Masters Theses

Cohesion as a meaning-making resource in selected Nandi Kass Tv interviews on agriculture In Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Cohesion as a meaning-making resource in selected Nandi Kass Tv interviews on agriculture In Kenya Mutai, Ruth Jerop Effective use of cohesive resources is vital for conveying agricultural knowledge, improving farming practices, and strengthening food security. Although cohesion has been extensively studied in written texts and major global languages, little is known about its use in orally delivered, community-based broadcast discourse in indigenous African languages. The purpose of this study was to examine how cohesive resources operate in Nandi agricultural interviews broadcast on KASS TV. Specifically, the study: Analyzed the cohesive strategies used to construct thematic and interactional meaning; examined their role in shaping meaning in spoken Nandi discourse; and assessed their implications for communication between interviewers and Nandi speaking rural audiences. The study is guided by Halliday and Hasan’s (1976) theory of cohesion, which conceptualizes cohesion as a multi-layered resource for meaning construction. This framework is extended in the current study to include discourse pragmatic and prosodic strategies. Cohesion is realized through lexical, grammatical, and discourse-pragmatic resources, as well as prosodic features such as pause, tempo, and intonation. An interpretive qualitative research design was adopted. Five purposively sampled KASS TV agricultural interviews aired between August 2023 and March 2025 were analyzed. The sample was sufficient for in-depth analysis of linguistic and prosodic features in Nandi broadcast interviews, with thematic saturation achieved when no new cohesive patterns emerged. The data were transcribed using Jefferson conventions, and an inductive analytic approach was used to identify cohesive patterns and their thematic and interactional functions. Findings indicate that lexical and referential cohesion maintain thematic continuity and reinforce key agricultural concepts. Strategic repetition of terms such as keswek ‘breeds’ and chego ‘milk’ sustained topical focus while emphasizing their economic and nutritional significance. Referential variation, including alternation between biikab Kalenjin ‘Kalenjin people’ and kootab Kalenjin ‘Kalenjin community' strengthened shared group identity in food security discussions. Prosodic features such as pause, tempo and intonation further enhanced clarity and emphasized important points. The study concludes that cohesion in spoken Nandi broadcast discourse is multidimensional, emerging through coordinated interaction of verbal and prosodic resources that support collaborative knowledge construction. These findings highlight the communicative value of indigenous Nilotic languages in agricultural broadcasting and rural development. Accordingly, the study recommends that broadcasters and agricultural extension officers deliberately use lexical, grammatical, discourse-pragmatic, and prosodic cohesive resources to maintain thematic focus and reinforce key concepts. It further recommends that pause, tempo, and intonation be intentionally employed to emphasize key points and support interactional meaning. Finally, interviewers and educators should design interactions that utilize these cohesive resources to strengthen audience engagement, comprehension, and effective knowledge transmission.

Adaptive moment estimation of the spatial autoregressive model parameters

Thu, 01 Jan 2026 00:00:00 GMT

Adaptive moment estimation of the spatial autoregressive model parameters Otieno, Michael Oduor; Wagala, Adolphus; Kerich, Gregory Traditionally, estimation of the spatial autoregressive (SAR) model parameters has been done using the maximum likelihood estimation (MLE) technique. Several variants of the MLE technique, such as quasi-MLE (QMLE) and adjusted-QMLE, among others, have also been used. However, in the presence of large data sets, MLE has been found to be computationally costly due to the matrix inversion involved in maximizing the log-likelihood function. The adaptive moment (ADAM) estimation method is a viable alternative. It eliminates the cost of matrix inversion in the widely used MLE method. Moreover, it eliminates the need to store the whole data set since the gradients can be computed from every data point, or a batch of data points sampled from the whole data set. However, ADAM has been developed and widely used for independent data. This study seeks to design ADAM for use in a spatial data setting. ADAM is found to perform better than the standard MLE in large data setting since it has the least values of Akaike Information Criterion and higher values of the McFadden’s R-squared. It also converges faster than MLE and hence is most appropriate for large data sets.

