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
48 results
Search Results
Item Alcoholic Beverage Use Among Somali Youth Living in Eastleigh, an Urban Suburb in Nairobi, Kenya(European Journal of Preventive Medicine., 2018) Korio, Abdi Aden; Nyavanga, Eunice JemalelBackground: Harmful use of alcohol causes a large disease, social and economic burden to societies. Alcohol use is the third largest disease risk factor for deaths among youths between 15-29 years that contribute to 4% of the global burden of disease. Eastleigh also is known as “Little Mogadishu” is a suburb in Nairobi that is mostly inhabited by both Somali Community from Kenya and majorly from migrations from Somalia. It hosts about 30,000 Somali refugees and characterized by extremes of wealth and poverty. Objective: The aim of this study is to identify the prevalence of alcohol use and the patterns of use among Somali Youth living in Easteigh suburb in Nairobi. Method: This is an exploratory cross-sectional study among youth aged between 18-25 years of age that used a face-to-face interview. Results: Findings indicated a high prevalence among those who are male, of younger age, with married parents, born in Eastleigh, with lower educational level, the singles, the unemployed and those with high family income. Alcohol use is comorbid with other licit psychoactive substances that include tobacco products, miraa and shisha. Conclusion: These participants have relatively high alcohol use that is comorbid with other licit psychoactive substances. Recommendations include further studies to be done in this community using standardized instruments to cover a larger area and interventions to target younger youth of below 15 years of age and policy on treatment of young people with mental disorders to include substance abuse as well.Item INVENTORY MANAGEMENT PRACTICES FOR ESSENTIAL DRUGS AT PUBLIC AND MISSION HOSPITALS IN MERU COUNTY, KENYA(International Journal of Current Business and Social Sciences, 2015) Meeme, Shadrack M.; Okero, Dominic C.; . Muiruri, Lilian K.BACKGROUND: Essential drugs are important for quality service delivery in the healthcare system. Proper inventory management of essential drugs in the health facilities is critical in ensuring availability of essential drugs (ED). Despite the importance of the required essential drugs at various user points, about one third of the world’s population does not have access to ED. This is a serious problem considering that drugs take up a significant portion of the healthcare budget and availability of ED is critical in quality healthcare provision which is a priority of the Health Systems. OBJECTIVES: To examine the current stock control practices for essential drugs at public and mission hospitals in Meru County, determine the current storage practices for essential drugs at public and mission hospitals in Meru County and establish the current practices for managing returns of essential drugs at public and mission hospitals in Meru County. METHODS: Cross-sectional descriptive study design was employed in the study and it involved 205 clinical and inventory management staff dealing with essential drugs inventory management and use in four hospitals in Meru County, Kenya. RESULTS: Method by which essential drugs are approved and issued were mostly FEFO (First Expiry First Out) 36(90.0%) and FIFO (First In First Out) 2(5.0%) and was significant on the inventory management practices (χ2 Wald test P-value =0.011). Good inventory control practices were identified mainly in FEFO (First Expiry First Out) approval and issuance methods. Stages of inspection were significant on the inventory management practice (χ2 Wald test P-value =0.000). There was significant correlation between the inventory management practices and inspection stage of essential drugs (χ2 Wald test P-value =0.037) with best practices identified when inspection was done before storage. This implies that inspection before storage increased odds of good inventory management practices. From the study it established that the main suppliers of essential drugs were MEDS 35.5%, KEMSA 29.0%, Pre-qualified supplier 19.4% and Private distributors 16.1% (p-value= 0.734). The study established that ordering of drugs mainly depended on past consumption 61.1 % other than request by users 22.2 %, majority of clinical staff 56.6 % complained of receiving drugs of questionable quality from the hospital drugs store indicating a problem in inspection of ED before storage. CONCLUSIONS: The study concluded that mission hospitals performed better than public hospitals in all aspects of inventory management. This is significant and considering that health care workers use essential drugs to deliver quality services to the clients. Patient visiting mission hospitals were likely to get all prescribed medicine which was a measure of quality on patient perspective than patient seeking health care from public health facilities: RECOMMENDATION: The study recommends public health facilities to benchmark with mission hospitals to improve inventory management practices thus ensuring availability of ED .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 The Design Criteria in Implementation of a Health Management Information System: a Case of Kenyatta National Hospital(2016) Omambia, Salim Matagi; Odhiambo-Otieno, G.W; Mwaura, WanjaEmbracing modern technology is one among very many ways of improving efficiency and reducing costs within healthcare organizations. While the integration of information and health services potential benefits cannot be disputed, there are many challenges which affect its adoption, in fact, majority of organizations have abandoned their newly acquired systems only to go back to their old manual systems.The objective of this study was to determine the design phase of the implemented Health Management Information System at Kenyatta National Hospital. This study was a cross-sectional descriptive study, the targeted population of the study were 35 healthcare workers who were involved in the designing of the Health Management Information System at Kenyatta National Hospital, and the sample technique used was snowball sampling The study utilized an in-depth interview schedule for 33 respondents in the design phase who were selected using snow-ball, the data collected from the field was analyzed through the use of univariete and bivariete statistics. Data presentation was in form of descriptive statistics such as frequency distribution, percentages, pie