Nurses’ perception on healthcare services quality in mission hospitals in Kiambu County, Kenya

Background: Despite adoption of quality improvement initiatives in Kenyan Health facilities, quality gains are not yet optimal in both public and private sector. The private sector, which includes mission hospitals, face myriad of challenges ranging from perception of poor regulation to unqualified staff and gaps in quality of care.Purpose: To assess nurses’ perception on healthcare services' quality in mission hospitals in Kenya.Method: A descriptive cross-sectional study using quantitative and qualitative methods of data collection. Simple random sampling was used to select 188 nurses for administration of selfadministered questionnaire. A total of 20 in-depth interviews and 4 focus group discussions were conducted. Descriptive statistics and linear regression analysis were used to analyze quantitative data using SPSS v20. Qualitative data was analyzed thematically using Nvivo v11.Results: Overall nurses' perception of quality of services was 3.62. The perceived quality of services processes was 3.5187. Length of patient-provider interaction (β=0.225, t=4.761, p=0.001), teamwork (β=0.170, t=3.550, p=0.001), upholding patients’ rights (β=0.178, t=3.773, p=0.001), capacity to conduct quality assessment (β =0.125, t=2.510, 0.013) and availability of effective quality improvement teams (β=0.550, t=12.556, p=0.001).Conclusion: urses' perceived quality of services to be fair with a substantial room for improvement. To achieve a competitive edge, it is imperative for the hospital's management to engage visionary and quality conscious leaders, capable of identifying quality gaps and implementing improvement initiatives. The initiatives should focus on institutionalizing team-based quality audits, developing a quality patient-focused culture in service delivery

Birth Preparedness and Complication Readiness among Women with Pregnancy and Childbirth related Complications at Kenyatta National Teaching and Referral Hospital, Kenya

Background: In developing countries, particularly those in Sub-Saharan Africa, women and newborns continue to face increased risks of mortality and morbidity during the time of pregnancy, birth and postpartum. Preparing for childbirth and being ready for complications is a key strategy in reducing maternal mortality and morbidity as this would reduce delay in obtaining skilled maternal care especially during childbirth. This survey was evaluating birth preparedness and complication readiness (BPCR) among womenseeking services at Kenyatta National Teaching and Referral Hospital.Methods: A cross-sectional hospital-based study was conducted among women admitted in the antenatal and postnatal ward. Data was collected using a standardised questionnaire. A respondent was considered to have satisfactory BPCR if she reported that she had identified the place of delivery, made prior financial arrangements and organised for means of transport to place of childbirth and/or for the time of obstetric emergencies ahead of childbirth.Results: The survey recruited 353 women aged between 15 and 44 years. Majority were married (n=288, 81.6%) and unemployed (n=232, 65.7%). Additionally, most of the participants were multiparous (n=345,97.7%) and had made at least 1 visit at the Antenatal Clinic during their current pregnancy (n=331, 93.8%). The proportion of women whose BPCR was rated as satisfactory was 56.7% (95% confidence interval, (CI) 49.7% - 63.6%). Factors associated with satisfactory BPCR included: being married (OR10.66, 95%CI5.21-21.83), having post-secondary education (OR 11.52, 95% CI 6.62-20.05), being in formal employment (OR 4.14, 95%CI2.51-6.82), gestation >28 weeks (OR=1.83,95%CI1.08-3.09), multiparity (OR=1.87,95%CI1.21-2.88), visiting Antenatal Care Clinic (OR=9.31, 95% CI 2.70-32.09)and particularly visiting the clinic more than 2 times (OR=4.43, 95% CI 2.75-7.13).Conclusions: The study documented sub-optimal BPCR. This highlights the need to review the current strategies and approaches being utilised to promote BPCR

Impact of community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret, Kenya

Background: Despite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality, health care service of young street females (YSFs) is still deficient. The present study aimed to evaluate the impact of the community strategy package on the uptake of reproductive tract infections (RTI) health services among the target population. Materials and methods: A pre-test-post-test quasi-experimental with a qualitative and quantitative approach was applied among the YSFs aged 10–24 years. The study used structured questionnaires and key informant interviews to collect data from the respondents. Results: The study enrolled a total of 77 young street females in Eldoret municipality. A significantly higher proportion of respondents reportedly first sought treatment for RTI at a health facility after the implementation of the community strategy package (97.1%) when compared to the proportion of respondents who first sought treatment at a health facility in the pre-intervention phase (51.0%)(p＜0.001). Early seeking of treatment improved significantly after the introduction of the intervention; 72.0% and 94.1% of the respondents sought treatment early during the pre-intervention and post-intervention phase, respectively (p ​= ​0.011). Conclusion: The study recommends the adoption of the community strategy as an intervention to increase the uptake of RTIs health services and promotion of the reproductive health of young street females

Prevalence, knowledge, attitude and practice of speeding in two districts in Kenya: Thika and Naivasha

Introduction In Kenya, RTIs had the second highest increase in disability-adjusted life years between 1990 and 2010, compared to other conditions. This study aims to determine the prevalence, knowledge, attitudes and practices for speeding in Thika and Naivasha districts in Kenya. Methods Direct observations of vehicle speed were conducted at various times during the day and different days of the week on six roads selected based on a multi-stage sampling method in two districts to determine the prevalence of speeding. Roadside KAP interviews were administered to drivers, at motorcycle bays, petrol stations, and rest areas. Results Eight rounds of speed observations and four rounds of KAP interviews were conducted between July 2010 and November 2012. Results from the speeding observational studies show an overall high proportion of vehicles speeding above posted limits in both districts, with an average of 46.8% in Thika and 40.2% in Naivasha. Trend analysis revealed a greater decline in this prevalence in Thika (OR: 0.804, 95% CI: 0.793-0.814) than in Naivasha (OR: 0.932, 95% CI: 0.919-0.945) over the study period. On average, 58.8% of speeding vehicles in Thika and 57.2% of speeding vehicles in Naivasha travelled at 10 km/h or higher above speed limit. While the majority of respondents agreed that speeding is a cause of road traffic crashes in both Thika (70.3%) and Naivasha (68.7%), knowledge of speed limits at the location of the interview was limited. Enforcement levels also remained low, but subsequent rounds of data collection showed improvement, especially in Thika. Conclusions This study demonstrates an improvement in the prevalence of speeding in two districts of Kenya over 2010-2012. It also highlights the need for further action to be taken to address the problem, and represents new data on speeding in Kenya and Africa. © 2013 Elsevier Ltd

Trauma systems in Kenya: A qualitative analysis at the district level

© The Author(s) 2015. Injury is a leading cause of death and disability in low- and middle-income countries. Kenya has a particularly high burden of injuries, accounting for 88.4 deaths per 100,000 population. Despite recent attempts to prioritize injury prevention in Kenya, trauma care systems have not been assessed. We assessed perceptions of formal and informal district-level trauma systems through 25 qualitative semi-structured interviews and 16 focus group discussions with Ministry of Health officials, district hospital administrators, health care providers, police, and community members. We used the principles of theoretical analysis to identify common themes of prehospital and hospital trauma care. We found prehospital care relied primarily on good Samaritans and police. We described hospital care in terms of human resources, infrastructure, and definitive care. The interviewers repeatedly emphasized the lack of hospital infrastructure. We showed the need to develop prehospital care systems and strengthen hospital trauma care services

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis - implications for public health communications in Australia

Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. Participants Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). Main outcome measures Primary outcome: responses to question € If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'. Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates