Concurrent Mixed Methods Approach Research Articles

RESOURCE PROCUREMENT AND CLIMATE SMART AGRICULTURE IN LAIKIPIA COUNTY, KENYA

Objective: The objective of this study is to determine how resource procurement influences climate-smart agriculture projects in Laikipia County, Kenya. Theoretical Framework: This study is anchored on Transaction Cost Economics Theory, which states that a project will attract transaction costs all through the procurement process. This study anchors on this theory as small-scale farmers need to be innovative to reduce procurement costs and have bargaining power over exploitive stockists. Method: A concurrent mixed method approach that adopted the descriptive cross-sectional survey and correlational design was employed to study two World Bank-sponsored Kenya Climate Smart Agriculture projects. Stratified and Simple random sampling were employed to get a sample of 225 small-scale farmers and purposeful sampling identified four key informants. Data was collected using questionnaires and an interview guide and analyzed using descriptive, inferential, and content data analysis techniques. Results and Discussion: The composite mean and standard deviation of 3.25 and 1.163 respectively. The relationship between resource procurement and the performance of climate-smart agriculture projects had a fairly strong linear coefficient of correlation (r= 0.524) and p-value of (p=0.000<0.05) indicating a fairly strong and significant relationship. Therefore, effective procurement of inputs, machinery, and other resources is critical in sustainable agriculture. Research Implications: Consequently, it is critical to have policies that promote effective procurement and safeguard small-scale farmers from exploitive stockists. Originality/Value: This study contributes to the literature by providing reliable and triangulated empirical data through authentic methodology enhancing suitability for data generalisability and replicability. The relevance and value of this research is evidenced by the need to promote food security in a healthy ecology

RESOURCE ALLOCATION AND CLIMATE SMART AGRICULTURE IN LAIKIPIA COUNTY, KENYA

Objective: The objective of this study was to determine how resource allocation influences climate-smart agriculture projects in Laikipia County, Kenya. Theoretical Framework: Pareto Efficiency Theory states that at a certain level, it is not possible to utilize more resources to improve one party, without jeopardizing the other party. The study sought to heighten the level of food production to guarantee food security without threatening the environment. Method: A concurrent mixed method approach that adopted the descriptive cross-sectional survey and correlational design was employed to study two World Bank-sponsored Kenya Climate Smart Agriculture projects. Stratified and Simple random sampling were employed to get a sample of 225 small-scale farmers and purposeful sampling identified four key informants. Data was collected using questionnaires and an interview guide and analyzed using descriptive, inferential, and content data analysis techniques. Results and Discussion: The composite mean and standard deviation of the respondents' opinions on resource allocation were 3.52 and 1.143, respectively. The correlation coefficient of resource allocation and the performance of climate-smart agriculture projects was weak, with r=-0.220 and p-value p=0.000<0.05. Therefore, though resource allocation is a crucial factor in food production, judicious and effective resource allocation is critical to realizing the full potential of the projects. Research Implications: Consequently, it is critical to have policies that promote the effective allocation of public and private goods to promote food production coupled with enhanced healthy ecology. Originality/Value: This study contributes to the literature by providing reliable and triangulated empirical data through authentic methodology enhancing suitability for data generalisability and replicability. The relevance and value of this research is evidenced by the need to promote food security in a healthy ecology.

