International Peer Reviewed Journals and Books
Not a member yet
2732 research outputs found
Sort by
Factors Influencing Adherence to Combined Antiretroviral Therapy among HIV-Infected Adolescents in Machakos County, Kenya
Get PDFPurpose: This study investigated factors influencing adherence to combined antiretroviral therapy (cART) among HIV-infected adolescents in Machakos County, Kenya.
Methodology: The study applied a mixed-methods approach. Quantitative data from structured questionnaires and medical records, along with qualitative data from key informant interviews, were analyzed to understand the impact of stigma/discrimination, healthcare factors, social support, and socio-demographic characteristics on adolescents\u27 adherence to cART.
Findings: The study found that reliable availability of antiretroviral drugs, caregiver support, and a supportive healthcare environment were crucial for maintaining treatment regimens. Financial barriers, transportation costs, and system failures were identified as challenges to adherence. Inferential statistical analysis revealed significant factors affecting adherence: frequency of clinic visits, time to receive medication, and treatment by staff. Frequency of clinic visits showed a negative correlation with adherence probability, indicating that more frequent visits were associated with higher adherence. Surprisingly, a longer time spent at the clinic was positively correlated with adherence, suggesting that more time spent at the clinic may reflect more comprehensive care. Poor treatment by staff negatively impacted adherence highlighting the need for better patient-staff interactions. Social support was also crucial, with 82.8% of respondents having someone accompany them to appointments, 89.4% having support to remember medication, and 97.6% receiving support from the clinic. Most social support came from family members (63.3%), followed by hospital staff (59.5%), with notable dissatisfaction from community (26.8%) and friends (26.8%). Demographic factors, such as age, level of education, living with extended family, and ART regimen, also influenced adherence. Age was negatively associated with adherence, with each additional year decreasing adherence likelihood by 4%. Primary education completion was linked to an 81% higher chance of non-adherence. Living with extended family positively influenced adherence increasing it by 23%. The ART regimen TDF/3TC/DTG was associated with a 28% decrease in adherence compared to ABC/3TC/LPV/r.
Unique Contribution to Theory, Practice and Policy: Recommendations include enhancing support systems, improving healthcare experiences, tailoring interventions, and optimizing clinic visits to address these barriers. In conclusion, addressing determinants such as demographic, clinical, social, and healthcare-related factors can lead to targeted interventions that enhance adherence rates and improve health outcomes for HIV-infected adolescents. The study\u27s findings provide valuable insights for healthcare providers and policymakers to develop strategies that support this vulnerable population in Machakos County and beyond
Asthma Self-Management Practices among Patients with Asthma at Chuka County Referral Hospital (CCRH), Kenya
Get PDFPurpose: Asthma is a global public health problem that affects people of all ages contributing significantly to morbidity and mortality.It is a chronic inflammatory disease of the respiratory tract. This study aimed at assessing self-management practices for asthma control among adult patients with asthma.
Methodology: The study adopted a descriptive cross-sectional survey design. A sample size of 118 patients was obtained using Fisher’s et al formula and the sample was selected using simple random sampling. A researcher administered questionnaire was used to collect data. Data was analyzed using statistical package for social sciences version 26 to generate frequencies, mean and measures of central tendency. Pearson’s correlation coefficient was used to determine the relationship between self-management practices and asthma control.
Findings: The study concluded that there is a negative correlation between self- management practices and Frequency of Asthma Control, r = -0.190 with a significance p-value = 0.045. This implies that frequency of asthma symptoms and practice of trigger identification and control are statistically significant at 0.05 level (2-tailed). Key facilitators of asthma self-management practices include; effective communication with healthcare workers, availability and affordability of medications in government hospitals. Some of the reported barriers to asthma self-management include presence of comorbidities, poor self-control and lack of knowledge on ASM.
