Browsing School of Nursing by Title
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Kamau, Kariri James; Osuga, Ben Onyango; Njuguna, Susan (Health Systems and Policy Research, 2017)[more][less]
Abstract: The right to the highest attainable standard of health is a fundamental human right and, central to this right within a hierarchical health system, is the existence of a well-functioning referral system that allows for continuity of care across the different tiers of care. A referral system enables management of client health needs comprehensively with resources locally unavailable. This study sought to establish challenges facing implementation of the referral system for quality health care services in Kiambu County, Kenya. Specifically, investigated the influence of infrastructure, capacity of health care workers, health information systems and financial resources on implementation of health care referral system. A crosssectional research design was done targeting health care workers in public health care facilities Tier 2 and Tier 3 in Kiambu County and two hundred and seventy one respondents took part in the study. A statistical analysis was done using SPSS 20 and Excel 2013. Both questionnaires and interview guide were employed as data collection tools which attained quantitative and qualitative data. Inferential statistics was used to conduct regression analysis. From the findings of the study it was established there existed a relationship between independent and dependent variables as revealed by infrastructure with coefficient 4.457; capacity of health care workers with coefficient 4.105; health information systems with coefficient 4.405; and financial resources with coefficient.4.013. The p value was <0.001. The study concluded that infrastructure, health information systems, capacity of health care workers, and financial resources are challenges in implementation of health care referral system in Kiambu County and should be strengthened. The study recommended that Kiambu County Health care facilities should improve infrastructure; implement a standard referral system monitoring toolkit and curriculum to train health workers on the referral policies and guidelines; develop standard referral forms/registers and provide adequate funds for implementation monitoring and evaluation. URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3621 Files in this item: 1
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Tuya, Scolastica Wabwire; Gatere, Ruth; Njuguna, Susan (International Journal of Professional Practice (IJPP), 2023)[more][less]
Abstract: Health professionals maintain, improve and broaden their knowledge and skills in a way that helps them develop qualities and competencies during practice. Continuous Professional Development (CPD) in nursing enhances competencies grounded in evidence base as new knowledge emerges in health care, and is therefore a valuable tool for implementing best practices. Advances in reproductive health seek to reduce risk of maternal morbidity and mortality that could be as a result of women not spacing births or having unmet needs for family planning. This study sought to evaluate the influence of CPD in provision of Long Acting Reversible Contraception (LARC), and to identify challenges in provision of service by nurses at Mbagathi County Hospital, Nairobi, Kenya. A cross sectional study design was used on a population of nurses working at Mbagathi County hospital, in units that provide reproductive health services. Sixty six nurses were eligible to for the study and were therefore purposively selected due to their numbers of eligibility so as to allow every one of them to participate in the study. Data was collected using a semi structured questionnaire. Descriptive analysis was conducted in MS excel and chi square test in epi-info version 7. The response rate was 98%, where 58(88%) questionnaires were analysed. The mean age of the nurses was 33.5 (SD± 7.5). The outcome of this study showed significant association between CPD and provision of LARC: OR: 7.47, at 95 % CL: CI: 1.82-30.65 and P-Value -0.003. Inadequate supplies and equipment were the major challenges in provision of LARC. Continuous Professional Development in Long Acting Reversible Contraception influenced service delivery in provision of contraceptive method. The study recommends improved provision of commodities and supplies for family planning, improved knowledge and skills on LARC, and targeted updates in family planning practices for effective service delivery. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/4125 Files in this item: 1
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Kahare, Munanie Mercy; Mwangi, Eunice; Njuguna, Susan (Kahare, M. M., Mwangi, E. & Njuguna, S. (2020). Determinants of Hospital Emergency Preparedness in Machakos County Kenya: A Case of Machakos Level 5 and Kangundo Level 4 HospitalsAcademic Journal of Health Systems and Reform (AJHSR), July 29, 2020)[more][less]
