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 Influence of Demographic Factors on Uptake of Diagnostic Imaging by Oncology Patients in South Rift Counties, Kenya(Journal of Medicine, Nursing and Public Health,, 2024-08) Muikamba, Lilian; Tenambergen, Wanja; Muiruri, LilianPurpose: To determine the influence of demographic factors on uptake of diagnostic imaging by oncology patients in South Rift Counties, Kenya. Methodology: A cross-sectional research design was adopted when collecting data from 5 public hospitals in South Rift Counties. The study issued questionnaires to oncology patients and interviewed the rest of the respondents. A pre-test study was done at Texas Cancer Center in Nairobi County. Quantitative data was analyzed using descriptive statistics and binary logistic regression analysis. Qualitative results data was analyzed through thematic method. Results: 74(25%) patients had 41-50 years and 65(22%) were 61-70 years. The least number of oncology patients who were 3(1%) and they were 18-20 years of age. Further, 264(89%) were married while 33(11%) were not married. Additionally, 182(61%) were male patients while 115(39%) were female patients. Additionally, 166(56%) had a tertiary level of education while 39(13%) had primary school qualifications. In addition, 203(68%) were Christians and 80(27%) were Muslims and only 5(2%) were not religious. Notably, 110(37%) of the patients had breast cancer while 77(26%) had colon cancer. The least group of patients who were 12(4%) had lung cancer. Additionally, most of healthcare workers who were 12(39%) had more than 50 years while 10(32%) had 41-50 years. However, 4(13%) had 18-30 years. Further, 18(58%) had a master’s degree while 5(16%) had a PhD. In addition, 17(55%) had more than 10 years of service while only 5(16%) had 5-7 years. The Chi-square result revealed that χ2 (1, N = 297) = 461.599, p < 0.05. That is the Pearson Chi-Square was 461.599 at a p-value of 0.027. Conclusion and Recommendations: Most patients that sought cancer diagnostic imaging were middle and old aged male people who were married. This meant that unmarried young female adults hardly sought imaging services. The most common cancer illnesses scanned were breast, colon, and cervical cancers. The study recommends that that the hospital management should provide more funding for sensitization programs to inform unmarried young people especially females to seek early diagnostic imaging services. This will enable them to ensure that no cancerous cells are growing to be discovered at a late stage for effective management.Item Effectiveness of Bystander Knowledge through Community-Based Training on Responsiveness of Prehospital Emergency Care in Nairobi County, Kenya(Journal of Health, Medicine and Nursing, 2025-07) Musyoka, Felistus Ndanu; Tenambergen, Wanja; Mapesa, JobPurpose: Most of the emergencies occur outside heath care setting and prehospital emergency care is vital in reducing preventable deaths and disabilities. In Nairobi, emergency response remains fragmented, and bystander involvement is limited due to low knowledge and training. To assess the effect of bystander Knowledge through community-based training on responsiveness of pre-hospital emergency care. Methodology: This quasi-experimental pre-post intervention in Mama Lucy Kibaki Hospital's catchment area trained 128 Community Health Promoters (CHPs) to educate 64,000 households on emergency notification and response. Baseline and end-line data collected via questionnaires were analyzed using SPSS v26.0. Findings: Training bystanders dramatically improved their emergency response knowledge and efficiency. Knowledge scores significantly increased (p=0.001), with notable gains in knowing the emergency number (55% to 83%), saving the tollfree number (16% to 73%), and recognizing 1508 (4% to 48%)— all p<0.0001. The percentage of individuals knowing what to do in an emergency rose from 85% to 94% (p<0.001), and the mean knowledge score increased from 6.39 to 7.30 (p<0.001). Improvements were observed across all demographic groups. Post-secondary educated respondents showed the strongest gains (+13.7 percentage points to 96.5%, p<0.001). Males experienced greater improvement (+14.4 points to 93.7%) than females (+9 points to 82.2%). The training was most effective for interior residents (achieving 100% knowledge) and those near major roads (+21.3 points to 78.9%, p<0.001). Casual labourers demonstrated the largest gains (+40.9 points to 90.9%). Workingage participants, specifically those aged ≤30 and 31-40 years, also showed significant knowledge increases (+11.4 and +10.9 points, respectively). These knowledge gains led to faster emergency responses, with 87% of reports occurring within 0-5 minutes postintervention, compared to 0% at baseline. Delays exceeding 15 minutes plummeted from 80.4% to 4.1% (p<0.001). The strongest predictors of knowledge were post-secondary education (OR=5.64, p<0.001) and interior residence (OR=7.32, p<0.001). Casual labourers showed reduced odds of knowledge (OR=0.24, p=0.017), while respondents aged 31-40 years had 74% higher