Determinants of utilization of skilled birth attendants in maternal and neonatal health centres of excellence in Kibish Subcounty, Turkana County

Thu, 01 Jan 2026 00:00:00 GMT

Determinants of utilization of skilled birth attendants in maternal and neonatal health centres of excellence in Kibish Subcounty, Turkana County Lopodo, Gabriel Ekal Background: Skilled birth attendance (SBA) is an important intervention for reducing preventable maternal and neonatal morbidity and mortality. It enables timely identification and management of complications during childbirth and referral for advanced care when required. However, utilisation of SBA remains uneven, particularly in remote and underserved settings. In Kenya, SBA was 89% nationally in 2022, compared with 53% in Turkana County. Despite the establishment of Maternal and Newborn Health Centres of Excellence (MNH CoEs) to improve access to quality maternal and newborn services, there is limited evidence on utilisation of SBA in Kibish Sub-County. This study therefore assessed utilisation of SBA and factors influencing its utilisation among women of reproductive age in MNH CoEs in Kibish Sub-County, Turkana County. Objectives: The broad objective of the study was to assess the determinants influencing the utilisation of SBA among women of reproductive age in MNH CoEs in Kibish Sub-County, Turkana County. The specific objectives were to assess socio-demographic characteristics associated with utilisation of SBA; to assess obstetric factors associated with utilisation of SBA; to determine the influence of health facility accessibility on utilisation of SBA; and to explore perceived cultural factors influencing utilisation of SBA among women of reproductive age in MNH CoEs. Methods: The study employed a cross-sectional mixed-methods design using a convergent parallel approach. The study involved 369 participants aged 15–49 years who had at least one delivery in the preceding two years and had lived in Kibish Sub-County for at least two years before the study. Quantitative data were collected through structured questionnaires, and qualitative data were collected through eight FGDs conducted in each of the catchment villages and four KIIs involving County and Sub-County RH coordinators and in-charges of the two health facilities. Quantitative data were entered into SPSS v20 and analysed using statistical tests such as frequencies, Prevalence, and Logistic regression, as applicable. Qualitative data were translated, transcribed, and thematically analysed both manually and with NVivo. Ethical approval was obtained from MTRH /Moi University IREC (Approval no: 0003543) and NACOSTI (License No. NACOSTI/P/20/5223). Findings: Most of the respondents were aged 25-34 years (65.0%, n=240), had no formal education (93.2%, n=344), and lived within 5 km of a healthcare facility (59.9%, n=221). Hospital delivery was reported by 58.0% (n=214) of participants; 213 (57.7%) reported being attended by a skilled health professional at their last birth; 55.3% (n=204) had parity of ≥4, and 93.1% (n=344) had at least one ANC visit. Reduced utilization of SBA was associated with husbands who were herdsmen [95% CI: 2.35-20.91; p=0.001, AOR = 7.01], parity ≥5 [AOR = 8.86; 95% CI: 2.77–28.33; p<0.001], and transport cost ≥500 [AOR = 9.30; 95% CI: 3.08–28.09; p<0.001], while having ≥4 ANC visits [AOR = 0.092; 95% CI: 0.019–0.451; p=0.003] increased utilization of SBA. Six main themes emerged from the FGDs and five from the KIIs: highlighting cultural practices related to placenta disposal, umbilical cord care, preferred birthing position, gender of the birth attendant, domestic responsibilities, breastfeeding and naming practices, and the roles of husbands and mothers-in-law in childbirth decisions. Conclusion: SBA utilisation in Kibish Sub-County was suboptimal. Higher parity, having a husband who was a herdsman, and higher transport costs were associated with increased likelihood of home delivery, while attending four or more ANC visits was associated with reduced likelihood of home delivery. Qualitative findings indicated that cultural practices, family decision-making, and challenges in accessing and using health facilities influenced childbirth decisions. Interventions to improve SBA utilisation should therefore address transport-related barriers, strengthen ANC engagement, and incorporate culturally responsive approaches to maternal and newborn care. Recommendations: The findings highlight the need for community-based interventions to improve access to maternal and newborn health services in remote areas through strengthened health infrastructure, transport systems, and community-based ANC outreach. There is also a need to invest in operationalising and optimizing the use of Maternity Waiting Homes (MWHs) for expectant women residing away from health facilities. Culturally responsive and respectful maternity care should also be strengthened through community engagement and promotion of practices that do not compromise maternal and newborn safety.

