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Evaluation of Adherence to World Health Organization Guidelines on Clinical Management of Cryptococcal Meningitis among Health Care Providers in Selected Hospitals, Kisumu, Kenya
Get PDFPurpose: Prevalence of Cryptococcal meningitis has risen and remained high over the last several decades in line with the HIV/ADS pandemic which has consequently led to the increase of Cryptococcal Meningitis associated mortality rates ranging from 17% to 100% in Africa. The aim of the present study was to assess the adherence to WHO guidelines on clinical management of CM in adults among HCP in JOOTRH and KCRH.
Methodology: This was a cross-sectional analytical study which was carried out in Kisumu County, Kenya. Sample size was obtained using Yamane (1967) formula. The sample calculation yielded a sample size of 119 respondents with a 97% response rate. Bivariate analysis was done using logistic regression from which chi square, odds ratios and the p- values were drawn
Findings: Findings from demographics showed that many were females (n=64, 55.2 %). Distribution of age bracket showed that many (n=74, 64.3%) were aged 30 years or below. From the results,76%(n=88) reported using lumbar puncture with rapid CrAg assay while very few reported using lumbar puncture with rapid cerebral spinal fluid India ink test (3%, n=4) in diagnosing cryptococcal meningitis. Majority (90.5%, n=105) reported using amphotericin B deoxycholate + fluconazole as first line antifungal therapy. In management of hypokalemia, majority (93%, n=56) did not monitor potassium daily but all (100%, n=60) administered 1 liter of normal saline infused with 20 mEq of potassium chloride two hours prior to each infusion of amphotericin B. 93%(n=56) did not administer two of 250-mg tablets of magnesium trisilicate, or magnesium chloride 4 mEq twice/ day for supplementation of magnesium.
Unique Contribution to Theory, Practice and Policy: This study recommends that the County government of Kisumu in collaboration with the two hospital management teams, need to organize and provide periodic training opportunities for the health care providers on the WHO guidelines on management of Cryptococcal meningitis whose prevalence is high in this region, and consistently avail current recommended clinical guideline/protocols in all the clinical departments to ease reference, hence promote adherence. In addition, they should include the aspect of adherence to WHO guidelines on management of cryptococcal meningitis, as one of the yearly appraisal objectives and provide timely supportive supervision in order to promote and streamline optimal adherence
Utilization of Male Contraceptives among Males in Bungoma County, Kenya
Get PDFPurpose: Kenya has several policies to promote male participation in family planning, but data on male contraceptive use by male respondents is scanty. Available reports indicate that utilization of male contraceptives in Bungoma County to be less than 1%. This has been linked to high maternal deaths in Bungoma County. Limited male contraceptive choices has been cited as a barrier to utilization of current male contraceptives which calls for more research on male respondents to inform utilization, barriers, development and rollout of new male contraceptives. The aim of the study is to determine utilization of male Contraceptives among males in Bungoma County in Kenya.
Methodology: A Cross-sectional Analytical study conducted among 395 males aged 20-69 years in Bungoma County in Kenya. Sample size was determined by Fisher et al. formula and multistage sampling technique was employed. Descriptive and inferential analyses were employed with p-value < 0.05 being considered significant.
Findings: 80.9% of males are using aform of contraceptive with condom being the most used contraceptive (89.3%). Commodity related issues (X2 =40.570, p < 0.001), service delivery point (X2 = 82.252, p < 0.001), staff gender preference (X2 = 10.013, p = 0.018 were found to be statistically significant barriers to utilization. There was a significant association (X2 = 59.286, p < 0.001) between level of knowledge and utilization. 99% of the males are not aware of any other contraceptive other than condom vasectomy and withdrawal. If a new contraceptive was developed, the majority would prefer a pill when required.
Unique Contribution to Theory, Practice and Policy: This study established a higher utilization of male contraceptives and influencers of utilization than earlier documented. Lack of knowledge by healthcare providers on new contraceptives calls for continuous medical education on the status of contraceptive development. These findings will inform the policy makers on the areas to focus on by leveraging on the existing opportunities to improve utilization of the current and any other contraceptive that is to be developed. It provides an opportunity for more research on male respondents
Accuracy Comparison of Hard, Soft, and UnQuantized Decisions across Diverse MIMO Channels and M-QAM Demodulation
Get PDFPurpose: In this paper, hard, soft, and non-quantized Viterbi decision algorithms are examined and compared over multiple-input multiple-output (MIMO), Quadratic amplitude modulation, QAM schemes, and M-ary channels.
