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Item Provision of adolescent and youth-friendly services in public health facilities in Migori County, Kenya(International Journal of Community Medicine and Public Health, 2023-09) Nyaga, Lillian Njoki.; Ongombe, Musa.O; Mwangi, Eunice M.Background: Global and national guidelines on provision of adolescent and youth-friendly services (AYFS) exist. However, the extent to which these services are provided in developing countries, including Kenya, is unknown. Therefore, this study aimed to assess provision of AYFS in public health facilities in Migori County, Kenya. Methods: A cross-sectional study design was employed. The study setting was public health facilities in Migori County. The county has 275 health facilities, of these 159 are government owned/public health facilities. A multistage sampling of 114 public health facilities was done from which 210 healthcare providers (HCPs) were sampled using simple random sampling. Three facility in-charges were purposively selected to represent each of the county's three Levels of healthcare delivery system. Data was collected using structured questionnaires, key informant interviews guide, and Health facility observation checklists. Results: Majority 153 (74%) practiced nursing and 148 (71%) had worked at their current workstation between 1-5 years. Equitable, accessible, acceptable, appropriate, and effective AYFS are provided in the government owned public health facilities. Conclusion: Inadequate AYFS training of healthcare providers and poor implementation of existing policies including weak engagement of young people in AYFS significantly hinder the effective provision of AYFS in public health facilitiesItem Influence of product selection on health commodity security among level four public health facilities in Nairobi County, Kenya(International Journal of Community Medicine and Public Health, 2022-07) Kaitany, Fridah C.; Mwangi, Eunice M.; Njoroge, KeziaBackground: Procurement of health products and technologies in Kenya faces challenges as seen by increased public complaints regarding erratic supplies of the essential drugs and other medical supplies in public health facilities. Often overlooked, is the need to build effective product selection systems which can ensure there is availability of health commodities. Methods: The study adopted a cross sectional survey research design with descriptive approach involving 120 top management team, procurement officers, stores clerks, pharmaceutical officers and head of departments who were involved in procurement of health products and commodities from the 4 level four government health facilities in Nairobi County (Mbagathi Hospital, Pumwani Maternity Hospital, Mama Lucy Kibaki Hospital and Mutuini Hospital). The survey used questionnaires to collect data from the respondents. Consent was obtained from participantsabove the age of 18 years was included in to the study. Informed consent was taken prior to conduct of the study. Results: Correlation analysis indicated that product selection and health commodity security were positively correlated (r=0.769, p<0.05) while regression analysis indicated that product selection influenced health commodity security in level four public health facilities in Nairobi City County, Kenya (β=0.457; p=0.05). Conclusions: Product selection is important to ensure health commodity security. The management at the facilities should ensure product selection committees are available in the facilities, products selected are registered for use in the country and ensure that the user departments are involved in product selection.Item Promoting delivery of reproductive health services through legal support and capacity development of healthcare providers in a health provider network in Kenya(Journal of Obstetrics and Gynecology of JOGECA East and Central Africa, 2021-08) Munyasia Lusike Nelly,; Mwangi, Eunice M.; Tenambergen, Wanja M.Health provider networks (HPNs), an innovation in the private sector, is a service delivery model that has improved access to health services. However, there are no known studies or empirical evidence to support their effectiveness in Kenya. Objective: To determine the influence that legal support and provider capacity building have on providing quality reproductive health services in a healthcare provider network in Kenya. Methods: A cross-sectional study design was used. The study was carried out among Reproductive Health Network Kenya (RHNK) healthcare providers spread all over 42 counties in Kenya. The target population was 457 health care providers within RHNK and five board members. A sample of 252 health care providers was drawn using simple random sampling. A structured questionnaire was used to collect data from the 252 health care providers in the network. Quantitative data were analyzed using the IBM SPSS software, version 23, for descriptive and inferential statistics, and results were presented in tables. Results: A total of 252 respondents were included in this study; 52 (n=132) were male. Forty-six percent % (n=117) of the respondents were between 41-50 years. Nurses