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A Thesis Submitted In Partial Fulfillment of the Requirement for the Award of Masters of Science Degree in Health Systems Management of Mount Kenya University
No full textAn effective medical intervention to prevent maternal morbidity and mortality is maternal health care (MHC). Therefore, quality of MHC is an important concern in addressing the challenges faced by Kenya as a country with high maternal mortality. This study assesses the influence of quality maternal healthcare service on client satisfaction in Rongai Sub-County health institutions. The study targeted all women of reproductive age (18-49 yrs.) seeking maternal health services in Rongai sub-county health facilities. The study adopted a descriptive cross-sectional design. The health care facilities were clustered according to administrative regions (wards) and the respective levels of care. That is, hospitals, health centers, and dispensaries, and simple random sampling were employed to choose the health facilities for the study. Convenience sampling was used to get 465 mothers, and purposive sampling method used to get healthcare practitioners in charge of the selected healthcare facilities. A questionnaire was administered to women searching for maternal healthcare services within Rongai Sub County to measure client satisfaction. An observational checklist was used to assess the facilities' ability to provide quality maternal health care as per WHO validated indicators for the provision of quality maternal medical care. An interview schedule was administered to the key informants (health care providers) to ascertain facilities' readiness to offer maternal healthcare. The data was analyzed descriptively (Means) and inferentially (Pearson Chi-Square) to test the relationship between the categorical variables and Spearman's correlation analysis to determine the co-relation between structural organization and items availability with clients' satisfaction. All the test was performed at 95% (P=0.05) level of significance. Through Pearson Chi-Square analysis, it was indicated that the level of education, employment status, income level and distance from the health facility are some of patients' related factors that influence their satisfaction with maternal health services (P value less than 0.05). It was also noted that referrals influenced the choice of facility the most and there was inadequate availability of some critical healthcare items in most facilities. Spearman's correlation analysis indicated that the need for adequate delivery services had the strongest and statistically significant correlation with client satisfaction (R= 0.998, P=0.003). This study concluded that the dimensions of quality maternal healthcare positively influence client satisfaction. The outcomes also indicate that 50% of the facilities were found to be inadequate with infrastructure such as placental pits, equipments, incinerators and 83.3% of the facilities not utilizing the partograph in monitoring mothers in labor. It is recommended that the county government strengthen the infrastructural aspects in the facilities and mechanisms for monitoring quality of healthcare delivery. Employment and equitable distribution of staff across the facilities. The County government to embrace stakeholder involvement in provision of quality maternal healthcare as this enhances equitability, efficiency, and effectiveness service delivery. Mechanisms for dissemination, implementation and monitoring of the policies/guidelines should be put in place
Antimicrobial and antioxidant activity of acetone leaf extract of Senna Singueana
Get PDFEmergence of resistance among many commercially available antibiotics has dimmed all the efforts made in the antibacterial agent development. Many infections that results from bacteria exposure have as well resulted into development of other complications. The multidrug resistance has been ignited by misuse and improper use of the antibiotics. On the other hand the oxidation reaction in the body results into free radicals that have deleterious impact on the body. The increased concentration of these free radicals which are very reactive tend to attack the biomolecules resulting into damage and in some instances result into death of the cells or tissues. The increase free radicals results into a state of oxidative stress which is trigger in many conditions such as cancer, diabetes, neurodegenerative disorders and aging. The conventional medicines used in management of the bacterial infections and oxidative stress related conditions are expensive and in some cases have side effects and are less potent. Alternatives from plants have been identified