School of Health Sciences

Factors Affecting Health Facility Delivery among Women of Reproductive age in Mwingi North Subcounty- Kitui County, Kenya

Wed, 01 Jan 2020 00:00:00 GMT

Factors Affecting Health Facility Delivery among Women of Reproductive age in Mwingi North Subcounty- Kitui County, Kenya Mutiiria, Mathew Munyamaara High maternal mortality rate is one of the major public health concerns in developing countries, Kenya included. Most of the deaths are caused by factors attributed to pregnancy and childbirth. In Kenya, maternal mortality increased from 380/100,000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990 to 2010. The objectives of this study were to determine the prevalence of health facility deliveries, determine the socio demographic factors, social economic factors affecting health facility delivery and to describe health service-related factors affecting health facility deliveries in Mwingi North Sub County. This is a descriptive cross sectional study design conducted from December 2017 to February 2018 in Mwingi North Sub County. Proportionate sampling techniques were used. A structured questionnaire was administered to collect data. Respondents were drawn from the five wards of the sub county. Descriptive and inferential statistics and chi square tests were carried out. Variables significant at pvalue < 0.05 in bivariate analysis were included in the multivariable regression model; variables with a pvalue of <0.05 were considered statistically significant. Interviews were done for 245 women from the five wards of the sub county ie Kyuso 91 (37.4%), Ngomeni 45 (18.3), Tseikuru 43 (17.7%), Mumoni 33 (13.5%) and Tharaka 32 (13%) respectively. The age group 20-24years had the largest proportion 31.6% (74/240). Mean age was 27 years with standard deviation of 6.6. Prevalence of Delivery in a health facility was 50.4% whereas 49.6% of the respondents delivered in their homes. = On bivariate analysis 9 variables out of all the 15 variables of interest had a pvalue of≤ 0.05. Women who lived <5kms from the health facility had pvalue 0.0001, area of residence (ward) pvalue=0.01, number of children pvalue=0.001, parity of the women 0.001, means of transport chosen pvalue 0.02 number of ANC visits made pvalue=0.01, presence of cultural practices pvalue=0.03, cost of transport pvalue=0.001 and partner occupation pvalue=0.001 On multivariate logistic regression model distance from health facility, number of ANC visits and the means of transport were statistically significant in determining place of delivery. (Pvalue< 0.05) influencing health facility delivery. Health facilities are the preferred sites for delivery regardless of the level of education, religion, marital status and occupation of the respondents. Long distance from a health facility was significantly associated to home deliveries. Attendance of the prescribed ANC visits is associated with delivery at home. Improving accessibility of health care services and health education on importance health facility deliveries would increase prevalence of delivery at a health facility and consequently decrease maternal mortality rate.

Knowledge,attitude and practice towards breast cancer screening among HIV positive women attending health facilities in Imenti South Sub County,Meru county,Kenya

Sat, 01 Jan 2022 00:00:00 GMT

Knowledge,attitude and practice towards breast cancer screening among HIV positive women attending health facilities in Imenti South Sub County,Meru county,Kenya Kauro, Martin Stanley The incidence of breast cancer in HIV/AIDS infected women is not well documented because they could die before detection or before development of breast cancer. With the introduction of HAART, these patients live long and have all the chance to develop breast cancer. HIV positive women with breast cancer suffers a double burden of disease hence the necessity of this study. The general objective of this study was to determine knowledge, attitude and practices affecting breast cancer screening among HIV positive women attending health facilities in Imenti South Sub County. The study employed descriptive cross section study design to collect qualitative and quantitative data. A sample size of 340 respondents was used to collect data using self administered questionnaires targeting HIV positive women from 18 years and above attending health facilities in Imenti South Sub-County. Data collected was analyzed using SPSS which included Pearson's Chi-Square (X2) and the results were presented in frequency tables. The results show there is a significant relationship between, level of education, marital status, main occupation and age on the knowledge towards level breast cancer screening. Also there is a significant relationship between age, of education, and marital status on breast cancer screening practices and finally there is significant relationship between level of education, marital status, and occupation towards breast cancer screening attitudes. The results show that 49.7% of the respondents were aware of breast cancer screening with 49.7% having heard about breast cancer screening through health care facilities. Less than half (41.2 %) of those who have ever heard of breast cancer screening, can correctly define what breast cancer screening is. Twenty point five percent of the respondent could correctly identify the appropriate age to start breast cancer screening while 33.7% of the respondent could correctly identify how often should one undergo breast cancer screening. A significant negative association was found between the attitude that breast cancer cannot be cured even if early diagnosis is made against breast cancer screening uptake (61.7 % of the participant don't agree that early detected breast cancer can be successfully treated). This belief has led the participant not to engage in breast cancer screening hence the finding; fear of positive outcome makes the respondent not to participate in breast cancer screening (63 % of the respondent strongly agreed). A number of participant (11%) also felt breast cancer screening is a culturally driven secrecy. Consequently, only 34.6% of the participant has ever undergone any of breast cancer screening method. The study therefore concludes that breast cancer awareness influences the acceptance of breast cancer screening. the study recommends the following: It is recommended that the county Government of Meru in conjunction with non-governmental organization should ensure that there are training programs on breast cancer as well as other types of cancer in the comprehensive care units in order to raise the level of awareness and the importance of breast cancer screening. The Ministry of Health should come up with a breast cancer screening policy to facilitate subsidies of consultation and screening fee and introduce mobile screening units to improve uptake.

