School of Nursing & Health Sciences

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ASSOCIATION BETWEEN KNOWLEDGE, ATTITUDE, AND UTILIZATION OF NATURAL REMEDIES TO CURE INFECTIOUS DISEASES AMONG NAROK RESIDENTS, NAROK COUNTY, KENYA
(2021-07) Henry Nyabuto Gori
Natural remedies have been used globally as an intervention in the management, healing and prevention of disease. Some have been used as a stand-alone medicine or alongside western medicines depending on the nature of the disease. In some parts of Africa and Kenya specifically, there are communities that have also been using the natural remedies including the Maasai communities in Narok county. Narok town has grown to be a cosmopolitan community, and hence it is not clear whether natural remedies are still being utilized in these regions. Therefore, this study was aimed to explore the association between knowledge, attitude, and utilization of natural remedies to cure infectious diseases among Narok county residents. This study employed a cross-sectional study design, and data was collected from a sample of three hundred and eighty-one people who were residents of Narok town using a self-administered closed-ended questionnaire. The data was analysed using negative binomial regression models to explore the associations in STATA version 13.1. The Incidence rate ratios (IRR) and the 95% confidence interval (CI) were reported in the tables. The results of this study show the majority of the respondents knew most of the natural remedies including garlic (81.9%), ginger (85.1%), honey (96.6%), rosemary (58.6%), aloe (89.8%) and blackjack (63.1%), but in the utilization there was slightly reduction in proportions of those who were utilizing. The most commonly utilized natural remedies were honey, aloe, ginger, garlic and wheatgrass juice. After adjusting for all the potential confounders, those who had moderate knowledge (IRR = 1.47; 95% CI: 1.26 – 1.71) and high knowledge (IRR = 2.16; 95% CI: 1.83 – 2.55) were more likely to utilize natural remedies than those with low knowledge. On the relationship between attitude and utilization of natural remedies, those who indicated that they will keep using the remedies in the future (IRR = 1.20; 95% CI: 0.98 – 1.48, p < 0.10) and believed that the natural remedies can be used to cure (IRR = 1.33; 95% CI: 1.14 – 1.57) and prevent (IRR = 1.22; 95% CI: 1.04 – 1.44) infectious diseases were at a higher rate of utilization than the reference groups before adjusting for the potential confounders, but after adjustment, the differences attenuated. In conclusion, this study found a relationship between knowledge and utilization of natural remedies to cure infectious diseases. However, despite the respondents having knowledge about several natural remedies under investigation, their utilization was slightly reduced when compared with the knowledge percentage. But at least most respondents had utilized more than five natural remedies that were under research. As people are utilizing the natural remedies, health education and health promotion on the safe ways of preparation, storage and utilization is therefore very necessary in order to avoid negative health and side effect that might be associated with some natural remedies. Proper documentation of these alternative medicine should also be encouraged.
FACTORS ASSOCIATED WITH UTILIZATION OF PRECONCEPTION CARE AMONG WOMEN ATTENDING MOTHER AND CHILD HEALTH CARE IN KAPSABET REFERRAL HOSPITAL, NANDI COUNTY, KENYA
(2021-07) Hanna Ndungwa Nyabuto
Preconception care (PCC) is the care provided to all male and female who have not conceived before, whether planning or not to have a baby for they are potential parents. It is also the care given to women who have had a child and planning to get more (inter conception care). The aim for PCC is to decrease the danger of poor pregnancy outcomes and poor health for women, foetus, and neonates. Healthy mothers and children is the wish of every individual, family, country and Nation. Nobody wishes have a sick mother or child, yet most mothers are still suffering adverse health conditions caused by poor pregnancy outcomes in Kenya. Thus, the aim of this study was to find out factors that are associated with preconception care utilization among women in Kapsabet referral hospital in Nandi County, Kenya. A cross-sectional study design was used with a target of population of about 24,000 women in Nandi County. Data was collected from 200 women participants using a validated questionnaire. The zero-inflation Poisson regression analysis was employed to explore the factors associated with utilization of preconception care using the ‘zip’ command in STATA version 13.1. The unadjusted and adjusted incidence rate ratios (IRRs) and the 95% confidence intervals (CIs) were then presented in the tables for further interpretation. After adjusting for all variables, the study found the following variables to be associated with utilization of preconception care among women: marital status, religion, family size, ethnicity, residence, education, pesticide use, alcohol use, previous delivery, having ever lost pregnancy, and the number of current pregnancy. Those who were SDAs (IRR = 1.52; 95% CI: 1.31 – 1.76; p ≤ 0.001), had more than 4 household members (IRR = 1.24; 95% CI: 1.11 – 1.39; p ≤ 0.001), had tertiary education (IRR = 1.42; 95% CI: 1.20 – 1.67; p ≤ 0.001), were using pesticides (IRR = 2.22; 95% CI: 2.00 – 2.46; p ≤ 0.001) and were in their fourth pregnancy (IRR = 1.42; 95% CI: 1.16 – 1.73; p ≤ 0.001) were more likely to use PCC than the reference groups. In conclusion, several variable were associated with the utilization of PCC. However, there were some factors that were associated with low utilization of preconception care including the married, non-local tribes, those residing in rural areas, and those who were drinking alcohol, had previously delivered and lost pregnancy. Public health education and promotion is therefore necessary to improve maternal, newborn and child health in the county.