RESOURCE STEWARDSHIP AND CLIMATE SMART AGRICULTURE IN LAIKIPIA COUNTY, KENYA

Objective: To examine the extent to which resource stewardship influences the performance of climate-smart agriculture projects in Laikipia County, Kenya. Theoretical Framework: The study was anchored on the Stewardship theory that envisages that unsupervised managers, will derive their satisfaction from the organization's success hence, remain accountable stewards. Judicious stewardship is the only way to achieve food security in a healthy ecology. Method: A concurrent mixed method approach that adopted the descriptive cross-sectional survey and correlational design was employed to study two World Bank-sponsored Kenya Climate Smart Agriculture projects. Stratified and Simple random sampling were employed to get a sample of 225 small-scale farmers and purposeful sampling identified four key informants. Data was collected using questionnaires and interview guide and analyzed using descriptive, inferential, and content data analysis techniques. Results and Discussion: The respondents’ opinions on resource stewardship had a composite mean and standard deviation of 3.47 and 1.138 respectively. The relationship between resource stewardship and the performance of climate-smart projects had a weak linear correlation of (r= -0.007) and p-value (p=0.923>0.05) indicating a weak and insignificant relationship. Despite the portrayed confidence in resource stewardship, stewardship is not a quick-fix approach hence, detested in the use of resources. Research Implications: Consequently, it is vital to have policies that enforce, promote, and subsidize activities that stimulates stewardship in food production. Originality/Value: This study contributes to the literature by providing reliable and triangulated empirical data through authentic methodology enhancing suitability for data generalisability and replicability. The relevance and value of this research are evidenced by the need to promote food security in pursuance of the achievement of sustainable development goals.

RESOURCE CAPACITY PLANNING AND CLIMATE SMART AGRICULTURE IN LAIKIPIA COUNTY, KENYA

Objective: The purpose of this study was to establish the extent to which capacity planning influences the performance of climate-smart agriculture projects in Laikipia County. Theoretical Framework: The study was anchored on the theory of change whose pillars are planning, participation, and evaluation. These factors are critical in capacity planning of scarce resources and evaluating the effectiveness of the process. Method: A concurrent mixed method approach that adopted the descriptive cross-sectional survey and correlational design was employed to study two World Bank-sponsored Kenya Climate Smart Agriculture projects. Stratified and Simple random sampling were employed to get a sample of 225 small-scale farmers and purposeful sampling identified four key informants. Data was collected using questionnaires and interview guide and analyzed using descriptive, inferential, and content data analysis techniques. Results and Discussion: The respondent’s opinion on capacity planning had a composite mean and standard deviation of 2.88 and 1.219 respectively. Capacity planning and the performance of climate-smart agriculture projects had a strong correlation coefficient of r=0.644 and p-value p=0.000<0.05. Therefore, resource capacity planning is fundamental in enhancing climate-smart projects, through proactive decisions, risk management, and cost reduction. Research Implications: Consequently, it is imperative to have policies that prioritize and promote capacity planning of the scarce public and private goods to enhance their allocation. Originality/Value: This study contributes to the literature by providing reliable and triangulated empirical data through authentic methodology enhancing suitability for data generalisability and replicability. The relevance and value of this research was evidenced by the need to promote food security in pursuance of the achievement of sustainable development goals.

Peru’s National Policy on Financial Inclusion and Its Alignment with Sustainable Development Goal I

This article analyzes the implementation of the National Financial Inclusion Strategy (NFIS) and its alignment with Sustainable Development Goal (SDG) I: Eradicate poverty. Despite the progress achieved, structural gaps persist and substantially limit the NFIS’s contribution to poverty reduction, especially among rural, indigenous, extreme poverty, and other vulnerable groups. The article employs a mixed methods approach combining qualitative and quantitative techniques. On the qualitative side, a hermeneutic documentary analysis of the NFIS and related regulations was carried out, with a critical textual interpretation supported by specialized software. Quantitatively, descriptive statistical techniques were applied to analyze official financial inclusion indicators—methodological integration was achieved through analytical triangulation under a concurrent mixed methods approach. The progress of initiatives under the NFIS was evaluated, identifying limitations such as the digital divide in rural areas, limited financing for Micro and Small Enterprises, gaps in financial education, and growing exposure to digital fraud. Although the NFIS promotes greater access to financial services, it does not explicitly focus on the poorest and most excluded populations. Therefore, it is recommended that the objectives and indicators of the NFIS be reformulated to focus on universal access and effective use of financial services by the population in extreme poverty and chronic exclusion. In addition, a strategic articulation with social protection policies is necessary, as well as promoting culturally relevant microfinance and inclusive finance models, strengthening consumer protection, and consolidating public–private alliances in high-poverty areas. Finally, strong monitoring and accountability are also key.