Unique Contribution to Theory, Practice and Policy: This study recommends implementation of outreach programs in the community to increase awareness about asthma and associated self-management essentials
Socio-Demographic and Economic Predictors Influencing Immunization Coverage among Under-5 Children of Nomadic Pastoralists in Garissa County, Kenya
Get PDFPurpose: The purpose of the study is to determine socio-demographic and economic predictors influencing immunization coverage among under-5 children of nomadic pastoralists in selected manyattas in Garissa County, Kenya
Methodology: The study was a cross sectional study design on immunization coverage in Balambala Sub County in Garisa County. The population was selected from household residents of Manyattas in Balambala, among families who had children for immunization. The inclusion criteria was the guardians/caretakers of children aged 0-60 months in Manyattas of Balambala Sub County in Garisa County, whose parents/Caregivers gave informed consent to participate in the study. Children must have resided in Balambala Sub County for more than 6 months. Systematic sampling method was used to collect data from the sample. Data collection was done by use of questionnaires on social demographic and economic factors associated with children immunization. SPSS version 12 was used for analysis where Univariate and multivariable analysis was done to determine association between socio-demographic and economic factors and immunization among children under five years. Ethics Review committee approval no ISERC/MSc/015/2024 was obtained.
Findings: The analysis of factors associated with immunization coverage among caregivers reveals significant associations with several socio-demographic characteristics. Caregivers’ age emerged as a critical factor, with those aged 35-44 showing the highest rate of fully immunized children at 88.2%, while caregivers aged 45 and above had the lowest full immunization rate at 37.5%. Caregivers from households earning more than KSh 20,000 had the highest rate of fully immunized children (92.9%), while those earning less than KSh 10,000 had the lowest rate (65.2%).
Unique Contribution to Theory Practice and Policy: Enhance education and awareness by implementing community-based education and awareness programs to improve health literacy among caregivers, particularly focusing on the importance of completing the full immunization schedule. health education initiatives should target caregivers with no or low levels of formal education and involve community health volunteers for effective dissemination of information
Factors Associated With Adoption of Electronic Medical Record System among Healthcare Providers in Kirehe District Health Facilities, Rwanda
Get PDFPurpose: The goal of this study is to determine the factors associated with adoption of EMR system among healthcare providers in Kirehe District health facilities. The study intends to answer a series of research questions about determining the level of EMR use among healthcare service providers, evaluation of the perception of healthcare providers towards medical care using EMR and the assessment of factors associated with the adoption of EMR system among healthcare providers in Kirehe District Health Facilities.
Methodology: The researcher used a cross sectional study design with quantitative approach. Thus, the researcher used census method, which involved the whole target population in the study as a sample size since the numbers of medical personnel in Kirehe District are manageable in terms of time and economy. The researcher used a questionnaire to collect data in this study. Chi-square test was used to assess the association between EMR system adoption and independent variables. The multivariable analysis was applied to identify factors associated with the EMR system adoption by considering the AOR, 95% and p-value less than 0. 05. Tables and Figure were also used to present the data.
Findings: The study findings showed that 25.8% of study participants had low, 36.0% had moderate while 38.2% had high levels of EMR use in Kirehe District Health Facilities. The percentage of adoption of EMR system at health facility was 38.2. Findings revealed that most of the study participants (86.8%) said they prefer using EMR rather than paper-based medical records. A big number (78.7%) of study participants believed that the quality of care is improved when using EMR. A lot of study participants (50.0%) strongly agreed that decisions about patient care are quickly taken based on electronic data. During the record of patient’s data, most of the study participants (55.1%) agreed that errors are reduced while using EMR system. A big number of study participants (53.7%) strongly agreed that EMR system makes easy the generation of reports as it is automated and strongly agreed (57.4%) that the reports from the EMR system are accurate. Most of study participants (65.4%) strongly agreed that recording patient’s data using EMR system saves time. A lot of study participants (95.6%) said that EMR use has a positive impact on patient care provision. Perception on reporting facilitation (easy generation of reports), EMR work use experience, data-driven decision-making and quality of internet were significantly associated with EMR system adoption among clinicians in Kirehe District Health Facilities. Clinicians who strongly agreed that EMR system eases reports generation were more likely to adopt the EMR system use (AOR=3.14, 95%CI: 1.128–6.023, p<0.001) compared to those who strongly disagreed. Clinicians who have used EMR system between 1 to 3 years were more likely to adopt EMR system use (AOR=4.23, 95% CI: 1.309–8.003, p=0.021) compared to those who have used the system for a period of less than 1 year. Clinicians who strongly agreed that EMR system supports in quick data-driven decision-making to improve patient’s care were more likely to adopt the EMR system use (AOR=5.61, 95%CI: 1.829–11.864, p=0.022) compared to those who strongly disagreed. Clinicians who said that the quality of internet at the health facility was good during working hours were more likely to adopt EMR system use (AOR: 4.29, 95%CI: 1.005-7.879, p=0.002) compared to those who reported that the internet was unreliable.