as the savior to the current problems. Plants synthesized secondary metabolites that are pharmacologically active among many conditions. This has seen many plant being explored for their medicinal properties. Senna singueana has been widely used as an antimalarial agent in many countries including Kenya and Tanzania. This antimalarial property has been widely investigated by many researchers. However its antimicrobial and antioxidant activity is not well known. This study aimed at evaluating the antimicrobial and antioxidant activity of acetone leaves extract of Senna singueana. The antimicrobial activity was evaluated by the diffusion method employing the disc diffusion technique. The antimicrobial activity was investigated against four bacteria strains; three gram negative; Escherichia coli, Acinetobactor baumanni and Salmonella enteritidis and one gram positive Methicillin Resistant Staphylococcus aureas. The antioxidant property was investigated by monitoring its free radical scavenging property using the DPPH free radical. The zones of inhibition at 100 mg/ml concentration levels were 14.00±0.00 mm, 12.33±0.577 mm, 12.00±0.00 mm and 13.00±1.00 mm for Acinetobactor baumanni, Salmonella enteritidis, Escherichia coli and Methicillin Resistant Staphylococcus aureas respectively. Ciprofloxacin at 10 ug/ml recorded 30.00± 1.00 mm, 37.33±0.577 mm, 39.667±0.577 mm and 30.667±0.577 mm for Acinetobactor baumanni, Salmonella enteritidis, Escherichia coli and Methicillin Resistant Staphylococcus aureas. The antioxidant results showed that the acetone extract was significantly scavenged the DPPH free radicals at concentration levels 500 ug/ml, 250 ug/ml and 125 ug/ml. The activity at tis particular concentration levels was was comparaeble to L-ascorbic acid and no significant difference was noted between them (p>0.05). The antioxidant activity of the acetone extract at lower concentrations of 62.5 ug/ml, 41.25 ug/ml and 15.625 ug/ml was lower than the L-ascorbic acid. In conclusion Senna singueana is a potential antioxidant and antimicrobial agent and can be taken as an alternative to the conventional drug
Frontline Nurses’ Post-Traumatic Stress Disorder and Associated Predictive Factors During the Second Wave of COVID-19 in Central, Uganda
No full textBackground: Prior to the COVID-19 pandemic, the Ugandan healthcare system was already under severe strain due to a lack of human resources, poor working conditions, and poor management. At the center of these challenges are nurses, the backbone of the health system. This study investigated post-traumatic stress disorder and associated predictive factors during the second wave of COVID-19 among frontline nurses in the country.
Participants and Methods: This was a hospital-based cross-sectional study conducted among 601 nurses between May and June 2021. Post-traumatic stress disorder was assessed using PTSD Checklist-Civilian. The bivariate and multivariate logistic regression analyses were conducted to determine the factors predicting PTSD. P-values less than 0.05 were considered statistically significant at 95% CI.
Results: The estimated prevalence of post-traumatic stress disorder was 65.7%. In the multivariate logistic regression, the predictive factors of PTSD among the study participants were social support (AOR: 0.49; 95% CI: 034– 0.60; p ≤ 0.001), fear of getting infected with COVID-19 (AOR: 3.10; 95% CI: 2.17– 4.43; p < 0.001) and increased workload (AOR: 1.65; 95% CI: 1.16– 2.34; p < 0.001).
Conclusion: The results of the study highlight the impact of COVID-19 on the mental health of front-line nurses. Assessing PTSD among nurses may increase the understanding of COVID-19 induced mental health issues. Identifying the risk factors like lack of social support and heavy workload and providing treatment is essential given that various waves of COVID-19 seem inevitable. Supportive strategies like counseling should be provided to the nurses to prevent or manage PTSD
How universities lost out on TSC’s lucrative training deal
Get PDFThe Teachers Service Commission(TSC) Chief Executive Officer Nancy Macharia has explained how top Kenyan Universities missed out on the multi-million teachers training program rolled out for a period of one year.
Speaking on Tuesday, November 30, Macharia stated that when the initiative was launched, many universities, especially public universities, gave them wide berth.
According to the commission, they expected many universities to put in so much effort in a bid to get this contract, but many of them missed out.
The institutions which successfully got the contract are Kenyatta University, Riara University, Mt Kenya University and the Kenya Education Management Institute.
