International journal of professional Practice (IJPP)

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Aflatoxin Analysis in Staple Food Cereals and Assessment of Households’ Awareness on its Management in Tharaka-Nithi County, Kenya
(International Journal of professional Practice (IJPP), 2020) Marangu, Victor Mwiti; Gisemba, Beatrice; Juma, Rose
Aflatoxins are naturally occurring harmful toxins produced by the fungi Aspergillus flavus and Aspergillus parasiticus. Aflatoxin contamination is a cross-boundary and multifaceted problem that requires participation and involvement of both private and public stakeholders. Agriculture is the main economic activity of Tharaka-Nithi County, yet it is among the hot spots of aflatoxin in Kenya. The county is extremely vulnerable to climate-related risks; however, there is lack of local data on aflatoxin contamination to inform interventions chiefly due to lack of local research, testing facilities, and qualified personnel. The main purpose of this study was to analyze cereals used as staple foods for aflatoxin contamination and to evaluate households’ awareness on the overall management of aflatoxin, and identify factors contributing to aflatoxin contamination. Eighty one samples were collected and laboratory analysis conducted using ELISA Kit. Aflatoxin levels in 25.8% of samples was above the Kenyan standards of 10ppb with 17.2% exceeding 20ppb. Aflatoxin levels in 44.4% of market samples exceeded 10ppb. The level of aflatoxin contamination was associated with the type of cereals and grains (p<0.05). There was no difference in mean level of aflatoxin in cereals from the study areas (p>0.05). Furthermore, there was no difference in mean level of aflatoxin in the cereals and grains collected from the markets and households (p>0.05). Majority of the farmers (84.7%) were aware of aflatoxin. However, detailed information on its management was scanty and inconsistent. Awareness creation on aflatoxin contamination to all stakeholders in the cereals value chains is needed for their concerted efforts in its control. Recognition of these barriers together with the opportunities for aflatoxin containment, the researcher hoped to improve the knowledge on aflatoxin management, health, and economic well-being of households and by extension the national food security.
Alcohol, tobacco and other Drug Use and Bullying among High School Students in Nakuru District, Kenya
(IJPP, 2010-09) Kariuki, M.; Oteyo, J.s.; Ndege, P.K.
The objective of this study was to determine the prevalence of alcohol, tobacco and other drugs (ATOD) use among secondary school students in Nakuru District, Kenya, and its association with bullying. A total of 1000 form one to four male and female students aged between 13 and 19 years were selected from 40 private and 45 public secondary schools were surveyed between January and June, 2009. The mean or median age for male students was 14 (SD=4.90) and for female students 13.8 (SD=4.8). GSHS was used to collect data which was analyzed by frequencies, chi-square and logistic regressions. In the study, 33.7% of students reported having been bullied by students abusing ATOD in the last 30 days preceding the survey and 15.9% reported the use of alcohol, 12% cigarettes and 8% smokeless tobacco in the last 30 days preceding the survey. Cumulatively, 9.6% of students recorded having used other drugs. There was a significant relationship between alcohol and tobacco use with bullying. However, there was no statistically significant association between the use of other drugs and bullying (X2 = 3.583, df= 1, p=0.058). The prevention of ATOD and bullying among students represents an essential public health measure that may allow for total children's development, qualifying them for a healthy and safe social coexistence. The researchers recommend that focus on prevention programs against alcohol and drug use in secondary schools in general should be mounted to reduce or eliminate bullying altogether.
Assessment of nutritional status and biomarkers among chronic haemodialysis patients
(IJPP, 2013-06) Barwecho, M.J; Thaimuta, Z.L;
Although biomarkers have significance on the nutritional status, there is little information about its relationship among patients on maintenance haemodialysis (MHD). The study was done to determine the significance of the relationship between nutritional status and biochemical markers among chronic haemodialysis patients. The study was done at Kenyatta National Hospital (KNH), Nairobi-a teaching and a referral hospital. This was a cross-sectional, prospective study among chronic haemodialysis patients. Fifty patients on chronic maintenance haemodialysis for 3 months and more were included in the study which was carried out May 2012. All eligible study subjects gave informed consent. Biochemical tests of albumin, electrolytes: sodium and potassium and urea were done and anthropometric measurements taken. The reagents for all biochemical analysis were provided by JAS INC., Court Miami Lakes Florida. The relationship between nutritional status and dietary intake, anthropometric status primary diagnosis, co-morbid, socio-demographic factors and dialysis related factors were determined. Fifty subjects were recruited in the study. The consent for the study was sought at Kenyatta National Hospital/University of Nairobi Ethics and Research Committee (KNH/UON ERC). Electrolytes mainly potassium were elevated. Sodium and albumin was low. There were significant correlations between albumin and hospital attendance, albumin and nutritional counseling and BMI with anthropometric parameters. The electrolyte levels of sodium and potassium are useful nutritional biomarkers for HD patients coupled with regular nutritional advice. Anthropometric parameters and BMI can be used for nutritional status assessment.
