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
11 results
Search Results
Item Policy Factors Associated with Nurse Managers' Preparedness in Mentorship Role at Kenyatta National Hospital, Kenya(Journal of Medicine, Nursing and Public Health, 2024-08) Mwasi, Julita Thirindi; Njuguna, Susan; Mulu, MosesPurpose: Mentorship plays a crucial role in the professional development of nurses, emphasizing a patient-centric approach to nursing care. However, there exists a lack of clarity regarding the preparatory measures for nurses in charge who, at the same time, are ward managers, posing challenges in effectively conveying their multifaceted responsibilities. This research aimed to assess policy factors associated with the preparedness of nurse managers for mentorship roles at Kenyatta National Hospital. Methodology: The study employed a descriptive cross-sectional design, utilizing a simple random sampling strategy to engage 88 respondents. Data collection involved a carefully designed self-administered questionnaire comprising a blend of open-ended and closed-ended inquiries to ensure a comprehensive exploration. Data analysis was done using descriptive statistics and correlation analysis. Results: Key findings revealed that 42% of participants were moderately prepared for mentorship roles, while 58% were inadequately prepared due to time constraints, workload, and lack of management support. Correlation results revealed that nurses’ level of involvement in policymaking was significant at r(87)= .281, p=.008). The nurse managers are best placed to offer mentorship to other nurses, especially to junior nurses who have joined the profession. Conclusion and Recommendations: The study concluded that while nurses were actively involved in policy-making processes, their contributions were often disregarded during policy development, leading to a lack of clear guidelines for mentorship programs despite existing standard operating procedures within nurse manager units. It is imperative for the hospital management to actively involve all stakeholders, including nurse Managers in the policy development process. Considering the input of nurse managers alongside other stakeholders will ensure that policies regarding mentorship programs are comprehensive and inclusive.Item Training institutional Factors Influencing Curriculum Implementation on Emergency Obstetrics and Neonatal Care for Faith-Based Diploma Nursing Students in Meru and Tharakanithi County(Journal of Medicine, Nursing and Public Health, 2024-09) Kivuva, Mirriam Muendi; Njuguna, Susan; Odhiambo, Roselyne A.Purpose: Maternal and newborn healthcare is fundamental to achieving positive health outcomes in a country. The implementation of the curriculum on emergency obstetrics and neonatal care (EmONC) plays a crucial role in preparing skilled birth attendants. This study aimed to assess training institutional factors influencing curriculum implementation on emergency obstetrics and neonatal care for faith-based diploma nursing students in Meru and Tharakanithi County. Methodology: A total of n=216 (84.7%) responses (second-year and third-year diploma in nursing programs students) were received out of a target population of N=255 (100%) respondents while a total of n=10 (90.9%) responses (nurse educators) were received out of a target population of N=11(100%) respondents. Data was collected through an online- administered questionnaire to nursing students and nurse educators. In addition, key informant interviews were used to collect qualitative data from nurse educators. Data was cleaned coded, and entered into the scientific package for social sciences (SPSS) software vs. 27. Descriptive and inferential statistics were used to interpret findings. Results: Bivariate correlation, showed a strong positive correlation coefficient of 0.898 and 0.640 for nurse educators and students respectively, and are all statistically significant (p<0.05). Conclusion: This study concluded that training institutional factors positively influence implementation of curriculum on EmONC in Meru and Tharakanithi County. Based on the findings of this study the study recommends several actions to improve curriculum implementation in EmONC. The college administration needs to avail necessary resources in the classroom and skill lab to facilitate learning in EmONC and make arrangementsfor students to get preservice EmONC if possible before graduation.Item Assessment of Satisfaction with Online Learning Environment Among Nursing Students in Kenya Medical Training College (KMTC) Nairobi(Innovative Journal of Social Sciences,, 2023-08) Chebii, Maryline; Mutinda, Agnes Kasusu; Njuguna, SusanIn recent years, there has been an increased use of eLearning in medical training colleges, driven by technological advancements, learners' desire for flexibility, and the COVID-19 pandemic. However, there is limited literature on nursing students' satisfaction with the eLearning environment at Kenya Medical Training College (KMTC) in Nairobi. Therefore, this study aimed to assess nursing students' satisfaction with online learning at KMTC Nairobi, focusing on students and institutional-related factors. A cross-sectional survey was conducted, involving 259 nursing students who were selected proportionately from eligible classes. The findings revealed that a significant proportion of students faced challenges in accessing a computer 115(50.2%), reliable internet 151(65.1%), and a conducive study area 123(53.2%). Cross-tabulation