Nursing

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Patient and Health System Related Factors Associated with Non-Adherence to Antihypertensive Medication among Patients at Chuka Referral Hospital, Kenya
(Scientific Research Publishing Inc., 2021) Gikunda, C.; Gitonga, L.; Kamweru, P.
Background: Non-adherence to hypertensive medication continues to be- come a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 pa- tients who attended the medical clinic that year. Objective: This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. Methods: This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4th-May 30th 2019. In- ferential and descriptive statistics were used for data analysis, aided by SPSS version 25. Results: 64% of the patients stated that they had missed medica- tion. A significant negative correlation (rpb = −0.23, p < 0.05) between age and non-adherence, significant positive correlation with monthly income (rpb = 0.24, p < 0.04), non-significant relationship between non-adherence and ma- rital status (rpb = −0.13, p = 0.25) and patients’ level of education (rpb = −0.06, p = 0.57). The overall model of health system related factors were found to be significant (p < 0.05) and this included; quality of health service, physician patient relationship, stock out, health education, and availability of medicine (p = 0.012). Conclusion: Lacks of funds, unavailability of drugs are the lead- ing factors to regimen completion. This could be easily be addressed by the government.
Knowledge and Attitude of Nurse-Midwives Regarding Maternal Health Care Quality Standards in Two Regional Teaching and Referral Hospitals in Kenya
(Scientific Research Publishing Inc., 2022) Impwii, D.K.; Kivuti-Bitok, L.; Karani, A.
Maternal mortality remains a major health concern in Sub- Saharan Africa and Kenya in particular. Providing quality maternal health care has the potential of preventing over 75% of maternal deaths. The quality of maternal health care requires the utilization of maternal health care quality standards. Objectives: The objective of this study was to determine the nurse-midwives knowledge and attitude toward the use of maternal health care quality standards. Methodology: This study was a descriptive cross-sectional survey carried out at Embu and Meru teaching and referral hospitals in Kenya, between August and December 2021. Eighty-five nurse-midwives working in the maternity unit participated in the study. Data was collected using a self-administered semi-structured questionnaire and analyzed using SPSS version 27.0. Pearson’s correlation coefficient and Chi-square at Alpha level of 0.05 were used to test the relationship between the variables which were the nurse-midwives knowledge, attitude, and use of the quality stan- dards. Result: Most (84.7%, n = 72) nurse-midwives were female and 44.7% (n = 38) were aged 20 - 29 years. Majority (64.7%, n = 55) were diploma holders and almost half (44.7%, n = 38) had practiced for 1 - 9 years. The av- erage score for knowledge was 5.0 with 69.4% (n = 59) having a score of <7. Most nurse midwives (88.2%, n = 75) supported the use of the standards even though only 67.1% (n = 57) indicated that they use them. The support for the standards is significantly related to the gender of the respondents and their duration in maternity. There was no significant association between know- ledge and use of maternal health care quality standards (X2 = 0.433, r =−0.085). There is no association between support for the standards and theiruse (X2 = 0.008). Knowledge and attitude toward the maternal health care quality standards are not significantly associated (X2 = 0.156). Conclusion: The knowledge and attitude of the nurse-midwife neither influence each oth- er nor do they influence the use of maternal health care quality standards.
Cardiocurative effects of aqueous leaf extracts of Ximenia americana (linn.) and Pappea capensis (eckl. and zeyh.) against myocardial infarction in rats
(Journal of advanced biotechnology and experimental therapeutics, 2022-12-21) Gaichu, Daniel Muthee; Patricia Mathabe; Mathew Piero Ngugi
Different plants are traditionally applied in the treatment of different diseases, including chest pains, hypertension, and inflammation, among others. This study scientifically evaluated the curative treatment effects of X. americana and P. capensis leaf aqueous extracts in rats induced with myocardial infarction. The rats were randomly distributed as follows: Normal control group, consisting of rats treated with oral normal saline; Negative control group, comprising rats induced with MI and treated with normal saline; Positive control group, consisting of rats induced with MI and orally treated with propranolol (10 mg/Kg bw); and three experimental groups consisting of rats induced with MI and treated with plant extracts at dose levels 150, 200 and 250 mg/Kg bw. This study’s findings demonstrated that there was a significant reduction in the amounts of cTnT, LDH-1, CK-MB, T-cholesterol, triglyceride, LDL-c, and malondialdehyde, as well as a significant increase in levels of HDL-c, catalase, SOD, and glutathione peroxidase among rats treated with propranolol and plant extracts as compared to the negative control rats. Additionally, LC-MS analysis revealed the presence of flavonoids, tannins, and phenolics, which could explain the observed cardiocurative effects. This study concluded that aqueous leaf extracts of X. americana and P. capensis possess cardiocurative activities in rats with myocardial infarction. However, further studies on isolated fractions of the phytochemicals present are recommended. This study provides preliminary data useful in the development of pure and safe cardioactive compounds.
