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Knowledge and Perception of Women towards Cervical Cancer Screening in Meru County, Kenya.
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/12Globally, epidemiological transition from communicable to non-communicable diseases is on increase with Cervical cancer associated with human papilloma virus being among leading causes of morbidity and mortality in women.Cervical cancer is preventable but majority of Kenyan women have never been screened yet free services are available in most health facilities. Cervical cancer screening for all women aged 18 to 69 years in Kenya is reported to be 3.2%as compared to the National Cervical Cancer Prevention program target of 70%.Underutilization of screening services is cited to result from lapses in service availability, negative perception among others.The study aimed at assessing knowledge and perception of women towards cervical cancer screening in Meru Teaching and Referral Hospital. A descriptive cross-sectional study design was used. Data was collected from 352 respondents (n=352) selected through purposive sampling technique using structured questionnaires. Data was cleaned, coded and entered using SPSS version 23,analysed using descriptive and inferential statistical techniques and presented using tables and charts.Results showed that 69% were aware of cervical cancer while 46.29% were not, 86.9% did not know the cause of cervical cancer.61.9% had heard about cervical cancer screening but 38.1% had not. 78.4% had never heard about human papilloma virus vaccine.The correlation between utilization of cancer screening services and knowledge of cervical cancer screening, was found to be statistically significant r= 0.294, p < 0.001, two tailed. An inverse relationship between screening and perceived pain, r= -0.117, p=0.029 and perceived embarrassment r= -0.109, p=0.041 was also established. This suggests that perception influences utilization of screening negatively.The results would help county managers in decision making and planning for cervical cancer screening as a priority for strengthening service delivery.This study recommends sustained public health education to create positive social change that will include increased awareness, change of perception to cervical cancer and improved screening practices
Factors influencing Healthcare Waste Management System in Machakos County, Kenya
No full textMachakos 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
Relationship Between Structural Arrangement and Provision of Primary care Quality: A Case of Health Centers in Nakuru County, Kenya
No full textIntroduction: 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
Factors influencing uptake of antenatal care in Taita Taveta County, Kenya
No full text49% of pregnant women are able to make four or more ANC visits in Sub Saharan part of Africa. General objective of the study was to find out factors influencing uptake of ANC in public health facilities in Taita Taveta County. The specific objectives were; to assess influence of early initiation of ANC on uptake of ANC in, determine influence of skilled health providers’ attitude on uptake of ANC, establish influence of availability of community health volunteers on uptake of ANC and determine effects of skilled health providers’ availability on uptake of ANC. A total of three hundred and eighty four mothers and eighteen health facility in-charges participated in the study. The study adopted survey research design and data collected using structured questionnaires for the sampled mothers and key informant interview for the in-charges. The researcher analysed data using Statistical Package for the Social Sciences (SPSS) version 23. Descriptive analysis (percentages and frequencies) and inferential analysis (Chi-square and Spearman’s correlation tests, and regression analysis at significance level of alpha=0.05) were performed. Results indicated 43.6% of the mothers managed 2 ANC visits, 41.7% 3 visits and14.7% just 1 ANC visit. The findings also indicated that timing of ANC initiation had significant association (X2 (6) = 102.854, p < 0.001) and weak negative relationship (Spearman’s R = -0.201, p < 0.001) with uptake of ANC. An R2 of 0.071 (7%) showed early ANC initiation had low degree of influence on ANC uptake. Reception during ANC visits had significant association (X2 (8) = 564.235, p < 0.001) and strong positive relationship (Spearman’s R = 0.905, p < 0.001) with ANC uptake; and adequacy of privacy had significant association (X2 (8) = 459.447, p < 0.001) and moderate positive relationship (Spearman’s R = 0.763, p < 0.001) with ANC uptake. An R2 of 0.819 (81.9%) showed skilled health providers’ attitude had high degree of influence on ANC uptake. Moreover, number of CHVs visits had significant association (X2 (8) = 317.099, p < 0.001) and high positive relationship (Spearman’s R = 0.870, p < 0.001) with ANC uptake; and CHVs perceived importance had significant association (X2 (8) = 321.872, p < 0.001) and strong positive relationship (Spearman’s R = 0.863, p < 0.001) with ANC uptake. An R2 of 0.784 (78.4%) showed that availability of CHVs had high degree of influence on ANC uptake. Lastly, the results indicated that waiting time had significant association (X2 (6) = 354.829, p < 0.001) and moderate negative relationship (Spearman’s R = -0.745, p < 0.001) with ANC uptake; presence of skilled health providers had significant association (X2 (4) = 668.9, p < 0.001) and strong positive relationship (Spearman’s R = 0.947, p < 0.001) with ANC uptake; and adequacy of sessions had significant association (X2 (8) = 321.872, p < 0.001) and strong positive relationship (Spearman’s R = 0.899, p < 0.001) with ANC uptake. An R2 of 0.920 (92%) showed that availability of skilled health providers had high degree of influence on ANC uptake. The researcher concludes that; pregnant women in the county are knowledgeable about ANC, however initiation is poor; Staff attitude contributes significantly towards improved ANC uptake; Pregnant mothers who have been visited by CHVs initiate ANC in time; Availability of healthcare providers in the right number and mix contribute to improved ANC uptake. The researcher, therefore recommends that County should recruit additional healthcare providers to render better quality ANC service
