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Item Determinants of Quality Maternal Care among Women in Garissa County Referral Hospital(INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI), 2025-08) Abdi, Hassan Maryan; Kimemia, Fredrick; Kawila, CarolineThe determinants of quality maternal care among women in Garissa County Referral Hospitals are multifaceted and can be attributed to a combination of individual, structural, and systemic factors. The general objective of this study was to examine the determinants of quality maternal care among women in Garissa County Referral Hospital. The specific objectives include to examine how physical factors and accessibility contribute to quality maternal care among women in Garissa County Referral Hospital. The study was guided by the Social Cognitive Theory and Social Action Theory. A descriptive research design was employed. The target population consists of 314 employees at Garissa County Referral Hospitals, with a sample size of 63 participants, determined using Yamane's formula. Data collection involved the administration of questionnaires and key informant interviews. The collected data was analyzed using the Statistical Package for Social Sciences (SPSS). The findings from this study suggest the study emphasize the significant role of physical accessibility in determining maternal health outcomes, especially in areas like Garissa County, where geographical, infrastructural and social factors significantly hinder access to timely maternal healthcare. The results of a binary logistic regression analysis conducted indicated Physical Accessibility, Is Not Statistically Significant Predictors, Although Access and Staffing scores were included in the model, their coefficients were not statistically significant (p > 0.05): Access: B = 0.010, p = 0.873. The study concludes Geographic isolation, poor infrastructure, lack of emergency services and limited transport options all contribute to delays in seeking maternal care, which increases the risk of maternal complications and deaths. Among the recommendations policies aimed at providing financial support, such as subsidized healthcare services or maternal healthcare insurance schemes, could significantly improve access to care for women from low-income households.Item Capacity Building as a Predictor of Service Provision among Community Health Promoters in Nandi County, Kenya(East African Journal of Health and Science,, 2025-09) Chebet, Risper; Vundi, Susan; Kimemia, FredrickCapacity building is increasingly recognised as a cornerstone for strengthening community health systems, particularly in underserved regions where Community Health Promoters (CHPs) play a vital role in bridging the gap between households and formal healthcare services. This study examined the role of capacity building in enhancing the effectiveness of CHPs’ service provision in Nandi County, Kenya. The research adopted a descriptive design and targeted 1,567 CHPs across six sub-counties, from which a stratified random sample of 306 was drawn. Data were collected using a structured fivepoint Likert scale questionnaire that was pretested in Uasin Gishu County to ensure reliability and validity. A total of 287 responses were obtained, yielding a 93.8 percent response rate. Descriptive statistics indicated that although many CHPs had received some form of training, gaps persisted in the consistency, adequacy, and relevance of these capacity-building initiatives, which in turn affected their ability to deliver services effectively. Inferential analysis using Pearson correlation showed that capacity building had a statistically significant positive relationship with service provision (r = 0.518, p < 0.01), while regression analysis confirmed that capacity building was the strongest predictor among all facilitators, explaining a substantial portion of the variance in CHP performance outcomes. CHPs who accessed regular training, mentorship, and learning resources demonstrated greater confidence, improved efficiency, and stronger engagement with their communities. The findings underscore that beyond financial incentives, supplies, and job security, sustained investment in capacity building remains the most critical enabler of community health service delivery. The study concludes that institutionalising structured and continuous professional development programs for CHPs is essential for equipping them with the skills to respond to evolving health challenges, foster innovation, and build trust between communities and health systems. Policymakers and stakeholders are therefore urged to prioritise capacity building as a strategic pathway toward achieving universal health coverage in Kenya and similar contextItem Influence of Performance Planning on Health Workers Performance at Public Hospitals in Nairobi County Kenya(Intra Africa Journal Hub (IAJH), 2025-08) Okaka, Anjichi Jane; Njoroge, Kezia; Kimemia, FredrickEffective performance management is crucial for delivering health services. It is a key component of the healthy workforce pillar in health systems, contributing significantly to optimal healthcare outcomes. By evaluating and enhancing employee performance, performance management systems help healthcare organizations maximize the contributions of healthcare professionals towards expected health outcomes. Performance planning is a vital part of performance management systems. It is a strategic process that ensures organizational goals are achieved through collaboration with staff. This involves setting SMART goals by both employers and employees and creating a plan to achieve these goals. The study aimed to investigate the impact of performance planning on the performance of medical staff in public hospitals in Nairobi County, Kenya. The goal was to understand how performance planning within performance management systems affects health workers' performance. The study was based on goal-setting theory. A cross-sectional descriptive survey design was used. Stratified random sampling method was used to recruit 594 health professionals from Mama Lucy, Mbagathi, and Makadara Hospital. 