Mission Hospitals Research Articles

Does cross-cultural adjustment affect employee work commitment? Assessing the role of work factors within selected mission hospitals in Kenya

Background Globalization has expanded the scope of business with many companies relying on the contribution of expatriates to fill skills gap in foreign business operations, transferring management knowledge, launching new operations, and coordinating activities on a global scale. Expatriates, however, face challenges that stem from cultural differences. Their commitment levels depend on how well and how quickly they adjust to the unfamiliar culture(s) of the host country. Methods This study sought to investigate the implications of work factors on commitment of expatriates working in selected mission hospitals in Kenya. It was anchored on the provisions of the Three-Component Commitment and International Adjustment theories and a randomly selected sample of 112 respondents from a target population of 156 medical expatriates. Results and conclusions The results depicted that work-related factors significantly affected employee commitment (β= -1.033, p=0.000). To conclude, we argue that employee commitment amongst expatriates can be enhanced through work factors’ cross-cultural adjustment. We further recommend setting up of cross-cultural adjustment policies for expatriate workers within the workplace, particularly in mission hospitals.

Effect Of Strategic Innovation On Sustainability Of Mission Hospitals In Kiambu County, Kenya

Kenya's healthcare sector plays a crucial role in economic growth and the realization of Vision 2030. Mission hospitals in Kiambu County, however, face sustainability challenges, including inadequate financial resources, staff turnover, weak health systems, and patient non-payment. This study investigated how strategic innovation affects the sustainability of these hospitals, focusing on business models, services, processes, and technological innovations. The research involved 100 managers from seven mission hospitals, using a census approach and a cross-sectional descriptive design. Data were analysed using SPSS, with multiple linear regression to determine relationships between variables. The study found that adopting innovative business models, aligning with market trends, improving service quality, and implementing technological solutions like telemedicine and electronic health systems significantly enhanced operational efficiency, patient satisfaction, and financial stability. The study recommended that mission hospitals regularly review and adapt their value propositions, while the government should support innovation through policies to ensure healthcare sustainability.

Transformational Impact Rating System: a method to assess the impact potential of hospitals in low-resource settings

Background: Historically, many Christian mission hospitals were established by home churches from developed countries in their colonies. With countries gaining independence and missionary medical staff leaving these hospitals, the majority have closed. These hospitals provide critical assistance to communities that need their services the most, yet they often lack the financial and human resources needed to realize their full potential for community impact. Existing charity rating organizations rate few charities and lack transparency for donors, and limited resources exist to help volunteers find organizations that would benefit from their services the most. We propose a transparent Transformational Impact Rating System (TIRS) that can be used by funding agencies and volunteer directing agencies to assess the potential for transformational impact of any hospital anywhere in the world. Methods: Research to inform the rating system was conducted via a comprehensive review of existing charity rating organizations, in-depth interviews, and surveys. The rating system was developed by identifying, down-selecting, categorizing, and allocating weights to variables of importance. The rating system was then implemented via a custom-built website. Results: To receive a score, data is collected from the hospital and surveys of donors, volunteers, staff, patients, and the local community. Hospitals receive an overall score and scores in each of five categories: regional impact potential, financial health, operational performance, external relations, and volunteer experience. Conclusion: TIRS provides a proof-of-concept platform through which all hospitals in low-resource settings can make their impact potential visible to donors and volunteers. If TIRS (or modified similar tools) are used by those interested in helping mission hospitals, they will be more likely to adopt best practices, and invisible hospitals that are struggling in remote areas will be more likely to receive much-needed resources. The Christian community has a mandate to serve the poor and marginalized, resulting in a large number of Christian schools, colleges, and hospitals established across the globe. These establishments face increasing threats to their existence, and tools like TIRS can help direct declining funds and manpower to hospitals that have the highest potential for transformational impact.

