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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 Boit
Shifting 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.
Improving midwifery educators’ capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study
(2022) Cheptum, Joyce Jebet
Background: 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 for
Factors Affecting Quality Documentation In Labour Among Midwives At Kenyatta National Hospital
(2023) Mulei, Charity Ndunge; Cheptum, Joyce Jebet; Mageto G. Irene
Background 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.
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.
Factors Linked to Female Genital Mutilation Practice Among Women Living In Alungu Village of Mandera County, Kenya
(2023) Mohammed, Mohammud Sheikh; Cheptum, Joyce Jebet
Background: 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.