Availability and Utilization of the Mechanisms for Monitoring and Evaluating Continuing Professional Development in Kenya: A Case of Middle Level Health Training Institutions
(IJPP, 2014-01) Mwita, Nzomo; Mwanzo, Isaac; Muthwii, Sammy M.; Kabiru, Ephantus W.
In Kenya, middle• level health training institutions (MLHTls) produce the bulk of health workers at continuing professional development (CPD) training level. However, information on whether monitoring and evaluation (M&E) mechanisms for CPD training are available and utilized at MLHTIs in Kenya is scarce and may not be relied on to develop appropriate M&E systems. The main objective of this study was to determine the availability and utilization of the mechanisms for monitoring and evaluating CPD training among public, private and faith-based MLHTIs in Kenya. The study was guided by two hypotheses: there are no significant differences in the availability of M&E mechanisms for CPD training among institutions in the three categories (public, faith-based, private); and, there are no significant differences in the utilization of M&E mechanisms for CPD training among institutions in the three categories. The respondents were 375 tutors from public, faith-based and private MLHTIs, selected using a mix of sampling techniques: stratified, purposive, proportionate to size and simple random. Data collection was conducted using a questionnaire, key informant interviews, and desk review. Quantitative data was analysed using Statistical Package for Social Sciences (SPSS), while data from desk review was analysed through a process of data reduction, organization and interpretation. Pearson's chi-square test was used to determine the significant differences (p
The Caves of Mount Elgon and Their Sandfly Fauna David K
(IJPP, 2011-01) Sang, David K.
A survey of the Kenyan side of Mount Elgon revealed numerous caves which were found harbouring phlebotomine sandflies. Among the morphologically identifiable males of rwo species of the genus Phlebotomus, sub-genus Larroussius were indistinguishable females, a proportion of which were infected with promastigotes of Leishmania. The suspected vector of this parasite, Phlebotomus pedifer was found predominant in a relatively low altitude escarpment belt at l 750- l 900m, and represented over half of the identified male sandflies detected from the slopes of Mount Elgon. These male sandflies were associated with females infected with Leishmania and those which bit man. At intermediate and higher altitudes, the caves harboured mainly P.elgonensis and were associated with river valleys and major promontories. The escarpment which is a proven focus of cutaneous leishmaniasis was approximately 257 sq km and 10% of the study area, and took the form of a narrow, elongate cliff along the entire southern slopes of the mountain. Details of the distribution of caves on the slopes of Mount Elgon and their sandfly fauna are presented.
Characteristics of Nurses Upgrading to Higher Levels of Nursing Education at a Regional Referral Hospital in Eastern Kenya
(IJPP, 2014-01) Kathuci, Rosemary K.; Simba, Justus M.; Nyangena, Elijah N.; Nephat, N.
