Homa Bay County Research Articles

Treatment-seeking behaviours of patients with tungiasis in endemic areas of Homa Bay County, Kenya: a mixed-methods study

BackgroundTungiasis, an ectoparasitic disease caused by sand fleas, causes suffering to millions of people in the tropics. Although the Kenyan National Policy Guidelines list tungiasis treatments as including disinfectants, flea repellents, and botanical oil, the insufficient knowledge and financial constraints of affected communities have led to neglect and inappropriate self-treatment. Current reports show insignificant progress on educational activities at the community level. Therefore, we investigated community residents’ treatment-seeking behaviour concerning tungiasis, using an endemic area of Kenya as the research setting.MethodsA cross-sectional mixed-methods design was employed. Quantitative data were collected from the participants—410 adults who had experienced tungiasis—using a questionnaire, while qualitative data were collected from 20 older adults to 10 medical staffs using semi-structured individual interviews. The study was conducted in two sub-counties of Homa Bay County, Kenya.ResultsFactors significantly correlated with using non-guideline-listed treatments for tungiasis were ‘not knowing the causse of tungiasis’, ‘not seeking treatment from healthcare facilities and traditional healers’, and ‘wait and see to prevent infection in non-affected members’. The interviews with the older adults revealed 19 self-treatment options for tungiasis, and 40% of the participants opted for self-removal using sharp objects. Only two of these treatments were listed in the guidelines. The most frequently mentioned reason for using a self-treatment option was ‘Someone else’s idea’. The most frequently mentioned reason for choosing the best self-treatment option was ‘Effectiveness’. Interviews with medical staff revealed 11 treatment options; only five of these treatments are listed in the guidelines. The most frequently mentioned reason for selecting/using the treatment was ‘Supply situation’.ConclusionsResidents’ socioeconomic factors, cultural factors, and access to appropriate treatment, as well as knowledge of medical staff were significant factors that influenced the residents’ tungiasis treatment-seeking behaviours. This study provides feasibility and baseline data to establish an effective, safe, and sustainable treatment for tungiasis.

Perception of the Youth Aged 15 to 24 Years on Sexual Debut, Mitigation Strategies, and Associated Health Effects in Homa Bay County, Kenya

Perception of the Youth Aged 15 to 24 Years on Sexual Debut, Mitigation Strategies, and Associated Health Effects in Homa Bay County, Kenya

Influence of Teachers’ Professional Training and Development on Students’ Academic Performance in Public Secondary Schools in Ndhiwa Sub-County Homabay County, Kenya

Purpose: The persistent academic underperformance in public secondary schools in Kenyan rural areas has raised concerns among educators, policymakers, and local communities. The purpose of the study is to evaluate how teacher professional training and development influence academic performance. One of the key factors believed to have contributed to this challenge is the lack of sufficient and effective professional training and development programs for teachers. There is a growing need to examine how teachers' professional training and development influence students' academic outcomes. The problem this study seeks to address is the unclear and under-researched relationship between teachers' professional development and students' academic performance in Ndhiwa Sub-County. Methodology: The study used descriptive research design and 15 public secondary schools, 113 teachers and 522 students were involved in the study as study respondents. The study used document analysis and semi structured questionnaires to collect the quantitative data, which was analyzed through descriptive statistics (frequencies and percentages). Findings: The study reveals that teachers' professional training and development have a significant impact on students' academic performance in public secondary schools in Ndhiwa Sub-County. The findings also indicated that teachers who undergo continuous professional development are better equipped with modern teaching strategies, content knowledge, and student engagement techniques, which in turn positively influence students' academic outcomes. Teachers with higher levels of training and access to ongoing professional development demonstrate improved classroom management, increased use of learner-centered methodologies, and more effective assessment technique. Unique Contribution to Theory, Practice and Policy: From the study findings, the study recommends that schools and educational authorities should develop more structured and regular Continuous Professional Development (CPD) programs that focus on subject-specific training, pedagogical skills, and updated teaching methodologies. This is because the study findings likely indicate that teachers who engage in regular training and development show better performance in student outcomes. The education policy makers should come up with the programs that forge partnerships between secondary schools and local universities or teacher training colleges to provide advanced training opportunities and access to educational research.

