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Assessment of the Midwives Knowledge on Utilization of Partograph in Management of Labour in Public Health Facilities in Tharaka Nithi County
(International Journal of Health Sciences and Research, 2021-12) Mwari, P.S.; Gitonga, L.K.; Mukhwana, E.S.
The World Health Organization (WHO) has recommended Partograph as a labor management tool due to its impact in reducing obstetric labor complications and maternal deaths over the years. This labor management tool is inexpensive and appropriate for use in low-resource settings, particularly in developing countries. Despite the fact that many African countries, including Ethiopia, Kenya, and Nigeria, have adopted the Partograph in labor management, there is little information on midwives' knowledge on the use of the tool in labor management. Understanding of how to use a Partograph is essential for reducing complications and maternal deaths. The purpose of this study was to determine midwives' knowledge on using the Partograph in labor management. The study adopted a cross sectional survey design. 45 midwives were randomly selected from 16 public health facilities in Tharaka Nithi County. Questionnaires were used to collect data. Focused Group Discussions were also conducted with 77 postnatal mothers who gave birth in the 16 health facilities. The collected data was analyzed using descriptive statistics (means, frequencies, and percentages) and Chi-Square tests. Thematic analysis was used to examine qualitative data. Results showed that 74% of midwives had used Partograph in labor monitoring, while 26% had never used the tool. 60% of the midwives had received Partograph training. Despite not having been trained, some midwives were using the Partograph. Findings revealed inconsistencies in the use of Partograph in labor management. A large proportion of midwives deviated from the WHO's recommended use of Partograph in the first stage of labor. The study recommended that the Tharaka Nithi County government, through the Ministry of Health, invest in Partograph utilization in-service training programs to provide nurses and midwives working in the maternity wing the necessary knowledge and skills for proper Partograph utilization. There is also a need for policy changes in institutions to ensure that nurses use of the Partograph as a strategy for reducing maternal mortality rates, improving motherhood, and labor management in the County
Assessment, Training and Evaluation of Emergency Obstetric and Neonatal Care Competences for Midwives in Tharaka-Nithi and Embu Counties, Kenya.
(Science Publishing Group, 2016) Gitonga, Lucy Kawira Gitonga
Abstract: Midwifery education in many countries currently follows a didactic curricular model where students learn through classroom lecture with little opportunity for skills practice, simulation and role play needed to develop critical thinking, values and the clinical decision making abilities needed for effective practice. Many midwifery students graduate having attended a limited number of women in labour and some with minimal clinical experience in antepartum, family planning or newborn care. In addition, the assessment of student progress and readiness for practice may not be linked to the intended outcomes of learning and targeted clinical competencies. The aim of the study was to assess, train and evaluate training in "Emergency Obstetric and Newborn Care" for midwives in order to improve the availability of emergency obstetric and Newborn care (EmONC) in Embu and Meru hospitals, Kenya. A three phase explorative study was used involving assessment, training and evaluation of 113 midwives from the maternity units of two hospitals I Kenya. Data was collected by use of a questionnaire, case study and checklist. Data was analysed using SPSS 2.0. Correlational analysis was also used. The results indicated that respondents on assessment of antenatal skills scored an average of 95.2% while on normal labor, childbirth and immediate newborn care skills they scored an average of 89.63% on postpartum care (mother and baby) an average of 87.92%, on management of complications they scored a mean of 88.22%. Based on the findings, CPD in EmONC should be provided to all midwives at all levels of health care delivery in the country including incorporating such activities in the induction programmes for midwives.
Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device Uptake among Mothers Delivering at Meru Hospital
(Scientific Research Publishing Inc, 2019-03-04) Kirigia, Consolata; Gitonga, Lucy; Muraya, Moses Maugu
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 immediate 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 hours after delivery. The objective was to assess Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers delivering in Meru Hospital. Descriptive research design was used and a population of 289 mothers was targeted. Sample size of 74 respondents was selected using simple random sampling. Questionnaires and interview schedules 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 used to test the relationship of study variables and presented in tables. The qualitative data were analyzed thematically. The findings revealed that provider related barriers such as none provision of the services and untimely counseling for the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic and reproductive characteristics also played a role in low uptake. Using the 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 methods was a barrier to the uptake. Therefore, barriers to PPIUCD uptake are provider related, alternative methods of contraception and client related such as lack of information, unemployment, young age and low parity. 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.
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.
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.
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.
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.
