Homa Bay County Research Articles

Measures to Enhance Use of Social Media Platforms among SDA Churches in Rachuonyo North Sub-County, Homa-Bay County, Kenya

Measures to Enhance Use of Social Media Platforms among SDA Churches in Rachuonyo North Sub-County, Homa-Bay County, Kenya

Fiscal Decentralization and the Efficiency of Public Service Delivery - A Case Study of Homabay County

This study aims to examine how fiscal decentralization affects the effectiveness of public service delivery in Homabay County. It uses a stochastic frontier method to estimate time-varying efficiency coefficients and investigates the effects of fiscal decentralization on those efficiency coefficients. The results show that, in some cases, fiscal decentralization can increase the effectiveness of public service delivery. Initially, the decentralization process needs appropriate political and institutional conditions or goodwill. Second, it would seem that good outcomes call for a high enough degree of expenditure decentralization. Third, there must be sufficient decentralization of both revenue and expenditure. Lastly, fiscal decentralization could make public service delivery less effective if these conditions are not met. The paper recommends the need for developing countries to adopt fiscal decentralization because it helps subnational governments raise revenues through enhancing tax administration and collection by the government as well as taxpayer compliance. It also supports legislation and policy changes that give subnational governments more fiscal authority.

Counseling and Academic Performance in Public Secondary Schools in Rangwe Sub County of Homa Bay County, Kenya

Counseling and Academic Performance in Public Secondary Schools in Rangwe Sub County of Homa Bay County, Kenya

Factors Influencing Household Tree Planting Behaviour. A Case Study of Wangchieng Ward, Homabay County

The ever-increasing impacts of climate change in sub-Saharan Africa have made many aware and struggle with livelihood options from nature, and the need for households and communities to plant trees can no longer be over-emphasised. Community tree planting is crucial for global environmental sustainability. The information that guided the public in selecting the tree they plant in their private spaces is important, especially to policymakers. This paper was aimed at analysing the factors that influence community tree planting behaviour. The study used a mixed-methods approach that involved both qualitative research using focus groups as well as quantitative research using questionnaires administered to the residents of the ten locations in Wangchieng ward: Homabay County in December 2021. A sample of 380 community households was selected, 38 in each location, through purposive sampling technique and mixed structured questionnaires delivered to them. The questionnaires assessed community attitudes and conservation involvement against the socioeconomic background, benefits, and costs of planting trees. Results showed that most residents of Wangchieng ward have positive attitudes towards tree planting. The data collected from the questionnaires showed that socioeconomic factors such as age, education levels and income were positively related to participation in community tree-planting programs among respondents. A stepwise binary logistics conducted ranked six variables as the major factors influencing household tree planting. The importance of trees was ranked at position one (most influential variable) with an odd ratio of 9.287, and at position six was education level with an odd ratio of 1.207. The full model containing all the variables was statistically significant at χ2 (10, N = 370) = 98.312, p < .001, clearly indicating that the model was able to distinguish respondents who have planted and those who have not planted trees in the last six months. Thus, it is recommended that household tree planting can significantly be enhanced by improving knowledge on the importance of trees, their various ecosystem goods and services, making seedlings cheaply available for households as well as promoting households to do agroforestry in their farmers

What to expect when girls are expecting: psychosocial support challenges and opportunities in the context and aftermath of teenage pregnancy in Kenya

BackgroundAn understanding of the psychosocial support challenges and opportunities in the context of teenage pregnancy is important for developing appropriate interventions for pregnant and parenting girls. This qualitative study was conducted in Homa Bay County, Kenya, to examine the experience of teenage pregnancy and the resultant psychosocial support needs from the perspectives of both pregnant/parenting girls and their own parents, who are typically expected to provide various forms of support.MethodsThe study used a descriptive case study design, drawing on counseling case notes documented by psychologists who held counseling sessions with 20 pregnant or parenting girls and 6 of their parents as part of a psychosocial support intervention. The counseling case notes formed a qualitative data set, which was analyzed thematically.ResultsEmerging master themes were related to pregnant and parenting girls’ experience of sexual violence and adverse childbirth outcomes; psychological trauma confronted by girls and their parents alike; parental need for support in communicating with pregnant/parenting girls about sex and sexuality; and the availability of family support as a resource for teenage mothers.ConclusionPregnant and parenting teenage girls require a range of psychosocial support responses that recognize the realities of sexual violence and other challenges in the lives of the girls themselves, as well as in the lives of their parents and caregivers. While parents and other caregivers can serve as an important resource for supporting affected girls, they often need assistance as well, in order to support pregnant/parenting girls effectively. These realities need to be taken into account to maximize the effectiveness of health and development programs for pregnant and parenting girls. Furthermore, emerging themes from actual counseling sessions with affected girls and parents can provide important insights into the potential psychosocial support needs of the broader population of pregnant and parenting girls.

