Level In Kenya Research Articles

Black Theology and Its Response to Poverty in the Public Sphere – A Case for the Africa Inland Church in Kenya

ABSTRACTPoverty levels in Kenya, as in many other parts of the world, are still unacceptably high. Various responses against poverty since independence, by the government and non-governmental agencies, especially churches, have not succeeded in eradicating the scourge. A closer look at Black theology demonstrates its emphases on the conflict between the oppressor and the oppressed; and on preferential options for the poor. These emphases in Black theology provided a theological legitimacy for a response against slavery in the Americas and apartheid in South Africa, and are now strongly related to the ongoing engagement with poverty and its causes. Although the Africa Inland Church plays a notable role in the provision of education, healthcare and relief supplies among the poor and the vulnerable in Kenya, the theological framework provided by Black theology could position the Africa Inland Church to better respond to poverty and its causes, while partnering with other responsible poverty response agencies in Kenya.

Decentralising and integrating HIV services in community-based health systems: a qualitative study of perceptions at macro, meso and micro levels of the health system

IntroductionHIV services at the community level in Kenya are currently delivered largely through vertical programmes. The funding for these programmes is declining at the same time as the tasks of...

Hospitals as complex adaptive systems: A case study of factors influencing priority setting practices at the hospital level in Kenya

There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months. In this paper, we apply complex adaptive system (CAS) theory to examine the factors that influence PSRA practices. We found that PSRA practices in the case hospitals were influenced by, 1) inadequate financing level and poorly designed financing arrangements, 2) limited hospital autonomy and decision space, and 3) inadequate management and leadership capacity in the hospital. The case study hospitals exhibited properties of complex adaptive systems (CASs) that exist in a dynamic state with multiple interacting agents. Weaknesses in system ‘hardware’ (resource scarcity) and ‘software’ (including PSRA guidelines that reduced hospitals decision space, and poor leadership skills) led to the emergence of undesired properties. The capacity of hospitals to set priorities should be improved across these interacting aspects of the hospital organizational system. Interventions should however recognize that hospitals are CAS. Rather than rectifying isolated aspects of the system, they should endeavor to create conditions for productive emergence.

Fertility Transitions in Ghana and Kenya: Trends, Determinants, and Implications for Policy and Programs

As a continent with 54 independent states Africa’s diversity is often highlighted but frequently forgotten when fertility is discussed. Fifty and more years ago to consider that all African countries and societies had a single fertility pattern (large numbers of children) and single trend (unchanging over time) was a valid characterization. Since the 1960s however that uniformity has disappeared replaced by substantial inter- and intra-country differences in fertility patterns and trends that render previous perceptions of continent-wide homogeneity obsolete. In this chapter we consider two African countries—Ghana and Kenya—whose fertility patterns and trends and their determinants have been well documented (Bongaarts 2008; Garenne 2008; Machiyama 2010; Shapiro and Gebreselassie 2008; Sneeringer 2009). Both countries have benefited from regularWorld Fertility Surveys (WFS) and Demographic and Health Surveys (DHS) that record trends in fertility family planning (FP) and other relevant indicators. The recently introduced Performance Monitoring and Accountability 2020 (PMA2020) surveys monitor progress since 2012 for the FP2020 initiative and occasional Situation Analysis and Service Provision Assessment surveys have also detailed the readiness of the health system in both countries to make quality FP services available. Ghana and Kenya share some common history: both have relatively strong health system legacies from the period of British colonialization; both were among the earliest countries to achieve independence; they were the first two African countries that developed policies to address population growth in the 1960s; and both have received substantial and sustained resources over several decades from many external donors and technical assistance organizations explicitly intended to increase the availability and quality of family planning services. However they are composed of cultures that are both diverse within each country and markedly different in many ways between the two countries. The two countries demonstrate remarkably different pathways in fertility and family planning patterns and trends from the 1970s to the present. We highlight some of the key differences and similarities explain why they have occurred and identify insights that could inform a wider understanding of fertility transitions and the role of family planning in other African countries. (excerpt)

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

BackgroundPriority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya.MethodsWe used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long’s actor interface analysis and VeneKlasen and Miller’s expressions of power framework to examine and interpret our findingsResultsThe interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals.ConclusionsDesigning hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1796-5) contains supplementary material, which is available to authorized users.

