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 Determinants of Utilization of Home-Based Care in Kisumu County.(International Journal of Health Sciences, 2024-08) Ratori, Erick Enock; Oluoch, Musa; Mwangi, MuthoniPurpose: To examine the factors influencing the utilization of Home-Based Care in Kisumu Central. It examined the influence of predisposing factors, enabling factors, the environment and Health Behaviors on utilization of Home-Based Care. Methodology: This was a mixed research design which employed both qualitative and quantitative methods to examine and characterize the elements that impact the use of home-based care. The study samples consist of 120 respondents selected from among home based care users. The data was collected through structured questionnaires that were self-administered to home-based care users. The collected data was quantitative and analyzed using descriptive and statistical tools like SPSS (version27). The findings were displayed in tables. Descriptive statistics, Bivariate correlation and multivariate regression models were utilized to determine the relationship between the independent and dependent variables. Findings: The study found that predisposing factors, enabling factors, the environment and health behaviors were significant factors influencing the utilization of home-based care in Kisumu Central Sub County with significant p=.000 each. Unique contribution to theory, practice and policy (recommendations): Theory: The study challenges traditional theories by demonstrating that predisposing factors, enabling factors and the environment are more significant than health behaviors in influencing Home-Based Care utilization. Policymakers should implement strategies that target investments in and support for Home Based Care as a vital component of healthcare delivery, particularly for individuals with chronic illnesses and those requiring personalized and accessible care within their homes.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.Item Training Influence on the Performance of Mental Health Professionals in Selected Public Psychiatric Hospitals Kenya(Journal of the Kenya National Commission for UNESCO, 2024) Wambu, Fredrick; Oluoch, Musa; Tenambergen, TenambergenPublic hospitals have been struggling with issues related to low general performance and personnel productivity. Concerns have been raised about differences in study leave and training received by employees at public health facilities, which explain why employee performance is low. There are serious consequences when employee well-being is not addressed through good training. Failing to prioritize their training can result in increased rates of disengagement, absenteeism, and turnover. The objective of this study is to evaluate how training influence performance of mental health professionals. The study adopted mixed methodologies in a cross-sectional descriptive research design. About 146 mental health professionals, were sampled using stratified random proportionate sampling. Purposive sampling was used to select ten key informants. Content analysis was used on qualitative data, descriptive and inferential statistics were used to analyze quantitative data. The study findings show there is a correlation between training and employee relations (r=0.584, p<0.001), between training and appraisal (r=0.529, p<0.001), between training and remuneration (r=0.415, p<0.001) between training and performance (r=0.280, p < 0.001). This study recommends that in order to maximize employee performance, hospital management should prioritize the ongoing skill development of their staff. Only via ongoing training and development procedures is this achievable.Item Enhancing Productivity in Laikipia County's Public Health Facilities: The Role of Motivational Strategies for Healthcare Workers(Academic Journal of Health Systems and Reform (AJHSR), 2024-06) Lekurtut, Christine; Oluoch, Musa; Muiruri, LilianThis study investigated the influence of motivational strategies on the productivity of health workers providing medical services in public health facilities within Laikipia County. With healthcare delivery being a critical aspect of societal well-being, understanding the factors that affect the performance of healthcare professionals is essential for optimizing service provision. Motivation plays a pivotal role in driving employee performance, and this research aims to explore the relationship between motivational strategies and the productivity of health workers. Using a mixed-methods approach, data was collected through surveys and interviews conducted among healthcare professionals working in various public health facilities across Laikipia County. The survey questionnaire assessed perceptions of motivational strategies implemented in the workplace, while semi- structured interviews provided insights into the experiences and perspectives of health workers regarding motivation and productivity. Preliminary findings suggest that motivational strategies such as recognition, career advancement opportunities, training and development, and supportive work environments significantly impact the productivity of health workers. Positive reinforcement and acknowledgment of achievements emerged as particularly effective motivational tools in enhancing job satisfaction and performance among healthcare professionals. The findings underscore the need for targeted interventions aimed at fostering a conducive work environment and promoting employee motivation to improve the quality and efficiency of healthcare delivery in underserved regions.Item Determinants of Health Facility Preparedness in the Management of Gender Based Violence in Kenya: A Case of Primary Health Facilities in Mombasa County(Journal of Popular Education in Africa., 2023-09) Onkoba, Phyllys Kemunto; Tenambergen, Wanja; Oluoch, MusaGender based violence (GBV) is a significant obstacle to achieving human rights and sustainable development goals. the study aimed at establishing