Factors associated with low birth weight among neonates born at Olkalou District Hospital, Central Region, Kenya

Introduction: ninety-two percent of Low Birth Weight(LBW) infants are born in developing countries, 70% in Asia and 22% in Africa. WHO and UNICEF estimate LBW in Kenya as11% and 6%by 2009 Kenya Demographic Health Survey. The same survey estimated LBW to be 5.5% in Central Province, Kenya. Data in Olkalou hospital indicated that prevalence of LBW was high. However, factors giving rise to the problem remained unknown.Methods: a cross-sectional analytic study was therefore conducted to  estimate prevalence and distribution and determine the factors associated with LBW in the hospital.LBW was defined as birth of a live infant less than 2500g.We collected data using a semi-structured questionnaire and review of health records. A total 327 women were randomly selected from  500mothers.Data was managed using Epi Info 3.3.2.Results: the prevalence of LBW was 12.3% (n=40). The mean age of  mothers was 25.6±6.2 years. Mean birth weight was 2928±533 grams.There were 51.1% (n=165) male neonates and 48.9% (n=158) females. The following factors were significantly associated with LBW:LBW deliveryin a previous birth (OR=4.7, 95%C.I.=1.53-14.24), premature rapture of membranes (OR=2.95, 95%C.I.=1.14-7.62), premature births (OR=3.65,95%C.I.=1.31-10.38), and female newborn (OR=2.32,  95%C.I.=1.15-4.70). On logistic regression only delivery of LBW baby in a previous birth (OR=5.07, 95%C.I.=1.59-16.21) and female infant  (OR=3.37, 95%C.I.=1.14-10.00)were independently associated with LBW. Conclusion: prevalence of LBW in the hospital was higher than national estimates. Female infant and LBW baby in a previous birth are  independent factors. Local prevention efforts are necessary to mitigate the problem. Population-based study is necessary to provide accurate  estimates in the area

Abortion related stigma: a case study of abortion stigma in regions with high and low incidences of unsafe abortion

Background: Abortion accounts for 35% of maternal mortality in Kenya. Kenya has reported an increase in the rate of unsafe abortions from 32 to 48 per 1000 women of reproductive age in 2002 and 2012 respectively. During the same period, women presented in public health facilities with severe complications indicating that women were having unsafe abortions.Objective: To investigate the association between incidences of unsafe abortion and stigma attitudes and beliefs about abortion among community member’s in two counties located in regions with either high or low incidences of unsafe abortion.Design: A cross-sectional comparative study.Settings: General community members in Trans Nzoia and Machakos Counties.Subjects: Men and women of reproductive age in Trans Nzoia and Machakos Counties.Results: Respondents in Trans Nzoia County reported the highest full-scale abortion stigma levels (μ=55.4) compared to those from Machakos County (μ=53.07). The mean differences in SABAS scores for all the four subscales were significant for fear of contagion, exclusion and discrimination and Negative stereotyping (p-value <0.000). Incidence region, educational attainment and marital status were all significantly associated with stigmatising attitudes. Respondents in the 35-49 age group showed more stigmatising attitudes than younger respondents, and married individuals showed more stigmatising attitudes than single respondents, and lower education levels were associated with higher levels of stigma.Conclusions: Mean stigma scores for counties with high incidence of unsafe abortions were higher than those from regions with a low incidences of unsafe abortion. Male community members, those with lower levels of education were more likely to report higher levels of stigma at the community level. The majority of women seeking abortion were viewed negatively by general community members, and this could explain women’s decision to seek an unsafe abortion

Abortion-related stigma and unsafe abortions: perspectives of women seeking abortion care in Machakos and Trans-Nzoia Counties, Kenya

Background: The rate of unsafe abortions in Kenya increased from 32 per 1000 women of reproductive age in 2002 to 48 per 1000 women in 2012-- one of the highest in Sub- Saharan Africa. Abortion-related stigma has been linked to high levels of unsafe abortions.Objective: To explore the perspectives of women seeking abortion services in public and private health facilities in regions with high as well as low incidence of unsafe abortions in Kenya on abortion-related stigma.Design: A comparative qualitative study.Setting: Selected public and private health facilities offering post abortion care services in Machakos and Trans Nzoia CountiesSubjects: Women seeking abortion related services in private and public health facilities in Machakos and Trans Nzoia Counties.Results: Abortion-related stigma manifested in various forms including verbal abuse such as ridicule and name calling, isolation, physical abuse and denial of services. The stigma was in form of self-stigma, from the community and from health providers. Due to stigma, women preferred to seek information on abortion only from trusted friends and close relatives, regardless of their reliability so as to keep abortion confidential. Private facilities were reported as the main facilities where women could get an abortion confidentially, but costly compared to public facilities. As a result, women who could not afford private facilities chose to self-induce and present in a health facility to seek post abortion (PAC) care as the only way to access services, regardless of the dangers. Young single women seeking abortion services reported higher levels of stigma from health providers compared to older married women. Perception that abortion was illegal in Kenya perpetuated stigma and prevented women from seeking safe abortion services due to fear of being arrested.Conclusion: Stigma associated with abortion is a major barrier to women seeking and receiving safe, comprehensive abortion care. Therefore, understanding abortion-related stigma is a critical step to designing measures to address barriers to women accessing safe reproductive health services

Determinants Of Under Nutrition Among School Age Children In A Nairobi Peri-Urban Slum

Background: Malnutrition is a major public health concern affecting a significant number of school age children influencing their health, growth and development, and school academic performance. Objective: To establish the determinants of under nutrition among school age children between 6-12 years in a low-income urban community. Design: A cross-sectional descriptive study. Setting: Kawangware peri-urban slum, Nairobi, Kenya. Subjects: Three hundred and eighty four school children aged 6 - 12 years. Results: A total of 4.5% were wasted, 14.9% underweight and 30.2% stunted. The children who were over nine years of age were more underweight (72.4%, p=0.000) and stunted (77.2%, p=0.000) than those below eight years. The girls were more wasted (29.1%, p=0.0 13) than the boys (18.2%), whereas the boys were more stunted (65.7%, p=0.003) than the girls (50.7%). The other variables found to have had significant association with the nutritional status of the children were: monthly household income (p=0.008), food prices (p=0.012), morbidity trends (p=0.045), mode of treatment (p=0.036) and school attendance (p=0.044). Conclusion: The findings of this study show evidently that there is under nutrition among school age children, with stunting being the most prevalent. The Ministry of Education and Ministry of Health therefore need to develop policies which can alleviate under nutrition among school age children. We also recommend that awareness be created among the school age children, parents and teachers, on the dietary requirements of both boys and girls. East African Medical Journal Vol. 85 (10) 2008: pp. 471-47

DETERMINANTS OF UNDER NUTRITION AMONG SCHOOL AGE CHILDREN IN A NAIROBI PERI-URBAN SLUM

Background: Malnutrition is a major public health concern affecting a signifi cant number of school age children infl uencing their health, growth and development, and school academic performance.Objective: To establish the determinants of under nutrition among school age children between 6-12 years in a low-income urban community.Design: A cross-sectional descriptive study.Setting: Kawangware peri-urban slum, Nairobi, Kenya.Subjects: Three hundred and eighty four school children aged 6 - 12 years.Results: A total of 4.5% were wasted, 14.9% underweight and 30.2% stunted. The children who were over nine years of age were more  underweight (72.4%, p=0.000) and stunted (77.2%, p=0.000) than those below eight years. The girls were more wasted (29.1 %, p=0.0 13) than the boys (18.2%), whereas the boys were more stunted (65.7%, p=0.003)than the girls (50.7%). The other variables found to have had signifi cant association with the nutritional status of the children were: monthly household income (p=0.008), food prices (p=0.012), morbidity trends (p=0.045), mode of treatment (p=0.036) and school attendance (p=0.044).Conclusion: The fi ndings of this study show evidently that there is under nutrition among school age children, with stunting being the most prevalent. The Ministry of Education and Ministry of Health therefore need to develop policies which can alleviate under nutrition among school age children. We also recommend that awareness be created among the school age children, parents and teachers, on the dietary requirements of both boys and girls

Implementation of Universal Health Coverage Program in Kisumu County, Kenya: Importance of Social Marketing Strategies

Universal Health Coverage is where communities have access to all needed health services without financial hardship. In Kenya, Universal Health Coverage (UHC) program was launched in December 2018, through a presidential decree. This study aimed to understand population needs, acceptability, and perceptions about UHC implementation. The study was undertaken in four pilot counties of Kisumu, Machakos, Nyeri and Isiolo between February and March 2019, using exploratory qualitative data collection techniques. However, this paper focuses on the County of Kisumu which was selected due to its high prevalence of infectious diseases. Respondents included women of reproductive age, men, youth, and elderly persons. In-depth interviews were conducted among health care providers and managers. Scientific and ethical approval was obtained from the Kenya Medical Research Institute’s Scientific and Ethical Review Unit (SERU). Consenting to participate was individualized. Analysis was done thematically. Findings suggest that UHC was understood variously by different groupings. Sensitization about the UHC programme was done through electronic media, by CHVs, education sessions, political class and outreaches. Planning for the programme was done by holding meetings, trainings for community registration and developing budgets. However there was a lot os misunderstanding, confussion and misconcepts about the UHC concept as it was seen as a means to seek for votes by politicians. Barriers for successful implementation included critically understaffed facilities.