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Kenyan Mortality and Survivorship Tables
No full textMortality tables are one of the oldest statistical tools widely used by demographers , medics
and actuaries.This is because,they enables the representation of mortality in terms of probability.
These tables are constructed from vital registration data e.g census data basing on reference
years and can be broadly classi ed into two,i.e complete life table and abridged life tables.
Complete life table considers all the single years of age from birth to the last applicable
year.This table is also known as unabridged life table. The latter is constructed using
age intervals.In most cases,these time intervals are usually of ten or ve years.
Life tables provides an e ective way of presenting and evaluating survival and mortality
data.They provide a method of analysing summary tables ,mortality curves ,survival
plots and life expectancies.
It is of great bene t to understand the basics of life table construction not only to scholars
but also to industrial players like pension schemes,hospitals ,life o ces and even in social
security as through examination of mortality rates and survival rates,these sectors are able
to make the right cause of action.
In this research work,we reviewed the basic methodology of mortality table analysis
with a speci c focus on applying the Kenyan insured lives experience data.Thereon we
constructed complete Kenyan life tables by age and gender and compared them with the
standard English Life Tables
Developing A Web Map For Civil Engineering Applications: A Case Study Of Laikipa County
No full textInformation Communication Technology is one of the greatest technological revolutions of our age and a key driver of economic prosperity among nations. Today information is regarded as a resource and therefore a factor of production. This migration towards an information society is enabled by the internet and most importantly the World Wide Web. The goal of this project was to develop a web map that shares key spatial data consumed in Kenya for Civil engineering applications using Laikipia County as a case study. The idea for this project came from the proposal by the Kenya government to develop the Kenya National Spatial Data Infrastructure (KNSDI) which began in 2001 as part of vision 2030 to allow sharing of spatial information among organizations and the public; however the project was never completed due to lack of support. Potential beneficiaries of such a web map would include: the government by making delivery of spatial data to the public as a service easier and civil engineering practitioners. The most common web maps currently in use world-wide are Google maps, Microsoft Bing maps and OpenStreetMaps; they mainly display information such as streets, hotels, restaurants, banks, bus stops and schools among many others. Some common applications of web maps include: delivery services such as food delivery services, taxi services such as Uber maps, tracking services such as vehicle tracking, defence such as the military. For this project a user needs assessment was done using a questionnaire to determine the relevant datasets used in civil engineering applications in Kenya. The design technologies applied to this web map consisted of a triad of web design languages; they are: HTML, CSS and JavaScript. Web optimization technologies were used to create a more user friendly and cost effective web map that utilizes network and computational resources efficiently, they included AJAX, image tiling, image compression and image file formatting. The result was a web map that displayed data on topography, land parcels, administrative boundaries, forestry, rivers and man-made structures such as roads and railways. The web map was hosted on a website with the URI www.beampositioningsystems.com.
Key words: World Wide Web, web mapping application, civil engineering, spatial, GIS, data, information, Kenya
Psychiatric Comorbidities Among Epileptic Patients Attending the Mathari Outreach Psychiatric Clinic in Kariobangi, Nairobi County
No full textIntroduction: It is appreciated that due to a number of factors related to the mechanism of the epilepsy and behavioral disorders, such as common neuropathology, developmental disturbances, effects of ictal neurophysiology and inhibition of hypometabolism surrounding the epileptic focus among others, it is not uncommon to find epileptic patients also suffering from a psychiatric disorder or a behavioral problem (Fahad & Cavazoz, 2016).The primary concern however is that, since it is neurological and patients tend to exhibit symptoms that could be synonymous to a psychiatric illness in our clinical settings in Kenya, the psychiatric co-morbidities are or could be overlooked.
Study objective: Therefore this study seeks to assess psychiatric comobordities among epileptic patients attending the Mathari outreach psychiatric clinic in Kariobangi, Nairobi County.
Research Design: The study will adopted a descriptive cross-sectional research design
Study Site: The research was carried out at the Mathari outreach psychiatric clinic in Kariobangi, Nairobi County.
Target Population: The study targeted adult epileptic patients at the Mathari outreach psychiatric clinic in Kariobangi, who have been diagnosed with epilepsy
Sample size: Convinience sampling was used to get 144 respondents.
Research Instruments: A researcher- designed questionnaire and the MINI International Neuropsychiatric Interview were used and data analysis: Data analysis will be done using SPSS version 23.
Findings: The prevalence of the psychiatric comorbidities was 79.2%. Most of the respondents were suffering from affective disorders. 43.8% were having depression or depression with melancholic feelings. Suicidality was also found to be a prevalent comorbidity.