Treatment Compliance Among Women with Pregnancy Induced Hypertension Attending Selected Health Facilities in Rachuonyo North Sub-County, Homabay County, Kenya

Treatment compliance among expectant women with pregnancy-induced hypertension (PIH) is a global health challenge. Gestational hypertension remains a leading cause of Maternal and infant mortality and morbidity. However, very little has been done to mitigate the situation. The general objective of this study was to assess treatment compliance among women with gestational hypertension in Rachuonyo North Sub-County. The specific objectives were to establish the socio-demographic factors that affect compliance, to determine the level of knowledge, and to establish the health system factors affecting treatment compliance. A cross-sectional study was undertaken targeting pregnant women aged 15-49 years with gestational hypertension. Data were collected using structured questionnaires, Focused Group Discussion guides, and Key Informant Interviews. A total of 175 women responded. The women who were pregnant had been diagnosed with gestational hypertension and were on treatment for at least one month were included in the study. Two doctors, two clinical health officers, and two Nurses were included as key informants. Data were analyzed using Chi-Square, Fisher's Exact, and Mann-Whitney U-test. Treatment compliance was 18.3% whereas the level of knowledge was 68.1%. Age (p=0.007), education (p=0.038), explanation of gestational hypertension (p=0.001), medication counseling (p=0.024) and frequency of follow up (p<0.001) were significantly associated with treatment compliance. However, education level was theonly significant factor that could predict treatment compliance with respondents who had completed primary school being 4.968 times more likely to comply (O. R= 4.968, p=0.05) compared to those who had not completed primary. The study findings are useful for planning and designing appropriate interventions for improving treatment compliance among women with gestational hypertension.

Interventional behavioural change communication on HIV and aids related high risk behaviour among fishermen in Homabay and Siaya Counties, Kenya

Background: Risky sexual behaviors such as sexual concurrency, sexual networks (fish for sex exchange) and unprotected sex, have been reported as the main cause of STIs/HIV infections among the fisher folks. Behavioural change mechanisms such as condom use, and abstinence are some of the interventions used in the prevention HIV/AIDS spread in Kenya.Methods: This was a follow up study on a three tie quasi-experimental study involving 246 randomly selected fisher folks in Mbita and Usenge along Lake Victoria. The study had three phases. baseline, intervention and endline. The survey used questionnaires to collect data among respondents. Using a sample frame in the beach management unit offices, fisherfolks were identified and invited to participate. Consent was obtained from participantsResults: Various variables were influenced by behavior change communication strategies used. These includes use of condom every time of sexual encounter p>0.000, risk associated with non-condom use p>0.004, stopping using condom and fear of getting HIV/AIDS p>0.009, Sexual intercourse without condom use is dangerous p>0.000, whether remembering to use condom every time of sex is difficult P.0.000, whether they are keeping many sexual partners p=0.004, receiving fish/money in exchange for sex in last six months p=0.006.Conclusions: Multiple sexual partners, non-condom use, fish for sex, alcohol consumption and circumcision were significantly associated with risky sexual behavior among the Fisherfolks, therefore other existing interventions need to be intensified to supplement behavior change communication to curb sexually transmitted diseases and further spread of HIV and AIDS.