the determinants of health facility preparedness in the management of GBV: A case of PH facilities in Mombasa County. Descriptive cross-sectional research design was used in establishing the factors influencing health facility preparedness in the management of GBV. The study focused on health workers working Mombasa County Primary health (PH) facilities including the hospital administrators, medical officers, clinical officers, nurses, counsellor, psychiatrists, pharmacists and lab technicians working in Level 2, Level 3 and Level 4 health facilities. The study employed the random sampling approach where all the elements had equal chances of being chosen. The study sample was 334 which was 16.4% of the target population. A questionnaire was used in collecting the necessary data aimed at fulfilling the purpose of this study. Data was analyzed using SPSS version 25 and both descriptive and analytic statistics were done. Pearson correlations was used to assess the strength of the association between the study variables. Finally, the multiple regression was run in order to find out the collective predictive power of the independent factors on the dependent variables. The study found and concluded that that budget allocation, health information management system and professionalism were significant factors in influencing the PH facilities preparedness in the management of GBV with significant value of .000 each. Further, the study concludes that physical infrastructure was an insignificant determinant of the PH facilities preparedness in the management of GBV with significance value of .084Item Determinants of utilization of National Health Insurance Fund cover in public health facilities by public health care workers in Makueni County(International Journal of Community Medicine and Public Health, 2022-11) Muia, Angeline M.; Njoroge, Kezia; Oluoch, MusaBackground: Robust healthcare funding systems are seen as critical for guaranteeing universal healthcare access. This implies that health services should be adequately accessible to everyone ensuring health situation doesn’t reduce the patient and their family to poverty making analysis of determinants of National Health Insurance Fund (NHIF) cover utilization critical. Methods: Descriptive research design was used to study utilization of NHIF cover among health professionals in public hospitals in Makueni County. Stratified random sampling technique was used to sample the facilities across the different levels. The study sample was 291 from a target population of 1183 health professional. The data was collected using structured questionnaires. Statistical package for social science (SPSS version 25) was used to code and analyze the raw data. Pearson's coefficient of correlation and multiple regressions were used to assess the association between determinants and NHIF utilization. Results: The study found and concluded that at the significance level of 95%, alternative insurance covers, perceived quality of health services and NHIF communication strategy significantly influenced utilization of NHIF cover by public health care workers at α=0.05. On the other hand, NHIF scheme characteristic was an insignificant determinant of utilization of NHIF cover among public health care workers in Makueni County. Conclusions: The study concludes alternative insurance covers, NHIF scheme characteristics, perceived quality of health services influenced utilization of NHIF cover and NHIF communication strategy influenced utilization of NHIF cover among health workers.Item FACTORS INFLUENCING HIV/AIDS CLIENT SATISFACTION AT COMPREHENSIVE CARE CENTRES IN WAJIR COUNTY, KENYA(European Journal of Public Health Studies, 2021) Mohamed, Ibrahim Abdi; Oluoch, Musa; Tenambergen, Wanja Mwaura-Service delivery is one of the core pillars of health systems building blocks and client satisfaction is one of the parameters that is used to assess the status of services offered in an institution. This study investigated the factors that influence HIV/AIDS Client satisfaction at the Comprehensive Care Centre’s (CCCs) in Wajir County. Specific objectives were to assess the influence of availability of HIV/AIDS testing services, availability of HIV drugs, availability of care and support system and the availability of the institutional support towards HIV/AIDS at the CCCs on clients’ satisfaction. A descriptive cross-sectional study was employed where both quantitative and qualitative data were gathered through survey questionnaires and key informant interview guide. Out of the targeted 157 clients at the sub-County and county referral hospitals about 147 positively responded, leading to a 93.6% response rate. SPSS version 24 was used to code and analyze the collected data. Chi-square and Logistic regression analysis were done to determine the relationship between and among the variables. Bivariate analysis revealed a significant relationship between client satisfaction and predictor variables. The results indicated the probability of being satisfied with services in the Comprehensive Care Centre’s was 51.3 per cent higher for people who reported availability of HIV testing services and 56.9 per cent higher for people who reported accessibility of HIV care and social support. Based on the findings, the study’s policy recommendations are hospitals management needs to ensure sufficient HIV testing services are available and accessible to patients. Further, stakeholder collaboration with hospital management is recommended for strengthening service delivery at CCCs in Wajir County.Item Factors that influence healthcare service utilization during COVID-19 pandemic among pregnant women and caregivers with children under two years in Rongo sub-county, Migori County, Kenya(International Journal of Community Medicine and Public Health, 2021-08) Awino, Doreen Baraza; Tenambergen, Wanja Mwaura-; Oluoch, MusaBackground: Health systems have failed in past epidemics to maintain delivery of routine health essential