Upgrading refers to the process of nurses improving their initial educational qualification to a higher level. It enables nurses to add to their knowledge and skills, professional value, self -esteem and are rated higher within the nursing cadres. The number of nurses upgrading in Kenya has continued to increase over the years with adult students becoming the new majority in the student body. The upgrading nurses enter the academic programs with varied characteristics making them a unique group. This study sought to describe the characteristics of nurses upgrading to higher educational levels at a regional referral hospital in Eastern Kenya. The study design was a descriptive cross-sectional survey. Data was collected from 160 nurses using a structured self-administered questionnaire. Data collected was checked for accuracy, coded and analysed using STATA Version 10. Results showed that 63.2% of the respondents were above 35 years with a mode age of 40-44 years and >50 years. The ratio of male to females was 1:5. 53.2% of the respondents had Enrolled Community Health Nursing (ECN) as their initial qualification. 47.7% of the respondents had upgraded while 20%were currently upgrading. Age and initial qualification significantly influenced nurses to upgrade (p= 0.000 and p= 0.04 respectively) with the younger and those with certificate qualification more likely to upgrade. The preferred mode of study was distance learning with 83.65% of those upgrading opting for it. It was recommended that institutions of higher learning should strive to provide upgrading programs in nursing via distance learning mode and work closely with the professional bodies and the hospital to see how best to have it delivered. Nurses could also benefit from continuous medical education especially on the significant characteristics of age and initial qualification to use them for their advantage to take up upgrading.
Clinical and Socio-Demographic Predictors of Psychosocial Distress in Women with Breast Cancer in Nairobi, Kenya
(International Journal of Professional Practice (IJPP), 2023) Muriithi, Wanjiru; Kaaria, Zipporah; Mapesa, Job
Research shows that 25%–50% of breast cancer patients worldwide experience distress, with Africa reporting 71% and Kenya 34-50% distress cases. This study investigated clinical and socio- demographic predictors of breast cancer patients' psychosocial distress. Poor quality of life outcomes, reduced adherence to treatment, and inferior clinical and psychosocial functioning are all associated with psychosocial distress. This study adopted an exploratory, sequential cross- sectional design. The study targeted 763, 18–70-year-old female breast cancer patients. Breast cancer patients, nurses, lay navigator, and oncologists were enlisted through opportunity sampling technique for collection of both the qualitative and the quantitative data. Interviews, focus group discussions, and questionnaires were used to collect data. Using a total score of >11, with NCCN cut-off mark of >4 for clinically significant distress; and >7 for severe distress, psychosocial distress was screened using distress thermometer and problem checklist. Notably, income and stage of diagnosis emerged as significant predictors of psychosocial distress, clinical anxiety, and depression. Income predicted severe distress (OR = 5.5, p = 0.001), anxiety (OR = 2.8, p = 0.004), depression (OR = 4.7, p = 0.001), and early diagnosis had an inverse relationship with distress (OR = 0.3, p = 0.006) and depression (OR = 0.5, p = 0.049). Still, testimonials showed that young women had more emotional distress, while elderly women had more physiological distress. Marriage provided two insurance policies. The study emphasises understanding of emotional and psychological distress factors, identifying patients who need extra help, and using psychotherapy and social interventions to alleviate suffering, enhance resilience, and improve treatment outcomes
Comparative Study of Professional Competences of Graduates of Innovative and Conventional Medical Schools in Kenya: A Case of Graduates of Moi and Nairobi Universities
(IJPP, 2011-09) Kimeu, Anastasiah; Mengech, Harun arap K.; Kangethe, Simon
A population of 280 intern doctors was randomly sampled using Gay's (1992) sample estimate of 20%. An increase of 10% in the sample accounted for non-response. The desired random sample size was therefore 84 intern doctors. A purposively selected sample of 47 supervisors from a population of 140, which included medical doctors and nursing officer in charges, was also assessed. A total of 54 (63% questionnaires) from graduates were returned with 26 of these from graduates of school of medicine- Moi university, while 28 were returned from University of Nairobi. A total of 47 (100%) questionnaires were returned from supervisors. The graduates from the conventional school rated themselves 82% on the excellent category in the knowledge of scientific foundation of medicine while the graduates from innovative school ratings were 89% on the same category. On further analysis of the results, there was no significant difference between the graduates. The ratings of supervisors on graduates from conventional school (56%) and those from innovative school (53%) on this competence showed no significant difference either. The majority of graduates of the two schools considered themselves highly competent in clinical skills (76% IMS; and 79% CMS). However, there was no significant difference between the ratings of proportion of graduates from the two schools. The findings on supervisors ratings (70%, 30% IMS; and 70%, 30% CMS) of graduates showed no significant difference. The graduates from the two medical schools do not differ at all as perceived by their supervisors on the seven global competences. However, there seems to be significant differences in the way graduates perceive themselves with regard to six competences as shown in the study. The author notes that these differences may be due to limitation of the self assessment method used in the study, which does not always provide for objective information as was the case in graduates' ratings. However, this limitation applied equally to respondents of the two universities, the differences between the graduates from the two schools of medicine can be indicative of the effects resulting from the different curricula used.
