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Determinants of cervical cancer screening among women of reproductive age in Bomachoge Chache Sub County, Kisii County

2025-02-07T07:23:58Z

Title: Determinants of cervical cancer screening among women of reproductive age in Bomachoge Chache Sub County, Kisii County Authors: Osoro, Benson Sibota Abstract: Introduction: cervical cancer, the second most prevalent cancer after breast cancer in Kenya but the leading cause of cancer deaths, has had an increasing incidence. Between 2020 and 2021 the prevalence stood at 28.7% with a mortality rate of 50% of the cases diagnosed in 2020. In spite of the possible prevention with early detection through screening, only 4% of reproductive age women in Kisii Sub-County were screened for cervical cancer in the year 2017 against the national target of 75%. Objectives: to examine the determinants of cervical cancer screening among women of reproductive age in Bomachoge Chache Sub County, Kisii County, Kenya. Methods: the study utilized mixed methods applying convergent parallel design. A total of 394 participants from seven health facilities were selected for the study through stratified random sampling. Quantitative data was gathered using questionnaires while qualitative data was obtained via focused group discussions. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27. Chi-square test was used to determine predictors of cervical cancer screening prevalence and bivariate regression analysis determined the association between determinants of cervical cancer screening and screening practices. A p-value of less than 0.05 (typically ≤ 0.05) was considered statistically significant. Qualitative data was analyzed thematically. Data was presented in tables and pie charts,k and narratives for qualitative data. Results: 206 (57.5%) of the participants were aged between 16 to 19 years, 190 (53%) were married with over 67% of them having at least secondary school education. Notably, although 248(69.2%) of the participants were aware of cervical cancer only 104 (41.9%) were screened. Cervical cancer screening was positively associated with feeling of being at risk of cervical cancer (p <.0001), not being afraid of screening procedures (p <.0001), preference of being attended by a female (p <.0001), a distance of <1km from the nearest screening center (p < .0007). Participants perceived cervical cancer to be caused by witchcraft, curses and sexual immorality. They also had misconceptions such as prayers being a cure to cervical cancer. Further, delay in service delivery was attributed to shortage of health care professionals and inadequate hospital infrastructure. Conclusions: study participants were aware of cervical cancer, risk factors, and warning signs. Screening practices were positively associated with knowledge on cervical cancer, source and monthly income and level of education. Participants perceived that they were not at risk of cervical cancer and believed that witchcraft and sexual immorality were causes of cervical cancer and prayers perceived as the cure.

Assessment of the referral process for emergency obstetric care in basic facilities in Bungoma County, Kenya

2025-02-07T07:13:34Z

Title: Assessment of the referral process for emergency obstetric care in basic facilities in Bungoma County, Kenya Authors: Nekesa, Jacquelyne Wamalwa Abstract: Background: Emergency Obstetric Care (EmOC) refers to a package of essential healthcare services that should be available to all women during pregnancy, labour and after birth. Women who develop obstetric complications should access timely and appropriate care, including referral so as to prevent pregnancy-related morbidities and mortalities, which has largely been attributed to delays and poor management in the healthcare referral system. The World Health Organization highlights that any inability in the referral system to securely transport pregnant women to an appropriate level of care with competent personnel when complications arise can have adverse effects on maternal and fetal outcomes. Objectives: The study objectives included: to determine the influence of communication and transport on the emergency obstetric referral process; to assess the perceived competence on the use of emergency obstetric signal functions among healthcare workers; to determine the availability of supplies and equipment in the provision of EmOC; and to assess client satisfaction with obstetric emergency referral care from level 3 and 4 facilities in Bungoma County. Methods: A cross-sectional design was adopted. The study was conducted in Bungoma County from August 2022 to December 2022. Multistage sampling was used, comprising of stratified random sampling (for levels of healthcare - levels 3 and 4 facilities) and simple random sampling (for healthcare workers and women participants). The study participants included healthcare workers (n=161) in Level 3 and 4 obstetric units, and women (n=379) with obstetric emergencies referred from these facilities. Data was collected using questionnaires and observation checklist. Data was analyzed using descriptive statistics, including measures of central tendency and inferential statistics as applicable, and presented in summary tables. Results: Effective communication and transport was strongly associated with quality EmOC during referral process (linear regression coefficient, T=3.24, p=0.001); healthcare workers' perceived competence on the use of signal functions was statistically associated with the provision of quality EmOC (linear regression coefficient, T=7.15, p=0.003); the availability of supplies and equipment was also strongly associated with the quality of EmOC services (Chi-square value=240.05, p=0.002); Clients’ overall satisfaction with the referral process had a significant relationship with the quality of EmOC services (logistic coefficient value=0.088, p=0.002). Overall, the findings were statistically significant, highlighting a significant association between the study variables and the quality of EmOC services during obstetric referral process. Conclusion: Effective communication and transport, healthcare workers’ perceived competence on EmOC signal functions, and the availability of supplies and equipment have a direct influence on the referral process of emergency obstetric care, and the overall client satisfaction. Clients’ (women) satisfaction was positively associated with Quality EmOC services during referral process. Recommendations: The study recommends that the county ensures effective communication and transport mechanisms and constant availability of supplies and functional equipment for obstetric referrals; ensure regular support supervision and continuous professional development to enhance HCWs competence on EmOC signal functions; and to improve the overall emergency obstetric referral care in basic facilities so as to meet clients’ expectations/satisfaction. A qualitative study is also warranted to provide in-depth understanding of clients’ experiences and/or salient issues on satisfaction.