A parenting program delivered through existing community-based peer groups to improve early child development in Homabay and Busia Counties, Kenya: study protocol for a cluster-randomized controlled trial

BackgroundPoor early childhood development (ECD) is a major global health concern that is associated with various adverse outcomes over the lifecourse. Parenting interventions especially during the earliest years of life can benefit ECD. However, there is limited evidence from Kenya about the effectiveness of parenting interventions for improving ECD outcomes especially across rural disadvantaged communities. This paper describes the study protocol for an impact and implementation evaluation of a community-based group parenting program that aims to improve ECD in rural Kenya.MethodsWe will conduct a cluster-randomized controlled trial to determine the effectiveness of a parenting program for caregivers of young children in Homabay and Busia counties in Western Kenya. Sixty-four village clusters will be randomly assigned to either the parenting intervention arm or the waitlist control arm with stratification by county. In each village, 10 primary caregivers with a child aged 0–24 months will be enrolled. The parenting program will be delivered through existing peer groups within communities whereby caregivers will receive counseling and psychosocial support to enhance their parenting skills and wellbeing to in turn promote ECD. The intervention curriculum comprises 21 sessions targeting various nurturing care messages, including early learning, responsive caregiving, child nutrition, health, protection, and caregiver mental health. Group sessions are facilitated by a trained volunteer biweekly for a total of 11 months. The primary trial outcome is an overall measure of ECD using the Global Scales of Early Development long form version. Secondary outcomes include various caregiver outcomes (e.g., parenting practices, mental health) and other child outcomes (e.g., socioemotional development, dietary diversity). All outcomes will be assessed at baseline and endline. We will also conduct a qualitative implementation evaluation at endline and interview various stakeholders to assess program fidelity, quality, and sustainability.DiscussionThis trial will evaluate the effectiveness of a parenting intervention on ECD and caregiving outcomes and assess program implementation quality as delivered through existing community-based peer groups. This study will provide rigorous evidence that can be used to inform scale-up of this program model that leverages existing community social networks and resources for improving caregivers’ parenting skills and promoting ECD in rural Kenya and other similar settings across LMICs.Trial registrationClinicalTrials.gov #NCT06165315. Registered on December 11, 2023.

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ (CPIPE) intervention in Kenya and Ghana: study protocol

BackgroundPoor person-centered maternal care (PCMC) contributes to high maternal mortality and morbidity, directly and indirectly, through lack of, delayed, inadequate, unnecessary, or harmful care. While evidence on poor PCMC prevalence, as well as inequities, expanded in the last decade, there is still a significant gap in evidence-based interventions to address PCMC. We describe the protocol for a trial to test the effectiveness of the “Caring for Providers to Improve Patient Experience” (CPIPE) intervention, which includes five strategies, targeting provider stress and bias as intermediate factors to improve PCMC and address inequities.MethodsThe trial will assess the effect of CPIPE on PCMC, as well as on intermediate and distal outcomes, using a two-arm cluster randomized controlled trial in 40 health facilities in Migori and Homa Bay Counties in Kenya and Upper East and Northeast Regions in Ghana. Twenty facilities in each country will be randomized to 10 intervention and 10 control sites. The primary intervention targets are all healthcare workers who provide maternal health services. The intervention impact will be assessed among healthcare workers in the study health facilities and among women who give birth in the study health facilities. The primary outcome is PCMC measured with the PCMC scale, via multiple cross-sectional surveys of mothers who gave birth in the preceding 12 weeks in study facilities at baseline (prior to the intervention), midline (6 months after intervention start), and endline (12 months post-baseline) (N = 2000 across both countries at each time point). Additionally, 400 providers in the study facilities across both countries will be followed longitudinally at baseline, midline, and endline, to assess intermediate outcomes. The trial incorporates a mixed-methods design; survey data alongside in-depth interviews (IDIs) with healthcare facility leaders, providers, and mothers to qualitatively explore factors influencing the outcomes. Finally, we will collect process and cost data to assess intervention fidelity and cost-effectiveness.DiscussionThis trial will be the first to rigorously assess an intervention to improve PCMC that addresses both provider stress and bias and will advance the evidence base for interventions to improve PCMC and contribute to equity in maternal and neonatal health.Trial registrationClinicalTrials.gov: NCT06085105. Protocol version and date: v2-11-07-23

