School of Health Sciences
http://ir.jooust.ac.ke/handle/123456789/281
2024-03-29T07:46:31ZDeterminants of Diarrheal Cases among Children under five Years in Households using Domestic Water in Kangemi, Nairobi County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12138
Determinants of Diarrheal Cases among Children under five Years in Households using Domestic Water in Kangemi, Nairobi County, Kenya
Onyango, Isabella Sophia
Gastrointestinal illnesses known as diarrheal diseases cause loose, watery stools to flow more than three times each day. Inadequate sanitation and hygiene, tainted drinking water, and other factors contribute to the estimated 4 billion cases of diarrhea that occur annually around the world. The situation is even worse in Kenya, where youngsters in Nairobi's slums are exposed to unhygienic conditions. The main goal of this study was to identify the factors that contribute to diarrheal cases in children under the age of five in Kangemi, Nairobi County. The specific goals of this study were to investigate the economic, demographic, and awareness factors of diarrheal illnesses in children under the age of five in Kangemi homes using domestic water. What factors affected the management of domestic water in Kangemi, Nairobi County, for incidences of diarrhoea in children under five years old? This study employed a cross-sectional descriptive study design that included quantitative and qualitative research techniques.The study's target population included 381 parents of children aged 0 to 59 who resided in Kangemi. 195 respondents made up the sample size determined by Yamane (1967).In the quantitative research, 185 respondents were found using proportionate stratified random selection, whilst 10 respondents were chosen using purposive sampling strategies in the qualitative research. To evaluate the validity and reliability of the data gathering instruments, a pre-test was conducted in the Kawangware informal settlement. Descriptive and inferential statistics were used in the analysis of the data using the SPSS computer 55.3% of respondents strongly agreed that low income was a contributing factor in poor access to medical services,while 70% of respondents strongly agreed that households lacked access to full medical coverage. The study also found that 31.1% of respondents had only a secondary education, while 51.6% of respondents were casual employees. In terms of demographic determinants, the study found that 31.9 percent of respondents strongly agreed that the high population of slums contributes to bad health, while 81.0 percent of respondents strongly agreed that congestion caused inadequate drainage and sanitation facilities. According to awareness determinants, 77.3 percent of respondents strongly believed that residents, strongly agreed that parents received instruction in sanitation to improve their living conditions. In conclusion, the majority of Kangemi households did not have comprehensive medical coverage, and a small number of them had limited access to medical care because of their low income. Due to poor drainage and solid waste management, majority of Kangemi's residential areas were densely populated; creating a slum-like condition that contributed to poor sanitation, hygiene and overall health conditions. Many mothers in the community, according to information, received training in child care but only a small number received instruction in sanitation to enhance their living conditions. The county government of Nairobi City was advised by this study to improve Kangemi inhabitants' access to medical care by lowering medical costs. In order to enhance their living conditions, it was also suggested that the County Government of Nairobi open adrainage system and arrange training for both parents that focused on sanitation in the sub county of Kangemi.