Professional Conduct Reforms and Service Delivery by Kenya Police Service in Homa Bay County, Kenya

Professional Conduct Reforms and Service Delivery by Kenya Police Service in Homa Bay County, Kenya

Influence of Strategic Human Capital Development on Implementation of Homa Bay County Integrated Development Plan

Influence of Strategic Human Capital Development on Implementation of Homa Bay County Integrated Development Plan

Foodscapes, finance, and faith: Multi-sectoral stakeholder perspectives on the local population health and wellbeing in an urbanizing area in Kenya.

Rapid urbanization (growth of cities) can upset the local population's health and wellbeing by creating obesogenic environments which increase the burden of non-communicable diseases (NCDs). It is important to understand how stakeholders perceive the impact of urbanizing interventions (such as the construction of a new hypermarket) on the health and wellbeing of local populations. Because low- and middle-income countries (LMICs) lack the reliable infrastructure to mitigate the effects of obesogenic environments, so engaging stakeholders who influence dietary habits is one population-level strategy for reducing the burden of NCDs caused by newly built developments. We conducted key informant interviews with 36 stakeholders (25 regulatory and 11 local community stakeholders) from Kisumu and Homa Bay Counties of Western Kenya in June 2019. We collected stakeholders' perspectives on the impacts of a new Mall and supermarket in Kisumu, and existing supermarkets in Homa Bay on the health and wellbeing of local populations. Through thematic discourse analysis, we noted that some stakeholders thought supermarkets enabled access to unhealthy food items despite these outlets being also reliable food sources for discerning shoppers. Others linked the changing physical environment to both an increase in pollution and different types of diseases. Stakeholders were unsure if the pricing and convenience of supermarkets would stop local populations from buying from their usual small-scale food vendors. The key finding of this study was that engaging relevant stakeholders as part of population health impact assessments of new developments in cities are important as it directs focus on health equity and prevention in instances of resource constraints. The findings highlight, also, that community members have a strong awareness of the potential for interventions that would improve the health and wellbeing of local populations.

Digital Platform Skills for Teachers in Public Primary Schools in Homa Bay County, Kenya

Purpose: The purpose of this study was to establish the readiness of headteachers and teachers in integrating Digital Literacy Programme (DLP) in teaching and learning in public primary schools in Homa Bay County, Kenya. Digital Literacy Programme was a project that was introduced and funded by the Government of Kenya for all public primary schools in Kenya.
 Methodology: The study adopted both qualitative and quantitative survey research designs. A population of 845 head teachers and 6529 teachers were involved in the study. Some 85 head teachers and 362 teachers were sampled for the study. Questionnaires and interviews were the main research instruments used for the study. The reliability coefficient for the piloted teachers stood at 0.96 while that of the head teachers’ coefficient was reported at 0.95. The quantitative research data was analyzed using SPSS and presented in tables, frequencies and percentages. Interviews were recorded, transcribed, organized into main themes and reported.
 Findings: Majority of the respondents who were teachers, (41.6%), could only write using a digital device. Most head teachers, (34.2%), preferred tablets contrary to the preference of the majority of teachers, 31.4%, who cited desktop computers for online teaching and learning. The study also revealed that the majority of teachers and head teachers felt insecure with the digital devices in schools.
 Unique Contribution to Theory, Policy and Practice: Introduction of digital learning in the Kenyan education sector did not meet the required threshold but was timely. Challenges were met here and there. Both teachers and headteachers were struggling to cope with the modern teaching and methods that required the integration of technology in the teaching and learning process. However, with continuous practice, the digital gaps were set to close in Kenyan schools. In line with the Kenyan ICT Policy of 2006 on electronic learning, the promotion and development of content to address the educational needs of primary, secondary and tertiary institutions in Kenya needed to be emphasized.

