KeMU Digital Health Repository
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Welcome to African Digital Health Library community Kenya node.
The African Digital Health Library (ADHL), Kenya node, makes available health-related content ranging from theses, dissertations,from the School of Medicine, Kenya Methodist University.
ADHL currently operates in 5 Sub Saharan African Countries and is supported by the medical librarians. It is a collaborative effort among medical librarians at major universities in sub-Saharan Africa Kenya, Mali, Nigeria, Zambia and Zimbabwe and is funded by the Office of Global AIDS/US Department of State and the U.S. National Library of Medicine / National Institutes of Health. The Kenyan node is managed through the Kenya Methodist University Library and The University of Nairobi.
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Item Determinants of a functional refferral system in Kisumu County,Kenya. Patient perspective.(Global Journal of Health Sciences, 2019) Nango, Wilbert Otieno; Mwangi, Eunice Muthoni; Oluoch, MusaPurpose: Most referral health facilities are faced with challenges ranging from congestion of patients at these health facilities, strained/ limited resources (both human and material) to deal with the voluminous patients, slow rate of service delivery to the patients which normally results in compromised quality of medical care provided to the patients. The study therefore aimed to find out the determinants of a functional referral system in two high level health facilities; Jaramogi Oginga Odinga Referral Hospital (JOOTRH) and Kisumu County Referral Hospital (KCH). Methodology: A cross sectional study was conducted using a quantitative approach to data collection. Three hundred and thirty eight out-patient clients were systemically selected to participate in the study. Data was collected using Individual questionnaire. The collected quantitative data were coded and analyzed using the SPSS 25.0 Computer program. The quantitative data were then analyzed using the descriptive statistics and logistic regression models. Results: The research findings revealed that there is a positive significant correlation between primary health facility characteristics (r = 0.474**; P<0.000).It also revealed that there is a positive significant correlation between receiving facility characteristics (r = 0.475**; P<0.000) to a functional referral system. Further Multivariate analysis also revealed a significant association between referral health facility characteristics and a functional referral system, (β3 = .425, P =.000).The results further revealed that there was a negative significant association between receiving health facility characteristics and a functional referral system, (β4 =.-0.156, P < .000). Unique Contribution to Theory, Practice and Policy: The County government of Kisumu should supply adequate drugs and equipment’s to attract more patients seeking medical care services to the primary level facilities. Quality of services offered and general cleanliness at the primary health facilities should also be improved to boost patient’s confidence in them. Key Words: Functional Referral System, health facilities; Jaramogi Oginga Odinga Referral Hospital (JOOTRH) and Kisumu County Referral Hospital (KCH).Item Relationship Between Structural Arrangement and Provision of Primary care Quality: A Case of Health Centers in Nakuru County, Kenya(Health Systems Management Journal, 2019-08) Kandagor, Amos Kipngetich; Wanja, Mwaura-Tenambergen; Mwangi, Eunice MuthoniIntroduction: Healthcare is a fundamental need, its availability and comprehensiveness helps in making people’s life better and productive. Delivery of quality care requires an efficient system with adequate capacity of well trained and motivated health workforce, good infrastructure, good leadership and governance and effective system for financing primary care. This study aimed at finding out the relationship between structural arrangement and provision of primary care quality in Kenya and majorly focused on the public health centers in Nakuru County. Methods: The study used census research design. A total of 102 respondents comprising technical health workers were included in the study. Data was collected using closed and open ended questionnaire and was analyzed using SPSS. Descriptive analysis was used to profile the characteristic of the respondents. Mean standard deviation and correlation was used to perform analysis of the extent to which each independent variable was considered significant in influencing provision of quality primary care service. Findings: Adequate infrastructure led to an increase in provision of primary care quality in health centers (r=0.453, P<0.001), while increased employee capacity improved provision of primary care quality (r=0.365, P<0.001). Sufficient fund and effective financial management improved provision primary care quality (r=0.567, P<0.001) and effective governance improved provision of primary care quality (r=0.613, P<0.001). Conclusion: The results show that good infrastructure, sufficient funds, high staff capacity, transparency and accountability improved primary care service delivery. Good structures lead to good processes and ultimately good health outcome. Provision of equipment’s to perform the necessary work, adequate allocation and timely release of funds to health centers, career progression and continuous professional development, institute staff retention measures and frequent auditing of assets and liabilities and report made public.Item Factors Influencing Rational Drug Use in Public Hospitals among Doctors and Pharmacists in Meru County(International Journal of professional practice (IJPP), 2019-05) Wahome, Dennis Mwiti; Mwangi, Eunice Muthoni; Mutwiri, TitusRational use of medicines requires that patients receives affordable, right drug and dose for the adequate period of time. Irrational drug use is influenced by lack of essential drugs, lack of training and weak implementation of policies. The purpose of this study was to assess the factors that influence rational drug use among doctors and pharmacists in public hospitals in Meru County. Specific objectives were to examine how staff awareness on policy guidelines, management practices, product selection and inventory management influence rational drug use. A cross-sectional research design was adopted for this study. The sample size was 102 doctors and pharmacists in the public hospitals in Meru County. A Likert based questionnaire was used to collect data. There was a significant relationship between staff awareness (r=.232, p<0.05) and inventory management (r=.324, p<0.05) on rational drug use. Coefficient of determination (R) of 0.402 was obtained compared to overall R2 of 0.162 and this explains 40.2% of total variations that explained factors that influence rational drug use among the healthcare workers in Meru County. The ANOVA findings (p<0.05) shows that there was correlation between the predictors variables and the dependent variable RDU. The study recommends the following to the Hospital Management Team i) to offer training on rational drug use, ii) offer support supervision and appraisals iii) Constitute active Drugs and Therapeutics Committees iv) to form procurement committee with all stakeholders to strengthen inventory management.