5. Research Articles
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Item Improving midwifery educators’ capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study(2022) Cheptum, Joyce JebetBackground: International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The objective of the study was to assess the capacity of university midwifery educators to deliver the updated competency-based curriculum after the capacity strengthening workshop in Kenya. Methods: The study used a quasi-experimental (pre-post) design. A four-day training to strengthen the capacity of educators to deliver emergency obstetrics and newborn care (EmONC) within the updated curriculum was conducted for 30 midwifery educators from 27 universities in Kenya. Before-after training assessments in knowledge, two EmONC skills and self-perceived confidence in using different teaching methodologies to deliver the competency-based curricula were conducted. Wilcoxon signed-rank test was used to compare the before-after knowledge and skills mean scores. McNemar test was used to compare differences in the proportion of educators’ self-reported confidence in applying the different teaching pedagogies. P-values < 0.05 were considered statistically significant. Findings: Thirty educators (7 males and 23 females) participated, of whom only 11 (37%) had participated in a previous hands-on basic EmONC training – with 10 (91%) having had the training over two years beforehand. Performance mean scores increased significantly for knowledge (60.3% − 88. %), shoulder dystocia management (51.4 – 88.3%), newborn resuscitation (37.9 − 89.1%), and overall skill score (44.7 − 88.7%), p < 0.0001. The proportion of educators with confidence in using different stimulatory participatory teaching methods increased significantly for simulation (36.7 – 70%, p = 0.006), scenarios (53.3 – 80%, p = 0.039) and peer teaching and support (33.3 – 63.3%, p = 0.022). There was improvement in use of lecture method (80 – 90%, p = 0.289), small group discussions (73.3 – 86.7%, p = 0.344) and giving effective feedback (60 – 80%, p = 0.146), although this was not statistically significant. Conclusion: Training improved midwifery educators’ knowledge, skills and confidence to deliver the updated EmONC-enhanced curriculum. To ensure that midwifery educators maintain their competence, there is need forItem Challenges Experienced By Midwifery Trainers In Midwifery Training(Journal of Midwifery and Nursing, 2023) Cheptum, Joyce Jebet; Mbuthia, Florence; Chelagat, DinahMidwifery involves building relationships with women, their families and the entire community. Midwives are driven by a strong conscience to provide the best care to their clients. Midwifery training is quite involving, encompassing theoretical and practical skills, thus it requires a well-managed curriculum to ensure quality training and products. Aim, the objective of this review is to highlight the challenges experienced by midwifery trainers in midwifery training. Methodology, a descriptive overview was undertaken through a rapid literature review of the relevant local and international literature to highlight the global challenges of midwifery trainers. Results, the challenges experienced in many training institutions by midwifery trainers range from infrastructural, financial resource and human resource. Discrimination of the midwifery profession, lack of motivation and poor well – being and lack of emotional resilience of the trainers and lack of/ or inequalities in the training and education opportunities are challenges in training. Clinical set up challenges include lack of support from the clinical setting, overcrowding of students or poorly resourced facilities. The emerging and re-emerging health issues poses a challenge to the midwifery trainers. Conclusion, Midwifery trainers experience and myriad of challenges, which could compromise on the quality of midwifery training.Item Effectiveness of Antenatal Health Education via Mobile Phone Calls Among Women Seeking Antenatal Care Services in Kisii County, Kenya(2023) Malachi, Zillah M.; Lucy W. Kivuti-Bitok; Cheptum, Joyce J.; Karani, Anna K.Knowledge of antenatal care is important in reducing maternal mortality and morbidity. Mobile phones have demonstrated an increase in the use of antenatal care services. However, few studies have indicated the effectiveness of health education on antenatal care via mobile phone calls. In this study, we aimed to evaluate the effectiveness of health education on antenatal care provided through mobile phone calls among pregnant women in Kisii County, Kenya. A total of 160 pregnant women up to 26 weeks of gestation were recruited for the study from 16 sub-county health facilities (clusters) in Kisii County. The women were enrolled in their first visit and followed up until delivery. The sub-county health facilities were randomly assigned to either intervention or control arms. The intervention involved giving health education on antenatal care through mobile phone calls. All the participants in both study arms received routine antenatal care. However, those enrolled in the intervention sites additionally received health education through mobile phone calls. The primary outcome measure was antenatal care knowledge scores. Baseline and end-of-study questionnaires were used to collect data. Women in the intervention group scored highly in antenatal care knowledge post-intervention as compared to those in the control group, 7.87 (SE of the difference = 0.68, p-value < 0.001, 95% CI (6.53–9.20). Health education delivered through mobile phone calls has great potential in improving antenatal care knowledge.Item Factors Affecting Quality Documentation In Labour Among Midwives At Kenyatta National Hospital(2023) Mulei, Charity Ndunge; Cheptum, Joyce Jebet; Mageto G. IreneBackground Information: Midwives have posed varying knowledge and practice levels of quality midwifery documentation due to a number of factors. Quality midwifery documentation shows care given to two lives whose interests could be in conflict. Objective: The study sought to determine the factors affecting the quality of documentation in labour among midwives at Kenyatta National Hospital labour ward. Methodology: This was a descriptive cross-sectional study among 51 consenting midwives selected using a simple random sampling technique. Data was collected using a self administered structured questionnaire. Ethical approval was sought. Results: Most of the midwives demonstrated excellent knowledge on quality midwifery documentation. However, only 51% practised quality midwifery documentation with 21.4% making entries ahead of time, 17.4% documenting for colleagues and 13.7% documenting only normal labour. This was attributed to insufficient time (86.3%), high patient-to-midwife ratio (92.2%) and understaffing (86.3%). In conclusion, several factors affected the quality of documentation among midwives.Item Factors Linked to Female Genital Mutilation Practice Among Women Living In Alungu Village of Mandera County, Kenya(2023) Mohammed, Mohammud Sheikh; Cheptum, Joyce JebetBackground: Female Genital Mutilation/Cutting (FGM/C) is a harmful traditional practice with severe health complications, deeply rooted in many sub-Saharan African countries. In Kenya, the prevalence of FGM/C is 15% in women aged between 15 and 49 years. The Kenyan Somalis practice FGM/C with a prevalence above 90%. FGM/C practice continues to persist in Alungu village, Mandera County in the North Eastern of Kenya despite efforts by anti-FGM programs. However, the underlying factors behind FGM practice in the area have not been explored. Objective: To assess factors contributing to female genital mutilation practice among women living in Alungu village of Mandera County, Kenya. Methods and materials: This study utilized a descriptive cross-sectional design. The study population was women of reproductive age (from 18 to 49 years) who resided in Alungu village in Mandera County, Kenya. A study sample of 98 women was selected using simple random sampling technique. Data was collected using a researcher-administered questionnaire and analyzed using the Statistical Package for Social Science (SPSS). Results: Most of the respondents were aged 35 – 44 (45.8%), married (100%), had no formal education (74.7%) and had no formal employment (89.2%). All participants agreed that traditional beliefs, customs and rite of passage to womanhood contributed to FGM, 90.4% of the participants acknowledged that FGM is a symbol of ethnic identity and inclusivity. Factors affecting prevention of and response to FGM were low involvement of women in anti-FGM programs (91.6%); support for FGM by local leaders and elders (100%); failure by authorities to take action against those perpetuating FGM (100%); indifference to FGM practice continuation among local religious and political leaders (96.4%) and poor enforcement of existing laws against FGM (100%). Conclusion: A wide range of socio-cultural factors did contribute to FGM practice among women living in Alungu village, Mandera County.Item Bridging the Gender Divide in Digital Technology Courses and Careers in Kenya(2023) Luvanda, AnthonyKenya’s digital technology advancements—chief among them the mobile money transfer application referred to as Mpesa—has led to the country’s status as an emerging digital economy. However, the long strides in the move toward a fully-fledged digital economy are not reflected in the digital technology workforce with regard to gender balance. While digital technology careers are highly touted as the jobs of the future, women occupy less than 30 percent of digital technology positions in Kenya. The root cause of the problem can be traced to disadvantages that girls and young women accumulate throughout their years in education. This study takes a qualitative approach in trying to identify the root causes for the exclusion of girls and young women from digital technology courses at all levels of education—namely lower primary, upper primary, junior high school, senior high school, and the tertiary level in both rural and urban communities. The study identifies various cumulative factors that contribute to fewer women taking up digital technology courses, such as: inadequate infrastructure; insufficient staffing and training of digital technology personnel at learning institutions; the negative impact of gendered social norms; poor advocacy of digital technology careers and the absence of vocational counseling; and the lack of women role models. To increase the number of women in digital technology careers, we must improve institutional digital technology infrastructure at all levels of education, enhance the training of digital technology personnel within all levels of education, build girls’ interest in digital technology-related courses from the earliest years, increase digital technology advocacy and awareness among girls, and enhance vocational counseling on digital technology career.Item Effective approaches for enhancing data management and semantic interoperability within the healthcare sector(2023) Harriet, Loice Tsinale; Mbugua, Samuel; Luvanda, AnthonyIn a variety of contexts, Big Data is widely used. In healthcare Big Data has its own characteristics, including heterogeneity, incompleteness, timeliness and durability, privacy, and ownership. To enhance health-related science, these features present a number of challenges for data storage, mining, and sharing. Big Data helps to understand electronic health records, gather demographic and medical data such as clinical data, medical conditions, and diagnosis, allow doctors to provide a wide variety of patients with quality health care and also to make informative decisions. The large volume of data also provides researchers in the fields of medicine and healthcare with the ability to use tools and techniques to unlock hidden solutions. This study sought to investigate the effects that the existing approaches have on enhancing data management and semantic interoperability in healthcare sector. 180 respondents who took part of the survey were chosen from the Kenyatta University Teaching, Referral & Research Hospital. It was discovered that implementing health standards and tools can help healthcare companies in a number of ways by eliminating compatibility concerns and assuring accurate data representation. Consequently, encouraging successful adoption boosts decision-making processes, encourages sustainability, improves data quality, allows for interoperability, and makes it easier to comply with regulations. These implications help improve patient care, healthcare systems, and overall health outcomes.Item Optimizing Multi-Agency Cooperation in Kenya’s National Security Planning and Response(International Journal of Scientific and Research Publications,, 2023) Mutungi , Joseph M; Tarus , Christopher BoitShifting geo-political, environmental, and socio-economic factors on the global front continue to herald new realities to the national safety and security of individual countries. To address security challenges and the emergent threats, nations have had to adopt contemporary perspectives. One of the most common, and fruitful of these perspectives in the Kenyan national security setup is that of multi-agency cooperation (MAC). This qualitative inquiry therefore sought to establish the nature and structure of interagency collaboration, collecting data from 111 participants sourced through the snowball sampling method. The data was collected using interviews and thematically analyzed based on emergent themes. The study established that MAC in Kenya is structured at the cabinet level, but also often takes the peer-to-peer collaboration format, and the in-group structure of collaboration. The study proposes Blending Outsider Insights and Techniques (the BOIT Model) to enhance the operational effectiveness and outcomes of MAC frameworks within Kenya’s vast and dynamic security landscape. The model would be useful in improving perspectives and enhancing Tactical Resourcefulness under Stress (TARUS) within agencies and services involved in managing Kenya’s national security and safety.Item Reversible effect of castration induced hypogonadism on the morphology of the left coronary arteries in adult male rabbits(Anatomy and Cell Biology (ACB), 2023-07) Anangwe, Duncan; Obimbo, Moses Madadi; Ongidi, Ibsen Henric; Gichang, Peter BundiHypogonadism is associated with an increased risk of coronary artery disease. This study sought to describe the histomorphology of the left coronary arteries of the adult male rabbit following orchiectomy and subsequent testosterone administration. We included 20 adult male rabbits, divided into a baseline group (n=2), an interventional group subjected to castration only (n=6), an intervention group subjected to castration followed by testosterone injection (n=6), and a control group (n=6). Key variables under investigation were serum testosterone levels, the intima-media thickness of coronary arteries, smooth muscle cell density, and adventitial collagen fiber density. The mean coronary arteries’ intimal medial thickness was significantly higher in the castrated group than in controls (0.488 mm and 0.388 mm, respectively), while the testosterone-injected group had a mean of 0.440 mm. Mean smooth muscle cell density was significantly lower in the castrated rabbits versus controls (26.96% and 47.80%, respectively), this observation being reversed with testosterone injection (47.53%). Mean adventitial collagen fiber density was significantly higher in the castrated group than in controls (66.6% and 36.1%, respectively), with a marginal difference after testosterone injection (65.2%). This study demonstrates that castration induced hypogonadism causes morphological changes in the coronary arteries that are partly reversible using testosterone injections. These findings provide a morphological basis for understanding the role of testosterone in coronary arteries.Item Gender-Based Assessment of the Effects of Adoption of Alternative Livelihood Strategies on Pastoral Households in West Pokot County, Kenya(International Journal of Gender Studies, 2023-09) Kondoltiony, Emmanuel PsongolPurpose: The purpose of this study was to assess, from a gender perspective, the effects of Alternative Livelihood Strategies (ALSs) on households in the pastoral community of West Pokot County. Methodology: This study applied both quantitative and qualitative research approaches and adopted a cross sectional survey research design. The target population was adult household members in West Pokot County. While multi-stage cluster sampling technique was employed to sample 371 household survey respondents, 15 participants for Key Informant Interviews (KIIs) and nine Focus Group Discussions (FGDs), were purposively selected. Data was collected using questionnaires, KII schedule and FGD guide. Validity and reliability of the data collection instruments were achieved through triangulation method and pilot-testing in Baringo County. Quantitative data was then analyzed using descriptive statistics with the help of Statistical Package for Social Sciences (SPSS) version 23. The analyzed data was presented in tables and charts. Thematic analysis was employed for qualitative data that was presented in narrative and verbatim forms. Findings: The study results were that adoption of ALSs had three effects on the pastoral households. First, it blurred the boundaries that separated men and women in terms of household roles and socioeconomic status. Second, ALSs affected the way household members related to each other. The effects were both negative and positive, depending on type and level of ALSs adopted. Third, adoption of ALSs caused improvement in the socioeconomic status of most households. Overall, ALSs had more positive effects on households and had caused general improvement in living standards. Unique Contribution to Theory, Practice and Policy: Structural Functionalism theory and the Harvard Analytical Framework may be used to emphasize the critical contribution of both men and women in the wellbeing of pastoral households, through equitable and inclusive adoption of ALSs. The findings of this study could enable development agencies to formulate concrete interventions and policies to curb the negative effects of adoption of ALSs on households while leveraging on the positive ones, from a gender perspective. This will enhance adoption of ALSs and the community’s well-being.