Relationship between Employee Communication and Performance: Analysis of Public Health Organizations in Homa-Bay County

Relationship between Employee Communication and Performance: Analysis of Public Health Organizations in Homa-Bay County

Work-Life Balance Practices and Teacher Performance in Public Secondary Schools in Kenya

The importance of Work-Life Balance (WLB) in organizations cannot be over-emphasized, for there is so much to lose or gain depending on whether the Work-Life Balance practices are available or not. The objective of this study was to investigate the influence of work-life balance practices (administrative adherence to leave policies, supportive work environment by the school administration, make-up time, and job sharing) on teachers' performance in public secondary schools in Homa-Bay County, Kenya. The variables of the study were discussed in relation to spillover theory. The study used a descriptive survey design. The sample included 320 teachers from 74 schools. Simple and stratified random sampling techniques were used. Questionnaires were used to collect data. Content validity was tested through expert judgement. Test re-test was used to test reliability. The reliability of the questionnaire instrument was 8.5. The study used Pearson correlation coefficient, ANOVA, and multiple linear regression analysis in the data analysis. The study established that work-life balance leads to an increase in teachers' performance. The study concluded that WLB translates to productivity and that people who combine all aspects of their life in a balanced manner are satisfied with their jobs. The study recommended, among others, that institutions invest in more work-life balance practices to enable teachers to maintain a healthy balance between work and their private lives. It is also recommended that policies and structures that enhance the WLB of teachers should be promoted. Additionally, it is recommended that the Teachers Service Commission should support regulations on work-life balance practices to improve teacher performance.

Development of Improved Groundnut Varieties for Dietary Upliftment among Households in Homa Bay County, Kenya

Low dietary diversity is one of the major causes of malnutrition in Kenya. As a result, the government of Kenya and its partners have promoted the uptake of plant based legumes such as Improved Groundnut Varieties to offer solution to the rising cases of poor nutrition. Understanding the impact of Improved Groundnut Varieties on dietary diversity is critical but evidence shows that it’s not yet explored. This study sought to estimate the impact of Improved Groundnut Varieties (IGVs) on dietary diversity among smallholder farmers in Homa Bay County, Kenya. The study used multi-stage sampling procedure where the sub-counties and wards were purposively selected. The villages and respondents were selected using simple random sampling. Cross-sectional data was collected through interview schedules on a random sampling of 384 households. Both descriptive statistics and econometric methods, Propensity Score Matching method were used. The results pointed out that Improved Groundnut Varieties had a positive and significant impact on the diets of the farmers. Households cultivating IGVs had better dietary diversity non-adopters. Overally, this study recommends sensitization of farmers to adopt IGVs and the need for the government to facilitate extension service provision, trainings and access to credit to increase yields and incomes. Again, the study recommends formation of farmers groups that are business hubs as opposed to social welfare to enhance bargaining power and access to inputs and outputs market. Additionally, there is need for intersectoral collaboration between agriculture and health sector to sensitize farmers on the importance of diversifying diets and consuming the crops grown in the farms.

Transition to independent care for youth living with HIV: a cluster randomised clinical trial

Transitioning youth living with HIV to adult care is a crucial step in the HIV care continuum; however, tools to support transition in sub-Saharan Africa are insufficient. We assessed the effectiveness of an adolescent transition package (ATP) to improve youth readiness for transition to independent HIV care. In this hybrid type 1, multicentre, cluster randomised clinical trial, we assessed the effectiveness of an ATP (administered by routine clinic staff, which included standardised assessments and chapter books to guide discussions at scheduled clinic visits) in four counties in Kenya, with HIV clinics randomly assigned 1:1 to ATP or control (standard-of-care practice). Clinics were eligible to participate if they had at least 50 youth (aged 10-24 years) living with HIV enrolled in care. We used restricted randomisation to achieve cluster balance and an independent biostatistician used computer-generated random numbers to assign clinics. We excluded very large clinics with more than 1000 youth, clinics with fewer than 50 youth, paediatric-only clinics, clinics with logistical challenges, and the smallest clinics in Homa Bay county. Youth were eligible for the transition intervention if they were enrolled in participating clinics, were aged 15-24 years, and were aware of their positive HIV diagnosis. Study staff assessed transition readiness scores overall and by four domains (HIV literacy, self-management, communication, and support) in youth with HIV, which were then compared between groups by use of mixed-effects linear regression models. Analysis was by intention-to-treat and was adjusted for multiple comparisons. This trial is registered with ClinicalTrials.gov, NCT03574129. We identified 35 clinics in four counties; of these, ten were assigned to the intervention group and ten to the control group. Of 1066 youth with HIV enrolled between Nov 1, 2019, and March 18, 2020, 578 (54%) were in intervention and 488 (46%) in control sites. Mean baseline transition readiness score was 12·1 (SD 3·4) in ATP sites and 11·4 (3·7) in control sites. At 1 year, adjusting for baseline scores, age, and months since HIV disclosure, participants in the ATP group had significantly higher overall transition readiness scores (adjusted mean difference 1·7, 95% CI 0·3-3·1, p=0·024), and higher scores in HIV literacy domain (adjusted mean difference 1·0, 0·2-1·7, p=0·011). At 12 months, 15 serious adverse events were recorded, none of which were thought to be related to study participation. Integrating ATP approaches could enhance long-term HIV care in youth with HIV as they age into adulthood. US National Institutes of Health.

