Empirical Analysis of Factors Affecting Growth of Technology Based Business Incubators in Kenya: The Case of Kenya Industrial Research & Development Institute (KIRDI)

Techno-based incubators have been in Kenya since 1967 to support SMEs in the manufacturing sector and nurture them to grow into medium and large industries.  Despite the many years of incubation concept, Kenya has experienced slow growth of techno-based incubators, registering only six notable techno-based incubators, most being institutions of higher learning.  Further, despite existence of incubators past statistics show that three out of five businesses including those in manufacturing sector still fail within first few months of operation.  This paper is a report of an empirical study carried out to analyze factors influencing growth of techno-based incubators in Kenya from the perspective of an existing technology based incubator at KIRDI.  The research was qualitative, using descriptive design and employed a case study approach, based on a census of staff running the four KIRDI incubator centres, in both South B and South C Campuses of the Institution. An interview schedule and questionnaires incorporating Likert-type scales were developed to collect data on the variables. The findings established a strong positive relationship (r=0.751) between independent variables and dependent variable, however further analyzed each independent variable has its own weight on the dependent variable. Keywords: Business Incubation, Technology, Small and Medium Enterprise

Influence of Home Based Factors on Internal Efficiency Primary Schools in Bungoma North and Kimilili-Bungoma Districts, Kenya

Education reform efforts in developing countries are aimed at making education an effective vehicle for national development. Educational attainment, especially primary education, is perceived as one of the main vehicles for spurring economic growth and improving living standards in developing countries. In Kenya, the proposed allocations to both the Ministry of Education and that of Higher Education constitute 13% of the total expenditure for the Financial Year 2011-2012, out of which the Teachers Service Commission receives 4.6% of the total annual expenditure. Bungoma-North and Kimilili-Bungoma Districts have consistently performed poorly in Kenya Certificate of Primary Education despite some schools within the same Districts performing above average. The mean scores in 2008, 2009 and 2010 were 246.96, 240.89 and 234.19 respectively. This raised concern on internal efficiency of primary schools in the districts. The purpose of this study therefore was to examine the influence of home based factors on internal efficiency of primary schools in Bungoma-North and Kimilili-Bungoma Districts. Objectives of the study were to: Establish the extent to which parental level of education; parental occupation; language use at home and parental income influence internal efficiency of primary schools. Education Production function theory (Psacharopoulos & Woodhall, 1985) was used in this study to show the influence of home based factors on internal efficiency of primary schools. The research designs used were correlation and descriptive survey designs. The target population consisted of 106 Head teachers, 530 standard eight teachers, 6850 standard eight pupils and 2 District Quality Assurance Officers (DQASOs). The study sample consisted of 40 head teachers, 200 standard eight teachers, 400 class eight pupils who were selected using simple random sampling technique and 2 DQASOs who were selected using saturated sampling technique.  The study used questionnaires and interview schedules as research instruments. From the research findings, the study established that Parental level of education, occupation; income and language used at home do influence academic achievement of pupils. Fathers’ level of Education was a significant predictor of pupils’ performance, Pupils Performance in KCPE improved by 16.973 with fathers Education, The variation in Kenya Certificate of Primary Education pupils results were accounted for by home based factors (6.1%). Keywords: School; Internal; Efficiency; Primary; Kenya.

Hospitalization Events Among Sickle Cell Anemia Patients at Homabay County Referral Hospital, Western Kenya