Abstract: Emergency preparedness is emerging as a key security priority globally. Plans are needed, not only for responding to the impacts of events, but also to maintain business continuing while managing the crisis, and to guide recovery and reconstruction effectively. Machakos being along Nairobi-Mombasa highway recorded 27% increase of emergency cases in 2017, 39% 2018 in Machakos level 5. During these period deaths increased from 191 to 497 from 2016. 35% increase of referrals to other hospitals was recorded. In the face of these emergencies, the ability of affected facilities like Kangundo level 4 and Machakos Level 5 Hospital Kenya to provide care to the injured can quite literally make the difference between life and death. This study assessed the determinants of Hospital Emergency Preparedness in Kangundo level 4 and Machakos Level 5 Hospitals in Machakos County. The study adopted cross-sectional design and simple random sampling method. Whereby a sample size of 128 respondents was obtained using the Yamane 2008 formula; 49 respondents from Kangundo level 4 and 79 from Machakos level 5 hospital. Simple random sampling was applied to select respondents. Self-administered questionnaire as a data collection tool was applied. The questionnaire was developed based on the objectives and identified gaps from literature review. The finding reveals high understanding of the meaning of emergency preparedness (M = 4.29; SD = 0.67), with 94 (74%) of the respondent considering themselves prepared for emergency. The mean was 3.67; SD = 1.06. While 80 (64%) considered themselves key leadership figure in emergency preparedness. One hundred and eleven (88%) of the respondents agreed with the statement that training on emergency preparedness should be conducted quarterly with mean of M = 4.27; SD = 0.95. Respondent agreed that emergency tray is well equipped with various equipment for management of emergency with a mean of 3.51± 1.101 and that hospital has a drug supply system with drug suppliers with mean of 3.51± 1.108. Majority of the respondent agreed with the statements that financial allocation for emergencies preparedness should be increased (4.07± 1.195), and that the facility has transport and logistics support in case of any emergency (3.4 ± 1.231). The respondent further agreed with proposition that the hospital has policy in place for emergency preparedness 91 (72%) and the hospital has a clear chain of command system in case of any emergencies 83 (65%). There results showed strong and positiverelationship between commodity availability, financial resources, policies and emergency preparedness with coefficient of correlation of r=0.619, p<0.001, r=0.626, p<0.001, and r=0.702, p<0.001 respectively. The study found that policy formulation and implementation, commodities and finances significantly influenced emergency preparedness. The study variables under this study are important in determining emergency preparedness, and that emergency preparedness will work well if the variables in this study are taken into account. Therefore, hospital management need to build stable drug supply system with adequate drug suppliers. Resources should be allocated to purchase ultra-modern equipment. Additionally, clear mechanism of access of emergency commodities should be developed by hospital management and staff be made aware on it. There is need for staff participation in emergency policy formulation, guidelines, emergency plans, and lobbying for emergency preparedness. Addition institution needs to make emergency drills, safety inspections regular. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/4123 Files in this item: 1
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Jillo, Ali Jillo; Ofware, Peter Obonyo; Njuguna, Susan; Mwaura-Tenambergen, Wanja (Pan African Medical Journal, April 23, 2015)
[more][less]Abstract: Introduction: Access to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng’adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads. Methods: A crosssectional study design was used to establish the effectiveness of Ng’adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection. Results: There was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p<0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p<0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p<0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p<0.05.There was significant reduction in home deliveries from 89.5%-79.5% with a p<0.05. Conclusion: The Ng’adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana. URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/2966 Files in this item: 1
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Gathitu, Eunice Wambui; Osuga, Ben Onyango; Njuguna, Susan; Kihara, Peter (nternational Journal of Current Innovation Research,, 2017)[more][less]
URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3666 Files in this item: 1
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Onyando, Jack Omondi; Olouch, Musa; Njuguna, Susan (International Journal of Current Business and Social Sciences, 2018)[more][less]
Abstract: Strengthening health service delivery as a building block to the health system is key to the attainment of the health-related Sustainable Development Goals, which include the delivery of effective interventions to reduce adolescent and youth mortality as well as the burden of HIV/AIDS. The Government of Kenya and its partners have over the years recommended certain standards through Adolescent Sexual Reproductive Health Policies and guidelines, with youth friendly centres continuing to be used as one model in providing reproductive health services to the youth. Despite these guidelines, the effectiveness of the centres has been acknowledged to depend on many factors which include institutional, service provider, policy and youths’perceptions. The study examined how those factors affected effectiveness of the centres in Kisumu County- one of the counties with some of the worst youth sexual and reproductive health indicators. The study used both quantitative and qualitative approaches to collect data and utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 182 youth seeking services from8 centres. The key informants were mainly service providers who were working at the centres at the time of study and were interviewed using an interview guide. Focused group discussions were conducted with the youth from two of the facilities, while a checklist was used to assess mostly institutional elements. The coding, entry and analysis of the quantitative data were doneusing Statistical Package for Social Sciences (SPSS) Version 20. Qualitative data