HIGHS AND LOWS OF CURRICULUM INTEGRATION: AUTHORS’ THEORETICAL PERSPECTIVES

This paper used a desk review approach to deal with the move towards and emphasis given to integration of curriculum content, not only in Kenya but also world over. The purpose of the paper is to bring out the meaning, rationale and arguments about the concept of curriculum integration. The discourse about curriculum integration is important to the policy makers, all those involved and working as curriculum developers, and for the curriculum implementers.   Article visualizations

JUSTIFICATION FOR INITIATION AND INTRODUCTION OF INTEGRATED ENGLISH CURRICULUM IN SECONDARY SCHOOLS

This study focused on the justification for initiation and introduction of integrated English curriculum in secondary schools in Kenya. The study used a qualitative approach to get the views from selected teachers, head teachers and heads of English at Kenya Institute of Education (KIE), Ministry of Education (MoE) and Kenya National Examinations Council (KNEC). Basic quantitative techniques such as frequencies and percentages were used to analyse some of the data that were obtained. The study employed questionnaire and interview instruments to collect data from the respondents. The researcher organized raw data collected from questionnaires and interviews. It was realized from the study that integrated English curriculum was introduced to enable teachers use integration as a teaching approach across the two disciplines and between and/or among their constituent parts. Despite this good intention, it was found that majority of the teachers of integrated English 57.4 % did not undergo any type of in-service training before they started the actual teaching of integrated English curriculum. The study recommends that the teachers and their head teachers should be helped to acquire and develop necessary skills on how to integrate English language and Literature. Equally, the study recommends that pre-service training in colleges, universities should be reformed, and an integrated approach adopted.   Article visualizations

PRINCIPALS’ ROLE IN MONITORING INSTRUCTIONAL ASSESSMENT AND ITS INFLUENCE ON TEACHING AND LEARNING OUTCOME IN SECONDARY SCHOOLS IN KAJIADO COUNTY, KENYA

With the core business of the school being instruction, the principals’ monitoring of instructional assessment is necessary in enhancing teaching and learning processes and outcome in schools. Despite measures being in place, teaching and learning outcome has remained consistently low, especially in Kajiado County. The objective of this study is to assess the influence of principals’ monitoring of instructional assessments on teaching and learning outcome. The study was guided by the result-based management theory. The study employed a descriptive survey design. This study population of study comprised 727 respondents in all the 9 public secondary schools in Kajiado. These respondents included 122 teachers, 594 students and 9 principals. Out of these, 342 respondents were sampled and they were comprised of 9 principals, 97 teachers and 201 students. Proportionate sampling was used to draw a sample of 97 teachers’ and 201 students per school. Further, simple random sampling was used to sample teachers while convenience sampling was applied to draw the sample of students to participate in the study per school. Data was collected by questionnaires and interview schedule. A pilot study was conducted in two schools for the purpose of addressing validity and reliability of the instruments before the actual study was conducted. Content validity was determined by seeking the judgment of professional experts in the area of educational research, evaluation and assessment. Reliability level was ascertained by using Cronbach’s alpha technique to check internal consistency of the instruments. The analysis of quantitative data was done using frequencies, percentages and means and then presented in tables and figures. Qualitative data was arranged into themes and presented through narration and in verbatim. The study established that principals' checking of assessment practices, even-though inconsistent, significantly influenced performance. The study concluded that principals' monitoring of instructional practices (mean=3.5, SD=1.2) significantly influenced performance in schools. It recommended that the Ministry of Education should organise training for principals to improve their skills of monitoring assessment.  Article visualizations

DOES THE INTEGRATION OF ICT IN PHYSICS INSTRUCTION IN SECONDARY SCHOOLS PLAY THE MAGIC CARD?

Physics is one of the subjects that have suffered low enrolment and performance in secondary schools. This enrolment and performance are pegged to the students’ perception that Physics is difficult and uninteresting due to its abstract nature. Research has shown that integration of ICT in Physics instruction has the capability of simplifying the abstract content as well as creating interest in learners and consequently improving the quality of education. However, for this to be possible, Physics requires adequate operational ICT knowledge and resources. This study targeted 40 schools, 40 principals and 121 Physics teachers. The study was based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Descriptive survey design was used. Random sampling technique was used to get a sample of 18 schools and 52 Physics teachers whereas purposive sampling was used to get 18 principals. Questionnaires, interview schedules and an observation schedule were used to collect data. Validity and reliability of the study instruments were established through consultation, triangulation and piloting. The data was analyzed using SPSS. The study found that integration of ICT in Physics instruction in secondary schools was still very low. The study recommends that more ICT resources should be provided to secondary schools; and requisite integration skills should be given to all Physics teachers.   Article visualizations

Strengths and weaknesses in the implementation of maternal and perinatal death reviews in Tanzania: perceptions, processes and practice.