Phytochemicals Analysis, In vitro Anti-plasmodium Activity of Delonix regia Bark and Carica papaya Leaf Extracts in Combination with Chloroquine

Background: The effectiveness of treating malaria may be jeopardized by artemisinin-resistant parasites. Pharmaceutical companies have been using plants for a very long time to generate the prototype molecules needed to treat Plasmodium infections. Objective: To evaluate anti-plasmodial potency of extracts of Delonix regia and Carica papaya when used in combinations with chloroquine. Methods: The plants were collected from Homa-Bay County in Kenya, dried under shade to a consistent weight, and then milled into a fine powder. Organic solvents were then used for extraction. After phytochemical screening of the extracts was conducted, In vitro tests were done on the extracts against Plasmodium falciparum, with a starting concentration of 100µg/mL. To prepare the test concentration ranges, the extracts were serially diluted 2-fold in growth medium. In a sealed gas chamber, the assay plates were incubated at 370C for 72 hours with 3% O2 and 4% CO2 with N2 as the balance. By comparing each well's absorbance to that of a well that contained the drug-free control, the number of parasites still present at each concentration of the test substance were ascertained. Plotting survival against concentration enabled the determination of the IC50 values by a non-linear dose response curve fitting. Results: In this investigation, the extracts from Delonix regia showed significant synergism (based on IC50 shifts) with CQ for both the ethyl acetate and methanol extracts with the exception of the highest combination dosage. Carica papaya extracts were much improved by the presence of CQ; however, this was not consistently reflected in the corresponding CQ IC50. Conclusion: The results of this study which revealed synergism between the study plants extracts and chloroquine, support the reasons why some traditional healers have started combining medicinal herbs with chloroquine to boost its potency.

Analysis of Economic Efficiency: Case of Sweet Potato Seed Vine Production in Homabay County, Kenya

Sweet potatoes are not only a nutritious, high value food for the daily diet, but also an important source of income. In the selected survey areas in the Lake Region of Kenya, sweet potato is amongst the major commercially grown crops. Therefore, in order to understand the profitability and performance of sweet potato producers in the study area, this study was implemented. Sweet potato is one of the main commercially produced crops in the selected survey areas in the lake region of Kenya. Therefore, this study was conducted to understand the profitability and performance of sweet potato producers in the study areas. The study employed Cost Function in the analyses of Economic Efficiency of Sweet Potato Seed Vine Production system in Kenya. A multi-stage random sampling technique was used to select sample size of 150 sweet potato vine producers for this study. By use of a structured questionnaire, data was collected on production input, output, input and output prices, characteristics of sampled farmer and plot. Using the maximum likelihood method, the variables of the cost function were estimated. Result revealed that the farm level cost- efficiency was about 56 percent. The research has shown that age and farm size were negative but significantly related to cost-efficiency at ten and one percent respectively. Gender, farming experience, Education, access extension to and credit were positive but significantly associated with cost-efficiency at one percent. The study advocates for policy decision that youthful farmers be inspired to venture into SP vine production and the government to enhance access to education, credit and extension services the ongoing farming.

A pilot study of dimeticone oils versus sodium carbonate treatment for tungiasis: A randomized cohort trial in Homa Bay County, Kenya.

