Assessment of consumption patterns for essential medicines: a study of the Nyeri county referral hospital

Background: Nyeri is one of the pilot Universal Health Coverage roll-out counties aimed at guaranteeing healthcare service access to all households in the region by 2022. The aim of the study was to provide management insights into ways of optimizing pharmaceutical management to ensure essential medicine are consumed by majority of population in need by 2022.Methods: A mixed-methods approach was used, combining quantitative and qualitative data collection techniques.Results: Amoxicillin had the highest (751,000) consumption over the study period. Other essential medicines with high consumption include paracetamol (432,000), metformin (280,264) and enalapril (111,800). The most cited reason for stock-outs was limited allocation of budget for medicines, a point that was mentioned by eight of the ten respondents.Conclusions: The study concludes that the stock-out frequency for essential medicines at the Nyeri County Referral Hospital is high. The frequent and persistent stock-out frequency for essential medicines is a problem considering the high consumption for essential medicines

Architecture and Memory

The objective of this thesis is to come up with a design which will celebrate the experience during and after the Post-Election violence that rocked Kenya through the design of the Museum of Hope in Uhuru Park, in Nairobi, Kenya. The museum is intended to create an experiential journey that allows visitors to explore sentiments of the climate of the country during this political time, while also evoking optimism in design. The recent history of Kenya is marred by struggle, violence, terror, hope, joy and peace. The site of Uhuru Park has witnessed this unending cycle, making it a politically charged zone that has brought people together during times of protest and of peace. The thesis proposes that the manipulation of space in design affects the perception of the mind and body of the user, thus helping make the understanding and appreciation of past history a vehicle for national pride and progress, while at the same time, bringing the future of the country into focus. Architecture beyond the building should strive to enhance the human condition and promote emotional well-being through the manipulation of space, forms, tectonics, light, air and ventilation. It should impact the mind and body. According to Danze and Sonnenberg, an architect and a psychoanalyst respectively, “buildings are inert objects, but our experience of them transcends the physical realm and extends into our deepest consciousness.” Architecture today should have a significance to the surrounding culture and people it is being designed for. Introspection upon emotional consciousness concludes that there are two outstanding characteristics within responsiveness. Emotions can have affective elements; meaning they can be classified as pleasant or unpleasant, and they also have distinctive qualities which differentiate them from their affective aspects. Once exposed to certain emotions, only then can this experience trigger the imaginative mind of the individual, creating an even richer experience to what they are exposed to. Emotions simply involve evaluations. The intention of the thesis is to enhance the exposure of the user, through a variety of experiences when navigating a space, while also celebrating human nature through these changes. The thesis develops and proposes design methods and tools for translating key emotions of horror, fear, hope and joy into spatial design

Collaborative Decision Support Tools for Water Resources Management - A Scientific Case Study of Nairobi River Catchment

Es wird ein Massenbilanzverfahren innerhalb eines Modells angewandt, das auf Einzugsgebietsebene erstellt wurde, um den aktuellen Status der Wasserbilanz festzustellen. Anschließend wird aufgezeigt, dass die Modellanwendung und Datenanalyse den Mindestanforderungen für plausible Ergebnisse entspricht. Eine Methodik wurde entwickelt, die Fachleute befähigt in Kooperation mit den Stakeholdern ein angepasstes Wasserbilanzmodell zu erstellen und anzuwenden

Moderating Effect of Firm Characteristics on the Relationship Between Video Online Marketing and Market Performance of Registered Tours and Travel Agencies in Nairobi City County, Kenya