odds (OR=1.74, p=0.039). Gender, most employment statuses, and age >50 years did not significantly affect knowledge Unique Contribution to Theory, Practice and Policy: Community-based training significantly improves bystander knowledge and emergency response times, offering a vital solution for strengthening pre-hospital emergency systems in Low- and Middle-Income Countries (LMICs). This highlights the critical need for diverse bystander training strategies. The study recommends; developing a specialized pre-hospital emergency care training model for the elderly. Conducting further research on how marital status influences knowledge acquisition from training. Revising the WHO Emergency Care System Framework (ECSF) to explicitly incorporate bystander training.Item Health Products and Technologies Financing and Health Products and Technologies Management in Level Four and Five Hospitals in Nyeri County(Journal of Service Science and Management,, 2024-10) Machanga, Alice Muthoni; Tenambergen, Wanja; Kimemia, FredrickThe study aimed to assess the impact of Health Products and Technologies (HPTs) financing on the management of HPTs in level four and five hospitals in Nyeri County, Kenya. A mixed-methods research design was employed, integrating both cross-sectional data and interviews. The census method was used to involve 51 health professionals, while 6 key informants were purposively sampled. Data were gathered using questionnaires, which were pre-tested in Laikipia County to ensure reliability. Quantitative data were summarized through descriptive statistics, such as frequencies and percentages, while correlations and multiple hierarchical regression were performed to determine the relationship between HPTs financing and management, analyzed via SPSS version 25. The qualitative data were thematically analyzed and presented verbatim. Results indicated that HPTs financing had a significant influence on the management of these resources, explaining 43.3% of the variance, and 43.9% when leadership practices were controlled for. The regression model was: Management of HPTs = 20.162 + 0.321 Financing. The study rejected the null hypothesis, confirming that financing significantly affects the management of HPTs in public hospitals in Nyeri County. Recommendations included allocating more flexible and targeted funding for HPTs, using data analytics for more informed budgeting, and improving the timeliness of fund disbursement processes. These actions are vital for enhancing healthcare services, especially in resource-limited settings. The study provides essential insights for policymakers, hospital administrators, and researchers, contributing to future academic work and the development of efficient financial strategies for HPTs management in public healthcare systems.Item Determinants of Effective Child Immunization Delivery: A Study of Community Health Units in Informal Settlements in Nairobi County, Kenya(Journal of Service Science and Management,, 2024) Chepkorir, Lenah; Tenambergen, Wanja; Mapesa, JobThe effectiveness of Community Health Units (CHU) in delivering child im- munization services is a critical component of public health in urban informal settlements. In Nairobi County, CHU are tasked with ensuring that all chil- dren receive necessary immunizations. However, the effectiveness of these units is influenced by several factors, including the Accountability System and Human Resource Management practices. Despite the implementation of CHU, a significant proportion of children in these informal settlements re- main unimmunized. Previous studies have not sufficiently explored how the clarity of accountability systems and adherence to human resource practices impact the effectiveness of CHU in delivering child immunization services. This gap necessitates an in-depth examination to enhance the performance of CHU in such vulnerable populations. We aimed to examine the influence of the accountability system and Human Resource Management practices on the effectiveness of CHU in delivering child immunization services in urban in- formal settlements in Nairobi County, Kenya. The study adopted a cross-sec- tional descriptive design, utilizing an interpretivist research philosophy to ex- plore the depth of the relationship between the independent variables (Ac- countability System and Human Resource Management) and the dependent variable (effectiveness of CHU delivery of child immunization services). A sample of 354 Community Health Workers was selected from 449 fully func- tional CHU in the informal settlements using stratified simple random sam- pling. Data was collected via a structured questionnaire and analyzed using descriptive statistics and binary logistic regression to determine the relationship between variables using SPSS version 26. The findings revealed that a clear accountability system significantly increased the effectiveness of CHU in de- livering child immunization services, with an odds ratio of 0.140. Similarly, ad- herence to standard human resource practices significantly improved CHU performance, with an odds ratio of 0.207. The logistic regression model indi- cated that 43.1% of the variance in CHU effectiveness could be explained by the independent variables. The results underscored the importance of clear communication channels, community involvement in monitoring and evalua- tion, and consistent support supervision as vital elements in enhancing CHU performance. We conclude that strengthening accountability systems and ad- hering to standard human resource practices are essential for improving the delivery of child immunization services by CHU in informal settlements. These results imply that policymakers and health administrators should prioritize these factors to achieve full immunization coverage and improve public health outcomes in underserved urban areas.