Mothers’ knowledge of mother-to-child transmission of HIV and infant feeding practices in Juba, South Sudan

Introduction: While exclusive breastfeeding for the first six months of life is recommended for HIV-infected mothers, this may not be practiced fullyin South Sudan; exclusive formula feeding, which is the best alternative to breastfeeding, may not be practical.Objective: To assess the knowledge of mother-to-child transmission of HIV (MTCT) and practices of feeding infants in the first six months of life among HIV-infected mothers attending Antiretroviral Therapy Centres in Juba Teaching Hospital (JTH) and Juba Military Hospital (JMH).Method: A cross-sectional study in which 304 HIV-infected mothers with children aged 6-18 months were interviewed between October and  December 2016 using structured questionnaires. Key informant interviews (KIIs) and focus group discussions (FGDs) were also conducted using interview guides. Quantitative data was analysed using Statistics Package for Social Sciences software. Chi-square test was used to test the presence of significant association between the variables and the association is statistically significant when the p-value is < 0.05. Multiple logistic regression analysis was used to identify which predictor variables have major effect on the dependent variable. Qualitative data was transcribed in English and summarized according to the key themes, and the information obtained was used to supplement and interpret the findings of the quantitative data.Results: Only 120 (40%) of the HIV-infected mothers had a good knowledge of MTCT; 213 mothers (70.1%) practiced mixed feeding, 70 (23.0%)  practiced exclusive breastfeeding and 20 (6.6%) practiced exclusive formula feeding. The factors that were found to have a positive effect on choice of infant feeding methods were having more than one child (odds ratio = 0.303, 95% Confidence interval: 0.161-0.571, p = 0.001) and participation in the prevention of motherto-child transmission of HIV programme (PMTCT) (odds ratio = 2.260, 95% Confidence interval: 1.251-4.084, p = 0.007). Stigma (p = 0.248) and mothers’ knowledge of MTCT (p = 0.072) were not statistically significantly associated with the mothers’ infant feeding practices.Conclusion: Knowledge of MTCT is low. Mixed feeding before six months of age is predominant among the HIV-infected mothers. It is thereforerecommended that HIV-infected mothers receive adequate information from counsellors regarding MTCT and exclusive breastfeeding for the first six monthsof an infant’s life.  Key words: Knowledge, infant feeding, HIV-infected mothers, Juba

INFLUENCE OF TEACHER CHARACTERISTICS ON LEARNING READINESS AMONG 5-6 YEARS OLD IN PUBLIC PRE-SCHOOLS IN KIMILILI-BUNGOMA SUB-COUNTY, KENYA

Learner readiness enhances academic achievement and predicts children’s performance in the near future. Children who are ready are less likely to experience behavioural and emotional problems and score higher in reading, mathematics and fine motor skills than those who are not ready. However, teachers are still struggling with learners from preschool who are not well prepared for grade one. This paper provides empirical evidence of the influence of teacher characteristics on learning readiness among 5-6 years old using data obtained from 356 pre-schoolers and 55 preschool teachers in public pre-schools in Kimilili-Bungoma Sub County, Kenya. The multiple regression analysis results indicate that selected teacher characteristics variables (age, years of schooling and number of workshops attended) are statistically significant in explaining variations in learning readiness among pre-schoolers. It is recommended that the Ministry of Education, County and Sub-County Education office and public preschools should ensure that preschool teachers managing learners are qualified and attend more in service training.  Article visualizations

Quality Education for the Pastoralist in Public Primary Schools in Kajiado County, Kenya: Case Study of Dupoto-E-Maa Education Project in Kajiado Central District

Conditions of learning are critical in determining quality of education. There have been real concerns raised by stakeholders regarding the quality of education for pastoralists in public primary schools in Kajiado Central District in Kenya. Interventions have been put in place to address the issue of quality education. One such intervention is the Dupoto-e-Maa education project. The study investigated the extent to which the project has promoted quality educations in terms of institutional capacity in the public primary schools in Kajiado Central District. The evaluation used both cross-sectional survey and phenomenological research designs. Phenomenological research design provides in-depth information about individuals, groups or institutions as they naturally occur. This design helped generate qualitative data through information gathered from head teachers, School Management Committees (SMC), teachers, pupils, Quality Assurance and Standards Officer (QASO) and project staff. The cross-sectional survey design assisted the evaluators to access quantitative data from a wide range of informants. A sample size of 183 respondents was selected using purposive sampling as well as stratified random sampling procedures. Head teachers of the sampled schools participated as key informants. The instruments of data collection used in the study included questionnaires, interview guide, document analysis guide, Focus Group Discussion (FGD) guide as well as observation guide. From the analysis it was concluded that Dupoto-e-Maa education project had significantly contributed to improved institutional capacity in terms of installing new facilities in schools as well as rehabilitating the existing ones. They were also involved in teacher training programs as well as stakeholders’ awareness campaigns. The study recommends that the Constituency Development Fund (CDF), the County Government of Kajiado and the Government of Kenya (GoK) should allocate/commit more resources for improved infrastructure as well as in-service training and professional support of teachers. The findings could also be used to inform policy dialogue with regard to education for pastoral communities. Keywords: Pastoralists, Quality education, Institutional capacity, Public primary schoo