Tungiasis is a cutaneous parasitosis caused by the female flea Tunga penetrans. Two-component dimeticone (NYDA) is the only treatment for tungiasis recommended by the World Health Organization; however, this topical drug is not available in Kenya. In Western Kenya, sodium carbonate is commonly used in the treatment of tungiasis. This study evaluated the 7-day cure rates for tungiasis by comparing sodium carbonate and NYDA treatments in Homa Bay County, Kenya. This was a randomized, observer-blinded, parallel-treatment cohort trial. Twenty-three eligible children with 126 flea infections were matched and randomized. All participants received both treatments, with one treatment on each foot. We recorded all health conditions/information, including inflammation scores and adverse events. Observations were performed on days 3, 5, and 7 using a digital microscope to confirm dead or live fleas based on the viability signs. Twenty-three children aged 3-13 years were analyzed. The proportion of dead fleas on day 7 was higher after NYDA treatment than after 5% sodium carbonate treatment (87% versus 64%, respectively, P = 0.01) NYDA. Median survival was 5 days for both treatments; NYDA had significantly higher trend of flea non-viability rate than 5% sodium carbonate (P<0.01). There were no significant differences in the inflammation score or pain/itchiness between the two treatments. On the last day, 14 children indicated their preference for NYDA in future treatment of tungiasis, whereas nine children preferred the 5% sodium carbonate solution. NYDA was significantly more effective than 5% sodium carbonate for tungiasis treatment. Both treatments were safe but the children preferred NYDA more. Future studies with more participants and an extended observation period are warranted to confirm our findings. The findings suggest that NYDA should be made more available in tungiasis endemic area. UMIN-CTR; UMIN 000044320.

Prevalence and intensity of ectoparasites in Nile tilapia hatcheries in Homa Bay County, Kenya

Prevalence and intensity of ectoparasites in Nile tilapia hatcheries in Homa Bay County, Kenya

Women's preferences for HIV prevention service delivery in pharmacies during pregnancy in Western Kenya: a discrete choice experiment.

Pharmacy-delivered HIV prevention services might create more options for pregnant women to use HIV prevention tools earlier and more consistently during pregnancy. We quantified preferences for attributes of potential HIV prevention services among women of childbearing age in Western Kenya. From June to November 2023, we administered a face-to-face discrete choice experiment survey to women aged 15-44 in Kenya's Homa Bay, Kisumu and Siaya counties. The survey evaluated preferences for HIV prevention services, described by seven attributes: service location, travel time, type of HIV test, sexually transmitted infection (STI) testing, partner HIV testing, pre-exposure prophylaxis (PrEP) and service fee. Participants answered a series of 12-choice questions. Each question asked them to select one of two service options or no services-an opt-out option. We used hierarchical Bayesian modelling levels to estimate each attribute level's coefficient and understand how attributes influenced service choice. Overall, 599 participants completed the survey, among whom the median age was 23 years (IQR: 18-27); 33% were married, 20% had a job and worked regularly, and 52% had been pregnant before. Participants, on average, strongly preferred having any HIV prevention service option over none (opt-out preference weight: -5.84 [95% CI: -5.97, -5.72]). The most important attributes were the availability of PrEP (relative importance 27.04% [95% CI: 25.98%, 28.11%]), followed by STI testing (relative importance 20.26% [95% CI: 19.52%, 21.01%]) and partner HIV testing (relative importance: 16.35% [95% CI: 15.79%, 16.90%]). While, on average, participants preferred obtaining services at the clinic more than pharmacies, women prioritized the availability of PrEP, STI testing and partner HIV testing more than the location or cost. These findings suggest the importance of providing comprehensive HIV prevention services and ensuring PrEP, STI testing and partner HIV testing are available. If pharmacies can offer these services, women are likely to access those services at pharmacies even if they prefer clinics.

Seasonal Maize yield forecasting in South and East African Countries using hybrid Earth observation models