Integrating Faith and Fashion: How Muslim Women in Ghana Are Redefining Workplace Dress Codes

This study assessed the interplay of fashion, religion, and employment among Muslim women in Ghana’s formal sector. It examined their fashion consumption behaviors and how religion influences their attire choices, focusing on their awareness of Islamic fashion laws. Employing a concurrent mixed method approach, the study targeted Muslim women in various formal institutions in Accra, Ghana. Data collection involved questionnaires, observations, and interviews. Descriptive and Regression analysis was conducted to test hypotheses. The study discovered a significant association between contemporary fashion features in Muslim women’s styles and their knowledge of Islamic fashion laws. It also revealed that Islamic and contemporary fashion characteristics influence their understanding of clothing regulations under Islamic law. The study suggested the integration of religious beliefs in the fashion industry. It recommends involving professionals with religious and fashion expertise in education, promoting current trends in fashion that align with Islamic laws, and enforcing workplace rights for Muslim women. This study provides unique insights into how Islamic laws influence the fashion choices of Muslim women in Ghana’s formal sector, bridging a gap in understanding the intersection of faith, fashion, and professional life. Additionally, the findings highlight the dual impact of fashion and religion not only on personal identity but also on professional engagement within the workplace. These results emphasize the need for a more inclusive fashion industry that respects and reflects diverse religious tenets while supporting women in their career endeavors. This integrative approach could potentially enhance workplace inclusion and boost the career prospects of Muslim women in the formal sector.

Sustainable tourism development through community homestays: a case study of Ayodhyapuri Community Homestay in Madi, Chitwan, Nepal

ABSTRACT In rural areas of Nepal, homestays are becoming an important source of income for many families. Homestay offers many benefits, such as experiencing the local culture, learning about different cultural practices in a homely environment, improving language skills, and many more. This study is an attempt to explore the status and homestay owners’ perceptions of Ayodhyapuri Community Homestay, Madi, Nepal. In this study, a concurrent mixed-methods approach was applied using a questionnaire and informal interviews to understand the homestay situation. The research explores how a specific community in Nepal has developed a sustainable tourism industry through the use of homestays, with a focus on how the community has balanced economic growth with environmental and cultural sustainability. Along with this, it also examines the impact of ecotourism on the local community, including the economic benefits, social and cultural impacts, and environmental sustainability practices. The finding suggests that homestays play a vital role in conserving nature, reducing human-wildlife conflict, preserving culture, and generating employment opportunities.

An Evaluation of the Implementation of the Social Studies Curriculum in Ghana: A Case Study of the Asante Akim North District

The purpose of this study was to evaluate the Social Studies Curriculum for Senior High Schools in Ghana to determine whether the subject has attained its goal(s). The study took place in the Asante Akim North District. The population for study were all Social Studies teachers and students in the district. The multi-stage sampling technique was adopted for the study and the sample size was 120, made up of 100 students and 20 teachers. The concurrent mixed method approach was adopted. The main instruments used for collecting data were questionnaires, interviews (focus group and semi-structured interview) guide, observation and documentary analysis. Quantitative data were tabulated, organized, analysed and interpreted to draw sound conclusions and generalizations. The data were presented in the form of tables and percentages. Words were used to interpret the tables and percentages for easy understanding. The qualitative data responses were described and explained in the form of themes. Sometimes responses were quoted verbatim to authenticate claims made. The study revealed that most of the teachers who are the curriculum implementers have forgotten the subject's general objectives. Therefore, they teach the subject without any cognizance of the attainment of these objectives. Concerning the findings of the study, it is recommended that the district education directorate should organize periodic workshops, in-service training and seminars for teachers teaching the subject. This will help Social Studies teachers acquire the relevant knowledge and the pre-requisite skills needed to effectively implement the Social Studies curriculum in the Asante Akim North District.”

A concurrent mixed-method study exploring the experiences of interprofessional collaboration among Canadian midwives and obstetricians.