Medicinal Plants Used for Treatment of Gastrointestinal Infections in Tharaka-Nithi County
(International Journal of Pathogen Research, 2022-08-22) Kiteme M. Purity; Onyango O. Benson; Njagi C. Eric; Ogolla O. Fredrick
Health care is a basic need to humans which can only be achieved with medicines with high efficacy against disease causing pathogens. Globally, gastrointestinal infections are major health concern particularly to travelers since over 60% visiting tropical and subtropical regions develop diarrhea. Herbal plants have been used for decades to treat gastrointestinal infections globally including Tharaka-Nithi County in Kenya. However, there is little information on the demography of herbalist and the plants used in treatment of gastrointestinal infections such as typhoid, cholera and shigellosis. A cross sectional survey was carried out involving thirty herbalists to assess their demographic data and to establish herbs commonly used to treat typhoid, cholera and shigellosis in Tharaka-Nithi County. Data collected was subjected to Chi square test of association and descriptive statistics and presented in percentages. There were more male herbalists (65.52%) in the study than female herbalist (34.48%). Most of the herbalist (65.52%) were aged above 70 years. There was a significant (p < 0.05) association between herbalists’ level of education and age (X2 (6, N = 30) = 17.349, p = 0.008). Most herbalists were found to have below primary education level 58.62%. Aloe vera, Aspilia pluriseta, Ficus sycomorus and Physalis peruviana were identified as commonly used plants for treatment of cholera with Aspilia pluriseta being most preferred (27%) by herbalist above the age of 70 years. Vangueria infausta, Eucalyptus globulus, Carissa edulis and Erythrina abysinnica were commonly used for treatment of shigellosis with Eucalyptus globulus being most preferred (58.6%) by herbalist above the age of 70 years. Erythrina abysinnica, Carissa edulis, Vangueria infausta and Eucalyptus globulus were commonly used for treatment of typhoid while 50.0% of herbalist above the age of 70 preferred Erythrina abysinnica. Most of the herbalists had below primary education level. In conclusion, herbal medicine is mostly dispensed by older people in Tharaka-Nithi County in Kenya. Different herbal plants are used in the treatment of cholera, shigellosis and typhoid.
Complementary and Alternative Medicine Use and Adherence to Conventional Cancer Treatment in Meru County, Kenya
(Open Access Health Scientific Journal, 2023-02-26) Kiraki Monicah Wambui1,2*, Gabriel Mbugua2 , Robert Kei Mburug2 , Catherine Gichung
Background: Non-communicable diseases (NCDs) are the leading cause of global mortality with cancer ranking among the top cause of death. Unfortunately, most of these deaths occur in developing countries due to delays in the diagnosis of the disease. Consequently, the use of complementary and alternative medicine (CAM) among cancer patients is on an upward trend hence adherence to conventional cancer treatment (CCT) is a major health concern. Methods: A cross-sectional study was carried out in a conventional cancer centre in Meru County. A researcher-administered questionnaire was used to obtain data from 117 consenting patients. Demographic data, clinical data, history of any use of CAM before and after cancer diagnosis and any side effects were obtained from the study participants. Data were analyzed using the Statistical Package of Social Sciences (SPSS). Results: There were more female (53.8%) participants, mainly married (59.8%), Christians (97.4%) with primary education and above (69%). Almost half of the participants (47.9%,) were using CAM. Most of the participants (85.7%) started using CAM after a cancer diagnosis. More than half of the respondents using CAM (52%) had disclosed to the HCP mainly to find out about drug-drug interaction risk (41.4%). Only one (1.8%) CAM user had withdrawn the CCT to use CAM due to dissatisfaction with conventional medicine. Conclusion: The use of CAM is complementary and not alternative to CCT and hence may not influence adherence to CCT among cancer patients in Meru County. However, there is a need to provide health education to cancer patients on the use of complementary medicine and analyze the outcomes of patients who use complementary medicine while on CCT.