Comparative study on quality of life among married and non- married women living with HIV/ AIDS
(IJPP, 2010-09) Luhahi, Yema
Human immunodeficiency virus (HIV) infection is a serious health problem among married and non-married women. It has become a health problem for women of all ages. Antiretroviral therapies introduced in the mid 1990s have allowed many women with HIV infection to live long~ before progressing to AIDS, and to have longer survival time following an AIDS diagnosis. Then the issue of quality 0£.life becomes important for these women. The progression of HIV disease most often results in a decreasing quality of life. While examining quality of life among women living with HIV/AIDS, limited attention has been paid to study addressing the issue of whether there is a difference in the levels of quality of life between married and non-married women living, with HIV/AIDS. This study will assess and compare the levels of quality of life in married and non-married women living with HIV/AIDS. Random systematic sampling of 114 women living with HIV/ AIDS who participated in the study were-administered well structured questionnaires by the palliative care nurses. Quality of life was evaluated using World Health Organization's Quality of Life HIV short form (WHOQOL HIV BREF) instrument. The data reported in this study suggest that there is no significance difference with regard to quality of life between married and non-married women. The independent t test revealed that the levels of quality of life differed significantly in the married and the non-married respondents, t (112) = -2.64; p value =.01. But controlling the effect of the covariates in both groups, the result revealed that there was no significant difference in the levels of quality of life in non-married and married women, t (1J2) = -1.4, p value = .17. The apparent difference (t (112) = -2.64; p value =.01) in the levels of quality of life was found to be due to covariates variables.
A Comparison between Self and Clinician-collected Vaginal Swabs for Detection of Bacterial Vaginosis among Women in Kisumu, Kenya
(IJPP, 2011-06) Mwangi, JN; Kisia, A; Bukusi, EA; Wamae, CN
Two tests are available for diagnosis of bacterial Vaginosis (BV), Amsel and Nugent. The latter is considered more sensitive. Laboratory diagnosis for BV requires a vaginal swab specimen. In developing countries, vaginal swabs are only collected by trained health clinicians and use of speculum, examination couch and expensive equipment like autoclave is necessary. In contrast, women in developed countries have a choice of either collecting self swab or allowing a trained health clinician to collect the vaginal swab. This study sought to evaluate the validity and reliability of self collected vaginal swabs for diagnosis of BV by comparing with clinician collected ones. Ten beaches were identified based on convenience along Lake Victoria in Kisumu County from which 105 women volunteers were enrolled. Three vaginal swabs were collected from each woman. The first two swabs were self collected while the third one was collected by a qualified clinician. Smears were prepared, read and interpreted by Nugent method while demographic and clinical data were obtained by use of structured questionnaires and pelvic examination forms respectively. There was high agreement (validity) between the clinician collected and the first self collected swab, Kappa score of K=0.952 (p<0.001). The reliability of the clinician and the second self collected swab had a Kappa score of K=0.905 (p<0.001). The self collected vaginal swabs (SCVS) were found to be valid and reliable for use in diagnosis of bacterial vaginosis.
Deep Learning Network Intrusion Detection with the Conv1d-Lstm Model: Integrating CNN and LSTM For Superior Performance
(International Journal of Professional Practice (IJPP), 2024) Lukogo, Cikambasi Ciza; Muriira, Lawrence Mwenda; Murungi, Robert Mutua
Increased cases of cyber-attack and the rising levels of sophistication presents a significant threat to corporate networks, resulting in potential data breaches, financial losses, and reputational harm. Traditional Intrusion Detection Systems, which rely on predefined signatures and rules, have proven inadequate due to high false positive and false negative rates. This study introduces an innovative AI-based intrusion detection model to enhance corporate network security leveraging on deep learning techniques. The objective was to propose a Conv1d-LSTM Model, integrating convolutional neural networks (CNN) and recurrent neural networks (RNN) to analyze network traffic data from the CSE-CIC-IDS-2018 dataset, which encompasses a wide array of attack types, and provides a realistic representation of modern network traffic. This deep learning model effectively detects complex patterns and temporal dependencies in the data. The performance of the innovated model was evaluated using precision, accuracy, recall, and F1 score, to demonstrate its superior detection capabilities compared to conventional Intrusion Detection Systems (IDS). Additionally, a comparative analysis of CNN and RNN performance on the same dataset was conducted, highlighting the strengths and limitations of each approach. This research underscores the importance of integrating advanced AI methodologies into IDS frameworks to protect corporate networks from cyber threats.