This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. A concurrent mixed-methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. Eighteen RMs across Canada completed a demographic survey and the Midwifery-Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery-Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi-structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife-physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician-midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter-Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. This study provides support for the Midwifery-Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. The authors adhered to Consolidated criteria for reporting qualitative research (COREQ).

PERUMUSAN STRATEGI PEMASARAN BERKELANJUTAN THE BLOOMS GARDEN UNTUK MENDUKUNG KOLABORASI DESTINASI PARIWISATA


 
 
 This research was carried out at the tourist destination The Blooms Garden Bedugul Bali. This study aims to analyze (1) the current marketing strategy of The Blooms Garden Bedugul Bali; and (2) formulation of a sustainable marketing strategy for The Blooms Garden to support collaborative tourism destinations in Bedugul. This research is categorized as research with a Concurrent Mixed Method approach. The data collected is in the form of qualitative data and quantitative data. Qualitative data were collected from interviews, observations and documentation. Meanwhile, quantitative data was collected by gathering information from The Blooms Garden management regarding strengths, weaknesses, opportunities and threats which were then converted into numerical data with weights and ratings. Analysis of data sourced from interviews, observation and documentation was analyzed using interactive data analysis techniques from Miles & Huberman. Determination of the marketing strategy implemented by the manager of the tourist attraction of The Blooms Garden is analyzed using SWOT analysis.
 The results of the study show that (1) the current marketing strategy undertaken by The Blooms Garden Bedugul Bali to attract and increase tourist visits includes the installation of banners and billboards scattered along the road from Denpasar to Bedugul; website opening; via social media; and cooperate with online travel agencies such as traveloka, tiket.com, and so on. However, the marketing strategy undertaken by The Blooms Garden has not succeeded in bringing in tourists as expected; and (2) The Blooms Garden's sustainable marketing strategy formulation to support collaborative tourism destinations in the Bedugul region is an integrated diversification strategy. This marketing strategy means that The Blooms Garden Bedugul Bali can integrate with other tourism destinations in the Bedugul area. The sustainable marketing strategy in collaboration with other destinations in the Bedugul area is intended as an effort to increase tourist visits, especially environmentally conscious tourists who often visit the well-known Botanical Gardens and Lake Beratan, directed to visit The Blooms Garden as well. If possible, pass tickets apply between the Botanical Gardens, Lake Beratan and The Blooms Garden.
 
 

Facilitators and barriers for implementation of health programmes with Māori communities.

Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness. The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study. For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation. Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.

Correlates of Commitment to Career Choices of Pre-Service Education Students in Selected Universities in Kenya

The study attempted to establish the correlates of commitment to career choice of pre-service education students in six public and private universities in Kenya. The third and fourth year pre-service education students were the respondents in this study. Correlational research design and concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered by the use of questionnaires and interviews. In data analysis, frequencies, means, standard deviation, linear regression and Pearson product moment correlation coefficient were used. The pre-service education students were found to be moderately committed to their career choice and that intrinsic motivation, self-concept, status of the teaching profession, fallback and socio-cultural beliefs were correlated to career choice. Fallback however had an inverse correlation to the commitment of career choice. The study recommends that factors which motivate pre-service education student’s choice of teaching as a career should be clearly understood, so that only students motivated by those factors which were found to promote commitment, like intrinsic motivation, self-concept, status of the teaching profession and social cultural beliefs are the ones placed to train as teachers.

Not a passive learner but an active one: a focus on the efficacy of philosophy-based language instruction and its consequences on EFL learners’ critical thinking, engagement, and academic achievement

This study investigates the impact of Philosophy-Based Language Teaching (PBLT) on the critical thinking skills and learner engagement of English as a Foreign Language (EFL) students. A concurrent mixed-methods approach, including semi-structured interviews, document analysis, and academic achievement tests, was employed with an experimental group (EG) exposed to PBLT and a control group (CG) receiving traditional instruction. The results reveal a substantial positive effect of PBLT on the critical thinking abilities of EFL learners, as evidenced by thematic analyses of interviews and document content. Themes include heightened critical thinking awareness, collaborative knowledge construction, and increased learner engagement. Academic achievement tests further demonstrate significant improvement in the experimental group’s performance. A comparison with existing literature underscores the novelty of our mixed-methods approach. Implications for language teachers, materials developers, syllabus designers, and policy-makers are discussed, highlighting the potential of PBLT in cultivating critical thinking and learner engagement.

