Policy making to address imbalances in human resources for eye health in rural Kenya

A human resources mapping study in 2011 highlighted that Kenya had attained the WHO target of 4 ophthalmologists per million population. However, 49% of the ophthalmologists were based in the capital city and served only 8% of the overall population. The cataract surgical rate was 553 operations per million population per year, which is significantly below the required rate of 2,000 per million population per year

A GROUNDED THEORY STUDY FOR ANTENATAL CARE IN KENYA

The purpose of the study was to analyze nurse–client interaction processes in rural health facilities. This was an inductive, qualitative, grounded theory study. Constant comparative analysis of data was used to generate themes, concepts and theoretical statements. Six main concepts emerged from data: Willingness of mother to attend antenatal clinic, reciprocal exchange of information, nursing care and treatment, focused preparation of mother, evaluating readiness for delivery within the rural context and referral of client. These concepts were key to the generation of “Owino’s theory of nurse-client interactions for childbirth preparedness”. Nurse-client interaction processes in preparation for delivery by a skilled attendant is influenced by the complex rural context. High quality interaction should help the nurse and mother rise above contextual challenges

UPTAKE OF TASK SHIFTING AS A COMMUNITY STRATEGY IN KENYA

The objective of the study was to evaluate the uptake of task shifting as a community strategy in Kenya. This study adopted qualitative data collection methods in three different contexts; peri-urban, rural and arid Kenya. The results suggest that voluntary counselling and testing, community health education, hygiene, referrals and family planning services should be shifted to Community Health Workers (CHWs) and they should be trained to diagnose and treat some common childhood ailment. There is evidence that CHWs perform an important role in helping to achieve the Millennium Development Goals (MDGs) for health, particularly for child survival and treatment of TB and HIV/AIDS. Effective task shifting requires appropriate utilization of primary health care services, effective training and incentives for health workers to provide services

DETERMINANTS DE LA SOUS-ALIMENTATION DES MENAGES EN CÔTE D’IVOIRE : CAS DES REGIONS CENTRE ET CENTRE-EST

Undernutrition is one of the major issues in the development agenda; the increase in food prices in recent years increases the vulnerability of households and climate change has adverse impacts on agricultural production.The objective of this study is to identify the determinants of undernutrition households in the Central and East-Central Côte d'Ivoire, ranked among the most deprived areas. Using data from the Survey of Household Living Standards (ENV 2002), Logit econometric models revealed that among these factors include household size, gender of household head, education level of the head household, the main occupation of the household head, the industry, living environment and the practice of farming. This analysis shows that the undernourished households are characterized in particular by high size, low level of education, the exercise of the profession of craftsman in the informal sector and are mostly headed by women. These determinants are levers that authorities may rely to reduce undernutrition. Therefore, it is desirable for the government to popularize family planning (reduction in household size), raising the level of education of the population at least at the secondary level, to promote the profession of craftsman by the capacity building and stakeholder access to microfinance to combat undernutrition

UPTAKE OF COMMUNITY HEALTH STRATEGY ON SERVICE DELIVERY AND UTILIZATION IN KENYA

Great Lakes University of Kisumu developed and tested a Comprehensive Primary Health Care (CPHC) model to facilitate the uptake of essential health services towards Millennium Development Goals (MDGs). The model focused specifically on the principles of intersectoral collaboration, community participation and empowerment to enhance access to health care. A study was undertaken in partnership with the Ministry of Health (MOH) to assess the implementation of the components of the model in different socio-demographic contexts in Kenya, and their relationship with health outcomes. This was a comparative, descriptive study which engaged the end users, policymakers, managers and communities in the design and implementation of research to enhance the utilisation of results. The CPHC intervention elements included: establishment of Community Health Units, governance and linkage structures, training of the health workforce, establishment of Community Based Information system and using it for regular dialogue at community and health facility levels leading to decisions and health actions.Findings showed improvements in governance and management of the health system; service delivery and health outcomes such as immunization coverage, Antenatal Clinic attendance and health facility delivery

Impact of internship programme on the performance of public health care institutions

The study seeks to obtain the impact of internship programme on the performance of public health care institutions. Contextual factors are sought that influence the relationship, impact and effect between internship programme and performance of public healthcare institutions. The research design adopted is descriptive survey through both qualitative and quantitative data. This study is conducted in Kakamega County, western region of Kenya. The population of the study is 2225 with a stratified randomly selected sample of 444 respondents. Primary data is collected through questionnaires while secondary data is sourced from official hospital records, journals, text books and internet articles. Data is analyzed using descriptive and inferential statistics. The study concludes that internship programme influences performance of public healthcare institutions

Factors influencing mobilization of Kenyan resources for health and development

Community Based Organizations (CBOs) have performed a key role in complementing initiatives of governments towards meeting the basic needs of its citizens not only in Kenya. This was a descriptive study that employed both qualitative and quantitative methodologies. Three sampling methods were used namely purposive, stratified and random. Purposive sampling was used to identify all the relevant CBOs while stratified sampling was applied on gender composition, nature of activities, level of performance, size of membership, geographical location among others while random sampling was utilized to identify CBOs within the various stratums. 14 CBOs were selected for the study from a population of 41 CBOs. Findings indicate that inaccessibility to resources from the corporate sector, presence of management structures and governance in CBOs among others has greatly influenced the ability of the CBOs to mobilize internal resources

Improvement of health outcomes through the contribution of entrepreneurial theories in Kenyan communities

Community Health Workers play an important role in the community strategy program in Kenya. They drive the crucial role of broadening access and coverage of health services in remote areas and undertake actions that lead to improved health outcomes. However, a lot of concentration on improvement of health outcome through this cadre of health workers has been purely a human health science issue and the progress of the process has been a bit slow. On the other hand, Community Health Workers potentials have also not been fully utilized due to their low economic status. Studies have shown the importance of having forces pushing the background factors to influence health outcomes. The one possible force is the driver influencing the socio-economic factors. The aim of the study is to inject an entrepreneurial model into the existing health model to drive the socio-economic aspect in the hope of improving the Community Health Workers economic status and the community health outcomes

Effects of distributive justice complaints resolution strategies on customer satisfaction in Kenya’s banking industry

Maintaining a loyal customer base has witnessed banks invest in various marketing strategies among them complaint resolution strategies so as to have an ever satisfied clientele. The purpose of this study is to establish the effect of customer complaint resolution strategies on customer satisfaction. The study utilizes an explanatory survey design and focuses on all the 20 banks based in Eldoret, Kenya as at June 2010. Additionally, 2300 customers are targeted for the study. A sample of 372 customers was selected using systematic sampling techniques. A self-administered questionnaire was used to collect primary data and both descriptive and inferential statistics were used for data analysis. The study reveals two dimensions of complaint resolution strategies; Equity and Need and explained 57% of the total variance hence distributive justice theory on complaint resolution is valid in Kenya. Results of the Hypothesis testing indicated that distributive complaint resolution strategies are significant (p<0.05) and accounts for 17% of customer satisfaction. The study concludes that distributive complaints resolution strategies are an important feedback mechanism to establish customer satisfaction levels and banks are advised to invest in them

The implication of the shortage of health workforce specialist on universal health coverage in Kenya

Abstract Background Globally, there is an acute shortage of human resources for health (HRH), and the greatest burden is borne by low-income countries especially in sub-Saharan Africa and some parts of Asia. This shortage has not only considerably constrained the achievement of health-related development goals but also impeded accelerated progress towards universal health coverage (UHC). Like any other low-income country, Kenya is experiencing health workforce shortage particularly in specialized healthcare workers to cater for the rapidly growing need for specialized health care (MOH Training Needs Assessment report (2015)). Efficient use of the existing health workforce including task shifting is under consideration as a short-term stop gap measure while deliberate efforts are being put on retention policies and increased production of HRH. Methods The Ministry of Health (MOH) with support from the United States Agency for International Development-funded FUNZOKenya project and MOH/Japan International Cooperation Agency (JICA) project conducted a country-wide training needs assessment (TNA) to identify skill gaps in the provision of specialized health care in private and public hospitals in 46 out of Kenya’s 47 counties between April and June 2015. A total of 99 respondents participated in the TNA. Structured questionnaires were used to undertake this assessment. The assessment sought to determine the extent of skill gaps on the basis of the national guidelines and as perceived by the County Directors of Health (CDH). The questionnaires were posted to and received by all the respondents a week prior to a face-to-face interview with the respondents for familiarization. Data analysis was done using SPSS statistical package. Results Overall, the findings revealed average skill gaps on selected specialists (healthcare professional whose practice is limited to a particular area, such as a branch of medicine, surgery, or nursing, especially, one who by virtue of advanced training is certified by a specialty board as being qualified to so limit his or her practice, Free dictionary) at 85 and 62% when compared to the guideline and as perceived by the CDH respectively. It also revealed that gynecologists exceeded the requirements by 88 and 246% against the guidelines and as perceived by the CDH respectively. Conclusion There is an overall huge gap in health specialists across the 46 counties, and the focus of training should be on the following specialists: cardio-surgeons, neurosurgeons, oncologists, nephrologists, lung and skin clinical officers, anesthetic clinical officers, cardiology nurses, forensic nurses, dental nurses, accident and emergency nurses, and oncology nurses. More innovative approaches, including the use of technology, need to be considered to address this challenge in the immediate, medium, and long terms. Policies and legal frameworks should be developed to facilitate cross-county sharing of specialist expertise. Efforts need to be made to ensure harmonized skill gaps revealed by the guideline and as perceived by the CDHs to inform the development of mitigation strategies