Overcoming the challenges of cataract blindness in Nigeria: An action plan for ophthalmologists

Abstract Purpose: The purpose of this study was to explore the eye care provider factors responsible for low cataract surgical rates (CSRs) in Nigeria and to develop an action plan to boost the CSR. Methods: This was a cross-sectional survey of ophthalmologists practicing in Nigeria. An online questionnaire was distributed via E-mail and social media platforms to respondents. Data collected included sociodemographic characteristics, type, and location of the eye hospital where respondents practiced, cataract surgeries performed monthly, frequency and type of outreach activities by the eye hospitals, barriers to uptake of cataract surgery at the hospitals, and suggestions on measures to overcome such barriers. Statistical analysis was done using IBM-SPSS version 20, and the level of significance was P < 0.05. Results: A total of 201 ophthalmologists responded to the survey. Majority (88.0%) were practicing in university or government hospitals while only 8 (4.0%) were working in mission hospitals. The average monthly cataract surgeries performed per hospital ranged from 0 to 600, with a median of 30 surgeries. Mission hospitals were more likely to perform ≥50 cataract surgeries per month compared to other hospitals (P = 0.003). Majority (75.1%) of hospitals organized outreach activities to identify cataract patients. Higher frequency of outreach activities (P = 0.028) and combining surgery with screening (P = 0.036) were associated with a higher likelihood that the cataract patients that were identified received surgery. Conclusion: The conduct of frequent outreach activities in which eye screening and cataract surgery are combined should boost CSRs and reduce the burden of cataract blindness in Nigeria.

Financial Management Practices and Financial Sustainability in Mission Hospitals, Kiambu County, Kenya

Purpose: The study aimed to examine the role of financial management practices in the financial sustainability of mission hospitals in Kiambu County, Kenya. It seeks to understand how financial planning, funding practices, working capital management, and health sector regulations impact the economic stability and operational viability of these vital healthcare institutions. Methodology: The study utilized a descriptive cross-sectional research design to explore the financial management practices and their impact on the financial sustainability of mission hospitals in Kiambu County, Kenya. Data collected on various financial indicators and management practices were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22. Descriptive statistics such as mean and standard deviation were computed to summarize the financial management practices observed in the hospitals. The findings were presented using tables to display the summary statistics and charts and graphs to illustrate trends and comparisons across different financial indicators. Additionally, inferential analyses, including Pearson correlation and multiple linear regression, were conducted to assess relationships between variables and determine the predictors influencing the financial sustainability of the hospitals. Findings: The study achieved an 89.6% response rate, revealing a predominantly male (53.4%) and mature workforce, with most respondents aged 31–40 and over 51. Significant positive relationships were found between financial sustainability and financial planning and control practices (β1 = 0.241, p = 0.003), financing and funding practices (β2 = 0.231, p = 0.002), and working capital management practices (β3 = 0.332, p = 0.000). Financial management practices explained 39.2% of the variation in financial sustainability. Health sector regulations significantly moderated the relationship between financial planning and control practices and financial sustainability (β4a = -0.215, p = 0.035), but had no significant moderating effect on financing or working capital management practices. Unique Contribution to Theory, Practice and Policy: The study findings align with several financial theories, providing valuable insights into financial management practices in mission hospitals. They support the Pecking Order Theory by highlighting the prioritization of internal financing to maintain autonomy and minimize information asymmetry. Additionally, the findings contribute to the Cash Conversion Cycle Theory, emphasizing the role of efficient working capital management in enhancing liquidity and reducing the need for external financing. Moreover, the research supports contingency theory by underscoring the influence of financial management practices on financial sustainability and advocating for tailored financial strategies in mission hospitals. The study also contributes to the theory of budgeting by stressing the importance of systematic budgeting in financial decision-making for resource allocation and financial stability. These insights offer valuable guidance for both policymakers and practitioners in mission hospitals, informing policy decisions and providing practical recommendations to enhance financial management practices and achieve greater financial sustainability in these healthcare institutions.