COMMUNITY-BASED INTERVENTIONS i IN REDUCING ALCOHOL ABUSE IN KAPSABET WARD, NANDI COUNTY, KENYA
(2020-07) Kiprono Mathew Rotich
There are many icasesiof idomestic iand iotheriformsiof iviolence iattributed ito ialcohol iand idrugs iin iNandi iCounty ibut imost iare inot idocumented. iThe ipurpose iof ithe istudy iwas ito iassess ithe ieffectioficommunityiintervention imethodsiinireducingialcoholiabuse iin iKapsabetiward, iNandi iCounty. iThe istudy ievaluated ithe ieffect iof icommunity-advocacy icampaigns, ipeaceful idemonstrations, iand ifamily-based iinterventions iagainst ialcohol iabuse iin iKapsabet iWard i– iNandi iCounty. iThis istudy iused iquantitative iexploratory idescriptive iresearch idesign. iThe itarget ipopulation iof ithe istudy iwas i35,962 ithat icomprised i185 iCommunity ileaders, i214 ireligious ileaders, i289 isocio-economic igroup ileaders, iand i35,274 icommunity imembers. iThe isample isizeiofi380irespondentsiwasiestablishediusingiKrejcie i&iMorgani(1970)imethodology. iProportionate istratified irandom isampling iwas iused iand ifurther iconvenience isampling iwas iused ito iidentify ispecific irespondentsiforiinterviews. iThisistudy iused iquestionnairesiand ikey iiinformant iinterviews ito icollect iprimary idata. iThe istudy iapplied idescriptive istatistics ithat iincluded imean, ifrequencies iand ipercentages igenerated iusing iSPSS isoftware iand iexcel iprograms. iQualitative idata iwas ianalyzed ithematically. iPresentation iof ifindings iwas idone iusing ibie-charts, itables iand ifigures. iThe ifindings ishowed ithat ithe icommunity-advocacy icampaigns ihas ia ipositive iand istatistically isignificant i(r=0.868; ip<0.05) ieffect ion ireducing ialcohol iabuse iamong ithe icommunity imembers iin iKapsabet iward, ithe ieffect iof ipeaceful idemonstrationsihasia ipositive iandistatisticallyisignificanti(r=0.810;ip<0.05)ieffectionireducing ialcohol iabuse iand ideaths iamong imembers iof ithe icommunity, ithe ieffect iof ireligion ias ian iinterventioniagainstialcoholiabuse ihasia ipositiveiandistatisticallyisignificanti(r=0.853;ip<0.05) i ieffect ion ireducing ialcohol iabuse iand ideathsiamong imembersiof ithe icommunity iand ifamilyibased iintervention ihas ia ipositive iand istatistically isignificant i(r=0.817; ip<0.05 ieffect ion ireducing ialcohol iabuse iin ithe icommunity. iThis iimplies ithat ifamily- ibased iintervention icontribute igreatly ito ithe iextent ito iwhich ialcohol iconsumption ican ibe ireduced. iIn iconclusion ithe ipoliciesiregarding ilocal ibrewing iare idisregarded iby imany ibrewersibecause ithey icontinue ibrewingichangaaiandibusaaieveryiday. iThereiareilowianti-alcoholicampaignsidoneionipeaceful idemonstrationsiagainst ialcohol iabuse. iReligiousileadersiare iclose imentorsito imany ipeople iin ithe isociety iand itherefore iit iisitheir iduty ito icriticize iand icondemn ithe iuse iof ialcohol iand idrug isubstance. iFurther iparentsiare ialwaysinumberione irole imodelsito itheir ichildren iand itherefore itheir ichampioning iin idemonstration ins iagainst ialcohol iabuse iwill ileave itheir ichildren iand iyouths iliving ithe isame ilifestyle. iThe istudy irecommends ithat ithe icounty igovernment ishould iput imore ipressure ion ifollow-ups iagainst ilaw ibreakers iwho icontinue ito ibrew ibusaa iand ichangaa. iThe icounty igovernment ishould iintroduce iregular ianti-alcohol icampaigns idone iby ivarious iorganizations iagainst iexcessive iuse iof ialcohol. iReligious ileaders ishould ilead iby iexample iand ilive ia iChristian ilife ibecause imany iyoung iand iold ipeople iin ithe isociety iuse ithem iasithe irole imodels. iAnd ifinallyiparentsiare irecommended ito ishare imore iinsightsion ithe iuse iof ialcohol iwith itheir ichildren. iThey ishould ibe iopen ito icommunicate iwith ichildren iand iclarify iexpectationsiregardingialcoholiuseiatitheifamilyisetiup.