Approximately 700,000 new cases of sickle-cell anemia (SCA) occur annually in the world with 60%-80% dying before their 5th year birthday. SCA patients often experience hospitalization events including admissions for pain and vaso-occlusive crisis, infections and blood transfusions. However, limited studies have evaluated these events to improve comprehensive care programs. A descriptive cross-sectional study design was adopted on 227 SCA patients receiving healthcare between January 2017 and December 2017 at Homabay County Referral Hospital, Western Kenya. A complete enumeration sampling technique was used, and data was collected from hospital medical records. A total of 167 (73.57%) SCA patients were admitted to the hospital, 64 (38.32%) had pain and vaso-occlusive crisis (PVC), 47 (28.14%) malaria infection and others had combination of infections or conditions. SCA patients with malaria had increased chance of admission (12.86% CI; 5.36-30.85%. P value <0.0001) and blood transfusions (11.67% CI; 5.27-25.82%, P value <0.0001). In addition, less than 20% were given drugs at the time of discharge suggesting unavailability of drugs. PVC is the leading cause of hospitalization and malaria infection prolong the period of admission and increases blood transfusions among SCA patients. The study provides important information on the need for improved care for PVC and enhanced malaria intervention among SCA patients. Key words: SCA, Vaso-occlusive crisis, hospitalization events and blood transfusion

Successful Global Health Research Partnerships: What Makes Them Work?

There are many successful global health research partnerships, but little information is available about what makes them successful. We asked 14 research colleagues from Uganda, Kenya, and the United States who have extensive global health research experience about what they considered the top three factors that led to or impeded successful international research collaborations. Four key factors were identified: 1) mutual respect and benefit, 2) trust, 3) good communication, and 4) clear partner roles and expectations. Initial and ongoing assessment of these factors in global health research partnerships may prevent misunderstandings and foster a collaborative environment that leads to successful research

Computing the Geographic Extent of Maternity Health Services to Predict the Utilization of Skilled Delivery in Siaya County, Western Kenya

In Kenya, no study has attempted to incorporate the target population, nor the availability coverage and accessibility coverage to expose hidden gaps in the provision of maternity health services that target rural and marginalized populations for a high burden, yet low resource setting such as rural Siaya County. A cross-sectional study design used publicly available geospatial data in combination with administrative ward level data from the web-based district health information software, version 2 (DHIS 2). AccessMod version 5 was used for geographic coverage analysis. ArcGIS (version 10.5) and R (version 3.5.3)sufficed for the preparation of input geospatial data and the manipulation of AccessMod results respectively. The association between the geographic coverage and skilled delivery was computed using a Zero-inflated Poisson regression model at a 95% confidence level. The findings in Siaya County revealed a higher likelihood of a skilled delivery 34% (0.34; CI: 0.339–0.347) and 16% (0.16; CI: 0.162–0.167) respectively. This likelihood is for every unit increase in the proportion of pregnant women within a one-hour geographic extent of a hospital and health center—on foot, as compared to being within a similar geographic catchment area of a dispensary 7% (0.07; CI: 0.0678–0.0723) based on motorcycle traveling time. The immediate implication is that the population coverage capacity and, by extension, quality of existing facilities offering free maternity health services increases a pregnant woman’s likelihood of utilizing skilled delivery, regardless of proximity. Future research should also consider looking at the cost-implications of scaling up existing maternity health services, albeit based on local routine health facility data

Prevalence of Under Nutrition and Its Effects on Response to Malaria Treatments Among Children Under Five Years at Ahero and Homa Bay Hospitals, Western Kenya

Nutritional status of a person with malaria infection is thought to contribute to host treatment outcome. Limited studies have investigated the association despite the widespread concern with nutrition in malaria endemic areas. We evaluated the impact of under nutrition on the treatment outcome by Artemether Lumefantrine and Clindamycin plus Quinine. Sample of 384 children aged below five years diagnosed with uncomplicated Plasmodium falciparum malaria, were randomized to receive Clindamycin plus quinine or Artemether-lumefantrine (AL) for treatment. The children were followed up for 28 days to monitor body weight and height, clinical and parasitological parameters of treatment response.Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 28 days of follow-up. Prevalence of underweight was 6 % (n=23) and stunting was 12% (n=45). Body weight increased over the 28 day follow up period. The initial mean weight was 13.03kg while the mean weight on day 28 was 13.7kg.The proportion of children with stunting was comparable between the female and male children: 40% verse 60%, p=0.06. Generally, the prevalence of underweight was comparable between the treatment arms (p=0.08). Similarly, the prevalence of stunting was not significantly different between the treatment arms (p=0.34). Cure rate was high in the Artemether group (96.5%) compared to the Clindamycin group (44.2%). Children who were underweight were 0.69 times less likely to be cured compared to those who were not underweight, but this difference was not significantly different from that of children were had no underweight (p = 0.429). Treatment outcomes were known for 43 of the 45 (95.6%) children with stunting. Overall, stunted children were 1.15 times more likely to be cured compared with children who were not stunted, but this difference was not statistically significant (p=0.704). No association between under nutrition (underweight and stunting) and treatment outcome was observed.  Further research is suggested on the impact of under nutrition on response to malaria treatment using Artemether Lumefantrine alone on children less than five years. Ministry of health and other policy makers may formulate guidelines to improve management of children with malaria taking into consideration their nutritional status, and to integrate nutrition in malaria programmes

