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 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.Item 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.Item Factors that Contribute to Non-Adherence to Antiretroviral Therapy among HIV and AIDS Patients in Central Province, Kenya(IJPP, 2013-01) Nyambura, Anthony Wanjohi; Odhiambo-Otieno, George W.; Otieno, Michael F.Adherence concerns have been one reason expressed by opponents of antiretroviral therapy in developing countries or resource poor settings. The objective of the study was to determine factors contributing to non-adherence to Anti-retroviral therapy among HIV and AIDS patients. This was a Cross sectional, descriptive study carried out in Provincial General Hospital Nyeri, Karatina and Thika District Hospitals. The participants included 300 interviewees, 15 Key Informant Interviews (KIIs) and 3 Focus Group Discussions (FGDs) with 8 members each. In regards to the results, the Odds ratio was used to test for association between variables and level of significance. Results also showed that the prevalence of adherence to ART was 7 4%. Risk factors associated with non-adherence were: age (p<0.039 OR=l.287 95% CI 1.013-1.634), occupation (p<0.0001 OR=l.675 95% CI 1.449-1.937), food (p<0.002 OR=0.419 95% CI 0.242-0.726), level of education (p<0.023 OR=0.593 95% CI 0.378-0.930), and stigma (p<0.002 OR=2.456 95% CI 1.375-4.389). 23% of those who lacked community support were found to be suffering from stigma and did not adhere to Antiretroviral Therapy (ART). Through the FGDs the study revealed that co-treatment of HIV and other diseases like tuberculosis, diabetes, epilepsy and mental illness remains a major challenge. 66% of Key Informants reported pediatric ARV drugs formulations were inappropriate, unpalatable and inadequate, dependence on care givers and the laboratories were ill-equipped in terms of facilities, reagents and personnel. In conclusion, the level of adherence (74%) was sub optimal (less than 95% which is the acceptable) but comparable to that of other developing countries. Taking ARV drugs without eating any food made patients suffer from side effects thus making them avoid the medication. Stigma, discrimination, lack of family and community support were huge obstacles to ART adherence. Co-treatment of HIV and other infections remain a major challenge. Shortage of appropriate pediatric formulations, unpalatability of some ARV drugs and dependence on care givers contributed to pediatric ART non-adherence. Health facilities with functioning laboratory, adequate personnel and stock of ARV drugs enhanced ART adherence.