OBJECTIVES: Tanzania institutionalised maternal and perinatal death reviews (MPDR) in 2006, yet there is scarce evidence on the extent and quality of implementation of the system. We reviewed the national policy documentation and explored stakeholders' involvement in, and perspectives of, the role and practices of MPDR in district and regional hospitals, and assessed current capacity for achieving MPDR. METHODS: We reviewed the national MPDR guidelines and conducted a qualitative study using semi-structured interviews. Thirty-two informants in Mara Region were interviewed within health administration and hospitals, and five informants were included at the central level. Interviews were analysed for comparison of statements across health system level, hospital, profession and MPDR experience. RESULTS: The current MPDR system does not function adequately to either perform good quality reviews or fulfil the aspiration to capture every facility-based maternal and perinatal death. Informants at all levels express differing understandings of the purpose of MPDR. Hospital reviews fail to identify appropriate challenges and solutions at the facility level. Staff are committed to the process of maternal death review, with routine documentation and reporting, yet action and response are insufficient. CONCLUSION: The confusion between MPDR and maternal death surveillance and response results in a system geared towards data collection and surveillance, failing to explore challenges and solutions from within the remit of the hospital team. This reduces the accountability of the health workers and undermines opportunities to improve quality of care. We recommend initiatives to strengthen the quality of facility-level reviews in order to establish a culture of continuous quality of care improvement and a mechanism of accountability within facilities. Effective facility reviews are an important peer-learning process that should remain central to quality of care improvement strategies.<br/

Extensive hyperpigmentation during pregnancy: a case report

Abstract Introduction Skin hyperpigmentation is common during pregnancy and often is due to endocrinological changes. Usual patterns include linea nigra, darkening of areola and melasma. We report a rare diffused hyperpigmentation condition in a pregnant woman of dark colored skin. Case presentation A 19-year-old Tanzanian primigravida at 32 weeks gestation presented at our antenatal clinic concerned about an insidious but progressive onset of unusual darkening of her abdominal skin and both breasts. Her antenatal record was unremarkable except for this unusual onset of abnormal skin color. Findings from her physical examination were unremarkable, and she had a normal blood pressure of 120/70 mmHg. Her abdomen was distended with a uterine fundus of 34 weeks. Almost her entire abdominal skin had darkly colored diffuse deep hyperpigmentation extending cephalad from both iliac fossae to involve both breasts to 2-3 cm beyond the areolae circumferentially. She had a fetus in longitudinal lie and cephalic presentation, with a normal fetal heart rate of 140 beats per minute. Other examination findings were unremarkable. The impression at this stage was exaggerated pigmentation of pregnancy. No medical treatment was offered but she was counseled that she might need medical treatment after delivery. She progressed well and had spontaneous labor and normal delivery at 38 weeks gestation. She was lost to follow up. Conclusion Unusual pregnancy-related skin hyperpigmentation can occur with no adverse consequences to pregnancy, although may worry a pregnant woman. Reassurance and conservative management may be all that is required to allay a patient's concerns.</p

Molecular screening for Plasmodium falciparum resistance markers for artemisinins in Mbita, Kenya

Artemisinins-based combination therapies (ACTs) are being recommended against uncomplicated malaria in endemic areas of Africa. However, in these areas data on their long term usefulness is limited. It has been demonstrated that ACTs resistance may be due to single nucleotide polymorphisms (SNPs) in the chemotherapeutic target, the SERCA-type ATPase protein (PfATPase6). This study analyzed PfATPase6 mutations in asymptomatic infections from samples collected from Mbita, a malaria endemic region in Kenya. Mutations in A623E and S769N residues were screened with gene specific primers followed by sequencing. The study demonstrates that there is no mutation in Mbita, Kenya because neither A623E nor S769N PfATPase6 mutations were detected. Resurgence of infections in this area could be due to re-infections and not drug failure. The study recommends that other sites be assessed for PfATPase 6 mutations to verify the long-term usefulness of ACT and monitor any emergency of resistance.Keywords: ACT (Artemisinins-based Combination Therapy), Molecular, Mutations, PfATPase 6doi: 10.4314/ajcem.v12i3.

Delivering at Home or in a Health Facility? Health-Seeking Behaviour of Women and the Role of Traditional birth attendants in Tanzania.

Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health

Quality Of Antenatal Care In Rural Southern Tanzania: A Reality Check.

Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions.Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions

SENSITIVITY OF MICROSCOPY COMPARED TO MOLECULAR DIAGNOSIS OF P. FALCIPARUM: IMPLICATIONS ON MALARIA TREATMENT IN EPIDEMIC AREAS IN KENYA

Detection of Plasmodium species by microscopy has been the gold standard for diagnosis of malaria for more than a century. Despite the fact that there is a significant decline in the number of positive cases reported from microscopy, anti-malarial drugs prescriptions are on continuous increase as patients present with symptoms of malaria. This makes it difficult to establish accuracy, sensitivity and specificity of light microscopy in diagnosis of malaria in epidemic areas. This study was designed to compare microscopy with polymerase chain reaction as diagnostic methods for malaria in three epidemic areas in Kenya. A total of 356 patients presenting with malaria symptoms were diagnosed by microscopy and dried blood filter paper spots were collected from patient in Kisii, West Pokot and Narok districts. Plasmodium falciparum DNA was extracted from the dried blood filter samples. Primers specific for the Plasmodium Species were designed and used in a two step amplification of the Pfmdr gene. The PCR products were analyzed in ethidium bromide stained 1.5% agarose gel. It was found that 72 out of 350 specimens diagnosed as negative were positive for P. falciparum by nested PCR, while 6 which were microscopy positive were confirmed so by nested PCR. This study demonstrates that there is a high level of misdiagnosis which may either lead to denial for deserved treatment or undeserved treatment. Nested PCR detection of malaria parasites is a very useful complement to microscopy although it is expensive and takes long time. Additionally, smear negative patients suspected to have malaria should be subjected to PCR diagnosis to improve rational drug use. The economic burden of misdiagnosis and mistreatment of malaria outweighs that of PCR diagnosis, hence this diagnostic mode could be tenable in the long run even in rural areas