Department of Nursing
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Item Determinants of uptake of long-acting reversible contraceptives among women of reproductive age attending meru teaching and referral hospital, meru county in Kenya(Chuka University, 2024) Munyiri LilianThe most efficient and reasonably priced forms of birth control are long-acting reversible contraceptives (LARC). In spite of their effectiveness, less than 15% of women globally who are of reproductive age use LARC. In Kenya, just 18% of women who are of reproductive age are using LARC procedures. The frequency in Meru County (11.2%) is much lower than it is nationwide. This study set out to evaluate the variables affecting the uptake of LARC among women who were receiving care at the Meru Teaching and Referral Hospital and were of reproductive age. Analytical crosssectional survey research design was used in the study. Women of reproductive age (WRA) requesting family planning services at Meru Teaching and Referral Hospital in Meru County were the study's target population. Ten key informants were chosen through purposive sampling, and 117 women who were of reproductive age were chosen by systematic random sampling. In order to get quantitative data for this study, the researcher utilized a semi-structured questionnaire that she had created, and to gather qualitative data, she employed a key informant guide. The Embu Teaching and Referral Hospital served as the pretesting site for the research tools. The presentation of qualitative data involved the thematic organization and narrator. The mean, mode, and standard deviation of descriptive statistics were used to assess quantitative data. Chi-square tests were utilized to examine the relationship, at a 95% confidence interval, between the uptake of LARC and variables linked to social culture, health facilityrelated characteristics, and knowledge level. The strength and connection of the factors that were discovered to be significant were tested using regression analysis. According to the study, the uptake rate for LARC among women who were of reproductive age was 11.2%. The factors that affected this rate were as follows: a good level of knowledge, which influenced LARC uptake at x2(N=170), 5.16, p=.018, the timeliness of service provision at x2(N=170), 15.62, p<.001, and distance to the health facility at x2(N=170), 10.84, p<.001. The spacing of children at x2(N=170), 20.51, p<.001, and who decides to seek family planning services at x2(N=170), 6.32, p=.012, were the main social and cultural determinants that affected LARC uptake. The study also generated three themes which are, high cost of LARC services, inadequate staff who have been trained on insertion and removal of LARC and inadequate supplies required for service provision The study came to the conclusion that LARC uptake among women of reproductive age was impacted by both individual and health facility characteristics. The study makes several recommendations, the ministry of health to launch widespread campaigns to raise awareness and knowledge about LARC among women of reproductive age, that health facilities should enhance the promptness with which they provide services, particularly family planning services, and that they should support women's autonomy in choosing when to seek family planning services. Further research should be carried out to explore on health care provider characteristics that influence uptake of LARC.Item Determinants of teenage pregnancies in Tigania central sub-county, meru county, Kenya(Chuka University, 2024) Lintari Mwirabua StanleyTeenage pregnancy has harmful consequences on the health and wellbeing of adolescent girls. It can lead to severe complications during delivery which can result into their own morbidity and mortality and that of their infants. Though a high prevalence of teenage pregnancies was noted in Tigania Central Sub-County in Meru County, the factors behind this trend were unclear. Consequently, this study assessed the determinants of teenage pregnancies in Tigania Central Sub-County, Meru County, Kenya. The study evaluated the sociodemographic, socioeconomic and cultural factors associated with teenage pregnancies in the sub-county. This study utilized an analytical cross-sectional study design. An aggregate of 161 teenage girls and nine community health promoters (CHPs) from Tigania Central Sub-County, Meru County constituted the study sample. The teenage girls were recruited using cluster and simple random sampling methods while the CHPs were selected using purposive sampling method. The teenage girls responded to a researcher-administered structured questionnaire while the CHPs responded to an interview guide. The questionnaire was pretested among 12 teenage girls whereas the interview guide was pretested among one CHP at Amwathi in Igembe North, Meru County. The study’s quantitative data were analyzed using descriptive measures that included percentages and frequencies. The data was further subjected to bivariable logistic regression analysis to establish associations between the study variables. In addition, odds ratios were used to determine the likelihood of the independent variables influencing the dependent variable. Quantitative data analysis was performed using the Statistical Package for Social Science version 28 with the results presented in tables, charts and graphs. Qualitative data was analyzed using thematic analysis with findings reported verbatim. Ethical principles of study approval, participants’ consent, voluntary participation, confidentiality and anonymity in data handling and reporting were observed. A total of 142 teenage girls and 7 CHPs took part in the study. Most (56.3%, n = 80) of the teenage girls indicated that they had ever been pregnant. Early menarche (β = -1.615, p = 0.000, OR = 5.03), initiation to sex at an early age (β = -1.264, p = 0.011, OR = 3.54), poor awareness of contraceptives (β = -1.202, p = 0.015, OR = 3.33) and low use of contraceptives (β = -0.938, p = 0.016, OR = 2.56) were the sociodemographic factors found to be associated with teenage pregnancies in the sub-county. Teenage girls’ poor education background (β = -1.024, p = 0.003, OR = 