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Item Determinants Of Effective Implementation Of Health Management Information System: A Case Of Wajir County Kenya(Researchjournali's Journal Of Public Health, 2018-02) Ahmed, Sugow Bishar; Onyango-Osuga, Ben; Oluoch, Musa; Mwaura, Dr WanjaThe general objective of this study is to establish the determinants of effective implementation of Health Management Information System, a case of Wajir County, Kenya. The study was pegged to the following four specific objectives; health information management practices, technology, human resource and stakeholders. The study employed a descriptive survey research design to gain knowledge and understanding of the design and implementation of health information systems using Wajir County as a case study. The target population of this study was Health Information Officers, Sub County Health Management Team and hospital departmental Managers of the six sub counties of Wajir county. This study used an interview guide and a questionnaire to collect primary data. Data analysis used SPSS to generate quantitative reports through tabulations, percentages, and measures of central tendency. Based on the study observations the study concludes that health information management practices influence the implementation of Health Management Information System to very great extent. Although there was Internet connection in Wajir County, the Internet connection was not reliable. The study noted that the common internet connections utilised in the Wajir County was 2G of 3G with very few facilities utilizing 3G network connections. The findings also reveal top management of health facilities played a key role in the implementation of Health Management Information System. However, majority of the respondents indicated that the monitoring and evaluation function was weak in many of the facilities in Wajir County. The study recommends that the government should provide adequate infrastructure in the form of computers, internet connection and office space if necessary with the help of funds available with each institution. Take measures to involve the private sector through regular consultations and bringing in requisite legislations so that a comprehensive picture of the health status in the country could be obtained. Ensure the resources to strengthen data utilization are developed and distributed to every facility in the County for example manuals, standard operating procedures, research results and equipment like computers. The county should also improve the skills and competency of the staff with regard to data interpretation, use of information and evidence-based decision making through regular training programmes. Training related to HMIS activities should be conducted regularly in a planned manner with adequate and timely release of funds. There should be clear guidelines for the type of reporting and management of different data elements. Management of Wajir County Government should strengthen the Monitoring and evaluation function in health facilities with a view of enhancing efficiency and effectiveness in these facilities.Item MOTIVATIONAL FACTORS THAT INFLUENCE RETENTION OF NURSING FACULTY IN KIAMBU NURSE TRAINING INSTITUTIONS(Journal of Health, Medicine and Nursing, 2018) Susan, Wanja Nyambura; Mwaura-Tenambergen, Wanja; Oluoch, MusaPurpose: The main purpose of this study was to establish the motivational factors that influence retention of nursing faculty in Kiambu County. Methodology: The study design was descriptive cross-sectional. The study population comprised nursing faculty currently working in Nursing Council of Kenya registered Institutions in Kiambu County. The total population of full time nurse educators in the 7 NCK registered schools in Kiambu County was approximately 50. Census sampling method was used where the entire nursing faculty in Kiambu County. The study used questionnaires to collect the required data. Descriptive statistics was used mainly to summarize the data. SPSS was used for analysing complex data. Data presentation was through the use of pie charts, and frequency tables. Results: The study findings revealed that there was a significant relationship between the effect of career development opportunity and the period of time the faculty had worked in the current organization. Availability of human resources was cited by 50% of the respondents as the work environment factor requiring improvement. Majority (66.7%) of the respondents said management of their respective institutions was not responsive to the faculty’s needs. There was no significant relationship (P=0.081) between the academic status of the respondent and the effect of institutional management factors on motivation. Policy recommendation: The study recommended that a research exploring the intrinsic factors that motivate faculty in Kiambu County Nursing Institutions needs to be carried out and the institutional management of Kiambu County nursing programs should institute a system of continually finding what the faculty needs are and responding to these needs.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 FACTORS INFLUENCING COLLECTION OF BLOOD DONOR TEST RESULTS IN NAIROI COUNTY – A CASE STUDY OF NAIROBI REGIONAL BLOOD TRANSFUSION CENTER(Journal of Health, Medicine and Nursing, 2018) Gititu, George; Oluoch, Musa; Tenambergen, WanjaBackground: The Kenya National Blood Transfusion Services screens all donated blood for HIV, Hepatitis B&C and syphilis with each blood donor being informed of testing of his or her donated blood and availability of test results for collection at the Regional Blood Transfusion Centers. The study-assessed factors influencing collection of blood test results by blood donors as only less than 10% blood donor’s return to collect their test results. Method: The study utilized descriptive cross-sectional study approach employing a mix of both quantitative and qualitative approach. 385 blood donors and seven key informants interviewed using a pre-designed questionnaire and Key informant respectively. Quantitative data was analyzed using Epi info 6.04 while qualitative data was transcribed and analyzed using content thematic framework approach. Results: 95% of participants did not return to collect their test results with 90% not being aware that test results are available for collection. 50% of those who had not collected their test results would not have collected even after being adequately informed. 93% would not collect their test results in presence of friends fearing stigmatization and would not share the outcome of the test even with their families. Conclusion: The study concluded that the collection of donor test results is greatly influenced by knowledge, location of result collection sites, working hours of collection sites, stigma and cultural beliefs. The Study recommends mass sensitization on availability of test results, where to collect results and demystify social cultural beliefs.Item 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.