Effect of Mentorship on Performance of Mission Hospitals in Kenya

Purpose: Those who employ creative leadership tend to do so by creating conditions which promote creativity. Creating such conditions are described as psychological, material, and/or social supports that trigger, enable, and sustain creative thinking in others. The study sought to establish the effect of mentorship creative leadership practice on performance of mission hospitals in Kenya and to establish the moderating effect of perceived organizational support on the effect of mentorship creative leadership practice on performance of mission hospitals in Kenya.
 Methodology: The study was grounded on servant leadership theory and Transactional Leadership Theory. The cross-sectional survey design was used as the study design with the positivist philosophy also being adopted. The sample populations comprised 285 Mission hospital staff at middle or lower levels of employment selected through census. Questionnaire was the main data collection instruments. This was tested for validity and reliability before being used for the study. Collected data was analyzed quantitatively using SPSS 24th version software and was presented in the form of descriptive and inferential results. Descriptive statistics involved percentages, means and means of Standard deviations while inferential involved linear regression analysis. The study results were presented through use of tables and figures
 Findings: The findings of the study underscore the substantial influence of effective mentorship in enhancing both individual and organizational performance in the context of Mission hospitals in Kenya. The strong agreement among respondents on the various aspects of mentorship, combined with the significant statistical correlation between mentorship and improved hospital performance, underscores the value of investing in robust mentorship programs. Perceived organizational support moderates the effect of mentorship on performance of Mission hospitals in Kenya.
 Unique Contribution to Theory, Practice and Policy: The study recommends that healthcare institutions prioritize the development and enhancement of mentorship programs. These programs should focus on leadership development, skill acquisition, and professional growth, tailored to the diverse needs of individual employees. From the study, Mentorship could explain upto 63.1% of the performance of mission hospitals in Kenya. This study therefore recommends further study on other factors affecting performance of mission hospitals in Kenya.

Effect of Creative Work Culture on Performance of Mission Hospitals in Kenya

Purpose: Those who employ creative leadership tend to do so by creating conditions which promote creativity. Creating such conditions are described as psychological, material, and/or social supports that trigger, enable, and sustain creative thinking in others. The objective were to establish the effect of creative work culture on performance of mission hospitals in Kenya and to establish the moderating effect of perceived organizational support on the effect of creative work culture on performance of Mission Hospitals in Kenya.
 Methodology: The cross-sectional survey design was used as the study design with the positivist philosophy also being adopted. The sample populations comprised 285 Mission hospital staff at middle or lower levels of employment. Purposive sampling was used in identifying samples that possess the information needed for the study. Questionnaire was the main data collection instruments. This was tested for validity and reliability before being used for the study. Collected data was analyzed quantitatively using SPSS 24th Edition software and was presented in the form of descriptive and inferential results. Descriptive statistics involved percentages, means and means of Standard deviations while inferential involved simple regression analysis.
 Findings: The study found that a creative work culture, where staffs are confident in their creative capabilities and where there's a positive, collaborative climate, significantly contributes to hospital performance.
 Unique Contribution to Theory, Practice and Policy: The study was grounded on interactionist perspective and transactional leadership theory. The study recommends that healthcare institutions should encourage creativity and innovation at all levels by providing opportunities for staff to express their ideas and collaborate. Training programs focusing on creative thinking and problem-solving skills should be implemented to enhance the creative capabilities of the staff. Leadership should emphasize the importance of a positive and collaborative work climate, where team members feel a strong sense of belonging and commitment. Regular team-building activities and brainstorming sessions can further promote this culture.

ANALISIS EFEKTIFITAS DIMENSI KEPEMIMPINAN (Studi Kasus pada RSUD Prof. dr. Soekandar Mojokerto)

Success in the management of District Hospital of Prof. dr. Soekandar Mojokerto closely related to leadership effectiveness at the managerial level. Measurement of the effectiveness of leadership that has been applied by a manager can be judged from the point of view of the perception of employees, so that it can be seen the gap between perception and expectation of the employees. This study aims to perceive and identify the expectations of leadership based on appraisals, as well as analyzing the things that become priorities for improving leadership effectiveness based on gap analysis.
 Measurement of leadership effectiveness used three dimensions such as; relationship of innate leadership, task structure, position power of the leader. Research is a descriptive survey using a method stratified random sampling. Numbers of samples were 126 employees who occupy positions in hospital management at District Hospital of Prof. dr. Soekandar Mojokerto.
 The results showed that the assessment of employees on the effectiveness of leadership in District Hospital of Prof. dr. Soekandar Mojokerto had been viewed that it did not in line with expectations at both the head of departement, head of section, coordinators and staff space. While the results of the gap analysis showed that there was a lack of appreciation of the employees,because of less rewarding high to performing employees, achieving promotion to employees and find it was fairless in giving punishment to the employees.
 To improve the effectiveness of leadership in District Hospital of Prof. dr. Soekandar Mojokerto need step of improvement priorities such as the development of a vision and mission hospitals, tariffs improvement, strengthen partnerships, develop human resources and public services.