The commission stated that they would have wanted many public universities to participate, but since they didn't apply, they should take up the opportunity when it will be rolled out next time
Continuity and change of kuria system of social control, leadership and governance, 1885-1995
No full textThe Kuria have not been adequately studied and are still imperfectly understood. Besides the physical remoteness, the official reputation of the Kuria as "backward" "unsophisticated" and "litigious" had contributed to a widespread misconception of the area as a place of banishment. Often, they were viewed by the colonial state as timid and endangered by their more powerful neighbours hence amenable to pax Britannica. As such Kuria community became a headache to both the colonial and post colonial authorities by settlement of political issues through informal systems and non-police security organs in the process of attempting to enhance their system of social control, leadership and governance. This study therefore, was an attempt to examine continuity and change of Kuria system of social control, leadership and governance over time. The study is informed by Methodology based on both primary- oral interviews and archive and secondary data collection techniques were used through purposive sampling and snowballing technique. Three analytical frames were used to analyze data i.e. theoretical reflections, documentary review and content analysis. Two theories were used for analysis and interpretation. Conflict theory was used since it is concerned with causes and impacts of conflicts in the society. It was supplemented with political settlement theory which explains resolutions reached after conflicts to form acceptable political institutions. Literature review based on the objectives and research premises aligned to each chapter. The study found out that, the Kuria pre-capitalist and economic system has been substantially transformed, traditional elders who used to benefit social relations of subordination and obligation, have retained their ideological systems which they tactfully deploy to gain economic and other advantages from people who, under the traditional system, would normally be bound to them.And that conservationist policy of the colonial and postcolonial state facilitated elders' claims on their subordinates, and both operated together with a mutually reinforcing effect
Total flavonoid, total phenolic and ant diabetic activity of Zingiber Officinale powder sold In local Dispensary
No full textDiabetes mellitus is a common metabolic disorder that has affected about 2.8 % of
the population worldwide. This disease is characterized by hyperglycemia which is
the condition of having high glucose levels. Many conventional drugs used to
manage this condition are very expensive in some cases and not void of side effects.
Finding an alternative antdiabetic is paramount in the efforts compact diabetes.
Plants or herbal medicines have shown to be potent against many ailments diabetes
included. However, very few studies have been studied or evaluated. The current
study evaluated the concentrations of the phenolic and flavonoid and the
antidiabetic activity of Zingiber officinale. The total flavonoid and total phenolic
content were conducted following standard in vitro assays: aluminum nitrate
calorimetric and Folin–Ciocalteu method respectively. The antidiabetic activity
was conducted by in vitro assay of alpha amylase inhibition. Catechin, gallic acid
and metformin were used as standards for flavonoid, phenolic and amylase
inhibition assays respectively. The results showed that 150.257±1.786 mg GAE/f
dw and 121.396± 1.179 mg CE/g dw phenolics and flvanoids were recorded
respectively. The Zingiber officinale significantly inhibited the activity of the
amylase enzyme recording inhibition percentages of 45.465±7.965 %,
23.850±5.560 % and 11.940±2.520 % for 200 ug/ml, 150 ug/ml and 50 ug/ml
respectively. The standard andiabetic drug metformin recorded inhibition of
60.075±3.47 %. In conclusion, Zingiber officinale is a potential antioxidant and
antidiabetic agent
Dynamics of Devolution and implications In the Implementation of Development Programs on Healthcare Delivery Services In Narok County, Kenya
No full textThe Constitution of Kenya (CoK), 2010 delegated the management of healthcare
service delivery to the County governments. The County governments have been faced
with many challenges in managing the health care activities in Kenya since 2013. There
has been a lot of outcry from the members of the public about the mismanagement and
corruptions in the administration of the healthcare delivery activities. The purpose of
this study is to assess the healthcare delivery challenges faced at the County
government healthcare department of Narok, by looking at some of the major health
care activities which affects the development of the healthcare delivery at the two
referral hospitals to the study. The conceptual framework objectives, on procurements
practices, seek to establish if the procurements laid down regulations by (PPOA) are
being administered in the purchases of goods and services, while on leadership
management, it looked at efficiency, motivation and public access towards work
schedules, the capital resources allocation, involves examining their availability and
consistency trends, and the regulatory framework objective was based on assessing the
time factor requirements to carry out medical services. The study development
objectives contacted in the two referral hospitals were; to establish the effect of
procurements practices, determine the effect of leadership managements, to examine the
effect of resources availability to the hospitals and to assess the influence of the
continued use of national regulatory frameworks in the county. The target population
was 572 Narok County government health workers and in-patients, whereby the
researcher used quantitative design method of research through a descriptive stratified
random sampling method with a sample size of 57 participants. A questionnaire for the
data collection was used as an instrument of data collection. Data was analyzed using
SPSS (2013) tool and presented through tables and charts, diagrams and reports.
