School of Nursing, Midwifery and Paramedical Sciences

UTILIZATION OF HIV/AIDS CLINICAL CARE AND SUPPORT SERVICES AMONG HIV-INFECTED ADULTS IN BARINGO COUNTY, KENYA

2026-07-16T12:07:27Z

UTILIZATION OF HIV/AIDS CLINICAL CARE AND SUPPORT SERVICES AMONG HIV-INFECTED ADULTS IN BARINGO COUNTY, KENYA Otara, Danvas Nyachio The burden of HIV/AIDS in Baringo County is highest among Adults (>18 years), with over 40% of hospital beds occupied by HIV-related illnesses. Despite the majority of HIV/AIDS clients being enrolled in care programs, care interruptions (dropouts) and loss of follow-up remain major challenges with unclear reasons for defaulting. Therefore, this study aimed to investigate HIV/AIDS care and support service utilization among HIV infected adults in Baringo County, examining the relationship between client uptake, attitudes, accessibility and utilization of services. It also examined the impact of stigma and discrimination on service utilization. The study was conducted in Baringo County among HIV-infected adults enrolled in Comprehensive care centers using an analytical cross-sectional study design. A total of 580 study participants were randomly recruited u ng Fisher et al.'s (1998) formula from four purposefully selected sub-counties. Besides, an interviewer-administered questionnaire was used to collect data. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) version 27 with Inferential statistics (Univariate and bivariate) analyses conducted at a p = 0.05 significance level. Whereas, qualitative data was transcribed and analyzed thematically. Ethical clearance was sought from the Institutional Scientific and Ethics Review Committee at Masinde Muliro University (Ref No: MMU/COR: 403012 Vol 6 (01), the National Commission for Science, Technology and Innovation (NACOSTI) (Ref No: 963149), the Baringo County Government Department of Health (REF: BCG/HS/RES/01/VOL.1/07), and informed consent from participants. A total of 519 (89.5%) out of a sample size of 580 took part in the study. The Study found 50.7% HIV care uptake, with 80% deterred by a lack of knowledge and high transportation costs (72.3%). The majority of participants (90.6%) had positive attitudes towards HIV care and support services, but utilization was unfavorable due to low knowledge of available services (p = 0.001), fear of ARV drug use when the spouse is watching (p< 0.0001), and long distances to clinics (p 0.0001). Besides, statistically significant factors affecting the accessibility of clinic services were difficulty obtaining services (p < 0.0001), and long distance to clinics (p 0.0001), with clients unlikely to use them. HIV-related stigma and discrimination were found to negatively impact participants' utilization of services, with participants feeling ashamed to attend clinics (p<0.0001) and others judging them when seen attending clinics (p<0.0001), leading to low utilization rates with higher odds found in each case. In conclusion, the study found 50.7% of HIV-infected adults in Baringo County consistently utilize HIV care and support services, with higher education, community support services, counseling, and family support promoting utilization of services. However, factors like low socioeconomic status, long distances, high travel costs, and poor medication perception were associated with poor attitudes towards utilisation of services. Additionally, location optimization and clinic opening on holidays and weekends improve accessibility. Whereas, PLHIV were found to internalize the stigma and bigotry they face, contributing to a negative self-image and lower levels of utilization. The study recommends to the MOH increase HIV/AIDS care utilization through decentralization of services to the community or low-tier facilities, stigma reduction, integration of HIV care with other services, and scaling up services in under-resourced areas.