2022-01-01T00:00:00ZDeterminants of HIV Status Disclosure Among Adolescents in Bondo Sub-County of Siaya County
http://ir.jooust.ac.ke/handle/123456789/12136
Determinants of HIV Status Disclosure Among Adolescents in Bondo Sub-County of Siaya County
Obiero, Julius Ooko
Disclosure of HIV status to adolescents is controversial and a sensitive issue among
guardians, health workers, and parents of adolescents. However, HIV/AIDS is a chronic illness, and it’s a lifelong treatment. Adolescents who are HIV positive need to know their HIV status and treatment. The World Health Organization (WHO) recommends that children should know their HIV status at the ages of 6 to 12 years. Many children living with HIV are reaching adolescence and young adulthood since anti-retroviral drugs have become more readily available (National AIDS Control Council, 2018). However, the most challenging subject among families of adolescents infected with HIV is whether or not to tell the adolescent about their diagnosis and, if they do, whether or not to allow the adolescents to say to others (Burmen et al., 2017; SCHMT, 2018a). This cross-sectional study investigated the determinants of HIV status disclosure among HIV-infected adolescents. Caregivers of 209 HIV-infected adolescents (10-19 years) who have been receiving HIV care and support treatment for at least six months and are taking lifelong anti-retroviral therapy from Got Agulu Sub County Hospital, Bondo County Hospital, and Uyawi Sub County Hospital in
Bondo Sub County were enrolled. A purposive and systematic random sampling method was used to select the health facilities and study participants. Data was collected using a structured questionnaire. Statistical analysis for quantitative data was done using Stata software version 15 (Stata Corp, College Station, TX). Adolescents aged 15-19 years were more likely to be fully disclosed to (aOR, 2.46, 95% CI 1.03-5.94, p-value=0.005<0.05. Those with low viral load levels were more likely to be disclosed to (aOR, 9.53, 95% CI 2.30-49.4, p-value=0.004). Adolescent caregivers who were married had significantly higher odds of fully disclosing (aOR, 5.43, 95% CI 1.25-27.5, p-value=0.030), same as caregivers who were biological parents (aOR, 4.84, 95% CI 1.34-19.5, p-value=0.019). Finally, caregivers who had been educated on HIV care and treatment package of care were significantly more likely to fully disclose (aOR, 14.1, 95% CI 4.03-62.3, p-value=<0.001). A high score in the quality of counselling results in an increased level of disclosure by 0.117. This study identified the age of the HIV-infected adolescent, the Quality of counselling service delivery offered to caregivers, current viral load levels of the HIV-infected
adolescents, the marital status of the adolescent caregiver, the relation of the caregiver to the adolescent and the knowledge of the caregiver on the caregiver package of care on HIV prevention care and treatment as the factors determining the HIV status disclosure.
2023-01-01T00:00:00ZDeterminants of Intimate Partner Violence Among Pregnant Women Attending Antenatal Care Clinics in Bondo Sub-County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12134
Determinants of Intimate Partner Violence Among Pregnant Women Attending Antenatal Care Clinics in Bondo Sub-County, Kenya
Nyamongo, Kevin Onuonga
Intimate partner violence (IPV) at any stage in pregnancy is an issue that threatens the health of both the mother and the unborn child. Understanding its prevalence and determinants is crucial for developing interventions. Despite being located in an area
with higher rates of IPV during pregnancy than the national average, there is a paucity
of data on the prevalence of this form of abuse and its determinants in pregnant women in Bondo Sub-County. This study investigated the prevalence, risk factors, and disclosure patterns of IPV among expectant mothers attending antenatal care (ANC) clinics in Bondo Sub-County. The study used a cross-sectional design and included a sample of 360 pregnant women recruited through systematic sampling method from ANC clinics in three healthcare facilities. Data on participants’ and their partners’ characteristics, experiences of IPV, social support and disclosure patterns were collected using pre-tested structured questionnaires. The questionnaires were
administered over a three-month period by trained research assistants from September