2.78), their parents’ lack of an income source (β = 1.366, p = 0.000, OR = 3.92), living with non-parents (β = 1.093, p = 0.002, OR = 1.66) and being exposed to work labour at an early age (β = -2.774, p = 0.000, OR = 16.03) were the socioeconomic factors found to be associated with teenage pregnancies in the subcounty. Early marriages (β = 2.587, p = 0.000, OR = 13.29), adverse peer influence (β = 1.381, p = 0.013, OR = 3.98), exposure to sexual abuse or violence (β = 1.327, p = 0.001, OR = 3.77) and involvement in cultural initiation ceremonies (β = 0.824, p = 0.017, OR = 2.28) were the cultural factors found to be associated with teenage pregnancies in the sub-county. The study concludes that a wide range of sociodemographic, socioeconomic and cultural factors led to teenage pregnancies in Tigania Central Sub-County. The study recommends that teenage girls should be educated on the dangers and repercussions of teenage pregnancy and should be counselled against engaging in irresponsible sexual conduct. On policy, authorities should take firm legal actions against perpetrators of teenage pregnancies. Further research on the effects and outcomes of teenage pregnancies in the sub-county would equally be informative.Item Adherence to focused antenatal care guidelines among nurses and midwives working in selected hospitals in Imenti South sub-county, Meru county, Kenya(Chuka University, 2024) Mwiti Glory KanyiriFocused antenatal care is essential to improving neonatal and maternal health by preventing, identifying, and treating medical conditions that endanger a pregnant woman’s health besides a fetus. Maternal mortality ratio and morbidity remain and one of the strategies to reduce maternal mortality ratio is the effective implementation of focused antenatal care. This study aimed to determine nurses’ and midwives’ adherence to focused antenatal care guidelines among nurses and midwives working in selected public health facilities in the Imenti-South Sub-County, Meru County. The study adopted an analytical cross-sectional research design. It involved all 55 nurses and midwives working at the antenatal clinic in the level 4 hospitals, level 3, and level 2. Ethical clearance was obtained from the Chuka University Institutional Ethics Committee. Permit to collect data was obtained from the NACOSTI, the County director of medical services, Meru County, Imenti South health coordinator, and an informed consent signed by the respondents. Data was collected using an observational checklist and a researcher-administered questionnaire. Data was cleaned, coded, and entered in the Statistical Package of Social Sciences (SPSS) (V.27) for analysis. Descriptive statistics like mean, frequencies, median, percentages, and range were used to summarize, data was presented in tables and graphs. A chi-square test was used to show the relationship between sociodemographic characteristics and adherence to focused antenatal care guidelines. Regression analysis was used to determine predictors of adherence. The mean age of the participants was 35.91 ±10.92 SD with more than half being less than 36 years (56.4%). The majority were females (60%). About threequarters had a diploma in nursing. Average years of experience was 10.45 ±10.05 SD while working in the ANC department was 3.89 ±3.71 SD. The majority of the facilities were level II (60%). More than half of the nurse-midwives had no in-service training on FANC (72.7%). Most nurse-midwives had poor knowledge of FANC guidelines (67.3%). More than half of the facilities had adequate resources to offer ANC services (58.2%). There were slightly more participants with good adherence to FANC guidelines (50.9%) than those with poor adherence (49.1%). Adherence was significantly associated with the level of the facility. There was no significant association between adherence and knowledge level of FANC guidelines (p>0.05). However, there was a significant association between adherence and availability of resources (p= 0.012, COR= 4.364; CI = 95% 1.383,13.772). Nurse-midwives have poor knowledge of FANC guidelines. The percentage of nurse-midwives with good and poor adherence to FANC guidelines was almost equal. Adherence to FANC guidelines is significantly associated with the availability of resources. There is a need to train the nurse-midwives on the current FANC guidelines as well as provide continuous monitoring and evaluation to enhance adherence. The county government in collaboration with the national government should ensure there are adequate ANC services resources in the facilities. An interventional study should be carried out to determine if the in-service training for the nurse-midwives will improve their knowledge of FANC guidelines.Item PUHE 473: HUMAN POPULATION DYNAMICS AND HEALTH(Chuka University, 2024-12-19) Chuka UniversityItem PUHE 371: BEHAVIORAL SCIENCE(Chuka University, 2024-12-19) Chuka UniversityItem PUHE 251: ANATOMY AND PHYSIOLOGY OF FOOD ANIMALS(Chuka University, 2024-12-19) Chuka UniversityItem PUHE 241/PUHU 141: COMMUNITY HEALTH I(Chuka University, 2024-12-19) Chuka UniversityItem PUHE 241/PUHU 141: COMMUNITY HEALTH I(Chuka University, 2024-12-19) Chuka UniversityItem NURU 132/HRIM 131: MEDICAL SOCIOLOGY AND ANTHROPOLOGY(Chuka University, 2024-12-19) Chuka UniversityItem NURU 123: CLINICAL CHEMISTRY(Chuka University, 2024-12-19) Chuka UniversityItem NURS 279: PRIMARY HEALTH CARE(Chuka University, 2024-12-19) Chuka UniversityItem NURS 273: COMMUNITY HEALTH II(Chuka University, 2024-12-19) Chuka UniversityItem NURS 224: HUMAN PATHOLOGY II(Chuka University, 2024-12-19) Chuka UniversityItem NURS 192: HEALTH ASSESSMENT(Chuka University, 2024-12-19) Chuka UniversityItem NUMS 848: DERMATOLOGY NURSING(Chuka University, 2024-12-19) Chuka UniversityItem NUMS 846: NEUROLOGY AND NEUROSURGICAL NURSING(Chuka University, 2024-12-19) Chuka UniversityItem NUMS 846: NEUROLOGY AND NEUROSURGICAL NURSING(Chuka University, 2024-12-19) Chuka UniversityItem HRIM 251: MEDICAL DATA CLASSIFICATION(Chuka University, 2024-12-19) Chuka UniversityItem HNDS 371: NUTRITION EPIDEMIOLOGY(Chuka University, 2024-12-19) Chuka UniversityItem HNDS 423: FOOD AND NUTRITION SECURITY(Chuka University, 2024-12-16) Chuka University