Protein-Energy Malnutrition among Women of Child Bearing Age in Semi Arid Areas of Keiyo District, Kenya

Background: Women of child bearing age are vulnerable to food shortage in arid areas and this ultimately affects their nutritional status. Research on these women remains largely unexploited in many parts of the developing countries such as Kenya. The study sought to establish the prevalence of malnutrition and associated factors among women of child bearing age in the Semi arid areas of Keiyo District. .Methods: This was a cross-sectional survey of 335 randomly selected women from three semi arid divisions. Anthropometric measurements of height, weight and mid upper arm circumference (MUAC) were taken. Nutrient intake data was collected using a 24 hour recall questionnaire. A structured questionnaire was used to collect data on socio-demographic information.  Data was analysed using SPSS V.16.0. T-test, chi-square and logistic regression were employed in the analysis. P-value of less than 0.05 was considered significant. Results: The mean (SD) age of mothers was 29.9±6.3 years. The prevalence of CED was 44.9%. Compared to RDA, protein, energy, vitamin A, Iron and Zinc intake were significantly low (p<0.05). Vitamin C and Folate intake were significantly higher than RDA. Based on BMI, 39 (12.2%) were underweight, 54 (16%) overweight while 49 (15.9%) were obese. Only 120 (35.8%) of the households ate a diversified diet. Age, marital status, education level, occupation and income level were significantly associated with under-nutrition (p<0.05) Conclusion: Enhancing diversified diets should be encouraged. Awareness on proper nutrition should be done through education to the community

The Effect of Rehabilitation on Nutritional Status of Alcohol Dependent Males in Nairobi, Kenya

Background: Habitual alcohol consumption leads to alcohol dependency which is associated with significant nutritional, medical, economical, and social risks. This has become a major public health issue globally both in developed and developing countries. The main objective of the study was to determine the effect of rehabilitation on nutritional status of alcohol dependent males in Nairobi Place and Mathari hospital in Nairobi, Kenya. Methodology: This was an experimental (Pre-post) study design of 57 rehabilitated alcohol dependent males recruited for the study within one week of admission and re-assessed after four weeks. Semi-structured interviewer administered questionnaire was used to collect data on social-demographic characteristics. A food frequency questionnaire was used to collect information on food consumed. Chi-square test of association, T-test and multivariate logistic regression were employed in the analysis. All the analysis was done using SPSS V.16.0 for windows and results were considered significant at 5% ?- level. Results: The proportion of under-nutrition before and after rehabilitation at Nairobi place was 10% and 5% respectively (?2=0.604, p=0.865). Mathari had 16.2% and 8.1% underweight before and after rehabilitation respectively (?2=1.349, p=0.592). In the first encounter Nairobi place and Mathari hospital, nutrient inadequacies were high in vitamin C at 80% and 61.9%; zinc at 67.4% and 79.8%; folate at 80% and 49.7% respectively. In the second encounter Nairobi place provided food with adequate nutrients while Mathari hospital food was inadequate in folate, Vitamin A and Vitamin C at probabilities of 100%, 100%, and 93% respectively. Socio-demographic characteristics and diseases were not significantly associated with under nutrition (p>0.05). Conclusion: Alcohol was the cause of under-nutrition in both centers as other factors were not significantly associated with under-nutrition. Rehabilitation play a role in the nutrition status and recovery of alcohol dependent males. The Government and program managers need to consider and place emphasis nutrition in alcohol and drug rehabilitation programs. Keywords: Alcohol dependence, Rehabilitation, Nutritio

Factors Influencing Roles Played by Church Leaders in Community Health Programmes’ Sustainability in Homa Bay District-Kenya

Introduction: Sustainability of community health programs in resource limited countries within sub Saharan Africa like Kenya, pose major challenges to most of the governments and the perceived benefiting communities. Churches around the world are involved in one way or another in various types of community development programs. Their involvement promotes sustainability of these programs. Key health indicators in Kenya have been worsening day by day for over decades. Though there is a reverse in most of the indicators, they still remain poor in regards to World Health Organization’s standards. Worse, sustainability of the on going programs remains one key observable challenge that seeks for synergistic partnership. Direct roles played by Church leaders in community Health programs in Homa-Bay District were not clearly understood. What influenced them to or not to play a role in these programs were also not known, yet there were adequate evidences which showed that sustainability of community health programs remained a challenge for decades. This caused a concern for investigation. The aim of the study was therefore to assess factors influencing the roles church leaders’ play in community health programs sustainability in Homa Bay District. It specifically looked at the roles played by church leaders in the design, implementation, monitoring and evaluation of the on going programs together with other partners, their unilateral roles in churches that promote sustainability of ongoing programs and also to determine institutional factors that influence the roles they play in Community Health Programs at the District. Methodology: The study was a cross-sectional exploratory study that employed qualitative approach of data collection. The study population were ordained church ministers, who were either priests or pastors together with their local lay leaders from Catholic, Seventh Day Adventist, Anglican Church of Kenya, Baptist and Full Gospel Churches in Homa Bay District. The findings of the study revealed that, Church leaders play very minimal roles in the programs and they vary from one church to another. What influences their roles were: -        The degree of support from overall church leaders to respective internal committees. -        Adapted policies by partners / church. -        The functionality level of relevant government coordinating structures in the District. In conclusion, church leaders are established to have minimal support to ongoing health programs due to inadequate sensitization and involvement by the government coordinating structures. So there is a need for government to strengthen its commitment towards sensitising church leadership to be involved actively and consistently among other partner