Climate change still adversely affects agriculture in the sub-Saharan Africa. There is need to strengthen early action to bolster livelihoods and food security. Most governments use pre- and post-harvest field surveys to capture statistics for National Food Balance Sheets (NFBS) key in food policy and economic planning. These surveys, though accurate, are costly, time consuming, and may not offer rapid yield estimates to support governments, emergency organizations, and related stakeholders to take advanced strategic decisions in the face of climate change. To help governments in Kenya (KEN), Zambia (ZMB), and Malawi (MWI) adopt digitally advanced maize yield forecasts, we developed a hybrid model based on the Regional Hydrologic Extremes Assessment System (RHEAS) and machine learning. The framework is set-up to use weather data (precipitation, temperature, and wind), simulations from RHEAS model (soil total moisture, soil temperature, solar radiation, surface temperature, net transpiration from vegetation, net evapotranspiration, and root zone soil moisture), simulations from DSSAT (leaf area index and water stress), and MODIS vegetation indices. Random Forest (RF) machine learning model emerged as the best hybrid setup for unit maize yield forecasts per administrative boundary scoring the lowest unbiased Root Mean Square Error (RMSE) of 0.16 MT/ha, 0.18 MT/ha, and 0.20 MT/ha in Malawi's Karonga district, Kenya's Homa Bay county, and Zambia's Senanga district respectively. According to relative RMSE, RF outperformed other hybrid models attaining the lowest score in all countries (ZMB: 25.96%, MWI: 28.97%, and KEN: 27.54%) followed by support vector machines (ZMB: 26.92%, MWI: 31.14%, and KEN: 29.50%), and linear regression (ZMB: 29.44%, MWI: 31.76%, and KEN: 47.00%). Lastly, the integration of VI and RHEAS information using hybrid models improved yield prediction. This information is useful for NFBS bulletins forecasts, design and certification of maize insurance contracts, and estimation of loss and damage in the advent of climate justice.

Effect of Innovative Technology on Revenue Collection in South Nyanza County Governments, Kenya

After the enactment of Kenya's new constitution in the year 2010, a lot of public services were delegated to the County governments. Ideally, the county governments should finance their operations. However, almost all Counties suffer from inadequate financial resources to carry out their functions. This has been attributed to poor revenue collections. The main objective of this study, therefore, was to establish the effects of innovative technology on revenue collection in the South Nyanza region counties of Kisii, Migori, Homabay, and Nyamira County Governments. Specifically, the study aimed at answering; what is the effect of mobile money, electronic billing, online banking, and electronic receipting on revenue collections in County Governments of the South Nyanza region? Anchoring on the technology acceptance model, the study used a descriptive research design with a sample of 352 from a target population of 720 respondents. Data was collected using questionnaires. The study used random sampling to select revenue collection officers, and tax and revenue managers at the selected county governments as respondents. Before data collection, the study did a pilot study in Narok County to test the reliability of the questionnaires using the Cronbach Alpha test. The data collected was analyzed descriptively followed by multiple regression analysis. The study found that there was a positive and significant (β = .415, p-value = .0001&lt;.05) relationship between mobile money and revenue collection. Secondly, the study found a positive and significant (β = .172, p-value = .0001&lt;.05) relationship between e-billing and revenue collection. Further the study established a positive and significant (β = .092, p-value = .0044&lt;.05) relationship between online banking and revenue collection. Lastly, the study reported a positive and significant (β = .360, p-value = .0001&lt;.05) relationship between e-receipting and revenue collection. The study concluded that innovative technology (mobile banking, e-billing, online banking and e-receipting) positively influence collection of revenue collection in South Nyanza Counties. The study recommended that from the findings and conclusions, the study recommends that the revenue management or administration of South Nyanza Counties of Kisii, Nyamira, Homabay and Migori should formulate policies to help ensure costs of revenue collections remains low. They should do cost benefit analysis of innovative technologies in revenue collection like mobile money in revenue collections to ensure that they don’t cost too much and eat into their revenue collections. The counties should also make policies aimed at using innovative technologies like e-billing to aid in revenue planning. Thirdly, the revenue administration team should ensure that there are adequate policies that guides use of innovative technologies like online banking, mobile money, e-billing and e-receipting can aid them in better audit of their revenues.

Financial Technology Services, Government Regulations and Financial Inclusion of Small-Scale Fish Farmers in Homa Bay County, Kenya