17 physicians, 201 nurses, and 21 clinical officers were sampled. Pretest study was conducted to evaluate validity and reliability of the research tool, with internal consistency measured using Cronbach's alpha coefficient. Primary data was collected through self-administered questionnaires. SPSS was used to code and analyze raw data. Inferential statistics and descriptive methods were employed for data analysis. Regression model was used to explore the relationship between independent and dependent variables. Results were presented using frequencies, means, standard deviations, and percentages. Findings indicated that clear job descriptions, setting SMART goals, and employee motivation significantly influenced health workers' performance. The study highlighted the importance of reliable plans, offering consistent evaluations, constructive feedback, and employer support. The research suggests, hospitals can enhance patient care quality by fostering a culture of accountability, recognition, and motivation, leading to improved performance.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 Factors Influencing Employee Turnover among TB/HIV Management Unit’s in Public Hospitals in Puntland State of Somalia(International Journal of Health Sciences, 2024) Hassan, Mohamed Mohamoud; Muiruri, Lillian ,; Kimemia, FredrickPurpose: To examine the factors influencing employee turnover among TB/HIV management unit’s in public hospitals in the Puntland State of Somalia. It examined the influence of job satisfaction, promotion opportunities, top management and organisation commitment on employee turnover among TB/HIV management units. Methodology: A descriptive research design was used to study the target population of 806 healthcare workers who work in public hospitals in the Puntland State of Somalia. The study sample consist of 267 respondents selected from among the healthcare workers in these hospitals. The data was collected through structured questionnaires that were self- administered to the health workers. The collected data was quantitative and analyzed using descriptive techniques and statistical tools like SPSS (Version 26). The findings were displayed as tables, charts, percentages, and means. Multiple regressions and Karl Pearson's correlation coefficient was also utilized to determine the relationship between the independent and dependent variables. Findings: The study found that organization commitment, job satisfaction and promotion opportunities were significant factors influencing the employee turnover among TB/HIV management unit’s in public hospitals in Puntland state of Somalia with significant value of p=.000 each. Further, the study also found that top management was an insignificant determinant of the employee turnover among TB/HIV management units in public hospitals in Puntland state of Somalia with significance value of .081. Unique contribution to theory, practice and policy (recommendations): Theory: The study challenges traditional theories by demonstrating that organizational commitment, job satisfaction, and promotion opportunities are more significant than top management in influencing employee turnover within specialized healthcare units. It suggests that healthcare administrators should focus on enhancing job satisfaction and career advancement opportunities rather than solely relying on top management strategies to improve retention. Policymakers should implement strategies that bolster employee engagement and career development in public hospitals, as these factors are crucial for reducing turnover and improving service stability.Item Individual Factors Associated with Uptake of Covid Vaccine Among Matatu Crew in Meru Matatu Stage, Meru County, Kenya(Public Health Research, 2022) Thuranira, Muthee Justin; Kawila, Caroline,; Kimemia, FredrickThe uptake of COVID-19 vaccines is an essential aspect towards enabling effective control on the spread of the virus. It is important that matatu crew, together with the vulnerable groups should receive vaccination to lower the incidence and disease transmission rate. In the Covid 19 vaccination campaign this group has been greatly sidelined. The study is aimed at determining individual factors that predict uptake of the Corona Virus 19 vaccine amongst the Matatu crew in Meru matatu stage. The study population was Matatu crew in Meru matatu stage. Sampling size determination was done using the Fischer’s formula. The sampling technique was systematic among the drivers, touts and conductors in Meru Matatu stage, while purposive selection was done among the key informants. The study used of questionnaire for quantitative and for qualitative data collection an interview guide was used. Data analysis from the self-administered questionnaire was analyzed quantitatively using descriptive statistics like frequencies and proportions. Chi-square analysis was used to capture associations amongst the categorical variables. Further, statistical significance was placed at p<0.05. Qualitative data was analyzed through the use of thematic analysis. Results were presented in tables, pie charts and bar graphs for ease of understanding. The study found a low uptake of Covid 19 vaccine among the Matatu operators. Individual characteristics such age (χ2=11.94, α=0.008), duty (χ2=99.98, α=0.00) marital status (χ2=35.891, α=0.00), education level (χ2=32.39, α=0.00), gender (χ2=9.021, α=0.002) were significantly associated with low COVID 19 uptake among the Matatu Crew operators. The study concluded that there was low uptake of Covid -19 vaccine among the Matatu crew in Meru and this was affected mostly by the individual characters of the crew. From the findings, the study recommended that the county health team should involve and train the Sacco official to deliver the Covid 19 vaccine. Further research should be done to determine other social mechanisms of improving Vaccine uptake and reducing mi nformation towards emergency vaccines.Item Influence of Health Logistics Management Information System on Availability of Medical Commodities in Public Health Facilities in Kajiado County, Kenya(Academic Journal of Health System and Reform (AJHSR), 2023-09) Bunyali, Julius Habakkuk; Njoroge, Kezia Muthoni; Kimemia, FredrickHealth logistics management systems is critical to ensure the availability of essential medicines and services. This study aimed to evaluate the influence of health logistics management information system on the availability of medical commodities in level 4 and 5 public health facilities in Kajiado County, Kenya. A descriptive cross-sectional study design was employed. Data were collected using a self-administered 5-point Likert