http://ir.mu.ac.ke:8080/jspui/handle/123456789/3856 2026-04-20T09:04:37Z 2026-04-20T09:04:37Z Adjagba, Alex Olateju Oguta, James Odhiambo Akoth, Catherine Toweet, Solomon Kimutai Okoth, Peter Jackson, Debra http://ir.mu.ac.ke:8080/jspui/handle/123456789/9907 2025-09-03T08:07:58Z 2025-01-01T00:00:00Z

Title: Sustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot Authors: Adjagba, Alex Olateju; Oguta, James Odhiambo; Akoth, Catherine; Toweet, Solomon Kimutai; Okoth, Peter; Jackson, Debra Abstract: Background Effective public financial management (PFM) is a foundational enabler of sustainable progress toward Universal Health Coverage (UHC). Achieving UHC requires not only increased funding for the health sector but also the efficient, equitable, and accountable use of resources. In 2019, Kenya piloted a UHC initiative across four counties to generate evidence to inform national scale-up. This study examines the PFM processes underpinning the pilot implementation, with a focus on how financial planning, budget execution, and accountability mechanisms influenced the delivery of UHC interventions at the county level. Methods This study employed a qualitative research design to explore PFM processes during the implementation of Kenya’s UHC pilot in four counties. Data were collected through 51 in-depth interviews and five focus group discussions with key stakeholders, including healthcare workers, patient representatives, and senior members of the County Health Management Teams (CHMTs). An inductive thematic analysis approach was employed to identify patterns and themes that emerged from the data. The analysis was facilitated using Dedoose software (Version 9.0.17), which enabled systematic coding and organization of the qualitative data. Results The UHC pilot program in Kenya featured a hybrid planning model, combining top-down directives from the national government with bottom-up inputs from county stakeholders. Despite this collaborative approach, county budgeting processes remained governed by the stipulations of the PFM Act. While counties welcomed additional UHC funds, the removal of user fees led to reduced facility-level revenue, increased service demand, and strain on human and material resources. Delays in fund disbursement, rigid budget structures, and limited financial autonomy further constrained implementation. These experiences underscore the need for a more coherent integration of PFM and health financing policies at the subnational level to ensure sustainable and equitable health service delivery. Conclusion The UHC pilot offers critical lessons for future health financing reforms. Addressing PFM bottlenecks—particularly those related to timely disbursement, budget flexibility, and local revenue generation—is essential to ensure the sustainability of UHC in Kenya and similar contexts. The study’s limitations necessitate further research before scaling up nationwide.

2025-01-01T00:00:00Z Zuniga, Julie Mungai, Margaret Chism, Lucy Frost, Livia Kakkar, Reha Kyololo, O’Brien http://ir.mu.ac.ke:8080/jspui/handle/123456789/9016 2024-04-22T07:05:59Z 2024-01-01T00:00:00Z

Title: Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review Authors: Zuniga, Julie; Mungai, Margaret; Chism, Lucy; Frost, Livia; Kakkar, Reha; Kyololo, O’Brien Abstract: Background The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies. Purpose Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA. Methods This systematic review of the literature used, PRISMA to guide the search. Findings The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces. Discussion There were gaps in the interventions that have been proven successful in other global settings. Conclusion In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.

2024-01-01T00:00:00Z Yadufashije, Callixte Muhimpundu, Liliane Mwanzia, Lydia Sangano, Georges Bahati http://ir.mu.ac.ke:8080/jspui/handle/123456789/8320 2023-11-08T07:54:04Z 2021-10-26T00:00:00Z

Title: Corona virus disease 2019 pandemic contributed to pregnancy devastating outcomes in low income countries Authors: Yadufashije, Callixte; Muhimpundu, Liliane; Mwanzia, Lydia; Sangano, Georges Bahati Abstract: Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments should develop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.

2021-10-26T00:00:00Z Rent, Sharla Bauserman, Melissa Laktabai, Jeremiah Tshefu, Antoinette K. Taylor, Steve M. http://ir.mu.ac.ke:8080/jspui/handle/123456789/8154 2023-10-17T06:02:17Z 2023-01-01T00:00:00Z

Title: Malaria in Pregnancy: Key Points for the Neonatologist Authors: Rent, Sharla; Bauserman, Melissa; Laktabai, Jeremiah; Tshefu, Antoinette K.; Taylor, Steve M. Abstract: In malaria-endemic regions, infection with the malaria parasite Plasmodium during pregnancy has been identified as a key modifiable factor in preterm birth, the delivery of low-birthweight infants, and stillbirth. Compared with their nonpregnant peers, pregnant persons are at higher risk for malaria infection. Malaria infection can occur at any time during pregnancy, with negative effects for the pregnant person and the fetus, depending on the trimester in which the infection is contracted. Pregnant patients who are younger, in their first or second pregnancy, and those coinfected with human immunodeficiency virus are at increased risk for malaria. Common infection prevention measures during pregnancy include the use of insecticide-treated bed nets and the use of intermittent preventive treatment with monthly doses of antimalarials, beginning in the second trimester in pregnant patients in endemic areas. In all trimesters, artemisinin-combination therapies are the first-line treatment for uncomplicated falciparum malaria, similar to treatment in nonpregnant adults. The World Health Organization recently revised its recommendations, now listing the specific medication artemether-lumefantrine as first-line treatment for uncomplicated malaria in the first trimester. While strong prevention and detection methods exist, use of these techniques remains below global targets. Ongoing work on approaches to treatment and prevention of malaria during pregnancy remains at the forefront of global maternal child health research.

2023-01-01T00:00:00Z