on the other handwere transcribed then coded using NVivo 9 software and analysed using content, thematic framework approach. Descriptive statistics and correlation tests were performed to determine significant associations. The study established significant weak positive correlation between institutional factors and effectiveness of YFCs, (Spearman's rho(r) = 0.373, p=0.043, CL=95%); a significant moderate positive correlation between policy factors and effectiveness of YFCs (Spearman's rho(r)=0.596 p=0.019, CL=95%); a significant strong positive correlation between service provider factors and effectiveness of YFCs, (Spearman's rho(r) = 0.896, p=0.003, CL=95%) and a significant moderate positive correlation between client factors and YFCs. (Spearman's rho(r) = 0.403, p=0.023, CL=95%). The findings also showed that a majority of youth felt the services were both visually (75.3%, n=182) and auditory confidential (84.1%, n=182); 53% (n=21) of the service providers were not exposed to youth friendly policies and guidelines, many of whom (95%) had been trained on health promotion and advocacy as part of AYFHS. From the findings, most the youth rated the services as good (73.6%, n=182) and 88.5% would recommend the facilities to their peers. The study concluded that the effectiveness of YFCs in Kisumu County is greatly influenced by service provider and the perceptions of the youth themselves. In view of the findings, this study recommends the need for the government and partners to: design centres that ensure integrated and innovative services; widely disseminate relevant policies and guidelines to the implementers; intensify training on ‘softer skills’ and supervision of service providers and to involve youth in the planning and management of affairs at the youth centres. Further research is also recommended. Description: Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3726 Files in this item: 1
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Kahiga, Keziah Wakonyo (Journal of Nursing Education and Practice, July , 2018)[more][less]
Abstract: Introduction: The literature demonstrates that little research has been conducted to explore job satisfaction among nurses working in obstetric units in Kenya. The perception of job satisfaction by nurses is influenced by the environment in which they work. Methods: A cross-sectional survey design was used to carry out the study. The study tools included the work quality index (WQI) and the demographic data questionnaires. Convenience sampling method was. Data were analyzed using the SPSS version 20. The items in the WQI were organized into six subscales and Cronbach’s alpha was calculated to obtain the reliability coefficient of each subscale. An independent t-test was used to compare the subscales scores for the male and female participants. ANOVA was conducted to compare the level of satisfaction with the six subscales and the participants’ characteristics. Pearson’s product-moment correlation coefficient was calculated to assess if there was any relationships, the magnitude and the direction of the relationship between the six subscales. Results: Nurses are most satisfied with the perception that the work associated with their position provides them with the opportunity to be of service to others and least satisfied with receiving enough time to complete indirect patient care tasks. There are no significant differences in the overall level of satisfaction between males and females though males are more satisfied with autonomy of practice and professional role enactment. The six subscales strongly and positively correlate with one another. Conclusions: Nurses working in the obstetric units are relatively dissatisfied with most of the aspects of the work environment. The more educated nurses are less satisfied than less educated nurses. Since all aspects of job satisfaction are interrelated, emphasis should be put on each of them so as to create a satisfying work environment for nurses working in obstetric units. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3797 Files in this item: 1
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Cheruiyot, B; Muiruri, L; Njuguna, R. S (Cheruiyot, B., Muiruri, L. & Njuguna, R. S. (2019). Implementation of Hospital Management information Systems on service delivery at Moi Teaching and Referral Hospital.World Journal of Medical Education and Research: Volume 20, Issue 1, 2019)[more][less]
Abstract: Hospital Management Information Systems (HMIS) has the potential to improve the quality of services delivered, as well as the efficiency and effectiveness of healthcare providers through the integration of various hospital functional units. However, the benefits of this implementation in service delivery have not been adequately addressed. This study sought to appraise the impact of the implementation of HMIS, on service delivery in Moi Teaching and Referral Hospital, (MTRH). The objectives of the study were: to examine the level of implementation of HMIS in MTRH; to establish the strategies motivating implementation and utilisation of HMIS, to assess the benefits that have been realized in utilizing Hospital Management Information Systems, and to assess the effect of HMIS on service delivery in MTRH. Cross sectional descriptive research design was utilised in the study; the sample size formula proposed by Cooper and Schildler formula was used to obtain 240 respondents from a target population of 587 users of HMIS. A structured closed-ended questionnaire and interviews were administered. Quantitative data was obtained, coded using SPSS v.21. Data was analysed using descriptive statistics, i.e. mean and standard deviations and inferential statistics i.e. Pearson Correlation Analysis and Multiple Regression Analysis. Of the 240 questionnaires distributed, 192 were