Factors affecting utilization of pit latrines in Tigania East Meru county, Kenya

Sun, 01 Jan 2023 00:00:00 GMT

Factors affecting utilization of pit latrines in Tigania East Meru county, Kenya Mwirigi, Sylvia Nkatha It is estimated that more than half of the population from developing countries experience communicable diseases related to inadequate sanitation and contaminated water. Children are the most affected cohort by the repercussions of poor sanitation because they suffer most from communicable disease burden associated with inadequate sanitation. In Kenya, the latrine coverage is estimated at 65% with at least 14 % of Kenyans still practicing open defecation. Latrine coverage in Meru County stands at 60%, with Tigania East Sub - County having over 40% still practicing open defecation and therefore the need to explore factors influencing utilization of pit latrines. The study aimed to determine the number of households with pit latrine and their utilization, to assess socio-demographic factors affecting pit latrine utilization, determine how knowledge of pit latrines use affects its utilization and determining the effect of social cultural practices on pit latrine use in Tigania East. The study was a cross-sectional descriptive design with 369 respondents across the Sub-County selected by systematic random sampling method. pilot testing of tools was done at Gankere Imenti North Subcounty, Validity and reliability test was described and ethical clearance was issued by Meru University of Science and Technology Institute Research Ethics Review Committee (MIRERC). Both descriptive and inferential statistics were performed using SPSS version 25 and results presented in form of charts and tables. Exploratory data techniques were used at the initial stage of analysis to uncover the structure of data and identify outliers or unusual entered values. Binary logistic regression was used at bivariate analysis to identify factors associated with pit latrine utilization. Further, multivariable logistic regression was used to adjust the crude odds ratio at bivariate analysis for confounders and effect modifiers. Adjusted odds ratio, 95% confidence intervals and associated p-values were presented and reported. Response rate was 93%, two demographic characteristics, age and household size were significantly associated with utilization of pit latrine. Respondents aged 18-35 years and 36-55 years were 5.21[95% CI = 2.1-11.34, p 0.004] and 3.32[95% CI = 1.9 - 6.84, p = 0.031] respectively and equivalent of 38.3 - 48.5 %, times more likely to utilize pit latrine as compared to those aged 76 - 85 years an equivalent of 6.1%. Likewise, respondents from household size of 1-6 members were 5.78[95%CI = 1.95 – 9.45, p <0.001] times more likely to utilize pit latrine (60.8%) compared to those from household size of 7 - 12 members at 39.2%. Owning a pit latrine significantly influenced utilization by 4.67[95%CI = 1.35 6.94, p =0.004] times (76.6%). Knowledge on pit latrine in preventing communicable diseases such as diarrhea influenced utilization of pit latrine by 2.96[95% CI = 1.46-5.98, p <0.001] times (73.4%). The current study recommends interventions targeting families with more than seven members be targeted in sensitization programs, knowledge and creation of awareness by building partnerships with stakeholders. Ministry of public health should collaborate with development partners and Non-state actors to improve the economy of the area, fund projects related to wet technologies and pour flush pit latrines in Tigania east sub-county. Further, community strategy program should extend or design a target-based program to reverse the taboos that discourage utilization of the pit latrines in order to promote health outcomes.

Factors influencing the uptake of contraceptives among youth in Imenti South subcounty, Meru county, Kenya

Sun, 01 Jan 2023 00:00:00 GMT

Factors influencing the uptake of contraceptives among youth in Imenti South subcounty, Meru county, Kenya Manene, Agnes Kiende Contraceptive methods have been in use since 1960s although underutilized in most countries. Pregnancies which are too many, too early and too frequent result in maternal child morbidity and mortality. Unintended pregnancy poses a major risk to the reproductive health of adolescence and young adults in developing countries noted as a result of the decreasing age of men arch and onset of sexual activity. This has a serious implication on economy and future human capital potential. Delivery of effective contraceptive services has a direct impact on maternal child wellbeing. The aim of the study was to determine factors influencing uptake of contraceptives among youth in Imenti south sub-county Meru County. The specific objectives of the study were to assess the social factors, determine the economic, individual factors and identify health service factors influencing the uptake of contraceptives the youth ages 18-24 years in Imenti South Sub-County Meru County. Collecting data about the uptake of contraceptives by youth is of importance in the prevention of teenage pregnancy, termination of pregnancy and transmission of sexually transmitted infections. The study will provide data information to assist policy makers in developing appropriate evidence-based strategies to promote knowledge on utilization of contraceptives use and help develop innovative and cost effective strategies for improving basic information and utilization among the youth. The findings of the study will be utilized by the Ministry of Health through community health work force to ensure the youth have the right information discussions on utilization of contraceptives. Questionnaires, in-depth interview guide and focused group were used for data collection. Out of the 1230 households in the sub county a sample of 146 respondents were systematically selected among the households by use of systematic random sampling method, where every 8th house hold was included. The results of the study showed that mean age group was 22.4. Information based on the social factors that influence uptake of contraceptives; there was significant association between intended number of children and uptake of contraceptives. Economic factors - Source of income significantly influenced uptake of contraceptives where those who had their own source of income were utilizing compared to others who were on their other sources. Individual factors - knowledge regarding what contraceptives were used for significantly influenced the uptake of contraceptives. For the facility based factors there was significant association between waiting time and utilization of contraceptives and Information on side effects of contraceptives was significantly related to uptake. Emanating from the study the following recommendations are made in older to improve on uptake of contraceptives: administrators should strengthen capacities to provide essential reproductive health services among the youth, incorporation of reproductive health information in curriculums and demonstrated need for better client counseling. The health administrators should strengthen capacities to provide essential reproductive health services among the youth in order to reduce the level of misinformation of contraceptives. There is need to Provide sex education and accurate knowledge on family planning and birth control as well as suggesting effective contraceptive methods to this particular age group. The medical officer in charge of Local health sector should collaborate with youth programs in the community through community leaders and ensure the youth have access to information on reproductive health. The County Director of education and policy makers should ensure incorporation of reproductive health information in curriculum to improve knowledge on family planning issues.