Consumers’ Perceptions towards Goat’s Milk: Exploring the Attitude Amongst Consumers and Its Implication for a Dairy Goat Breeding Programme in Siaya County, Kenya

Although most of the milk consumed in Kenya comes from cows, goat's milk is becoming increasingly popular despite the often negative public perception as evidenced in the literature. Studies on consumer willingness to pay for goat’s milk have revealed that consumers were more willing to pay a premium price to obtain the milk. However, there is inadequate information on consumers’ attitudes towards consumption of goat’s milk, factors associated with this attitude and their implication on a dairy goat breeding programme. By assessing consumer perception, the current study examined consumers’ attitude towards goat’s milk in Siaya County of Kenya, the factors that influenced the decision, and their implications on a dairy goat breeding programme. A snowballing sampling technique was used to select a sample of 84 survey respondents in the County. Primary data was collected using interviews with the help of sets of structured and semi-structured questionnaires. A 5-point Likert continuum scale was used to analyze and rank perceptions of consumers, with one (1) as strongly disagreed and five (5) as strongly agreed. The results showed that consumers’ perception towards goat’s milk was positive. There was a relationship between perception towards goat’s milk and socio-economic factors like age and education. From the findings, it was also evident that the price of goat’s milk and its relative scarcity were barriers to its consumption. This implies that a dairy goat breeding programme is likely to be successful in the study area and in areas with similar production circumstances. Policy interventions are, therefore, recommended to educate consumers on quality attributes of goat’s milk and provision of high value genotypes of dairy goats to farmers in the County to increase the volume of milk supply from the goats and, due to economies of scale, subsequently lower the cost of production and stabilize the market price of goat’s milk. Keywords: Attitude, Consumer perception, Goat’s milk, Breeding programme, Keny

Electronic medical records and quality of prescriptions in general practice

Quality of care for elderly patients has become an increasingly important area of research especially due to rapid increase in the number and share of this population. Unfortunately, there is a persistent gap in quality of care received by elderly persons as compared to recommendations of clinical guidelines. In this thesis, we sought to understand the quality of prescribing and applicability of clinical rules for evaluation of quality of care among the elderly in general practice using existing electronic medical record (EMR) systems in the Netherlands. We conducted a systematic review and found that one in five prescriptions to elderly persons in primary care is inappropriate. In another study, we established that approximately half of the elderly patients who received prescriptions of NSAIDs in general practice in the Netherlands do not get concomitant prescription of gastroprotective medication as recommended by guidelines. We also found that the brand of EMR is associated with differences in the rate of prescription of gastroprotective medications. Furthermore, we developed Logical Elements Rule Method (LERM) to assess the amenability of clinical rules for use in automatic evaluation of quality of care. Using the LERM, we investigated the applicability of computerized assessment of quality care based on a set of clinical rules recommended for use in Dutch general practice. We found that clear definition of clinical rules; optimal design of databases and electronic linkage between primary and secondary healthcare facilities can improve automatic evaluation of quality of care and implementation of clinical decision support

Prevalence and characterization of musculoskeletal disorders amongst women attending antenatal clinics at selected health facilities in Nairobi Kenya

Objective: The objective of this study was to determine the prevalence and to characterize Musculoskeletal disorders (MSDs) amongst women attending antenatal clinics (ANC) at selected health facilities in Nairobi, Kenya. Design: A cross-sectional descriptive study with multi-stage random sampling Setting: Antenatal clinics. Main outcome measures: Nordic Musculoskeletal questionnaire (NMQ) was used to screen musculoskeletal discomfort. Subjects: 287 pregnant women Method: Data concerning socio-demographic characteristics were obtained using a NMQ. It was then analyzed using the statistical package for the social sciences (SPSS) version 25.0 for descriptive and inferential statistics. Results: A prevalence rate of 78.4 % (n=225) MSDs was recorded. Majority of women 79.1% (n= 178), reported lower quadrant disorders with only 20% (n=45) reporting both upper and lower quadrants disorders. The most prevalent MSDs were lower back pain (LBP) (54%; n=155), hips/thigh/buttocks pains (49.5%; n=142) and ankles/feet pains (41.5%; n= 119). Wrists and hands (11.85%, n= 34) MSDs were common in the upper quadrant. Over a half of the participants (55.1%, n=124) reported MSDs in third trimester (24-36 weeks), while 27.6% (n=62) and 17.3 % (n=39) in the second (12-24 weeks) and first (1-12 weeks) respectively. There was a  statistically significant association between having upper back (p= 0.049), LBP (p< 0.001) and hip/thighs/buttocks (p< 0.001) MSDs and the gestation stages. Conclusion: Over 3 out of 4 women attending ANC have MSDs. Advancement in gestation weeks characterized increase in prevalence of MSDs. The study highlights the importance of developing ANC programs that would enable women cope with pregnancy-related MSDs changes