Unique Contribution to Theory, Practice and Policy: The study should implicate the need for a holistic approach which combines technology (IT, modern infrastructure), people (capacity building and successful adoption), policy and planning that support sustainability of EMR usage to fully realize benefits of EMR in improving patient care and health data management in Kirehe district
Socio-Demographic Factors Influencing the Utilization of Modern Contraceptives among Women in West Pokot County, Kenya
Get PDFPurpose: The purpose of the study was to determine the socio-demographic factors associated with utilization of modern contraceptives among adult women of reproductive age (18-49 years) in West Pokot County, Kenya.
Methodology: The study adopted a cross-sectional household survey and targeted 42,015 households in Pokot West sub–county. The study targeted one adult women of reproductive age (18-49 years) per household with a sample size of 396 adult women. The study utilized a questionnaire during collection of data. The study analyzed data descriptively and inferentially and the output is presented in tabular and pictographic formats.
Findings: The findings indicated that utilization of modern contraceptives stands at 24.5% among women aged 18 years to 49 years.The demographic characteristics associated with the utilization of modern contraceptives among women are Age (OR = 4.8248, t = 4.15, p < 0.05), Age is associated with increased likelyhood of utilizing modern contraceptives, while education levels (OR = 0.5055, t = -2.05, p < 0.05), occupation (OR = 0.5965, t = -3.50, p < 0.05) and the parity levels (OR = 0.5744, t = -2.72, p < 0.05) are associated with decreased likelihood of utilization of modern contraceptive. The income levels (OR = 0.8744, t = -0.40, p > 0.05) and marital status (OR = 0.9844, t = --0.03, p < 0.05), are not significantly associated with utilization of modern contraceptive.
Unique Contribution to Theory Practice and Policy: This study contribute to the body of knowledge that social demographic factors such as age, education lever, occupation, economic status are associated with utilization of modern contraceptives. This low lever of utilization of modern contraceptives noted in this study calls for targeted strategies such as health education to this risk population by health care workers and ministry of health dealing with reproductive services to improve modern contraceptive use among adult women of reproductive age. There is need to conduct further research on other counties combining social demographic factors and other social health care determinants associated with of use of health care services such as modern contraceptive use among women
Socially Responsible Public Procurement and the Social Economy: European and Global Institutional Approaches
Get PDFPurpose: This paper examines Socially Responsible Public Procurement (SRPP) as a strategic institutional tool for advancing the Social Economy at both European and global levels. It investigates the alignment of SRPP with inclusive, sustainable development goals, focusing on key initiatives such as the EU Social Economy Action Plan, the 2023 Council Recommendation, and the UN General Assembly Resolution 77/281.
Methodology: The research adopts a comparative policy analysis framework, assessing legislative instruments, international resolutions, and governance models. It incorporates multi-level governance and evaluates the practical impact of SRPP on Social Economy Entities (SEEs), complemented by a review of global and EU-level policy milestones.
Findings: SRPP is revealed as a transformative procurement approach that embeds social objectives into public spending. When effectively implemented, it facilitates the growth of SEEs, promotes local resilience, and fosters inclusive labor markets. However, mainstream adoption is hindered by institutional fragmentation, limited awareness, and inconsistent application across Member States.
Unique Contribution to Theory, Practice, and Policy: The study offers concrete policy recommendations, emphasizing the need for a supportive legal and fiscal ecosystem, improved stakeholder capacity-building, and transnational cooperation. It positions SRPP as a pivotal driver for advancing the Proximity Economy and the broader social and solidarity-based economic models
Profitability and Financial Growth of Cross Listed Firms at Nairobi Securities Exchange
Get PDFPurpose: Cross listing plays a significant role in the development of emerging capital markets through improved access to foreign capital, improved stock liquidity, access to new markets, and enhanced brand visibility which collectively contribute to improved financial growth for cross listed firms. The purpose of the study was to establish the financial effect of cross listing event by examining whether the changes in profitability had a statistically significant effect on the financial growth of cross listed firms at Nairobi Securities Exchange.