scale structured questionnaire from 108 health care providers (HCPs). Data were coded, processed, and descriptive and inferential statistics were performed. Spearman rank correlation and logistic regression analyses were performed to determine the relationship between variables and the effect of the independent variables on the dependent variable, respectively. Statistical significance was set at <0.05. Health care workers reported varied experience with health logistics management system components. Spearman coefficient and logistic regression analyses reported a positive correlation between inventory management, order process management, and information management systems and the availability of medical commodities (r = 0.733, p=0.000; r = -0.397, p=0.000; r = 0.737, p=0.000, and (β = 2.016, S.E. = 0.581, p< 0.05; β = 1.567, S.E. = 2.298, p< 0.05; β = 0.742, S.E. = 0.363, p< 0.05; and (β = 3.491, S.E. = 1.312, p< 0.05), respectively. In this study, HCPs are not sufficiently proficient in health logistics management system, which negatively impacts the availability of medical commodities. Order process management, inventory management, and information flow management systems have positive relationships and significantly influence the availability of medical commodities in public health facilities in Kajiado County.Item DETERMINANTS OF NURSES PERFORMANCE IN TIER THREE HEALTH FACILITIES: A CASE STUDY OF KAJIADO COUNTY, KENYA(Journal of Health, Medicine and Nursing, 2018-07) Kokwaro, Brenda; Oluoch, Musa; Adoyo, Maureen; Kimemia, Fredrick; Tenambergen, Dr. WanjaPurpose: Human Resources for Health (HRH) is critical for improved productivity and efficient delivery of health services. However, insufficient health personnel in terms of numbers and level of performance are a major constraint in disease control and maintenance of a health population. A study was carried out to determine the relationship between jobrelated factors, the work environment, organizational factors and policy practices that affect the performance of nurses in tier three health facilities in Kajiado County. Method:A cross sectional, descriptive study design was utilized, adopting qualitative and quantitative data collection approaches. Four tier three health facilities were included and one hundred and thirty (130) respondents were involved in the study. Purposive sampling was used Nurses working in the various departments in the respective facilities were issued with questionnaires to fill in and return. The heads of the different departments were interviewed using an interview guide. Inferential statistics was used to analyze the data. Quantitative data was analysed using SPSS version 23.0 and qualitative data was analysed through thematic content analysis. Results:Results on organizational-relation aspects revealed lack of necessary support provision for incompetent nurses. It also revealed a substantial lack of an appraisal and reviewsystem. The findings on job related factors showed that most of the nurses were diploma holders hence the need for opportunities for further training and enhancement in education levels to advance their knowledge. Findings on organizational factors showedthat inadequate staff levels led to increased workload on available staff which in turn affected the performance of nurses. Unique Contribution to Theory, Practice and Policy:The study recommends thatthere should add more refresher and training courses for the nurses, recruitment of more nursing staff and improvement of resources available.Item INFLUENCE OF REGULAR PROMOTION ON HEALTH CARE WORKERS RETENTION IN PUBLIC HEALTH FACILITIES IN GARISSA COUNTY, KENYA(Academic Journal of Health Systems and Reform (AJHSR), 2021-08) Hassan, Salah Dagane; Njoroge, Kezia; Kimemia, FredrickThis study sought to investigate the influence of regular promotion on health care workers retention in public health facilities in Garissa County, Kenya. The study was anchored on two theories namely: Maslow's Needs Hierarchy Theory and Herzberg’s two-factor theory. The study employed a descriptive research design and Self-Administered Questionnaire to collect data from 134 healthcare workers. Stratified sampling and Simple random sampling techniques were used to sample the Sub-Counties, Primary healthcare facilities, and respondents respectively. Data were analyzed using SPSS version 26 and the relationships between the variables were determined using correlation and multiple regression analysis. The correlation results showed that regular promotion was positively correlated to retention of healthcare workers in primary healthcare facilities in Garissa County. Regression analysis also showed that regular promotion influenced retention of health care workers in the County (ß = 0.239, p = .000Item Factors influencing uptake of antenatal care in Taita Taveta County, Kenya(Journal of Health, Medicine and Nursing, 2019) Ndegwa, Mwanyoha Ndegwa; Oluoch, Musa; Kimemia, FredrickPurpose: The general purpose of the study was to establish factors influencing uptake of antenatal care among pregnant women. Methodology: The study was conducted in TaitaTaveta County, Kenya, which had a population of 338,696, with 81,288 women estimated to be of reproductive age, and 9,823 women estimated to be pregnant per year. The county had a total of 60 public health facilities, including 1 public referral hospital, 3 sub-county hospitals, 18 health centres and 38 dispensaries. The total workforce for the public health facilities was 1000 health care providers, including 300 (30%) nurses/midwives, 25 (2.5%) doctors, and 1750 community health volunteers. Data was collected using structured questionnaires for the mothers (n=381) and key informant interview for the in-charges (n=17). Data was analysed using SPSS, version 23. Chi-square and Spearman’s R tests, and categorical regression were used to determine the relationship between uptake of antenatal care and the independent variables. The results were summarized and presented in form of tables, figures and charts. Findings: Results indicated that antenatal care initiation time (R2 = 0.07) had a weak positive influence on uptake of antenatal care, while skilled health providers’ attitudes (R2 = 0.82), availability of community health volunteers (R2 = 0.78), and availability of skilled health providers (R2 = 0.92) had a strong positive influence on uptake of antenatal care.