College of Health Sciences JKUAT (COHES)

Development of a Facility-Based Intervention Model on Male Partner Involvement in Maternal and Neonatal Health in A Public Health Facility, Kiambu County, Kenya

2026-08-06T11:20:47Z

Development of a Facility-Based Intervention Model on Male Partner Involvement in Maternal and Neonatal Health in A Public Health Facility, Kiambu County, Kenya Okwako, Joseph Mukobe The 1994 International Conference on Population and Development (ICPD) emphasized the need for men to actively participate in sexual and reproductive health. However, male partner involvement in maternal, newborn and child health (MNCH) in Kenya remains limited. This study aimed to develop, implement, and evaluate the effectiveness of a facility-based intervention model to promote male partner involvement (MPI) in maternal and neonatal health at Thika County and Referral Hospital. An exploratory sequential mixed-methods design was employed. The qualitative phase involved three focus group discussions (FGDs) with nurses and two FGDs with male partners to explore barriers and enablers to male involvement. Thematic analysis was conducted using MAXQDA 2022 software, which revealed key themes including limited awareness, traditional gender norms, and logistical constraints as major barriers. These insights informed the design of a structured health facility-based intervention, tested using a quasi-experimental pre-test/post-test design. Ethical approval was sought from Jomo Kenyatta University of Agriculture and Technology (Ref. No. JKU/ISERC/02316/1113) and informed consent from participants. A total of 60 women (30 intervention, 30 control) between 17–28 weeks’ gestation were recruited via systematic random sampling. Male partners in the intervention group received formal invitations to attend antenatal care (ANC) and were followed through six months postpartum. Quantitative data were collected using pre tested semi-structured questionnaires and analysed using SPSS v27.0. Statistical tests included chi-square, Fisher’s exact test, and Mann–Whitney U test, with a significance threshold of p < 0.05. The primary outcome male accompaniment to ANC was significantly higher in the intervention group (U = 11.000, p < 0.001), with a large effect size (r = 0.98). Significant improvements were also observed in male support during pregnancy and childbirth (p < 0.001), knowledge of danger signs in pregnancy (p < 0.001), awareness of exclusive breastfeeding recommendations (p = 0.005), and uptake of couple HIV counselling and testing (p < 0.001). These findings demonstrate that a context-specific, structured, facility-based intervention model can effectively enhance male partner involvement in MNCH and contribute to improved maternal and infant health outcomes. This study recommends that the National and County governments should consider adapting the intervention model to promote MPI in MNCH services. PhD in Nursing

Evaluation of Sickle Cell Crisis Determinants among Sickle Cell Disease Patients Aged 15 Years and Below in Three Selected Health Facilities in Nairobi City County, Kenya

2026-08-06T10:59:54Z

Evaluation of Sickle Cell Crisis Determinants among Sickle Cell Disease Patients Aged 15 Years and Below in Three Selected Health Facilities in Nairobi City County, Kenya Kimile, Davis Manthi Considering the lack of curative armamentaria for SCD and its crises, the associated management costs exert an unquantifiable burden on parents/caregivers, compounded with psychological trauma, social stigma, and other devastating effects. This study investigated factors associated with sickle cell crisis among SCD patients aged 15 years and below in three hospitals in Nairobi city County. A descriptive cross-sectional study was conducted among children aged ≤15 years with sickle cell disease (SCD), their caregivers, and healthcare professionals at three SCD-focused health facilities in Nairobi city County. A total of 193 participants were recruited using systematic sampling, while healthcare professionals were purposively selected. Data were collected using pretested structured questionnaires assessing sociodemographic and socioeconomic factors, knowledge and perceptions of SCD, medication adherence, and SCD-associated crises. Quantitative and qualitative data were analysed using descriptive statistics, thematic analysis, and multiple logistic regression in GraphPad Prism, with ethical approval and informed consent obtained prior to study commencement. The results showed that most patients aged below 15 years with SCD in the sampled hospitals were females (52.85 %). Regarding age, most affected patients were aged 0-5 years (46.63 %). 65.80 % of all the patients had primary school level of education, with a paltry 7.77 % having a secondary school level of education. Besides, most of the caregiver respondents of SCD patients aged 15 years and below were females (92.23 %). Most caregivers (37.82 %) were aged 26-30 years followed by those aged 31-35 years (26.42 %), with a minority (13.99 %) being aged 21-25 years. Most caregivers had attained primary education (53.37 %), were married (75.13 % and were peasants (63.73 %). The results showed most (96.89 %) caregivers resided in rented houses, which were mostly single-roomed (62.18 %), and most (62.69 %) earned 36 years]) = 1.415 -1.674 (Gender [Female])+3.849 (Age-group [26-30 years])+5.220 (Age-group [31-35 years]) + 3.856 (Age-group [> 36 years]). This study showed that patient and caregiver factors influence the severity of SCD and its crises, and their appropriate modification may improve the prognosis and the wellbeing of both the patients and the caregivers. Further, appropriate strategies must be formulated and implemented to improve adherence to treatment requirements for SCD patients aged 15 years and below to improve prognosis and quality of life. MSc in Public Health

Genetic Characterization of Biomphalaria pfeifferi from Asao Stream, Kisumu County Kenya: in Relation to Seasonal Variation, Selfing and Refractory Properties

