https://repository.seku.ac.ke/handle/123456789/1823 2026-04-04T14:51:43Z 2026-04-04T14:51:43Z Ngigi, Charles K. https://repository.seku.ac.ke/handle/123456789/7402 2023-12-01T07:24:06Z 2023-11-07T00:00:00Z

Title: Effect of mHealth technology in enhancing postnatal visits amongst mothers attending MCH/FP clinics in selected hospitals in Kakamega County, Kenya Authors: Ngigi, Charles K. Abstract: Postnatal care is the provision of health services to the mother and newborn after delivery. It offers the opportunity to assess the mother for any medical, mental, emotional and social issues, and early assessment of risk factors and physical problems with the baby. Postnatal care services are offered by skilled health care workers during the postnatal visits. In Kenya mothers are expected to attend a minimum of four postnatal visits spread across the postnatal period though only a few do that. Globally, very few postnatal mothers seek postnatal services within two days. High maternal and neonatal mortality rate is observed during the first forty two days after child birth. This trend continues throughout the first year of the neonate. The main goal of the study was to determine the effect of mobile health technology in enhancing postnatal visits among postnatal mothers in Maternal Child Health and Family Planning (MCH/FP) clinics in designated health facilities in Kakamega County, Kenya. The study was designed as a cluster Randomized Controlled Trial (RCT) that involved four arms. In control arm the participants received only the routine written and verbal communication whereas in intervention arm 1, participants received routine verbal and written communication and mobile SMS, in arm 2 they received written and verbal communication and a voice call whereas in arm 3, the participants received written/verbal communication and combination of voice call plus Short Text Messages sent to remind them to visit the postnatal clinic. The reminders were packaged together with postnatal (PN) educational health messages. The research involved a study population of 320 postnatal mothers attending MCH/FP clinics. The study sites were purposively selected from four Sub Counties in Kakamega County. Study subjects were selected using a systematic sampling technique until the target was achieved. Quantitative and qualitative data was collected using interview, FGD and KII guides. Data was entered into Microsoft Access data base and analysed using SPSS version 24. At the baseline it was observed that 27% of the participants adhered to 2nd and 3rd postnatal clinic visits. After the intervention there was significant difference (χ²=28, df=3, p=0.001) between control and intervention arm. Majority of participants (82%) had no/low knowledge on postnatal care before the intervention, however there was significant difference in knowledge between control and study arms (χ²=113, df=9, p=0.000) after sending health messages. This study concluded that postnatal mothers in Kakamega County have low or no knowledge on postnatal care and only a few attend postnatal clinic within two weeks. This is likely to affect the uptake of postnatal services. Postnatal mothers had a positive attitude on use of mobile health technology in health care. There is a significant relationship between mobile phone reminders and adherence to 2nd and 3rd postnatal visit. Kakamega County government should integrate use of mobile telephone services packaged together with postnatal educational health messages in the provision of health services. Description: Doctor of Philosophy in Public Health and Epidemiology, 2022

2023-11-07T00:00:00Z Gichure, Josphat N. https://repository.seku.ac.ke/handle/123456789/6089 2023-11-30T09:52:59Z 2020-09-09T00:00:00Z

Title: Integrating traditional techniques into conventional preservation methods to upgrade pastoral deep-fried beef products in Kenya Authors: Gichure, Josphat N. Abstract: Indigenous pastoral processing and preservation techniques have not been competitive along the formal meat value chain. Deep-fried products being the main indigenous pastoral products, low engagement in the formal chains and dynamics in their processing and preservation limit their competitiveness. Description: Doctor of Philosophy in Food Science and Technology, 2017

2020-09-09T00:00:00Z Kiptoo, Michael K. https://repository.seku.ac.ke/handle/123456789/1969 2023-11-30T09:38:28Z 2016-03-08T00:00:00Z

Title: Antiretroviral resistance and genetic diversity of human immunodeficiency virus among antenatal clinic respondents on nevirapine from North-Rift Kenya Authors: Kiptoo, Michael K. Abstract: Mother-to-child transmission (MTCT) of HIV-1 is responsible for infection of hundreds of thousands of infants every year. It is estimated that 600,000 newborns are infected yearly worldwide, with MTCT accounting for 90% of these infections. Human immunodeficiency virus (HIV) can be transmitted from mother-to-child at various stages of pregnancy including in utero and intra partum. A number of feasible and effective interventions to reduce MTCT among women of child hearing age are available. These interventions include prevention of primary HIV infection, avoiding unwanted pregnancies among HIV positive women, reduction of transmission from infected mothers to infants during pregnancy, labour, delivery and breathfeeding through provision of voluntary counselling and testing (VCT) services, antiretroviral therapy (ART), safe delivery practices, and breast milk substitutes. However, these approaches are not always possible in resource-poor countries. The use of antiretroviral (ARV) drugs, in particular revirapine, zidovudine and zidovudine/lamivudine combination, has been studied in both developing and developed countries. Although these studies have shown reduction in transmission of HIV, concerns regarding the development of drug resistant strains have been raised. The Ministry of Health in Kenya has implement nevirapine regimen to reduce MTCT in the public health facilities. This study aimed to investigate drug resistance in an MTCT setting in Kenya. A total of 309 HIV seropositive pregnant women taking part in the prevention of mother of child transmission of HIV (PMTCT) programme in three hospitals, namely, South Nandi Hills, Kapsabet, and Kitale district hospitals were enrolled in this study. A structured questionnaire was used to collect demographic information. Venous blood was collected into vacutainer tubes containing EDTA as anticoagulant. The enumeration of T-lymphocytes was carried out by flow cytometry and viral load was determined by nucleic acid amplification. The proviral HIV DNA extracted from peripheral blood mononuclear cells (PBMCs) was sequenced to determine the drug resistance associated mutations and HIV-1subtypes. The significance of associations was investigated by chi-square test and odds ratios. The HIV prevalence among the pregnant women was 6.7% (309 of 4638). The majority (85%) of the women visiting the antenatal clinic were not aware of their HIV status. Sixty percent (60%) of pregnant women had a CD4 count of more than 350cells/mm3 . The HIV transmission rate was 6% (4 of 59 infants). Drug resistance associate mutations were detected as minor population except in one mother-child pair where major populations were found. Nevirapine drug resistance was detected in 19.4% (7 of 36) and 100% (3 of 3) of the women and infants tested respectively. Even though the women had not been exposed to nucleoside reversed transcriptase inhibitors (NRTIs), drug resistance associated mutations were detected in 8 mothers (22.2%) as minor populations. The major circulating HIV-1 subtype in North-Rift Kenya was identified as A1 (50% and 71.8%) based on the env (C2V3) and pol (RT) regions respectively. Human immunodeficiency virus type 1 subtypes D (12.8%), C (10.3%), A2 (2.6%) and G (2.6%) were also detected based on sequencing of the pol region. Drug resistance outcomes in mothers and infants should be considered as an important secondary end point in PMTCT assessment. Description: Doctor of Philosophy Immunology, 2004

2016-03-08T00:00:00Z