Effects of Quality of Population Data on Budget Formulation in Nyandarua County

This study assessed how population data affects budget formulation in Nyandarua County. The study adopted a descriptive survey research design whose target population was the 1524 staff at the Nyandarua County headquarters. The sample size was 306 staff proportionately distributed between the levels of management in the departments that handle finance and budgets. The main instrument for primary data collection was a structured questionnaire that collected both quantitative and qualitative data. Descriptive statistics was used to analyse quantitative data while qualitative data was used to supplement interpretation of quantitative data. Analysed data was presented in percentages and frequency tables, charts and graphs for easy interpretation and discussion. Regression analysis was used to determine relationship between variables. The study revealed that though population records are maintained by the County Government there is need to improve on the way population records are obtained and maintained. In addition, the study revealed that the overall human population data in use by the county was of poor quality, was out of date and not clear to most staff members, meaning they could not trust its accuracy.  The study recommends that Nyandarua County should work with the relevant authorities to improve the quantity and quality of the demographic data it uses for budgeting. It also recommends that the county should organize to conduct baseline surveys on important indicators in the planning of the county development. Keywords: Population data, budget formulation, County Governmen

Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance : a multi-hospital, retrospective, cohort study

Background: Management of pneumonia in many low-income and middle-income countries is based on WHO guidelines that classify children according to clinical signs that define thresholds of risk. We aimed to establish whether some children categorised as eligible for outpatient treatment might have a risk of death warranting their treatment in hospital. Methods: We did a retrospective cohort study of children aged 2–59 months admitted to one of 14 hospitals in Kenya with pneumonia between March 1, 2014, and Feb 29, 2016, before revised WHO pneumonia guidelines were adopted in the country. We modelled associations with inpatient mortality using logistic regression and calculated absolute risks of mortality for presenting clinical features among children who would, as part of revised WHO pneumonia guidelines, be eligible for outpatient treatment (non-severe pneumonia). Findings: We assessed 16 162 children who were admitted to hospital in this period. 832 (5%) of 16 031 children died. Among groups defined according to new WHO guidelines, 321 (3%) of 11 788 patients with non-severe pneumonia died compared with 488 (14%) of 3434 patients with severe pneumonia. Three characteristics were strongly associated with death of children retrospectively classified as having non-severe pneumonia: severe pallor (adjusted risk ratio 5·9, 95% CI 5·1–6·8), mild to moderate pallor (3·4, 3·0–3·8), and weight-for-age Z score (WAZ) less than −3 SD (3·8, 3·4–4·3). Additional factors that were independently associated with death were: WAZ less than −2 to −3 SD, age younger than 12 months, lower chest wall indrawing, respiratory rate of 70 breaths per min or more, female sex, admission to hospital in a malaria endemic region, moderate dehydration, and an axillary temperature of 39°C or more. Interpretation: In settings of high mortality, WAZ less than −3 SD or any degree of pallor among children with non-severe pneumonia was associated with a clinically important risk of death. Our data suggest that admission to hospital should not be denied to children with these signs and we urge clinicians to consider these risk factors in addition to WHO criteria in their decision making

Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality

BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression.ResultsA total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death.ConclusionsA substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia

Strategic Direction and Organizational Performance in Government-Sponsored Youth Empowerment Organizations in Kenya

Purpose: Government-sponsored Youth Empowerment organisations (GSYEOs) are designed to skill, prepare, and empower the youths toward poverty eradication, formal employment, and self-reliance. However, poverty and unemployment among the youths in Kenya seem to be on an onward trajectory, and yet scarce research has been conducted on the influence of strategic direction on the performance of GSYEOs. This study examines the influence of strategic direction and the performance of GSYEOs in Kenya, which is anchored on strategic leadership theory and measured using the Balance Score Card framework. Design/Methodology/Approach: A descriptive research design was utilized and a random sample of five GSYEOs with a total population of 1089 employees was adopted, and a sample of 109 was derived. Correlation analysis results show that strategic leadership and organisational performance were positively and significantly correlated (r=0.661; P-value <0.05). Results from simple linear regression showed that 43.6% was a good fit for the organisational performance (R squared =0.436, R= 0.661). Implications/Originality/Value: The study recommends that GSYEO’s leadership encourage strategic direction implementation through adequate budget allocation

