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Authors: Abdow Alio Hassan, Dr. Kikuvi Gideon

Abstract: World Health Organization approximates that every year about 210 million women conceive; approximately 30 million develop complications; and 515,000 die. KDHS 2008 shows that in Kenya, more women are dying of pregnancy and childbirth related causes than was the case in 2003. In 2008, reported maternal deaths were 488 per 100,000 live births compared to 412 per 100,000 live births reported in 2003. Utilization of maternal healthcare services is low in various parts of the country. This study therefore sought to determine the level of utilization of antenatal care, skilled delivery attendants and postnatal care services at Eastleigh health centre. The specific objectives of this study were to identify the socio-demographic characteristic of the antenatal and postnatal clients in Eastleigh health centre and to identify factors that affect utilization of antenatal care, use of skilled delivery attendants and postnatal care services in Eastleigh health centre. The study design of this study was hospital based cross- sectional study. The data was collected using questionnaires. The study population included all women who are in reproductive age group residing in the selected Eastleigh Area and attending the health facility for their antenatal care services. The sample size of this study was 129 women aged 15 to 49 years who attend Eastleigh health centre for antenatal care services. Random sampling was used and a systematic interval procedure was adopted. Available information on the data collected was checked for internal consistency and completeness and it was coded and analyzed using Statistical package for Social Scientist (SPSS) and presented in Tables, charts, Graphs and interpreted by rates and proportions. The study established that most of the mothers attending Eastleigh health centre sought for antenatal care from skilled providers. However, they only sought for ANC for 2 times only. In addition, the mothers had sought for ANC when they were between 6 and 9 months pregnant. Further, most of the mothers had delivered in a healthcare facility, although a good number had delivered at home. The study also found that the factors that affect the utilization of the maternal health care services include religion, employment status, income level marital status, age, and distance to the health care centre. In order to improve access to the free maternal health care, government should put up health services as close as possible to the community where the people live. In addition, the ministry of health should ensure that all health facilities have enough essential drugs to avoid cases where women are referred drugs them from private pharmacy this contribute as a barrier to women. Further, Barriers such as long waiting time, lack of drugs, and inadequate number of staff need to be looked at by the hospital authorities so as to provide a good conducive atmosphere to the clients. 

Authors: Haji Abdinasir Ahmed, Monica Madam

Abstract: In the developing world, and especially in Africa, water related diseases account for 80% of the disease burden, and contribute to over 5 million deaths, where it is estimated to kill over 3million people every year, the overwhelming majority being children. To counter this problem, Solar Water Disinfection (SODIS) has been promoted in most of the developing countries including Kenya. SODIS is a simple method of household water treatment that uses transparent PET-bottles and sunlight to disinfect drinking water and exposed to the sun for 6 hours. During this time, the UV-radiation of the sun kills diarrhoea generating pathogens. The SODIS-method helps to prevent diarrhoea and thereby is saving lives of people. This study aimed at determining knowledge, attitude and practice on solar water disinfectant at House hold water treatment in Maalim Salat location, Wajir County. A cross-sectional design was used because it is more cost-effective and easy to carry-out in this area with a very short time. Systematic sampling procedure was employed to determine knowledge, attitude and practice on solar water disinfectant at House hold water treatment in Maalim Salat location, Wajir County. Information was collected using interviewer-administered questionnaire, the data was sorted, cleaned-out then entered and evaluated for Chi-square and analysis of variance using latest SPSS programme package. The analyzed data was summarized and presented using frequency tables, graphs, central tendency and standard deviations. The study found that most of the households in Maalim Salat Location had knowledge on SODIS, although a good number had no knowledge on SODIS. In addition, most of the household heads know how SODIS works but a good number do not know how it works. The study also found that most of the households in Maalim Salat Location were not using SODIS water treatment method despite the fact that the method was found to be really effective. It was further revealed that most of the households in this study were not using SODIS water treatment method. Further, the house holds that were using SODIS method had experienced problems or challenges with the SODIS method. Establishing a good follow-up network, in the case of NGOs, or service practices, in the case of manufacturers, that educates the user in the appropriate manner could help increase the knowledge of Maalim Salat Location residents. This study therefore recommends that SODIS practitioners need to be trained carefully and then have ongoing monitoring after training.

Authors: Cheronoh Joseph Kiplagat, Dr Njihia Peter

Abstract: Diabetes remains a major challenge to both civilian and combat populations. Serving in the Kenya defense forces military requires a certain level of physical fitness and freedom from any disability and disease. When civilians apply to join the military they are required to pass a medical exam. While not all medical conditions disqualify a person from joining the military, diabetes is one of those conditions that disqualify one from joining the military, others include asthma, hypertension and HIV infection and any obvious disability of the upper and lower limbs which may be attributed to among other conditions diabetes especially diabetic foot. In the recent years there has been unprecedented increase in the numbers of military members developing diabetes in the course of their service to KDF. Yet when they joined the service they were free from diabetes. Strenuous and regular exercises amongst this group are expected to protect them from this developing diabetes and other lifestyle disease. Developing diabetes while already serving in the military, however, is not automatic grounds for dismissal from the military. Because active service members have mandatory medical examinations and free access to health care, it is thought that there are few undiagnosed cases of diabetes among military personnel. Service members who develop diabetes and cannot be well controlled are referred to a medical evaluation board, which assesses their medical fitness and makes recommendations about follow-up care. The objective of this study was to establish various military exposures as a result of deployment can contribute to the development of diabetes on work performance and productivity and economic burden on the military medical scheme. To achieve this, a case study was done at defense forces memorial hospital involving diabetic patients who regularly attend diabetic clinic every week. Questionnaires touching on the risk factors of developing diabetes were used amongst patients attending the clinic every week. This work would be used to inform Kenya defense forces policy makers on the best way to prevent her personnel from developing type II diabetes. The results indicated that the Type II diabetes soldiers were involved in physical activities like a morning run, mountain climbing, weight lifting, judo and seat ups more than three times per week which decreases their likelihood of having obesity, which leads to diabetes. With regard to financial implication, the study established that given that at the time of the interview most of the Type II diabetes soldiers were under treatment or medication, the costs of treatment was a burden to them. The study therefore concludes that the high alcohol intake exacerbates the situation for diabetes type II patients. This study recommends that the barrack should come up with measures that will ensure that exercises are being undertaken in the field. The study also recommends that the Ministry of Health in conjunction with the Ministry of defense aligns the cost of treatment in accordance with their monthly pay. This study recommends further that the management at the barrack offers dinner to the soldiers with special diet for those with diabetes. In addition, the management at the barracks should extend their help to those who would like to curb alcohol addiction by establishing free counseling services.