Establishment Of Absolute Gravity Stations Referenced To International Gravity Station Network Of 1971 Datum In County Levels In Kenya

Establishment Of Absolute Gravity Stations Referenced To International Gravity Station Network Of 1971 Datum In County Levels In Kenya

Place of Residence Moderates the Risk of Infant Death in Kenya: Evidence from the Most Recent Census 2009.

BackgroundSubstantial progress has been made in reducing childhood mortality worldwide from 1990–2015 (Millennium Development Goal, target 4). Achieving target goals on this however remains a challenge in Sub-Saharan Africa. Kenya’s infant mortality rates are higher than the global average and are more pronounced in urban areas as compared to rural areas. Only limited knowledge exists about the differences in individual level risk factors for infant death among rural, non-slum urban, and slum areas in Kenya. Therefore, this paper aims at 1) assess individual and socio-ecological risk factors for infant death in Kenya, and at 2) identify whether living in rural, non-slum urban, or slum areas moderated individual or socio-ecological risk factors for infant death in Kenya.MethodologyWe used a cross-sectional study design based on the most recent Kenya Population and Housing Census of 2009 and extracted the records of all females who had their last child born in 12 months preceding the survey (N = 1,120,960). Multivariable regression analyses were used to identify risk factors that accounted for the risk of dying before the age of one at the individual level in Kenya. Place of residence (rural, non-slum urban, slum) was used as an interaction term to account for moderating effects in individual and socio-ecological risk factors.ResultsIndividual characteristics of mothers and children (older age, less previously born children that died, better education, girl infants) and household contexts (better structural quality of housing, improved water and sanitation, married household head) were associated with lower risk for infant death in Kenya. Living in non-slum urban areas was associated with significantly lower infant death as compared to living in rural or slum areas, when all predictors were held at their reference levels. Moreover, place of residence was significantly moderating individual level predictors: As compared to rural areas, living in urban areas was a protective factor for mothers who had previous born children who died, and who were better educated. However, living in urban areas also reduced the health promoting effects of better structural quality of housing (i.e. poor or good versus non-durable). Furthermore, durable housing quality in urban areas turned out to be a risk factor for infant death as compared to rural areas. Living in slum areas was also a protective factor for mothers with previous child death, however it also reduced the promoting effects of older ages in mothers.ConclusionsWhile urbanization and slum development continues in Kenya, public health interventions should invest in healthy environments that ideally would include improvements to access to safe water and sanitation, better structural quality of housing, and to access to education, health care, and family planning services, especially in urban slums and rural areas. In non-slum urban areas however, health education programs that target healthy diets and promote physical exercise may be an important adjunct to these structural interventions.

Status of Teachers’ Proficiency in Mathematical Knowledge for Teaching at Secondary School Level in Kenya

Mathematical knowledge for teaching (MKT), defined by Ball (Elementary Journal, 93, 373–397, 1993) as knowledge that is needed to teach mathematics, has been used as a framework by researchers to interrogate various aspects of teaching and learning mathematics. In this article, which draws from a larger study, we show how an in-depth analysis of MKT can illuminate what teachers know and need to learn. This study described here uses MKT theory (Ball, Thames & Phelps, Journal of Teacher Education, 59(5), 389–407, 2008) to develop an assessment tool, the MKT proficiency status tool, to measure and describe teachers’ MKT by proficiency status. The study explores Kenyan teachers’ interpretations of secondary school students’ unusual problem solving solutions from across five mathematics strands. In this article, we share findings from data collected using a MKT task questionnaire. Data were analyzed using descriptive statistics and interpreted against the MKT proficiency status tool continuum of fluent, partially fluent, and inadequate. The teacher was the unit of analysis. Findings from the study indicate that teachers’ levels of fluency were not consistent either by mathematical strand or by assessed MKT component. A fluency rate of 9.1 % for mathematical strands and 1.7 % for MKT components was found. The overall description of MKT proficiency status for this study was found to be partially fluent. From this study, we argue that the MKT proficiency status tool details and illuminates teachers’ professional development needs and enables an in-depth analysis of their MKT proficiency status.