2026-08-06T08:59:59Z

Genetic Characterization of Biomphalaria pfeifferi from Asao Stream, Kisumu County Kenya: in Relation to Seasonal Variation, Selfing and Refractory Properties Oduor, Noel Adhiambo Biomphalaria pfeifferi, a predominantly self-fertilizing freshwater snail, is the world’s most important intermediate host for Schistosoma mansoni, one of the causative agents of schistosomiasis, which affects about 200 million people in sub-Saharan Africa. Understanding the genetic variation, selfing rates, and refractory traits of B. pfeifferi is important for improving snail-based strategies to interrupt S. mansoni transmission. The use of multilocus genotypes (MLGs) is important in identifying unique lineages within the snail population. This study sought to determine: (i) if lineages of B. pfeifferi within Asao stream could persist through different seasons of the year, (ii) if infections by S. mansoni or other trematodes occur within the persistent lineages, (iii) if B. pfeifferi from the Asao stream are selfers and finally (iv) if there are refractory genotypes among snails from Asao stream. B. pfeifferi snails were collected from Asao Stream in six bi monthly (every other month) sampling times between November 2018 and September 2019. Snails were isolated and screened for S. mansoni and other trematode infections using the shedding method, cercarial morphology was examined microscopically. Successive infection and breeding experiments was done to determine refractory genotypes. Using 14 microsatellite markers in a multiplex Polymerase Chain Reaction (PCR), B. pfeifferi snails were genotyped. Data analysis was done using GENALEX software and R studio software; poppr and coin packages. For the first three objectives, a total of 502 B. pfeifferi snails were collected. Genetic differentiation among the snails was low, ranging from FST = 0.019, p = <0.05 (November and March) to FST = 0.372, p = <0.001) (July and March). Analysis of molecular variance (AMOVA) showed a small variation (8%) among sampling times. A total of 319 MLGs were identified, 26 of which were present at two or more sampling times. Four MLGs persisted across the 10 month sampling period, one of which was represented by 17 individuals. Of the trematode species S. mansoni was the most common at 64.79%, other trematodes included; Echinostomes (3.29%), Xiphidiocercariae (6.10%), Paramphistomoids (23.47), Sangunicolids (0.94%) and Strigeids (1.41%). The persistent MLGs had more trematode infections compared to those found only at a single sampling time. There was high inbreeding coefficients (Mean FIS =0.639) and low heterozygosity (Mean Ho=0.145), with selfing rates estimated at 77.77%. Objective four began with 300 non shedding snails, the breeding experiment generated 10 Fillial 3(F3) B. pfeifferi non-shedding snails. These findings suggest that B. pfeifferi in Asao stream is predominantly self-fertilizing, with persistent genotypes that may sustain S. mansoni transmission across seasons. The identification of 10 F3 non-shedding snails suggests the possible presence of refractory snails. This study highlights the need for year-round snail control and monitoring of potentially refractory snail genotypes should be considered in control strategies. MSc in Molecular Medicine

Uptake of Continuous Positive Airway Pressure and Outcomes among Newborns Admitted with Respiratory Distress in Three County Hospitals in Nairobi, Kenya

2026-08-06T08:41:57Z

Uptake of Continuous Positive Airway Pressure and Outcomes among Newborns Admitted with Respiratory Distress in Three County Hospitals in Nairobi, Kenya Musigula, Resty Respiratory distress (RD) is a leading cause of neonatal mortality, with bubble continuous positive airway pressure (bCPAP) being a low-cost, effective therapy. Despite its benefits, the adoption of bCPAP in neonatal units remains a challenge. This study aimed to assess the utilization and outcomes of CPAP therapy among neonates with RD and identify barriers to its implementation in three hospitals in Nairobi, Kenya: Mama Lucy Kibaki Hospital, Pumwani Maternity Hospital, and Mbagathi Hospital. This mixed-methods study employed both quantitative and qualitative approaches. A total of 178 neonates with RD requiring CPAP were recruited. The quantitative aspect of this study employed a prospective cohort design to examine the short-term outcomes of newborns within a defined 28-day period. The study examined key outcomes, including length of hospital stay, supplemental oxygen use, need for ventilatory support, referral, and mortality, for each neonate, comparing those initiated on CPAP with those who missed out on CPAP therapy. Data were analyzed using SPSS 27 software. A total of 22 healthcare providers participated in the qualitative component, comprising 22 structured in-depth interviews, of whom 5 also participated in Key Informant Interviews (KIIs), to identify barriers to effective CPAP implementation. Qualitative data were manually coded and thematically analyzed. Of the 178 neonates enrolled, 58% were male, with most neonates (30.3%) being born between 28 and 32 weeks of gestation. CPAP was initiated for 57.3% of the neonates, while the remaining neonates received oxygen therapy via nasal prongs (NP) or a non-rebreather mask (NRM). Neonates in the CPAP group had better outcomes, with a higher proportion discharged (78.43% vs. 61.84%, p = 0.0242) and a lower mortality proportion (12.75% vs. 35.53%, p < 0.001). The proportions of referral (2.94% vs. 2.63%, p = 1.000), trauma to the nares (2.94% vs. 0%, p = 0.3580), and air leak syndromes (0.98% vs. 0%, p = 1.000). The average length of hospital stay for all neonates was 15.6 days, with neonates initiated on CPAP experiencing shorter stays, exhibited through discharge within 7 days (43.14% vs. 27.6%, Crude OR = 2.0, 95% CI: 1.1–3.8), while those who missed out on CPAP had longer stays beyond 28 days (46.1% vs. 17.64%, Crude OR = 0.3, 95% CI: 0.1–0.5). The study identified several barriers to CPAP implementation, including inadequate human resources, poor infrastructure, limited equipment, and communication gaps among healthcare staff. Though most healthcare workers had basic CPAP knowledge, many had not undergone refresher training or continuing medical education. In conclusion, CPAP therapy demonstrated improved outcomes for newborns with RD, but its successful implementation is hindered by systemic challenges such as staff shortages, inadequate infrastructure, and equipment limitations. Addressing these barriers could improve neonatal survival and healthcare delivery in resource-limited settings. MMed in Paediatrics and Child Health