This study explored the impact of FinTech and Government Policies on Financial Inclusion for small-scale fish farmers in Homa Bay County, Kenya. The study focused on how access to finance has been widened through agency banking, mobile money and online banking services among these people who had low incomes or were marginalized. The research also examined whether government regulations affect the relationship between fintech channels and financial inclusion. The study was underpinned by Innovation Diffusion Theory, Financial Intermediation Theory, Technology Acceptance Theory and Public Interest Regulation Theory. This study employed causal research design with a sample size of 495 small scale fish farmers using stratified random sampling technique that yielded 144 respondents. Data analysis involved multiple regression, correlation analysis and diagnostic tests that utilized SPSS 26.0 for data analysis. The results showed that agency banking; mobile money services and online banking together explained 58.1% of variation in financial inclusion among the farmers indicated by R squared of 0.581.The findings revealed that Agency Banking had significant effect on financial inclusion (β = .231, p = .001 &lt; .05), as well as Mobile Money Services (β = .196, p = .019 &lt; .05) and Online Banking Services (β = .410, p = .000 &lt; .05). Therefore, the study concludes that Agency Banking; Mobile Money and Online Banking play important role in enhancing financial autonomy among small scale fish farming communities through increased access to bank accounts, secured transactions processes and agent incomes respectively. In view of the findings, the study recommends that financial institutions together with fintech companies should invest in platforms which are user-friendly safe secure meant for use by small holder dairy farmers themselves. Keywords: Agency banking, Mobile money services, Online banking services, Government regulations, Financial technology services, Financial inclusion

Fiscal Devolution and Healthcare Accessibility A Case Study of Homa Bay County

Fiscal devolution has gained prominence as a policy approach in many developing countries, aiming to enhance healthcare accessibility. This study focused on the influence of Fiscal devolution on healthcare accessibility in Homabay County. The study employed a mixed-methods approach to assess the impact of fiscal devolution on public sector efficiency, combining quantitative data analysis and qualitative observations. With an emphasis on metrics like service quality, punctuality, and accessibility, quantitative data were gathered via questionnaires and administrative records. Key stakeholders, such as representatives of the local government, prominent members of the community, and recipients of services, were interviewed in-depth and participated in focus groups to get qualitative data. The data were analyzed using appropriate SPSS version 27 statistical techniques and thematic analysis to identify patterns and relationships. Results showed that fiscal devolution had both positive as well as negative effects on healthcare accessibility in Homabay County, underlining the importance of effective local government and resource allocation processes. Preliminary data indicate that fiscal devolution in Homabay County has had a mixed effect on healthcare accessibility. On one hand, decentralization has empowered local authorities to make decisions tailored to local needs, resulting in improved service responsiveness and community engagement. On the other hand, challenges related to inadequate financial resources, capacity constraints, and intergovernmental coordination have hindered the efficient delivery of public services. Effectiveness of fiscal devolution largely depends on the presence of effective local governance structures, transparent resource allocation mechanisms, and capacity building initiatives.

Mental health issues associated with the management of tuberculosis in Homabay, Busia and Kakamega Counties, Kenya.

Despite the implementation of patient-centred care, mental health issues remain a significant risk factor and comorbidity for Tuberculosis (TB) disease. Mental health issues being co-morbidities to TB are likely to increase the disease burden of the affected population. This study therefore investigated the prevalence and impact of mental health issues in Tuberculosis (TB) patients. This cross-sectional study design used mixed methods in data collection. The study used structured questionnaires, key informant interviews and focus group discussions. 127 TB patients were purposively selected from a group of patients who previously recovered successfully, with a history of relapse or are currently on TB treatment in high-volume facilities in Homa Bay, Busia and Kakamega Counties. 30 Key informant interviews were conducted with Healthcare workers. Quantitative data analysis was done using STATA version 14. Thematic analysis was employed to analyze qualitative data using NVivo version 10. The findings showed that the most common mental health issues affecting TB patients were anxiety (66%) and depression (55%), which were commonly experienced during the presumptive stage of TB. Qualitative data revealed that stigma was the main barrier that hindered TB patients from accessing care. TB patients articulated the benefits of support structures ranging from positive encouragement, reminders on taking drugs, accompaniment to the clinic, and financial support in TB management. Furthermore, the study established that the majority of Health Care Workers (HCWs) were not prepared to handle TB patients' mental issues, a gap that is likely to impact the quality of care TB patients receive. The study established that mental health issues impact TB treatment outcomes. Healthcare systems should prioritize the integration of mental health care into TB programs to address the high prevalence of mental health issues among TB patients.