Prevalence and determinants of undiagnosed diabetes mellitus among patients presenting for elective surgery at Moi Teaching and Referral Hospital, Eldoret Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Prevalence and determinants of undiagnosed diabetes mellitus among patients presenting for elective surgery at Moi Teaching and Referral Hospital, Eldoret Kenya Kimetto, Joan Background: Diabetes mellitus (DM) is a group of metabolic disorders characterized by chronic hyperglycemia due to defects in insulin secretion, action, or both. The International Diabetes Federation estimates that over 10.5% of adults aged 20–79 years globally have diabetes, with half undiagnosed. In Kenya, the true prevalence is unclear, and the reported 3% likely underestimates the burden. Routine diabetes screening is uncommon, particularly among elective surgical patients. Known risk factors include age, overweight/obesity, physical inactivity, poor diet, family history, and comorbidities such as hypertension and dyslipidaemia. However, local evidence on these determinants remains limited, underscoring the need to assess undiagnosed diabetes among elective surgical patients. Objective: To determine the prevalence of undiagnosed DM and describe the social, demographic, economic, lifestyle and clinical factors associated with undiagnosed DM among patients presenting for elective surgery at Moi Teaching and Referral Hospital (MTRH). Methods: This was a descriptive cross-sectional study conducted in four surgical wards of MTRH (Kilimanjaro, Longonot, Rehema, and Sergoit). A total of 540 adult patients (≥18 years) admitted for elective surgery with unknown diabetes status were recruited through consecutive sampling. Data was collected using a structured questionnaire and clinical measurements, including fasting plasma glucose. Undiagnosed diabetes mellitus was defined as fasting plasma glucose ≥7.0 mmol/L with no prior history of diabetes. Ethical approval was obtained from the Institutional Research and Ethics Committee (IREC) of Moi University/MTRH, and permission to undertake the study was granted by hospital management. Written informed consent was obtained from all participants. Data were analyzed using SPSS version 20. Descriptive statistics were used to summarize variables as frequencies and percentages (n, %). Associations were assessed using binary logistic regression, with results presented as odds ratios (OR) and 95% confidence intervals (CI). Statistical significance was set at p<0.05. Results: The prevalence of undiagnosed DM among patients presenting for elective surgery in MTRH was 3.5%. The highest prevalence was found in the age group 36-55 years, with a rate of 6.3%. Single individuals exhibited a significantly higher likelihood of undiagnosed DM (p-value of 0.029). Additionally, business persons and those employed portrayed a higher likelihood of undiagnosed DM with statistically significant associations (p-values of 0.04, 0.01 and 0.02 respectively). Although clinical, lifestyle and dietary factors were found to be associated with the undiagnosed DM, these relationships were not statistically significant. Conclusion: There is a higher proportion of persons with undiagnosed diabetes among those presenting for elective surgery at MTRH compared to the general population. Among those presenting for elective surgery, the middle-aged, and employed are at a higher risk of undiagnosed diabetes. Recommendations: Routine screening is recommended in all adults undergoing elective surgery at the Moi Teaching and Referral Hospital and similar healthcare facilities to enable early detection and appropriate management of undiagnosed diabetes. The Ministry of Health Kenya should incorporate opportunistic diabetes screening into national guidelines and strengthen implementation across hospital settings