RELATIONSHIP BETWEEN CLIMATE CHANGE AND OCCURRENCE OF INFECTIOUS DISEASES (DIARRHEA, PNEUMONIA AND MALARIA) IN TANGA, TANZANIA
(2020-12) Samweli Faraja Miyayo
Climate change extremes are now a contemporary issue. The Intergovernmental Panel on Climate Change acknowledges that evidence on trends in public health threats, including infectious diseases resulting from climate change, exists. The groups most affected by climate change are those with less ability to adapt to changes, and thus causing concern for their health. There are also several studies in Sub-Saharan Africa that are aimed at understanding the morbidity and mortality of diarrhea, pneumonia and malaria. Nevertheless, literature on the understanding of the relationship between climate change and the occurrence of diarrhea, pneumonia and malaria are limited. This study therefore sought to bridge this gap by exploring the relationship between climate change and the occurrence of infectious diseases (i.e., diarrhea, pneumonia and malaria) in Tanga, Tanzania. The study adopted a longitudinal study design using the Health Management Information System (HMIS) data in Tanga and Handeni districts, Tanzania, for the period between January 2016 and December 2018. While, the monthly climate change data (i.e., precipitation, humidity and temperature) for the same period were retrieved from the Tanzania Meteorological Authority (TMA). The data were analyzed using Multilevel Mixed-Effects Negative Binomial Regression (MMENBR) to assess the association between climate change indicators and the infectious diseases as well regional differences (i.e., Tanga and Handeni districts) using STATA version 13. The analysis showed a significant relationship between climate change and the occurrence of infectious diseases. There were mean differences in the climate indicators and in the occurrence of infectious diseases between Tanga and Handeni districts among all the age groups except for the newborns (i.e., < 1 month) in different years. The trend differences, between the two district, in the occurrence of infectious diseases and climate indicators were also statistically significant. There was an association between precipitation and an increased rate of diarrhea without dehydration (Adjusted incidence rate ratio, IRR = 1.01; 95% Confidence interval, CI: 1.00 – 1.01; p ≤ 0.10) and diarrhea with dehydration (Adjusted IRR = 1.01; 95% CI: 1.01 – 1.02; p ≤ 0.01), and a reduced rate of malarial infections (Adjusted IRR = 0.99; 95% CI: 0.99 – 0.99; p ≤ 0.001). The relationship between humidity levels and the occurrence of diarrhea without dehydration (Adjusted IRR = 0.98; 95% CI: 0.97 – 0.99; p ≤ 0.05), severe diarrhea (Adjusted IRR = 1.03; 95% CI: 1.01 – 1.06; p ≤ 0.05), non-severe pneumonia (Adjusted IRR = 1.01; 95% CI: 1.01 – 1.02; p ≤ 0.05) and severe pneumonia (Adjusted IRR = 1.02; 95% CI: 1.01 – 1.03; p ≤ 0.05) were statistically significant. On the other hand, an increase in the maximum temperature was associate with an increased incidence of diarrhea with severe dehydration (Adjusted IRR = 1.13; 95% CI: 1.01 – 1.27; p ≤ 0.05) and malaria as diagnosed using blood smear technique (Adjusted IRR = 1.18; 95% CI: 1.03 – 1.35; p ≤ 0.05). Furthermore, the minimum temperature was associated with increased rates of malaria as diagnosed using rapid diagnostic test (Adjusted IRR = 1.23; 95% CI: 1.09 – 1.39; p ≤ 0.001). The rates of malaria were in the opposing directions when using blood smear and rapid diagnostic test for the different temperature indicators (i.e., maximum and minimum temperature). In conclusion, there was an association between climate change and the rates of infectious diseases in Tanga and Handeni districts, Tanzania. The results of this study have critical policy implications for health intervention programs and resource allocation during the different seasons. The health facilities should be well equipped while at the same time health professionals should be prepared to handle the major iii infectious diseases in the different seasons of the year.
LIFESTYLE FACTORS INFLUENCING BODY WEIGHT AMONG WORKERS AT SEVENTH-DAY ADVENTIST INSTITUTIONS IN KIGALI, RWANDA: IMPLICATIONS ON MAJOR ORAL DISEASES
(2015-07) Susana Judith Tito Mamani
This study examined the lifestyle factors which influence body weight and their relationship with major oral diseases among workers at Seventh-day Adventist institutions in Kigali, Rwanda. Furthermore, this study also explored whether lifestyle factors are related with dental caries and periodontal diseases. Research questions included: (1) What are the body weight and oral health status of workers in Seventh day Adventist (SDA) institutions in Kigali, Rwanda?; (2) What is the lifestyle of workers in SDA institutions in Kigali, Rwanda in terms of a) diet?, b) physical activity?, and c) stress?; (3) Which of the lifestyle factors (diet, physical activity, and stress) significantly influence(s) body weight among workers in SDA institutions in Kigali, Rwanda?; (4) Is there a significant relationship between body weight and oral health status of workers in SDA institutions in Kigali, Rwanda? Methodology. A descriptive-correlation research design was used in this study. Data were collected using questionnaires, measurement of BMI, periodontal and caries index. Using the SPSS software, Pearson product-moment and Chi Square, correlations were computed to link factors that influence body weigh with oral health status. Results. Workers at Seventh-Day Adventist Church institutions in Kigali, Rwanda were generally overweight, the oral status showed high prevalence of caries and gingivitis affecting 67% of the participants. Diet (insufficient consumption of fruits and vegetables in terms of amount and frequency, poor choices and intake of quality dietary fats, and high consumption of starchy foods) and physical activity significantly influenced body weight while body weight and oral health status showed no significant relationship.