Genetic variation of the Plasmodium falciparum circumsporozoite protein in parasite isolates from Homabay County in Kenya

The Plasmodium falciparum Circumsporozoite Protein (PfCSP) has been used in developing the RTS,S, and R21 malaria vaccines. However, genetic polymorphisms within Pfcsp compromise the effectiveness of the vaccine. Thus, it is essential to continuously assess the genetic diversity of Pfcsp, especially when deploying it across different geographical regions. In this study, we assessed the genetic diversity of the Pfcsp on isolates from Homabay County, a malaria-endemic region in western Kenya, and compared it against other isolates from Kenya. We extracted DNA from 27 microscopically confirmed P. falciparum positive samples and conducted Illumina sequencing to generate paired-end short reads. The sequences were then mapped to the Pf3D7 reference genome, and genetic variation was analyzed using bcftools. Additionally, we retrieved isolates from two other malaria-endemic regions in Kenya, Kisumu (n=58) and Kilifi (n=596), from MalariaGEN version 7 and compared their genetic diversity and natural selection. We also evaluated the predicted binding affinities for HLA class I and II supertype alleles for the identified haplotypes using NetMHCpan and NetMHCIIpan. Our results show that the N-terminal of PfCSP was relatively conserved with a notable mutation at A98G across all isolates. The number of NANP repeats varied across the three Kenyan sites within the central repeat region. Furthermore, the C-terminal region showed polymorphism within the Th2R and Th3R regions. Haplotype network analysis of the Kenyan isolates revealed 69 haplotypes, with the 3D7 reference being found in the most prevalent haplotype. When assessing the predicted binding affinities between supertypes in HLA class I and II with the identified haplotypes, we observed stronger predicted binding affinities to multiple haplotypes except for those containing the 3D7 reference. The results suggest the need to take into account the existing changes occurring in Pfcsp while developing malaria vaccines.

Influence of Feedback Provision on Teachers’ Attitude towards Performance Appraisal in Public Primary Schools in Homa-Bay Sub County, Kenya

This study examined the influence of feedback provision on teachers’ attitudes towards performance appraisal in public primary schools in Homa-Bay Sub- County, Kenya. The appraisal of teachers’ performance in public schools in Kenya was initiated by the Teachers Service Commission in 2016. However, the initiative received resistance from the teachers’ unions rendering its implementation to be suspended temporarily until May 2016. Teachers’ performance evaluation guides improvement of teaching skills, to recognize and reinforce teaching excellence, to help teachers focus on student outcomes, and to plan in service education activities. Even so, there is a dearth of information regarding the factors influencing public primary school teachers’ attitudes towards performance appraisal in Homa-Bay Sub County. Therefore, the study specifically sought to: determine the influence of feedback provision on teachers’ attitudes towards performance appraisal in public primary schools in Homa-Bay Sub-County. The study was guided by goal setting theory. The study adopted a descriptive survey research design. The target population comprised of 1 CSO 57 head teachers and 548 teachers from 57 public primary schools. A sample size of 26 head teachers and 133 teachers were selected for inclusion in the study through simple random sampling. Therefore, a total of 160 respondents took part in the study. Self-administered questionnaires were used to collect data from one CSO, 26 head teachers and 133 teachers. Structured and semi- structured interviews were conducted through interview guides. Quantitative data was analyzed using descriptive statistics through SPSS and results presented in tables, while the qualitative data was analyzed thematically. The study revealed that both head teachers and teachers strongly agreed that feedback is only given to them when they ask. This is seen in the highest mean rating of 4.48. The second which was agreed by most head teachers and teachers was that feedback has led to negative attitude towards performance appraisal. This was evidenced by the overall mean rate of 4.08.

