questionnaire was used to collect quantitative data from 283 health workers selected randomly while 10 key informants were selected purposively from this sample for in- depth interviews. Results: Total 50.0% of the participants acknowledged that finances were adequate to run DHIS2. The main champions of DHIS2 used in decision-making were the county health records and information officers (56.2%) and the sub-county health records and information officers (39.0%). Up to 78.5% agreed or strongly agreed that organizational hierarchy influenced DHIS2 use and 80.8% agreed or strongly agreed that there was improved staff performance due to DHIS2 utilization. On the other hand, the major challenges experienced in the use of DHIS2 for evidenced-based decision-making were the lack of management support (34.3%), poor skills among the users (48.6%), lack of adequate computers (36.7%), unreliable internet connectivity (47.1%), lack of power backup (27.6%), and resistance to change (21.0%). Conclusion: The main funding for the DHIS2 system comes from the County government while health records and information officers are the main promoters of DHIS2 use. The main determinants of DHIS2 used are the availability of computers, network and internet services, trained staff and legislation. The main challenges inhibiting DHIS2 use are lack of management support, poor skills among the users, lack of adequate computers, unreliable internet connectivity, lack of power backup and resistance to change.Item PATIENT SATISFACTION WITH EMERGENCY CARE SERVICES ACCESSED AT SELECTED HEALTH FACILITIES IN NAIROBI CITY COUNTY: PATIENTS’ PERSPECTIVE(JournalofHealth,Medicine andNursing, 2019) Edwin, Osiyel Daniel; Tenambergen, Wanja Mwaura; Muiruri, LillianPurpose:The main aim of the study was to study the factors influencing patient satisfaction with emergency care services accessed at selected health facilities in Nairobi City County.Methodology:In this study, descriptiveresearchdesign was adapted. The target population of thestudy included patients seeking emergency healthcarefrom five public health facilitiesin in Nairobi County. Stratified proportion and simple random sampling technique wereused to select 304respondentsamong patientsin emergency department.Data collection tool was used to obtain quantitative data. Nairobi City County referral facilities were purposely selected because of the high number of patient throughput. Systematic sampling was done to identify the respondents. Descriptive cross-sectional study design was used where quantitative approach was used for data collection.Findings:The results showed that there is a positive and significant influence of the physician servicefactors on accessand patient’s perspectiveto emergency healthcare services in public hospitals in Nairobi County (r = .596**, P= .001). On waiting timefactor, findings show that there is a positive and significant influence access and patients’ perspective to emergency healthcare services in public hospitals in Nairobi County(r=.407**, P= 0.001) onquality of care,findings show that there is a positive and significant influence access and patients’ perspective to emergency healthcare services in public hospitals in Nairobi County(r=.255**, P= 0.001). Lastly, results showed that there is a positive and significant influence of the health facility typefactor on access to emergency healthcare services in public hospitals in Nairobi County (r = .257**, P= .001). This implies that the fourfactors are important and significant determinants of accessand useofemergency healthcare services in public hospitals in Nairobi County. Unique contribution to theory, policy and practice: The researcher brings in a wealth of new knowledge to the field of emergency healthcare, where the health sector can adopt a strong pillar of health service delivery by introducing a physician specialty course on emergency healthcare and medicine, further, proper mechanisms can be put to reduce waiting times before a patient seeking emergency healthcare is attended to. This would rely on the quality of care the patient receives when in need.