Exploring therapeutic communication in managing chronic non-communicable diseases: a mixed-method study in Ghana

BackgroundGlobally, the burden of chronic non-communicable diseases is increasing rapidly and approximately one in three of all adults suffer from multiple chronic conditions. Therapeutic communication plays a crucial role in achieving curative, preventive, and promotive goals regarding chronic disease management. We examined therapeutic communication between health professionals and patients with chronic non-communicable diseases at the Ho Teaching Hospital.MethodsWe adopted a concurrent mixed-methods approach. The quantitative aspect of the study was descriptive while the qualitative was explanatory. The quantitative study was conducted among 250 patients. The qualitative data was collected among eight health professionals. A stratified sampling and simple random sampling methods were used to recruit patients for the quantitative survey while purposive and convenient sampling was used for the qualitative aspect of the study. The quantitative data was collected using a semi-structured questionnaire while the qualitative data was collected using an in-depth interview guide. The quantitative data were analyzed using STATA v17 and the qualitative data were analyzed thematically using Atlas ti. The major themes that emerged were, therapeutic communication practices, barriers to therapeutic communication and possible solutions to good therapeutic communication.ResultsWe found that 37% patients were 60 years and above with 53.2% being females. It was noted that 36.4% of patients have had tertiary-level education. We found that 59.2% of patients reported having good therapeutic communication with health professionals. We, however, noted that male participants were 92% less likely to practice good therapeutic communication compared with females (aOR = 0.92,95% Cl = 0.46–1.84). Health professionals’ activities to ensure good therapeutic practices included their capacity to listen, build rapport with their patients, and clarify information. We found that the major facilitators of good therapeutic communication included trust in the health professionals (90.4%), conducive environment (93.2%), using simple and plain language by health professionals (92.0%) We found that there are myriad of barriers that impede communication process. This included language, health professionals’ inability to break terminologies, and the unconscious state of patients.ConclusionsThe study revealed that there was good therapeutic communication between health professionals and patients with CNCDs. Nevertheless, it was also identified that ineffective therapeutic communication between health professionals and their patients due to barriers like language could lead to dissatisfaction with care, misdiagnosis, and noncompliance to treatment regimen. For Ghana as a country to achieve SDG target 3.4 by reducing mortality due to NCDs and improve wellbeing of patients by 2030, it will be imperative on Ghana Health Service to design communication strategy training for health professionals that could help improve therapeutic communication between patients and health professionals.

Bold techno competence in language learning: a study on the effects of efficacy of workshops in decreasing technostress and boosting academic enjoyment, autonomy, and language achievement

This study investigated the impact of techno-competence workshops on English as a Foreign Language (EFL) learners’ language achievement, technostress, academic enjoyment, and autonomy in a large university in Iran. A concurrent mixed-methods approach was employed, with qualitative data collected through structured interviews and quantitative data gathered using a teacher-made test validated through a known-group procedure. Ninety-six upper-intermediate EFL learners were randomly assigned to an Experimental Group (EG) and a Control Group (CG). Results revealed a significant decrease in technostress, an increase in academic enjoyment, and heightened autonomy among participants attending the techno-competence workshops. The quantitative analysis demonstrated a substantial improvement in language achievement for the EG compared to the CG. Findings contribute to the understanding of the multifaceted impacts of techno-competence on language learning outcomes and offer practical insights for educators, curriculum developers, and policymakers in fostering effective language education in technologically enriched environments. Despite certain limitations, this study lays the groundwork for future research endeavors exploring the intricate dynamics between techno-competence and language learning outcomes across diverse contexts.