FACTORS ASSOCIATED WITH UTILIZATION OF CERVICAL CANCER SCREENING AMONG WOMEN OF REPRODUCTIVE AGE AT GELEGELE LOCATION, IN BOMET COUNTY, KENYA
(2019-07) Chelangat Martha
Cervical cancer is a major global public health problem. Cervical cancer is a malignant neoplasm of the cervical area of the uterus in which the cells of the cervix become abnormal and begin to grow uncontrollably. The latest world cancer statistics indicates that cervical cancer is the fourth most common cancer in women globally with over half a million new cases and the second most common in developing countries with over four hundred thousand new cases annually. In Kenya, cervical cancer screening uptake is low with less than 4% of all women reported to have undergone cervical cancer screening. This is due to poor perceptions regarding susceptibility to cervical cancer, the severity of cervical cancers and benefits of having a cervical cancer screening. The purpose of this study was to determine the factors associated with utilization of cervical cancer screening services among women of reproductive age in Gelegele location, Bomet County, Kenya. The objectives of the study was to determine the prevalence of uptake of cervical cancer screening, to determine the level of awareness of cervical cancer screening and to determine factors associated with utilization of cervical cancer screening. The study used cross sectional study design as it adopted quantitative approach through a structured survey questionnaire. The target population for the study was women of reproductive age. The sample size comprised of 350 women residence of that location. data was collected using structured questionnaires, analyzed in three phases which included both descriptive and inferential statistics and presented using tables. Associated factors were determined by use of logistic regression model using STATA version 13.1and statistical significance determined at p < 0.05. Factors significantly associated with utilization of cervical cancer screening services: Age (OR = 2.87; 95% CI: 0.93-8.49; p < 0.10), high school education (OR = 2.26; 95% CI: 0.89-5.75; p < 0.10), presence of chronic illness (OR = 2.52; 95% CI: 1.02-6.20; p < 0.05), and presence of cervical cancer screening fee (OR = 0.10; 95% CI: 0.02-0.43; p < 0.01). Prevalence of cervical cancer screening was 15.1%. Factors associated with frequency of utilization of cervical cancer screening services were; religious affiliation, marital status, parity, education, presence of chronic illness, distance to the cancer screening facility and charging screening fee. This study generated information that will be used to develop policies to improve the uptake of cervical cancer screening.
FACTORS INFLUENCING COMPLIANCE TO LIFESTYLE MODIFICATIONS AMONG HYPERTENSIVE PATIENTS ATTENDING SPECIAL CLINIC IN NYAMIRA COUNTY REFERRAL HOSPITAL, KENYA
(2017-06) Stephen Marita Ogega
Compliance to lifestyle modification is essential in the management of hypertension. The aim of this study was to identify factors that influence compliance to lifestyle modification among hypertensive patients attending special clinic at Nyamira County Referral Hospital. A descriptive correlational study design was used to describe, determine and evaluate individual, family, health services and socio-cultural factors that influence compliance to lifestyle modification among these patients. A structured self-administered questionnaire was used to collect data from each of 224 hypertensive patients who participated in the study. The data acquired was analyzed using frequencies, means and correlation and regression were to determine the relationships. The findings revealed that most of the respondents were non-compliant (80%) while onl 20% were compliant to the lifestyle modifications. The inferential statistics findings indicated Pearson correlation scores as being; socio-cultural =(r=0.229, p=0.01), individual =(r=0.67, p=0.00), family (r=0.581 p=0.00) and health service = (.581, p=.000). The percentages of contribution to compliance to lifestyle modification by each of the factors are: individual factors – 43%, health service factors – 7.3%, family factors - .7%. In conclusion, there is very low level of compliance to lifestyle modifications mainly accounted for by the individual, family, and health service factors but weak with socio-cultural factors. Therefore, there is need to develop health programs that will assist the hypertensive patients control the factors contributing to the low compliance to their engagement in lifestyle modifications.