Patient-Related Factors Influencing Uptake of Cervical Cancer Screening Services among Outpatient HIV-Positive Women at PCEA Chogoria Hospital, Tharaka-Nithi, Keny
(Open Access Library Journal, 2023-02-27) Peter Nyakimwa Mong’are* , Lucy Kawira Gitonga, Eugene Sundays Mukhwana
Cancer of the cervix is the leading gynecological malignancy in women and the most prevalent cancer among HIV-positive women. HIV-positive women have up to six times higher risk of contracting cervical cancer as compared to HIV-negative women. The World Health Organization (WHO) recommends that sexually active girls and women should start screening for cervical cancer as soon as they are diagnosed with HIV. However, studies conducted in most developing countries, including Kenya, have established a low uptake of CCS services among this population. The purpose of this study was to determine patient-related factors influencing cervical cancer screening (CCS) uptake among women living with HIV (WLHIV) in PCEA Chogoria Hospital, Tha raka-Nithi County, Kenya. A cross-sectional descriptive survey design was used. A total of 130 WLHIV were recruited into the study using convenient sampling technique. Data was collected using a semi-structured questionnaire and was analyzed using both descriptive statistics and inferential statistics. Chi-square tests were used to establish the association between patient-related factors and screening for cervical cancer. The findings of the study revealed that 79% of the WLHIV had screened for cervical cancer. Most of the WLHIV screened for cervical cancer as a personal initiative or after recommendation by a health care worker. Patient-related factors such as level of education, age, marital status, partner support, and religion significantly (p < 0.05) influ enced the likelihood of the WLHIV screening for cervical cancer. The study recommends that health care workers should continually initiate and support CCS to WLHIV because this modality appeared to greatly increase the uptake of CCS. Moreover, health care workers should encourage partner support for CCS. Policy formulators can use the information as a guide in formulating policies that will enhance uptake of CCS among WLHIV
Evaluation of Effectiveness of Continuous Professional Development in Clinical Practice among Nurses and Midwives in Meru County, Keny
(International Journal of Professional Practice (IJPP) Vol .12 Issue No. 4, 2024, 2024-04-20) Odhiambo Roselyne Akinyi *1, Gitonga Lucy Kawira 2 , Marwa Immaculate Nyaseba
The global Maternal Mortality Rate (MMR) is 223 per 100,000 live births, with hemorrhage being the leading cause of death. In Sub-Saharan Africa, the need for nurses and midwives is increasing. Incidentally, only 3.5% of the world's health staff are accountable for 27% of the disease burden. The depicted heavy workloads have largely contributed to poor participation in Continuous Professional Development activities among nurses and midwives. Meru County’s MMR burden, which exceeds the global MMR, remains a concern. However, the Nursing Council of Kenya stipulates a total of 20 CPD hours to be met annually for all nurses. The aim of the study was to evaluate the effectiveness of CPD in clinical practice among nurses and midwives in Meru County. This study seeks to inform the public on the gaps in the uptake and implementation of CPD, and provide recommendations to improve its effectiveness. The study utilized both the qualitative and the quantitative techniques, and adopted Randomized Clinical Trial design. A sample of 78 nurses and midwives was obtained from a target population of 98. Quantitative data was collected using questionnaires and case studies, and analyzed using SPSS version 26, to derive descriptive statistics, while qualitative data was collected through interview schedule checklists and observation, and was analyzed thematically. Pearson’s chi square tested the relationship between knowledge and CPD uptake in clinical practice (p=0.00) at 95%CI. Paired t-test compared means within the control and intervention groups (t=1.000). Despite the provision and use of BEmONC guidelines, major gaps were observed in Active Management of Third stage of labour (17.9%) and also in completion of the patograph (mean=1.7). Despite the efforts to maintain competence levels in clinical practice, gaps pertaining to standardization still exist. The study recommended continuous training to bridge quality gaps and need in clinical practice among nurses and midwives
Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device Uptake among Mothers Delivering at Meru Hospital
(Scientific Research publishing, 2019-03-04) Kirigia,Consolata, Gitonga,Lucy
Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices at 3.8%. Low uptake of 3.4% was reported in Meru Hospital and lack of literature on im- mediate Post Partum Intra Uterine Contraceptive Device (PPIUCD) uptake. Immediate Post Partum Intra Uterine Contraceptive Device is a long acting reversible contraceptive device inserted into the uterus immediately within 48 hoursafterdelivery.TheobjectivewastoassessBarrierstoImmediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers de- livering in Meru Hospital. Descriptive research design was used and a popu- lation of 289 mothers was targeted. Sample size of 74 respondents was se- lected using simple random sampling. Questionnaires and interview sche-dules were used to collect data. The collected data were entered and analyzed using Statistical Package for Social Science windows version 23.0. Descriptive analysis was used to obtain frequencies and percentages. Chi-square was usedto test the relationship of study variables and presented in tables. The qualita- tive data were analyzed thematically. The findings revealed that provider re- lated barriers such as none provision of the services and untimely counselingfor the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic andreproductivecharacteristicsalsoplayedaroleinlowuptake.Usingthe chi square test, there was a significant relationship, P = 0.001 between young age of the mothers, unemployment (53%), low parity (56%) and low uptake. Preference for other alternative contraceptives (25.8%) such as hormonal methodswasabarriertotheuptake.Therefore,barrierstoPPIUCDuptake are provider related, alternative methods of contraception and client relatedsuchaslackofinformation,unemployment,youngageandlowparity.The findings will inform Meru hospital management on barriers to immediate PPIUCD uptake. The study recommends an investigation on why providers hinder PPIUCD uptake and create awareness on PPIUCD services to the community.
Evaluation of cardiopreventive efects of Ximenia americana (Linn.) and Pappea capensis (Eckl. and Zeyh.) leaf aqueous extracts in rat models with myocardial infarction
(Future Journal of Pharmaceutical Sciences, 2023-06-24) Daniel Muthee Gaichu1,3* , Patricia Mathabe2 and Mathew Piero Ngugi3
Background Myocardial infarction is a signifcant health issue in both wealthy and underdeveloped nations. Globally, it is the leading cause of deaths among cardiovascular diseases. In 2012, myocardial infarction-related deaths were about 14.1 million out of 17.5 million cardiovascular disease-related deaths. Clinical management of myocardial infarction remains a challenge because most conventional drugs provide symptomatic relief only. In addition, conventional remedies are associated with numerous advese efects and arguably, in many cases are quite expensive. Hence, herbal remedies, which are widely available, with comparatively fewer side efects, and are afordable, provide a more attractive therapeutic alternative. This study aimed at determining cardiopreventive efects of aqueous leaf extracts of X. americana and P. capensis. Phytochemical screening was done using liquid chromatography-mass spectrometry. Wistar albino rats were employed to test for cardiopreventive efects of the extracts and were randomized into 6 groups of 5 animals each. Groups I, II, and III were normal, negative, and positive controls, respectively, and rats were given normal saline, salbutamol (7.5 mg/Kg bw), and propranolol, respectively. Groups IV, V, and VI rats were treated with extracts dose levels 50, 100, and 150 mg/Kg bw, respectively. Biochemical analysis was done to determine efects of the extracts on levels of serum cardiac troponin T, creatine kinase-MB, lactate dehydrogenase-1, and lipid profles. Levels of oxidative stress markers were determined in the heart tissue. Results The LC–MS analysis revealed diferent phytocompounds in the extracts, including favonoids, phenolic acids, glycosides and tannins, which are known to confer cardioprotective activities. The extracts signifcantly prevented increase in cardiac troponin T, creatine kinase-MB, lactate dehydrogenase-1, total cholesterol, triglycerides, LDL, and MDA levels, as well as a signifcant increase in superoxide dismutase, catalase, glutathione peroxidase, and HDL levels. Conclusions This study confrmed that Ximenia americana and Pappea capensis extracts have the potential to prevent myocardial infarction in rats. Generally, P. capensis extract showed better activity as compared to X. americana extract. The efects of the extracts could be attributable to the presence of various cardioactive phytocompounds. Therefore, these plants can be considered in the development of potent and safe cardiopreventive drugs.
