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Determinants of a functional refferral system in Kisumu County,Kenya. Patient perspective.
No full textPurpose: 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)
Influence of structural arrangement on provision of quality primary care health services in public health centers in Nakuru County, Kenya
No full textThe Alma Ata Declaration of 1978 emphasized the importance of primary care as an
approach to achieve health for all. Kenya has gradually expanded primary care health
service delivery to increase access and comprehensiveness of healthcare services. It has
equipped referral facilities with modern equipment, while primary care health facilities
continued to struggle with limited resources. As a consequence, this gap has become a big
impediment to Kenya’s quest to achieve universal health coverage. Structural arrangement
has been cited as the major contributing factor to quality health services delivery. This
study examined relationship between structural arrangements and provision of quality
primary care health service in public health centers. The objectives was to assess whether
infrastructural resources, financial resources, staffing and governance influence provision
of quality primary care services in public health centers in Nakuru County. Acrosssectional
study design with mixed data collection methods was adopted for this study. A
total of 110 respondents from 33 public health centers in Nakuru County were included in
the study sample. The respondents were Clinical officers, Nurses, Pharmaceutical
Technologist and Laboratory Technologists. Data entry and analysis was done using SPSS
Version 20. Descriptive analysis was used to profile the characteristic of the respondents.
Mean, Standard deviation, correlation and regression was used to determine the
relationships. The findings showed that modern equipment and adequate supply of
essential commodities was associated with high quality primary care health service delivery
(r=0.453, p<0.01). Sufficient funds and effective management of resources significantly
determined quality of primary care health service (r=0.365, p<0.01). Health worker skills,
experience and training were statistically associated with quality primary care service
(r=0.567, p<0.01). Transparency and accountability were strongly and positively associated
with improved quality of primary care service at the public health centers (r=0.613,
p<0.01). Regression analysis showed financial resource (β= 0.32) and governance (β= 2.49)
significantly improved quality of primary care health service delivery. Study concludes
good structural arrangements lead to good processes and ultimately good health outcome.
The study recommends that county government of Nakuru should i) supply adequate
equipment to perform the necessary work, ii) provide sufficient allocation and timely
release of funds to health centers, iii) provide career progression and continuous
professional development among its health workforce, and iv) institute staff retention
measures and frequent auditing of health centers assets and liabilities and provide a report
to the public
Influence of training on performance of nursing officers, in Nyeri County, Kenya
No full textPurpose: 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
Factors influencing uptake of antenatal care in Taita Taveta County, Kenya
No full textPurpose: 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
Innovation for Food Security and Nutrition in Kenya Towards Attainment of The Big Four: A Review of Chelelang’ the Wonder Bean Technology
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/19Various genetic and environmental factors adversely affect the yield of beans in East and southern Africa.These include climate change variables such as temperature,moisture,pests, diseases and soils.This paper reviews genetically superior genotypes with reference to yields of various bean lines and varieties in east and South Africa.Also considered were two climatic variables including: temperatures and moisture.A series of on-farm and station trials were carried out to screen lines and varieties from five international nurseries in Kenya,Uganda,Tanzania,Rwanda and Burundi.Sixty four (64) genotypes were screened in Nakuru,Bomet and Meru districts.Using farmer field schools and on station trials in Kaguru-Meru,Egerton-Nakuru and Bomet.The trial yielded superior bean genotypes such as Ciankui,Tasha and the EU a word winning Chelelang “the wonder bean”.These germ plasms had been inspected by KEPHIS and were recommended for commercial growing in cool highlands and warm humid arid- lands.These were the areas with temperatures in the range of 22-30oc and moisture levels of about 400mm per year.It was also observed that Chelelang yielded 1750 Kg/ha(19.5bags) as compared to an average of 550kf/ha (6.0 bags) (i.e 3.19 times better) than Rose coco the control.The new technology (Chelalang) was a bean of choice to replace low yielding environmentally vulnerable commercial varieties and temperatures of 300C and moistures of about 400mm.The current technology average yield =550kg/ha=6.11 bags/ha.Average yield of new technology (Chelalang) = 1750kg/ha=19,4bags/ha. bags/ha/season=38.9 bags/year.Kenya has a potential of 800,000ha for growing beans. This results to 800,000 x 38.9 bags =31,120,000 bags.Average bean consumption in the country is estimated at 26,666,666 bags giving a surplus of =4,453,333 bags. /year.At a price of ksh.4000/bag would translate to an additional revenue of Ksh.4,453,333 x 4000 =17,613,333,333/year.The technology contributed to reduction of hunger and provision of proteins bean. Adoption of this new technology would save the nation a lot of revenue which is appropriate for VISION 2030
Personal characteristic and academic help-seeking behavior of basic diploma nursing students in Kenya Medical Training College, Nairobi
No full textPurpose: This cross-sectional mixed survey sought to describe AHSB of basic diploma nursing students in KMTC, Nairobi, Kenya. The study examined the influence of sources of help, options of help-seeking and personal characteristics on help-seeking behavior.