Determinants of Demand for Community Differentiated Service Delivery among People Living with HIV in Kakamega County
(International Journal of Professional Practice (IJPP), 2023) Owiti, Winnie Sarah; Njoroge, Kezia; Mapesa, Job
Community differentiated service delivery model (CDSD) is community level health system strengthening intervention that addresses barriers to accessing health services. Increased number of stable people living with human immunodeficiency virus (PLHIV) has prompted more emphasis to promoting CDSD model utilization as a significant policy to improve health outcomes and meet the international commitment to make health services accessible. However, key health systems policy makers have put more emphasis on improving physical access rather than its patterns of utilization. This study seeks to understand demand for CDSD model and its determinants among PLHIV in order to device appropriate strategies that will encourage better utilization. The objectives were to assess CDSD model of choice, and factors that determine its demand among PLHIV. A quantitative design was conducted in Kakamega County, Kenya. Systematic random sampling was used to select 402 participants from facilities with high number of stable patients. A pretested interview schedule, and structured questionnaire was used to collect data using an open data kit app. Non parametric test was used to determine determinants for demand for CDSD model. A total of 402 (depicting a response rate of 100%) participants took part in the study. The tests revealed 66 % (264) of participants prefers the family model, 25 % (100) community anti-retroviral treatment groups, 8% (30) community drug distribution points, and 2% (8) community pharmacies. Determinants of demand were awareness 76% (307), acceptability 44% (176), service availability 78% (314), and service cost 78% (315). The findings indicate that the model of choice is the family model. Determinants for demand that affect utilization of the model include awareness, service availability and cost of the services. Policy makers in the ministry of health need to use these key determinants of demand to estimate its impact on health service delivery and health outcomes.
Diagnostic Accuracy of Malaria Microscopy in the Highlands of Central Kenya: Implications for Proper Treatment
(IJPP, 2013-06) Batra, Neale S.; Ndege, Peter K.; Kaburu, Mercy; Clauw, Daniel J.; Wilson, Mark L.
Over-diagnosis of malaria is a problem in many African countries and appears to be occur¬ring in the highlands of central Kenya. Blood-smear microscopy, the standard technique for malaria diagnosis in this area, relies heavily on technician skill. Hence, Rapid Diagnostic Tests (RDTs) are increasingly considered the gold standard for diagnosis, but are often not available in resource-constrained settings. We compared the results of microscopy and RDTs performed on finger-prick blood samples from 250 patients referred to laboratory malaria testing at one private and two government health facilities in/near Meru, Kenya. Across the three sites, 97 .1%-100% of microscopy-diagnosed Plasmodium-positive samples were found negative by RDT. Of the three study sites, the government district hospital had the highest microscopy-based positive rate (27.3% as compared to 5.9% and 9.3% in the other two set¬tings). These results indicate alarming levels of inaccurate malaria diagnosis in the Meru re¬gion. Many factors may play a role in this phenomenon, and it is likely that a "systems level" approach is necessary to remedy this problem.