Establishing Factors Leading to the Pre-service Education Students’ Choice of Teaching as a Career

This paper established factors leading to the pre-service education student’s choice of teaching as a career. The third and fourth year pre-service education students from six public and private universities in Kenya were the respondents. Concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered using questionnaires and interviews. In data analysis, frequencies, means and standard deviation were used. The study established that the following factors affected pre-service education student’s decision to become teachers. (i) Fallback, (ii) External factors, (iii) Self-concept (iv) Altruistic reasons (v) Extrinsic reasons and (vi) Intrinsic motivation. The findings established that all the influential factors were important to the pre-service education students to join the teaching profession. None of the influential factors was very important to their decision to choose teaching as a career. The pre-service education students pointed out that their high school grade is what really determines their career path. Fallback as one of the influential factors was found to have been slightly important in their decision to enter the teaching profession.

Roles of health system leadership under emergency in drought-affected districts in northeast Uganda: a mixed-method study

ObjectiveHealth system leadership plays a critical role in sustaining healthcare delivery during emergencies. Thus, we aimed to assess the contribution of health system leadership in sustaining healthcare delivery under emergency...

Pre-service Education Students’ Commitment Level to Their Career Choice

The study attempted to establish commitment level to career choice of pre-service education students in six public and private universities in Kenya. The third and fourth year pre-service education students were the respondents. Correlational research design and concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered by the use of questionnaires and interviews. In data analysis, frequencies, means, standard deviation, linear regression and Pearson product moment correlation coefficient were used. The pre-service education students were found to be moderately committed to their career choice. The study recommends Improvement of career guidance in schools so that students clearly understand and choose careers in relation to their interest and abilities because this will increase their commitment to their career choices and reduce the job hopping being experienced in the world of work.

Role reversal in adult child-aging parent family travel

While family tourism has gained increasing attention from researchers, the relationship between adult children and their parents in family vacations remains an under-researched area. Drawing on role reversal theory and social exchange theory, this research examines the effects of role reversal on the well-being of adult children in family travels and with respect to “individual” and “relation” perspectives as mediating mechanisms. A quantitative-dominant concurrent nested mixed methods approach was employed. Results show that adult children can benefit from assuming the parental role in relation to their elderly parents as this reversal in roles can promote their well-being by stimulating their commitment to parents and by reducing their perceived cost of sacrifice. These effects were also moderated by their parents' confirmation.

Impact of point-of-care ultrasound use on patient referral decisions in rural Kenya: a mixed methods study

BackgroundPoint-of-care ultrasound (POCUS) is recognized as a key imaging modality to bridge the diagnostic imaging gap in Low- and Middle-Income Countries (LMICs). POCUS use has been shown to impact patient management decisions including referral for specialist care. This study explored the impact of POCUS use on referral decisions among trained healthcare providers working in primary rural and peri-urban health facilities in Kenya.MethodsA concurrent mixed methods approach was used, including a locally developed survey (N = 38) and semi-structured interviews of POCUS trained healthcare providers (N = 12). Data from the survey was descriptively analyzed and interviews were evaluated through the framework matrix method.ResultsSurvey results of in-facility access to Xray, Ultrasonography, CT scan and MRI were 49%, 33%, 3% and 0% respectively. Only 54% of the facilities where trainees worked had the capacity to perform cesarean sections, and 38% could perform general surgery. Through a combined inductive and deductive evaluation of interview data, we found that the emerging themes could be organized through the framework of the six domains of healthcare quality as described by the Institute of Medicine: Providers reported that POCUS use allowed them to make referral decisions which were timely, safe, effective, efficient, equitable and patient-centered. Challenges included machine breakdown, poor image quality, practice isolation, lack of institutional support and insufficient feedback on the condition of patients after referral.ConclusionThis study highlighted that in the setting of limited imaging and surgical capacity, POCUS use by trained providers in Kenyan primary health facilities has the potential to improve the patient referral process and to promote key dimensions of healthcare quality. Therefore, there is a need to expand POCUS training programs and to develop context specific POCUS referral algorithms.