were the majority at 73 (n=184), and 31 % % (n=78) of the respondents owned nursing homes. Fifty-one percent (n=127) of the respondents were diploma holders, and 28 (n=70) had 16-20 years of % work experience. The bivariate analysis reported that legal support (r=.235**, p< .05) and capacity building (r= .213**, p< .05) had a positive and significant influence on the provision of quality reproductive health services in the provider network. Conclusion: Legal support and capacity building through training, mentorship, and coaching significantly impact reproductive health services quality in a provider network.Item Determinants of adverse drug reactions reporting in retail chemists in Nairobi County, Kenya(International Journal of Community Medicine and Public Health, 2020-08-28) Njiru*, June W.; Mwangi, Eunice M.; Oluoch, MusaBackground: Reporting of adverse drug reactions remains the mainstay of a vibrant pharmacovigilance system that seeks to safeguard medicines in a health system. This study sought to establish the impact of the national medicines regulatory body, The Pharmacy and Poisons Board (PPB), the operationalization of pharmacovigilance implementation strategies in the retail chemists, the effect of the capacity and that of underlying motivation factors of the retail chemist personnel on reporting of adverse drug reactions. Methods: This was a descriptive cross-sectional study design conducted between May 2018 to June 2018. Results: 149 (60%) of the respondents stated that PPB did not engage retail chemists as stakeholders in pharmacovigilance, 127 (51%) said they had never read any PPB publication on pharmacovigilance, 151 (61%) said they had general knowledge on pharmacovigilance, receiving feedback from PPB was considered a major motivational factor towards ADR reporting by 237 (96%). Multivariate analysis of the determinants of ADR reporting in retail chemists established that the pharmacovigilance implementation strategies (p<0.026), retail chemist personnel (p<0.001) and underlying motivational factors (p<0.05) had significant influence on ADR reporting in retail chemists in Nairobi County. Conclusions: PPB has not engaged retail chemists on pharmacovigilance matters as key stakeholders and this has impacted the quality of the pharmacovigilance implementation strategies in the chemists as well as the capacity and motivation of the retail chemist personnel to report ADRs.Item Role of County Health Governance in Implementation of Social Insurance National Scheme in Selected Counties in Kenya(Kenya Methodist University, 2019) Mwangi, Eunice M.; Mapesa, Job; Wairia, Samuel K.Health care financing (HCF) is one of the building blocks of a health system. Kenya envisions to have Universal Health Coverage (UHC) by 2022. To achieve this, the National Hospital Insurance Fund (NHIF) was identified as a vehicle towards the realization of UHC. NHIF collects revenue, pools risks, and purchases health services for its members. NHIF uses capitation as a strategic purchasing model to provide primary care health services (PCHS). This study aimed to establish the role of County Health Governance in implementation of the NHIF national scheme. Specifically, the study sought information on NHIF’s communication with the County Health Management Team (CHMT), CHMT knowledge of NHIF national scheme guidelines, suitability of county health facility Infrastructure , adequacy of NHIF capitation funds, NHIF accountability and how they all influence provision of NHIF primary care health services. This was a cross sectional research. All 120 County and Sub-County Health Management Team members were purposively sampled from Nakuru and Nyandarua Counties, a 96% (115) response rate was achieved. Results showed that, 64(56%) of respondent said NHIF was accountable to the population, 73(63%) said the county health facility infrastructure was adequate and 67(58%) said there were guidelines directing implementation of NHIF PCHS. However, 66(57%) said patients were not accessing NHIF primary care health services, 70(61%) said capitation funds were not adequate and 59(51%) said communication from NHIF to them was inadequate. Chi square results indicated that all variables, NHIF communication χ² = 5.364, p < 0.05, availability of guidelines χ² = 10.447, p < 0.05, suitability of county health facility infrastructure χ² = 13.199, p < 0.001, adequacy of NHIF capitation funds χ² = 6.956, p < 0.05 and NHIF accountability χ² = 10.982, p < 0.05 were scientifically significant and influenced implementation of the national scheme outpatient services. The study concludes that there is minimal participation of the CHMT in NHIF decision making and this hinders successful implementation of the NHIF National scheme. The study recommends that 1) NHIF improves communication with the CHMT members, so as to involve them in the implementation of NHIF national scheme, 2) NHIF to raise awareness of the strategic purchasing function in order to promote a shared understanding which will enrich knowledge of the roles and responsibilities of all the players including the County and National governments, NHIF, Citizens and providers.