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 Strengthening Social Accountability Process in Community Health Systems: Exploring the Role Of Community Actors in Africa and South Asia: Systematic Review(International Journal of Scientific and Research Publications,, 2022-04) Abuga, Malkia M.; Tenambergen, Wanja; Njoroge, KeziaBackground: Despite a growing body of literature on social accountability in health systems, many questions remain unanswered about how community actors interact with health workers and demand accountability. Social accountability is viewed as an empowerment process and a social practice in which communities actively participate in changing the conditions that affect their health. Local factors, such as the role of community actors, influence the effectiveness of social accountability. The purpose of this research was to assess empirical evidence on the role of community actors in social accountability. Methods: Electronic searches were conducted for eligible studies within each of the Pubmed, Medline, Google Scholar and SciELO databases from 2012 to January 2022. Peer-reviewed English language publications describing a social accountability mechanism with a focus on the role of community actors in Africa and South Asia were eligible for inclusion. There were no restrictions on the research design. Results: The review included eleven relevant studies. According to the findings, community actors include Community Health Workers, Health Facility Committees, Community Elected Leaders, and the media, among others. Their responsibilities include monitoring services and health worker’s performance, gathering and sharing information, and resolving complaints. Some of the enablers to the role community health actors include diverse committee membership and the legitimacy of community leaders. On the other hand, knowledge and power asymmetry, the lack of a clear mandate, a lack of clarity on their roles and fear of reprisal are among the barriers to their role in Social Accountability. Conclusion: Community actors are part of the community health system, and understanding their role, strengths, and challenges has a practical impact on how they contribute to the overall health system's strength. The findings show that they can exert social pressure through their powerful coalitions, which is critical in Social Accountability activities. As a result, in order to maximize their potential, novel approaches to addressing the limitations identified in this review are required.Item FACTORS INFLUENCING COLLECTION OF BLOOD DONOR TEST RESULTS IN NAIROI COUNTY – A CASE STUDY OF NAIROBI REGIONAL BLOOD TRANSFUSION CENTER(Journal of Health, Medicine and Nursing, 2018) Gititu, George; Oluoch, Musa; Tenambergen, WanjaBackground: The Kenya National Blood Transfusion Services screens all donated blood for HIV, Hepatitis B&C and syphilis with each blood donor being informed of testing of his or her donated blood and availability of test results for collection at the Regional Blood Transfusion Centers. The study-assessed factors influencing collection of blood test results by blood donors as only less than 10% blood donor’s return to collect their test results. Method: The study utilized descriptive cross-sectional study approach employing a mix of both quantitative and qualitative approach. 385 blood donors and seven key informants interviewed using a pre-designed questionnaire and Key informant respectively. Quantitative data was analyzed using Epi info 6.04 while qualitative data was transcribed and analyzed using content thematic framework approach. Results: 95% of participants did not return to collect their test results with 90% not being aware that test results are available for collection. 50% of those who had not collected their test results would not have collected even after being adequately informed. 93% would not collect their test results in presence of friends fearing stigmatization and would not share the outcome of the test even with their families. Conclusion: The study concluded that the collection of donor test results is greatly influenced by knowledge, location of result collection sites, working hours of collection sites, stigma and cultural beliefs. The Study recommends mass sensitization on availability of test results, where to collect results and demystify social cultural beliefs.