The Impact of HIV/AIDS Treatment and Counseling on the Prevalence of Tuberculosis and Malaria Co Infections
(International Journal of Mathematical, 2023-01-14) Mark O. Okongo,Murwayi A. Lunani, Bathsheba K. Menge ,Jimrise O. Ochwach
HIV/AIDS remains one of the leading causes of death in the world with its effects most devastating in Sub Saharan Africa due to its dual infection with opportunistic infections especially malaria and tuberculosis. An investigation of the prevalence level of Tuberculosis (TB) and malaria in the absence of any intervention strategy (treatment and counseling) for HIV/AIDS individuals when RM and RT is less than unity showed that the prevalence level of the two diseases rise with time. This unexpected rise in prevalence when RM < 1 and RT < 1 is due to the presence of HIV/AIDS. Administration of treatment and counseling forthe HIV/AIDS individuals at this lower levels of the reproduction numbers of TB and malaria, reduces the prevalence levels of TB and malaria. The study further observed that when the reproduction number of TB and malaria is greater than unity, then counseling and treatment for the HIV/AIDS individuals is more effective in reducing the prevalence level of TB and malaria in the population both at the initial stages of the administration of the strategies and in the long run.
Knowledge and Attitude of Nurse-Midwives Regarding Maternal Health Care Quality Standards in Two Regional Teaching and Referral Hospitals in Kenya
(Scientific Research Publishing Inc., 2022-09-08) Impwii, Domisiano Koome; Kivuti-Bitok, Lucy; Karani, Anna
Introduction: Maternal mortality remains a major health concern in Sub- Saharan Africa and Kenya in particular. Providing quality maternal health care has the potential of preventing over 75% of maternal deaths. The quality of maternal health care requires the utilization of maternal health care quality standards. Objectives: The objective of this study was to determine the nurse-midwives knowledge and attitude toward the use of maternal health care quality standards. Methodology: This study was a descriptive cross-sectional survey carried out at Embu and Meru teaching and referral hospitals in Kenya, between August and December 2021. Eighty-five nurse-midwives working in the maternity unit participated in the study. Data was collected using a self-administered semi-structured questionnaire and analyzed using SPSS version 27.0. Pearson’s correlation coefficient and Chi-square at Alpha level of 0.05 were used to test the relationship between the variables which were the nurse-midwives knowledge, attitude, and use of the quality stan- dards. Result: Most (84.7%, n = 72) nurse-midwives were female and 44.7% (n = 38) were aged 20 - 29 years. Majority (64.7%, n = 55) were diploma holders and almost half (44.7%, n = 38) had practiced for 1 - 9 years. The av- erage score for knowledge was 5.0 with 69.4% (n = 59) having a score of <7. Most nurse midwives (88.2%, n = 75) supported the use of the standards even though only 67.1% (n = 57) indicated that they use them. The support for the standards is significantly related to the gender of the respondents and their duration in maternity. There was no significant association between know- ledge and use of maternal health care quality standards (X2 = 0.433, r = −0.085). There is no association between support for the standards and their use (X2 = 0.008). Knowledge and attitude toward the maternal health care quality standards are not significantly associated (X2 = 0.156). Conclusion: The knowledge and attitude of the nurse-midwife neither influence each oth- er nor do they influence the use of maternal health care quality standards.
Essential Maternal and Newborn Care Skills Training for Midwives: Their Impact on Reducing Maternal and Neonatal Mortalities in Kenya
(Science Publishing Group, 2016-01-27) Gitonga, Lucy
Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning. Little is known about how CPD participants put the experience and the new knowledge into practice and whether it has impact on patient care outcomes. The primary objective of this study was to evaluate the effectiveness of CPD of Midwives on Essential Maternal and Newborn care skills on maternal and neonatal mortality in Embu County, Kenya. The study was an interventional non-randomized pretest post test study design of midwives from the participants of the 2010 ministry of health training on essential maternal and newborn care skills. Sixty (60) midwives working in maternity unit of Embu level five hospitals were targeted. The study was carried out in two phases. Phase one involved environmental scanning of the factors that support good performance in the workplace using a questionnaire. Phase two involved evaluation of the impact by testing a hypotheses using data collected by use of questionnaires, evaluation checklist and chart audit. Data were analyzed using qualitative content analysis and presented using percentages and frequency tables. Chi-square test and correlation analysis were used to show the association between variables, which are midwives essential maternal and newborn care skills and maternal and neonatal mortality. A chi-square χ2 = 14.143, df = 9 and a coefficient = 0.357. This coefficient is less than p-value at Alpha 0.05 and therefore is not significant, proving that the essential maternal and neonatal care skills do not contribute to reduction in mortalities as such two variables are almost independent of each other, whether one exists does not necessitate the existence of another nor does it reduce maternal and neonatal mortalities in Kenya.