Education model for building health care capacity in protracted refugee contexts : policy brief

2023-09-21T06:27:55Z

Title: Education model for building health care capacity in protracted refugee contexts : policy brief Authors: Pilkington, F. Beryl; Mbai, Isabella; Judith, Mangeni; Abuelaish, Izzeldin Abstract: Reliance on humanitarian NGOs for health care in protracted displacement situations like Dadaab is not sustainable. Refugees need to be equipped to play a greater role in providing primary health care for their communities. Findings of project research clearly indicated overwhelming support for the development of a health-related degree, with most prospective students and community health workers expressing interest in taking the degree. As a result, a BSc degree in Community Health Education has been developed and ready for implementation. This policy brief highlights the importance of developing education models aimed at addressing health and higher education equity issues in protracted refugee situations.

Comparison of nutritional status between breastfed and replacement fed infants born to HIV infected mothers in Nairobi

2023-09-20T07:11:07Z

Title: Comparison of nutritional status between breastfed and replacement fed infants born to HIV infected mothers in Nairobi Authors: Nyaga, Emily E. Abstract: Infants born to HIV infected mothers may be at a higher risk of altered nutritional status secondary to feeding practices. Exclusive replacement feeding (ERF) is costly and poor mothers in the society may not adhere to guidelines on replacement feeding for example over diluting the formula milk and inappropriate cleaning of utensils among others. The recommended exclusive breastfeeding (EBF) practice has challenges based on cultural beliefs and practices related to infant feeding in Kenya. The overall objective of the study was to compare nutritional status of breastfed and replacement fed infants born to Human Immunodeficiency Virus (HIV) infected mothers in Nairobi. This was a cross-sectional study conducted in Nairobi North District in four City Council health centers (Kariobangi, Baba Dogo, Mathare North and Kasarani). Study subjects were a dyad of HIV infected mother and her child selected using random sampling. A sample size of 110 was targeted distributed in the selected facilities proportionately. The study tool was a questionnaire. A salter scale was used to weigh the children and a height board (stadiometer) was used to measure the length. Data was analyzed using statistical analysis (stata) software and Epi info™ for anthropometric data analysis. There was a significant difference (p=0.02) in mean weight for age Z scores between EBF and ERF infants. The study findings show a positive correlation between ERF and negative growth gradients (p=0.037), wasting (p=O.OI9), higher family income (p=0.025). Formula milk over dilution also had a positive correlation with underweight (p=0.035). There was also a positive correlation between abnormal growth gradients and ERF (p=0.03), respiratory infections (p=0.013), past gastrointestinal problems (p=0.023) while underweight was positively correlated with respiratory infection (p=0.02l)and past gastrointestinal problems (p=0.47). A multivariate logistic regression analysis revealed an association between wasting and mode of infant feeding (p=0.014) and also with abnormal growth gradient (p=0.043). There was also significant association between stunting and mode of infant feeding (p=0.003) while abnormal growth gradients were significantly associated with the age of the infant (p=0.002) with older infants tending to have experienced abnormal growth gradients. EBF infants had better nutrition status compared to ERF infants. HIV infected women should be counseled on exclusive breastfeeding for the first six months of life unless replacement feeding is acceptable, affordable, sustainable and safe for infants before this time. The study duration was eight months.