Teacher Factors Affecting the Implementation of Early Childhood Development Education in Kericho Municipality, Kericho County

Childhood education is crucial in the life of a child because it lays the foundation of intellectual and physical development. Concerns have been raised over the state of the ECDE programmes with regard to the negative teacher attitudes towards selection and use of instructional resources due to low remuneration, lack of time and demotivation.  The study adopted the descriptive survey design and was carried out in Kericho Municipality Zone, Kericho County.  The fact that class one pupils cannot read or perform simple arithmetic shows that they did not acquire the skills in ECDE. This aroused concern to the researcher and raised questions that begged for answers. The study findings can benefit the young children to acquire the skills of reading, manipulative, numeric, interpersonal skills and positive attitude towards education. The objective of the study was to assess the influence of teacher preparedness in the use of available instructional materials in the teaching and learning and to explore the attitude of teachers and its influence on the selection and use of instructional in ECDE centres in Kericho County. The study adopted mixed research methods (qualitative and quantitative). Simple random and stratified sampling techniques were used to select respondents who comprised of a target population of 84 head teachers and 180 pre-school teachers to get the sample size of 25 headteachers and 54 pre-school teachers from the selected ECDE centres. Data was collected using questionnaires, interviews and observation and was analyzed using descriptive statistics, this included frequencies and percentages. Majority of the pre-school teachers 75 (94.9%) agreed that they used available IR in teaching and learning in ECDE centres, however the status of the available materials in the centres were either inadequate, obsolete, dilapidated or unsuitable for use. From the study findings it was concluded that teachers were well prepared to use the available IR though they did not maximize the use of IR in teaching and learning. Keywords: Instructional resources, teacher preparedness, attitude

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of selftreatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance

Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya: A gap analysis

Background: There is increasing global evidence on the impact of advanced nursing andmidwifery practitioners, and Kenya’s healthcare system has an excellent opportunity todevelop scopes of practice and other regulatory frameworks for the integration of theseroles. Objective: The primary purpose of this gap analysis was to explore the existing evidenceon opportunities and threats toward the integration of the advanced practice nursing(APN) and advanced practice midwifery (APM) roles in Kenya’s healthcare system. Methods: The study team conducted a structured electronic database search of PubMed,CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrievearticles and credible websites for reports highlighting the opportunities and threatstoward the integration of the APN and APM roles in Kenya’s healthcare systems. Theretrieved articles were screened for relevance and synthesized for reporting using thetraditional literature review approach. Results: The Kenya Health Policy Framework 2014–2030, growing population needs,and implementation of universal health coverage provide an opportunity to harness andleverage advanced practice roles in nursing and midwifery. There is also momentum todevelop advanced practice because of strategic alliances and global evidence showing thecontributions and quality of services offered by advanced practice nurses and advancedpractice midwives. However, lack of financial support, structural challenges, and lack ofnational policies, regulations, and legislation continue to obstruct progress. Conclusion and implications: for nursing policy:Developing scopes of practice forAPN and APM in Kenya will benefit the professions, the country’s healthcare deliverysystem, and the population. Achieving universal health coverage depends on a healthworkforce trained and practicing at optimal levels in tandem with education and trainingto deliver quality car

Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya:A gap analysis

BACKGROUND: There is increasing global evidence on the impact of advanced nursing and midwifery practitioners, and Kenya's healthcare system has an excellent opportunity to develop scopes of practice and other regulatory frameworks for the integration of these roles.OBJECTIVE: The primary purpose of this gap analysis was to explore the existing evidence on opportunities and threats toward the integration of the advanced practice nursing (APN) and advanced practice midwifery (APM) roles in Kenya's healthcare system.METHODS: The study team conducted a structured electronic database search of PubMed, CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrieve articles and credible websites for reports highlighting the opportunities and threats toward the integration of the APN and APM roles in Kenya's healthcare systems. The retrieved articles were screened for relevance and synthesized for reporting using the traditional literature review approach.RESULTS: The Kenya Health Policy Framework 2014-2030, growing population needs, and implementation of universal health coverage provide an opportunity to harness and leverage advanced practice roles in nursing and midwifery. There is also momentum to develop advanced practice because of strategic alliances and global evidence showing the contributions and quality of services offered by advanced practice nurses and advanced practice midwives. However, lack of financial support, structural challenges, and lack of national policies, regulations, and legislation continue to obstruct progress.CONCLUSION AND IMPLICATIONS FOR NURSING POLICY: Developing scopes of practice for APN and APM in Kenya will benefit the professions, the country's healthcare delivery system, and the population. Achieving universal health coverage depends on a health workforce trained and practicing at optimal levels in tandem with education and training to deliver quality care.</p

Childbirth is not a Sickness; A Woman Should Struggle to Give Birth : Exploring Continuing Popularity of Home Births in Western Kenya.