Early Warning System and Preventive Diplomacy in Land-Based Conflicts among Pastoralist Communities in Samburu County
(International Journal of Professional Practice (IJPP), 2022) Kamau, Carolyne Gathoni; Riungu, Festus Kinyua; Karuga, Zipporah
The use of preventive diplomacy in conflict prevention can be traced back to various human civilizations where treaties were concluded, alliances formed, inter-ethnic marriages solemnized and various forms of traditional and scientific knowledge employed to prevent inter-state and intra-state conflicts. However, localizing this strategy at community level remains a challenge due to lack of institutional structures and resources to advance capacity of preventive diplomacy in land-based conflicts. The study examines the influence of early warning system on land-based conflicts among the pastoralist communities in Samburu County. The study was guided by conflict prevention theory, and the target population comprised 424 individuals from different institutions involved in peace and security discourses in Samburu County, Kenya. Using Yamane formula to calculate the sample size, stratified random sampling technique was applied to select 206 respondents. Primary data was collected using a questionnaire, and it was processed using descriptive, inferential, and thematic content analysis techniques. Analyzed data was presented using tables, figures, and narratives. Findings indicated that early warning system is used by both the state and the non-state actors to predict trends of violent conflicts from open source information, inter alia, NDMA which publishes early warning system in a monthly bulletin; smart-phone applications that monitor rangeland conditions, and disseminating threats alerts. Complementing scientific methods with traditional knowledge to forecast the future is indispensable, and so are the District Task Forces which work closely with Samburu district peace committees to monitor livestock migratory routes and conduct night watch on herders to prevent them from rearming. The study concluded that the early warning system tool has been applied to predict trends on land-based conflicts in Samburu, but there is need to increase resources in order to increase its capacity. Synergy between multiple actors is recommended to avoid a confused response.
EFFECT OF KNOWLEDGE ACQUISITION ON ACADEMIC PERFORMANCE OF POSTGRADUATE STUDENTS OF PRIVATE UNIVERSITIES IN KENYA
(International Journal of Professional Practice (IJPP), 2022) Ouma, Onditi Walter; Murithi, Simon; Nzioki, Susan
The concept of Knowledge Management (KM) has been used in measuring and gauging institutional performance. However, the effect of Knowledge Acquisition (KA) practices on academic performance of higher learning institutions is yet to be contextualized. This study attempted to bridge the aforementioned academic gap by assessing the effect of KA practices on academic performance on postgraduate students of private universities in Kenya, based on the theory of Resource Based View (RBV). Descriptive cross-sectional survey design was employed. A sample of 370 respondents was drawn from a population of 12,919 postgraduate students and faculty/department heads. Stratified random sampling technique was adopted in obtaining this sample. The findings established 27.8% variation in postgraduate academic performance; KA practice had very weak positive and insignificant correlation (r=0.044) and insignificant partial factor effect (β = 0.040, p=0.526) on postgraduate academic performance in private universities. The study concluded that KA did not have significant effect on postgraduate academic performance in private universities in emerging economies. Therefore, factors other than KM contributed to the academic performance, and they are worth exploring in future studies. The study recommends further research in methodologies and measures of knowledge acquisition as ways of improving application of knowledge management practices on students’ academic performance
Effects of Moringa Stenopetala Bac. Leaf Supplement on Growth Performance of Broiler Chicken
(International Journal of professional Practice (IJPP), 2020) Nathaniel, Ebenezer Udofia; Onyancha, Jared Misonge; Mugambi, Mworia; Ncene, William; Moriasi, Gervason Apiri
Poultry keeping is the most widespread of all livestock enterprises, it plays a great role in food security improvement, socio-cultural and economic development in most countries. While broiler production is a source of income, it is a good source of protein and a profitable investment. In developing world, high feed to gain ratio and high feed costs are among the challenges in poultry keeping. Current attempts to mitigate these challenges involve the use of antibiotics in feed as growth promoters, prophylaxis and disease treatment. It is notable that the use of conventional antibiotics for promoting growth and performance has been effective. However, undesirable residual effects and antibiotic resistant pathogens due to antibiotics in conventional poultry feeds is of global health concern. Therefore, there is continuous need to evaluate natural alternatives to antibiotics to mitigate the problems encountered with conventional antibiotics. Many medicinal plants have been associated with growth performance enhancement, Moringa stenopetala Bac leaves are used as food for humans. Seeds, bark, roots, and flowers are widely used in traditional medicine. Leaf extracts are reported to have the greatest antioxidant activity. The extracts of Moringa stenopetala leaves have antioxidant potential, β-carotene, protein, vitamin C, calcium, potassium and natural antioxidants including flavonoids, phenolic, ascorbic acid and carotenoids and are thought to be responsible for their effectiveness The current study evaluated the effect of broiler chicken feed supplemented with M. stenopetala on feed conversion ratio. The study was prompted because the available data is limited and contradictory. Experimental study design was used. Cobb 500 broiler of one-day-old (165) chicks were obtained from Kenchic Ltd, Kenya and randomly selected. Feed meals were prepared by Unga feed Ltd, Kenya by replacing antibiotics with powders of M. stenopetala. Concentrations of 0.0 to 0.65 w/w % for powders were supplemented. Five treatments were used in the experiments and results were analyzed using Minitab Version 19.1. A one-way analysis of variance (ANOVA) followed by Fisher’s Least Significant Difference was used at 0.05 Level of significance. Results indicated increases in the chicken weight gains in all the treatment groups at the end of treatment week five but with no significant difference except for the negative control group (p<0.05). Also, at the end of 5th week, the results obtained showed that all the chicken in all the experimental groups had a significantly lower feed conversion ratios except for the chicken on the negative control experimental group (p<0.05).