Methods: Data was collected using self-administered questionnaires. Descriptive statistics and inferential statistics (in particular, the chi-square, Fisher’s Exact and binary logistic regression) were derived from the data. All statistical tests of significance were at 95% confidence level.
Results: the study revealed that 90.9% (n=160) of respondents were adaptive help seekers, 72.8% (n=126) preferred peers to lecturers and 75.6% (n=133) frequently sought help from fellow students, especially during group discussions. By contrast, 54.6% (n=95) of the respondents approached instructors during class or immediately after lesson; with only 24.6% (n=43) engaging lecturers privately. Adaptive help seeking was positively associated with personal factors of self-efficacy (p=0.034), the notion that the student is of equal worth with peers (p=0.038) and a feeling that help seeking is not a sign of weakness. On binary logistic regression, students who felt that seeking help was a sign of weakness were significantly less likely to be adaptive help-seekers. The study concludes that personal factors are significant predictors of adaptive help seeking behavior of student nurses in KMTC Nairobi.
Unique contribution to theory, practice and policy: The research recommends that institutions encourage students to treat peers as people of equal worth; and that seeking help is not a sign of weakness. Moreover, schools should explore ways of increasing help seeking from lecturers, especially in their office
Determinants of a functional refferral system in Kisumu County,Kenya. Patient perspective.
No full textMost referral health facilities are faced with challenges ranging from congestion of patients at these health facilities, limited resources both human and material to deal with the voluminous clients, slow rate of service delivery due to high numbers as a result of the by-passing tendencies. Self-referrals normally results in compromised quality of medical care provided to the patients. The problems mentioned above affects most of the high level health facilities which are traditionally meant to be referral health facilities. The study conducted in the month of August 2017 therefore aimed to find out the determinants of a functional referral system in two level 5 health facilities; Jaramogi Oginga Odinga Referral Hospital (JOOTRH) and Kisumu County Referral Hospital (KCH). The objectives of the study were to; examine the extent to which the primary health care centres characteristics, patients’ characteristics, receiving health facility characteristics and proximity to a health facility influence a functional referral system. A cross sectional study was conducted using a qualitative approach to data collection. Three hundred and thirty eight patients were systemically selected to participate in the study. Data was collected using an individual questionnaire through one on one interview between the dates 14th- 22nd August 2017. The collected data were coded and analyzed using the SPSS 25.0 Computer program. The qualitative data collected were analyzed quantitatively using the descriptive statistics and linear regression models. The results indicates that there was a positive and significant influence of the primary health facility characteristics (r=.474**, p<0.001) and receiving facility characteristics (r=.475**, p<0.001) on a functional referral system at the two high level facilities. There was also a negative but significant influence of proximity to health facility (r=- 0.137**, p=0.017) on a functional referral system at the two level 5 facilities. On patients characteristics, a significant interaction was found on gender χ2 (1) = 4.64, p= 0.031, education level χ2(2) = 20.37, p<0.001 and Marital status χ2(2) = 8.78, p= 0.012 with a functional referral system. Conclusion – Factors influencing functional referral system are primary health centre characteristics, patients’ characteristics, proximity to a health facility and referral health facility characteristics. It is therefore recommended that the County government of Kisumu should improve the supply of drugs and quality of service delivery at the primary health facilities to attract more patients seeking primary care services, specialists movement especially to the lower level health facilities need to be reinforced by the Ministry of Health to boost the citizen’s confidence in quality of care at these facilities, more sensitization strategies need to be put in place to educate both the patients and health care providers on the recommended referral practices that should be upheld to improve efficiency and effectiveness of service delivery
Use of Complementary and Alternative Medicine among Cancer Patients in Meru County, Kenya.