Methodology: The proposed system supports the design methodology of a decoding scheme of the LLR algorithm between MIMO and M-ary channels. The proposed system is designed and tested using MATLAB.
Findings: The results provide valuable insights into the balance between computational efficiency and decoding accuracy, which helps in choosing appropriate decision algorithms for specific MIMO and M-QAM communication systems. The results demonstrated different scenarios, including MIMO (2x2), (4x4), and M-ary (4,16, and 32 QAM) technologies.
Unique Contribution to Theory, Practice, and Policy: Experimental results show that although non-quantized decisions achieve the highest accuracy, they require significantly more computational resources. Hard decisions provide simpler implementation with lower computational costs but lower accuracy. The soft decision-making method balances performance and complexity and outperforms hard choices regarding bit error rate (BER) in all tested scenarios. It also enhances our understanding of Viterbi decoding in LLR estimation across different connectivity conditions. The scenarios showed that the soft solution is better than the hard solution, as previously known, depending on the conditions. However, from the results obtained using Matlab simulations, the silky solution appears to be the best in terms of the balance between complexity and better performance as the data show
The Influence of Artificial Intelligence on Customer Service Automation in E-Commerce in Rwanda
Get PDFPurpose: To aim of the study was to analyze the influence of artificial intelligence on customer service automation in e-commerce in Rwanda.
Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
Findings: The influence of Artificial Intelligence (AI) on customer service automation in e-commerce has been transformative, enhancing efficiency, personalization, and customer engagement. Studies show that AI-powered chatbots and virtual assistants have reduced response times by 40% and lowered operational costs by 20-30% while improving customer satisfaction. AI-driven Customer Relationship Management (CRM) systems have boosted repeat purchases by 20% and increased engagement by 35% through personalized recommendations. However, challenges persist, including lack of emotional intelligence, trust issues, and transparency concerns, with 47% of customers expressing distrust in AI interactions due to impersonal and robotic responses. SMEs struggle with
Unique Contribution to Theory, Practice and Policy: Technology acceptance model (TAM), service quality (SERVQUAL) model & unified theory of acceptance and use of technology (UTAUT) may be used to anchor future studies on the influence of artificial intelligence on customer service automation in e-commerce in Rwanda. E-commerce businesses should invest in AI algorithms that leverage customer purchase history, browsing behavior, and real-time preferences to provide context-aware and hyper-personalized responses. Governments and regulatory bodies should develop ethical guidelines to govern the use of AI in customer service
Government Ownership Structure and Financial Performance of Firms Listed at the Nairobi Securities Exchange, Kenya
Get PDFPurpose: Different groups of shareholders have a growing impact on the financial performance of companies listed on Nairobi securities markets. Policies regarding different ownership structures and the performance of companies at the NSE have led to the growing need to establish how distinct ownership structures influence the performance of this security market. This study sought to establish the relationship between government ownership structure and the impact it brings on the financial performance of firms listed at the Nairobi Securities Exchange in Kenya.
Methodology: The study adopted a causal quantitative design and targeted the population of all the 62 firms listed at the NSE, Kenya thereby conducting a census on the study population for a period of 10 years between 2014-2023. Secondary data was sourced from NSE, CBK, CMA, and financial statements of the respective companies listed at the NSE and stored in data collection sheets to aid in the analysis of data. STATA18 software was applied to conduct inferential analysis and correlation analysis using the panel regression model. The research correlation analysis findings depicted a weak negative correlation between government ownership structure and the financial performance of listed companies at the NSE.
Findings: The study findings of the panel regression model indicated coefficient values of 2.010 with P values of 0.051. From the overall results, government ownership had a negative effect on the financial performance of companies listed at the NSE, Kenya.
