Adoption of Computerised Health Information System Focusing on Kenya’s Health Facilities

Although the benefits of information technology are clear adapting new information systems to health care has proven difficult globally and rates of use have been limited. With the challenge of inadequate health workers and low quality of service delivery, Information Communication Technology is essential to ensure availability of Information to multiple users and multiple settings. It is also important for Integration of variable types of data media, data legibility, reduced medical errors, complete and quality data. It also enable structured data entry, accurate calculation of processes, provision of tools for decision support and data based analysis. Although Kenya as a developing country has invested in Information Communication Technology with the aim of improving patient care, all indications have shown slow adoption of technology in healthcare industry. Therefore it is important to focus on means of hastening adoption of HIS in order to enhance service delivery in the health sector and hence effective service delivery for Kenyan people. Keywords: Adoption, Health Information Systems, ICT Infrastructure

The relationship between leadership and organisational effectiveness among indigenous banks in Kenya

Defining leadership effectiveness (LE) remains a controversial subject with scholars and researchers disagreeing on a common definition. Most studies term leadership effectiveness as the leaders’ ability to successfully exercise personal influence and abilities in order to accomplish set standards. Such leadership effectiveness was measured using three elements, namely influence, follow commitment and versatility. To be effective, leaders must possess certain competencies and perform specific tasks (independent variables). In this study, three leadership competencies, namely strategic thinking, emotional effectiveness and transformational leadership were examined. Similarly, seven leadership tasks (set organisational direction, develop human capital, build core competencies, create organisational alignment, sustain appropriate organisational culture, manage change and establish balanced organisational control) were identified as essential for the attainment of leadership effectiveness (intervening variable) which, in turn, leads to organisational effectiveness (dependent variable). Given the importance of leadership effectiveness to organisational effectiveness, the purpose of this study was to identify, investigate and empirically test the possible relationship between leadership effectiveness and organisational effectiveness within the Kenyan indigenous banks. To achieve the aim of the study, a survey was undertaken using a structured self-administered questionnaire. The respondents were identified using both probability and non-probability techniques with the survey yielding 257 usable questionnaires that were statistically analysed. The proposed hypothetical relationship between leadership effectiveness and organisational effectiveness was assessed using Structural Equation Modelling (SEM), a multivariate statistical technique. The SEM included Cronbach’s alpha and confirmatory factor analyses to assess the dicriminant reliability and validity of the measuring instrument, and Goodness-of-fit indices. The study findings demonstrated the existence of a strong relationship between leadership competencies, tasks performed and leadership effectiveness which in turn impacts on organisational effectiveness, in this case the overall effectiveness of the Kenyan indigenous banks

The Influence of Infrastructural Investment on Adoption of ICT in Health Information System: A Case of Sub County Referral Hospitals in Nakuru County, Kenya

The use of Information Communication Technology is essential in overcoming the challenges of inadequate health workers and low quality of service delivery. This study was an effort to strengthen the Health Management Information Systems pillar by seeking to assess the adoption of ICT in Health Systems in Nakuru County. The overall objective for this study was to assess the adoption of ICT in health information systems. For the purpose of this paper the researcher has focused on establishing the influence of infrastructural investment on adoption of ICT in HIS. The study employed cross-sectional design with a deductive approach. The target population was 534 made of medical personnel drawn from the sub-county Hospitals within Nakuru County out of which a sample of 98 respondents was used in the study. Data was collected using self-administered questionnaires with questions based on five points Likert Scale which required the respondents to indicate their level of agreement with the statements. The data was analyzed and descriptive statistics used to summarize the responses into frequencies and percentages. The findings were presented in bar graphs with descriptive narratives. The results showed that Lack of adequate ICT infrastructure has hampered ICT adoption in public hospitals in Nakuru County. The study recommends improvement of ICT infrastructure. The County Health Ministry should also support ICT adoption in the public hospitals by allocating adequate funds for this purpose. Keywords: Adoption of ICT, Health Information Systems, ICT Infrastructur

Interepidemic Rift Valley Fever Virus Seropositivity, Northeastern Kenya

Exposure is associated with long-term retinal disease and is most common in rural settings among older men who have contact with aborting animals