Today's marketing is critical for tours and travel agencies to raise awareness of their products. Video marketing has grown in popularity as a result of widespread internet distribution. While many of these videos were created purely for entertainment purposes, others have served as the fundamental building blocks of serious corporate marketing campaigns. Currently, eighty-seven percent of online marketers use online video content as their marketing strategies. However, the market performance of tours and travel agencies in Nairobi city county exhibits a downward trend, necessitating adoption of online video marketing to enhance transparency. This study specifically investigated the effect of online video marketing on market performance, it also established the moderating effect of firm characteristics on the relationship between online video marketing and market performance of registered tours and travel agencies in Nairobi city county, Kenya. The study adopted a positivist philosophy. Both descriptive and explanatory research designs was used. A self-administered semi-structured questionnaire was used to collect primary data a sample of one hundred and seventy-nine were used. The study instrument's validity and reliability were tested and they were reliable. Data analysis included the development and interpretation of both descriptive and inferential statistics, such as frequencies, mean, percentages, and standard deviation, and was presented using tables, and numerical values. The results of regression analysis established that online video marketing had a positive and significant effect on market performance, and Firm characteristics had a positive moderation effect on the relationship between online video marketing and market performance of the registered tours and travel agencies in Nairobi city county, Kenya. However, the tours and travel agencies should focus more on the key characteristics of these online video content, which ultimately made reference to the purchase process and is open to the potential business outcome. Keywords:Online video marketing, Market performance, Firm characteristics, Tours and travel agencies in Nairobi city county, Kenya. DOI: 10.7176/EJBM/14-24-04 Publication date: December 31st 202

The development of a successful antidumping regime in Kenya

Magister Legum - LL

Expenditure on medicines in Nyeri County between 2014 and 2017: a retrospective analysis using the ABC and VEN classifications of medicines.

This research aimed at evaluating the category of medicines that consumed most of the allocated budget in Nyeri Couty and assessing whether Nyeri County procured the right medicines, at the right cost, in the right quantities. The archival method was used to collect medicines procurement data from the following 5 hospitals: Nyeri County Referral Hospital, Karatina Sub-County Hospital, Mukurwe-ini Sub-County Hospital, Othaya Sub-County Hospital and Mt. Kenya Sub-County Hospital. Medicines shortfall analysis, cost analysis, the ABC method, the VEN method, and ABC-VEN matrix analysis were the study tools used to analyze the data.The findings revealed that all the five hospitals reported insufficient budgetary allocation for medicines, with Nyeri County Referral Hospital having the highest budgetary shortfall of (58.60%) while Mt.Kenya Sub-District Hospital had the lowest shortfall of (9.44%). To curb these shortages, the researcher proposes that the government should promote economic growth. The ABC-VEN matrix analysis of the five hospitals revealed that about 10% of the items consumed about 70% of the annual drug expenditure (ADE) of the hospitals. These items are vital, hence had to be procured. To prevent locking up of capital due to these items, the researcher proposes that low buffer stock needs to be maintained while keeping a strict vigil on the consumption level and the stock in hand

Lessons learnt in urban community-led total sanitation from Nakuru, Kenya

Community-led total sanitation (CLTS) is a process where communities are mobilized through innovative participatory methodology to completely eliminate open defecation (OD). However, in urban areas experiences are rare. Practical Action and Umande Trust have implemented a project Realising Rights to Total Sanitation (RRTS) in Nakuru, Kenya, adapting the urban CLTS methodology to the urban context. In a participatory approach, design sessions are held with landlords, tenants, project team and technical staff of County government. This comes up with low cost toilets that meet urban public health and building regulations. It is also address wider issues of feacal sludge and solid waste management, access to clean water, and waste water management. It has worked with lending institutions to assist landlords in accessing the necessary finance to upgrade their facilities. It has also capacity build county staff to adopt CLTS approaches, replicate and scale it within Nakuru County

FR2.2: Understanding Gender-Specific Constraints to Agricultural Technology Adoption: Evidence from Cassava Farming in Kenya

