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 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 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 Influence of Performance Planning on Health Workers Performance at Public Hospitals in Nairobi County Kenya(Intra Africa Journal Hub (IAJH), 2025-08) Okaka, Anjichi Jane; Njoroge, Kezia; Kimemia, FredrickEffective 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.Item Enhancing Quality of Documentation of Nursing Care in Selected County Referral Hospitals in Kenya(Journal of Health, Medicine and Nursing,, 2025-07) Mukuna, Njeri Anne; Mwaura-Tenambergen, Wanja; Njoroge, KeziaPurpose: Good health is a key Sustainable Development Goal, and quality nursing care documentation plays a vital role in achieving this goal by enhancing patient safety, care continuity, and accountability. Despite its importance, studies consistently show persistent gaps in nursing documentation that can compromise care outcomes and patient trust. This study describes efforts towards enhancing quality of nursing care documentation in County Referral Hospitals in Kenya. Methodology: Using a mixed-methods design, the research combined baseline audits of 158 patient files with surveys from 88 nurses and interviews with five nurse managers. An intervention phase followed, where a Continuous Professional Development (CPD) module was implemented in Nyeri County Referral Hospital. This training used a systems thinking approach to highlight how people, processes, and resources interact to affect documentation practices. Findings: Post-intervention, 62 patient files were audited, showing marked improvements: 93.5% of files contained patient details on every sheet (up from 44.4%), detailed assessments increased to 51.6%, and documentation of interventions, patient responses, and shift instructions all rose above 80%. Overall, there was improvement from 22% to 81.2% good nursing care documentation. Despite these gains, gaps remain, especially in timeliness and workload-related barriers. Unique Contribution to Theory, Practice and Policy: This study makes a unique contribution by demonstrating the effectiveness of a systems thinking approach in improving nursing documentation within resource-constrained settings. The study recommends conducting routine refresher training, and addressing staffing shortages to allow nurses adequate time for thorough, timely records. High-quality documentation supports critical thinking, legal protection, interprofessional collaboration, and patient-centered care. Sustaining these improvements demands committed leadership and continuous mentorship. This research highlights that targeted interventions, guided by systems thinking, can significantly enhance nursing documentation quality, ultimately contributing to safer, more effective healthcare delivery in Kenyan County Referral Hospitals and beyond.Item The Influence of Health Financing on Management of Health Products and Technologies in Selected Counties, Kenya(Journal of Medicine, Nursing and Public Health, 2025-06) Meme, Shadrack Mururu; Kawila, Carol; Njoroge, KeziaHealth Products and Technologies (HPTs) are critical pillars of the health system and essential to achieving Kenya's Universal Health Coverage (UHC). UHC prioritizes access to highquality medical care with minimal financial hardship. Despite efforts to enhance HPTs management, counties like Kisumu, Machakos, Nyeri, Kiambu, and Isiolo in Kenya face inefficiencies. This study aimed to determine the influence of health financing on the management of HPTs. The utilization management theory guided the research. The research was conducted in Kisumu, Kiambu, Machakos, Nyeri, and Isiolo counties, using the pragmatism paradigm to support a mixed-methods design. Quantitative data utilized a descriptive research design, while qualitative data employed an exploratory design. A census sampling method was used in the study where 141 staff managing HPTs at level 4 and 5 public health facilities were targeted. Participants were drawn from clinical, pharmacy, service delivery, and administration departments. Key informant interviews were conducted with County Directors of Health and County Pharmacists. Data collection involved pre-tested questionnaires and key informant interview guides to ensure validity and reliability. Quantitative data was analyzed using descriptive and inferential statistics, while qualitative data was thematically analyzed. The study adhered to research ethics throughout the investigation. The study found that the model explained 53.5 % (R Square value of 0.535) of the variance in the management of HPTs. This meant that the model had strong explanatory power, but there was still a significant portion of variance (46.5%) that was not accounted for by these predictors. The HPTs financing had a coefficient of 0.231 implying that, for every one-unit increase in financing, the management of HPTs is expected to increase by 0.231 units, assuming all other factors remain constant. This positive coefficient suggests that better financing is associated with improved management of HPTs. HPTs financing provided the lowest significant contribution of 0.206 (Beta=0.206; t=2.683; P=0.009). The study concluded that HPTs financing provides a statistically significant influence on the management of HPTs in public hospitals in Kenya.Item The Influence of Human Resource Factors on Access to Mental Health Services in Primary Care Facilities in Kiambu and Makueni Counties, Kenya(Food and Public Health, 2025-01) Musyoki, Milcah Ndinda; Njoroge, Kezia; Kyalo, Caroline KawilaThe incidence of mental health issues in Kenya has increased over the years. Although Kenya has adopted a policy framework to integrate mental health services in primary healthcare facilities, only 29 of the 284 hospitals in level four and above