Human Resource Development and Organisational Performance in Government-Sponsored Youth Empowerment Organizations in Kenya

Purpose: Government-sponsored Youth Empowerment organisations (GSYEOs) are designed to skill, prepare, and empower the youths toward poverty eradication, formal employment, and self-reliance. However, poverty and unemployment among the youths in Kenya seem to be on an onward trajectory. Yet, scarce research has been conducted on the influence of strategic direction on the performance of GSYEOs. This study examines the influence of strategic direction and the performance of GSYEOs in Kenya, which is anchored on strategic leadership theory and measured using the Balance Score Card framework. Design/Methodology/Approach: A descriptive research design was utilised, a random sample of five GSYEOs with a total population of 1089 employees was adopted, and a sample of 109 was derived. Simple analysis results show that the relationship between organisational performance and Human Resource Development is statistically significant as (p&lt;0.05), 65.0% of the variation in the organisational performance can be explained by the regression model (R2=0.65, ΔR2=0.644, F(1,64) =118.748, P&lt;0.05). &nbsp;Results showed that that 65% was a good fit for the organisational performance. Implications/Originality/Value: The study recommends that the Government of Kenya allocate and prioritise funding for capacity building in Government-Sponsored Youth Empowerment Organizations

Socio-Cultural Factors Influencing Child Faecal Matter Disposal among Caregivers in Wadajir District in Mogadishu- Somalia

Backgroup: Diarrhea kills 2,195 children every day-more, than AIDS, malaria, and measles combined. Under-five mortality rate in Somalia is presently the third worst in the world after Angola and Chad. Though there are multiple contributory causes, childhood diarrhea is one of the leading causes of child mortality. There is a plethora of evidence suggesting that diarrheal diseases is acquired through ingesting food, water or any other fluids contaminated with human excreta, hence safe disposal of children’s feces is as essential as the safe disposal of adults’ feces. This study aimed at assessing the socio-cultural factors influencing disposal of child fecal matter among care givers of children aged 5 years and below in Wadajir District in Mogadishu, Somalia.Methodology: This study adopted a qualitative approach. Data was collected using Key informants. Key informant sample size was determined using the data saturation approach. Qualitative data was analyzed thematically using the NVivo software.Results and Conclusion: The key themes which emerged indicated that: perception that ‘child fecal matter is not harmful’, lack of gender sensitive latrines, culture of open defecation, low literacy levels among care givers, internal displacement and poverty, and Islamic religion influenced disposal of child fecal matter, were the main sociocultural factors influencing disposal of child faecal matter.Recommendation: To reduce diarrhea infections in Mogadishu, there is need to promote proper child fecal matter disposal. We recommend development and implementation of hygiene and sanitation interventions; promoting construction and utilization of latrines as well as health education interventions targeting care givers in Wadajir District, Mogadishu, Somalia. Key words: Diarrhea, Socio-Cultural Factors, Child Fecal Matter Disposal, Mogadish

Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study

Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and promote improvements in the quality of newborn care across hospitals.Methods Continuously collected routine patients’ data from structured paper record forms for all admissions to newborn units (NBUs) from 16 purposively selected Kenyan public hospitals that are part of a clinical information network were analysed together with data from all paediatric admissions ages 0–13 years from 14 of these hospitals. Data are used to show the proportion of all admissions and deaths in the neonatal age group and examine morbidity and mortality patterns, stratified by birth weight, and their variation across hospitals.Findings During the 354 hospital months study period, 90 222 patients were admitted to the 14 hospitals contributing NBU and general paediatric ward data. 46% of all the admissions were neonates (aged 0–28 days), but they accounted for 66% of the deaths in the age group 0–13 years. 41 657 inborn neonates were admitted in the NBUs across the 16 hospitals during the study period. 4266/41 657 died giving a crude mortality rate of 10.2% (95% CI 9.97% to 10.55%), with 60% of these deaths occurring on the first-day of admission. Intrapartum-related complications was the single most common diagnosis among the neonates with birth weight of 2000 g or more who died. A threefold variation in mortality across hospitals was observed for birth weight categories 1000–1499 g and 1500–1999 g.Interpretation The high proportion of neonatal deaths in hospitals may reflect changing patterns of childhood mortality. Majority of newborns died of preventable causes (&gt;95%). Despite availability of high-impact low-cost interventions, hospitals have high and very variable mortality proportions after stratification by birth weight