Factors which predict violence victimization in Kenya

Aims: The purpose of this paper is to identify the factors that predict interpersonal violence at the personal level in Kenya. Another aim is to interpret the implications of the study for violence prevention programs. Setting and design: Study is set in Kenya and is based on the responses of 2,399 collected in 2012. Methods and materials: The study's dependent variable is reported violence victimization. Results: The logistical regression analysis identified seven factors that predicted violence victimization. These included being the victim of a property crime, payment of bribes to the police, fear of crime in the neighborhood, poverty, whether there was a police station in the neighborhood, whether the police were visible in the area, and the respondent's trust in the neighbors. The surprising finding was that 72 percent of the violence victims were also property crime victims. Conclusion: The findings imply that target hardening should be the basis used to implement violence prevention programs in Kenya. It appears that crime prevention efforts 5 should begin with law enforcement personnel when they respond to reported crime, property or violent offenses. These findings suggest that there is an ongoing need to protect victims from re-victimization by preparing them to protect both their premises and their persons in the future.

Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya.

BackgroundDeveloping countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept was applied at district level in Kenya to assess how many women had UONs and where the women with unmet needs were located.MethodsA facility based retrospective study was conducted in 2010 in Malindi District, Kenya. Data on pregnant women who underwent a major obstetric intervention (MOI) or died in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The main outcome measures in the study were the magnitude of UONs and their geographical distribution.Results566 women in 2008 and 724 in 2009 underwent MOI. Of these, 185 (32.7%) in 2008 and 204 (28.1%) in 2009 were for Absolute Maternal Indications (AMI). The most common MOI was caesarean section (90%), commonly indicated by Cephalopelvic Disproportion (CPD)–narrow pelvis (27.6% in 2008; 26.1% in 2009). Based on a reference rate of 1.4%, the overall MOI for AMI rate was 1.25% in 2008 and 1.3% in 2009. In absolute terms, 22 (11%) women in 2008 and 12 (6%) in 2009, who required a life saving intervention failed to get it. Deficits in terms of unmet needs were identified in rural areas only while urban areas had rates higher than the reference rate (0.8% vs. 2.2% in 2008; 0.8% vs. 2.1% in 2009).ConclusionsThe findings, if used as a proxy to maternal mortality, suggest that rural women face higher risks of dying during pregnancy and childbirth. This indicates the need to improve priority setting towards ensuring equity in access to life saving interventions for pregnant women in underserved areas.

The accountability for reasonableness approach to guide priority setting in health systems within limited resources--findings from action research at district level in Kenya, Tanzania, and Zambia.

BackgroundPriority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT).MethodsThis intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods.ResultsThe values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes.ConclusionsDistrict stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This provides arguments for the continued application and further assessment of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications.

IT Strategic Alignment Maturity levels in Kenya

<p><em>Strategic alignment focuses on the activities that management performs to achieve cohesive goals across the IT (Information Technology) and other functional organisations (e.g., finance, marketing, H/R, research, manufacturing). Therefore, alignment addresses both how IT is in harmony with the business, and how the business should, or could be in harmony with IT. Alignment evolves into a relationship where the function of IT and other business functions adapt their strategies together. Achieving alignment is evolutionary and dynamic. It is a process that requires strong support from senior management, good working relationships, strong leadership, appropriate prioritization, trust, and effective communication, as well as a thorough understanding of the business and technical environments. Achieving and sustaining alignment demands focusing on maximizing the enablers and minimizing the inhibitors that impact alignment. Once the maturity of IT business alignment is understood, an organisation should be able to identify opportunities for enhancing the harmonious relationship of business and IT.</em></p>

Tuberculosis and HIV at the national level in Kenya: results from the Second Kenya AIDS Indicator Survey.

Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa. In the second Kenya AIDS Indicator Survey, we collected data on knowledge and experience of HIV and tuberculosis, as well as on access to and coverage of relevant treatment services and antiretroviral therapy (ART) in Kenya. A national, population-based household survey was conducted from October 2012 to February 2013. Information was collected through household questionnaires, and blood samples were taken for HIV, CD4 cell counts, and HIV viral load testing at a central laboratory. Overall, 13,720 persons aged 15-64 years participated; 96.7% [95% confidence interval (CI): 96.3 to 97.1] had heard of tuberculosis, of whom 2.0% (95% CI: 1.7 to 2.2) reported having prior tuberculosis. Among those with laboratory-confirmed HIV infection, 11.6% (95% CI: 8.9 to 14.3) reported prior tuberculosis. The prevalence of laboratory-confirmed HIV infection in persons reporting prior tuberculosis was 33.2% (95% CI: 26.2 to 40.2) compared to 5.1% (95% CI: 4.5 to 5.8) in persons without prior tuberculosis. Among those in care, coverage of ART for treatment-eligible persons was 100% for those with prior tuberculosis and 88.6% (95% CI: 81.6 to 95.7) for those without. Among all HIV-infected persons, ART coverage among treatment-eligible persons was 86.9% (95% CI: 74.2 to 99.5) for persons with prior tuberculosis and 58.3% (95% CI: 47.6 to 69.0) for those without. Morbidity from tuberculosis and HIV remain major health challenges in Kenya. Tuberculosis is an important entry point for HIV diagnosis and treatment. Lack of knowledge of HIV serostatus is an obstacle to access to HIV services and timely ART for prevention of HIV transmission and HIV-associated disease, including tuberculosis.

A THEORY OF HUMAN MOTIVATION: THE TIRIMBA GROUPING THEORY OF MOTIVATION

There is an argument that money is the only motivator that management can use effectively to enhance the performance of employees at all levels. It’s however of questionable wisdom whether employees who happen to differ in the social class grouping can be motivated by only one factor, financial motivation of money. Theorists have concentrated on the generalized motivators without detail look unto those needs that motivate workers at the low, middle and high class levels that compound the environment of today in both developing and developed nations. This study will add to the existing knowledge in motivation as regards the factors that motivate workers at the varied social classes by coming up with a theory, ‘the Tirimba theory of motivation’ which was aimed at identifying the key motivators at the low, middle and high class social levels of workers. The main objective therefore is to determine the key motivators at the low, middle and high class levels at the contemporary context. Descriptive research design was adopted with the population being strategic management scholars at graduate level in Kenya. The sample survey of this study was extracted from the Masters of Business Administration (MBA) students of Jomo Kenyatta University of Agriculture and Technology, Nairobi campus 2012-2013 current students that was identified on case study method. The study relied wholly on qualitative data from both primary and secondary sources. Primary data was collected by use of semi-structured questionnaires. Secondary data was gathered by aid of already published books, journals, and published and unpublished research projects. Relevant conclusions and recommendations were made as per the data collected and the theory to be suggested explained amid the research work.

A national population-based assessment of 2007–2008 election-related violence in Kenya

BackgroundFollowing the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence.MethodsA cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed.ResultsOf 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001).ConclusionOn a national level in Kenya, politically-motivated and opportunistic sexual and physical violations were commonly reported among sampled adults with associated health and mental health outcomes.