filled and returned, with most respondents familiar with HMIS. The respondents moderately agreed that the implementation of HMIS was done well and as per expectations. The Hospital Records module had the highest implementation level, while Consulting Doctor module scored the lowest. On the level of utilisation of HMIS, the result indicate that the mean values were above average on a five point Likert scale. The Further Records module had the highest implementation level, with the majority agreeing that the module had been adequately utilised. Conversely, the Consulting Doctor module posted the lowest utilisation level. On the strategies motivating the utilisation of HMIS results indicate that the strategy of allaying perceptions and fears among staff on the use of HMIS is the one mostly deployed by the hospital in order to improve the level of Utilisation of HMIS. Results indicated that the anticipated benefits of HMIS were all above average. The results of the regression analysis suggested that HMIS implementation (β=.215, p˂0.05), HMIS Utilisation (β= ..697, p˂0.05), motivation strategy (β= .193, p˂0.05), and HMIS benefits (β= .045, p˂0.05) had a positive significant effect on service delivery. Therefore, the null hypothesis is rejected. The value of the F-statistic is (F=172.917, p˂0.05) is robust. The coefficient of determination value of R2= .787 means that 78.7% of the variation in service delivery at the hospital can be explained by HMIS. The study recommends that a policy be drafted to entrench HMIS implementation and utilisation in the country. URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3762 Files in this item: 1
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Owiti, Sarah Winnie; Njuguna, Roseline Susan (International Journal of Scientific and Research Publications, April , 2016)[more][less]
Abstract: initiated across all health facilities to guide the implementation of quality standards. The use of guidelines in health management system describes the measure that can improve performance in health service delivery. Despite having guidelines there are disparities in the quality of services delivered in health facilities. The study focused on implementation of quality guidelines for improved health services. The objectives of the study were to establish the management practices used in the implementation process of the Kenya Quality Model for health and to explore the Human resources factors that influenced the implementation process of the Kenya quality model of health.A cross-sectional study involving 110 clinical managers in six public health facilities in Kakamega County, Kenya was carried out.Public health facilitieswere selected using random sampling, Clinical Managers were sampled using stratified and proportionate sampling. Quantitative data analysis yielded descriptive statistics and Chi-square (χ2) tests.The management practices used to implement guidelines was methods of quality improvement with mean 3.8, planning 3.3, continuous quality improvement 3 P-value was 0.04 indicating a significant relationship with improved quality of health services. The human resource for health factors that affected implementation of guidelines were awareness of guideline contents with a mean score 3.7 and motivation 3 and a p-value of 0.03 which indicated a relationship between human resource for health and improved quality of health services. The study recommends formation of quality improvement teams that can be responsible for the implementation process and development of quality monitoring tools. It further recommends Strategies to be put in place to increase the number of health human resources and train all health managers on the quality guidelines to prepare them for the implementation process. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3772 Files in this item: 1
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Akunga, Daniel Nyagetiria; Wanyoro, Anthony; Wanyoro, Anthony Karanja (Journal of Cancer Treatment and Research, January , 2018)[more][less]
Abstract: In Kenya, 51.2% of estimated women population of 11 million aged 15 years and older are at risk of developing cervical cancer. Research shows that screening a woman even once between the ages of 35 and 40 years reduces her lifetime risk of cervical cancer by 25–36%. However, the effective cervical cancer screening in developing countries is as low as 18.5%. Low levels of utilization of Cervical Cancer Screening Services (CCSS) among health care workers have been documented. This study sought to determine the utilization of cervical cancer screening services by healthcare workers (HCWs) in selected health facilities in Machakos County. It was also thought imperative to determine individual HCW attributes influencing utilization of cervical cancer screening services in selected health care facilities in the county. The study adopted a descriptive cross-sectional study design involving 271 female health workers drawn from all the level 4 and level 5 facilities within the county. Respondents were stratified according to level of facility and according to their cadres. Data was collected via self-administered questionnaires and a facility assessment tool. Data analysis used SPSS version 21. Association was subjected to binary logistic regression. Only 25% of HCWs had utilized cervical cancer screening services. HCWs who had certificate (OR = 0.05, p-value < 0.01), diploma (OR = 0.04, p-value < 0.01) and degrees (OR = 0.09, p-value = 0.01) were less likely to utilize CCSS as compared to HWCs who had attained graduate studies or higher. Also health workers aged 30 years and below (OR = 0.12, p-value = 0.01) and those aged between 31 and 40 years (OR = 0.30, p-value = 0.05) were less likely to utilize CCSS as compared to healthcare workers who were aged more than 50 years. The study recommends establishment of tailor-made sensitization programs on young female health care worker aimed at increasing their uptake of CCSS services among these group. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3796 Files in this item: 1