offer mental healthcare services, with Mathari National Referral Hospital serving as Kenya's sole referral for such services. This scenario clearly demonstrates that access to mental health is not fully mainstreamed in primary healthcare facilities. Worse still, the existing service statistics show that Kenyan psychiatry is under-resourced in terms of personnel. This study, therefore, explores the influence of human resource factors on access to mental health services in primary care facilities in Kenya. The study adopted a cross-sectional mixed methods research 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 staff members in the selected counties. Collected data was analyzed using descriptive statistics and logistic regression. Results indicated that human resource factors significantly predict access to mental health services in primary care health facilities in Makueni and Kiambu Counties.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 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 Awareness and Utilization of Sexual and Reproductive Health Services among Adolescent Girls in Kajiado County, Kenya(Global Journal of Health Sciences,, 2025-01) Aluda, Wilfrida Kadenyi; Mapesa, Job; Njoroge, KeziaPurpose: Adolescent Sexual and Reproductive Health (ASRH) is a global concern, with over 1.2 billion adolescents at risk due to limited access to essential health services. In Kenya, high rates of unintended pregnancies and STIs among adolescents highlight the need for effective sexual health education. In Kajiado County, cultural barriers limit ASRH service access, leaving many girls unaware of available resources. Methodology: A mixed-method design examined the impact of referral systems on ASRH service utilization among adolescent girls in Kajiado County. Quantitative data were collected from 422 girls through structured questionnaires, while qualitative data came from FGDs, IDIs and KIIs. Quantitative analysis used SPSS version 26 and qualitative data underwent thematic analysis. Findings: While 78% of participants showed general SRH awareness, only 45% were knowledgeable about contraception and 38% about STIs. Unintended pregnancies were common (65%), with just 30% aware of preventive options. Peer influence (60%) and schools (50%) were primary information sources; however, stigma (55%) and inadequate outreach (62%) were significant barriers to access. Statistical analysis confirmed these barriers were associated with lower SRH knowledge levels (Fisher's exact test: < 0.05). Unique Contribution to Theory, Practice and Policy: Despite increasing SRH awareness among adolescent girls in Kajiado County, significant knowledge gaps persist, particularly in contraceptive use and STI prevention. Recommendations include educational initiatives on SRH, greater parental involvement and enhanced outreach programs. Future research should explore community-based and digital strategies to improve SRH knowledge and service use among rural adolescents.Item Influence of Healthcare Provider Training on the Survival Rate of Cardiac Arrest Among Adults in Kenya(Journal of Medicine, Nursing and Public Health,, 2024-04) Tole, Eunice; Njoroge, Kezia; Oluoch, MusaThe study purpose was to determine the influence of healthcare provider training on the survival rate of cardiac arrest among adults in Kenya. A cross-sectional design was used to collect data from 402 nurses in Machakos Level 5 Hospital, Muranga Level 5 Hospital, and the Aga Khan University Hospital, Nairobi. Descriptive and inferential statistics were examined and the findings were presented through tables, figures, and explanations. The major results of the questionnaire provided 280(77%) nurses were of a positive opinion on the relevance of CPR in their work jurisdiction. Therefore, out of 191(60%) who attended CPR training, 143(45%) had completed the training to get a certificate. Further, 207(64%) had acquired BLS training and 170(53%) had heart saver training. In the training, 273(85%) noted that they had gained teamwork skills while at the same time, 285(88%) said that they were able to use patient simulators that enabled them to gain relevant skills applicable during actual occurrence. That notwithstanding, 193(60%) had no training in ACLS while 186(58%) did not get life support training every 2 years. More discouraging was that 149(46%) never got a chance to put into practice their CPR skills at a team-based CRP event therefore .145(45%) lacked the actual real- life experience to respond to a CPR. It was also noted that 188(59%) nurses were not in a position to administer medication in a CPR occurrence since they lacked training in advanced life support. Further, the regression results indicated that the Pearson correlation coefficient of r was 0.495** at α < 0.002 and 99% significance level. Therefore, since the correlation values were less than 1 and significance level was less than 0.05, the study rejected the null hypothesis. It was concluded that healthcare provider training had a significant influence on the survival rate of cardiac arrest among adults. Healthcare providers lacked advanced professional skills such as ACLS training and lacked the zeal and discipline to consistently attend CPR training every 2 years. Hospitals were noted to have poor implementation of policies that guided the correct exposure to CPR management to all healthcare providers. The recommendations on the healthcare provider training are that the hospital management should enact learning and development policies that make it mandatory for various staff in different units to attend CPR training. Additionally, the medical staff should improve awareness through internal forums such as hospital workers' unions on the need to acquire advanced professional skills such as ACLS training.
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