analysis showed that various student factors, including navigating online platforms (p = 0.026), browsing the internet (p = 0.003), accessing and using a computer (p = 0.003), having reliable internet access (p = 0.01), and being in a conducive environment for online classes (p = 0.01), were significantly associated with high satisfaction with e-learning. Institutional support for e-learning was perceived as inadequate, significantly impacting satisfaction levels (p < 0.05), particularly in terms of technical support availability and access to e-learning platforms for all students. The study recommends actions to improve the online learning experience, including ensuring access to computers and reliable internet and addressing gaps in institutional support.Item Organizational Factors Influencing the Adoption of the District Health Information System 2 in Uasin Gishu Sub County Hospitals, Kenya(World Journal of Medical Education and Research, 2020) Kuyo, R.O; Muiruri, Lilian; Njuguna, SusanSound 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 the health information system pillar. The aim of this study was to assess the use of District Health Information System data in decision making in Uasin Gishu Sub County Hospitals. The specific objectives were to determine the level of knowledge, organizational, technical and behavioral factors that influence the use of DHIS2 data in Uasin Gishu Sub County Hospitals. The study was conducted in Uasin Gishu Sub County Hospitals. The study employed both quantitative and qualitative approaches using cross-sectional research design. A questionnaire was used to collect quantitative data from 283 health workers who were selected randomly while 10 key informants were selected purposefully from this sample for in-depth interviews. The quantitative data was coded and analyzed using R Software for descriptive, bivariate and multivariate logistic regression. Thematic analysis was used to analyze qualitative data using Qualitative Data Analysis (QDA) software. Bivariate association between the independent variables and the dependent variable was assessed using Pearson‘s Chi Square test and fishers exact test where chi square assumptions were violated. Multivariate analysis was done using logistic regression to assess for predictors. A P value of 0.05 was considered as significant. The results of the quantitative data were presented in the form of graphs, tables and charts, while the results for qualitative data were presented in the form of themes. Approval to conduct the study was obtained from the KeMU Scientific Ethics Research Committee (SERC) and from National Commission for Science, Technology and Innovation (NACOSTI). Consent was sought from participants for the study. The study found that 68.4% of the participants reported good, very good or excellent competence levels in data management using DHIS2 while use of information in DHIS2 to inform policy and operational decision making was reported as good, very good, and excellent by only 37.3%, 18.9%, and 8.0% respectively. A half of the participants (50.0%) acknowledged that there are adequate finances to run DHIS2, the main champions promoting use of DHIS2, information for decision making in the County were county health records and information officers (56.2%). Moreover, 61.7% of the participants agreed or strongly agreed that age influences the way health workers adopt and use DHIS2 in the hospitals while 65.4% of the participants were dissatisfied with the IT support received from the Ministry of Health. Although 80.9% of the participants had log in credentials, only 24.2% had difficulty with logging into the DHIS2. Furthermore, 79.5% had low or moderate level of training in DHIS2 but 15.0% had never trained and this could be the reason why only a third of the participants had some confidence in handling a task using DHIS2. The study concludes that the level of knowledge regarding the use of DHIS2 information is fair across the six Sub County Hospitals in Uasin Gishu County but utilization of DHIS2 information by county health managers for decision making is low. It also concludes that the main funder of the DHIS2 system is the County Government while support from National Government is minimal, while age influences the way health workers adopt and use DHIS2 data in Uasin Gishu Sub County Hospitals. Lastly, the level of training on DHIS2 is generally low while utilization of information on DHIS2 in facilitating evidence-based decision making in the Sub County Hospitals range from moderate to low. Consequently, the study recommends that the County scales up utilization of DHIS2 information and generates policy measures to ensure utilization of DHIS2 information to facilitate decision making at the County.