Methodology: The study adopted the event study methodology to undertake an impact analysis of the financial effect of cross listing focusing on a census survey of eight firms primarily listed at Nairobi Securities Exchange and cross listed in other East African Securities Exchanges. The scope of the study entailed cross listings that took place between 2000 and 2015. The study performed the classical tests of hypothesis using the paired t-test and variance-comparison test and inferential statistics using two-way fixed effects panel regression model.
Findings: The study established that cross listing had a statistically significant effect on the financial performance of the firms primarily listed at Nairobi Securities Exchange. Further, the study findings indicate that the observed changes in liquidity, profitability, operational efficiency, leverage, and firm valuation had a statistically significant effect on the financial growth of the cross-listed firms that was sustained up to five years post cross listing.
Unique Contribution to Theory, Practice and Policy: The study supplemented the static trade-off theory which posits that a firm’s optimal capital structure is attained by creating a trade-off between costs and benefits of debt or equity financing, hence providing a better understanding of a firm’s financing decisions. Further, the study augmented the pecking order theory which postulates that a firm maintains an optimal capital structure through establishing a hierarchical preference for cheaper sources of financing including retained earnings, debt, and equity. Consequently, the study complements the existing body of literature on maintaining an optimal capital structure and enhancing financial growth through regional cross listings
The Effect of Medium-Term Expenditure Frameworks (MTEFs) on Budget Performance in Kenya
Get PDFPurpose: The primary aim of this study was to examine the effect of Medium-Term Expenditure Frameworks (MTEFs) on budget performance in Kenya. Specifically, the study sought to determine whether the adoption and implementation of MTEFs have contributed to improving fiscal discipline, enhancing budget execution rates, strengthening revenue collection efficiency, and promoting overall credibility in public financial management. By applying econometric analysis to Kenya’s budget data over the period 2012/2013–2023/2024, the study aimed to assess both the short-run and long-run effects of MTEFs on budget outcomes, thereby providing empirical evidence to inform fiscal policy reforms and enhance the effectiveness of budgetary frameworks in the country.
Methodology: The study adopted a quantitative research design to investigate the effect of Medium-Term Expenditure Frameworks (MTEFs) on budget performance in Kenya. Secondary time-series data spanning the fiscal years 2012/2013 to 2023/2024 were utilized, with the Budget Execution Rate (BER) serving as the proxy for budget performance. MTEFs and other fiscal policy variables were specified as explanatory factors within the econometric framework. The Johansen cointegration approach was employed to examine the existence of long-run equilibrium relationships, while the Vector Error Correction Model (VECM) was applied to capture short-run dynamics and adjustment processes. To ensure the validity and robustness of the estimations, diagnostic procedures—including stationarity testing, optimal lag length determination, and checks for normality, serial correlation, and heteroscedasticity—were conducted. This methodological approach provided a rigorous framework for disentangling both the long-term and short-term effects of MTEFs on budget execution outcomes in the Kenyan context.
Findings: The Johansen cointegration analysis established that MTEFs have a positive and statistically significant long-run effect on the Budget Execution Rate (BER), with a coefficient of +0.32 (p = 0.031). This implies that over time, the adoption and effective implementation of MTEFs enhance budget execution by improving fiscal discipline, strengthening expenditure prioritization, and aligning resource allocations with actual spending. In the short run, however, the Vector Error Correction Model (VECM) results revealed that MTEFs exert a negative and statistically significant effect on budget execution. Across the first three lagged periods, the coefficients ranged between –0.73 and –1.01, with p-values ranging from 0.002 to 0.026, indicating that immediately following MTEF reforms, budget execution performance tends to decline.