Effects of Perceived Image of NHIF Outpatient Facilities on Utilization of Primary Care Services by Private University Employees in Nairobi County
(International Journal of professional Practice (IJPP), 2019-01) Kironji, Keziah M.; Tenambergen, Wanja Mwaura; Mwangi, Eunice Muthoni
The NHIF is a mandatory health insurance fund covering public and private formal sector workers and their dependents as the main health insurer in Kenya. NHIF has embarked on an ambitious reform program intended to convert it to a Social Insurance Health Scheme with an aim of serving as workers’ first pillar of social insurance. The national formal scheme members are entitled to all primary health services after selecting their preferred facilities from a list of the NHIF outpatient ones. However, there are some members of National formal scheme whose contributions are remitted to NHIF by their employer every month but do not utilize primary care services. This study sought to determine the effects of perceived image of NHIF outpatient facilities on utilization of primary care services by the national formal scheme members in Nairobi with a focus on Private University employees. This study adopted a cross-sectional descriptive design with mixed methods approach. Multistage sampling with simple random sampling was used. Quantitative techniques were used for data collection. Descriptive statistics, F-Statistics, P-values, Pearson’s Rho ®, mean-scores, standard deviations, co-efficient of determination (R2) and the coefficient of multiple determinations (Adjusted R2) were analyzed using SPSS version 24. The rationale of this study was to inform top management of NHIF to undertake decisions in regards to utilization of primary health services by NHIF members by understanding effects of safety of healthcare services, waiting time at the health facilities, healthcare workers interpersonal skills and facilities amenities and physical outlook affect utilization of primary care services. The multiple regression results indicates that in a combined relationship only three factors on perceived image of NHIF facilities influence utilization of primary care services; safety of healthcare services (X1; β1 = .315, P ˂0.05), healthcare workers interpersonal skills (X3; β3 = .0.049, P ˂0.05), and healthcare facilities amenities and physical outlook (X4; β4 = .027, P ˂0.05). Waiting time is negative (X2; β2 = -.018, P ˂0.05) and thus does not influence utilization of primary care services. In a combined model, all four factors have no scientifically significant influence on utilization of primary health services by national formal scheme members in Nairobi County. The study recommends that NHIF should vet facilities they accredit to offer primary care services to ensure safety of healthcare services, train workers on effective interpersonal skills and improve facility amenities and physical outlook of NHIF outpatient facilities
Effects of Public Private Partnerships in Strengthening Faith-Based Health Systems in Kisii County, Kenya
(International Journal of professional Practice (IJPP), 2021) Ringera, William; Tenambergen, Wanja; Oluoch, Musa
Public-Private Partnerships (PPPs) are important in enhancement of efficiency and effectiveness in different agencies. PPPs is a concept that has been borrowed and applied in various sectors. It is noted that within governments, Health Ministries’ focus on the public sector often disregard the frequently much larger private finance and private provision of healthcare. This study examined the effects of PPPs in material support, leadership/management, and human resources for health (HRH) on strengthening of health systems in faith-based organization (FBO) health services in Kisii County, Kenya. A cross- sectional descriptive study was conducted targeting 78 FBO facilities’ officials from Tabaka, Christianmarian and Nyanchwa; and officials from the Ministry of Health. Data was collected using structured questionnaires and interview schedules, and analysed using SPSS Version 20 and Ms. Excel. The study found that PPP on leadership and management, material support, HRH and provision of guidelines for the implementation of the PPP were significantly associated with strengthening of FBO health systems at p<0.05.The study conclude that PPPs targeting material support, leadership and management, provision of guidelines for PPP process, and HRH improved provision of public health services in FBO facilities in Kisii County. Therefore, the PPP is yielding fruits in the Government’s effort to strengthen delivery of public health services, particularly in areas of HIV/AIDS and maternal, neonatal and child health-MNCH, in Kisii County. From the viewpoint of Kisii County Government, FBO facilities are able to effectively complement the work of government in public health services and should be supported through the PPPs.