Use of Integrated Malaria Management Reduces Malaria in Kenya

BACKGROUND: During an entomological survey in preparation for malaria control interventions in Mwea division, the number of malaria cases at the Kimbimbi sub-district hospital was in a steady decline. The underlying factors for this reduction were unknown and needed to be identified before any malaria intervention tools were deployed in the area. We therefore set out to investigate the potential factors that could have contributed to the decline of malaria cases in the hospital by analyzing the malaria control knowledge, attitudes and practices (KAP) that the residents in Mwea applied in an integrated fashion, also known as integrated malaria management (IMM). METHODS: Integrated Malaria Management was assessed among community members of Mwea division, central Kenya using KAP survey. The KAP study evaluated community members' malaria disease management practices at the home and hospitals, personal protection measures used at the household level and malaria transmission prevention methods relating to vector control. Concurrently, we also passively examined the prevalence of malaria parasite infection via outpatient admission records at the major referral hospital in the area. In addition we studied the mosquito vector population dynamics, the malaria sporozoite infection status and entomological inoculation rates (EIR) over an 8 month period in 6 villages to determine the risk of malaria transmission in the entire division. RESULTS: A total of 389 households in Mwea division were interviewed in the KAP study while 90 houses were surveyed in the entomological study. Ninety eight percent of the households knew about malaria disease while approximately 70% of households knew its symptoms and methods to manage it. Ninety seven percent of the interviewed households went to a health center for malaria diagnosis and treatment. Similarly a higher proportion (81%) used anti-malarial medicines bought from local pharmacies. Almost 90% of households reported owning and using an insecticide treated bed net and 81% reported buying the nets within the last 5 years. The community also used mosquito reduction measures including, in order of preference, environmental management (35%), mosquito repellent and smoke (31%) insecticide canister sprays (11%), and window and door screens (6%). These methods used by the community comprise an integrated malaria management (IMM) package. Over the last 4 years prior to this study, the malaria cases in the community hospital reduced from about 40% in 2000 to less than 10% by 2004 and by the year 2007 malaria cases decreased to zero. In addition, a one time cross-sectional malaria parasite survey detected no Plasmodium infection in 300 primary school children in the area. Mosquito vector populations were variable in the six villages but were generally lower in villages that did not engage in irrigation activities. The malaria risk as estimated by EIR remained low and varied by village and proximity to irrigation areas. The average EIR in the area was estimated at 0.011 infectious bites per person per day. CONCLUSIONS: The usage of a combination of malaria control tools in an integrated fashion by residents of Mwea division might have influenced the decreased malaria cases in the district hospital and in the school children. A vigorous campaign emphasizing IMM should be adopted and expanded in Mwea division and in other areas with different eco-epidemiological patterns of malaria transmission. With sustained implementation and support from community members integrated malaria management can reduce malaria significantly in affected communities in Africa

Postepidemic Analysis of Rift Valley Fever Virus Transmission in Northeastern Kenya: A Village Cohort Study

RVFV infection causes significant disease in both human and animal populations, resulting in significant agricultural, economic and public health consequences. We conducted a cohort study on residents of a high-risk area to measure human anti-RVFV seroprevalence, to identify risk factors, and to estimate the durability of prior RVFV immunity. One hundred two individuals tested for RVFV exposure before the 2006–2007 RVF outbreak were restudied to determine interval anti-RVFV seroconversion and persistence of humoral immunity since 2006. Ninety-two additional subjects were enrolled from randomly selected households to help identify risk factors for current seropositivity. Seroprevalence in the region was high (23%). 1/85 at-risk individuals restudied in the follow-up cohort had seroconverted since early 2006. 29% of newly tested individuals were seropositive. After adjustment in multivariable logistic models, age, village, and drinking raw milk were significantly associated with RVFV seropositivity. Visual impairment (defined as ≤20/80) was much more likely in the RVFV-seropositive group. Among those with previous exposure, RVFV titers remained at protective levels (>1∶40) for more than 3 years. This study highlights the high seroprevalence among Northeastern Kenyans and the ongoing surge in seroprevalence with each RVF outbreak

The sero-epidemiology of Rift Valley fever in people in the Lake Victoria Basin of western Kenya

Rift Valley fever virus (RVFV) is a zoonotic arbovirus affecting livestock and people. This study was conducted in western Kenya where RVFV outbreaks have not previously been reported. The aims were to document the seroprevalence and risk factors for RVFV antibodies in a community-based sample from western Kenya and compare this with slaughterhouse workers in the same region who are considered a high-risk group for RVFV exposure. The study was conducted in western Kenya between July 2010 and November 2012. Individuals were recruited from randomly selected homesteads and a census of slaughterhouses. Structured questionnaire tools were used to collect information on demographic data, health, and risk factors for zoonotic disease exposure. Indirect ELISA on serum samples determined seropositivity to RVFV. Risk factor analysis for RVFV seropositivity was conducted using multi-level logistic regression. A total of 1861 individuals were sampled in 384 homesteads. The seroprevalence of RVFV in the community was 0.8% (95% CI 0.5–1.3). The variables significantly associated with RVFV seropositivity in the community were increasing age (OR 1.2; 95% CI 1.1–1.4, p<0.001), and slaughtering cattle at the homestead (OR 3.3; 95% CI 1.0–10.5, p = 0.047). A total of 553 slaughterhouse workers were sampled in 84 ruminant slaughterhouses. The seroprevalence of RVFV in slaughterhouse workers was 2.5% (95% CI 1.5–4.2). Being the slaughterman, the person who cuts the animal’s throat (OR 3.5; 95% CI 1.0–12.1, p = 0.047), was significantly associated with RVFV seropositivity. This study investigated and compared the epidemiology of RVFV between community members and slaughterhouse workers in western Kenya. The data demonstrate that slaughtering animals is a risk factor for RVFV seropositivity and that slaughterhouse workers are a high-risk group for RVFV seropositivity in this environment. These risk factors have been previously reported in other studies providing further evidence for RVFV circulation in western Kenya