Unique Contribution to Theory, Practice and Policy: The study recommended strategies that will encourage more private individuals and institutions to co-own state enterprises, the study recommends that the government look into implementing management practices similar to those of the private sector and advance the divestment program. Furthermore, to provide government-owned firms an advantage in management, the government should think about implementing training in business acumen and entrepreneurship. In conclusion, the study recommends that the ownership structure in Kenya should be restructured to reduce government ownership further to pass more control and decision-making to private investors. However, the government should retain some ownership in foreign and local firms to enhance shareholders\u27 confidence, protection of investments, and managerial monitoring
The Detrimental Effects of Technology on the Academic Performance of University Student Athletes: The Implications of Online Sports Betting in Kenya
Get PDFPurpose: This study explores the impact of technology, particularly online sports betting, on the academic performance of university student-athletes in Kenya. While technology offers opportunities, it also creates challenges, such as distractions, poor time management, sleep disruption, and financial or psychological distress.
Methodology: This study employed a descriptive research design targeting 24,639 student-athletes and university sports officers across Kenyan universities. Using simple random sampling, a representative sample of 423 participants was selected, including 385 athletes and 38 sports officers. Data collection involved self-report questionnaires, observation score sheets, and key informant protocols, with gambling behaviors carefully recorded during observations.
Findings: The regression analysis showed that gambling severity explains 5% of the variance in students’ academic performance (R² = 0.05), with the model being statistically significant (F = 12.907, p < 0.001). The regression coefficient (β = 0.346, p < 0.001) indicates a positive and significant relationship, meaning that an increase in gambling severity predicts poorer academic performance. Additionally, demographic factors significantly moderated this relationship, increasing the explained variance to 56.6% (R² = 0.566, F = 3.07, p < 0.001). This suggests that demographic characteristics strongly influence how gambling severity affects academic outcomes, aligning with findings that socioeconomic background relates to gambling addiction and its effects.
Unique Contribution to Theory, Practice and Policy: Based on the study findings, it was recommended that the Online sports betting companies should engage scholars in formulating policies that advocate for responsible gambling practices while mitigating the risks associated with academic detrimental online betting behaviours. Secondly, prior to granting licenses, betting companies should implement technological solutions that empower users to establish personal gambling limits, particularly for student-athletes representing Kenyan universities, to prevent excessive spending and potential addiction. Third, both public and private higher education institutions should create betting policies that foster mental wellbeing, which may include regular mental health workshops and screenings
Innovation Strategies and Financial Performance of Insurance Firms in Kenya: A Case of Sanlam Kenya PLC
Get PDFPurpose: The purpose of this study was to evaluate the effect of innovation strategies on the financial performance of Sanlam Kenya PLC and to assess the moderating effect of organizational culture on this relationship. The study specifically focused on three types of innovation strategies: product innovation, process innovation, and market innovation.
Methodology: The research adopted a mixed-methods design anchored on the resource-based view, dynamic capabilities, open innovation, and institutional theory. The target population was 650 employees from the finance, marketing, innovation, and ICT departments at Sanlam Kenya PLC. Using Krejcie and Morgan’s sampling table, a sample of 242 respondents was selected through stratified and purposive sampling techniques. Quantitative data were analysed using SPSS Version 28, employing descriptive statistics (frequencies, means, and standard deviations) and inferential statistics (t-tests, ANOVA, and correlations) to test hypotheses. Qualitative data were analysed thematically to identify emerging patterns and insights that complemented the quantitative results.
Findings: The study revealed that all three innovation strategies product, process, and market innovation had a significant positive effect on financial performance, measured by return on investment, return on assets, and revenue growth. Market innovation showed the strongest influence (R² = 0.367), followed by product innovation (R² = 0.137) and process innovation (R² = 0.123). Moreover, organizational culture was found to significantly moderate the relationship between innovation strategies and financial performance, with a higher explanatory power (R² = 0.846), indicating that culture enhances the effectiveness of innovation in driving performance.
Unique Contribution to Theory, Practice and Policy: The study recommends that insurance firms, particularly Sanlam Kenya PLC, should prioritize market-driven innovation while strengthening their organizational culture to maximize the financial benefits of innovation strategies. Product and process innovations should be aligned with cultural values that encourage adaptability, creativity, and openness to change. Furthermore, the study suggests that future research be extended to other financial services sectors in Kenya, including banking and investment institutions, to validate and generalize the findings across the broader financial industry
The Effect of Board Tenure and CEO Duality on Firm Performance of Companies Listed in Nairobi’s Stock Exchange
Get PDFPurpose: This study sought to investigate the effects of board tenure and CEO duality on firm performance among companies listed in Nairobi Stock Exchange from a time period of year 2014 to 2023.