to November 2020. Descriptive statistics were used to show the prevalence of IPV and disclosure patterns. Associations between potential risk factors and IPV were examined using multivariate logistic regression. The study findings revealed a 35.3% prevalence of IPV among expectant mothers attending ANC clinics in Bondo Sub-County. Psychological abuse (23.9%) was the form of IPV that most women reported. This was followed by sexual abuse (16.4%) and physical abuse (15.6%). Expectant mothers who were unemployed (AOR=2.90, 95%CI: 1.08-7.79), had partners who consumed alcohol on a daily (AOR=4.84, 95%CI: 1.69-13.88) or occasional basis (AOR=2.19, 95%CI: 1.16-4.13), and those who did not count on their siblings or parents for support (AOR= 2.48, 95%CI: 1.14-5.43) had significantly higher odds of facing IPV. Among women who faced IPV, only 40.2% disclosed their experiences to someone with the majority (60.8%) disclosing to parents and only 7.9% disclosing to institutions. In conclusion, the prevalence rate of IPV among expectant mothers attending ANC clinics in Bondo was high. Unemployment, having a partner who drinks alcohol and lack of support from siblings or parents were the main risk factors. Disclosure levels were low with the majority of women who disclosed their experiences disclosing to parents. The findings from this study point to the need for community and health care interventions to address IPV during pregnancy in Bondo Sub-County
2022-01-01T00:00:00ZAwareness of Autism Among Primary School Teachers in Kisumu Central Sub-County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12129
Awareness of Autism Among Primary School Teachers in Kisumu Central Sub-County, Kenya
Sadia, Moses Omondi
Autism is a spectrum of neurodevelopmental disorders exhibited in early childhood with variable manifestations as children grow up. Therefore, teachers need to understand the condition in order to deliver apt educational services to autistic children. However, the level of awareness of the condition is poorly understood among pre-primary school teachers. This study,therefore, analyzed the understanding of the spectrum condition of autism among pre-primary school teachers in western Kenya. A descriptive cross-sectional study design was employed to assess the understanding of the spectrum condition of autism among 321 lower school teachers of Kisumu Central sub-county in western Kenya. The study participants were selected using purposive sampling, and primary data was collected using semi-structured questionnaires and a Key Informant interview guide. The quantitative data were analyzed using SPSS version 20. However, the qualitative data were analyzed thematically. The response rate was 76.9% with 16.8% (41) males and 83.2% (203) females. A total of 41.5% (n=110) of the teachers had never heard of autism. Of all the teachers who had heard of autism, 100% (7) were from special needs schools, and 64.4% (67) and 45.1% (60) were from public and private schools, respectively. About 78.8% (105) of teachers perceived autism as a neurodevelopmental disability and academically challenged children, 15% (20) as a psychiatric illness similar to madness, 4.5% (6) as spiritual affliction/demon-possessed children and 1.5% (2) as parental neglected children. This study shows that lower school teachers have an inadequate understanding of the spectrum condition of autism, and this limits service delivery. This study, therefore, recommends special training for pre-primary school teachers to cover the spectrum condition of autism.
2023-01-01T00:00:00ZKnowledge Attitude and Practice of Covid-19 Preventive Measures among Pregnant Women Attending Antenatal Clinics in Kisumu and Siaya Counties
http://ir.jooust.ac.ke/handle/123456789/12126
Knowledge Attitude and Practice of Covid-19 Preventive Measures among Pregnant Women Attending Antenatal Clinics in Kisumu and Siaya Counties
Ondieki, Everlyne Delylah
Coronavirus (COVID-19) infection can lead to an increased risk of adverse pregnancy outcomes among pregnant women. To curb the spread of COVID-19, World health organization (WHO) recommended a series of preventive measures. However, the third wave persisted, and while the wave was tapering off, Kisumu and Siaya counties had a peak resurgence in the number of COVID-19 cases with a positivity rate of 28.4%. Knowledge, attitude and practice (KAP) studies are very useful in providing useful information about prevention and control measures. However, it was unknown whether pregnant women in Kisumu and Siaya counties, Kenya have a good knowledge, positive attitude toward COVID-19 preventive measures and taking precautions to avoid infection. This study determined the knowledge, attitude and practice of COVID-19 preventive measures among pregnant women attending antenatal clinics (ANC) in Kisumu and Siaya counties. The findings from this study will help provide information to guide in designing context specific information and education interventions to be provided during ANC visits. A concurrent mixed-methods study was conducted in Kisumu and Siaya Counties in western Kenya; a cross-section survey among 402 pregnant women attending ANC in 12 hospitals, four focused