Determinants of adherence to dietary guidelines among Type 2 Diabetes Mellitus patients at Moi Teaching and Referral Hospital-Kenya
(African Journal of Food, Agriculture, Nutrition and Development, 2021-06-27) Jepkemoi, Gladys; Gichunge, C; Masibo, P.
Diabetes is one of the major non-communicable diseases and an important public health problem not only in Kenya but all over the world. It is estimated that the prevalence of diabetes in Kenya is at 5% among adults. Although the care regimen is complex, patients with good diabetes self-care behaviors can attain excellent glycemic control. It is vital that patients adhere to their stipulated routines to minimize the burden of the disease on the healthcare systems. The objective of this study was to determine the association between socio-economic and demographic factors with adherence to dietary guidelines among Type 2 diabetes mellitus (DM) patients in Moi Teaching and Referral Hospital (MTRH), Eldoret. A cross-sectional study with mixed methods was conducted among 313 Type 2 DM patients at MTRH. Systematic random sampling was used to select the participants, while purposive sampling was used to select 6 key informants and 50 patients who participated in a Focus Group Discussion (FGD). Data were analyzed using descriptive and inferential statistics. Adherence to dietary guidelines was significantly associated with income (p< 0.001) and the frequency of attending clinics (p=0.001). Education levels (p= 0.634), Occupation (p=0.358) and Age (p=0.737) had no significant association with dietary adherence. Better ways should be explored in enhancing adherence to dietary guidelines for Type 2 DM patients with high income levels. The study findings are useful in informing implementation and evaluation of nutrition strategies for the control and management of Type 2 DM. This includes nutrition counseling and education, which would inform decisions leading to optimal quality care and cost-effectiveness in the management of Type 2DM.
Dietary diversity interventions and its impact on iron status of preschool children 36-59 months in Emali, Kenya
(Food Science & Nutrition Research, 2020) Kimiywe, J.O; Lubeka, C.B; Kiboi, W.K
Background: Dietary diversity is considered crucial in ensuring adequate micronutrient intake, especially among children since they have increased nutrient requirements. Iron deficiency is the most common nutrient deficiency in the world and a major public health risk particularly in the developing countries. This study assessed the impact of dietary diversity interventions on iron status of preschool children in Emali Kenya. Methods: A non-randomized pre-post intervention trial involving 495 pre-school children aged 36-59 months in Early Childhood Development (ECD) schools was conducted. Dietary diversity of the children was enhanced by establishing school gardens in the early-childhood education centers and innovative home-gardening techniques in the homes of selected children’s caregivers. Poultry houses for rearing chicken were also constructed at the ECD centers to provide the children with good sources of protein and minerals. Structured nutrition education on appropriate child feeding was also offered to the children’s caregivers. Children were clustered in two communities the Kamba and Maasai to represent the different ecological settings. Results: Dietary diversity score improved significantly in the Kamba community which recorded a high uptake of the dietary diversity intervention programs. Only 9.1% of the children did not meet the minimum acceptable dietary diversity after the intervention from the 48.1% pre-intervention. The intake of iron-rich foods also improved considerably (77.5%) after the intervention with the prevalence of anemia reducing to 3.4%. Prevalence of anemia among the Maasai children remained high (58.3%) due to low intake of iron-rich foods such as green leafy vegetables (34.6%) and meat (21.8%). Conclusion: Anemia is a matter of public health concern among preschool children. Dietary diversity interventions such us; kitchen gardening, nutrition education (enhancement of food nutritional value through better food preparation methods) and implementation of other nutrition-sensitive agriculture interventions can significantly enhance dietary diversity score and iron status of children.
Distinct Patterns of Host Adherence by Neisseria gonorrhoeae Isolated from Experimental Gonorrhea
(Canadian Journal of Infectious Diseases and Medical Microbiology, 2021-05-15) Yingxia, He; Zhang, Song; Zhang, Yingmiao; Bicong, Wu; Xue, Ying; Chenglin, Ye; Qiao, Li; Adhiambo, Njiri Olivia; Tembo, John Mambwe; Hongxiang, Chen; Huahua, Cai; Tie, Chen
Neisseria gonorrhoeae (N. gonorrhoeae, gonococci, or GC), the etiologic agent of gonorrhea, is a human-obligate bacterial pathogen. -e GC surface contains pili that mediate the adherence to host cells. Studies have shown that GC pili, coded by pilin genes, undergo remarkable changes during human experimental gonorrhea, possibly generated by DNA phase variation during infection. -e question that arises is whether the changes in pilins can alter the adherence capacity of N. gonorrhoeae to host cells. In this study, six variants initially isolated from male volunteers infected with one single clone of GC were examined for their adherence patterns with human Chang conjunctiva cells. In this study, we showed that the variants showed distinct adherence patterns to this cell line under light microscopy and scanning electron microscopy. Moreover, two reisolates showed higher adherence capacities than that of the input strain. -e results provide an additional example as to how the pilus variation may play a role in the pathogenesis of N. gonorrhoeae.
