HEAD TEACHERS’ PARTICIPATIVE LEADERSHIP STYLE AND TEACHERS’ JOB SATISFACTION IN PUBLIC PRIMARY SCHOOLS IN BARINGO SUB-COUNTY, KENYA

This study investigated the effects of head teachers’ participative leadership style on teachers’ job satisfaction in public primary schools in Baringo Sub-county, Kenya. To this  far, lots of research conducted in this area have not been exhausted on the participative leadership style, rather most of the studies have focused on leadership in general. The study employed a descriptive cross-sectional survey design, in which both quantitative and qualitative methods of data collection and analysis were applied. The study respondents included 1250 teachers randomly selected from 127 public primary schools, 127 head teachers, and 127 School chairpersons (B.O.M representative) in Baringo Sub-county, Kenya. An interview schedule was used to analyse qualitative data using thematic analysis. The study used Pearson’s correlational analysis and established that there was a positive relationship between participative leadership style and teachers’ job satisfaction. Regression analysis established that job establishment and position had a control effect on job satisfaction. The study concluded that top positions in schools enjoyed more benefits in their positions and there is a need to streamline leadership aspects in most primary schools. The positive influence contributes to teachers’ job satisfaction in public primary schools in Baringo Sub-county, Kenya. This shows that Public Primary Schools in Baringo Sub-county, Kenya should consider applying head teachers’ participative leadership style in school. The study recommends that the head teacher needs to play the role of a coach and mentor at the same time to his/her subordinate.  Article visualizations

Entrepreneurial Orientation and Firm Performance: Evidence from Small and Micro-Enterprises in Kenya

Entrepreneurial orientation is a significant determinant of firm performance. The multifaceted nature of EO prompted a need for a more insightful study to bring to fore the extent of effect it has on performance. Nonetheless, past research has shown that simply examining the effect of Entrepreneurial Orientation on firm performance provides an incomplete picture. To stimulate the relationship between Entrepreneurial Orientation and firm performance, there is need to control internal and external contingent factors. Using data from 333 Small and Micro-enterprises (SMEs) in Uasin-Gishu County in Kenya, the study showed that innovativeness (β1= 0.632, p value = 0.000) and pro-activeness (β2= 0.246, p value = 0.000) have positive effects on firm performance; however, risk-taking  negatively  effects  firm performance (β3= -0.163, p value = 0.002). The study makes significant contributions to the understanding of the relationship between Entrepreneurial Orientation and performance of SMEs. This knowledge is invaluable to both SME owners and policy makers in designing and shaping firm and industry-level strategies that are appropriate for positive outcomes of entrepreneurship. Keywords: Entrepreneurial orientation, Innovativeness, Pro-activeness, Risk-taking, Firm Performanc

A Comparison of the Socio- Economic Characteristics of Dairy-Crop Integrators versus Non Integrators: A Case Study in Elgeyo-Marakwet County, Kenya

The aim of this study was to compare the different inherent socio economic characteristics amongst the dairy-crop integrators and non integrators in Elgeyo-Marakwet County, Kenya. The study carried out a census of 85 integrators and 85 non integrators. The data were collected with the help of a structured questionnaire. Descriptive statistics such as means and percentages were used to present the findings. The study found out that Integrators had a higher household size mean unlike the non integrators. The integrators had a lower mean in years of schooling of as compared to that of non integrators who had a higher mean of years of schooling. On the other hand, Integrators had a larger size of land on average as compared to non integrators. The study therefore recommends policy interventions to enhance access to credit, reduce illiteracy levels among rural entrepreneurs through training and extension services. Key words: Integration, Non-integration, Off-farm income, Househol

Herbal remedies and other risk factors for preterm birth in rural Kenya

Background: Premature infants contribute substantially to infant morbidity and mortality especially in low resource settings.  Information on herbal remedy use, previous preterm birth and low social-economic status and their association with incidence of preterm birth in Kenya is scanty. Objectives: To determine the use of herbal remedy use in pregnancy, previous preterm birth and low socio-economic status as risk factors for Preterm Birth in Kitui County among the immediate post-partum mothers. Methods: Unmatched case control study with a 1:4 ratio of cases to controls. The study was done in Kitui and Mwingi District Hospitals.  A total of 107 mothers with preterm birth (cases) and 453 mothers with term births (controls) were eligible and administered structured interviews. Results: Of the sample, 98% of cases resided in rural areas compared to 90% of controls.  The cases had a higher parity and were more likely to belong to the lowest three and four levels of socio-economic status. On multivariate logistic regression analysis, predictors of preterm birth were: preeclampsia (OR=9.06 [2.60-31.63], p=0.001), previous preterm, (OR=9.31 [2.82-30.68], p<0.001), low socioeconomic status (OR=1.51 [1.05-2.16], p=0.03), herbal use in first trimester for 2-5 days (OR=11.10 [4.34-28.41], p<0.001), herbal use in first trimester for 6-10 days (OR=44.87,[4.99-403.87] p=0.001), and herbal use in second trimester for 6-10 days (OR=16.43 [4.53-59.57], p<0.001). Use of prescribed folic acid in second trimester for more than 31 days was associated with lower risk of preterm birth (OR=0.20 [0.12-0.34], p<0.001). Conclusion: Herbal use in pregnancy regardless of gestation, previous preterm birth and low socio-economic status and are risk factors for preterm birth in Kitui County Kenya.  Interventions targeted to reduction of these risk factors will be an important additional prong in the reduction of preterm birth. Key words: Preterm birth, herbal remedy, risk factor

Dynamic MAIT cell response with progressively enhanced innateness during acute HIV-1 infection.

