Risk Factors for Non-communicable Diseases Among Adults of 25-65 Years at Kakamega County General Hospital, Kenya

In Kenya the growing number of premature deaths with half of all hospital admissions and 33% of all deaths are associated with Non-communicable diseases. The study determined the physical measurements and lipid parameters of adults 25-65 years at Kakamega County General Hospital. Data was collected using the WHO STEPs Instrument: Physical measurements assessed were Mid Upper Arm Circumference, Waist Hip measurements, Body mass Index and blood pressure. The study significance level was 0.05. Data was analyzed using SPSS version 20. Descriptive statistics was used. χ2 test of independence was used to find out the relationship between anthropometric measurements and lipid parameters. Data was presented in form of tables, figures and texts. There was a significant relationship between BMI and Triglycerideχ2 (12, N=60)= 25.752 P=0.012, BMI and LDLχ2(8,N=60)=19.312 p=0.013, BMI and Total Cholesterol χ2(8, N=60)=18.694 p=0.017, MUAC and HDL χ2(4, N=60) =14.446 p=0.006, WHR and Total Cholesterol χ2(2, N=60)=17.985 p=0.000, WHR and LDL χ2(2, N=60)=15.246p=0.000. The study advocated for policies to reduce the incidences of risk factors for NCDs which will assist in achievement of Sustainable Development Goals. Kenyan population are in need of screening for risks associated with NCDs

Assessing Capacity and Performance of Health Systems Using Principal Component Analysis: Results from Cross Sectional Survey in Kakamega County, Western Kenya

Background: Strong health systems are fundamental if countries are to improve health outcomes and accelerate the attainment of the Sustainable Development Goal (SDGs) number 3 ‘Ensure healthy lives and promote well-being for all at all ages.’ Despite the strong consensus on need to strengthen health systems, many health systems lack the capacity to measure or understand their own weakness and constraints which effectively leaves policy makers without ideas of what they should actually strengthen. Methods: Principal Component Analysis (PCA) was used to factor weights which were used to assess individual contribution of indicators to the health system performance.  PCA is a type of a multivariable linear regression of all indicators in one model. PCA index was classify variables from heighted to the lowest indicator and further used to rank the indicator. Indicators of individual health system building block were weighted independently to measure the amount of contribution to the respective health system building block. The weights were then aggregated to produce individual health system building block indices which were the independent variables in the multivariable linear regression model. Coefficients of the regression was used to assess marginal effects and p-value<0.05 were considered statistics significant result Results: Service delivery (p<0.0001), health financing (p<0.0001), health workforce (p=0.005) and medical supplies and commodities (p<0.0001) had significant effect on service provision. Health governance was not a significant factor influencing service provision. Conclusions: Among the health system building blocks that significantly influenced service provision were service delivery, health workforce, and health financing and medical supplies. This is the first study to the best of the knowledge of the researcher to apply principal component analysis, to analyze health system performance in a devolved system Kakamega. The method provides opportunity for future application in health systems analysis even in absence of comparative data Keywords: Principal Component Analysis, Health Systems DOI: 10.7176/JHMN/59-0

Factors affecting physical activity of recuperating alcoholics in Asumbi-Homabay rehabiliation center, Kenya

Background: Alcoholism is a widespread problem in Kenya and is associated with severe impacts on health and quality of life of the individual. Physical activity is an affordable and sustainable adjunct treatment option for recuperating alcoholics; however its’ rarely used in rehabilitation of alcoholics in Kenya. Objective: This qualitative study sought to elicit facilitators and barriers that influence the practice of physical activity amongst recuperating alcoholics under rehabilitation. Methods: A focus group guide was utilized to gather views and perceptions of 15 alcoholics and 5 health professionals through focus group discussions. Constant comparative approach was used to analyze verbatim transcripts obtained from in-depth interviews. This analysis entailed three stages including open, axial and selective coding. Results: Recuperating alcoholics’ recognized various forms of physical activity to promote mental and physical health during their rehabilitation. Health professionals and significant others considerably supported the recuperating alcoholics to practice physical activity however physical activity facilities and facilitation was lacking in Asumbi rehabilitation center. Conclusions: The rehabilitation centres should have physical activity experts and facilities that can offer individualized physical activity services and support needed by the recuperating alcoholics