FACTORS ASSOCIATED WITH COMPLIANCE TO TREATMENT AMONG TYPE 2 DIABETES PATIENTS ATTENDING DIABETES OUTPATIENT CLINIC AT MOI TEACHING AND REFERRAL HOSPITAL, ELDORET, KENYA
(2019-07) Kapten M. Muthoka
Medication and treatment noncompliance among type 2 diabetes patients has been shown to predict morbidity, disability, immature mortality and general poor health outcome. Given the increased risks associated with poor treatment compliance, the study aimed at assessing the rate of compliance, as well as factors associated with compliance to treatment among type 2 diabetes patients attending the Diabetes Outpatient Clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. The study adopted a cross-sectional study design, with data collection taking place over duration of 3 months. Data was entered into SPSS version 20.0 and analyzed using stepwise multiple regression and Pearson’s product-moment correlation coefficient to assess for associations of social demographic and social economic factors with compliance to medication and lifestyle modification. Rate of compliance was computed as a percentage on basis of means from indicators of compliance as captured in the questionnaires. Factors associated with compliance were considered to be significant at p < 0.05. The rate of compliance to treatment among type 2 diabetics was 79.9% while health education (p = 0.045), depression (p = 0.001) and duration on medication (p = 0.021) were the only factors found to be significantly associated with treatment compliance. Therefore, from the study it was concluded that compliance to treatment was 79.9% and patients who are not depressed, have taken medication for a longer time, and have received adequate health education are more compliant. The study recommended that health education efforts as well as strategies to diagnose and manage depression among type 2 diabetics should be enhanced among key Ministry of Health stakeholders in charge of diabetes care programs.
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF THE OLDER PERSONS AGED 65 YEARS AND ABOVE IN TURBO SUB COUNTY, KENYA
(2019-07) Felix Cherwon
Elderly nutrition is an essential aspect of the aging process. Nutrition has tremendous effects on quality of life as it is characterized by overnutrition and undernutrition. Malnutrition prevalence affects the quality of life among older persons negatively. According to United Nations projections in 2017, there was an estimate of 967 million elderly persons globally. The global malnutrition rates range between 13%-30% among this population. In Kenya, 25% of older persons aged over 65 years are either at risk or undernourished. Prevalence is greater in rural areas where over 30 % of men of older persons are underweight. This study sought to assess factors associated with nutritional status of the elderly in Turbo Sub County, Uasin Gishu County, Kenya. This study’s specific objective was to determine the nutritional status of the older persons above 65 years and factors associated with that nutritional status. This study adopted a cross-sectional survey design. The study employed random sampling to select study sites, while purposive sampling was employed to sample the respondents. The study used an interviewer-administered questionnaire to collect data, MUAC tapes for mid upper arm length, weight scales, and height meter for BMI assessment. The results were analyzed using descriptive statistics and logistic regression analysis to highlight the odds ratio using a 95% confidence interval. Data was analyzed using Stata v21 data software tool. The key variables used entailed family size, age, gender religion, residence, education, source of income, marital status, gender, smoking, exercise, dietary food intakes, source of income, mid-upper arm circumference as well as body mass index. According to the findings, with reference to the BMI, indicated that 45.6% had normal nutritional status, 5.4% were underweight, 1.5% were severely underweight, and 1.3% were very severely underweight while MUAC assessment indicated that 74% of the respondents had good nutritional status while 26% were malnourished. Factors which were found to be significantly associated with nutritional status of the older persons were age (70-74 years, OR=2.56;95% CI), religion (SDA OR=0.9 and Protestants OR=0.43 compared to Catholics), education (Primary level OR=0.32), source of income, farming (OR= 0.27), alcohol intake (OR=0.81), vegetable intake (Intake of 1-3 times intake OR=3.80) and fruit consumption (intake of 2-4 times intake OR= 0.27). Nutrition plays a vital role among the older persons general health, statistically significant factors associated with nutritional status include age state, religion, education levels, source of income consumption of alcohol, vegetable intake, and fruits consumption. As the source of income plays a crucial aspect in sourcing food for consumption at the household, there is need to motivate and encourage the younger population on benefits of good savings and to invest in income-generating activities which plays a vital role in facilitating nutritious food at the households. Further health promotion on lifestyle behavior change is key towards lifestyle behaviors such as intake of alcohol. Promoting positive behavior among the elderly is key in promoting good nutrition status and overall good quality of life. Moreover, advocacy on increased intake of fruits and vegetables among the elderly is pertinent in promoting and enhancing the body’s ability for elderly protection morbidity.