More than 95% of Kenyan women receive antenatal care (ANC) and only 62% access skilled delivery. To explore women‘s opinion on delivery location, 20 focus group discussions were conducted at an urban and rural setting in western Kenya. Participants included health care workers, traditional birth attendants (TBAs), and women who attended at least four ANC visits and delivered. Six in-depth interviews were also conducted with a combination of women who gave birth in a facility and at home. Discussions were digitally recorded and transcribed for analysis. Data was subjected to content analysis for deductive and inductive codes. Emergent themes were logically organized to address the study topic. Findings revealed that delivery services were sought from both skilled attendants and TBAs. TBAs remain popular despite lack of acknowledgement from mainstream health care. Choice of delivery is influenced by financial access, availability and quality of skilled delivery services, physical access, culture, ignorance about childbirth processes, easy access to familiar TBAs, fear of hospitals and hospital procedures, and social stigma. Appreciation of TBA referral role, quality maternity service, and reproductive health education can encourage facility deliveries. Formal and informal health workers should cooperate in innovative ways and ensure safe motherhood in Kenya.Keywords: Delivery decision; Traditional birth attendants; Skilled delivery; Focus group discussions; Keny

An examination of postpartum family planning in western Kenya: I want to use contraception but I have not been told how to do so

Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as in-depth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya.La planification familiale du post-partum (PF) au Kenya est faible en raison de la sensibilisation insuffisante et la sensibilisation des femmes, en particulier dans les zones rurales. Ce document identifie les types les plus répandus de la PF, l&apos;intention et les besoins non satisfaits chez les femmes, la consultation de la PF et les obstacles à l&apos;adoption de la PF. Des discussions à groupe cible avec les prestataires de services, les accoucheuses traditionnelles (AT) et des mères, ainsi que des entrevues en profondeur dégagent les principaux thèmes, y compris la PF du post-partum préféré, les limites de la consultation de la PF en cours et les obstacles à l&apos;adoption de la PF. La PF du Post-partum est commune, y compris les contraceptifs injectables, les contraceptifs oraux, les bobines, les préservatifs et les méthodes de calendrier. La consultation de la PF est prodiguée par des pairs, les amis, les accoucheuses traditionnelles et les prestataires officiels de santé. Les pratiques de la PF sont associées avec le soutien de la famille, l&apos;alphabétisation, l&apos;accès à l&apos;information sur la PF, les effets secondaires, les coûts et la religion. En conclusion, les changements dans la prestation de services et de l&apos;éducation pourraient encourager la hausse de l’utilisation de la PF du postpartum au Kenya

An examination of postpartum family planning in western Kenya: “I want to use contraception but I have not been told how to do so”

Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as in-depth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya.La planification familiale du post-partum (PF) au Kenya est faible en raison de la sensibilisation insuffisante et la sensibilisation des femmes, en particulier dans les zones rurales. Ce document identifie les types les plus répandus de la PF, l&apos;intention et les besoins non satisfaits chez les femmes, la consultation de la PF et les obstacles à l&apos;adoption de la PF. Des discussions à groupe cible avec les prestataires de services, les accoucheuses traditionnelles (AT) et des mères, ainsi que des entrevues en profondeur dégagent les principaux thèmes, y compris la PF du post-partum préféré, les limites de la consultation de la PF en cours et les obstacles à l&apos;adoption de la PF. La PF du Post-partum est commune, y compris les contraceptifs injectables, les contraceptifs oraux, les bobines, les préservatifs et les méthodes de calendrier. La consultation de la PF est prodiguée par des pairs, les amis, les accoucheuses traditionnelles et les prestataires officiels de santé. Les pratiques de la PF sont associées avec le soutien de la famille, l&apos;alphabétisation, l&apos;accès à l&apos;information sur la PF, les effets secondaires, les coûts et la religion. En conclusion, les changements dans la prestation de services et de l&apos;éducation pourraient encourager la hausse de l’utilisation de la PF du postpartum au Kenya