Risks of infections among HIV exposed infants during the first 18 months of life in Western Kenya

BACKGROUNDInfants exposed to HIV are more vulnerable to infections compared to those not HIV exposed. The occurrence and risks of infections among these infants are less understood. High maternal viral load can result in advanced disease, low maternal survival rates and puts the infant at higher risk of having early T- cell abnormality [24]. AIMThis study aimed at characterizing the infections among HIV Exposed Infants (HEI) and establishing the risk factors associated with infections for interventions that will improve their health outcomes. METHODOLOGYA cohort study was conducted using records of HEI enrolled at the PMTCT program in Kisumu County Referral Hospital (KCRH) in western Kenya, between January 2015 and December 2017. Using a simple random sampling technique, 260 records were obtained and a structured checklist resembling HEI follow-up cards was developed for quality assurance in data abstraction. Targeting those who had completed the 18 months follow-up, died or confirmed HIV positive during the process. Excluded were transfers, loss to follow-up and infants who had incomplete records. Data entry was done using Microsoft Excel then exported to SPSS version 20 for data analysis. RESULTSA total of 46 infants reported different infections with an incidence rate of 17.3 new cases per 100 persons. Respiratory tract infections were the leading cause of infections contributing to 34.6% (18) of the infections. Other infections were malaria 17.4% (9), gastroenteritis 8 15.4% (8), oral thrush 11.5% (6), measles 9.6% (5), UTIs 5.8% (3). The risks to infections were high maternal viral load (OR 8.20 CI 3.32-20.25, p≤ 0.001), incomplete Co-trimoxazole prophylaxis (OR 2.23 CI 0.91- 5.50, p≤0.050) and mixed feeding (OR 2.59 CI 1.05 -6.36, p≤0.040). High burden of gastroenteritis peaking at around the 7 th month of the 18 month was recorded. CONCLUSIONHigh maternal viral load, incomplete Co-trimoxazole prophylaxis dosage and mixed feeding are a risk to infections among HEI. These findings provide critical information for health promotion and improvement of PMTCT interventions. Lifespan approach in understanding and protecting these infants from risks and infections, pneumonia in particular is crucial. RECOMENDATIONSHome delivery and breastfeeding for only 1 year compared to the recommended breastfeeding duration of 2 years should be discouraged. Future studies be conducted in multiple sites involving HIV infant comparator to enrich the findings

Barriers to Cryotherapy Treatment Services for Precancerous Cervical Lesions among Women in Western Kenya