Efectiveness of in-service training plus the collaborative improvement strategy on the quality of routine malaria surveillance data: results of a pilot study in Kayunga District, Uganda
(Springer Nature, 2021) Westercamp, Nelli; Staedke, Sarah G.; Maiteki-Sebuguzi, Catherine; Ndyabakira, Alex; Okiring, Michael John; Kigozi, Simon P.; Dorsey, Grant; Broughton, Edward; Hutchinson, Eleanor; Massoud, Rashad M.; Rowe, Alexander K.
Background: Surveillance data are essential for malaria control, but quality is often poor. The aim of the study was to evaluate the efectiveness of the novel combination of training plus an innovative quality improvement method— collaborative improvement (CI)—on the quality of malaria surveillance data in Uganda. Methods: The intervention (training plus CI, or TCI), including brief in-service training and CI, was delivered in 5 health facilities (HFs) in Kayunga District from November 2015 to August 2016. HF teams monitored data quality, con‑ ducted plan-do-study-act cycles to test changes, attended periodic learning sessions, and received CI coaching. An independent evaluation was conducted to assess data completeness, accuracy, and timeliness. Using an interrupted time series design without a separate control group, data were abstracted from 156,707 outpatient department (OPD) records, laboratory registers, and aggregated monthly reports (MR) for 4 time periods: baseline—12 months, TCI scaleup—5 months; CI implementation—9 months; post-intervention—4 months. Monthly OPD register completeness was measured as the proportion of patient records with a malaria diagnosis with: (1) all data felds completed, and (2) all clinically-relevant felds completed. Accuracy was the relative diference between: (1) number of monthly malaria patients reported in OPD register versus MR, and (2) proportion of positive malaria tests reported in the laboratory register versus MR. Data were analysed with segmented linear regression modelling. Results: Data completeness increased substantially following TCI. Compared to baseline, all-feld completeness increased by 60.1%-points (95% confdence interval [CI]: 46.9–73.2%) at mid-point, and clinically-relevant complete‑ ness increased by 61.6%-points (95% CI: 56.6–66.7%). A relative − 57.4%-point (95% confdence interval: − 105.5, − 9.3%) change, indicating an improvement in accuracy of malaria test positivity reporting, but no efect on data accuracy for monthly malaria patients, were observed. Cost per additional malaria patient, for whom complete clinically-relevant data were recorded in the OPD register, was $3.53 (95% confdence interval: $3.03, $4.15). Conclusions: TCI improved malaria surveillance completeness considerably, with limited impact on accuracy. Although these results are promising, the intervention’s efectiveness should be evaluated in more HFs, with longer follow-up, ideally in a randomized trial, before recommending CI for wide-scale use. Keywords: Collaborative improvement, Quality improvement, Malaria, Surveillance, Uganda, Data quality
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.
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.
Essential Maternal and Newborn Care Skills Training for Midwives: Their Impact on Reducing Maternal and Neonatal Mortalities in Kenya
(Scientific Research Publishing, 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.
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.
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
Evaluation of midwives’ and nurses’ continuing professional development in reducing maternal and neonatal mortality in embu county, Kenya.
(Open Journal of Obstetrics and Gynecology 4:249-259, 2014) Gitonga, L.K.; Muriuki, N.S.