Evaluation of a financial incentive intervention on malaria prevalence among the residents in Lake Victoria basin, Kenya: study protocol for a cluster-randomized controlled trial

BackgroundIn the Lake Victoria basin of western Kenya, malaria remains highly endemic despite high coverage of interventions such as mass distribution of long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS) programs, and improvement of availability and accessibility of rapid diagnostic tests (RDT) and artemisinin-based combination therapy (ACT) at community healthcare facilities. We hypothesize that one major cause of the residual transmission is the lack of motivation among residents for malaria prevention and early treatment.MethodsThis study will aim to develop a demand-side policy tool to encourage local residents’ active malaria prevention and early treatment-seeking behaviors. We examine the causal impact of a financial incentive intervention complemented with malaria education to residents in malaria-prone areas. A cluster-randomized controlled trial is designed to assess the effect of the financial incentive intervention on reducing malaria prevalence in residents of Suba South in Homa Bay County, Kenya. The intervention includes two components. The first component is the introduction of a financial incentive scheme tied to negative RDT results for malaria infection among the target population. This study is an attempt to promote behavioral changes in the residents by providing them with monetary incentives. The project has two different forms of incentive schemes. One is a conditional cash transfer (CCT) that offers a small reward (200 Ksh) for non-infected subjects during the follow-up survey, and the other is a lottery incentive scheme (LIS) that gives a lottery with a 10% chance of winning a large reward (2000 Ksh) instead of the small reward. The second component is a knowledge enhancement with animated tablet-based malaria educational material (EDU) developed by the research team. It complements the incentive scheme by providing the appropriate knowledge to the residents for malaria elimination. We evaluate the intervention’s impact on the residents’ malaria prevalence using a cluster-randomized control trial.DiscussionA policy tool to encourage active malaria prevention and early treatment to residents in Suba South, examined in this trial, may benefit other malaria-endemic counties and be incorporated as part of Kenya’s national malaria elimination strategy.Trial registrationUMIN000047728. Registered on 29th July 2022.

Influence of Audit Committee Independence on the Quality of Audit Reports of Sacco’s in Homabay County, Kenya

Every operating organization keeps tabs on its development by producing accurate financial statements at the conclusion of each fiscal year, which are subsequently distributed to various individual users who are concerned with the organization's development. The accuracy of the financial accounts is then verified by an audit procedure, which is sealed by a transparent audit report provided to the specific business by the audit committee. The main objective of this study was to examine the influence of audit committee independence on the quality of audit reports of Sacco’s in Homabay County, Kenya. This was supported by the fact that there are numerous Sacco’s in Homabay County, many of which had apparently experienced audit problems in the past. Stakeholders’ theory served as the study's compass. This study adopted a descriptive causal research design, the target population was 104 audit committee members of deposit taking Sacco’s in Homabay County as at December 2021. Out of the target population determined using the Krejcie and Morgan formula, 82 members of the audit committee provided responses for the study. Primary data was collected using research questionnaire which involved drop and pick method. Descriptive statistics including a frequency table, mean, and standard deviation were used for data analysis while inferential statistics included Pearson’s correlation analysis. The study found that audit committee independence in Homabay County, Kenya, had a positive and significant impact on the caliber of audit reports on Sacco’s (r=0.530, p&lt;0.05). The study recommends that Sacco’s audit committee members should be as independent as possible in executing their mandate so as to ensure audit reports provided are of quality.

Development of Digital Literacy Skills among Learners in Public Primary Schools in Homabay County, Kenya

Digital literacy direct learners towards innovative, creative and transformational learning in the 21st century. It is one of the core competency in the Competency Based Curriculum. The objective of this study was to assess the availability of ICT infrastructure in public primary schools to develop learners’ digital skills. Constructivist learning theory guided the study. Concurrent embedded mixed method was used. A population of 5713 was targeted for study where a sample of 571 respondents composed of 8 head teachers, 78 teachers and 485 grade six learners were selected. Stratified random, simple random and purposive sampling procedures were used to select the study sample. Data collection instruments included interviews, questionnaires, focused group discussion and observation schedule. Descriptive statistics were used to analyse quantitative and qualitative data. Some of the key findings of the study were majority of public primary schools in Kasipul lack internet connectivity and only 32.1% have computer labs. The results further indicated that teachers have basic knowledge and skills in digital literacy. However, only 23.2% of teachers have been trained in digital literacy. The study recommends that Ministry of education in collaboration with Ministry of Information and Communication Technology enhance internet connectivity in all primary schools to support implementation of digital literacy to develop learners’ digital skills