Factors Hindering Formal and Informal Nursing Mentorship Programs in Kenyan Public Universities
(Science Publishing Group, 2016-03-31) Oluchina, Sherry; Gitonga, Lucy K.
Introdruction: Mentorship was a one to one reciprocal relationship between a more experienced and knowledgeable mentor and a less experienced mentee. Objective: The study aim was to evaluate barriers of formal and informal nursing mentorship programs in Kenya public universities. Methods: The study utilized a cross-sectional study design. It used both qualitative and quantitative methods in data collection where 305 mentees and mentors participated. Simple random, purposive and snowball non probability samplings were used to select participants. Exploratory and thematic content analyses were done. Results: Barriers encountered were work overload, lack of recognition of mentors, roles of mentors and mentees not clear, lack of support from mentors and institutions, unavailability of mentors, unfit mentor-mentee ratio, inappropriate mentor-mentee matching, unfit personality traits and inadequate time. Recommendations: The study therefore recommended that, all the stakeholders should be encouraged to evaluate nursing mentorship programs in institutions’ of higher learning.
Contraceptive Knowledge among Men and its Influence on their Participation in their Partner’s Modern Contraceptive use in Dallas Sub-location, Embu County, Kenya
(International Journal of Health Sciences and Research, 2023-08) Ndunge Koome, Agnes; Prof. K. Gitonga, Lucy; Dr. Kiongo, Josphat
Background: Maternal morbidity and mortality is a global health concern. Use of modern contraceptive has the potential of reducing maternal mortality by two thirds. However, the prevalence of modern contraceptives is low especially in sub–Saharan Africa region. Male participation has been promoted as one of the strategies to increase contraceptive prevalence. The objective of the study was to determine the influence of contraceptive knowledge on participation in partner contraceptive use among married or in-union men. Methods: A cross-sectional survey was carried out in Dallas Sub-location of Embu County involving married or in-union men aged 18 to 64 years. Data was corrected using a semi-structured questionnaire developed and administered by the researcher. SPSS version 28.0 was used to analyze data. Descriptive statistics were used to summarize the data whereas Chi-square was used to test relationship at 95% CI. Results: Most participants (37.9%, n=89) were aware of three or more modern contraceptive methods with about three quarter (75.2%, n=155) aware of oral contraceptive pills. A significant relationship was established between the participants contraceptive knowledge and number of children (p=0.021) as well as highest academic qualification (p=0.011). Most participants (86.3%, n=202) indicated that they participated in their partner’s use of modern contraceptives. The correlation between knowledge and men participation was not significant (p=0.674). Conclusion: Men had adequate contraceptive knowledge and high level of participation in their partner’s modern contraceptive use. The level of knowledge did not significantly influence their participation.
Patient Related Factors Influencing Timely Diagnosis of Tuberculosis in Tharaka Nithi County, Kenya
(International Journal of Health Sciences and Research, 2023-10) Linda, B.K.; Gitonga, L. K.; Mukhwana E. S.; M’Kiunga, K. S.