services. Most resources including human and essential supplies are all diverted to address health emergency, sometimes resulting in lack of important basic and routine health services. Methods: This was a retrospective cross-sectional study with mixed data collection methods, where respondents were asked questions on how COVID-19 affected them with regard to utilization of MCH healthcare during the first peak of the COVID-19 in Kenya. Two high volume facilities were selected purposively based on volume and capacity of services offered. A random sample was drawn from the stratum using a list generated by community health workers (CHWs) attached to the health facilities. Key informant interviews were used to collect data among health care providers and structured questionnaire was used for pregnant women and caregivers. Independent variables, social distancing, social stigma, communication and human mobility restriction were associated with health care service utilization and significant at 0.05 p value. Results: Correlation analysis indicated social stigma (r-0.407, p<0.512), social distancing (r-0.324, p<0.001) and human mobility restrictions (r-0.606, p<0.001) negatively influenced service utilization. Whereas COVID-19 related communication (0.631, p<0.001) was protective and thus promoted service utilization. The hierarchical linear regression model explained 67.73% of the total variations in the health care service utilization, which was r=0.6773. Conclusions: From the findings social stigma, communication, social distancing and human mobility restrictions influence health care service utilization. Ministry of health should strengthen targeted community outreaches for pregnant women and caregivers with children under two years.Item Health System Influence On Functionality of Managers in Public Hospitals: A Case of Sub County Hospitals in Bungoma County(Journal of Public Policy & Governance,, 2021-07) Mugasia, Tony Chahale; Muiruri, Lillian; Oluoch, MusaManagers tasked with leading and managing the hospitals in the developing economies often have little formal preparation and face challenges in execution of their mandates. This study therefore interrogated the influence of management knowledge, organization capacity building systems, internal work environment and hospital finance on the functionality of managers in public Sub County hospitals in Kenya focusing on Bungoma County. A descriptive approach was adopted and 170 managers from the 10 Public Sub County hospitals in Bungoma County were targeted. A structured questionnaire was used to collect quantitative data which was analysed through SPSS version 24 to give descriptive and inferential statistics. The results of the study indicated that management knowledge of a manager had a positive and significant influence on manager’s functionality to manage Sub-County Hospitals (β = 0.263; P-value <0.05); organization capacity building systems had a positive and significant influence on management of Public Hospitals (β = 0.327; P-value < 0.05); internal work environment had a positive and significant influence on management of Public Hospitals (β = 0.360; P-value < 0.05) and health finance equally had a positive and significant influence on management of Public Hospitals, this influence was not significant (β = 0.112; P-value < 0.05). This implies that a unit increase in these factors would lead to a significant increase in management of the Sub-County hospitals. Based on these, the study recommended the county government of Bungoma County to set aside a budget to recruit health workers to address HRH gaps. The county government to enhance their financial commitment towards the running of the public hospitals in the county. The County to increase proportion of their exchequer to the public hospital the current proportion is not adequate. County top leaders to revise the finance accountability frameworks for efficient funds utilization. Furthermore, the local political leaders should collectively rework their conflict resolution mechanisms with the management of the hospitals and look for alternatives problem solving mechanism to reduce interference with the normal operation of hospitals.Item Determinants of adverse drug reactions reporting in retail chemists in Nairobi County, Kenya(International Journal of Community Medicine and Public Health, 2020-08-28) Njiru*, June W.; Mwangi, Eunice M.; Oluoch, MusaBackground: Reporting of adverse drug reactions remains the mainstay of a vibrant pharmacovigilance system that seeks to safeguard medicines in a health system. This study sought to establish the impact of the national medicines regulatory body, The Pharmacy and Poisons Board (PPB), the operationalization of pharmacovigilance implementation strategies in the retail chemists, the effect of the capacity and that of underlying motivation factors of the retail chemist personnel on reporting of adverse drug reactions. Methods: This was a descriptive cross-sectional study design conducted between May 2018 to June 2018. Results: 149 (60%) of the respondents stated that PPB did not engage retail chemists as stakeholders in pharmacovigilance, 127 (51%) said they had never read any PPB publication on pharmacovigilance, 151 (61%) said they had general knowledge on pharmacovigilance, receiving feedback from PPB was considered a major motivational factor towards ADR reporting by 237 (96%). Multivariate analysis of the determinants of ADR reporting in retail chemists established that the pharmacovigilance implementation strategies (p<0.026), retail chemist personnel (p<0.001) and underlying motivational factors (p<0.05) had significant influence on ADR reporting in retail chemists in Nairobi County. Conclusions: PPB has not engaged retail chemists on pharmacovigilance matters as key stakeholders and this has impacted the quality of the pharmacovigilance implementation strategies in the chemists as well as the capacity and motivation of the retail chemist personnel to report ADRs.