Methodology: The study was based on the Agency Theory of Jensen &Mackling (1976) emphasizing on managerial behavior in an organization. The study adopted a causal study design which was appropriate. The target population comprised of 65 listed firms in Nairobi Stock Exchange and a sample size of 41 firms, excluding financial and insurance firms as they are being regulated. Secondary data was collected from the audited annual financial reports and was analyzed by using both descriptive and inferential statistics.
Findings: The study revealed that board tenure had significant effect on the performance of firms listed in Nairobi stock exchange. Where the board tenure (β 0.016), (P=0.000 had positive and significant relationship on firm performance. The study also revealed that CEO duality had a positive non-significant relation with firm performance (β 0.056), (P=0.25).
Unique Contribution to Theory, Practice and Policy: The study recommended improvement of those corporate governance features which have positive impact on firm performance such as CEO Duality
Entrepreneurial Orientation and Performance of Small-Scale Agribusiness Grain Farmers in North Rift, Kenya
Get PDFPurpose: This study sought to determine the influence of entrepreneurial orientation and performance of small-scale agribusiness grain farmers in North Rift, Kenya. Further the study sought to determine the influence of entrepreneurial innovation, pro-activeness, risk-taking, competitive aggressiveness and autonomy on the performance of small-scale agribusiness grain farmers in North Rift, Kenya.
Methodology: The study adopted the positivist research philosophy and descriptive survey research design was utilized. Target population included 497,737 small-scale agribusiness grain farmers in North Rift, Kenya. Yamane’s Formula of sample size determination was applied to derive a sample size of 400 respondents. Questionnaire was used for data collection. SPSS version 25 was applied in analyzing the data collected. The quantitative data comprised of the descriptive and inferential statistics. Descriptive statistics were summarized into percentages, mean and the standard deviation which was presented using figures, frequency tables and pie-charts. Inferential statistics were applied to test the hypothesis for the study.
Findings: The findings showed that Innovation and performance of small-scale agribusiness grain farmers has a positive and significant relationship. Moreover, it was also established that pro-activeness, risk taking, competitive aggressiveness, and entrepreneurial autonomy significantly predicted the performance of small-scale agribusiness grain farmers in North Rift, Kenya. Entrepreneurial characteristics had a statistically significant moderating effect on the relationship between entrepreneurial orientation and performance of small-scale agribusiness grain farmers in North Rift, Kenya.
Unique Contribution: The study recommended , small-scale grain farmers to embrace entrepreneurial orientation, research institutions to contact regular market research, government institution to enact policies that support entrepreneurial orientation and training institutions to contact educational training, there is a need for educational institutions to integrate entrepreneurial innovativeness, risk management, pro-activeness, competitiveness, business autonomy and entrepreneurial characteristic into agricultural curricula to equip future farmers with the necessary skills
E-procurement System and Public Contract Management Performance at Rwanda Biomedical Center
Get PDFPurpose: To investigate the influence of the e-procurement system on public contract management performance at the Rwanda Biomedical Center (RBC).
Methodology: A descriptive research design and a mixed-methods approach were utilized. Data were collected through interview guides, questionnaires, and secondary sources. Employing the purposive sampling method, the study had a sample size of 80 respondents selected from the target population of 102 individuals involved in the contract management process at RBC, using the Krejcie and Morgan (1970) Table.
Findings: In line with regression analysis, findings revealed that among them, E-informing emerged as a highly effective component, with a β = 0.428 significantly enhancing contract management by facilitating timely communication, improving stakeholder coordination, and reducing information asymmetry. E-sourcing also showed a strong positive influence [β = 0.401] by promoting transparency and fairness in supplier selection, which directly contributed to better compliance and accountability in contract execution. E-contracting exhibited a moderate impact [β = 0.162], and e-payment demonstrated a minimal and statistically insignificant influence on overall contract management performance, despite contributing to financial accuracy and compliance.
Unique Contribution to Theory, Practice and Policy: The study recommends that Rwanda Biomedical Center should prioritize enhancing e-informing systems by investing in capacity-building programs to improve stakeholder ICT proficiency and addressing technical challenges such as system downtimes. For e-payment, efforts should enhance its interoperability with other e-procurement tools such as e-purchasing, e-invoicing, automated payment processing, and cash flow management, and implementation barriers to maximize its transactional efficiency and accountability in financial processes