Get PDFhttp://library.kemu.ac.ke/ijpp/index.php/ijpp/article/view/25Cancer is among the leading causes of death globally.Despite advancing technology in conventional methods of cancer diagnosis and treatment, access to services remains a big challenge especially in the developing countries.Out of desperation, patients may be tempted to use Complementary and Alternative Medicine (CAM) to improve their health outcomes.However, there is minimal data in Kenya and specifically Meru County on use of CAM among cancer patients.The study aimed to assess the level of use, sources and perceived effects of CAM among cancer patients in Meru County.A descriptive cross-sectional study design was adopted in this study.Data was obtained from 117 participants through a researcher administered questionnaire.Data was cleaned, coded and keyed manually into the statistical package of social sciences (SPSS) version 23.Data was then summarized using means,percentages, frequency tables and measures of dispersion.The results showed that almost half of the respondents (47.9%) were using CAM mainly to cure cancer (78.6%). here was no association between use of CAM and the socio-demographic factors (p>0.05).The common CAM methods used included; spiritual therapy (37.5%), vitamins and supplements (26.5%) and local/traditional herbs (19.6%).Friends (55.4%) and family members (53.6%) provided the major sources of information on CAM.Pastors and local chemists were the most common sources of CAMs used. Improved health (n=30, 53.6%) and ability to cope with the disease (n=16, 28.6%) were the most frequent perceived benefits reported by CAM-users. None of the CAM-users reported any adverse/side effects experienced after use of CAM.Conclusively, results depicted a significant percentage of cancer patients in Meru County use CAM; mainly spiritual therapy and vitamins and mineral supplements. Health care provider should pay close attention to use of CAM while taking history from cancer patients and advice accordingly.Meru county government should regulate all CAM products that are accessible to the public and ensure the providers are well trained and registered
Implementing business strategy: a critical analysis on the role of strategic communication among parastatals in kenya
No full textA review of literature indicates that strategy implementation is an important component of strategic management process. There still exists a high failure rate in the implementation of business strategy as a result of the existence of many potential barriers. The improvement of service performance is one of the most pressing issues facing public organizations in Kenya. The lack of communication-specifically strategic communication in the management structures of organizations has repeatedly been identified as one of the barriers to effective implementation of business strategy. The significance of this study was represented by its attempt to examine the influence of strategic communication on the implementation of business strategy among Parastatals in Kenya. Independent variables under study were communication policy alignment to strategy; adequacy of information communicated; communication channels used and communication activities. The dependent variable was the implementation of business strategy. This study adopted an exploratory approach using a descriptive survey design. The study was anchored on the philosophy of pragmatism; a mixed design involving quantitative and qualitative designs which were used to obtain information from 126 Parastatals drawn from the total population of 187. The target respondents comprised of managers at all three levels in sampled Parastatals in Kenya. The study required the collection of both primary and secondary data for triangulation purposes. The sampling frame entailed all Parastatals as obtained from the Kenya Gazette. Proportionate stratified random sampling was used to select a sample of 378 in selected strata's of 126 statistically selected Parastatal headquarters. Self-administered questionnaires were used to collect the data. A pre-test was conducted on a different sample of similar characteristics to the actual sample to ascertain the reliability of the data collection instruments. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version twenty two and summary statistics such as mean scores, variances, standard deviation and inferential statistics namely; correlation analysis and regression results were used to test the hypotheses. The results provided statistical evidence that a positive and significant influence exists between implementation of business strategy and strategic communication. In the practice, this study recommends that managers must make efforts to consistently communicate the strategic intent to all employees at all levels; have in place communication policies as well as conduct communication audits for proper alignment to strategy. Further, the study acclaims that managers at all levels should be competent communicators in giving correct, clear, timely and easily understandable information to employees to enhance success of implementation. On methodology, the study recommends further studies using experimental designs because strategy implementation is a process and actual effects can only be well captured using a longitudinal approach. Regarding policy, this study recommends that the need for Kenyan government to audit and strengthen existing communication policy frameworks to support and improve implementation of strategic plans. This study therefore is of significance to the Government of Kenya, policy makers and strategic management scholars to use the study finding
Determinants of strategic plan implementation in public universities: a case of selected public universities in Nairobi County, Kenya
No full textA thesis submitted in partial fulfillment for the award of the degree of Master in Business Administration, Kenya Methodist UniversityABSTRACT
The main objective of the study was to examine factors determining strategic plan implementation in the context of public institutions of higher learning. Specifically, the study sought to determine how leadership styles, communication, resources and technology influence strategic plans in public universities in Kenya. The study adopted a descriptive research survey design involving 13 universities in Nairobi. Out of the targeted 13 universities, 4 universities were samples. In each University the research sampled employees in the order of VC, DVCs, Registrars, CODs, HODs, PO,FO and Administrative Officers totaling to 279 respondents. The findings were analyzed using means, standard deviations, regression and correlation analysis. The study established that there was a moderate positive significant relationship between leadership style and strategic plan implementation (R= 0.424; p=0.000); leadership style significantly influences strategic plan implementation (p=0.011<0.05); there was a strong positive significant relationship between communication and strategic plan implementation (R=0.853; p=0.000); communication was a significant determinant of strategic plan implementation in public universities p=0.001<0.05; there was strong positive significant relationship between resource allocation and strategic plan implementation in public universities (R=0.842, p=0.000); resource allocation was found to be a significant determinant of strategic plan implementation in public universities p=0.000<0.05; there was strong positive and significant relationship between technology and innovation in respect to strategic plan implementation in public universities (R=0.718, p=0.000); technology and innovation was identified as a critical factor determining strategic plan implementation in public universities p=0.000<0.05. The study concludes that leadership style significantly influences strategic plan implementation in public universities; respondents avoided evaluating problems and concerns as they were discussed and Respondents rotated the role of team briefer among the staff; Communication was a significant determinant of strategic plan implementation in public universities. Resource allocation was found to be a significant determinant of strategic plan implementation in public universities. Technology and innovation was identified as a critical factor determining strategic plan implementation in public universities. The study recommends that top management of all universities in Kenya should strengthen their leadership styles in order to effectively enhance their strategic plan implementation. Clear channels of communication should be created between all management levels in public universities in Kenya. The national and county governments in Kenya should fully support strategic plan implementation in Kenyan universities by providing sufficient financial and non-financial resources. All universities in Kenya should put in place benchmarking programmes with technology oriented firms for example Safaricom and this will enhance technology transfer for effective strategic plan implementation