group discussions (FGDs) with 40 pregnant women and four key informants’ interviews (KIIs) among maternal and child health (MCH) clinic nurses. Ballot method of Simple random sampling was used to recruit women for the cross-sectional survey. Purposive sampling was used to select pregnant women for FGDs and nurses for KIIs. Correlation test was used to determine the correlation between knowledge, attitude and practice and data was plotted using a matrix plot, the distribution of continuous variables assessed using histograms, and the Shapiro-Wilk normality test. Pearson’s chi-square test was used to determine if there was a significant association between sociodemographic factors and knowledge, attitude and practices and multinomial logistics regression was used to determine predictors of knowledge, attitude and practice. Thematic analyses were used to describe qualitative findings. Of the 387 women interviewed, 98% (385/387) and 100% (387/387) had moderate and above scores in knowledge and attitude respectively and 23% had adequate practices. The matrix plot revealed a moderate correlation between knowledge and practice (R=0.3) and weak correlation between attitude and practice (R=0.2). Respondents age was significantly associated with knowledge (p=0.026) and attitude (p=0.042) and educational level was associated with knowledge, attitude and practice (p<0.05) in Pearson’s Chi-square test. Respondents from households with 3-5 and 6-8 members were 2.11 and 2.58 times likely to have poor practices, whereas respondents with tertiary level of education were 0.48 times less likely to have poor practices in multinomial logistics regression. The cost of face masks, smell of soaps, sanitizers and limited space were identified as barriers to COVID-19 prevention practices. Although pregnant women were aware of COVID-19 preventive measures, this did not translate into adequate COVID19 preventive practices. In Kenya, the government needs to implement measures to improve COVID-19 prevention practices, including COVID-19 vaccine uptake among pregnant women.
2023-01-01T00:00:00ZFactors Influencing the Satisfaction with the Family Planning Services among Women of Reproductive Age Seeking Family Planning Services at Health Facilities in Siaya County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12123
Factors Influencing the Satisfaction with the Family Planning Services among Women of Reproductive Age Seeking Family Planning Services at Health Facilities in Siaya County, Kenya
Kinyoki, Dennis Kimanzi
Client satisfaction is one of the desired outcomes of health care, and it is directly tied to health service consumption. It reflects the disconnect between the service's expectations and the client's experience with it. Client retention is currently one of the most serious issues in health facilities, and this problem has been largely related to a lack of sufficient and satisfying service to clients. The goal of this facility based, cross-sectional study was to find out what factors influence women of reproductive age's satisfaction with family planning services at health facilities in Siaya County, Kenya. The study was conducted among women of reproductive age seeking FP services in 4 sub-county public hospitals: Bondo, Ukwala, Madiany, and Yala, in Siaya County, as well as healthcare providers serving the women during the period of study. A simple random sampling technique was used to select the participants in quantitative findings while the purposive sampling technique was used for qualitative data. Data was collected using semi-structured questionnaires for women receiving service and a key informant interview guide for healthcare workers. Quantitative data were analyzed using descriptive statistics and inferential statistics using STATA (v 15) while qualitative data was analyzed using content analysis. Most (60.06%) of the clients served were aged between 20-24 years and 194 (56.56%) were married. The majority (92.71%) of the clients had high satisfaction with the services they received at the health facilities, and women with high levels of interaction with the providers were about 68% more likely to be satisfied with the FP services as compared to females with low provider-client interactions (OR= 0.68, p=.021<0.05). There was no statistically significant association between satisfaction and facility level, age category, marital status, who referred the females for FP services, the source of FP information, waiting time, cost of service, and level of education (a = 0.05). The Ministry of Health, through the individual health facilities and relevant stakeholders, should identify mechanisms for maintaining the satisfaction of women using family planning methods, while ensuring more information is provided by the mainstream healthcare workers.
2022-01-01T00:00:00ZDeterminants of Contraception among Women of Reproductive Age in the Health and Demographic Surveillance System of Rural Siaya County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12121
Determinants of Contraception among Women of Reproductive Age in the Health and Demographic Surveillance System of Rural Siaya County, Kenya
Asava, Dainah
Contraception aims to control child bearing, timing, and spacing. It has been shown to have good maternal and infant health outcome. This effects the achievement of the third Sustainable Developments Goals (SDGs) by reducing child mortality, improving maternal health and universal access to reproductive health. Globally more than 95% of women of reproductive age, (15-49) years are aware of reproductive health services and products; however, unmet need is experienced by 42% of women of reproductive age in developing countries. In Kenya contraception is at 58 %, with a fertility rate of 3.7, unsafe abortions reported by 48/1000 women, all these contributing to pregnancy associated maternal and child morbidities and mortalities. This study sought to identify the contraceptive preferences, demographic and sociological factors that determine contraception practice in the HDSS area, with contraceptive use as the dependent variable. This cross-sectional public health survey, analyzed the reproductive health status of women in the HDSS. Descriptive statistics was used to determine the proportions of women in various categories of explanatory variables. Logistic Regression assessed for possible association between the covariates and contraception. Among the 39,006 participants enrolled, 22,298 (57.17%) reported having ever used contraceptive methods. Hormonal methods were preferred by 14,407 (36.94%) and 21,854 (53.03%) participants from the short term and long term categories respectively, whereas, 7,888 (20.22%) and 382 (0.99%) participants preferred the non- hormonal methods from the short term and long-term categories respectively. Participants aged 15-24 years were 8,428, (21.61%) of the 39,006 participants, where 4,572, (54.24%) of them were not practicing contraception. 69.75% of the participants reported being married, 71.30% had no stable occupation. Ever use of contraception was reported by 75.57 % of those who accessed family planning services information through multi-media sources. Contraception was significantly associated with age, parity and access to information at P<0.001. The odds of contraception in married women at 45 years and above was at (OR 0.85,95% CI 0.77 to 0.94) compared to the single women of the same age (OR 1.13,95%
CI 0.99 to 1.30). Unmet needs were observed in 16,708 42.83% of the population, where 4,572 54.24% were youths aged 15-24 years. There is evidence of unmet needs in the adolescents and young adults. Implementation of strategic public health integrated policies that focus on the demographical and sociological status will support and promote subsidized access to reproductive health services.
2022-01-01T00:00:00ZKnowledge Attitude and Practice of Covid-19 Preventive Measures among Pregnant Women Attending Antenatal Clinics in Kisumu and Siaya Counties
http://ir.jooust.ac.ke/handle/123456789/12116
Knowledge Attitude and Practice of Covid-19 Preventive Measures among Pregnant Women Attending Antenatal Clinics in Kisumu and Siaya Counties
Ondieki, Everlyne Delylah
Coronavirus (COVID-19) infection can lead to an increased risk of adverse pregnancy outcomes among pregnant women. To curb the spread of COVID-19, World health organization (WHO) recommended a series of preventive measures. However, the third wave persisted, and while the wave was tapering off, Kisumu and Siaya counties had a peak resurgence in the number of COVID-19 cases with a positivity rate of 28.4%. Knowledge, attitude and practice (KAP) studies are very useful in providing useful information about prevention and control measures. However, it was unknown whether pregnant women in Kisumu and Siaya counties, Kenya have a good knowledge, positive attitude toward COVID-19 preventive measures and taking precautions to avoid infection. This study determined the knowledge, attitude and practice of COVID-19 preventive measures among pregnant women attending antenatal clinics (ANC) in Kisumu and Siaya counties. The findings from this study will help provide information to guide in designing context specific information and education interventions to be provided during ANC visits. A concurrent mixed-methods study was conducted in Kisumu and Siaya Counties
in western Kenya; a cross-section survey among 402 pregnant women attending ANC in 12 hospitals, four focused group discussions (FGDs) with 40 pregnant women and four key informants’ interviews (KIIs) among maternal and child health (MCH) clinic nurses. Ballot method of Simple random sampling was used to recruit women for the cross-sectional survey. Purposive sampling was used to select pregnant women for FGDs and nurses for KIIs. Correlation test was used to determine the correlation between knowledge, attitude and practice and data was plotted using a matrix plot, the distribution of continuous variables assessed using histograms, and the Shapiro-Wilk normality test. Pearson’s chi-square test was used to determine if there was a significant association between sociodemographic factors and knowledge, attitude and practices and multinomial logistics regression was used to determine predictors of knowledge, attitude and practice. Thematic analyses were used to describe qualitative findings. Of the 387 women interviewed, 98% (385/387) and 100% (387/387) had moderate and above scores in knowledge and attitude respectively and 23% had adequate practices. The matrix plot revealed a moderate correlation between knowledge and practice (R=0.3) and weak correlation between attitude and practice (R=0.2). Respondents age was significantly associated with knowledge (p=0.026) and attitude (p=0.042) and educational level was associated with knowledge, attitude and practice (p<0.05) in Pearson’s Chi-square test. Respondents from households with 3-5 and 6-8 members were 2.11 and 2.58 times likely to have poor practices, whereas respondents with tertiary level of education were 0.48 times less likely to have poor practices in multinomial logistics regression. The cost of face masks, smell of soaps, sanitizers and limited space were identified as barriers to COVID-19 prevention practices. Although pregnant women were aware of COVID-19 preventive measures, this did not translate into adequate COVID- 19 preventive practices. In Kenya, the government needs to implement measures to improve COVID-19 prevention practices, including COVID-19 vaccine uptake among pregnant women.