ASSESSMENT OF KNOWLEDGE AND PRACTICES ON MENOPAUSE AMONG PERIMENOPAUSAL WOMEN IN KIPKAREN, ELDORET TOWN, KENYA
(2019-07) DAISY CHEBET RUTO
Perimenopause refers to the period of years preceding menopause. The declining levels of estrogen results in psychological and physiological changes that may cause distressing symptoms. This ultimately affects women quality of life. This, therefore, informed the need to assess the level of knowledge and practices on menopause among perimenopausal women in Kipkaren, Eldoret Town, Kenya. The study was guided by the following objectives; to determine the knowledge on menopause among perimenopausal women; to examine practices towards practices on menopause among perimenopausal women and to establish the relationship between knowledge and practices on menopause among perimenopausal women. This study adopted a cross-sectional survey research design. The study targeted perimenopausal women in Kipkaren. The total population for the study was 123 women. The sample size was 92 respondents. The study adopted the use of questionnaires as the main data collection instruments. The researcher consulted her supervisors and other experts and specialists in this area for expert validation. The study then used Cronbach's Coefficient Alpha of 0.70 to test for the reliability of the questionnaires. The study adopted a quantitative analysis in order to achieve the objectives of the study. The study results indicated that 77.7% of the perimenopausal women noted that menopause is the cessation of the menstruation; most of the women (56.9%) noted that menopause is caused by stoppage of hormones; psychological changes during menopause were mood changes, insomnia, and depression. Osteoporosis was the main symptom of physical changes during menopause. The main diet that should be taken during menopause was proteins and calcium. The study results revealed that 67.0% took proteins, supplementary calcium or other vitamins in their diet; 31.0% did weight-bearing exercises such as power walking and strength training in order to reduce the risk of osteoporosis; only 22.0% consulted their healthcare provider after every six month; 35.0% avoided fats and too many sugars in their diets; 47.0% maintained normal body weight; 69.0% took healthy diets; and 76.0% had social interaction with others; 11.0% had unhealthy practice (abuse drugs, smoking, and alcohol) and that 96.0% practiced a healthy lifestyle that is avoiding smoking, drug abuse and drinking alcohol. This study concluded that menopausal women have considerable knowledge regarding menopause. Most of the perimenopausal women understand the meaning of menopause, causes, symptoms, and ways of managing the condition. The study concluded that there is a significant relationship between the education level and understanding of menopause; educational status and knowledge on symptoms of menopause; educational status and knowledge of the healthy diet during menopause. There is a significant relationship between education level and physical exercises. There is a significant relationship between knowledge of menopause symptoms and physical exercise. The study recommended that public health care systems should mobilize resources and take measures to improve women’s awareness and knowledge about menopause-related changes through a variety of educational tools and media.
KNOWLEDGE, ATTITUDE, AND PRACTICES TOWARD LASSA FEVER MANAGEMENT AMONG HEALTHCARE WORKERS IN MARYLAND COUNTY, LIBERIA
(2021-07) NEONORA ADE PAYNE-BARCLAY
This research study examined the knowledge, attitude, and practices towards Lassa fever (LF) management among healthcare workers in Maryland County, Liberia West Africa. This virus is transmitted by the rodent of the genus Mastomys natalensis commonly known as the “multi mammate rat.” The Mastomys rats are the carrier of the virus which is active in their urine and feces. The virus is a single-stranded RNA virus belonging to the virus family Muridae. This sought to study explored the relationship between knowledge, attitude and practice towards Lassa fever management among healthcare workers in Maryland County, Liberia. Two hundred and ninety-nine healthcare workers between 22 and 52 years participated in a quantitative research using the cross-sectional study design. Participants were selected randomly after stratification. Data was collected using structured questionnaires and analyzed o STATA for windows, version 16. Analysis included descriptive statistics (frequencies and percentages). The study used the logistic regression since the response variable, health care practices was categorical. This allowed us to classify respondents as practicing poor or good health care practices. The developed logistic model was found to be statistically significant, (𝟔) = 𝟐𝟒.𝟖𝟖, = 𝟎.𝟎𝟎𝟎𝟒 meaning that at least one of the predictor variables included in the model affected the health care practice outcome. The study found statistically significant predictors were health care worker cadre, z = 2.45, p = .014, OR = .62 95% CI (.43, .91) and experience z = 3.68, p = .000, OR = 2.32 95% CI (1.48, 3.63). The odds ratio health care cadre shows that higher cadre is associated with poor health care practices. In particular, an increase in cadre by one level lowers the odds of falling in the good practice category by a factor of 0.62. There was a statistically significant association between health care practices on Lassa fever management and the variables cadre, p = .002 and years of experience and as a health care worker, p = .000. Consistent with other studies on the knowledge about Lassa fever and its management, there is a lack of adequate knowledge of Lassa fever management among Healthcare workers. This study found that there was not infection prevention control measures put in place across governmental and private owned clinics so compliance was lacking. In conclusion, this study showed that knowledge on the management of Lassa fever both in governmental and private health facilities were less desirable putting Healthcare workers at risk of the virus. The study also showed that compliance to the control and prevention of Lassa fever management among healthcare workers is lacking due to the fact that none of the clinics and hospital have infection protective control practice put in place towards Lassa fever management. The researcher recommends the Director of the Maryland county health team must put in place proper and effective control practice and prevention strategies which are crucial in the management of Lassa fever for the healthcare workers. Both the public and private health facilities must consistently put priority in place to implement standard infection prevention and control interventions when caring for febrile patients to prevent nosocomial infections including Lassa fever. Sensitization on knowledge of LF by the Williams V S Tubman University through media platforms all year round in the county with an added focus on the students of health sciences.
FACTORS ASSOCIATED WITH HERBAL MEDICINE USE IN CHILDREN 0- 12 YEARS OLD: A CASE OF BONCHARI SUB COUNTY, KISII COUNTY, KENYA.