The life they now live: role of missionary hospitals in Sub Saharan Africa

Jesusʾ self confessed mandate was to proclaim good news to the poor and validate this message through miracles like healing. He sent out his followers to do likewise. Mission hospitals are the penultimate example of restoring health in the name of a Saviour who loves them. As a group of healthcare missionaries at Mbingo Hospital, Cameroon, we see the role for mission hospitals/systems for the following reasons: compassionate care, competence, an opportunity to reflect our faith, humility, vision, perseverance, social justice, integrity and accountability. We provide examples for each. Missionary hospitals/ systems in sub-Saharan Africa are a training group for the principles all of us need to mature in during our Christ-centered journey of life.

Effect of Composition of Board of Directors on Performance of Mission Hospitals in Kitui County, Kenya

Mission hospitals play a critical role in the provision of health services in Kitui County. The environment within which mission hospitals operate is ever changing and is aggravated by Kenya’s devolved governance structure. This study therefore sought to establish the effect of composition of board of directors on performance of mission hospitals in Kitui County. Stewardship Theory formed the foundation of the study. A descriptive1 research design1 was undertaken. The target population was the 21 mission hospitals in Kitui County with a cumulative total of 267 respondents comprising of board directors, chief executive officers, administrators and senior managers of these facilities who attend board meetings. A census was adopted since the respondents are few. To obtain primary data, the researcher made use of self-administered questionnaires. The drop and pick technique was chosen to administer questionnaires. For this research, data was analyzed using the Statistical Package for Social Sciences (SPSS Version 27.0). Based on study findings, the composition of the board of directors had a significant influence, as indicated by a p-value of 0.004, which was below the level of significance of 0.05. Key components of this impact include board size, independence, and the diversity of skills and gender representation. The study concluded that diversity encompasses not only gender representation but also a diversity of skills, backgrounds, and experiences among board members. Based on the findings, the study recommends mission hospitals in Kitui County to: review and optimize the composition of the board of directors by ensuring a balance of expertise, independence, and diverse perspectives.

An Evaluation of Pain Assessment Knowledge and Management among Nurses in Selected Hospitals in Benin-City Edo State, Nigeria.

Pain a significant global health concern that affect all races, genders, ages, geographical locations, and socioeconomic classes. Previous studies have reported poor knowledge of pain assessment among nurses. Assessment of pain is the first and most important step in pain management. Inadequately managed pain has many consequences for the patient, family, health professionals, and society. This study aims to assess the knowledge of pain assessment and management among nurses in selected hospitals in Benin-city Edo State, Nigeria. This study was carried out among 140 nurses in two selected mission hospitals in Benin City. A descriptive cross-sectional study design was used and convenience sampling technique was used to select study participants until the sample size was gotten. A self-administered questionnaire was used to collect information from the participants after undergoing pretesting for clarity in another secondary health facility. Data was analyzed using SPSS version 20.0 and statistical significance was set at p < 0.05 at 95% confidence interval. Ethical clearance was obtained from the Research Ethics Committee of Benson Idahosa University. Result shows that, Majority of the respondents in both hospitals had good knowledge of pain assessment with training and journals as the major source of information. While some got theirs from friends. The most common non pharmacologic intervention for pain used in both hospital is relaxation techniques while other techniques are not commonly used. Prescription pain medication is the common pharmacologic intervention in both hospitals. In conclusion proper pain management can lead to quick recovery and reduced complications and shorter hospital stay, foster nurse-patient communication effectively.

Non-Work Related Adjustment factors-a strong Predictor of Expatriates’ Commitment in Mission Hospitals in Kenya: The role of Transformational Leadership

Many organisations worldwide rely on the contributions of expatriates, who are crucial in filling skill gaps in business operations. However, expatriates face challenges that stem from cultural differences. This paper models the relationship between non-work-related adjustment factors and the expatriates’ commitment. Previous research provides mixed results on this relationship. Therefore, this paper fills the void by interrogating the influence of transformational leadership on the relationship between non-work adjustment factors and commitment. Based on a sample of 112 expatriates drawn from selected mission hospitals in Kenya, results indicated that non-work-related adjustment factors significantly affected the expatriates’ commitment (β=1.277, p=0.000). Transformational leadership also affected expatriate commitment (β=.951, p=0.000), and finally, transformational leadership moderated the relationship between the non-work related adjustment factors and expatriates’ commitment (β=1.127, p=0.000). The study recommends that human resource managers in the mission hospitals should set up policies on the non-work related adjustment of expatriates in their hospitals. Also, managers of institutions in the home country should prepare their expatriates on cross-cultural adjustment mechanisms to adapt to their commitment to their host country.

Abstract P191: Health Services Availability And Readiness For Management Of Hypertension And Diabetes In Primary Level Healthcare Facilities In Ghana

Background: Hypertension (HTN) and diabetes (DM) are the leading cause of adult morbidity and mortality in Ghana and other African countries. We explored the service availability (SA) and readiness (SR) of health systems for managing HTN and DM in the Bono Region, Ghana. Methods: We conducted a multi-center cross-sectional study of four primary health facilities between June 2022 and July 2022. We modified the World Health Organization (WHO) Service Availability and Readiness Assessment tool to focus on management of HTN and DM. We computed composite scores for SR based on domains of functional equipment, diagnostic capacity, medications, and clinical guidelines & protocols; SA based on service-specific domains and stratified by facility ownership (Mission vs Government). At a cutoff value of 70%, services were considered "available" or facility "ready" to manage HTN and DM based on previous studies. Results: The median number of HCWs was 7 (IQR 2-7). The overall average SR and SA scores were 75.5% and 63% respectively (Fig A & B). SR scores were higher at mission hospitals (84.5%) than at government hospitals. SA scores were generally lower than SR Scores for both Mission and Government facilities. Half of the health facilities had guidelines and had CVD training in the last 2 years (n = 2; 50%), and all (n=4,100%) had received supervisory visits regarding CVD care in the last three months. Conclusion: There are gaps in diagnostic capacity, basic equipment, clinical guidelines, and a limited number of physicians accounting for low scores, particularly in government facilities. Improving resource allocation and implementing a team-based care policy may enhance HTN and DM care in Ghana .

Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho.

Integrated testing, treatment and care are key strategies for addressing the dual burdens of tuberculosis and HIV. The GeneXpert instrument allows simultaneous HIV and tuberculosis testing, but its utilisation for integrated testing remains suboptimal. The study determined the extent to which tuberculosis testing and HIV early infant detection (EID) were integrated on the GeneXpert platform, or the potential for integration at selected health facilities. A mixed methods evaluation was conducted using retrospective secondary data analysis of laboratory records from 2017 to 2019, and semi-structured interviews. Data were collected between January 2020 and March 2020 in Lesotho. Forty-four health staff were interviewed across 13 health facilities: one regional, nine district, and three clinic level. Six were government facilities, six were mission hospitals, and one was a non-profit clinic. All facilities selected had at least one GeneXpert instrument used for tuberculosis or HIV testing; none included simultaneous testing for tuberculosis and HIV. In 2017, the average utilisation rate for the GeneXpert instrument for tuberculosis and EID testing was 63% and 24%, while in 2019, the average utilisation rate was 61% for tuberculosis testing and 27% for EID. Except for three sites where the testing rates were high, utilisation rates were sufficiently low that all the HIV EID and tuberculosis tests undertaken in 2017 and 2019 could have been performed using only the instruments currently dedicated to tuberculosis testing. There is a missed opportunity for the integration of testing for tuberculosis and HIV on the GeneXpert instrument. This study adds to the body of evidence on the need for integration of testing and highlights some practical and technical considerations for successful implementation of integrated tuberculosis and HIV testing.