STAKEHOLDERS ASPECTS INFLUENCING THE IMPLEMENTATION OF FOOD SECURITY PROJECTS IN VIHIGA COUNTY

2026-07-16T11:35:11Z

STAKEHOLDERS ASPECTS INFLUENCING THE IMPLEMENTATION OF FOOD SECURITY PROJECTS IN VIHIGA COUNTY KILELO, ELIZABETH SISIANOI Food security mostly depends on the growth and distribution of nutritious foods. Approximately two billion of the eight billion people worldwide are food insecure. In Kenya, food security has been a great challenge due to natural hazards, conflict and population growth over time. This study sought to identify the existing and distribution of agriculture and nutrition projects supported by stakeholders in Vihiga, the link between agriculture and nutrition goals on food security, factors influencing the implementation of food security projects, and the impact of public policy on food security. A descriptive cross-sectional design was adopted, employing mixed method of data collection. The study purposively selected thirty stakeholders, consisting of ten farmers and ten community health volunteers (CHVs) who provided qualitative data in two focus group discussions (FGD) as well as ten sessions of key informant interviews (KII) with individual stakeholders. The themes formed from the qualitative data were analysed thematically and manually, and verbatim quotes were used to explain the findings. Additionally, two hundred and seventy-three (273) structured questionnaires were used forS quantitative data. The results were analysed using (SPSS) version 20. The data revealed that the main agricultural project was; National Agricultural Rural Inclusive Growth Project (NARIGP) majoring in Dairy, Local Chicken, Banana, and vegetables. (75% ) of farmers were beneficiaries of these programs where (48%) were supported by indigenous vegetables while a small number of them (4%) were engaged in Dairy farming. There was a misconnection between nutrition and agriculture linkages on food security. The study found that the priority for agriculture is income generation, rather than household consumption. Agriculture is essential to nutrition, but that connection is overlooked. Poor collaboration was found to be among the factors influencing project implementation. This contributed to unequal program coverage which posed as obstacle in aligning agricultural projects with local nutrition demands. Limited land ownership presents a challenge for smallholder farmers’ ability to meet both income and nutrition needs, as approximately a third of surveyed (n=97, 35.5%) reported owning less than 0.5 acres of land while (n=59, 17.6%) had 2 acres and above. Moreover, although food and agriculture policies are in place, gaps still exist in adhering to these policies. It was revealed that budget allocation to the agriculture sector is at (2.4.%) which is still a quarter way to the international commitment of (10%). The study recommends that farmers be trained in intensive agriculture technology to help produce more from their small plots. The stakeholders should develop strategies to collaborate on specific projects related to agriculture and nutrition for example through strengthening existing positive relationships. The County should work to embrace inclusivity in policy formulation. Fast track the development of the County Agri-nutrition strategy to promote the integration of nutrition into agriculture programs and vice versa.

PREVALENCE AND PREDICTORS TO OCCURRENCE OF REPEAT PREGNANCY AMONG ADOLESCENTS ATTENDING HEALTH FACILITIES IN SUNA EAST, MIGORI COUNTY, KENYA

2026-07-16T11:00:40Z

PREVALENCE AND PREDICTORS TO OCCURRENCE OF REPEAT PREGNANCY AMONG ADOLESCENTS ATTENDING HEALTH FACILITIES IN SUNA EAST, MIGORI COUNTY, KENYA Oyugi .O., Samuel In many nations, teenage pregnancies and births continue to be an issue. Recurrent teenage pregnancies contribute to the load that keeps adolescents' poor health outcomes alive. Worldwide, an estimated 20,000 or more girls under the age of 18 give birth each day. In Migori, 25 percent of girls between the ages of 15 and 19 have started having children; of them, 3 percent are expecting their first child, and 20.9% have already given birth. Compared to the 14.7% national average, a higher percentage of teenagers are already moms. Because of this, the adolescent birth rate (or age-specific fertility rate) for girls in Migori County between the ages of 15 and 19 is 136 births per 1000 girls, significantly higher than the national average of 96 births per 1000 girls. Despite popular perception, not all teenage pregnancies result in births. Teenagers who started having children early are more likely to become pregnant again when they're still young. The purpose of this study was to look at the frequency and risk factors for teenage repeat pregnancies in Suna East, Migori County. The study specifically evaluated the frequency of repeat pregnancies, investigated the relationship between individual factors and the incidence of repeat pregnancies, identified the relationship between teenage behavior and the incidence of repeat pregnancies, and investigated the impact of the social environment on the incidence of repeat pregnancies among adolescents. A cross sectional analytic mixed method approach was adopted in this study with semi-structured questionnaires administered to 381 out of the targeted 402 adolescents at health facility level. Two focused group sessions and 5 key informant interviews were also conducted. The chi-square test was used for categorical data and the t-test for continuous variables when analyzing quantitative data. The defined objectives were followed in the transcription, summarization, and theme analysis of the qualitative data. At the 0.05 threshold of significance (95% confidence interval), statistical tests were run. To investigate the factors associated with recurring pregnancies, multivariate logistic regression was employed. 69.3% of the participants experienced recurrent pregnancy, albeit the data is not definitive. The most significant individual characteristics that indicate the likelihood of repeat pregnancy are ethnicity and awareness of contraception. Adolescent girls whose moms became pregnant before turning 18 were likewise at an increased chance of becoming pregnant again, and important behavioral risk factors linked to repeat pregnancy included not using a condom and having several sexual partners. Therefore, the study suggests interdisciplinary approaches that target risky behavior as well as the social and cultural norms that shape young people's choices about their health and pregnancy.

PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AMONG PRIMARY CAREGIVERS OF CANCER PATIENTS IN KAKAMEGA COUNTY, KENYA

2026-07-16T10:54:42Z

PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AMONG PRIMARY CAREGIVERS OF CANCER PATIENTS IN KAKAMEGA COUNTY, KENYA Odeny, Hellen Aoko Caregivers often undergo a deterioration in their Health Related Quality of Life (HRQOL) as a result of the considerable burden of caring for a cancer patient. Most research undertaken in Western nations have revealed a link between higher caregiving stress and poorer mental and physical well-being, as well as premature death, among family caregivers. Hence, the results of these studies may not have direct applicability to the people of Kenya, particularly in Western Kenya where the socioeconomic and ethnic circumstances are distinct. This research aimed to identify the characteristics associated with the health-related quality of life of main caregivers for cancer patients in Kakamega County. The basic objectives of the proposed research were to investigate the socio-economic determinants, ascertain patient characteristics, and evaluate the correlation between psychological aspects and HRQoL (Health-Related Quality of Life) among primary caregivers of cancer patients in Kakamega County. This research used an institutional-based cross-sectional analytical study design. The Kakamega County Referral Hospital was picked purposely as it houses the cancer center for the western area. The study population consisted of caregivers of cancer patients receiving treatment at the hospital. The caregivers were meticulously selected from a roster obtained from the Cancer Centre registry of cancer patients, where they are recorded as those who provide assistance throughout treatment. It is expected that every cancer patient has a designated caregiver. After calculation, the sample size consisted of 422 primary care providers. A data collection tool was obtained using a QOL questionnaire, such as WHOQoL-BREF, designed to measure both the objective and subjective aspects of quality of life. Additionally, the tool includes PHQ9/GAD-7, which are more sensitive and have a broader range of applications. The SPSS version is a statistics tool for social sciences. 26 was used for data input, cleaning and analysis. Socio-economic variables such as marital status (P=0.043), domicile (P=0.005), occupation (P=0.011) and income (P=0.027) were considerably connected with HRQoL. The patient's characteristics, such as the treatment style (P=0.022) and the kind of test performed (P=0.033), showed a substantial correlation with the patient's health-related quality of life (HRQoL). Caregiver knowledge and family support associated factors including severity of cancer as a disease(P=0.000), other family members supplying help with care(P=0.004), other family members with cancer(P=0.038) and chronic illness(P=0.000) were substantially connected with HRQoL. Psychological associated factors like melancholy (P=0.000), anxiety(P=0.017), perceived quality of life(P=0.000) and being pleased with one’s health (P=0.013) were substantially connected with HRQoL. The research revealed that socio-economic variables, psychological factors, patient characteristics and care giver’s knowledge on cancer were correlated with health-related quality of life among caregivers of cancer patients. The research indicated that financial expenses for cancer management may be lowered since this might lessen the financial stress care providers are enduring. Other family members should help main care providers not only financially, but also mentally to alleviate the strain of the primary care giver. Health care professionals should establish sometime to train caregivers about different forms of cancer their treatment, bad impact of the medications and how to help their patients at home so minimizing the burden of cancer, as a severity of the illness. Psychosocial support group networks should be developed for caregivers via multiple contact channels thereby lowering the mental and psychological strain felt by caregivers.