Unique Contribution to Theory, Practice and Policy: This study makes a threefold contribution. Theoretically, it refines public finance and institutional theories by demonstrating that Medium-Term Expenditure Frameworks (MTEFs) exert a dual effect—undermining budget performance in the short run due to transitional inefficiencies but enhancing fiscal discipline and budget credibility in the long run. Practically, the study provides evidence-based insights for budget practitioners, highlighting the need to strengthen institutional capacity, procurement systems, and absorptive mechanisms to minimize short-term disruptions when implementing MTEFs. At the policy level, the findings emphasize the importance of sustaining MTEF reforms despite early setbacks, while embedding adaptive mechanisms such as phased rollouts, stronger fiscal linkages, and improved cash management to optimize long-term budget performance in Kenya
Health Insurance Types, Out-of-Pocket Payments, Government Subsidy and Healthcare Utilization in Kenya
Get PDFPurpose: The use of healthcare is a necessity for every person. As such, there is a need to ensure that such services are made available to many people, especially in a developing country like Kenya. Health insurance provides added ease in how individuals access treatment and other continued care, as it eases the financial burden associated with treatment and care. This study investigates how health insurance types, out-of-pocket expenses, and government subsidy affects Kenyans’ patterns of healthcare service utilization.
Methodology: This study is grounded in the Consumer Theory of Demand for Health Insurance, Grossman’s theory of healthcare utilization, and the Behavioral Models of Health Care Utilization. To achieve this, the study employed multinomial logistic regression and binary logistic regression to analyze outpatient utilization and inpatient care utilization, respectively.
Findings: The key findings of the study affirm that NHIF had a positive and significant effect on health utilization; however, low enrolment, coverage, and attrition rates were also confirmed. Private and other forms of insurance had no significant effect on health utilization. Additionally, findings reveal that households suffering from chronic disease or those exposed to recurrent illnesses and lack health insurance coverage incur frequent out-of-pocket payments (OPP) to access medical care services. Lastly, findings revealed that social assistance by the government had a weak effect on the chances of visiting hospitals or other healthcare facilities for households seeking outpatient and inpatient health services.
Unique Contribution to Theory, Practice and Policy: The study recommended the enactment of policies that prioritize the expansion of public health insurance coverage. Additionally, public insurance schemes should formulate and implement policies that enhance targeted interventions by introducing specialized packages that address different health care needs and the burden of diseases. Lastly, the government should review health subsidization policies and introduce strategies that can enhance the identification and subsidization of the less privileged but disease-burdened households, particularly in rural areas and marginalized communities
Strategic Leadership Effects on Sustainable Organizational Performance of State Corporations in Kenya: The Mediating Influence of Digitalisation
Get PDFPurpose: Rapid disruptions in the technological environment in the last two decades have occasioned the digitalisation phenomenon which is fundamentally redefining the strategic leadership, operations and performance of organizations. Digitalization is currently not well integrated in strategic leadership literature. Additionally, there is limited empirical evidence regarding the influence of digitalization on the nexus between strategic leadership and sustainable organizational performance especially in the context of public sector organizations in developing countries. Consequently, this study attempted to address these knowledge and contextual gaps inherent in literature, by investigating the influence of the digitalisation phenomenon on the relationship between strategic leadership and the sustainable performance of State Corporations in Kenya.
Methodology: This empirical study was based on a positivistic research philosophy and involved a census survey of all the 250 State Corporations in Kenya. Primary data was collected using a self-administered structured questionnaire based on a Five point Likert scale. The quantitative data collected was subjected to both descriptive and inferential statistics based on linear regression analysis. Finally, the hypotheses stated were tested using Model 4 of Hayes process macros running on SPSS.
Findings: Three key findings in respect to State Corporations can be gleaned from the study. First, strategic leadership significantly positively influenced digitalization. Second, had a positive and significant influence on sustainable organizational performance. Third, digitalization significantly partially mediated the relationship between strategic leadership and organizational performance.
Unique Contribution to Theory, Practice and Policy: The study has important implications at three levels. First, it contributes to theory refinement by testing the predictions of the two theories undergirding its conceptualisation. Second, it provides useful insights and information that will assist policy formulation in public sector organizations relating to strategic leadership, digitalization and sustainable organizational performance. Finally, the study findings are bound to assist management practitioners to effectively create linkages among strategic leadership, digitalization and sustainable organizational performance which is often considered a challenge in public sector organizations