Clinical Outcomes of Surgery for Age-related Cataract with Intraocular Lens Implantation in Two Hospitals in North-Central Nigeria

Aims: The study aimed to assess the post-operative presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) from six weeks and above post-surgery, of patients operated for age-related cataract with biometry-calculated IOL power and available IOL power implantation, in two hospitals in Jos, Nigeria.
 Study Design: Retrospective cross-sectional survey.
 Place and Duration of Study: Eye units of two mission Hospitals in Jos namely; Bingham University Teaching Hospital and the Faith Alive foundation Hospital, between June and August 2021.
 Methodology: Patients aged 40 years and above, who had undergone surgery for age-related cataract in the preceding 18 months in two hospitals in Jos and were six weeks or more post-surgery were consecutively enrolled into the study, after obtaining informed consent. Socio-demographic data and surgical history were obtained from patients and their surgical records. The PVA and BCVA were assessed and categorized based on World Health Organization guidelines. 
 Results: A total of 87 patients were examined within the study period. Post-operative PVA was good (≥6/18) in 32 (36.8%), borderline (<6/18-6/60) in 41 (47.1%) and poor (<6/60) in 14 (16.1%) participants. After refraction, the proportion of good outcomes increased to 78.2% with only 8.1% of outcomes remaining poor. Biometry-calculated IOL power and available IOL power use did not significantly influence visual outcome (P=.645 and P=.146 for PVA and BCVA respectively).
 Conclusion: Majority of participants had post-operative PVA in the borderline category with residual uncorrected refractive error as the principal cause. Regardless of the IOL power implanted, surgery for age-related cataract enhanced patients’ vision. This study has shown that the presence of biometry is a guarantee of refractive success. Hence, refractive outcome audits are essential.

Incidence of Pencil and Pen Eye Injury among Children in Anambra State, South-East, Nigeria: Ten Year Retrospective Study

Background: Eye injuries constitute a significant portion of most ophthalmologic consultations and ocular emergencies with grave consequences, especially in children, if not managed well early enough. Traumatic eye damage is the leading cause of monocular blindness worldwide. This study aimed to determine the incidence, circumstances and types of ocular injury among children in Anambra state, South-East, Nigeria.
 Materials and Methods: A ten- year retrospective study of 211 children aged below 18 years who presented with eye trauma in two mission hospitals in Anambra State, Nigeria. Case file of children with ocular trauma were retrieved from the medical records and those with pencil and pen injury isolated. Required information was extracted from the case files and recorded in a pro-forma. The data was analyzed using Statistical Package for Social Science, Version 20 (SPSS-20).
 Results: The incidence of pencil/pen eye injury was 10.9% (23/211). The injuries were commoner in males (M:F=1.6:1) and in those aged five years and below. Stab injuries constituted 56.5% (13) of the injuries while 34.8% (8) were missile injuries. Forty-six percent (6) of the stab injuries were self-inflicted with two-third of this being in children younger than five years. Corneal laceration, followed by anterior uveitis, was the commonest form of eye injury.
 Conclusion: There is a high incidence of pencil and pen injury in South-East, Nigerian children. Although visual prognosis is good with early presentation and treatment, adequate preventive measures should be put in place to forestall the occurrence of this potentially blinding condition in children.