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 Effectiveness of Ng’adakarin Bamocha model in improving access to ante-natal and delivery services among nomadic pastoralist communities of Turkana West and Turkana North Sub-Counties of Kenya(Pan African Medical Journal., 2015-04) Jillo, Jillo Ali; Ofware, Peter Obonyo; Njuguna, Susan; Mwaura-Tenambergen, WanjaIntroduction: Access to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng’adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads. Methods: A crosssectional study design was used to establish the effectiveness of Ng’adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection. Results: There was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p<0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p<0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p<0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p<0.05.There was significant reduction in home deliveries from 89.5%-79.5% with a p<0.05. Conclusion: The Ng’adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana.Item Influence of Maternal Health Education Delivered Through Community Health Referral Project on Antenatal Care Attendance: A Focus on Mirihini and Midoina Communities of Kilifi County, Kenya(International Journal of Scientific and Research Publications, 2016-05) Shibonje, Janet Mukoshi; Mwaura-Tenambergen, Wanja; Njuguna, SusanTimely delivery of effective, safe, quality and personal services is a key pillar of health system strengthening. A Maternal, Newborn and Child Health (MNeCH) Project was initiated by the Ministry of Health and World Vision Kenya in Bamba Division, Kilifi County. The project’s goal was to strengthen health systems at the facility and community levels, including Antenatal Care (ANC). One of the strategies used by the project to achieve its goal was to strengthen community health referral system. The objectives of the study were 1) to determine whether providing maternal health education to pregnant women had any influence on ANC attendance in the intervention and control communities and 2) to determine whether issuing referral advice forms to patients has any influence on ANC attendance in the intervention and control communities. This study adopted the static group control design to assess the influence of community health referral practices on ANC attendance in Mirihini, the intervention community in Bamba and Midoina the control community. Primary data were sourced from 246 mothers of children aged below 2 years, parents of children aged 2 to 4 years, as well as Community Health Volunteers (CHVs). Quantitative analysis yielded descriptive statistics and cross-tabulations with Chi-square (χ2 ) tests. Qualitative data were transcribed, described and analyzed systematically to reveal themes and patterns. Maternal health education: In Mirihini, there was no significant association between providing maternal health education on the ideal number of ANC visits and women’s achievement of optimal ANC attendance (χ2 = 1.423, df=1 & a ρ-value = 0.233). In Midoina, a significant relationship between the two aspects was obtained (χ2 = 3.109, df = 1 & ρ-value = 0.078. Referral documentation: In Mirihini, issuing referral documents to pregnant women was significantly associated with women’s achievement of optimal ANC attendance (χ2 = 8.308, df =1 & ρ-value = 0.004). In Midoina, there was no significant association between two aspects (χ2 = 0.823, df = 1 & ρ-value = 0.185). The study recommends the need for: CHVs to deliver more information to support care-seeking behavior change; project officers to strengthen supervisory support to CHVs by engaging with MoH to provide reporting materials and ensure consistency of monthly review meetings.Item Technical Factors Affecting Electronic Medical Record System Information Use: A Case of Kakamega County Referral Hospital Outpatient Department(IOSR Journal of Nursing and Health Science (IOSR-JNHS), 2018-04) Nandikove, Peter; Wanja Mwaura, Tenambergen; Njuguna, SusanThe recent worldwide focus on healthcare quality improvement, cost containment and enhanced patient experience has led to increased need for adoption of Electronic Medical Record systems (EMR) ( Waithera L, Muhia J, Songole R , 2017). This technology agitates for paperless transactions health care and would significantly reduce clinician workload and medical errors while saving the institution major expenses. Kenya is globally acclaimed as a leader for its Information Communication Telecommunications (ICT) innovations such as M-PESA (Graham, 2010). Many studies have been done in other countries to study the factors influencing adoption and usage of EMR technology, but a small number of studies exist in Kenyan situation (Ministry of Health, 2010). This study sought to examine why the application of EMR technology has not kept pace with its demand. This study therefore sought to answer two key research questions derived from the study objectives which include the influence of network infrastructure, EMR system design and staff ICT skill levels on information use of electronic medical records technology in a public health institution in Kakamega County The study was guided by technology acceptance model as its theoretical framework (Seok Kim, Kee-Hyuck Lee, Hee Hwang and Sooyoung Yoo, 2016). The study adopted a cross-sectional survey design with a target population of 80 respondents working in Kakamega county referral hospital. A descriptive survey research design was used. Stratified random sampling was embraced to divide the population into homogeneous subgroups as per the professional cadres then did simple random sampling in proportion to their number in the population. A questionnaire with a 5-point Likert scale was constructed and used. Data was collected using structured questionnaires and analyzed using SPSS version 23. Both content and construct validity were used to ensure validity of the research instrument’s while reliability was determined by using the Cronbach-Alpha Coefficient. Pilot testing to pre-test and validate the research instruments was done prior to the main study. One of the two hypothesis was rejected, there seemed to exist no significant differences among