Authors: Utiku Useru, Dr Njihia Peter

Abstract: For many years pharmacists have debated about the rational use of drugs in scientific conferences and symposium. As a group, antibacterial contribute significantly to the cost of drugs and are claimed worldwide to account for 15% to 30% of the total health budget. Rational use of drugs require that patients receive medication appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time at the lowest cost to them and their community however it's been noted that there is a global problem of inappropriate antibacterial use. The general objective of this study was to determine the basis for antibacterial drugs use at the DFMH for the purpose of promoting rational drug use, improve safety, lower costs, and recommend areas that require further investigation. The study specifically sought to establish the factors that determine the basis of antibiotic use by prescribers; identify the patterns of antibacterial use and to determine the expenditure on antibacterial drugs as a percentage of total drug cost at the hospital between January and December 2013. This study was done at the Defence forces memorial hospital located in Nairobi County in Kenya. A retrospective cross-sectional study design was used to determine the basis of antibacterial use at the DFMH. The researcher collected data retrospectively for the period covering January and December 2013 from patient’s prescription records and 48 healthcare professionals were also administered semi structured questionnaires. The target population was therefore 9377 patients prescription records and 48 healthcare professionals. Qualitative data was analysed by use of content analysis presented in a prose form. On the other hand, quantitative data was analysed by use of Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics such as percentages and frequencies were used to describe the characteristics of the target population. Data was then presented in graphs and tables. This study established that there is a Drug and Therapeutics Committee at DFMH and a formulary list or EML authorized for acquisition of medicines. Further, all medicines on the formulary list were identified by generic names (INN) and the formulary or EML medicines were based on those recommended in the STG. In addition, the study found that the hospital had STGs for infectious diseases for the most prevalent conditions. The study also revealed that the most commonly used antibiotics were Amoxycillin, Cefuroxime, Ofloxacin, Flucloxacillin, Metronidazole, Clarithromycin, Azithromycin, Cefadroxil, Levofloxacin and Tobramycin respectively. In relation to expenditure on antibacterial drugs, the study found that in 2013 the budgeted cost of antibiotics was 17.97% which agreed with some studies; however the actual expenditure was 7.75% of the total drug hospital budget, this was lower in relation to other studies that concluded expenditure was 50% of total budget. The study concluded that antibiotic prescribing at DFMH was mainly based on STGs and EML, and that Amoxicillin a broad spectrum antibiotic was the most prescribed drug in the hospital. Further it concluded that antibiotic expenditure was 7.75% of the total medicines budget in the hospital. The study recommends that the hospital should continue encouraging the use of the STGs and hospital formularies in prescribing and to regularly revise the STGs according to WHO recommendations, it further recommends that the study should be carried out in other public hospital institutions in Kenya.

Authors: Chege Rose W, Mungai Peter G, Dr. Oresi Samwel N

Abstract: Substance abuse continues to be one of the most serious problems facing communities throughout the world. In Kenya, drug abuse is one of the major social problems with common and easily identifiable manifestations in public health. Drug abuse reduction necessitates the use of strategies that are focused at tackling the risk factors. The purpose of the study was to investigate on the causes of drug and substance abuse among the youth in Kenya with a survey of Mombasa County. The study also sought to establish how education standards/levels, government policy, culture, mass media and cost of drugs influence usage on drugs and substance abuse among the youth in Mombasa County. The target population was 298 youth in rehabilitation centers, counselors in rehabilitation centers and government administrators in Mombasa County. This study used a stratified random sampling to select 30% of the target population. The sample size of this study was 89 participants who included 66 youths in rehabilitation centers, 3 counselors and 11 government administrators. Questionnaires comprised of both the open ended and closed ended questions. Quantitative data was analysed by use of Statistical Package for Social Sciences (SPSS) version 21. In addition, descriptive and inferential statistics was used in this study. Descriptive statistics such as percentages, frequencies, mean and standard deviation were used. Data was presented in graphs and tables. Further, a multiple regression analysis was used to establish the relationship between the dependent and the independent variables. The study established that mass media influences drug and substance abuse among the youth in Mombasa County most followed by education standards/level, culture and cost of drugs.  However education standards/levels and cost of drugs had an inverse influence on drugs and substance abuse among the youth and culture and mass media had a positive influence on drugs and substance abuse among the youth in Kenya. This study therefore recommends that education standards should be enhanced through cooperation between the government and the NGOs to ensure that many people acquire basic education in the area. Further, the government should come up with programs highlighting the adverse effects of drug use. In addition, the study recommends that local communities should be made aware of the adverse effects of their norms and culture especially when their youths end up engaging in drug use.

 

 

 

 

 

 

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