Evaluation of the health-related quality of life of children in Schistosoma haematobium-endemic communities in Kenya: a cross-sectional study.

BACKGROUND: Schistosomiasis remains a global public health challenge, with 93% of the ~237 million infections occurring in sub-Saharan Africa. Though rarely fatal, its recurring nature makes it a lifetime disorder with significant chronic health burdens. Much of its negative health impact is due to non-specific conditions such as anemia, undernutrition, pain, exercise intolerance, poor school performance, and decreased work capacity. This makes it difficult to estimate the disease burden specific to schistosomiasis using the standard DALY metric. METHODOLOGY/PRINCIPAL FINDINGS: In our study, we used Pediatric Quality of Life Inventory (PedsQL), a modular instrument available for ages 2-18 years, to assess health-related quality of life (HrQoL) among children living in a Schistosoma haematobium-endemic area in coastal Kenya. The PedsQL questionnaires were administered by interview to children aged 5-18 years (and their parents) in five villages spread across three districts. HrQoL (total score) was significantly lower in villages with high prevalence of S. haematobium (-4.0%, p<0.001) and among the lower socioeconomic quartiles (-2.0%, p<0.05). A greater effect was seen in the psychosocial scales as compared to the physical function scale. In moderate prevalence villages, detection of any parasite eggs in the urine was associated with a significant 2.1% (p<0.05) reduction in total score. The PedsQL reliabilities were generally high (Cronbach alphas ≥0.70), floor effects were acceptable, and identification of children from low socioeconomic standing was valid. CONCLUSIONS/SIGNIFICANCE: We conclude that exposure to urogenital schistosomiasis is associated with a 2-4% reduction in HrQoL. Further research is warranted to determine the reproducibility and responsiveness properties of QoL testing in relation to schistosomiasis. We anticipate that a case definition based on more sensitive parasitological diagnosis among younger children will better define the immediate and long-term HrQoL impact of Schistosoma infection

Community-based natural resource use and management of Bigodi Wetland Sanctuary, Uganda, for livelihood benefits

publisher versionConservation and sustainable management of wetlands requires participation of local stakeholders, including communities. The Bigodi Wetland is unusual because it is situated in a common property landscape but the local community has been running a successful community-based natural resource management programme (CBNRM) for the wetland for over a decade. Whilst external visitors to the wetland provide ecotourism revenues we sought to quantify community benefits through the use of wetland goods such as firewood, plant fibres, and the like, and costs associated with wild animals damaging farming activities. We interviewed 68 households living close to the wetland and valued their cash and non-cash incomes from farming and collection of non-timber forest products (NTFPs) and water. The majority of households collected a wide variety of plant and fish resources and water from the wetland for household use and livestock. Overall, 53% of total household cash and non-cash income was from collected products, mostly the wetland, 28% from arable agriculture, 12% from livestock and 7% from employment and cash transfers. Female-headed households had lower incomes than male-headed ones, and with a greater reliance on NTFPs. Annual losses due to wildlife damage were estimated at 4.2% of total gross income. Most respondents felt that the wetland was important for their livelihoods, with more than 80% identifying health, education, craft materials and firewood as key benefits. Ninety-five percent felt that the wetland was in a good condition and that most residents observed the agreed CBNRM rules regarding use of the wetland. This study confirms the success of the locally run CBNRM processes underlying the significant role that the wetland plays in local livelihoods

The case of Tanykina community health insurance plan, Nandi County, Kenya.

Health financing mechanisms aims to achieve universal coverage for all and protection against the financial burden during illness. Community Based Health Insurance is one of the alternative sources of health financing especially in the rural and informal sectors. Tanykina Community Health Plan (TCHP) is a community based health insurance targeting the rural population and dairy farmers of Nandi North Sub County of Nandi County. Despite the wide coverage of the program, there is still low health care utilization in the sub-county. Using the Health Belief Model as the theoretical framework, the study purpose was to evaluate the clients and community perception of the services offered by Tanykina Community Health Plan and the influence they have on the utilization of health services by clients. The specific objectives were to evaluate the clients and community perceptions on the services offered by TCHP, to review the respondents' characteristics that determine the utilization of health services and to review the health provider factors that affect the utilization of health services by the clients of TCHP. This was a cross-sectional study design. Data was collected in March 2015 on a sample of 336 patients attending health facilities that offer services to clients of TCHP and the community at large. Systematic random sampling technique was used to determine the study sample. Data was collected using a structured interviewer administered questionnaire and analyzed by STATA version 10. Statistical tests were employed at 0.05 level of significant. Qualitative data was analyzed based on thematic framework to support the quantitative results. A total of 336 patients participated in the study of which 169(50.2%) were enrolled members of TCHP while 167(49.8%) were none members. Of all the respondents 183(54 %) were female and 163(48.5%) had attained at least secondary level of education. The enrolled members had the majority 94(55.6 %) being female and 91(53%) having attained college level of education compared to 82(49%) of the none-members. The average age of all the respondents was 41years. The level of education was highly correlated with increased healthcare utilization (p=0.069) though this was not statistically significant. Increased level of satisfaction correlated positively with increased used of outpatient services and this was statistically significant (p=0.05). The perceived availability of information was however no statistically significantly associated with increased utilization of health services in either outpatient department (p=0.112) or inpatient department (p=0.939). The increased level of perceived acceptance was highly associated with increased utilization of inpatient services (p=0.04). Being male increased the level of perceived acceptance by 10 % compared to the female counterparts. With regard to in-patient health services an additional increase in the level of education of the insured members and the duration of membership significantly increases the utilization of these services by 0.19 and 0.89 respectively. However, the duration of membership was statistically significant (p=0.008) in influencing the level of in-patient utilization. I recommend managers of community based health insurance to continuously evaluate the perceptions that the members have in order to improve utilization of health services. There is need to regularly monitor community based health insurance with respect to client satisfaction to enable prompt action by managers to act to increase the effectiveness of these schemes in achieving universal coverage

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

Analiza wydajności mlecznej i częstotliwości doju polskich krów rasy czarno-białej holsztyńsko-fryzyjskiej przebywających w oborze z automatycznym systemem doju (AMS)

The aim of the study was to analyse milk yield and the frequency of use of a milking robot by Polish HolsteinFriesian cows. The study was carried out on a farm where a double-stall Astronaut milking robot from Lely was installed in a free-stall slatted-floor barn for 120 cows. The material for the study was obtained from the herd management system and comprised 850 milking records. Daily milk yield (in kg), number of milking sessions per day, and average milk yield per milking were analysed. The experimental factors were lactation number (primiparous and multiparous cows), daily milk yield (≤15 kg, 15.1–25.0 and >25.0 kg) and stage of lactation (≤100 days, 101– –200 days and >200 days). The cows in the herd were found to use the milking robot with an average frequency of 2.49 times a day. No significant differences were noted in daily yield or frequency of milking between primiparous and older cows. They also did not differ significantly in terms of milk yield per milking. The level of daily yield influenced the milking frequency. Use of the milking robot was most frequent among primiparous and multiparous cows with daily yield of more than 25.0 kg of milk (2.82 and 2.67 times per day, respectively). In the case of both primiparous and multiparous cows, an increase in daily milking frequency was accompanied by an increase in the amount of milk obtained per milking. In the group of primiparous cows, the daily milking frequency increased in the three successive stages of lactation. Increased milking frequency was also found to be linked to a decrease in the amount of milk obtained in one milking. In the multiparous cows, the daily milk yield and quantity of milk per milking decreased systematically in successive stages of lactation, while the daily milking frequency varied irregularly