Gender differences in HIV testing service visits and its related factors among adults: a cross-sectional study in Homa Bay, Kenya

Introduction: at least 90% of people living with human immunodeficiency virus (HIV) were expected to know their HIV status by 2020. However, only 84% are aware of their status. This study determined the frequency of HIV testing services visits (HTS) and its related factors to HTS visits among adults in Homa Bay County, Kenya. Methods: this was a cross-sectional study. Quantitative and qualitative data were collected. A backward stepwise logistic regression analysis was conducted for quantitative data by gender. Qualitative data were thematically categorised into factors of HTS visits by gender. Results: a total of 645 adults participated in quantitative survey and 17 in qualitative survey. There were no gender differences in the frequency of HTS visits (males=56.3%; females= 58.7%, P=0.785). The frequency of visits was however significantly different between the rural-based (Rachuonyo North=87.5%; Ndhiwa=58.7%) and urban-based (Homa Bay Town=36.8%) facilities at P<0.001. In males, HTS visits were positively associated with ´being in Protestant church´, ´partner´s attitude´, and ´being accompanied by a friend to HTS´. ´Distance to HTS´ was negatively associated with HTS visits in males. For females, 'sexual intercourse in the past 2-5 months´ was positively associated with HTS visits. ´Being in a polygamous marriage´, ´not married´, ´community HIV testing´, and ´affordability of transport cost to HTS centre´ were negatively associated with HTS visits. Conclusion: there were no gender differences in the frequency of HTS visits. Social position for males and position in the family for females are suggested as the factors influencing HTS visits in Homa Bay County

Comparative functional exercise capacity of patients with type 2-diabetes and healthy controls: a case control study

Introduction: functional Exercise Capacity (FEC) is a valid measure of physical fitness in health and disease. However, there is paucity of studies on FEC in African patients with Type-2 Diabetes (T2D). This study compared FEC between patients with T2D and healthy controls. Methods: thirty five patients with T2D (18 men, 17 women) and 35 (16 men, 19 women) age-sex matched healthy controls participated in this case-control study. Anthropometric and demographic characteristics and cardiovascular parameters were measured following standard procedures. A glucometer was used to determine the Fasting Blood Glucose (FBG) level following at least 8 hours of overnight fasting. FEC was assessed using the Six-Minute Walk Test (6MWT) while Hand Grip Strength (HGS) test was measured with an electronic dynamometer. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05. Results: patients with T2D and controls were similar in age (p>0.05). There were significant differences in the distance covered during 6MWT between patients and controls (t= 0.329; p =0.03), exercise capacity (t=0.329; p=0.03), FBG (t=7.403; p=0.001), systolic and diastolic blood pressure (t=12.56; p=0.001 and t = 27.23; p = 0.001) respectively. There were significant inverse relationships between 6MWD and Body mass index (r = -0.39; p=0.02) and FBS(r = -0.51; p=0.02) in patients with type-2 respectively. No significant association was found between exercise capacity and HGS (p>0.05). Conclusion: patients with type-2 diabetes demonstrated lower functional exercise capacity than healthy controls. High body mass index and fasting blood glucose were significantly associated with lower functional exercise capacity

Teacher Education Students’ Pedagogical Content Knowledge: Retooling the Mentorship Process Within Schools of Education in Kenya

The impact of globalization has brought changes to education which requires teachers to demonstrate practical pedagogical wisdom in critical features of teaching, namely: the subject matter being taught, the classroom context, and the physical and psychological characteristics of the students, that is, Pedagogical Content Knowledge (PCK). High level of Pedagogical Content Knowledge (PCK) leads to delivery of high-quality instruction in today’s highly contextualized classroom settings and has the potential of producing learners who are prepared for a competitive society. However, teachers’ lack of PCK has been identified as a pervasive problem all over the world. In Kenya, it has been highly linked to the recurrence of poor performance in local and internal competitive examinations, poor attitudes in some subjects, and lack of motivation for continuous learning among school-age children along the education continuum. Even so, the voice of student teachers and that of the school practice advisors, at the center and apex of this mentorship process in the Universities, has been largely ignored in transformative teacher education discourse. Guided by literature on transformative teacher education, student teacher mentorship, and reflective pedagogy, this paper presents the perspectives of 50 Student Teachers (STs) and 10 School Practice Advisors. STs confidence in special teaching methods courses, pedagogical content competence in teaching both independently and collaboratively, key areas of concern for PCK improvement, and practical strategies for PCK mentorship were the focus. Based on a qualitative and an interpretive research paradigm, the sentiments of 50 STs who participated in the May-August, 2017 School Practice as well as the views of 10 School Practice Advisors (SPAs) from the School Education (SEDU) of Masinde Muliro University of Science and Technology were sought. Based on four domains of Pedagogical Content Knowledge (PCK) which include  Subject Matter Knowledge (SMK), Knowledge of Curriculum (KoC) and Knowledge of Learners (KoL), and Knowledge of Pedagogies (KoP), the paper provides insights for teacher educators and University Management on areas that need further improvement and strategies for developing beginning teachers’ PCK practices