THE RELATIONSHIP BETWEEN BURSARY DEMAND AND AMOUNT DISBURSED TO SECONDARY SCHOOL STUDENTS IN BUNGOMA COUNTY OF KENYA

Secondary school education is very critical in any education system because of the crucial role it plays in catalyzing national development. Consequently, maintaining a high student enrolment at this level should be a priority for all countries. The purpose of this study was to investigate equity in bursary allocation in relation to internal efficiency of secondary schools in Bungoma County, Kenya. The objectives of the study were: to determine the relationship between Bursary demand and amount disbursed to secondary school students. The study employed a mixed method research design. The sample size was 48 principals, 9 CDF managers, 5 bank managers and 883 students. Data was collected through questionnaires and document analysis. Qualitative data were analyzed through thematic narration, while quantitative data were analyzed using descriptive statistics and inferential statistics (multiple regression model and Pearson correlation). The study findings indicated that there was a strong significant relationship between Bursary amount applied and amount received. The study concluded that as the amount of bursary allocation to recipients increased so did the students’ performance with implication that higher bursary awards enables students to remain in school and attend lessons and they are more likely to perform better. Bursary disbursements were more or less the same between male and female students. The study recommended that children of the poor echelons of the society should be assisted to access the extra county schools through systematic measures that allow them to progress and perform well from primary schools.  Article visualizations

Effect of a patient-centered hypertension delivery strategy on all-cause mortality: Secondary analysis of SEARCH, a community-randomized trial in rural Kenya and Uganda

Background Hypertension treatment reduces morbidity and mortality yet has not been broadly implemented in many low-resource settings, including sub-Saharan Africa (SSA). We hypothesized that a patient-centered integrated chronic disease model that included hypertension treatment and leveraged the HIV care system would reduce mortality among adults with uncontrolled hypertension in rural Kenya and Uganda. Methods and findings This is a secondary analysis of the SEARCH trial (NCT:01864603), in which 32 communities underwent baseline population-based multidisease testing, including hypertension screening, and were randomized to standard country-guided treatment or to a patient-centered integrated chronic care model including treatment for hypertension, diabetes, and HIV. Patient-centered care included on-site introduction to clinic staff at screening, nursing triage to expedite visits, reduced visit frequency, flexible clinic hours, and a welcoming clinic environment. The analytic population included nonpregnant adults (≥18 years) with baseline uncontrolled hypertension (blood pressure ≥140/90 mm Hg). The primary outcome was 3-year all-cause mortality with comprehensive population-level assessment. Secondary outcomes included hypertension control assessed at a population level at year 3 (defined per country guidelines as at least 1 blood pressure measure \u3c140/90 mm Hg on 3 repeated measures). Between-arm comparisons used cluster-level targeted maximum likelihood estimation. Among 86,078 adults screened at study baseline (June 2013 to July 2014), 10,928 (13%) had uncontrolled hypertension. Median age was 53 years (25th to 75th percentile 40 to 66); 6,058 (55%) were female; 677 (6%) were HIV infected; and 477 (4%) had diabetes mellitus. Overall, 174 participants (3.2%) in the intervention group and 225 participants (4.1%) in the control group died during 3 years of follow-up (adjusted relative risk (aRR) 0.79, 95% confidence interval (CI) 0.64 to 0.97, p = 0.028). Among those with baseline grade 3 hypertension (≥180/110 mm Hg), 22 (4.9%) in the intervention group and 42 (7.9%) in the control group died during 3 years of follow-up (aRR 0.62, 95% CI 0.39 to 0.97, p = 0.038). Estimated population-level hypertension control at year 3 was 53% in intervention and 44% in control communities (aRR 1.22, 95% CI 1.12 to 1.33, p \u3c 0.001). Study limitations include inability to identify specific causes of death and control conditions that exceeded current standard hypertension care. Conclusions In this cluster randomized comparison where both arms received population-level hypertension screening, implementation of a patient-centered hypertension care model was associated with a 21% reduction in all-cause mortality and a 22% improvement in hypertension control compared to standard care among adults with baseline uncontrolled hypertension. Patient-centered chronic care programs for HIV can be leveraged to reduce the overall burden of cardiovascular mortality in SSA

ETHNOBOTANICAL STUDY OF MEDICINAL PLANTS USED BY SABAOTS OF MT. ELGON KENYA.