Knowledge and Practice of Prostate Cancer Screening among Healthcare Workers in Tertiary and Mission Hospitals in Southeastern Nigeria

Knowledge and Practice of Prostate Cancer Screening among Healthcare Workers in Tertiary and Mission Hospitals in Southeastern Nigeria

Factors Associated with Nutritional Practices of PregnantWomen Attending Antenatal Clinic of Selected Hospitals in Benin-City, Nigeria

The health of a pregnant mother and her nutritional status can influence the health and survival of the growing foetus because of the biological link between her and her child. This study assessed the knowledge and practice of healthy nutrition among pregnant women attending antenatal clinics in two selected hospitals in Benin City. A descriptive cross-sectional research design was used in this study. A sample size of 284 was sampled for the target population of 972 pregnant women attending antenatal clinics in tertiary and Mission hospitals using a selfstructured questionnaire with a split-half reliability test of Cronbachs alpha value of 0.886, 0.768, and 0.851. Data were analyzed using descriptive statistics (frequency and percentages). The result revealed that 157(55.3%) had good knowledge, 79(27.8%) had average knowledge while 48(16.9%) had poor knowledge. 81(28.5%) had poor practice while the majority 203(71.5%) had good practice of healthy nutrition. Ignorance (2.86±0.423), Religion (2.73±0.430), Cultural belief (2.88±0.422), were reported to be factors affecting the practice of healthy nutrition. Conclusion: Although knowledge and practices of healthy nutrition were high, the cultural belief still affects pregnant women’s practice of healthy nutrition and health talk should be encouraged on each antenatal day with an emphasis on healthy nutrition.

The Influence of Staffs’ Knowledge on Preparedness of Catholic Mission Hospitals for Health Service Delivery during Emergency Inflow of Patients in Nairobi County, Kenya

Purpose: To determine the influence of staffs’ knowledge on preparedness of catholic mission hospitals for health service delivery during emergency inflow of patients in Nairobi County, Kenya.
 Methodology: A cross sectional descriptive study design was used with quantitative approach for data collection and analysis. Four tier-3 Catholic Mission Hospitals were purposively selected and a stratified random sample of 647 members of staff from different cadres was taken. A structured questionnaire was used to collect data. Data was analyzed using STATA software v.16, where descriptive statistics were presented using frequencies and percentages whereas inferential statistics were presented using correlation and regression analysis.
 Findings: The study found out that staff training and exercises for knowledge and skills influenced preparedness of Catholic Mission Hospitals for health service delivery during emergency influx of patients. A positive and significant relationship was found at (r=0.211; p<0.01). This means that the hospitals are perceived as prepared for health service delivery during emergency influx of patients. However, staff drills (staff exercises) at (r = -0.147; p<0.05) were found insignificantly influencing services delivery. This means that the hospitals would be unprepared even if staff drills were in place.
 Recommendations: The study recommends that the managers of catholic hospitals should have scheduled staff trainings and drills for efficient and timely response in times of need for emergency service deliver. Policy guidelines on skills acquisition for the staff in the health institutions need to be developed to guide the trainings and frequent drills to sharpen the theory and practice of the healthcare team.

Survey of the use of traditional and complementary medicine among children with cancer at three hospitals in Cameroon.

There is lack of diagnostic and treatment resources with variable access to childhood cancer treatment in low- and middle-income countries (LMIC), which may lead to subsequent poor survival. The primary aim of this study was to determine the prevalence and types of traditional and complementary medicine (T&CM) used in Cameroon. Secondarily, we explored determinants of T&CM use, associated costs, perceived benefits and harm, and disclosure of T&CM use to medical team. A prospective, cross-sectional survey among parents and carers of children younger than 15 years of age who had a cancer diagnosis and received cancer treatment at three Baptist Mission hospitals between November 2017 and February 2019. Eighty participants completed the survey. Median patient age was 8.1 years (IQR4.1-11.1). There was significant availability (90%) and use (67.5%) of T&CM, whereas 24% thought T&CM would be good for cancer treatment. Common T&CM remedies included herbs and other plant remedies or teas taken by mouth, prayer for healing purposes and skin cutting. Living more than five hours away from the treatment center (P = 0.030), anticipated costs (0.028), and a habit of consulting a traditional healer when sick (P = 0.006) were associated with the use of T&CM. T&CM was mostly paid for in cash (53.7%) or provided free of charge (29.6%). Of importance was the fact that nearly half (44%) did not want to disclose the use of TM to their doctor. Pediatric oncology patients used T&CM before and during treatment but were unlikely to disclose its use to the child's health care team.