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Shibonje, Janet Mukoshi; Wanja, Mwaura-Tenambergen; Njuguna, Susan (International Journal of Scientific and Research Publications, May , 2016)[more][less]
Abstract: Timely delivery of effective, safe, quality and personal services is a key pillar of health system strengthening. A Maternal, Newborn and Child Health (MNeCH) Project was initiated by the Ministry of Health and World Vision Kenya in Bamba Division, Kilifi County. The project’s goal was to strengthen health systems at the facility and community levels, including Antenatal Care (ANC). One of the strategies used by the project to achieve its goal was to strengthen community health referral system. The objectives of the study were 1) to determine whether providing maternal health education to pregnant women had any influence on ANC attendance in the intervention and control communities and 2) to determine whether issuing referral advice forms to patients has any influence on ANC attendance in the intervention and control communities. This study adopted the static group control design to assess the influence of community health referral practices on ANC attendance in Mirihini, the intervention community in Bamba and Midoina the control community. Primary data were sourced from 246 mothers of children aged below 2 years, parents of children aged 2 to 4 years, as well as Community Health Volunteers (CHVs). Quantitative analysis yielded descriptive statistics and cross-tabulations with Chi-square (χ2) tests. Qualitative data were transcribed, described and analyzed systematically to reveal themes and patterns. Maternal health education: In Mirihini, there was no significant association between providing maternal health education on the ideal number of ANC visits and women’s achievement of optimal ANC attendance (χ2 = 1.423, df=1 & a ρ-value = 0.233). In Midoina, a significant relationship between the two aspects was obtained (χ2 = 3.109, df = 1 & ρ-value = 0.078. Referral documentation: In Mirihini, issuing referral documents to pregnant women was significantly associated with women’s achievement of optimal ANC attendance (χ2 = 8.308, df =1 & ρ-value = 0.004). In Midoina, there was no significant association between two aspects (χ2 = 0.823, df = 1 & ρ-value = 0.185). The study recommends the need for: CHVs to deliver more information to support care-seeking behavior change; project officers to strengthen supervisory support to CHVs by engaging with MoH to provide reporting materials and ensure consistency of monthly review meetings. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3795 Files in this item: 1
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Mukoshi Janet Shibonje; Wanja Mwaura-Tenambergen; Njuguna Susan (International Journal of Scientific and Research Publications, May , 2016)[more][less]
Abstract: - Timely delivery of effective, safe, quality and personal services is a key pillar of health system strengthening. A Maternal, Newborn and Child Health (MNeCH) Project was initiated by the Ministry of Health and World Vision Kenya in Bamba Division, Kilifi County. The project’s goal was to strengthen health systems at the facility and community levels, including Antenatal Care (ANC). One of the strategies used by the project to achieve its goal was to strengthen community health referral system. The objectives of the study were 1) to determine whether providing maternal health education to pregnant women had any influence on ANC attendance in the intervention and control communities and 2) to determine whether issuing referral advice forms to patients has any influence on ANC attendance in the intervention and control communities. This study adopted the static group control design to assess the influence of community health referral practices on ANC attendance in Mirihini, the intervention community in Bamba and Midoina the control community. Primary data were sourced from 246 mothers of children aged below 2 years, parents of children aged 2 to 4 years, as well as Community Health Volunteers (CHVs). Quantitative analysis yielded descriptive statistics and cross-tabulations with Chi-square (χ2 ) tests. Qualitative data were transcribed, described and analyzed systematically to reveal themes and patterns. Maternal health education: In Mirihini, there was no significant association between providing maternal health education on the ideal number of ANC visits and women’s achievement of optimal ANC attendance (χ2 = 1.423, df=1 & a ρ-value = 0.233). In Midoina, a significant relationship between the two aspects was obtained (χ2 = 3.109, df = 1 & ρ-value = 0.078. Referral documentation: In Mirihini, issuing referral documents to pregnant women was significantly associated with women’s achievement of optimal ANC attendance (χ2 = 8.308, df =1 & ρ-value = 0.004). In Midoina, there was no significant association between two aspects (χ2 = 0.823, df = 1 & ρ-value = 0.185). The study recommends the need for: CHVs to deliver more information to support care-seeking behavior change; project officers to strengthen supervisory support to CHVs by engaging with MoH to provide reporting materials and ensure consistency of monthly review meetings. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3990 Files in this item: 1
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Njuguna Susan; Wanja Mwaura-Tenambergen; Mapesa Job (International Journal of Community Medicine and Public Health, November , 2019)[more][less]