(2019-07) JACKLINE G. NGITI
Reports indicate that more than 80% of the world population relies on herbal medicine (WHO, 2013). This study examined herbal medicine use practice including factors associated with its use in children 0-12 years in Bonchari Sub County, Kisii County, Kenya. The specific objectives of the study were to identify the types of herbal medicines used in children in Bonchari Sub County, determine information sources utilized, explore factors contributing to herbal medicine use in children and determine the associated outcome of using herbal remedies in children. The research design used was case study design. Purposive sampling was used to include all the 30 parents/ guardians who presented at Kisii Level five hospital with a history of herbal medicine use on their children in 2014/2015. Semi structured, interviewer administered questionnaires were used to collect data. Data was analysed both quantitatively and qualitatively. Quantitative data was analysed using statistical package for social scientists (SPSS) version 21.0 while in qualitative analysis, thematic analysis was done. Findings revealed that there were a number of herbs used in children in Bonchari Sub County, with the most common being Spilanthes Mauritiana used to treat oral candidiasis (22.22%). The most common source of information on herbal medicine were the grandmothers (55.56%). Conviction that conventional medicine would not treat was the leading factor in the use of herbal medicine in children (40.74 %). Other reasons were that herbs are commonly used in the area (33.33 %), and herbs are easily available (25.93 %). Out of the 27 respondents who were interviewed, 20 of them (74 %) had children who developed serious complications after using herbal medicine. None of the respondents informed their medical practitioner that their child was on herbal medicine and none of the medical practitioners bothered to ask during regular visits. This study points to a belief system on herbs as the common treatment mainstream in the region making scientific study a necessity that will help us determine the beneficial and harmful herbs and advice the community accordingly. The results of this study further suggest that training on traditional medicine practice should be incorporated in the training of medical students and traditional healers should be officially sensitized by the Ministry of health on herbal medicine use practice so as to minimize the dangers that come with unregulated herbal medicine practices.
ASSESSMENT OF THE LEVEL OF DISASTER PREPAREDNESS OF HEALTH MANAGEMENT COMMITTEES IN PUBLIC HOSPITALS IN NANDI COUNTY, KENYA
(2017-06) Obed Limo
This study aimed at assessing the level of disaster preparedness of health management committees in public hospitals in Nandi County. The study employed descriptive research design. The researcher used census method where with use of self administered questionnaire and interview guide, the researcher was able to collect data from 41 and 16 committee members respectively. Quantitative data was processed and analyzed using the Statistical Package for Social Sciences SPSS version 20 while qualitative data was summarized consistent with the themes in the study objectives. Spearman’s correlation test of relationship was employed to test significance of relationship of challenges with the preparedness factors. The study established that the HMCs are not able to adequately fund disaster preparedness activities and putting in place programs for disaster preparedness within Nandi County. The overall rating on the staff preparedness for disaster is low. There is a significant relationship between Infrastructure developments for disaster readiness and lack of cooperation from the neighboring community and Lack of knowledge on disaster preparedness. Likewise, there is a significant relationship between inappropriate infrastructure and Funding of disaster preparedness and Programs in place for disaster. The study concludes that HMCs are not adequately prepared for disaster. The study recommends that the HMC should seek control and allocate more funds to disaster preparedness. The HMCs should be sensitized on disaster preparedness and similarly encouraged to work on the cooperation that lacks between the community and the public hospitals in Nandi County.
PREVALENCE AND RISK FACTORS OF CHRONIC KIDNEY DISEASE IN KERICHO COUNTY, KENYA
(2017-05) ROTICH JOYCE CHERONO
There is rising number of reported cases of kidney diseases from Kericho County. The number of patients attending the local hospitals’ hemodialysis has increased in the recent past. From the reports at MTRH, most patients attending dialysis come from Kericho County. Approximately seven out ten patients attending hemodialysis are from Kericho County. This was a mixed methodology research. The prevalence of Chronic Kidney Disease (CKD) was determined by reviewing admission data of adult medical patients in the years 2013, 2014 and 2015. The risk factors profile of CKD patients was assessed using a cross-sectional study design. The study population included doctors, nurses and patients. The study used questionnaires, document analysis and interview schedule as the main data collection instruments. The study adopted both the qualitative and quantitative analysis in order to achieve the objectives of the study. Content analysis was used to analyse both secondary and qualitative data. The study found out that 57.0% (13) of patients with CKD had used traditional medicines prior to onset of the disease. Doctors and nurses agreed that herbal concoctions might lead to CKD. Physical inactivity leads to increased prevalence of CKD due to the development of obesity, hypertension and diabetes. Tobacco smoking, Alcohol abuse and use of over the counter NSAIDs might have lead to increased prevalence of CKD in this region. The 3-year average prevalence of CKD was 0.41%, with 78.3% being less than 50 years of age, and 91% having low to medium income ratings. The doctors and nurses were in agreement that exposure to agrochemicals; physical inactivity and herbal medication could be risk factors for CKD. The study concluded that there was an increasing prevalence of CKD in Kericho County with the presence of associated risk factors such as occupational, lifestyle, dietary and cultural factors.