Conclusion: Clearly, the prevalence of psychiatric comorbidities among epileptic patients in Kenya is high. Psychiatric conditions including mood, anxiety, and psychotic disorders, are common among this population. Gender, education levels and employment situation were found to be associated with psychiatric comorbidities in epileptic patients.a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Primary School Teachers Knowledge, Attitudes And Practice On Sexual Violence Among Their Pupils
No full textThe aim of this study was to investigate the influence of knowledge, attitudes and practices on sexual violence amongst primary school teachers: a case study of Dandora primary schools in Nairobi. The specific objectives were to find out the level of knowledge of sexual violence amongst teachers in Dandora primary schools in Nairobi, to establish the attitude on sexual violence amongst teachers in Dandora primary schools in Nairobi, to find out the practices undertaken by teachers to address sexual violence in Dandora primary schools in Nairobi. This study utilized a descriptive cross-sectional survey research design. The population for this study consisted of the primary school teachers in Dandora Primary Schools in Nairobi Eastland. The primary schools included Dandora One primary, Ushirika Primary, Tom Mboya primary, Wangu Primary, and James Gichuru Primary. This made a total target population of 141. This study adopted census sampling technique to identify the respondents. Therefore, all the 141 respondents comprised the sample size of the study. A questionnaire was used to collect primary data. The questionnaire comprised of questions, which sought to answer questions related to the objectives of this study. The data for the study was analyzed both qualitatively and quantitatively. The data collected was keyed in and analyzed with the aid of SPSS. The Quantitative data generated was subjected to the descriptive statistics feature in SPSS to generate mean, and standard deviation which were presented using tables, frequencies and percentages, while Qualitative data consist of words and observations, not numbers. The study found that teacher possesses adequate knowledge on sexual violence among pupils. The possession of information was attributed to the fact that they had been trained on matters to deal sexual violence among pupils in primary school. The study found that the various types of child abuse included physical abuse, emotional abuse, psychological abuse, and sexual abuse. The study found that the cases of sexual violence are high and no single day passes without a report of an assaulted child. The media report cases of assaulted children in primary school. They have attributed this to the lack of the children ability to protect themselves from the perpetrators of the acts and the fact that the perpetrators are family members. The study concluded that the child may suffer from physical injuries as the perpetrator uses force to abuse the child. The study found that most children who encounter sexual violence in school or out of school do not have appropriate support services. The reason attributed to this is that in most cases people are not willing to get involved in such cases. The study concluded that the increasing awareness of the long lasting and detrimental consequences for experiencing sexual victimization in school setting have increased the need for establishing anti-violence and anti-bullying preventions programs to protect students’ well-being. This study has indicated that knowledge level of primary school teachers is very high regarding sexual violence among primary children. This is a positive sign that a very important group of caregivers is well aware of rights of children. The study recommended that this knowledge power of primary school teachers should be utilized by Government Agencies and Non-Government Organizations to launch awareness campaigns in other influential groups in the society
Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV.
No full textPURPOSE OF REVIEW:
This review offers an operational definition of systems engineering (SE) as applied to public health, reviews applications of SE in the field of HIV, and identifies opportunities and challenges of broader application of SE in global health.
RECENT FINDINGS:
SE involves the deliberate sequencing of three steps: diagnosing a problem, evaluating options using modeling or optimization, and providing actionable recommendations. SE includes diverse tools (from process improvement to mathematical modeling) applied to decisions at various levels (from local staffing decisions to planning national-level roll-out of new interventions). Contextual factors are crucial to effective decision-making, but there are gaps in understanding global decision-making processes. Integrating SE into pre-service training and translating SE tools to be more accessible could increase utilization of SE approaches in global health. SE is a promising, but under-recognized approach to improve public health response to HIV globally
Is sexual autonomy a protective factor for neonatal, child, and infant mortality? A multi-country analysis.
No full textBACKGROUND:
Sexual autonomy empowers women to set boundaries, take control of their bodies, prevent sexually transmitted diseases and avoid unplanned pregnancy. A woman's ability to negotiate safer sex is crucial for her survival and that of her child. Sexual autonomy among East African women is vital to the elimination of the deaths of neonates, infants, and children. The aim of our study was to explore the association of sexual autonomy on neonatal, infant, and child mortality.