Response to Treatment with Erythropoietin in Chronic Kidney Disease Patients with Protein Energy Wasting in Homa Bay Teaching and Referral Hospital, Kenya

Anemia is one of the major causes of morbidity in Chronic Kidney Disease (CKD). There are many causes of anemia in CKD, but the main cause is erythropoietin deficiency. CKD patients on hemodialysis have a high protein-energy wasting (PEW) prevalence that may explain Erythropoietin's (EPO) hypo-responsiveness. This study aimed to evaluate the response to EPO treatment in CKD patients with PEW in Homa County Teaching and Referral Hospital. The study was a retrospective medical chart review of patients on hemodialysis in 2018 and 2019 at Homa Bay County Teaching and Referral Hospital. The patients were classified according to PEW diagnostic using the Subjective Global Assessment tool and the Malnutrition Inflammation score tools. PEW prevalence was 41.2% while the prevalence for anemia was 85.3%. The mean hemoglobin at the onset of EPO treatment for patients with PEW and patients without PEW was 8.71 ± 1.82 and 9.53±1.90 g/dl while the final mean hemoglobin was 9.35±1.95 and 10.7±1.86 g/dl respectively. Differences between groups with PEW and groups without PEW were analyzed considering their responsiveness and a statistically significant improvement was recorded in patients without PEW after EPO administration (p-value=0.04). The relative risk of EPO resistance, considering 95 % confidence interval, was 0.3 with a range of 0.109 – 0.825. The risk of poor response to EPO treatment was reduced to 30 % in patients without PEW. This study concluded that PEW contributes to poor response to EPO treatment in hemodialysis patients. It is therefore important to correct wasting in these patients to improve response to EPO treatment. Key words: Anaemia, Erythropoietin, Protein Energy Wasting, Chronic Kidney Disease

Standardized enhanced adherence counseling for improved HIV viral suppression among children and adolescents in Homa Bay and Turkana Counties, Kenya.

Viral suppression is suboptimal among children and adolescents on antiretroviral therapy (ART) in Kenya. We implemented and evaluated a standardized enhanced adherence counseling (SEAC) package to improve viral suppression in children and adolescents with suspected treatment failure in Homa Bay and Turkana. The SEAC package, implemented from February 2019 to September 2020, included: standard procedures operationalizing the enhanced adherence counseling (EAC) process; provider training on psychosocial support and communication skills for children living with HIV and their caregivers; mentorship to providers and peer educators on EAC processes; and individualized case management. We enrolled children and adolescents aged 0 to 19 years with suspected treatment failure (viral load [VL] >1000 copies/mL) who received EAC before standardization as well as those who received SEAC in a pre-post evaluation of the SEAC package conducted in 6 high-volume facilities. Pre-post standardization comparisons were performed using Wilcoxon-Mann-Whitney and Pearson’s chi-square tests at a 5% level of significance. Multivariate logistic regression was performed to identify factors associated with viral resuppression. The study enrolled 741 participants, 595 pre- and 146 post-SEAC implementation. All post-SEAC participants attended at least 1 EAC session, while 17% (n = 98) of pre-SEAC clients had no record of EAC attendance. Time to EAC following the detection of high VL was reduced by a median of 8 days, from 49 (interquartile range [IQR]: 23.0–102.5) to 41 (IQR: 20.0–67.0) days pre- versus post-SEAC (P = .006). Time to completion of at least 3 sessions was reduced by a median of 12 days, from 59.0 (IQR: 36.0–91.0) to 47.5 (IQR: 33.0–63.0) days pre- versus post-SEAC (P = .002). A greater percentage of clients completed the recommended minimum 3 EAC sessions at post-SEAC, 88.4% (n = 129) versus 61.1% (n = 363) pre-SEAC, P < .001. Among participants with a repeat VL within 3 months following the high VL, SEAC increased viral suppression from 34.6% (n = 76) to 52.5% (n = 45), P = .004. Implementation of the SEAC package significantly reduced the time to initiate EAC and time to completion of at least 3 EAC sessions, and was significantly associated with viral suppression in children and adolescents with suspected treatment failure.