FACTORS INFLUENCING ATTITUDES OF NURSES TOWARDS PARTICIPATION IN INDUSTRIAL ACTION IN PUBLIC HOSPITALS IN NANDI COUNTY, KENYA
(2019-07) Joshua Gwaro Nyang’au
This study explored factors influencing attitudes towards participation in industrial action of nurses in public hospitals in Nandi County, Kenya. Pertinent factors such as personal values, professional commitment, service commitment, and job satisfaction were explored. A cross-sectional survey was done using the quantitative design where 191 nurses participated in the study. The data analysis was done using descriptive statistics, Pearson product-moment correlation coefficient, t test for independent samples, and one-way analysis of variance. Results show that nurses have a moderately positive attitude towards participation in industrial action with an overall value of M=2.5743, SD=0.61609, have moderately positive personal values with M=3.2887, SD=.49909, have an average professional commitment with M=3.3303, SD=0.48564, have high service commitment at M=3.6272, SD=0.45130, and are moderately satisfied with their job at M=3.4993 and SD=0.46256. The level of professional and service commitment does not influence the nurses’ attitudes towards participation in industrial action. Nurses who have positive values and high job satisfaction are less likely to participate in industrial action. Both male and female nurses have moderately positive attitudes towards participation in industrial action. The mean attitudes reveal that nurses aged 20 to 30 years have moderately negative attitudes while nurses aged 31 years and above have moderately positive attitudes towards participation in industrial action. Nurses who have served for 5 years and below have moderately negative attitudes while those who have served for 6 years and above have moderately positive attitudes towards participation in industrial action. Therefore, imparting sound personal values among nurses and providing a conducive working environment that fosters job satisfaction for nurses is paramount in combating industrial action.
FACTORS INFLUENCING HEALTH CHOICES IN VIEW OF EMERGING LIFESTYLE DISEASES AMONG THE SEVENTH-DAY ADVENTIST CHURCH MEMBERS IN ELDORET WEST STATION, KENYA
(2021-07) Limo, Edward Kipng’eno
This study identified the factors influencing health choices in view of emerging lifestyle diseases among Seventh-day Adventist (SDA) Church members in the Eldoret West station of Greater Rift Valley Conference of the SDA Church, Kenya. The objectives of the study were to determine the health choices among the SDA Church members, to evaluate their knowledge of lifestyle diseases, cultural beliefs on health, and attitudes towards the Adventist health message, and to find the correlations among these variables. Milio’s framework for prevention-changing health-damaging to health-generating life patterns was adopted for the study. It employed descriptive, correlational and comparative research designs. The data from 237 randomly sampled church members was analyzed using descriptive statistics, Pearson product-moment correlation coefficient, t-test for independent samples, and one-way analysis of variance. The study findings showed that SDA church members have good health choices (mean of 3.30) and moderately positive attitude towards the Adventist health message (mean of 2.85). Seventy percent (70%) of the research participants have knowledge of the risk factors and 81% are knowledgeable of the preventive measures of lifestyle diseases. Church members who have positive attitude towards the Adventist health message tend to have positive health choices. Moreover, church members with lower level of education, with higher income, and are members of the church for at least 20 years have more positive health choices. In comparisons, there were no significant differences in health choices of respondents grouped according to age and location of residence. It is recommended that the church continues its health education to church members with emphasis on risk factors and preventive measures of lifestyle diseases and promotion of Adventist health message for the purpose of encouraging them to adopt positive health choices.
EVALUATION OF FACTORS ASSOCIATED WITH UNDER MITIGATION OF FLOODS IN CHIKWAWA DISTRICT, MALAWI
(2016-07) Joseph Msambathukuta Chasweka
The present study was conducted in Lower Shire in Malawi about evaluation of factors associated with under mitigation of floods in Chikwawa district, Malawi. The study adopted descriptive correlation study design. The study employed Slovin formula to compute the sample size of 171 participants who are majorly victims of flood in the Lower Shire region. Participants included government officials who were interviewed and also victims in which questionnaires were administered to them. The findings of the study revealed that mode of coordination of government disaster response agencies mean, 2.16 was low. The overall rating was 2.1; this shows that the respondents do not agree that the government involve them in the mitigation of the disaster. There is a statistically significant relationship between mode of coordination of government disaster response agencies and involvement of affected communities. This means that as the government involves the affected communities, also the mode of coordination and response to the disaster improves. The p value is 0.00<0.05 and the Pearson Correlation r is 0.67.The study concluded that the government does not involve the affected communities in disaster response and mitigation. The government of Malawi exhibit poor coordination during disaster strike. There is a direct correlation between the government mode of coordination and involvement of the affected communities and recommended that the government should involve the affected communities for better mitigation of the disaster. The government of Malawi should improve the mode of communication by involving victims in mitigation and training.

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