Though the majority of people in Kenya and at Kopsiro Division in particular, rely on ethnomedicinal plant species to manage human ailments, the indigenous knowledge largely remains undocumented. Therefore, an ethnobotanical study was conducted on medicinal plant species used to manage human ailments at Kopsiro Division Mt. Elgon District Kenya. The objectives were to identify and document plants traditionally used for medicinal therapy by the Sabaots, to find out the method used for preparing and administering the drugs and to find out the conservation practices for the medicinal plants. Observations and semi-structured interviews were used to gather ethnobotanical data. 107 plants belonging to 56 families were identified and reported to be of medicinal value to the locals. Roots (47.3%) were the most frequently used parts of the plant followed by the bark (23.35%) then leaves (22.75%). The whole plant (1.8%), seed (1.2%), fruit (1.2%), sap (1.2%), flower (0.6%) and wood (0.6%) are least used in that order. The study revealed other hitherto undocumented medicinal plant species that may be new records for treating various ailments. Traditional medicine in Kopsiro division offers cheap, accessible and convenient remedy that suits the traditional lifestyle of the local community in comparison to the conventional medicine. Most medicinal plant species reported in this study were found to be under threat and this calls for urgent conservation measures so as to maximize the sustainable use of these vital resources in the study area

Effect of Phosphate Levels on Soil Rhizosphere Nutrient Balances and Finger Millet Yield

Soil infertility is one of the main factors leading to low finger millet production in the semi-arid tropics of Kenya. About 50-80% of P applied as fertilizer is adsorbed by soil and the amount of P needed to achieve maintenance of its adequate status and influence on other soil properties has not been well documented. An on-station experiment was therefore conducted at the KALROKiboko research station during the 2014 long and 2015 short rain seasons to investigate the influence of phosphorus rates on soil rhizosphere chemical properties and yield of three finger millet varieties. The experiment was laid out in a Randomized Complete Block Design in factorial arrangement and replicated three times. There were four P levels (0, 12.5, 25 and 37.5 kg ha-1 P2O5) and three varieties (U15, P-224 and local check-Kat FM1). Phosphorus application reduced the soil pH significantly for both seasons with the 37.5 kg ha-1 P2O5 rate eliciting the greatest pH from 9.26 to 7.90 (1.36 units) during the long rain season. As expected, soil phosphorus increased with the highest rate with 11 ppm during the long rain season and 9 ppm for the short rains. The organic carbon increased by 0.28% for the long rain season on the 25 kg ha-1 P2O5 rate while the highest rate increased total N by 0.05%. The 25 kg ha-1 P2O5 rate and U-15 indicated the highest yield for both seasons with a maximum of 3.71 t ha-1 realized during the short rain season. Monitoring change in soil nutrient status is important for prescribing P fertilization in order to maintain or replenish soil fertility. The application rate of 25 kg ha-1 P2O5 led to the optimal yields under the improved variety and hence the study recommends this rate

The challenges of achieving high training coverage for IMCI: case studies from Kenya and Tanzania

Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007–08

Finger Millet (Eleusine coracana) Fodder Yield Potential and Nutritive Value under Different Levels of Phosphorus in Rainfed Conditions

Scarcity of fodder is the major limiting factor for increasing livestock production in Kenya. With rising energy costs and declining water levels in the semi-arid tropics and sub-tropics, crops that use less water like finger millet could become an alternate fodder crop. The fodder potential of three finger millet varieties (U-15, P-224 and a local check) were evaluated under four P fertilizer levels (0, 12.5, 25 and 37.5 kg ha-1 P2O5) at three sites in Kenya for two cropping seasons. The trials were laid in randomized complete block design in factorial arrangement and replicated three times. A maximum of 28,189 kg ha-1 fresh stover yield was realized in the 25 kg ha-1 P2O5 treatment and consequently 11,616 kg ha-1 dry stover yield. The 25 kg ha-1 rate elicited the highest fresh stover yield at Kakamega and Alupe for both seasons while at Kiboko a linear increase was observed on the stover yield with increasing rates where the highest rate had more than 15% yield compared to the control. The varieties also showed significant differences in all the sites with the local variety, Ikhulule, showing the highest fresh and dry stover yield at Kakamega and Alupe peaking at 28,852 and 12,826 kg ha-1 fresh and dry stover yields respectively. Interactions between variety and phosphorus rates were revealed on the crude protein content of the finger millet stover. At Kiboko, the highest crude protein (11.0%) on varieties P-224 and U-15 was exhibited at the highest rate while on the local variety, Ekalakala, the highest protein (10.9%) was realized at the 25 kg ha-1 P2O5. At Kakamega and Alupe, the highest protein was observed on the local variety, Ikhulule at 12.5 kg ha-1 P2O5 rate with variety P-224 and U-15 showing the highest at the 25 and 37.5 kg ha-1 P2O5 respectively. Therefore, finger millet can provide a unique opportunity to improve the availability of fodder to smallholder livestock farmers