Female subsistence farmers in developing countries often have lower levels of agricultural productivity than men, partially due to lower adoption rates of agricultural technologies. These lower adoption rates may be due to lack of physical access to new technologies or lack of access to information about new technologies, among other explanations. In this study, we consider these two classes of explanations of low technology use among females, and test the relative impacts of interventions designed to combat each. Specifically, we consider adoption of a climate-resistant, early maturing cassava variety by female farmers. Using a randomized control trial with a 2x2 matrix treatment design, we plan to test the effects on cassava adoption by female farmers of two interventions: delivering cassava seeds to female farmers at their homes (improved access), and hiring female "lead farmers," to diffuse information about cassava seeds (improved information access). Results from a small pilot in 6 villages suggest that 1) male lead farmers are less likely than female lead farmers to train female household members during a household visit (despite all lead farmers being explicitly instructed to train females), and 2) female farmers almost unanimously prefer receiving training from a female lead farmer. Pilot results also provide insights on ways that the treatments can be improved, such as lead farmers providing follow-up training visits. These preliminary findings support the viability and importance of employing female trainers in teaching female farmers about new agricultural technologies

Characterization of the Nairobi River catchment impact zone and occurrence of pharmaceuticals: implications for an impact zone inclusive environmental risk assessment

The largely uncontrolled release of active pharmaceuticals ingredients (APIs) within untreated wastewater discharged to waterbodies, associated with many rapidly urbanising centres is of growing concern owing to potential antimicrobial resistance, endocrine disruption and potential toxicity. A sampling campaign has been undertaken to assess the source, occurrence, magnitude and risk associated with APIs and other chemicals within the Nairobi/Athi river basin, in Kenya, East Africa. The catchment showed an extensive downstream impact zone estimated to extend 75 km, mostly, but not exclusively, derived from the direct discharge of untreated wastewater from the urban centre of Nairobi city. The exact extent of the downstream boundary of the Nairobi city impact zone was unclear owing to the inputs of untreated wastewater sources from the continuous urbanized areas along the river, which counteracted the natural attenuation caused by dilution and degradation. The most frequently detected APIs and chemicals were caffeine, carbamazepine, trimethoprim, nicotine, and sulfamethoxazole. Paracetamol, caffeine, sulfamethoxazole, and trimethoprim alone contributed 86% of the total amount of APIs determined along the Nairobi/Athi catchment. In addition to direct discharge of untreated domestic wastewater attributed to the informal settlements within the conurbation, other sources were linked to the industrial area in Nairobi City where drug formulation is known to occur, the Dandora landfill and veterinary medicines from upstream agriculture. It was shown that there was a possible environmental risk of API ecotoxicological effects beyond the end of the traditional impact zone defined by elevated biochemical oxygen demand concentrations; with metronidazole and sulfamethoxazole exhibiting the highest risk

In vitro antioxidant and antimicrobial activity of Prunus africana (Hook. f.) Kalkman (bark extracts) and Harrisonia abyssinica Oliv. extracts (bark extracts): A comparative study

Background: Plants are new sources of antibacterial agents, hence the need to determine and evaluate the antibacterial properties, antioxidant activity and gas chromatography – mass spectrometer (GC-MS) profile of medicinal plants.   Methodology: In this study, sequential extraction of Prunus africana and Harrisonia abyssinica was used to obtain ethyl acetate and methanol extracts. Antioxidant activity was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH), whereas the total phenolic and total flavonoid contents were estimated using Folin-Ciocalteu and aluminium chloride, respectively. Antibacterial properties of the extracts against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Escherichia coliand Candida albicans were estimated using the disc diffusion method and compared against streptomycin.   Results: Screening of crude methanolic extracts revealed the presence of secondary metabolites which was further confirmed by Fourier transform infrared (FT-IR) characterisation that revealed the presence of H-bonded OH functional groups. The extracts revealed that P. africana had a higher total phenolic and total flavonoid contents compared to H. abyssinica. Methanolic extracts of both plants had moderate activity against selected microorganisms and both inhibited DPPH radical scavenging activity. GC-MS analysis of P. africana and H. abyssinica extracts revealed the presence of several phytochemicals that have been reported to have medicinal uses. Total phenolic and flavonoid contents showed positive correlations with the DPPH radical scavenging activity and negative correlations with EC50.   Conclusion: Prunus africana and H. abyssinica extracts had moderate antimicrobial properties against the selected microorganisms because of the presence of secondary metabolites