professionals with regards to EMR information use F (9,62) = 1.745, p > 0.05, one hypothesis was accepted, there seemed to exist a significant relationship between technical factors and EMR information use (r = 0.583, p <0.05). The study recommends that health facilities should increase infrastructure and resources that support EMR use, employees should be supported for further training on EMR operation and suppliers should regularly support and train health staff on how to use EMR effectively. The study results may be useful to hospitals as they gear towards integrating all their process by using technology.Item Health Literacy on Patients’ Rights Charter Among Users of Primary Care Health Facilities in Kiambu and Machakos Counties in Kenya(International Journal of professional Practice (IJPP), 2020-10) Njuguna, Susan; Wanja Mwaura, Tenambergen2; Mapesa, JobHealth literacy of patients’ rights and responsibilities is a challenge for users of primary health care facilities in many parts of Kenya. Low health literacy hinders the practice of patients’ responsibilities as described in the patients’ rights charter thereby negatively impacting health outcomes. Health literacy is associated with improved utilisation of health services leading to better health outcomes. The aim of this study was to establish the extent to which users of primary health care facilities in Kiambu and Machakos counties in Kenya have embraced health literacy as envisaged in the Patients’ Rights Charter. Specifically, the study sought to establish patient’s awareness of their rights; to establish the extent to which patients practice their responsibilities and rights in primary health care facilities; and to relate literacy to the demographic characteristic of the respondents. Health literacy of patients’ rights in the context of this study refers to the patients’ awareness of their rights and their ability to make basic health decisions concerning their rights as their responsibility. This was a descriptive cross-section study that used semi-structured questionnaire to collect quantitative data. A random sample of 422 patients from the outpatient department of four primary care health facilities was drawn. Every fifth patient who met the inclusion criteria and was willing to participate in the study was enlisted. Of the respondents enlisted, 389 (92%) complete questionnaires were analysed using SPSS version 25. Overall, majority of the respondents agreed that they were aware of their rights and they practised their responsibilities as per the Patients’ Rights Charter. The respondents’ awareness of their rights was statistically significant with regard to age (r = 0.293**, P ˂ 0.001), level of education (r =0.293**, P ˂ 0.001) and duration of health care services (r = 0.294**, P ˂ 0.001). Respondents’ practice of their responsibilities was statistically significantly related to age (r = .244**, P ˂ 0.001) and duration of receiving health care services (r = 0.342**, P ˂ 0.001). The study concludes that patient demographic characteristics like age, level of education, and the duration they had visited the health facility for services, had an influence on their health literacy based on Patients’ Rights Charter. This therefore draws the recommendation that health facilities should have a structured approach to health literacy of patient’s rights charter that targets demographic characteristics along the patients’ developmental stages through specific components of primary care health services.Item Influence of patients’ rights charter on health systems responsiveness in selected counties in Kenya: health care provider perspective(International Journal of Community Medicine and Public Health, 2019-10-14) Njuguna, Susan; Wanja Mwaura, Tenambergen; Mapesa, JobBackground: The role of health care providers in the implementation of responsiveness of health systems is unclear. Responsiveness of health systems is one of the goals set out by WHO in 2000. Effective leadership and governance of health systems incorporates all players involved in policy implementation. The objectives of the study were to establish how the health care provider’s awareness of patients’ rights charter influence health systems responsiveness and to establish how the health care provider practice of patients’ rights charter influence responsiveness of health systems in primary care settings. Methods: This was an exploratory cross section descriptive study design that used a psychometric semi- structured questionnaire to collect qualitative data that was analyzed quantitatively. Respondents were 62 purposively sampled health care providers from four, primary care health facilities. Key informant interviews from the four health facilities in-charges were carried out. Data was analyzed using SPSS vs 25 and themes. Results: Health care provider awareness of the content of patients’ rights charter (r=0.612*, p<0.001) and practice of patient’s right charter (r=0.610*, p<0.001) were statistically significant and influenced health systems responsiveness. Conclusions: Implementation of patients’ rights charter has an influence on responsiveness of health systems. Leadership and Governance of health systems requires a structured approach to implementation of policies that positively influence responsiveness of health systems. Supervision of health care providers for best practice can provide a basis for replication in other primary care facilities and lead to achieving responsiveness of health systems.