Mucosa-associated invariant T (MAIT) cell loss in chronic HIV-1 infection is a significant insult to antimicrobial immune defenses. Here we investigate the response of MAIT cells during acute HIV-1 infection utilizing the RV217 cohort with paired longitudinal pre- and post-infection samples. MAIT cells are activated and expand in blood and mucosa coincident with peak HIV-1 viremia, in a manner associated with emerging microbial translocation. This is followed by a phase with elevated function as viral replication is controlled to a set-point level, and later by their functional decline at the onset of chronic infection. Interestingly, enhanced innate-like pathways and characteristics develop progressively in MAIT cells during infection, in parallel with TCR repertoire alterations. These findings delineate the dynamic MAIT cell response to acute HIV-1 infection, and show how the MAIT compartment initially responds and expands with enhanced function, followed by progressive reprogramming away from TCR-dependent antibacterial responses towards innate-like functionality

A systematic review of task- shifting for HIV treatment and care in Africa

BACKGROUND: Shortages of human resources for health (HRH) have severely hampered the rollout of antiretroviral therapy (ART) in sub-Saharan Africa. Current rollout models are hospital- and physician-intensive. Task shifting, or delegating tasks performed by physicians to staff with lower-level qualifications, is considered a means of expanding rollout in resource-poor or HRH-limited settings. METHODS: We conducted a systematic literature review. Medline, the Cochrane library, the Social Science Citation Index, and the South African National Health Research Database were searched with the following terms: task shift*, balance of care, non-physician clinicians, substitute health care worker, community care givers, primary healthcare teams, cadres, and nurs* HIV. We mined bibliographies and corresponded with authors for further results. Grey literature was searched online, and conference proceedings searched for abstracts. RESULTS: We found 2960 articles, of which 84 were included in the core review. 51 reported outcomes, including research from 10 countries in sub-Saharan Africa. The most common intervention studied was the delegation of tasks (especially initiating and monitoring HAART) from doctors to nurses and other non-physician clinicians. Five studies showed increased access to HAART through expanded clinical capacity; two concluded task shifting is cost effective; 9 showed staff equal or better quality of care; studies on non-physician clinician agreement with physician decisions was mixed, with the majority showing good agreement. CONCLUSIONS: Task shifting is an effective strategy for addressing shortages of HRH in HIV treatment and care. Task shifting offers high-quality, cost-effective care to more patients than a physician-centered model. The main challenges to implementation include adequate and sustainable training, support and pay for staff in new roles, the integration of new members into healthcare teams, and the compliance of regulatory bodies. Task shifting should be considered for careful implementation where HRH shortages threaten rollout programmes

Decision makers' perspectives on implementation of governance attributes in the Kenyan Department of Health: a qualitative review in Uasin Gishu County

Background: Health care systems in low-income and middle-income countries, including Kenya, often perform poorly. Governance is increasingly recognised as an important factor in health system performance. However, conceptually and practically, governance remains poorly understood and difficult to measure. Attributes of good governance practices include transparency, equity, accountability, community participation and consensus orientation, setting shared directions, regulation and oversight, and the use of intelligence and information. The purpose of this paper is to examine the extent to which good governance attributes have been implemented by policy makers and managers of primary healthcare facilities in Uasin Gishu County, Kenya. Methods: Between April and July, 2016, we administered a survey to 108 decision makers at the constitutional level of governance in the department of health, Uasin Gishu County. We reviewed documents and collected data on practices of good governance using a 42-question self-administered structured questionnaire with open questions, and an adapted five -point Likert-type scale. We calculated proportions of level of agreement to establish the decision makers' perceptions on the extent of implementation of good governance practices. Cronbach's α for the items was between 0·7172 and 0·8421. We used factor analysis to identify latent factors. Qualitative information was coded and categorised into emerging themes. Findings: Data were collected between April and July, 2016. 93 people responded, of whom 42 (45%) were women. 58 respondents (64%) were older than 41 years; 64 (74%) had a degree qualification and 69% had been in their current positions for less than 5 years. About half of respondents agreed on good governance practices in strategic vision (51 [55%]) and regulation and oversight (50 [54%]). Respondents thought there was some effort, but that it was not good enough in implementing good practices in intelligence and information (51 [55%]), transparency (36 [39%]), participation and consensus orientation (44 [47%]), and respondents reported their belief that there were poor practices in accountability (64 [69%]) and equity (60 [65%]). The overall governance score was not good enough at 48% with only 9 respondents (10%) agreeing there were good governance practices. Though governance is mentioned in the strategic and development plans, there are no clear mechanisms of implementation and evaluation of governance attributes. Corruption, nepotism, lack of transparency, political interference and inadequate use of information affected governance performance. Interpretation: Our findings suggest that it is feasible to assess implementation of governance attributes in primary health care and we provide insight on strong and weak governance attributes. Overall, decision makers of Uasin Gishu County gave a poor score for governance of public health facilities. Structures should be put in place to improve accountability, equity, and community participation. Funding: Consortium for Advanced Research Training in Africa (CARTA); Future Health Systems

Cardiac manifestations of inherited metabolic disease linked to cellular vitamin B12 (cobalamin) uptake: Study in murine model of invalidation of Mtr gene in the heart

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