Data-informed stepped care to improve youth engagement in HIV care in Kenya: a protocol for a cluster randomised trial of a health service intervention

IntroductionAdolescents and youth living with HIV (AYLHIV) have lower retention in care, adherence to treatment, and viral suppression compared with adults. Stepped care is a process by which clients are...

Effect of Non-monetary Rewards on Employee Performance in Homa Bay County Government, Kenya

Despite Homa Bay County in Kenya spending 70% of its total budgetary allocation on recurrent expenditures like salaries and allowances, it was still struggling with poor service delivery and staff performance issues. Past empirical studies on non-monetary rewards have not established a link between non-monetary rewards and employee performance. Therefore, this study aims to examine the effect of non-monetary rewards on employee performance in Homa Bay County, Kenya. The study population constitutes 373 employees of HBCG, out of which a sample of 146 respondents was selected using stratified sampling techniques. Management staff, including branch managers, assistant managers, and supervisors of the five Nakumatt branches in the Western region, were selected for the study. A sample of 73 respondents was selected using saturated sampling techniques, while the remaining 10 were used for the pilot study. The findings revealed that non-monetary rewards explained a 62.7% (R2 =0.627) variation in employee performance. The study concludes that employee recognition, training, and development are both critical antecedents of employee performance in Homa Bay County, Kenya. The results of the study may be useful for the County Government administration's human resource reward policy formulation that might enhance employee performance and effective service delivery.

Identification of selected primary bloodstream infection pathogens in patients attending Kisii level five and Homa Bay county hospitals

Background: Bloodstream infection (BSI) contributes to a substantial proportion of mortality in sub-Saharan Africa and is marked by the presence of bacterial and/or fungal microorganisms in the blood. Because BSI can be life threatening, it requires a timely, reliable and accurate diagnosis. This study retrospectively analyzed data of identified BSI pathogens and compared the performance of the different diagnostic technologies used in terms of accuracy, sensitivity, turnaround time (TAT) and cost. Methods: Currently, culture followed by analytical profile index biochemical strips (API), (BioMerieux) are used as the conventional standard diagnostics in Kenyan public hospitals and labs. We compared the results of this standard to that of the BioFire FilmArray (FA) (BioFire Diagnostics) and MicroScan WalkAway-40 plus System (MS) (Beckman Coulter) used in diagnosis of BSI. The FA technology was able to identify 150/152 bacterial and yeast isolates with an overall accuracy of 99.04% (95% CI: 96.59-99.88%), sensitivity of 98.68% (95% CI: 95.33-99.84%), mean TAT of 8 hours 40 minutes per eight samples and running cost per sample of USD 140.11. The MS identified 150/152 isolates with an overall accuracy of 98.56% (95% CI: 95.86-99.70%), sensitivity of 98.68% (95% CI: 95.30-99.84%), mean TAT per sample was 42 hours and running cost per sample of USD 28.05. API detected 150/152 isolates, with an overall accuracy of 99.04% (95% CI: 96.59-99.88%), sensitivity of 98.68% (95% CI: 95.33-99.84%) and the mean TAT per sample was 53 and 103 hours for bacterial and yeast samples, respectively, with a running cost per sample of USD 28.05.Conclusions: The findings in this paper suggest that the FA and MS platforms should be able to perform adequately in Kenya referral hospitals and medical clinics as a rapid diagnostic tool.