Use of Mobile Phones for HIV Prevention and Testing Information Needs By Emerging Adult Male Population in Rural Kenya. A Qualitative Study

Human Immunodeficiency virus (HIV) and Acquired Immunodeficiency disease syndrome (AIDS) among young people in Sub-Saharan Africa (SSA) is a serious public health issue which needs urgent cost-effective interventions locally, regionally, and internationally. HIV and AIDS is currently the leading cause of death among young people in SSA, calling for strategic HIV prevention approaches applicable to emerging adults. While most studies have focused on young women, studies focusing on emerging male adults are lacking. The purpose of this dissertation study was to develop an in-depth understanding of the needs, barriers, and facilitators of using mobile phone to access HIV prevention and testing information by emerging male adults in rural Kenya.A qualitative descriptive study design was used. Sixty emerging male adults in rural Kenyan setting participated in the study. Thirty in-depth interviews and three Focus Group Discussions (FGDs) were conducted. Interviews were audio recorded, transcribed verbatim and coded using the software MAXQDA. Attention was focused on the readability, credibility, dependability, confirmability, transferability, and thus, trustworthiness of the findings. The findings derived from interviews centered around two major themes major theme: (i) Needs of emerging male adults in HIV prevention; and (ii) facilitators and barriers to the use of mobile phones in HIV and other disease prevention by emerging adults in rural settings. The results outlined emerging male adults in the rural setting are faced with myriad of risk factors and challenges in accessing and utilizing HIV information and prevention services. Findings also showed that most of the emerging adults in rural settings own a smartphone and this mobile technology can be tapped as a cost-effective intervention in creating awareness in HIV prevention and testing among the young people. The study underscore that HIV is still the greatest threat among emerging adults in SSA and mobile health and they were receptive and acknowledge several benefits of use of mHealth technology for creating awareness about HIV prevention and testing, but they also described many barriers. The findings and recommendations of the dissertation study have a great potential to inform the public health policy and healthcare informatics on cost-effective use of mobile phones in HIV prevention not only to this age group but also to other age groups faced with similar challenges as we work to reach and sustain an AIDS-free generation

Flexible scheduling, retirement plans and service delivery among civil servants in Kenya: a case of Nandi south

The density of the Citizen’s complaints of poor service in government ministries has been underscored and highlighted in the media such complaints was reflected during the year 2002 Constitutional Referendum in Kenya which in part called for an overhaul of the civil service structure through various Civil Service Reform Programmes and major reshuffle (inter-ministerial transfers). This paper highlighted effects of Staff welfare in service delivery within Civil Service offices in Kenya: A case of Nandi south. Stratified random sampling techniques were used to select 350 employees of Nandi south. Data collected through the use of questionnaires was analyzed using both descriptive and regression statistics. Descriptive findings revealed that there was low level of retirement plan services to the employees of Nandi south. Nevertheless, high levels of Flexible Scheduling services among employees were observed an indicator that retirement plans in the Workplace had significant effect on Service Delivery. Keywords: Services Delivery, Workplace, Retirement Plans and Flexible Schedulin

Factors Influencing the Implementation of Integrated Management of Childhood Illness (IMCI) by Healthcare Workers at Public Health centers & Dispensaries in Mwanza, Tanzania.

\ud Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. The healthcare workers can implement better IMCI through the collaboration of supervisors, IMCI focal person, Council Health Management Teams (CHMT) and other stakeholders interested in child health. However, significant barriers impede a sustainable IMCI implementation. Recommendations have been made related to supportive supervision and HealthCare system strengthening among others.\u

Characteristics, drivers, and predictability of flood events in the Tana River Basin, Kenya

Study area: Tana River Basin in Kenya. Study Focus: Flood-related impacts and losses have been rising. Therefore, understanding flood characteristics, drivers, and predictability is critical for informed decisions in the ongoing flood early warning (FldEWS) projects. This study presents an in-depth analysis of hydro-meteorological, Sentinel Mission (SM), and ensemble hydrological model datasets. We examine flood characteristics using observed hydro-meteorological and SM datasets, followed by statistical analysis of climate drivers of flood events at inter-annual and sub-seasonal (S2S) time scales. Finally, reforecasts from Global Flood Awareness System (GloFAS) are assessed against observed river flows. New hydrological insights for the study region: There is a high inter-annual variability of flood events with flood peaks occurring in May and December. SM satellites have the ability to map flooded areas in near-real time. At inter-annual timescales, positive Indian Ocean Dipole (IOD) and warm El Niño Southern Oscillation (ENSO) drives short rains (October to December). At Sub-Seasonal (S2S) timescales, Madden Julian Oscillation (MJO; phases 2-4) is a notable driver of flood related extreme rainfall. GloFAS offers reliable forecasts depending on the flood magnitude, trigger probability, and 'anticipation window' and it meets the tolerable skill requirements for flood preparedness actions (FAR 50%) with up to a 20-day lead time for 1 and 2-year return periods. We subsequently discuss how our research findings can inform the development of FldEWS in Kenya, with an emphasis on improved co-production of flood forecast information with relevant stakeholders.</p

Advancing operational flood forecasting, early warning and risk management with new emerging science: Gaps, opportunities and barriers in Kenya

Kenya and the wider East African region suffer from significant flood risk, as illustrated by major losses of lives, livelihoods and assets in the most recent years. This is likely to increase in future as exposure rises and rainfall intensifies under climate change. Accordingly, flood risk management is a priority action area in Kenya's national climate change adaptation planning. Here, we outline the opportunities and challenges to improve end-to-end flood early warning systems, considering the scientific, technical and institutional/governance dimensions. We demonstrate improvements in rainfall forecasts, river flow, inundation and baseline flood risk information. Notably, East Africa is a ‘sweetspot’ for rainfall predictability at sub-seasonal to seasonal timescales for extending forecast lead times beyond a few days and for ensemble flood forecasting. Further, we demonstrate coupled ensemble flow forecasting, new flood inundation simulation, vulnerability and exposure data to support Impact based Forecasting (IbF). We illustrate these advances in the case of fluvial and urban flooding and reflect on the potential for improved flood preparedness action. However, we note that, unlike for drought, there remains no national flood risk management framework in Kenya and there is need to enhance institutional capacities and arrangements to take full advantage of these scientific advances