Globally, the control of Tuberculosis (TB) has remained a public health challenge despite numerous prevention and treatment programs. Kenya is ranked among countries with a high TB burden globally and has the highest incidences of all types of tuberculosis compared to other East African Countries. The high prevalence of TB in Kenya been attributed to delays in the diagnosis of TB. The consequence of the delays has been the increased spread of the disease, disease advancement, poor treatment outcomes, and high cost of patient treatment and care the affected populations. The aim of this study was to assess patient related factors influencing timely diagnosis of TB in Tharaka Nithi County. Tharaka Nithi County is among the counties with the highest prevalence of TB in Kenya. The study adopted a descriptive cross-sectional survey study design. A sample of 154 patients randomly selected from three hospitals in Tharaka Nithi County was used. A self-administered questionnaire was used to collect data. The data was analyzed using both descriptive and inferential statistics. Associations between patient related factors and duration of TB before diagnosis was tested using Chi-square. The study findings revealed that most (70.86%) of TB patients had delayed diagnosis. Persistent cough was the major sign that led patients to seek for care, while believe that signs and symptoms would disappear was major reason for delay in seeking treatment and care. Sex, age, marital status, employment, self-medication, stigma, work and smoking history were the patients related factors significantly associated with timely diagnosis of TB (P<0.05). The study recommends promotion of care seeking behavior through raising public awareness on tuberculosis, enhancing active case findings, strengthening community-hospital referral systems, boosting health system partnerships for early detection of TB.
ORIGINAL RESEARCH: MIDWIVES’ KNOWLEDGE AND PRACTICE OF MIDWIFERY-LED CARE MODEL IN EMBU COUNTY, KENYA
(2023) Kirigia, Consolata; Prof Gitonga, Lucy; Dr Mukhwana, Sundays
The midwifery-led care model improves maternal and neonatal health outcomes. For midwives to autonomously utlise a midwifery-led care model, they must know what it entails within available practice guidelines. Little is known about practitioners’ knowledge and practice of this model in Embu County. The study found that there are gaps in knowledge and implementation of midwifery-led care in Embu. We recommend educating midwives about midwiferyled care, and the introduction of this model into the region as a means of strengthening midwifery practice to improve maternal and neonatal health outcomes.
Effectiveness of the Nursing Process Training on its Knowledge Level among Nurses in Selected County Referral Hospitals in Kenya
(International Journal of Health Sciences and Research, 2023-10-10) Gichobi, Beth; Prof. Gitonga, Lucy; Dr. Marwa, Immaculate
Background: Nursing process (NP) is an approach of solving problems systematically that should be utilized by nurses in identification, prevention and treatment of health problems and in promotion of wellness. However, its knowledge among nurses has been reported to be inadequate. Objective: To evaluate effectiveness of a NP training intervention on its knowledge level among nurses. Methods: A randomized controlled trial conducted in three phases: pre-intervention, intervention and post-intervention. Multi-stage cluster sampling technique was employed to get a sample of 60 nurses. Two cohorts of nurses were randomly assigned into experimental (n=30) and control group (n=30) and data was collected using questionnaires. Only the nurses in experimental cohort received training on the NP. Descriptive statistics were used to summarize data and t-test used to compare mean differences of the two groups. Results: In both groups, the participants mean age was 37.2 (±9.3), majority were females (73.3%), married (73.3%), and had diploma qualification (55.0 %). Before the intervention, the mean NP knowledge of the control group (M=17.1, SD=6.1) was higher than that of the intervention group (M=16.4, SD=4.2), t (58) =-0.52, p=0.61. However, after the intervention there was a significant increase in the mean NP knowledge of the intervention group (M=69.9, SD=11.4) compared to the control group (M=51.7, SD=11.3), t (57) =6.2, p<0.001. Conclusion: The NP training intervention had a positive effect on its knowledge level among nurses. Frequent such trainings are recommended to address the existing NP knowledge gaps among nurses.