2022-01-01T00:00:00ZDeterminants of Contraception among Women of Reproductive Age in the Health and Demographic Surveillance System of Rural Siaya County, Kenya
http://ir.jooust.ac.ke/handle/123456789/12107
Determinants of Contraception among Women of Reproductive Age in the Health and Demographic Surveillance System of Rural Siaya County, Kenya
Asava, Dainah
Contraception aims to control child bearing, timing, and spacing. It has been shown to
have good maternal and infant health outcome. This effects the achievement of the third Sustainable Developments Goals (SDGs) by reducing child mortality, improving
maternal health and universal access to reproductive health. Globally more than 95% of women of reproductive age, (15-49) years are aware of reproductive health services and products; however, unmet need is experienced by 42% of women of reproductive age in developing countries. In Kenya contraception is at 58 %, with a fertility rate of 3.7, unsafe abortions reported by 48/1000 women, all these contributing to pregnancy
associated maternal and child morbidities and mortalities. This study sought to identify the contraceptive preferences, demographic and sociological factors that determine contraception practice in the HDSS area, with contraceptive use as the dependent variable. This cross-sectional public health survey, analyzed the reproductive health status of women in the HDSS. Descriptive statistics was used to determine the proportions of women in various categories of explanatory variables. Logistic Regression assessed for possible association between the covariates and contraception. Among the 39,006 participants enrolled, 22,298 (57.17%) reported having ever used contraceptive methods. Hormonal methods were preferred by 14,407 (36.94%) and 21,854 (53.03%)participants from the short term and long term categories respectively, whereas, 7,888 (20.22%) and 382 (0.99%) participants preferred the non- hormonal methods from the short term and long-term categories respectively. Participants aged 15-24 years were 8,428, (21.61%) of the 39,006 participants, where 4,572, (54.24%) of them were not practicing contraception. 69.75% of the participants reported being married, 71.30% had no stable occupation. Ever use of contraception was reported by 75.57 % of those who accessed family planning services information through multi-media sources. Contraception was significantly associated with age, parity and access to information at P<0.001. The odds of contraception in married women at 45 years and above was at (OR 0.85,95% CI 0.77 to 0.94) compared to the single women of the same age (OR 1.13,95% CI 0.99 to 1.30). Unmet needs were observed in 16,708 42.83% of the population, where
4,572 54.24% were youths aged 15-24 years. There is evidence of unmet needs in the
adolescents and young adults. Implementation of strategic public health integrated policies that focus on the demographical and sociological status will support and promote subsidized access to reproductive health services.
2022-01-01T00:00:00ZPatient’s Self-Referral Decongestion Model
http://ir.jooust.ac.ke/handle/123456789/12103
Patient’s Self-Referral Decongestion Model
Moenga, Lydia B.
2023-01-01T00:00:00Z