METHODOLOGY:
This was a secondary analysis of demographic health survey (DHS) data on women of reproductive age (15-49 years) in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda. Data on our outcome variables neonatal, infant, and under-five mortality which were in binary form was extracted from the database. Sexual autonomy was classified as a composite variable of "respondent can refuse sex," "respondent can ask partner to use condom," and "if spouse is justified in asking husband to use condom." Other sociodemographic, maternal, health system and paternal variables were included in the analysis. STATA version 14 was used for analysis. Proportions and frequencies were used to describe the three outcome variables and sociodemographic characteristics. Chi-square tests were used to compare associations between sexual autonomy and categorical variables. Adjusted hazard ratios were used to determine the association between sexual autonomy and independent variables.
RESULTS:
The sampled women were predominantly urban (75%; n = 5758) and poor (48.7%; n = 3702). A majority of those that experienced mortality (neonatal mortality 53.5%, infant mortality 54.3%, under-five mortality 55.7%) were young (under 20) at the time of their first child's birth while their male partners were older. The multivariate analysis supports the beneficial effects of women's sexual autonomy in East Africa. Women who exercised sexual autonomy experienced significantly lower rates of child mortality at all three stages: neonatal (NHR = 0.80, 95% CI: 0.68-0.94, p = 0.006), infant (IHR = 0.82, 95% CI: 0.72-0.93, p = 0.003), and under-five (UHR = 0.84, 95% CI: 0.75-0.94, p = 0.002), net of all other factors. Receiving antenatal care and using contraceptives also contributed significantly to lower child mortality rates.
CONCLUSION:
Our findings suggest that sexual autonomy among East African women is an urgent priority that is crucial to the survival of neonates, infants, and children in East Africa. Women should be informed, empowered, and autonomous concerning their reproductive and sexual health
Self Narration Against The Backdrop Of HIV From Heartbreak To Daybreak
No full textThis study seeks to analyze the representation of the impact of HIV/AIDS on a patient
from the patient’s point of view. It focuses on the angle from which Wagura handles the
attitudes of other people on HIV/AIDS and how she brings out her feelings as an author
and persona. The objectives of this study are to evaluate the representation of the illness
of HIV/AIDS in the autobiography by analyzing the theme of despair and the theme of
hope through the agency of a woman and to evaluate the effectiveness of the stylistic
devices employed by the writer. The hypotheses guiding this study are that Wagura’s
autobiography is a journey trailing from desperation to hope and that she has employed
different stylistic devices to effectively pass across her message. The study employs the
theory of autobiography which helps to distinguish between an autobiographical work
from other literary works. In addition, I used formalism theory. The formalists’ approach
produced a theory concerned with the writer’s technical prowess and craft skill. The
feminist literary theories helped me explore the female experience in the text. I used
library research for qualitative reading of the secondary texts. This study concludes that
despite the suffering and desperation associated with HIV/AIDS, there is breaking of the
powerlessness associated with being HIV positive. This comes from a sufferer of the
disease
The Cost of Implementing Hiv Drug Resistance Testing in Kenya: a Case Study of a Service Delivery Site at Kenyatta National Hospital
No full textWorld health organization (WHO) recommends the inclusion of HIV drug resistance (HIVDR) testing in management of Human Immunodeficiency Virus (HIV) patients on treatment to mitigate the rising cases of HIVDR. However, despite this recommendation, there is paucity of information related to the cost of HIVDR testing in Kenya. This study aimed at estimating the unit cost of HIVDR testing, identifying the cost drivers for the HIVDR test, exploring opportunities for cost saving and documenting challenges and lessons learnt in implementation of HIVDR testing. To achieve these objectives, the cost analysis was performed at Molecular and Infectious Diseases Research (MIDR) Laboratory, a KNH/UON-CoEHM project initiative situated at the University of Nairobi Tropical and Infectious Diseases Institute (UNITID). The study utilized a mixed costing approach in quantification and valuation of the cost categories from the provider’s perspective. Data collection involved time and motion study of the laboratory procedures for HIVDR testing and interviewing the Laboratory personnel and the operations manager. As one of the cost saving opportunities adopted by the laboratory, we evaluated the cost of reagent volume reduction at amplification and sequencing processes intervention. Data entry and analysis was done in Microsoft excel and costs converted to US dollar (2019). The estimated unit cost for a HIVDR test was 102.42, 37.68%) and reagent cost (101.50, 37.35%). The other costs included, personnel (14.69, 5.41%), maintenance cost of equipments (4, 1.47%). Costs in relation to laboratory processes were, sample collection (22.79, 8.38%), amplification (10.34, 3.80%), sequencing (19.16, 7.05%). Halving reagents volume at amplification and sequencing processes reduced the cost for HIVDR test to $247.30. All the test performance characteristics for the modified assay were within acceptable ranges. The challenges experienced included, high staff turnover, insufficiencies in the supply chain and lack of a functional laboratory network for sample-referral mechanisms leading to sub-optimal utilization of the facility. Furthermore, uncertainty in donor funding raises concerns on the sustainability of such capital intensive endeavors