Background: Cervical cancer is the fourth most fatal and common disease globally among women of reproductive age in Kenya; it ranks the second most frequent type of cancer after breast cancer. Due to the high burden, cryotherapy treatment services, which are effective for the treatment of precancerous lesions are available in selected health facilities in Kenya, however, barriers to the treatment services are poorly understood. Nonetheless, understanding these barriers is critical for enhanced service delivery. Materials and Methods: A descriptive facility-based cross-sectional study design was carried out to determine the barriers to cryotherapy treatment services among 60 women of reproductive age on a one-year therapy at Migosi Sub County Hospital in Western Kenya. The participants were selected purposively and interviewed via telephone calls using pre-coded semi-structured questionnaires. However, data from 5 nurses working in the cryotherapy section were collected through face-to-face interviews at the health facility. Data were entered in an excel sheet and then exported to SPSS version 23.0 for analysis. Both descriptive and inferential statistics (Chi-square) were used and data were presented in form of tables. Results: Overall, 52 (85.4%) respondents adhered to post-care treatment instructions and reported no adverse reactions. However, 28 (46.7%) experienced unavailability of cryotherapy services at the time of the appointment and got the services later, 24 (40%) got the services at the time of the appointment but waited for a long time before being served, 37 (61.7%) did not know why they were being treated and 46 (76.7%) had misconceptions and myths about the therapy. In addition, there was a statistically significant association between knowing both the benefits of screening and cryotherapy [X2(1, N = 60) = 5.90, p = .02]. Also, the knowledge of the benefits of cryotherapy did not influence one’s decision to wait for cryotherapy treatment services, [X2(1, N = 60) = 3.98, p = .46]. Conclusion: The study shows very good adherence to post-treatment instruction but inadequate availability of cryotherapy treatment services. Also, the misconceptions and myths about cryotherapy are public health concerns. Therefore, the study recommends improved awareness campaigns and service delivery for the enhanced uptake of cryotherapy treatment services

Determination of energy gap directly from phase shift for nuclear systems with large neutron excess

507-510Considering 1S0 pairing in infinite neutron matter and nuclear matter, and knowing the fact that in the lowest order approximation, the pairing interaction has been taken to be the bare nucleon-nucleon interaction in the 1S0 channel, the energy gap has been determined directly from the 1S0 phase shifts. The values of energy gaps have been found to increase rapidly for low values of phase shifts, up to around 16°, and it is roughly constant with a value approximately equal to 1.08 MeV for phase shifts1 greater than 16°

HIV infection drives IgM and IgG3 subclass bias in Plasmodium falciparum-specific and total immunoglobulin concentration in Western Kenya

BACKGROUND: HIV infection is associated with more frequent and severe episodes of malaria and may be the result of altered malaria-specific B cell responses. However, it is poorly understood how HIV and the associated lymphopenia and immune activation affect malaria-specific antibody responses. METHODS: HIV infected and uninfected adults were recruited from Bondo subcounty hospital in Western Kenya at the time of HIV testing (antiretroviral and co-trimoxazole prophylaxis naïve). Total and Plasmodium falciparum apical membrane antigen-1 (AMA1) and glutamate rich protein-R0 (GLURP-R0) specific IgM, IgG and IgG subclass concentrations was measured in 129 and 52 of recruited HIV-infected and uninfected individuals, respectively. In addition, HIV-1 viral load (VL), CD4+ T cell count, and C-reactive protein (CRP) concentration was quantified in study participants. Antibody levels were compared based on HIV status and the associations of antibody concentration with HIV-1 VL, CD4+ count, and CRP levels was measured using Spearman correlation testing. RESULTS: Among study participants, concentrations of IgM, IgG1 and IgG3 antibodies to AMA1 and GLURP-R0 were higher in HIV infected individuals compared to uninfected individuals (all p < 0.001). The IgG3 to IgG1 ratio to both AMA1 and GLURP-R0 was also significantly higher in HIV-infected individuals (p = 0.02). In HIV-infected participants, HIV-1 VL and CRP were weakly correlated with AMA1 and GLURP-R0 specific IgM and IgG1 concentrations and total (not antigen specific) IgM, IgG, IgG1, and IgG3 concentrations (all p < 0.05), suggesting that these changes are related in part to viral load and inflammation. CONCLUSIONS: Overall, HIV infection leads to a total and malaria antigen-specific immunoglobulin production bias towards higher levels of IgM, IgG1, and IgG3, and HIV-1 viraemia and systemic inflammation are weakly correlated with these changes. Further assessments of antibody affinity and function and correlation with risk of clinical malaria, will help to better define the effects of HIV infection on clinical and biological immunity to malaria