Abstract: Background: The role of health care providers in the implementation of responsiveness of health systems is unclear. Responsiveness of health systems is one of the goals set out by WHO in 2000. Effective leadership and governance of health systems incorporates all players involved in policy implementation. The objectives of the study were to establish how the health care provider’s awareness of patients’ rights charter influence health systems responsiveness and to establish how the health care provider practice of patients’ rights charter influence responsiveness of health systems in primary care settings. Methods: This was an exploratory cross section descriptive study design that used a psychometric semi- structured questionnaire to collect qualitative data that was analyzed quantitatively. Respondents were 62 purposively sampled health care providers from four, primary care health facilities. Key informant interviews from the four health facilities in-charges were carried out. Data was analyzed using SPSS vs 25 and themes. Results: Health care provider awareness of the content of patients’ rights charter (r=0.612*, p<0.001) and practice of patient’s right charter (r=0.610*, p<0.001) were statistically significant and influenced health systems responsiveness. Conclusions: Implementation of patients’ rights charter has an influence on responsiveness of health systems. Leadership and Governance of health systems requires a structured approach to implementation of policies that positively influence responsiveness of health systems. Supervision of health care providers for best practice can provide a basis for replication in other primary care facilities and lead to achieving responsiveness of health systems Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3989 Files in this item: 1
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Njuguna, Susan; Tenambergen, W. Mwaura; Mapesa, Job (School of Nursing, Daystar University, Kenya, October 14, 2019)[more][less]
Abstract: Background: The role of health care providers in the implementation of responsiveness of health systems is unclear. Responsiveness of health systems is one of the goals set out by WHO in 2000. Effective leadership and governance of health systems incorporates all players involved in policy implementation. The objectives of the study were to establish how the health care provider’s awareness of patients’ rights charter influence health systems responsiveness and to establish how the health care provider practice of patients’ rights charter influence responsiveness of health systems in primary care settings. Methods: This was an exploratory cross section descriptive study design that used a psychometric semi- structured questionnaire to collect qualitative data that was analyzed quantitatively. Respondents were 62 purposively sampled health care providers from four, primary care health facilities. Key informant interviews from the four health facilities in-charges were carried out. Data was analyzed using SPSS vs 25 and themes. Results: Health care provider awareness of the content of patients’ rights charter (r=0.612*, p<0.001) and practice of patient’s right charter (r=0.610*, p<0.001) were statistically significant and influenced health systems responsiveness. Conclusions: Implementation of patients’ rights charter has an influence on responsiveness of health systems. Leadership and Governance of health systems requires a structured approach to implementation of policies that positively influence responsiveness of health systems. Supervision of health care providers for best practice can provide a basis for replication in other primary care facilities and lead to achieving responsiveness of health systems. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/4007 Files in this item: 1
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Njuguna, Susan; Tenambergen, Wanja Mwaura; Mapesa, Job (International Journal of Community Medicine and Public Health, November , 2019)[more][less]
Abstract: Background: The role of health care providers in the implementation of responsiveness of health systems is unclear. Responsiveness of health systems is one of the goals set out by WHO in 2000. Effective leadership and governance of health systems incorporates all players involved in policy implementation. The objectives of the study were to establish how the health care provider’s awareness of patients’ rights charter influence health systems responsiveness and to establish how the health care provider practice of patients’ rights charter influence responsiveness of health systems in primary care settings. Methods: This was an exploratory cross section descriptive study design that used a psychometric semi- structured questionnaire to collect qualitative data that was analyzed quantitatively. Respondents were 62 purposively sampled health care providers from four, primary care health facilities. Key informant interviews from the four health facilities in-charges were carried out. Data was analyzed using SPSS vs 25 and themes. Results: Health care provider awareness of the content of patients’ rights charter (r=0.612*, p<0.001) and practice of patient’s right charter (r=0.610*, p<0.001) were statistically significant and influenced health systems responsiveness. Conclusions: Implementation of patients’ rights charter has an influence on responsiveness of health systems. Leadership and Governance of health systems requires a structured approach to implementation of policies that positively influence responsiveness of health systems. Supervision of health care providers for best practice can provide a basis for replication in other primary care facilities and lead to achieving responsiveness of health systems. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/4001 Files in this item: 1