charts, bar graphs and tables. The data from the design phase were summarized in three main evaluation areas targeting the perception of the HMIS, purposes and processesFrom the findings, in the design stage although the respondents did not show systematic ordering there was evidence to the effect that the steps were followed during the design phase. From the findings majority of the key informants were able to define HMIS and distinguish the key features of the HMIS. Out of the 33 participants, 13 (33.4%) reported that they knew the persons who originated the idea of the electronic HMIS in KNH, a similar number were involved in the conceptualization of the system, while 4 (12.2%) indicated that they were involved in designing the HMIS and 18 (54.6%) were involved in implementation. Despite the general lack of knowledge on HMIS policy the informants demonstrated adequate understanding of the objectives of the electronic HMIS in KNH. Based on the responses obtained during interviews there were multiple problems related to the manual system that existed in KNH during the pre-implementation stage and these issues served as the basis for objective setting for the current HMIS in the hospital. Most key informants felt that the hypothesized benefits of the current HMIS were being realized including improved efficiency while four key informants felt that the benefits had been partially realized. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. A HMIS needs assessment was conducted and formed the basis of the electronic system requirements with specific proposals for improvement of the deficiencies identified in the manual HMIS. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. During the interviews the participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders.Based on the results and discussions, among the main problems that key informants described during the design phase was major inefficiencies characterized by evident mismatching of resources input and output which spanned several areas including time, human resources and finances however, participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase, planning plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders. As a recommendation we can say that NH and the MOH needs to come up with an established standardized policy for implementing interventionsItem Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case of Mama Lucy Kibaki County Refferal Hospital, Kenya(Global Journal of Health Science;, 2015) Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.Background: Health service delivery is a key pillar of health system management. However, there is limited peer reviewed literature on health services to adolescents necessitating assessment of whether the existing health facilities were prepared to implement the adolescent friendly health services. Staff capacity, health resources and health system factors were assessed in regards to health service delivery to adolescent cohort study. Methods: Cross-sectional research design was adopted, census, stratified random sampling and simple random sampling were used to establish study participants. Data was collected using structured questionnaires and focused group discussions for adolescents. Analysis was done using Statistical package for the social science Version 17.0 programme for data analysis and results were presented in tables and graphs. Results: The study established that there is limited adolescent friendly health services implementation in the facility. Even though 107 (73.3%) of the healthcare providers referred to the adolescent health services offered at the facility as friendly. Health workers capacity was limited in regards to adolescent friendly health service delivery. On the other hand 212 (100%) adolescents recommended specific health resources to be incorporated within the health system to improve the services rendered to them. Conclusion: The link between health care resources and adolescent health is not well understood by health workers and managers leading to inadequacy of services specific to adolescents. Laborious awareness drives to sensitize county referral health facilities to make a significant investment in the health system that supports adolescent friendly health service implementation. Similar studies need to be done in other county referral health facilities to generate more supportive evidence.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 Assessing How the Packaging of Immunization Services Influence Uptake of the Immunization Services in Selected Health Facilities of Kajiado North Sub-County Kenya(International Journal of Scientific Research in Science, Engineering and Technology IJSRSET, 2016) Kipngetich, Toweett John; Tenambergen, Wanja Mwaura; Adoyo, Maureen AtienoBackground: Immunization as a preventive measure to diseases is vital to organizational performance. Among the six pillars of the health system, this research focused on service delivery. A desk review indicated that there was low immunization coverage in the County. The objectives of the study was to determine how the cultural values, packaging of immunization and health promotion supports the uptake of immunization services Methods: A cross-sectional study utilizing a guided questionnaire, targeting 280 mothers and an interview guide targeting 9 health workers were used. Data analysis was done using SPSS version 21 using descriptive statistics. Qualitative analysis was done by thematic content analysis and framework analysis. Results: Majority of the respondents (mothers) were young with a mean age of 26 years. 233 (83%) agreed that immunization program is well explained to them when they visit health facilities. More than half 183(65.4%) of mothers got the information about immunization through continuous health education routinely offered in health facilities, whereas a significantly low 39 (13.9%) mothers got the immunization information through community health promotion. The correlation of health education with awareness indicated a (P-value = 0.406**) A p-value of 0.209** indicates that frequent visits to the health facilities did not influence the awareness of mothers on the immunization services offered in health facilities. Conclusion: The researcher concluded that there is a relationship between immunization uptake and immunization health promotion activities and recommended that the County Government of Kajiado should introduce outreach services and intensify health promotion activities