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 Factors influencing Healthcare Waste Management System in Machakos County, Kenya(Health Systems Management Journal, 2019-07) Mwania, Michael Musango; Oluoch, Musa; Kimemia, FredrickMachakos County health facilities have poor healthcare waste segregation, treatment and disposal practices; patients, health workers including waste handlers and the general population are exposed to risks of needle stick injuries and infection of HIV/AIDS and Hepatitis B&C. All population is exposed to risks associated with furans, dioxins and heavy metals released to the environment through open and crude burning of healthcare waste. World Health Organization recommends supporting and strengthening a health system based on six health system building blocks that includes quality service delivery. The study focused on strengthening the service delivery pillar of health systems in which good health services are expressed as both personal and non-personal quality care, through addressing aspects of safe healthcare waste management (HCWM) herein viewed as non-personal services that directly or indirectly affect patient, health workers and the general population health. The purpose of this study was to determine factors affecting HCWM system in Machakos County. Specific objectives were to determine the healthcare waste management process, health Managers role, human resource factors, and how healthcare waste management policy implementation affect HCWM system in health facilities in Machakos County. Methods: We used survey research design. A sample size of 120 respondents was drawn using both stratified random and purposive sampling techniques. Data was collected using questionnaires and an interview guide. Results: The findings showed that the role of health managers (β2 = .436, P < .001), human resource factors (β3 = .065, P < .002), and healthcare waste management policy implementation (β4 = .275, P < .001) influenced management of healthcare waste system. Conclusions: Health managers’ role had the strongest positive and significant influence on HCWM. Recommendations: i) adoption of safe technologies for treatment and disposal of healthcare waste, ii) refresher trainings on HCWM to all healthcare staff on existing HCWM policies in Kenya, iii) provision of adequate budget to procure enough HCWM commodities, iv) provision of adequate personal protective equipment to all health staff, and v) vaccination of health staff against Hepatitis B.Item Status of Health workers Knowledge on Maternal and Neonatal Health related to Service Delivery in Makueni County(Health Systems Management Journal, 2019-07) Kasanga, Bernard; Muthoni, Eunice; Oluoch, MusaGlobally, new born mortality remains unacceptably high. Neonatal mortality accounts for 60% of infant mortality rate in Kenya. In Makueni County, 1 in 22 children does not live to his or her first birth day. This unacceptable high mortality is despite existence of cheap and tested interventions which could reduce up to 70% of current deaths. Evidence of mismanagement of clients in the County health facilities has raised concerns whether health workers attending to mothers and neonates are knowledgeable. The purpose of this study was to determine health worker knowledge on maternal and neonatal health related to service delivery in Makueni County. Specific objectives were to determine prenatal care, preeclampsia and postnatal care knowledge among primary care givers and how it relates to service delivery. Methods: we used a cross sectional research design. A total of 163 health workers selected through simple random sampling were involved. Data was collected using a structured questionnaire and observational checklist. Results: On prenatal care, majority of health workers 89(54.6%) had good knowledge (X2 =45.1 p<0.05). Practice didn’t conform to guidelines since 30.3% and 69.7% of antenatal mothers didn’t have full history taken and general physical examination done respectively. On pre-eclampsia, majority of caregivers (78, 49.4%) had poor knowledge while on postnatal care 53(32.5%), 58(37.4%) and 132 (80%) had good knowledge in new-born care, management of neonatal infections and young infant feeding respectively. Conclusions: The study concluded that health workers were not following guidelines and lacked adequate knowledge in management of pre-eclampsia, newborn care and neonatal infections. Recommendations: The study recommends the following to Makueni County health managers (i) to have refresher course, targeted continuous medical education and standard operating procedure on management of pre-eclampsia (ii) to strengthen supportive supervision and ensure guidelines are adhered to (iii) to retrain workers on new-born care and management of neonatal infectionsItem Influence of training on performance of nursing officers, in Nyeri County, Kenya(Journal of Health, Medicine and Nursing, 2019) Ongori, Jeremiah M.; Oluoch, Musa; Adoyo, Maureen A.Purpose: The management of human resources in healthcare institution is essential to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Training and development is most effective in motivating and retaining high quality human resources within healthcare organization. This study therefore sought to establish the influence of training on the performance of nursing officers, in Nyeri County, Kenya. Methodology: This study adopted a cross sectional descriptive research design. The respondents constituted all nursing staffs and managers in Nyeri County Public Health facilities and at the County Director’s Office. Stratified random sampling was used to come up with a sample of 248 respondents. Data was collected using questionnaire. Descriptive statistics were used in the analysis of data with the help of SPSS. Chi-square analysis was used to establish relationships. Findings: The study found that training of nurses was conducted but there was a limitation in the diversity of approaches used. There was a significant relationship (χ2= 34.500, df=12, p=0.001, v=0.422) between training and the performance of nursing officers, in Nyeri County. The study concluded that training influences the performance of nursing officers, in Nyeri County, Kenya. Specifically, the lack of adequate training is a drawback in service delivery. Unique contribution to theory, practice and policy: The study recommends that training programs in the health sector should therefore be reviewed in order to employ more techniques in the training of nurses.