Findings indicated a negative development for healthcare in all the procurements
practices of study, in the leadership management, there was a partial positive
improvement development in quick decision making and a negative enhancement in the
healthcare efficiency and staff motivations, while on capital resources availability, there
was an negative improvements towards the healthcare development due to inadequate
funding and inconsistency, and on the national regulatory framework, there was a
negative improvement towards the achievement of a quick working schedule program
development of the health care delivery service. The researcher made the following
recommendations; The two hospitals should strictly abide to the laid down Public
procurement acts, plans and embrace the E- procurements methods, while in leadership
management, involving all the employees in decision contribution in HR policies,
initiating rewards and appreciations as well as improvements in channels of
communications between health workers and the public should be encouraged which is
currently, lacking, and in resources availability, more funds should be channeled to the
two hospitals, while on the regulatory frameworks, the county should start enacting
their own regulations which are in tandem with their work schedules. The study focused
between 2013 when devolution was introduced in Kenya to 201
Preparedness of Zimbabwe’s Health System to respond to Emerging and Reemerging Infectious Diseases; Focus on Parirenyatwa and Mpilo Hospitals
Get PDFInfectious diseases are responsible for a large number of deaths worldwide with Africa being the most affected. More than half of all deaths, 56 %, in low-income nations in 2016 were as a result of “Group I” conditions, which encompass communicable diseases. Some of these are emerging in countries where they were previously unknown such as Zika virus disease while others such as malaria are re-emerging. Recent outbreaks of plague in Madagascar and Marburg virus in Uganda have pointed to the need for health systems that are prepared to respond to infectious diseases, both emerging and re-emerging. The plague in Madagascar had 2348 confirmed cases and 202 deaths (case fatality rate 8.6 %) a situation, which may be extrapolated to other countries due to globalization. The study focus was to assess the preparedness of Zimbabwe’s Health System to respond to emerging and re-emerging infectious diseases. To determine the preparedness of the health system, the research sort to establish the readiness of Mpilo and Parirenyatwa health facilities to respond to emerging and reemerging infectious diseases, to establish the readiness of health personnel, to ascertain the availability of medicines and to determine relevance of protocols for reemerging and emerging infectious diseases at the hospitals. An explanatory convergent mixed methods approach was employed in data collection. Only health workers were included in the study, those that are exposed and work with patients that are suffering from emerging and reemerging infectious diseases. 257 respondents were interviewed and a questionnaire administered using purposive and stratified random sampling methods. Research findings indicated that the health system was severely compromised and could not respond to emerging and re-emerging infectious diseases. Although the country is ready to respond to infectious diseases in terms of enough bedding to handle the influx of patients, 30.7% of respondents representing the majority disagreed that the hospitals had efficient and active communication systems. Altogether, 46.7% indicated that the hospitals were not ready to respond to both emerging and re-emerging infectious diseases whilst 33.5% indicated that the hospitals were ready. Lack of adequate human resources, shortage of qualified and health staff in infectious diseases, inexperienced and poorly motivated health personnel were highlighted by the study.The study found that medicines for emerging and re-emerging infectious diseases are not always readily available, accessible and affordable. All responses relating to the perceived availability of medicines for emerging and re-emerging infectious disease response attained a mean composite score of 2.80 which implied that medicines for infectious disease response are not always readily available. A low composite index score for perceived relevance of protocols for re-emerging and emerging infectious diseases was calculated; the study concluded that protocols for re-emerging and emerging infectious diseases are irrelevant and inadequate for infectious diseases such as cholera, Ebola and Zika virus disease. The study concluded that the health system of Zimbabwe is not prepared for emerging and re-emerging infectious diseases. It is recommended that strategic frameworks for prevention and early warning and detection systems for infectious disease outbreaks are developed
Emergency preparedness among nurses at Machakos level five hospital in Machakos County, Kenya
No full textThe approach to handling emergencies has not been efficient in the practice area, which
could be due to deficient knowledge or lack of competence by the responders. This
therefore leads to an increase in mortality, morbidity, and calls for sufficient readiness
by nurses to prevent against future events. The study aimed at assessing whether nurses
at Machakos Level 5 Hospital (ML5H) were prepared for emergencies. The study also
looked in to strategies that ML5H has put in place to prepare nurses for emergencies.