Factors influencing demand for healthcare insurance:A study of jua kali workers in Nairobi
(IJPP, 2013-01) Nalebeson, Mugubi Robert N.; Odhiambo-Otieno, George W.
Health systems are a means to achieving better health outcomes for all. However, where patients depend largely on out of pocket (OOP) payments to access health services, there is often lack of care for those who cannot afford. This study aimed at establishing the fac¬tors influencing the demand for health insurance among Jua Kali workers in Nairobi. This was a cross-sectional research study involving mixed approach (simple random, purposive sampling, qualitative and quantitative methods) involving 130 Jua Kali workers from Associations/Cooperatives and 258 Jua Kali workers from non-organized groups; key informants from NHIF and the Department of Micro and Small Enterprise Department and was. The study was conducted between January to March 2012 within Pumwani Division in Nairobi County. Findings indicated that 113 (29.1%); 21.1% members of Jua Kali association and 11.8% individualJua Kali workers out of 388 were enrolled in NHIF while 262 (67.5%) were not enrolled in NHIF. Inadequate Knowledge of NHIF benefit and the KShs. 480 upfront NHIF premium payment were the main contributing factors to non-enrolment of262 (67.5%) of Jua Kali workers. 42.3 % individual Jua Kali and 6.1 % members of association with a monthly income less than KShs. 9,000 did not enrol in NHIF. To enhance more enrolment of Jua Kali workers, the study recommends that NHIF should design strategies that target the younger, low income and Jua Kali workers with low level of education with key information on health insurance benefits and the benefits of enrollment in NHIF , establish satellite pay¬ment offices within Jua Kali working zones to bring services closer to them, apply KShs. 160 per month instead of KShs. 480 and enhance networking and engage Jua Kali association as strategic partners for the purpose of motivating Jua Kali workers enrollment.
Factors Influencing the Utilization of Zidovudine and Nevirapine among HIV Positive Perinatal Women at Pumwani Maternity Hospital in Nairobi, Kenya.
(IJPP, 2014-01) Imbaya, Christopher L.; Odhiambo-Otieno, George W.; Okello-Agina, B.M.
Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) is a key strategy aimed at protecting babies from being infected with HIV by their mothers. Treatment with combination rather than single Antiretroviral (ARV) drugs has been found to be more effective in PMTCT. The objectives of this study were: 1. to determine the rates of utilization of single drug and combinations of Zidovudine (AZT) and Nevirapine (NVP) for PMTCT and 2. To determine the factors that influence the choice of treatment among HIV positive perinatal women at Pumwani Maternity Hospital (PMH) in Nairobi, Kenya. This was a cross-sectional descriptive study. The study site was Pumwani Maternity Hospital, which is a public health facility on the eastern suburbs of Nairobi County. A total of 326 post natalHIV Positive women were sampled and administered with questionnaires either at the Postnatal Clinic (PNC) or postnatal ward in Pumwani Maternity Hospital. Among the 326 HIV positive women, 299(91.7%) acknowledged having been given ARV's for PMTCT where 160(53.5%) and 139(46.5%) of them were given single and combination drug treatments respectively. Single dose NVP was used by 132(44.1 %) of the women while AZT alone was prescribed in 28(9.4%) of the women. The other 139 (46.5%) of the women received a combination of NVP and AZT. The frequency of Antenatal Clinic (ANC) visits was significantly related to the number of ARV's dispensed (p=0.001). Late ANC attendance and health problems were given as reasons why AZT was not dispensed while the main reason that was cited for NVP not being used was the lack of its availability. More than half of the HIV positive women delivering at PMH received single drug PMTCT. Availing combination PMTCT therapy should be enhanced. Success could be realized by encouraging frequent ANC attendance, availing alternative ARV treatment options and addressing health conditions that contribute to the use of monotherapy.