Socio-cultural determinants of men participation in partner modern contraceptive use in Dallas location, Embu County, Kenya
(International Journal of Contraception, Gynaecology and Obstetrics, 2022-12-27) Ndunge Koome, Agnes; K Gitonga, Lucy; Dr. Kiongo, Josphat
Background: Male participation in partner modern contraceptive use is a viable strategy for improving modern contraceptive prevalence among married women. Increasing the uptake of modern contraceptives has been shown to significantly reduce maternal deaths resulting from unsafe abortions due to unintended pregnancies. In Kenya, the level of management in their partner’s use of modern contraceptives is low. Therefore, it is imperative to establish the factors that influence the participation of men. This study explored the socio-cultural factors that influence married men’s participation in their partners’ contraceptive use in Dallas sub-location, Embu County, Kenya. Methods: A community-based cross-sectional survey was undertaken involving married men aged 18 to 64 years. Data were collected using a semi-structured and interview-administered questionnaire developed by the researchers. Statistical Package for Social Sciences (SPSS) version 28.0 was used to analyze data. Frequencies and percentages were used to summarize study findings. Association between the dependent and independent variables was analyzed using the Chi-square test. P-value of < 0.05 was considered to be statistically significant association between the variables. Study findings were presented in narrative form and by use of tables. Results: The mean age of the participants was 38.8 (SD+9.3). The majority of the participants (82.9%) indicated that their partners were using a modern contraceptive method. Most participants (86.3%) were participating in their partner modern contraceptive use. The main socio-cultural determinants of men participation were the number of children (p<0.01) and cultural attitudes (p<0.01). Conclusion: The level of participation in partner’s modern contraceptive use is high among married men. However, cultural norms continue to hinder their engagement in modern contraceptives. There is a need to develop a programme to educate men on the importance of their involvement in order to dilute the cultural barriers thus enhancing greater participation in their partner’s modern contraceptive use.
Socio-cultural determinants of men participation in partner modern contraceptive use in Dallas location, Embu County, Kenya
(International Journal of Contraception, Gynaecology and Obstetrics, 2022-12-27) Ndunge Koome, Agnes; K Gitonga, Lucy; Dr. Kiongo, Josphat
Background: Male participation in partner modern contraceptive use is a viable strategy for improving modern contraceptive prevalence among married women. Increasing the uptake of modern contraceptives has been shown to significantly reduce maternal deaths resulting from unsafe abortions due to unintended pregnancies. In Kenya, the level of management in their partner’s use of modern contraceptives is low. Therefore, it is imperative to establish the factors that influence the participation of men. This study explored the socio-cultural factors that influence married men’s participation in their partners’ contraceptive use in Dallas sub-location, Embu County, Kenya. Methods: A community-based cross-sectional survey was undertaken involving married men aged 18 to 64 years. Data were collected using a semi-structured and interview-administered questionnaire developed by the researchers. Statistical Package for Social Sciences (SPSS) version 28.0 was used to analyze data. Frequencies and percentages were used to summarize study findings. Association between the dependent and independent variables was analyzed using the Chi-square test. P-value of < 0.05 was considered to be statistically significant association between the variables. Study findings were presented in narrative form and by use of tables. Results: The mean age of the participants was 38.8 (SD+9.3). The majority of the participants (82.9%) indicated that their partners were using a modern contraceptive method. Most participants (86.3%) were participating in their partner modern contraceptive use. The main socio-cultural determinants of men participation were the number of children (p<0.01) and cultural attitudes (p<0.01). Conclusion: The level of participation in partner’s modern contraceptive use is high among married men. However, cultural norms continue to hinder their engagement in modern contraceptives. There is a need to develop a programme to educate men on the importance of their involvement in order to dilute the cultural barriers thus enhancing greater participation in their partner’s modern contraceptive use
Patients’ Perception to Achieving Optimum Nursing Care and Health Outcomes Among Orthopedic Patients at Kerugoya County Referral Hospital, Kirinyaga County, Kenya
(International Journal of Health Sciences and Research, 2023-10) Nyanchama Onchangwa, Teresa; Kawira Gitonga, Lucy; Kiboi Kahanya, Willy
Background: Nursing services are very crucial in the care of orthopedic patients in terms of satisfaction with quality care. Patients’ perception on the optimum nursing care is the view from the point of service delivery to assessment post-delivery. Thus, the study intended to assess patients’ perceptions to achieving optimum nursing care and health outcome in Kerugoya County Referral Hospital (KCRH). Methods: Data was collected prospectively within a period of one month using cross sectional analytical design. Census was utilized to get 70 orthopedic patients and 30 healthcare workers in orthopedic units. Result: About of the participants had a negative perception of the healthcare workers not having adequate time and also not working as a team. Despite this, more than half (54.3%) of the patients had a positive attitude towards the care offered. Overall satisfaction with the services offered (AOR= 7.8, C. I= 1.010-13.995, p-value = 0.039). Conclusion: Patients perceived sub-optimal nursing care of health worker time for their care and health worker teamwork but despite this there was better overall positive attitude on optimum healthcare offered.

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