Transforming the Health Sector in Kenya by Adopting Integrated Health Management Information System
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/24Achieving better health outcomes is every health organization’s dream.Several health management strategies have been developed;a key one being production of quality information for purposes of informed decision making.Most public health facilities in Kenya are by large extent using manual health information systems,which are cumbersome and fragmented leading to delayed or uninformed decision making. Five key drivers are viewed to influence Integration of Health Management Information System(IHMIS): i) organizational factor, ii) technical factor, iii) behavioral factor, iv) adopted leadership style and v) operationalization of the functions of management.The purpose of the study was to prescribe an ideal design of an IHMIS.A mixed method research design was adopted to determine the significance of the drivers identified in influencing the IHMIS.Both semi-structured questionnaire and a key informant guide were used to collect data that was analyzed and reported using mean scores,correlation and regression analysis.Integration of HMIS was found to positively and significantly correlate with organizational factor,technical factor,behavioral factor,leadership style adopted and operationalization of the functions of management.The study also showed that all variables accounted for total variation in the integration of HMIS.In a multiple regression analysis,the study found the model valid.However only 4 out of 5 of the predictor variables(operationalization of management functions,behavioral factor,technical factor,leadership style adopted) were good in explaining total variations in the integrated HMIS in Kenya. This implies that the more these variables are improved the better it gets in achieving integration of HMIS which is achievable if all the study variables are taken into account.The study suggests that the ideal design of an integrated HMIS would be in the form of an automated web based system in each health organization as opposed to the current manual system.IHMIS will be more successful,if integration within a single health organization is successful.The study recommends a central database for each level of care
Factors influencing rational drug use in public hospitals among doctors and pharmacists in Meru County
No full textAccess to essential medicines, vaccines and medical technologies is the anchor pillar in this study. Medical products must be of assured quality, safety, effective, scientifically sound and cost effective. Rational use of medicines requires that a patient receives appropriate medications to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time and at the lowest cost to them. It is concerned with how commodities are selected, procured, used and stored to ensure that the patients receive quality and efficacious products appropriate to their medical needs. There are a number of challenges that have been encountered in the rational use of drugs. These include lack of essential drugs, gaps in training and weak implementation of policy guidelines. The broad objective of this study was to assess the factors that influence rational drug use among doctors and pharmacists in public hospitals in Meru County. Specifically the study sought to determine how staff awareness on policy guidelines, management practices, product selection and inventory management influence rational drug use among doctors and pharmacists. A cross sectional study design was adopted having quantitative approaches. The sample size was 102 doctors and pharmacists who work in the public hospitals in Meru County. Both stratified and simple random samplings were used to sample the staff. A five point Likert scale based questionnaire was used to collect data. Quantitative data was analyzed using SPSS Version 23. Correlations were done between the dependent variable RDU and independent variables Staff awareness, inventory management, production selection and management practices. Significance levels were done at both 5% and 1%. There was a significant relationship between RDU and staff awareness (r=.232*, p=0.019) and inventory management (r=.324**, p=0.001). 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 (F (4,97)=4.68, p=0.002) shows that there is correlation between the predictors variables Staff awareness, management practices product selection , Inventory Management, and the dependent variable Rational drug use. This study recommends: i)The hospitals develop training manuals on rational drug use that will be used to create awareness on importance of Rational drug use among doctors and pharmacists to enhance knowledge and build capacity, ii) departmental heads to offer support supervision, quarterly assessment, appraisals and implement RDU in collaboration with doctors and pharmacists, iii) All the hospitals to constitute active Drugs and Therapeutics Committees in all the facilities to ensure that formularies are developed, policies are communicated and SOPs implemented, to enhance uniformity and build capacity, iv) to constitute procurement committee with all stakeholders including the doctors and pharmacists to ensure they are involved in the budgeting, selection and monitoring of Essential drugs