Continuing professional development (CPD) is one of the principal means by which health professionals (Nurses and midwives) maintain, improve, and broaden the knowledge and skills required for optimal patient care and safety, to be more specific reduction of maternal and neonatal mortality and morbidity. However, the lack of a widely accepted instrument to assess the impact of CPD activities on clinical practice thwarts researchers’ assessment of the effectiveness of CPD activities. The objective of the study is to develop a theory and practice-based, valid, reliable nation-al instrument to assess the impact of accredited CPD activities on reducing maternal and neonatal mortality in Kenya using an integrated model for the study of healthcare professionals’ behavior through environmental scanning of the factors that promote good performance. The researcher will analyze the instruments identified in a systematic review of factors motivating and demotivating nurses and midwives’ behaviours using criteria that reflect the literature on measurement development of CPD leaders and providers’ priorities. The outcome of this phase will be an inventory of instruments using a competence-based model. Working from this inventory, the most relevant items for assessing the concepts listed will be selected. Then, the researcher will verify whether these items are acceptable or need modification, what aspects need revision, and whether important items are missing and should be added. The outcome of this phase will be a new national instrument integrating the most relevant tools to fit our integrated model of healthcare professionals’ behavior. Two data collections are planned: 1) pretesting of the new instrument, to assess its reliability and validity and 2) a study using the instrument before and after CPD activities with randomly selected groups, one acting as control group to assess measurement effect. The researcher will conduct individual interviews and focus groups with CPD providers and leaders to identify anticipated barriers and enablers for implementing the new instrument in CPD practice. Drawing on the results from the previous phases, we will use consensus-building methods with the decision makers to develop a plan to implement the new instrument.
Factors Affecting Cervical Cancer Screening among Women Below 25 Years in Kithare Area, Tharaka Nithi County, Kenya
(Scientific Research Publishing, 2021) Ngari, Mugambi, D.; Nyamiaka, Machwara, S.; Mukami, Fridah, M.
Cervical cancer is the most common neoplasm among women globally affecting approximately 500,000 women with 275,000 succumbing to the disease every year. The prevalence of cervical cancer is disproportionately high in sub-Saharan Africa where the screening rate is low. The study sought to assess the factors affecting cervical cancer screening among women aged 15 - 25 years in Kithare area Tharaka Nithi County. The study was a descriptive cross-sectional study and interviewer administered questionnaires were used to capture the level of knowledge, individual perspectives, attitude and barriers influencing cervical cancer screening. This study was conducted between August and September 2018 with the sample size being 80 respondents. From the findings a significant number of women had two or more sexual partners. The level of knowledge on cervical cancer was significantly low as (55%, n = 44) were aware about the disease, (45%, n = 36) had the correct knowledge when to seek screening, (40%, n = 32) knew the correct interval for attending screening and only (18.7%, n = 15) had been screened before. Reasons for seeking screening for the 18.7% were to know their health status, due to abnormal discharge or as a result of bleeding. (86.3%, n = 69) believed that screening was helpful with reasons being; for early detection of the disease, to know the health status, to prevent infertility and death. (13.7%, n = 11) believed that screening was not helpful with reasons being; the procedure is uncomfortable, painful, it leads to a low self-esteem, fear of wrong results and the diagnosis of cancer. Barriers citied to cervical cancer screening were; inadequate knowledge, negative attitude towards screening, lack of the screening services and cost of services. The knowledge and practice of cervical cancer screening was inadequate. More education on screening should be provided to reduce the misconceptions involved. Provision of free services and more participation in education and sensitization from the healthcare providers should also be done.
Factors Associated with Household Dietary Diversity among Internally Displaced Persons in Nakwamekwei Camp, Kenya
(Science and Education Publishing, 2021) Gichunge, Catherine; Das, Arpita; Mutiso, Daniel; Jepkemoi, Gladys
The objective of this study was to assess factors associated with household dietary diversity score (HDDS) among internally displaced persons (IDPs) in Nakwamekwei IDP camp. A total of 159 IDPs aged≥18 years were recruited in this cross-sectional survey. Participants were recruited using systematic random sampling. Socio-demographic, anthropometric measurements, food security, HDDS, physical health, mental health and social support data were collected using a researcher administered questionnaire. Logistic regression model was used to examine associations between HDDS with factors known to affect HDDS. More than half of the population (55%) were underweight. About 66% of the IDPs had low HDDS, and 94% were food insecure. The prevalence of anxiety and depression symptoms was 45% and 77% respectively. In adjusted analyses, participants with anxiety [OR 1.16 (95% CI 1.10-1.28)] and depression [OR 2.30 (95% CI 1.55-3.40)] symptoms had significantly low HDDS. Additionally, each unit decrease in physical score was significantly associated with 57% increased risk of low HDDS [OR 1.57 (95% CI 1.15-2.14)] while each unit increase in social support score was significantly associated with 8% higher HDDS [OR 0.92 (95% CI 0.86, 0.97)]. Socio-demographic and lifestyle factors were not significantly associated with HDDS. Participants with high anxiety and depression symptoms as well as low physical score had low HDDS. Interventions that focus on improving the food security and socioeconomic status of the IDPS should be strengthened as this will lead to improvement of the IDPs overall health.
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.

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