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Chalulot, Geoffrey Kipkorir; Njuguna, Susan; Ndirangu, Eunice (Journal of Medicine, Nursing &Public Health, September , 2018)[more][less]
Abstract: The study aimed at establishing the institutional factors that influenced the implementation of policy on management of childhood illnesses in Bomet County. A descriptive cross sectional study design with both quantitative and qualitative approaches was used for data collection. The study population was a total of 279 health workers in Bomet County Hospital and Tenwek Hospital. A sample of 164 was arrived at which was selected using stratified and simple random sampling technique. The quantitative data was analyzed using Statistical Package for Social Sciences (SPSS version 24). The study established a significant positive relationship between institutional factors of enhancing compliance to policy procedures on implementation of policy on management of childhood illnesses at 0.824, p˃0.01. The study recommends that health institutions in Bomet County facilitate the dissemination and compliance to the implementation of the policy on management of childhood illnesses. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3794 Files in this item: 1
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Kuyo, Richard Ole; Muiruri, Lillian; Njuguna, Susan (International Journal of Medical Research & Health Sciences, October , 2018)[more][less]
Abstract: Background: Sound and reliable information is the foundation of decision-making across all health system building blocks that include service delivery, health workforce, health information, medical products, vaccines and technology, financing, leadership, and governance. This study is built on health information system pillar. Objectives: To determine the organizational factors influencing the use of DHIS2 in Uasin Gishu County. Methods: Study was conducted in Uasin Gishu-Sub County health facilities. A questionnaire was used to collect quantitative data from 283 health workers selected randomly while 10 key informants were selected purposively from this sample for indepth interviews. Results: Total 50.0% of the participants acknowledged that finances were adequate to run DHIS2. The main champions of DHIS2 used in decision-making were the county health records and information officers (56.2%) and the sub-county health records and information officers (39.0%). Up to 78.5% agreed or strongly agreed that organizational hierarchy influenced DHIS2 use and 80.8% agreed or strongly agreed that there was improved staff performance due to DHIS2 utilization. On the other hand, the major challenges experienced in the use of DHIS2 for evidenced-based decision-making were the lack of management support (34.3%), poor skills among the users (48.6%), lack of adequate computers (36.7%), unreliable internet connectivity (47.1%), lack of power backup (27.6%), and resistance to change (21.0%). Conclusion: The main funding for the DHIS2 system comes from the County government while health records and information officers are the main promoters of DHIS2 use. The main determinants of DHIS2 used are the availability of computers, network and internet services, trained staff and legislation. The main challenges inhibiting DHIS2 use are lack of management support, poor skills among the users, lack of adequate computers, unreliable internet connectivity, lack of power backup and resistance to change. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3793 Files in this item: 1
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Ole Kuyo, Richard; Muiruri, L; Njuguna, Susan (World Journal of Medical Education and Research, 2020)[more][less]
Abstract: Sound and reliable information is the foundation of decision making across all health system building blocks that include: service delivery; health workforce; health information; medical products, vaccines and technology; financing; leadership and governance. This study is built on the health information system pillar. The aim of this study was to assess the use of District Health Information System data in decision making in Uasin Gishu Sub County Hospitals. The specific objectives were to determine the level of knowledge, organizational, technical and behavioral factors that influence the use of DHIS2 data in Uasin Gishu Sub County Hospitals. The study was conducted in Uasin Gishu Sub County Hospitals. The study employed both quantitative and qualitative approaches using cross-sectional research design. A questionnaire was used to collect quantitative data from 283 health workers who were selected randomly while 10 key informants were selected purposefully from this sample for in-depth interviews. The quantitative data was coded and analyzed using R Software for descriptive, bivariate and multivariate logistic regression. Thematic analysis was used to analyze qualitative data using Qualitative Data Analysis (QDA) software. Bivariate association between the independent variables and the dependent variable was assessed using Pearson‘s Chi Square test and fishers exact test where chi square assumptions were violated. Multivariate analysis was done using logistic regression to assess for predictors. A P value of 0.05 was considered as significant. The results of the quantitative data were presented in the form of graphs, tables and charts, while the results for qualitative data were presented in the form of themes. Approval to conduct the study was obtained from the KeMU Scientific Ethics Research Committee (SERC) and from National Commission for Science, Technology and Innovation (NACOSTI). Consent was sought from participants for the study. The study found that 68.4% of the participants reported good, very good or excellent competence levels in data management using DHIS2 while use of information in DHIS2 to inform policy and operational decision making was reported