Taxation of Aid Funded Projects in Kenya: Law, Policy, Problems and Proposals for Reform
No full textForeign aid contributes largely to the development expenditure of developing countries. Tax
treatment of foreign aid has been a subject of discussion in the global and regional arena. The
United Nations Committee of Experts on International Cooperation on Tax Matters and the
African Tax Administration Forum have in their past sessions and publications advocated for
a coherent policy on the treatment of taxes in aid funded projects (AFPs). Kenya’s tax legal
regime provides for several tax exemptions for AFPs. Tax exemptions as a form of tax
expenditure has its merits and demerits hence there is need for their evaluation as to their cost
and benefit before they are granted. Tax treatment of AFPs requires a comprehensive and clear
policy and legal framework to avoid tax disputes. In Kenya, this has been a challenge. Based
on primary and secondary data, this research interrogates the nature of the problems in tax
treatment of AFPs, the adequacy of the existing policy and legal framework, the effects of the
problems and makes recommendations
Assessment Of Radiological Hazards Associated With Indoor Norm Dose Exposure In Residential Houses In Nairobi, Kenya
No full textIndoor air quality has profound impact on health worldwide; effects on respiratory, circulatory and immune systems due to sick building syndrome. This study examined the radiological hazards associated with indoor air quality in selected residential houses in Nairobi City for exposure to NORM. In situ measurements were done using Gamma Spectroscopy Multichannel NaI (Tl) analyzer on the type of building materials (for floor, walls and ceiling), used in three hundred and thirty (330) residential houses. Indoor NORM radioactivity content, ambient gamma equivalent dose were measured and the ventilation rate of the main living rooms evaluated. The radiological hazards assessed were; absorbed dose, effective dose and excess life time cancer risks. The results indicate potential exposure associated with NORM within the type of building materials. The dominant radionuclide identified was 40K; mean 107 kBq (103 -163) kBq (floor), mean 140 kBq (97 -344) kBq (walls) and mean 120 kBq (84 -167) kBq (ceiling) and dose rate of 0.32 mSv/yr (floor) and 0.34 mSv/yr for both walls and ceiling. Other NORMs were below their detection limits. For indoor ambient gamma dose rate, the ceiling was the dominant source of exposure for most residential houses and exceeds 2 mSv/yr. The indoor absorbed dose ranged from 60.34 - 272.73 nGy/h with a mean value of 113 nGy/h and varies with type of building material used with correlation significance of 26%. The results of mean absorbed dose rate show that residence within Kapiti Phonolites regions are relatively at risk of high exposure than those in Nairobi Phonolites. The indoor annual effective dose obtained from the floor, ceiling, and walls are 0.55 ± 0.18 mSv, 0.63 ± 0.21 mSv and 0.71 ± 0.24 mSv and are within the UNSCEAR indoor annual exposure of 0.41 mSv for adults, 0.45mSv for children and 0.53 mSv for infants, respectively. The findings of this study indicate potential exposure from tiled floors (1.34 mSv/a) and concrete roof (1.06 mSv/a). The estimated excess lifetime cancer risk ranges from 0.2 to 0.6 % with a mean value of 0.28%. The three parameters of ventilation namely; ventilation rate, air exchange rate per hour, and ventilation per area were studied. Most main living room residential houses had ventilation openings areas less than 5%, air change rate per hour ranges between 0.48 to 0.61 h-1 with mean value of 0.51 h-1, and are not compliant to the local minimum requirement of 0.5 - 1 h-l. This findings are in agreement with indoor air quality and exposure dependency on ventilation systems. However, there is indication of poor indoor air quality in some Nairobi residence whose exposure rate is dependent on; the type of building materials used, ventilation area opening, ventilation rate, the floor level, locations of residences, the size of the rooms, indoor occupancy and lifestyle. The study therefore recommends incorporation of radiation protection and safety standards of NORM in building materials of residential houses and indoor air quality standards, and policies for the building and construction industry of residential houses. Further investigations of the associations between indoor air quality and respiratory diseases or allergies and the air change rate in homes could be considered and public ventilation awareness campaigns