Teacher Education Students’ Pedagogical Content Knowledge: Retooling the Mentorship Process Within Schools of Education in Kenya

The impact of globalization has brought changes to education which requires teachers to demonstrate practical pedagogical wisdom in critical features of teaching, namely: the subject matter being taught, the classroom context, and the physical and psychological characteristics of the students, that is, Pedagogical Content Knowledge (PCK). High level of Pedagogical Content Knowledge (PCK) leads to delivery of high-quality instruction in today’s highly contextualized classroom settings and has the potential of producing learners who are prepared for a competitive society. However, teachers’ lack of PCK has been identified as a pervasive problem all over the world. In Kenya, it has been highly linked to the recurrence of poor performance in local and internal competitive examinations, poor attitudes in some subjects, and lack of motivation for continuous learning among school-age children along the education continuum. Even so, the voice of student teachers and that of the school practice advisors, at the center and apex of this mentorship process in the Universities, has been largely ignored in transformative teacher education discourse. Guided by literature on transformative teacher education, student teacher mentorship, and reflective pedagogy, this paper presents the perspectives of 50 Student Teachers (STs) and 10 School Practice Advisors. STs confidence in special teaching methods courses, pedagogical content competence in teaching both independently and collaboratively, key areas of concern for PCK improvement, and practical strategies for PCK mentorship were the focus. Based on a qualitative and an interpretive research paradigm, the sentiments of 50 STs who participated in the May-August, 2017 School Practice as well as the views of 10 School Practice Advisors (SPAs) from the School Education (SEDU) of Masinde Muliro University of Science and Technology were sought. Based on four domains of Pedagogical Content Knowledge (PCK) which include  Subject Matter Knowledge (SMK), Knowledge of Curriculum (KoC) and Knowledge of Learners (KoL), and Knowledge of Pedagogies (KoP), the paper provides insights for teacher educators and University Management on areas that need further improvement and strategies for developing beginning teachers’ PCK practices

Utilizing Technology: A Cross-Sectional Study on ICT in Healthcare in Kericho County, Kenya

Introduction: The potential for Information and Communication Technology (ICT) in healthcare is immense, revolutionizing the delivery of medical services and improving patient outcomes. ICT efficiently manages health information, facilitating electronic health records (EHRs) and streamlined communication among healthcare professionals, leading to significant changes, especially in underserved areas. Material and Methods: This cross-sectional study took place between March and April 2023 among healthcare professionals in Kericho County, Kenya. Participants were selected using simple random sampling and completed a self-administered questionnaire. Data on the ICT status of health facilities were collected using a checklist. The qualitative component involved key informant interviews with a health record and information department officer. Collected data were entered into Excel and analysed using R software for quantitative data and thematic analysis for qualitative data. Results: The study engaged 201 participants. Findings showed a 67.66% [95% CI=0.607, 0.741]; p-value<0.0001, uptake of ICT among healthcare workers. Those with computer training were approximately 10 times [OR = 10.867, 95% CI=3.121, 40.99] more likely to utilize ICT in service delivery than those without IT training. Operating at least one healthcare database was associated with over 2 times [OR=2.552, 95% CI=0.7475, 8.7195] higher likelihood of ICT uptake compared to those without this skill. Health facilities with eHealth platforms showed, on average, 38% higher [OR=1.386, 95% CI=0.7661, 2.223] utilization of ICT than those without. Conclusion: IT training for personnel is crucial, ensuring they can operate preferred health management and information systems (HMIS) within the sector. The presence of an IT department and the use of ICT for administrative purposes significantly affected the general uptake of ICT in health facilities. Additionally, infrastructure such as roads, power, and security had a significant association with ICT compliance. Improving these supportive elements will considerably enhance ICT uptake in healthcare

Healthcare providers’ level of involvement in provision of smoking cessation interventions in public health facilities in Kenya

Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers’ practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR=3.66; 95%CI: 1.63-8.26; P=0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker’s involvement in provision of smoking cessation care in Kenya

Food Environment in and around Primary School Children’s Schools and Neighborhoods in Two Urban Settings in Kenya

We conducted a cross-sectional study to provide an overview primary school children food environment in two urban settings in Kenya. Six schools, catering to children from low-, medium- and high-income households in the cities of Nairobi and Kisumu in Kenya, participated in the study. Data on types of food places and foods offered were collected and healthy and unhealthy food availability scores calculated for each place. We utilized prevalence ratio analysis to examine associations between food availability, food place characteristics and neighborhood income levels. Altogether, 508 food places, located within 1 km of the schools and the school children’s neighborhoods were observed. Open-air market sellers and kiosks were most common. The proportion of food places with high healthy food availability was 2.2 times greater among food places in Nairobi compared to Kisumu, 1.9 times greater in food places with multiple cashpoints, 1.7 times greater in medium/large sized food places and 1.4 times greater in food places located in high income neighborhoods. These findings highlight differences in availability of healthy foods and unhealthy foods across types of food places and neighborhood income levels and inform public health interventions aimed at promoting healthy food environments in Kenya