A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities.Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya.Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016.Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility.Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester.Keywords: System approach, maternal and child health care, Kenyan communities

Larviciding Potency of Water and Ethanol Extracts of Phytolacca dodecandra (L’ Herit) on Anopheles gambiae (Diptera: Culicidae)

Introduction: Plant extracts are an attractive target for search of effective malaria vector control agents. The reason for this is that they present a cost effective, target specific and bio-degradable insecticides. The other reason is that they posses varied phytochemical contents that vectors are unlikely to develop resistance to very soon. In this study, we report on effectiveness of ethanol and water extracts of Phytolacca dodecandra (L’ Herit) against Anopheles gambiae (Diptera: Culicidae) larvae. Methods: Crude ethanol and water extracts of leaves (shoot and midsection) and mature green fruits of P. dodecandra were scrutinized for larvicidal activity against 1 st to 4th instar larvae of An. gambiae. Larvicidal bioassays were conducted and effectiveness evaluated using the >80% as per the WHO methods and threshold respectively. ANOVA analyses were performed for statistical justifications of the larvicidal property with P considered significant at p 80%. We recommend that additional refinement and tests need to be done before commercial exploitation as a malaria vector larvicide. Keywords Anopheles gambiae, Phytolacca dodecandra, Azadirachta indica, Deltamethrin, Ethano

Development of maize single cross hybrids for tolerance to low phosphorus

Low available phosphorus (P) is one of the major hindrances to maize (Zea mays L.) productivity in acid soils. The objectives of this study were to: (1) develop P-efficient maize inbred lines, (2) develop single cross hybrids from the P-efficient inbred lines, and (3) determine their response to P application in the P-deficient acid soils of western Kenya. Ninety-eight inbred lines and 49 single crosses were developed and screened at P-deficient (2.0 to 2.2 mg P/kg soil) soils of Sega and Bumala. Mean grain yield (GY) for the hybrids was 75.3% higher with P-fertilizer than without P for the same hybrids. Thirty-three percent (33%) of these hybrids were inefficient but responsive to P application, 27% were efficient and none responsive, only 13% were efficient and responsive, while the rest were inefficient and non-responsive. GY was positively correlated (r = 0.57**) with plant height (PH) and ear height (EH) (r = 0.60**) and PH was correlated with EH (r = 0.86***). This study has developed and identified P-efficient maize germplasm that can be utilized directly or in developing other hybrids for use in acid soils of western Kenya and in other acid soils where P is limiting

A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities. Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya. Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016. Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility. Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester. DOI: https://dx.doi.org/10.4314/ahs.v19i2.6 Cite as: Mwangi A, Nangami M, Tabu J, Ayuku D, Were E, Fabian E. A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: Baseline Survey on Maternal Health. Afri Health Sci.2019;19(2): 1841-1848. https://dx.doi. org/10.4314/ahs.v19i2.

INTRODUCTION, FIRST READING AND REFERENCE

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Sexualised drug use in people attending sexual health clinics in England.

Recent evidence highlights an increase in ‘chemsex’, the use of recreational drugs during sex, in men who have sex with men (MSM) and an association with risky sexual behaviours and outbreaks of STIs.1 However, the extent of sexualised drug use in people attending sexual health clinics (SHCs) is unknown