Status of Health workers Knowledge on Maternal and Neonatal Health related to Service Delivery in Makueni County
No full textGlobally, 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 infection
Prevalence of Parasitic Infections amongst Children in Primary Schools in Tharaka South Sub County, Kenya
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/17Parasitic infections-soil transmitted helminths (STHs) and protozoan infections are among the most prevalent infections in developing countries.Health effects of these infections include; poor nutritional status,appetite,gastrointestinal morbidity,cognitive disability and iron deficiency anemia among others.The aim of this study was to investigate the prevalence of parasitic infections amongst children in primary schools in Tharaka South Sub County.A cross-sectional study was conducted among 481 children in five primary schools selected from three different age groups and classes in the County.To investigate intestinal helminths and protozoa,a single stool sample was examined from each child,and both thick and thin blood smears of each participant examined for malaria parasites.Statistical analysis was done using STATA 13 MP®.Prevalence was calculated and reported per 1000 persons.The risk of infection with protozoa and/or STHs by school,gender and age was analyzed using logistic regression for Odds Ratio (OR). Risk of infection with infectious parasitic infection and risk of polyparasitism was analyzed using multivariate logistic regression for OR.Results showed the prevalence of any parasitic infection was 548.86/1000persons.Prevalence of STHs was 83.16/1000persons,most prevalent STHs was Schistosoma mansonii 33.26/1000persons,while prevalence of protozoa was 466/1000persons and the most prevalent protozoa was Entamoeba hystolytica 235/1000persons.Bivariate analysis indicated a statistically significant positive association between Giardia lamblia and gender, (p=0.014),Giardia lamblia and being in age group (7 -10 years (p=0.041),it was found that a positive association between infection with EC and being in the age group of 7-10 years, p=0.037).Risk of infection was positively associated with being male, p=0.029 and being in class five,p=0.017.Polyparasitism was negatively (protective) associated with belonging to Kamatungu primary school, p=0.029 and Tunyai primary school, p=0.007.The study concludes that Protozoan infections were more common than soil transmitted helminths.Improved water sanitation and hygiene are essential in eradication of intestinal parasitic infection.Mass drug administration and health promotion interventions should also target protozoal infections of medical importance
Assessment of health workers perinatal knowledge and practices related to service delivery in Makueni County,Kenya
No full textA health system has six interdependent and interrelated pillars: health workforce; service delivery; information; financing; medical products, vaccines and technologies; leadership and governance. This study addressed health workforce pillar in order to strengthen maternal and new born services delivery in Makueni County. Globally, new born (neonatal) 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 cost-effective evidence-based interventions which could reduce up to 70% of current deaths. Review of client complaints in Makueni has revealed gross medical mismanagement raising concerns whether health workers attending to them are knowledgeable. This study assessed perinatal knowledge and practices among health workers in Makueni County. It specifically established prenatal care knowledge and practices, pre-eclampsia knowledge, postnatal care knowledge, home visits and hand hygiene knowledge among health workers in Makueni County. The study was cross sectional in design where 163 health workers selected randomly were interviewed using a structured questionnaire and a checklist used to observe antenatal care consultation practices. Data analysis was done using SPSS v25 and chi-square statistic test used to examine associations within variables. On prenatal care, 89 (54.6%) of health workers were rated as having good knowledge. However, practice did not conform to guidelines since 10 (30.3%) and 23 (69.7%) of mothers didn’t have full history taken and general physical examination done respectively. On pre-eclampsia 78 (49.4 %) had poor knowledge while on use of recommended drugs for pre-eclampsia, 70 (42.9%) had moderate knowledge and 39 (23.9%) poor knowledge. On postnatal care, 132 (80%) had good knowledge on young infant feeding while 35 (21.5%) had poor knowledge on new born care. On management of neonatal infections, 58 (37.4%) had good knowledge while on home visits 80 (48.5%) knew the importance of home visits but 88 (80.4%) did not know the optimal time for the visits. On hand hygiene 127 (77%) of health workers knew the four critical times for washing hands with soap under running water. The study concluded that workers had good knowledge on prenatal care, young infant feeding and hand hygiene. There were critical gaps in knowledge on pre-eclampsia, use of recommended drugs for pre-eclampsia, new born care, management of neonatal infections and home visits. Prenatal care practice did not conform to guidelines. The study recommended refresher courses and continuous medical education in focused antenatal care, management of pre-eclampsia, newborn care, management of neonatal infections and home visits. It also recommended strengthening of supportive supervision to ensure guidelines are available and adhered to in practice
Factors Influencing Rational Drug Use in Public Hospitals among Doctors and Pharmacists in Meru County
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/16Rational 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