http://erepository.uonbi.ac.ke/handle/11295/103968 2026-06-08T01:12:21Z http://erepository.uonbi.ac.ke/handle/11295/154016 Factors affecting the Utilization of Cancer Health Care Services: a case study of breast cancer screening among women in Kenya Waweru, Eric, M The study sought to examine the factors affecting the utilization of cancer health care services: a case study of breast cancer screening among women in Kenya. Specifically, the study sought to estimate the demand function for breast cancer screening in Kenya as well as assess the household characteristics, social and economic factors that determine utilization of breast cancer healthcare services in Kenya. The study utilized secondary data mainly the Kenya Demographic and Health Survey data of 2014. For the empirical model estimation, the study employed the dummy variable models namely LPM, Logit and Probit models. The results of the study reveal that breast cancer screening by medical practitioner remain minimal at best with only 11.4 percent of woman having had breast cancer screening done by a medical practitioner. The regression model results for LPM, logit and probit model indicate the demand function for breast cancer screening is downward sloping. This is supported by the finding that distance to health facility proxied by time taken to get water has a negative effect on seeking for breast cancer screening. However, upon controlling for the household income, the effect of distance remains negative but not significant implying that the income well – off households can pay the cost of travel to seek for health services. This calls for the need to subside the cost of breast cancer screening. Woman education level and household head education level were found to have positive effect on demand for breast cancer screening. However, the household size was found to reduce the probability of a women seeking for breast cancer screening services. lastly, women from male – headed households were found to have a lower probability of seeking for breast cancer screening services. Based on these findings, the study recommends the need for sensitization and awareness creating among women on the need and importance for breast cancer services, expansion of the health infrastructure to trade – off the negative effect of distance to health facility and subsidizing women breast cancer screening for women in the low wealth quartiles. 2020-01-01T00:00:00Z http://erepository.uonbi.ac.ke/handle/11295/152798 African Midwifery Students' Self-assessed Confidence in Antenatal Care: a Multi-country Study Hildingsson, Ingegerd; Helena, Lindgren; Annika, Karlström; Bäck, Lena; Mudokwenyu-Rawdon, Christina; Maimbolwa, Margaret C; Laisser, Rose Mjawa; Omoni, Grace; Chimwaza, Angela; Mwebaza, Enid; Jonah, Kiruja; Bharati, Sharma Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa.Objective: The aim of the study was to describe and compare midwifery students' confidence in basic antenatal skills, in relation to age, sex, program type and level of program.Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition.Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains.Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence. 2019-01-01T00:00:00Z http://erepository.uonbi.ac.ke/handle/11295/108043 A review of Kenya’s cancer policies to improve access to cancer testing and treatment in the country Makau-Barasa, LK; Greene, S; Othieno-Abinya, NA; Wheeler, SB; Skinner, A; Bennett, AV BACKGROUND: Cancer is the third-leading cause of mortality in Kenya, resulting in unique challenges to the country's health system. An increase in the number of cancer cases in Kenya over the past decade resulted in legislative actions and policies to guide delivery of cancer services. Kenya's new national cancer control strategy and past policy efforts provide an opportunity to synergise information and enhance understanding to improve cancer diagnosis and treatment in the country. The objectives of this study are to (1) document policy-modifiable factors based on a review of policy documents and results of a key informant survey and (2) develop recommendations to improve policies affecting cancer testing and treatment services in Kenya. This study builds upon our previous study Improving Access to Cancer Testing and Treatment in Kenya (Makau Barasa et al. J Global Oncol 2(216), 2017). METHODS: The study applied an in-depth systematic review of Kenya's cancer policies and guidelines, a qualitative analysis of results from a section of a semi-structured key informant survey focused on the opinions of clinicians delivering cancer services as well as cancer support groups and advocacy leaders, and a stakeholder analysis identifying key policy-makers and implementers. Details of the complete key informant survey were published in our previous study. RESULTS: Kenya's cancer policies have guided progress made in providing the legal and implementation frameworks for the development and delivery of cancer services at the national and county levels. Some policy implementation gaps are noted. These include inadequate financing for cancer services, limited research and data to support policy formulation, and the concentration of cancer services in urban areas. The key informant survey identified policy-modifiable actions that can address some of the gaps and improve the delivery of and access to cancer testing and treatment services in the country. Some of these include addressing the financial barriers affecting cancer testing and treatment services; increasing stakeholder engagement in training health personnel to deliver cancer testing and treatment services; decentralising cancer services and improving cancer surveillance and research; and increasing education and awareness about cancer symptoms, screening procedures and treatment options. A set of priority policy actions were selected from the study findings and used to develop recommendations for Kenya's policy-makers and stakeholders. CONCLUSIONS: Revisions to Kenya's cancer policies are seeking to address gaps noted in past policies and to improve access to cancer testing and treatment in Kenya. However, based on study findings, additional actions can be taken to strengthen policy implementation. Considering the policy formulation and implementation process and costs, this study recommends focusing on three priority policy actions that can have significant impact on improving access to cancer testing and treatment services. These include addressing financing, insurance and human resources gaps; increasing stakeholder engagement; and decentralising health services for better surveillance and data to inform policies 2020-01-18T00:00:00Z http://erepository.uonbi.ac.ke/handle/11295/107266 Training needs assessment for forensic nursing in Kenya Mageto, Irene G; Omoni, Grace; Cabelus, Nancy B; Inyega, Justus O Introduction: Forensic nursing has not been adopted in Kenya despite the fact that nurses work in settings that require this knowledge. The national Bachelor of Science in nursing syllabus calls for lectures in forensic nursing but lectures have neither been developed nor are there educators prepared to teach the unit. This study aimed at evaluating the training needs for forensic nursing in Kenya. Methods: The study adopted a descriptive cross-sectional study design. Data was collected utilizing a self-administered questionnaire, among 116 randomly sampled practicing nurses from three hospitals. Additionally, a focused group discussion was conducted among ten nurse educators and an in-depth interview with one key informant. Univariate analysis was conducted and the results presented using mean, standard deviations, frequency distributions, and proportions. Bivariate analysis was done using Pearson’s Chi-square test to determine relationships between categorical variables and P values of 0.05 or less were considered to have a significant association. Qualitative data analysis involved clustering together related types of narrative information then analyzed using thematic analysis. Results: Majority (90.5%) of the practicing nurses and 100% of the lecturers had no training on forensic nursing science whatsoever. The nurses and lecturers perceived training needs for forensic nursing practice included: advanced health assessment, 3.4%, evidence collection and documentation, 40.5%, forensic psychiatry, 12.9%, gender violence 5.2%, legal implications on forensic nursing 13.8%, theory and practice in forensic nursing, 24.1%. Majority of the nurses, 98.3%, had a positive attitude towards forensic nursing because they reported that forensic nursing is an integral component in the practice of nursing care in Kenya. Conclusion and recommendation: This study identified gaps in forensic nursing education in Kenya in that the nurses reported a lack of skills needed to care for forensic patients. Training in forensic nursing science is therefore strongly recommended. 2017-01-01T00:00:00Z