as good, very good, and excellent by only 37.3%, 18.9%, and 8.0% respectively. A half of the participants (50.0%) acknowledged that there are adequate finances to run DHIS2, the main champions promoting use of DHIS2, information for decision making in the County were county health records and information officers (56.2%). Moreover, 61.7% of the participants agreed or strongly agreed that age influences the way health workers adopt and use DHIS2 in the hospitals while 65.4% of the participants were dissatisfied with the IT support received from the Ministry of Health. Although 80.9% of the participants had log in credentials, only 24.2% had difficulty with logging into the DHIS2. Furthermore, 79.5% had low or moderate level of training in DHIS2 but 15.0% had never trained and this could be the reason why only a third of the participants had some confidence in handling a task using DHIS2. The study concludes that the level of knowledge regarding the use of DHIS2 information is fair across the six Sub County Hospitals in Uasin Gishu County but utilization of DHIS2 information by county health managers for decision making is low. It also concludes that the main funder of the DHIS2 system is the County Government while support from National Government is minimal, while age influences the way health workers adopt and use DHIS2 data in Uasin Gishu Sub County Hospitals. Lastly, the level of training on DHIS2 is generally low while utilization of information on DHIS2 in facilitating evidence-based decision making in the Sub County Hospitals range from moderate to low. Consequently, the study recommends that the County scales up utilization of DHIS2 information and generates policy measures to ensure utilization of DHIS2 information to facilitate decision making at the County. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/4124 Files in this item: 1
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Kishasha, K. Meshack; Oluoch, Musa; Njuguna, Susan (Journal of Health, Medicine and Nursing, 2018)[more][less]
Abstract: Purpose:The purpose of this study was to determine the performance, challenges and the opprtunities in task shifting for the cadre. Methods:This was a cross-sectional study design. Purposive snowballing technique was employed. One hudred and fifty Clinical Officers were targed for study. A sample of 45 was captured for study calculated as 30% of the target population. Structured questionnaires were administered and triangulated by focus group discussions and key informant interviews. Cross tabulation and chi-square tests were used to compare performance in various reproductive health procedures. Analysis of Variance was employed to test for significance in differences on various responses. Data from focus group discussion was transcribed and analyzed by content analysis. Analysis of the Quantitative data collected was done using SPSS (Version 22). Data collected was analysed using tables, graphs and descriptive statistics Results:The study found out that motivation builds a better, more satisfied and better performing workforce as evidenced by response of further training There was significant statistical evidence of competence in performing task shifted obstetrical and gyneacological procedures at p-value 0.05, computed chi-square value of 7.134 against the critical value of 9.488. Analysis of Variance with a computed value of 95.7, p-value 0.05 and critical Value of 2.45 indicated that responses from respondence differed significantly while response for anew act of parliament for the practice of new skills was 100%. Unique Contribution to Theory, Practice and Policy: The study recommeded for the development of task shifting policy framework the, strengthening of health systems workforce through task shifting for the cadre and sensitization of workforce at health facilities on the concept of task shifting. Description: Journal Article URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3791 Files in this item: 1
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Ikahu, Ann; Njuguna, Susan; Adoyo, Maureen; Gatimu, Joseph; Otiso, Dr Lilian (International Journal of Scientific and Research Publications, July 7, 2016)[more][less]
Abstract: The HIV policy in Kenya recommends routine HIV testing and counselling to all clients attending public health facilities to facilitate early diagnosis and enrolment to care and treatment. The World Health Organization (WHO) recommends task shifting in HIV testing and counselling to ease the burden on medical health workers. There is limited evidence on implementation of task shifting in a public health facilities in Kenya. The study aimed 1)to establish the perspectives of health care providers on taskshifting in the public health facilities in Kenya, and 2) assess client’s satisfaction with the services offered through the task shifting model. A mixed method approach was used; a cross sectional descriptive design was adopted with qualitative and quantitative approaches. Results indicated positive response among medical health providers with regard to the task shifting; 83% of the medical health providers described the relationship between medical and non-medical health providers as excellent. Levels of clients’ satisfaction improved significantly with introduction of task shifting from 50% to 70% respectively. There was also a correlation between the number of non-medical providers who were engaged and the annual uptake of the PITC services that increased from 122,442 in 2010 to 209,022 in 2014.Task shifting strategy in HIV testing and counselling was therefore found to be feasible for scaling-up of HIV testing and counselling in the public health facilities. URI: http://repository.daystar.ac.ke/xmlui/handle/123456789/3983 Files in this item: 1
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