This was a quantitative study using a cross- sectional descriptive design. The study
involved 132 nurses sampled from 405 the total population of nurses at ML5H.
Selection of participants was done using stratified random sampling coupled with
systematic random sampling methods. Self -administered questionnaires were used to
collect data and an observation checklist that measured on emergency preparedness.
Data was coded and entered into SPSS version 25 software for analysis. Data was
analysed using descriptive statistics and Chi-square test was used to determine if it
showed a significant relationship between variables. Majority (82%) of nurses
dismissed the likelihood of natural disasters occurring at the hospital. More than a half
(56%) of the nurses were found to have adequate knowledge on emergency
preparedness; More than three quarters (76.5%) of respondents reported that the
hospital did not carry out emergency drills. More than half (62%) of respondents
reported of the availability of emergency training for all nurses. Knowledge and
training, familiarity with procedures during emergencies, and familiarity with contents
of emergency management plan significantly affected emergency preparedness at P=<
0.05. The study recommended that, the hospital should conduct regular trainings of
nurses on emergency preparedness to enable them respond to emergencies effectively
and efficiently
Determinants Of Exclusive Breastfeeding Practice Amongst Mothers With Children Ages Below Six Months Living In Dayah IdP Camp Mogadishu, Somalia
No full textBreastfeeding is pivotal for the infant to grow healthy. The features influencing breastfeeding ought to be perceived so as to help it and give effective breastfeeding counselling. Prevalence of EBF is modest globally (35 percent), and it varies between 22 and 33 percent in Sub-Saharan Africa. The goal of this study was to look into the factors that influence exclusive breastfeeding among mothers with children under the age of six months who live in the Dayah IDP Camp in Mogadishu, Somalia. The study specifically aimed at establishing knowledge level about exclusive breast feeding (EBF) among mothers with children below six months living in Dayah IDP camp in Mogadishu, Somalia; to determine socio-demographic factors that influence (EBF) in the camp and to determine socio-cultural factors affecting EBF in the IDP camp. The target population in the camp was 900 mothers with children. Study population worked out to 399 and 10% was added to account for loss of respondents. A total of 438 respondents were chosen for the study using systematic random sampling. A descriptive crossectional study design was deployed. Structured questionnaire was used to collect qualitative data. quantitative data were collected at the Camp from two Focus Groups Discussion comprising nine mothers who delivered at home with the assistance of Traditional Birth Attendants and nine who delivered who delivered at a healthcare facility within Dayah IDP camp. The gathered data was analyzed using statistical program for social studies (SPSS) Version 25 and a regression model was utilized to determine the association between variables. Ethical approval for the study was obtained from the Mount Kenya University ethical review committee. Study participants gave written consent prior to responding to the questionnaires. The findings on the respondents recorded that 92.7% were knowledgeable about EBF but only 20.1% of them were practing EBF, 44.6% provided water and breast milk although 76.2% believed that breast milk is sufficient for infants. In terms of age, marital status, literacy and employment 47.4% of the women were aged between 26 and 35 years, 73.2% of them were married, 56.1% were illiterate and 69.4% unemployed. Mothers with babies that were 6 months were 20.8% of whom 52.6% were females. In conclusion results of the study show that respondents' knowledge level and socio-cultural factors had a substantial impact on exclusive breastfeeding practices, however sociodemographic parameters had no impact. This gap could be explained by the huge number of respondents who acquired information from health facilities. The study subjects received accurate information from health facilities regardless of their demographic characteristics. It is recommended that programmes focusing on informing expectant mothers and those that are nursing infants about exclusive breast feeding be emphasised. In addition, impeding socio-cultural norms ought to be identified and addressed to enhance the WHO recommended practice of feeding babies below six months strictly on breast milk. Additionally, expectant mothers must be encouraged to deliver in health facilities where they are attended to by female trained staff and are coached to solely breastfeed the infants