Management in Action: Managing the HIV/AIDS Curriculum in Kenya

Curriculum management can only be effective when the curriculum content and expected learning outcomes are clearly stated for the actual implementers. The implementers on their side especially the teachers and the school administration must ensure that the stated contents, instructional methodologies and the time lines are followed appropriately. This paper examines the extent at which the HIV/AIDS curriculum is being implemented at the Secondary School level in Kenya. The key objectives were to identify the policy dimensions of HIV/AIDS education curriculum and to determine the level of implementation of HIV/AIDS education curriculum in public secondary schools. Structured questionnaire, observation and in-depth interviews were used for data collection from selected school students and the curriculum implementers. The study concluded that HIV/AIDS aspects are taught in public secondary schools through infusion and integration into carrier subjects, though not allocated any specific time in the curriculum. The level at which these aspects are taught is very low, and when taught lecture method, which is a rather passive way of teaching, is the predominant method employed by the teachers. It is recommended that the teachers should be more creative and devise other forums that would ensure that these aspects are amply taught. Also the teachers should collect and avail more learning materials to their learners, including use of the internet to supplement what is provided in the text books.

Motivational Beliefs and Self-Regulation in Biology Learning: Influence of Ethnicity, Gender and Grade Level in Kenya

The study investigated the influence of ethnicity, gender and grade level on the motivational beliefs and self-regulation in Biology learning through a non-experimental quantitative study among 317 students in 2 co-educational schools in Nakuru (n = 155 ) and Siaya (n = 162) counties, Kenya. The study used a modified version of Motivated Strategies for Learning Questionnaire (MSLQ) which had 44 items to measure motivational beliefs and self-regulation. A 4 × 2 × 2 MANOVA revealed “ethnicity” as having the largest effect on these variables. There was a statistically significant difference between the Nakuru group and the Siaya group in favor of Nakuru with regard to self-efficacy in Biology learning. They also scored higher in most of the variables. There were no statistically significant gender differences in motivational beliefs and self-regulation in Biology learning. However boys were more self-efficacious with low test anxiety than girls. Girls had higher intrinsic value, cognitive strategy and self-regulation than boys. There were statistically significant grade level differences in favor of grade 12 students. Grade 11 students had the lowest scores in all the variables under investigation. The implications for the study are discussed.

Assessing trauma care at the district and provincial hospital levels: a case study of hospitals in Kenya

Trauma is a major cause of death and disability worldwide, of which more than 90% occur in low- and middle-income countries. Given the magnitude of this inequality, there is a need to devise and use tools to assess the capacity of facility-based trauma care. This study used two tools, hospital flowcharts and the World Health Organization's Trauma Care Checklist, to describe trauma care capacity at two hospitals in Kenya and ways in which this capacity can be strengthened. We found these hospitals had a large volume of trauma, but due to the lack of intensive care units, specialized trauma units, and axillary services, such as orthopedics and neurosurgery, the hospitals had a limited ability to provide definitive care for injured patients in critical condition. Additionally, organizational capabilities, such as trauma registries, trauma-specific training, and quality improvement programmes were lacking. The state of trauma care at district and provincial levels in Kenya demonstrates a strong case for national and global investment in clinical and systemic interventions.

A Kenyan Cloud School. Massive Open Online &amp; Ongoing Courses for Blended and Lifelong Learning

This research describes the predicted outcomes of a Kenyan Cloud School (KCS), which is a MOOC that contains all courses taught at the secondary school level in Kenya. This MOOC will consist of online, ongoing subjects in both English and Kiswahili. The KCS subjects offer self-testing and peer assessment to maximize scalability, and digital badges to show progress and completion to recognize and validate non-formal learning. The KCS uses the Moodle LMS with responsive web design to increase ubiquitous access from any device. Access is free and open, and the KCS intends to be a contextualized open educational resource for formal secondary institutions to support blended learning and a free source of non-formal education for lifelong learning. The expected outcomes are that this effort will reduce secondary school dropout rates, improve test scores, become a quality resource for blended learning, as well as validate and recognize lifelong learning in Kenya.

Impact of a decision-support tool on decision making at the district level in Kenya.

BackgroundIn many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions.MethodsThirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts.ResultsFindings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement.ConclusionsThis paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems.