Trans Nzoia County Research Articles

MISMANAGEMENT OF COUNTY RESOURCES: A CASE OF TRANS NZOIA COUNTY

The purpose of the study was to investigate mismanagement of county resources in Trans Nzoia County. The objective of the study is to determine the causes of mismanagement of resources for service delivery in Trans Nzoia County, establish the effects of redundancy in growth and development in county government on service delivery. Organization and management theory (Fredrick Taylor, 1961), was applied by researcher. The theory states that resources are to be managed effectively and efficiently. The researcher employed mixed research method that included qualitative and quantitative methods that led to triangulation design. The target population was 3000 people which gave a sample size of 900 people after the application of Greg and Morgan 1979 formula. The researcher employed purposive sampling technique and simple random sampling technique. Data collection was done by use of questionnaires and document analysis. The researcher also applied purposive sampling technique where data was collected from the people who had knowledge on what the researcher was conducting the study on. The researcher conducted a pre test and a post test of the research instruments to establish the validity and reliability of the instrument in the collection of data. Data was collected using questionnaires and document analysis. The findings indicated that the county resources were not well utilized and recommended that the people to handle finances should have the right qualifications and experiences.

THE EFFECTS OF WESTERN CHRISTIANITY AND AFRICAN TRADITIONAL RELIGION ON CULTURAL AND MORAL DEVELOPMENT IN TRANS NZOIA COUNTY, KENYA

The purpose of this study was to establish effects of Western Christianity and African Traditional Religion on moral and cultural development of the people of Trans Nzoia County. Morals and core values play a very important role in the upbringing of the youth in any given community in any given Geographical part on this planet. The study will be guided by the following objectives: Establish effects of Christianity on moral development, Determine effects of African Traditional Religion on moral development, Compare and contrast effects of moral development of Western Christianity and African Traditional Religion and to determine the role played by morals and core values in both Christianity and African Traditional Religion. Mixed Research method combined both qualitative and quantitative was employed in the study to unearth the hidden truth underlying in the study. The target population was 500 people which gave a sample size of 50Bishops and Pastors of 50 Churches. The researcher employed purposive and simple random sampling techniques. The researcher used two guiding theories in the study: the theory of Atonement on the Christian part and the theory of dual allegiance on the part of African Traditional Religion. Data was collected by use of Questionnaires and Interview schedules. The raw data was analyzed and descriptively availed for facilitation of research objectives and research questions. Computer program SPSS was employed to give the final accurate and precise results of Research findings. The findings indicate that the intrusion of foreign cultures in Trans Nzoia County has helped water down the quality of African morals on one part and the other part there is improvement on cultural and core values of the people of Trans Nzoia County. The conclusion on the same is that since communication and mobility has been so much developed in these resent times, it is easy for people from different parts of the world to meet and interact at any time at any given Geographical zone on the planet. The study recommends that the citizens of Trans Nzoia should be careful enough in considering the kind of morals to be applied in this county since the county is an Agricultural hub where people from different parts of the Earth converge either for commercial purposes or for learning Agri-business techniques.

Increasing Access to Eye Health Services in Kenya Using an mHealth System: A Cluster Randomised Controlled Trial

Background: A combination of limited access to eye services and low numbers of eye care providers in low- and middle-income (LMIC) populations results in high prevalence of avoidable vision impairment. Poverty, lack of awareness and greater distance are key barriers to accessing services. We investigated the effectiveness of the Peek Community Eye Health system (Peek CEH), a smartphone-based referral system comprising decision support algorithms (Peek Community Screening app), Short Message Service (SMS) reminders and real-time system level reporting. Methods: We conducted a single masked, cluster randomised controlled trial. All participants in a ‘community unit’ defined as a dispensary or health centre with its catchment population were eligible. Community units were randomly allocated (1:1) to receive either the Peek CEH and referral (intervention group) or the current standard with periodic health centre-based outreach clinics and onward referral (control group). Participants in the intervention group were assessed in their houses by screeners and those referred were asked to present for triage assessment in a central location. They also received regular SMS reminders. In both groups, community sensitisation was done followed by a triage clinic at the link health facility four weeks from sensitisation. During triage, participants in both groups were assessed and treated and, if necessary, were given a referral to Kitale Eye Unit, participants in the intervention arm received further SMS reminders. The primary outcome was the number of people per 10,000 population (rate) with eye conditions attending triage at four weeks of sensitization. Primary analysis was by intention to treat, with the intervention effect estimated using a t-test performed on cluster-level rates. Findings: Trial recruitment occurred between November 26, 2018, and June 7, 2019. We randomly selected 36 out of the 66 eligible Community Units; these were then randomised to either the intervention group (68,348 participants) or the control group (60,243 participants). 9,387 (13·7%) participants from the intervention group and 3,070 (5·1%) from the control group attended triage assessment. The mean attendance rate by participants with eye problems was 1,429 per 10,000 in the intervention arm and 522 per 10,000 in the control group, giving an estimated rate difference of 906 per 10,000 (95%CI: 689-1,124; p <0·0001). The mean hospital attendance was 82 per 10,000 in the intervention group and 33 per 10,000 in the control group, estimated rate difference of 49 per 10,000 (95%CI:25-73; p=0·0002). Hospital utilization (secondary care) by the catchment population remained consistent with normal annual levels (80 per 10,000), however a major improvement in the proportion of appropriate utilization was seen, with 13% (baseline 61%) having primary eye care conditions (most managed at triage) and 56% (baseline 8%) having priority vision impairing eye conditions. Interpretation: The Peek Community Eye Health system increased primary care and hospital attendance by people with eye problems compared with the standard approach in communities. This indicates the potential of this mHealth package to improve uptake of eye services and guide appropriate task sharing, through better matching of need to services. Trial Registration: This trial is registered with Pan African Clinical Trial Registry, number PACTR 201807329096632. Funding Statement: This study was funded through the Commonwealth Eye Health Consortium (CEHC), with funding from the Queen Elizabeth Diamond Jubilee Trust’s “Avoidable Blindness” programme. The CEHC is administered through the International Centre for Eye Health (ICEH) based at the London School of Hygiene & Tropical Medicine. MJB is supported by the Wellcome Trust 207472/Z/17/Z. Declaration of Interests: The Peek Vision Foundation (09919543) is a registered charity in England and Wales (1165960) with a wholly owned trading subsidiary, Peek Vision Ltd (09937174). Professor Matthew Burton is a Trustee of The Peek Vision Foundation and Dr Andrew Bastawrous is CEO of The Peek Vision Foundation and Peek Vision Ltd. HR is an advisor to Peek Vision Ltd. CB works at Peek Vision Ltd. All other authors declare no conflict of interest. This submission has not been published anywhere previously and is not simultaneously being considered for any other publication. Ethics Approval Statement: The study was approved by the Moi University Institutional Research and Ethics Committee, Kenya and the London School of Hygiene & Tropical Medicine Ethics Committee, UK. Permission was also granted by department of Health, Trans Nzoia County, Kenya. The study adhered to the principles of the Declaration of Helsinki on Ethics. Written informed consent from all participants was obtained by a trained field research team before enrolment; parents or guardians consented for children.

Perception of Farmers’ on Soil Fertility Problems and Replenishment Technologies in the North Rift Region of Kenya

This paper investigates the farmers’ perception on soil fertility replenishment technologies in the North Rift Region of Kenya. A survey was conducted in Trans Nzoia and Uasin Gishu counties of the North Rift Region of Kenya. A total of 108 respondents were interviewed. A two stage random sampling technique was employed in the study. In the first stage, farmer groups growing maize as the main crop were selected. The second stage involved the selection of farmers who were practicing cereal banking for ease of marketing of their produce. A survey and field demonstration plots were adopted. On-farm demonstration were carried out and used to ascertain the farmers’ perception towards the technologies. A structured questionnaire was administered to them to elicit information on their perception on soil fertility replenishment technologies (SFRT). Descriptive statistics and the multiple regression analysis was done using a Statistical Package for Social Sciences (SPSS). The results revealed that farmers perceived that technologies could be used to address the declining soil fertility. The inputs were affordable available, the Ministry of Agriculture, Livestock and Fisheries (MOALF) was effective in disseminating the technologies and that the technologies could work on any farm at mean score of 3.5, 4.1, 4.0, 3.4 and 4.6 out of 5.0 respectively. Farmers in Trans Nzoia county identified lack of capital (70.4%) compared to Uasin Gishu (39.9%) as the greatest challenge in the adoption of SFRT technologies. Credit schemes that offer loans with low interest rates should be established to enable farmers have access to credit.

Assessing Information Needs of Final Year Diploma Students at Kitale Polytechnic Library, Trans-Nzoia County, Kenya

This study assessed information needs of final year diploma students and the aspects explored were the adequacy, relevance, access and challenges faced in the use of the information resources. The study was limited to Kitale polytechnic library and the focus was the information that students seek to satisfy their information needs. The theory adopted for this study was the Principle of Least Effort that was developed by George Kengsley and explored in a study of library use of graduate students by Zao Lang. The independent variable was information needs and library user satisfaction was the dependent variable. Access and use of information resources, information literacy level and staff skills and competencies were the intervening variables. A descriptive research design was adopted to describe the level of students’ information needs and use of the library. Qualitative method was used to collect textual data and quantitative method was used to collect numerical data. The target population of 426 library staff members and final year diploma students based on the polytechnic management records was purposively sampled for study. A sample size of 68 participants was selected for study. The main data collection tools were a structured questionnaire and an interview schedule which targeted students and key informants (library staff) respectively. A pilot study was conducted at Eldoret National Polytechnic. This involved four library staff members and four diploma students who were in their final year of study. Validity was sought by use of expert knowledge in the field of information science to ascertain accuracy of the research instruments and the split half method was used to achieve reliability of the instruments and information collected. The researcher used interview to collect data from the library staff and questionnaires were employed to collect data from the sampled students. Qualitative data was analyzed thematically while quantitative data was analyzed to generate percentages, frequency distribution tables and charts. The results established that majority of students need information for academic purposes while others use it for other information related requirements. The study also revealed that the library collection does not adequately cater for the information needs of students and it was further established that most of the library information resources are rarely relevant to students’ information needs. The study concludes that most polytechnics are not keen on issues related to limited resources, staffing and the quality of information resources and services which negatively affect students in the library. The study recommended that polytechnic policy developers should formulate library policies that are not only academically inclined but also aimed at promoting other information related purposes. The study also recommended that the Institutional management should increase library allocation of resources to ensure improved equipping of a balanced library collection that addresses the diverse information needs of students. The study further recommended that polytechnic library management should enhance its acquisition policy to help acquire information resources from publishers that are more relevant to students’ education and courses of study. The study should be useful to TVET department of the Ministry of Education in their quality assurance programs to formulate policies for polytechnics that maintain high standards of libraries and quality information services for students. The study further recommended that another study should be undertaken to explore more on the use of Wi-Fi in the provision of information services for polytechnic students; an area that deems necessary based on the studies that have been highlighted in this research.

County level maize yield estimation using artificial neural network

Maize yield estimates are useful for county food security preparedness. Techniques such as regression and simulation have been used by various studies to model and predict maize yield. This study used a feed-forward, back propagation artificial neural network with levenberg-marquardt algorithm for training. Artificial neural networks framework was chosen because its a data driven method that is relatively less widely used in county level yield prediction. Moreover, neural networks has key merits, such as require less formal statistical training, ability to detect nonlinear relationships by identifying likely interactions between variables and the availability of multiple training algorithms. We modelled historical maize yield between 2005–2016 as function of satellite derived precipitation, temperature, reference crop evapotranspiration, soil moisture and normalized difference vegetation index (NDVI) to predict maize yields at pixel level. The data were obtained with a spatial resolution of $$\approx $$ 4 km and subsequently, the predictions was done at $$\approx $$ 4 km pixel size. The historical reference maize yield data was divided into two sets for model training and validation. The model predicted maize yield with $$R^2$$ and root mean square error of 0.76 and 0.038 MT/ha in Trans-Nzoia county and 0.86 and 0.016 MT/ha, respectively, in Nakuru county. These findings shows a promising future for applications targeting to rapidly assess county level food preparedness in Kenya because maize is a major staple food.

Assessing the hospital surge capacity of the Kenyan health system in the face of the COVID-19 pandemic.

IntroductionThe COVID-19 pandemic will test the capacity of health systems worldwide and especially so in low- and middle-income countries. The objective of this study was to assess the surge capacity of the Kenyan of the Kenyan health system in terms of general hospital and ICU beds in the face of the COVID-19 pandemic.MethodsWe assumed that 2% of the Kenyan population get symptomatic infection by SARS-Cov-2 based on modelled estimates for Kenya and determined the health system surge capacity for COVID-19 under three transmission curve scenarios, 6, 12, and 18 months. We estimated four measures of hospital surge capacity namely: 1) hospital bed surge capacity 2) ICU bed surge capacity 3) Hospital bed tipping point, and 5) ICU bed tipping point. We computed this nationally and for all the 47 county governments.ResultsThe capacity of Kenyan hospitals to absorb increases in caseload due to COVID-19 is constrained by the availability of oxygen, with only 58% of hospital beds in hospitals with oxygen supply. There is substantial variation in hospital bed surge capacity across counties. For example, under the 6 months transmission scenario, the percentage of available general hospital beds that would be taken up by COVID-19 cases varied from 12% Tharaka Nithi county, to 145% in Trans Nzoia county. Kenya faces substantial gaps in ICU beds and ventilator capacity. Only 22 out of the 47 counties have at least 1 ICU unit. Kenya will need an additional 1,511 ICU beds and 1,609 ventilators (6 months transmission curve) to 374 ICU beds and 472 ventilators (18 months transmission curve) to absorb caseloads due to COVID-19.ConclusionSignificant gaps exist in Kenya’s capacity for hospitals to accommodate a potential surge in caseload due to COVID-19. Alongside efforts to slow and supress the transmission of the infection, the Kenyan government will need to implement adaptive measures and additional investments to expand the hospital surge capacity for COVID-19. Additional investments will however need to be strategically prioritized to focus on strengthening essential services first, such as oxygen availability before higher cost investments such as ICU beds and ventilators.

Influence of Participatory Project Initiation on Sustainable Forest Management in Saboti, Trans-Nzoia County, Kenya

Forestry related projects fail due to the lack of participation by the community during the initiation stage. This further leads to unsustainable management of forests. This study was undertaken to examine how participatory project initiation influences sustainable forest management in Saboti forest in Trans-Nzoia County, Kenya. Participatory Development Theory guided this study. The explanatory research design was adopted. The target population was 2600 community forest association (CFA) members and 15 Kenya Forest Officers. Census sampling was used in the sampling of Kenya forest Officers and simple random sampling to select community forest management members. The sample size was 347 community forest management members and 15 Kenya forest Officers. Data were collected using questionnaires and through interview. Data were analyzed using descriptive and inferential statistics. Presentation of findings was carried out using tables. There was a significant influence of participatory project initiation on sustainable forest management (SFM) (r = 0.700, p=0.00). This implies that an increase in participatory project initiation improved sustainable forest management in Saboti. Participatory project initiation had a significant influence on sustainable forest management. The community participation in initiation had a significant influence on sustainable forest management. There is need for forest management to involve the community members during the initiation stage of the projects in order to achieve sustainable forest management.

Smartphone-Guided Algorithms for Use by Community Volunteers to Screen and Refer People With Eye Problems in Trans Nzoia County, Kenya: Development and Validation Study

BackgroundThe provision of eye care services is currently insufficient to meet the requirements of eye care. Many people remain unnecessarily visually impaired or at risk of becoming so because of treatable or preventable eye conditions. A lack of access and awareness of services is, in large part, a key barrier to handle this unmet need.ObjectiveThis study aimed to assess whether utilizing novel smartphone-based clinical algorithms can task-shift eye screening to community volunteers (CVs) to accurately identify and refer patients to primary eye care services. In particular, we developed the Peek Community Screening app and assessed its validity in making referral decisions for patients with eye problems.MethodsWe developed a smartphone-based clinical algorithm (the Peek Community Screening app) using age, distance vision, near vision, and pain as referral criteria. We then compared CVs’ referral decisions using this app with those made by an experienced ophthalmic clinical officer (OCO), which was the reference standard. The same participants were assessed by a trained CV using the app and by an OCO using standard outreach equipment. The outcome was the proportion of all decisions that were correct when compared with that of the OCO.ResultsThe required sensitivity and specificity for the Peek Community Screening app were achieved after seven iterations. In the seventh iteration, the OCO identified referable eye problems in 65.9% (378/574) of the participants. CVs correctly identified 344 of 378 (sensitivity 91.0%; 95% CI 87.7%-93.7%) of the cases and correctly identified 153 of 196 (specificity 78.1%; 95% CI 71.6%-83.6%) cases as not having a referable eye problem. The positive predictive value was 88.9% (95% CI 85.3%-91.8%), and the negative predictive value was 81.8% (95% CI 75.5%-87.1%).ConclusionsDevelopment of such an algorithm is feasible; however, it requires considerable effort and resources. CVs can accurately use the Peek Community Screening app to identify and refer people with eye problems. An iterative design process is necessary to ensure validity in the local context.

Determinants of Smallholder Maize Farmers’ Choice of Selling Point: A Case of Kwanza District, Trans-Nzoia County, Kenya

Commercialization of the smallholder maize sector in Kenya necessitates improving the ability of farmers to efficiently participate in both the formal and informal maize markets. Smallholder maize farmers of Kwanza district, Trans Nzoia County, however, have limited access to formal maize markets. This limits their competitiveness in the market hence a reduction in their returns. This study was aimed at assessing the factors that influence smallholder maize farmers’ participation in formal maize markets in the region. Multistage sampling technique was used to select 196 smallholder maize farmers from the region. Primary data was collected using semi-structured questionnaires and the Probit model used to assess the factors influencing smallholder choice of selling point. Age of household head, household size and source of market information negatively influenced the probability of the farmers selling through formal maize markets. Education level, access to credit, sorting produce, tarpaulin ownership and output price however positively influenced the probability of selling through the formal maize markets. The study recommends policies that ensure the availability and access of appropriate market information. Farmers could also be assisted in the acquisition of tarpaulin used for drying maize and other necessary infrastructure to avoid losses due to the poor post-harvest handling of their output. This will greatly help in commercialising the smallholder maize sector in the region. Keywords : Formal maize markets, Informal maize markets, Market participation, Transaction costs DOI: 10.7176/JESD/11-10-17 Publication date: May 31 st 2020

Influence of Entrepreneur’s Personal Characteristics in Entrepreneurial Networking on Growth of SMEs in Trans Nzoia County, Kenya

The growth of SMEs increases their potential of creating jobs, poverty alleviation, creating enterprising culture and economic growth rate. However, the growth of SMEs has been a concern to many stakeholders worldwide including government, scholars, SME operators and employees. In Kenya, majority of SMEs collapse before their third anniversary and those that remain majority collapse after five years. Thus there is a need to address low growth and high failure rate among SMEs. Entrepreneurial networking is one strategy that may influence growth of SMEs. This study was not only informed by low growth among the SMEs in various sectors but also by mixed results and contentious debate on effects of entrepreneur’s personal characteristics in entrepreneurial networking on growth of SMEs. The objective of the study was to determine the influence of entrepreneurs’ personal characteristics in entrepreneurial networking on growth of SMEs. This study was guided by entrepreneurship theory and entrepreneurial networking theory. The study employed a mixed research design: quantitative and qualitative approaches. Stratified and simple sampling techniques were employed to obtain 363 SMEs from 2,354 SMEs registered by Trans Nzoia County in Kenya. The SMEs were distributed in the following subsectors of whole trade, retail trade, manufacturing services, restaurant and agriculture. The data collection instruments were questionnaires. The questionnaires were self-administered to SME operators in Trans Nzoia county Kenya. Statistical Package of Social Science (SPSS) was used to analyze data. Descriptive statistics was used to summarize data. Inferential statistic (regressions) was employed in analysis. The study revealed that entrepreneurs’ characteristics (entrepreneurial orientation, education, age and networking skills)in entrepreneurial networking had positive significant influence on growth of SMEs. The study recommends entrepreneurs should embrace entrepreneurial orientation elements in networking to enhance growth of SMEs.

Qualitative exploration of perceived benefits of care and barriers influencing HIV care in trans Nzoia, Kenya

BackgroundSubstantial efforts have been made to ensure people living with HIV (PLHIV) are linked to and retained in care but many challenges deter care utilization. We report perceived benefits of seeking HIV care and barriers to HIV care that were identified through a formative assessment conducted to advise the development of an alternative care model to deliver antiretroviral treatment therapy (ART) in Trans Nzoia County, Kenya.MethodsData were collected in 2015 through key informant interviews (KIIs), in-depth interviews (IDIs), and focus group discussions (FGDs). The study involved 55 participants of whom 53% were female. Ten KIIs provided community contextual information and viewpoints on the HIV epidemic in Trans Nzoia County while 20 PLHIV (10 male and 10 female) participated in IDIs. Twenty-five individuals living with HIV participated in four FGDs - two groups for men and two for women. Key informants were purposively selected, while every third patient above 18 years at the Kitale HIV Clinic was invited to share their HIV care experience through IDIs or FGDs. Trained research assistants moderated all sessions and audio recordings were transcribed and analyzed thematically.ResultsFindings showed that PLHIV in Trans Nzoia County used both conventional and complementary alternative care for HIV; however, public health facilities were preferred. Popular perceived benefits of adopting care were relief from symptoms and the chance to live longer. Benefits of care uptake included weight gain, renewed energy, and positive behavior change. Individual-level barriers to HIV care included lack of money and food, use of alternative care, negative side effects of ART, denial, and disclosure difficulties. At the community level, stigma, limited social support for conventional HIV treatment, and poor means of transport were reported. The health system barriers were limited supplies and staff, long distance to conventional HIV care, and unprofessional providers.ConclusionsDiverse individual, community and health system barriers continue to affect HIV care-seeking efforts in Kenya. Appreciation of context and lived experiences allows for development of realistic care models.

Job Satisfaction among Health-Care Professionals in Selected Public Hospitals in Trans-Nzoia County, Kenya

A thesis submitted in Partial Fulfilment of the Requirement for the Award of the Degree of Master of Science in (Health Management) in the School of Public Health and Applied Human Sciences of Kenyatta University, March, 2021

Ecosystem-based Adaptation to Climate Change – Policy Making and Institutional Framework in Kenya’s Mt. Elgon Forest Ecosystem

Ecosystem-based Adaptation (EbA) is a strategy that relies on forest landscape’s biodiversity management and restoration to enhance the sustainable production and supply of ecosystem goods and services as alternative livelihoods to cushion the society against the negative impacts of climate change. As climate change becomes a reality, adaptation measures which are cost effective and economically beneficial are urgently required. Mount Elgon ecosystem in the western region of Kenya has EbA characteristics which could offer longer term solutions to adaptation to climate change impacts while providing a range of other benefits in terms of ecosystem goods and services. This paper established the existing capacities for Ecosystem based adaptation inclusion in the sub-national adaptation plans and policies in order to improve resilience to climate change impacts in the Mt. Elgon ecosystem. To achieve this, a descriptive survey was carried involving 405 household and 51 government and civil society respondent drawn from Saboti, Kiminini, Endebess and Kwanza sub-counties, Transnzoia County in Kenya. Results showed that there were good institutional representations in Mt. Elgon ecosystem with line ministries largely being responsible (63.4%) for the management of the individual natural resources that occur in the Mt. Elgon ecosystem while a few others were either co-managed (9.7%) or managed by the County Government of Transnzoia (9.7%). Majority (77%) of household respondents observed uncoordinated approach in ecosystem management. This should be addressed in order to increase ecosystem health which eventually leads to enhanced EbA services. Majority (73.2%) of government and civil society respondents cite inter-sectoral policy inconsistencies and conflicts as contributors to degradation of ecosystem health in the study area. This too has impacted negatively on EbA. A major conclusion in the study was that consolidation and harmonization of ecosystem policies in the Mt. Elgon’s ecosystem will lead to a healthy landscape that provides sustainable EbA services.

Impact of Motivation on Employee Performance in Kenya, A Case of Prisons Service in Trans-Nzoia County

Impact of Motivation on Employee Performance in Kenya, A Case of Prisons Service in Trans-Nzoia County

Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services in Trans Nzoia County, Kenya: study protocol for a cluster randomised controlled trial

BackgroundGlobally, eye care provision is currently insufficient to meet the requirement for eye care services. Lack of access and awareness are key barriers to specialist services; in addition, specialist services are over-utilised by people with conditions that could be managed in the community or primary care. In combination, these lead to a large unmet need for eye health provision.We have developed a validated smartphone-based screening algorithm (Peek Community Screening App). The application (App) is part of the Peek Community Eye Health system (Peek CEH) that enables Community Volunteers (CV) to make referral decisions about patients with eye problems. It generates referrals, automated short messages service (SMS) notifications to patients or guardians and has a program dashboard for visualising service delivery.We hypothesise that a greater proportion of people with eye problems will be identified using the Peek CEH system and that there will be increased uptake of referrals, compared to those identified and referred using the current community screening approaches.Study designA single masked, cluster randomised controlled trial design will be used. The unit of randomisation will be the ‘community unit’, defined as a dispensary or health centre with its catchment population. The community units will be allocated to receive either the intervention (Peek CEH system) or the current care (periodic health centre-based outreach clinics with onward referral for further treatment). In both arms, a triage clinic will be held at the link health facility four weeks from sensitisation, where attendance will be ascertained. During triage, participants will be assessed and treated and, if necessary, referred onwards to Kitale Eye Unit.DiscussionWe aim to evaluate a M-health system (Peek CEH) geared towards reducing avoidable blindness through early identification and improved adherence to referral for those with eye problems and reducing demand at secondary care for conditions that can be managed effectively at primary care level.Trial registrationThe Pan African Clinical Trials Registry (PACTR), 201807329096632. Registered on 8 June 2018.

Strategies for Improving Adult Education Participation in Kenya: A Case of Trans-nzoia East Sub-County

The Government of Kenya remains committed to enhancing literacy and numeracy to all her citizens. This is through the provision of adult education to cater for out of school youth and adults who missed out of basic education in line with the country’s educational objectives and the vision 2030. However, participation in adult education remains low despite high number of illiterate adult in the county. This paper shows the assessment of participation in adult education and the determined the strategies for its improvement in Kenya. It identifies the characteristics of adult learners, their reasons for learning, and the barriers to the effectiveness of the program. The determined strategies to improve participation in adult education include: Provision of civic education on adult education, Provision of physical facilities and program support materials, use of various innovative teaching methods, making adult learning practices highly motivating, imparting knowledge and skills easily applicable in life situations and empowering adult learners by facilitating access to new income sources. The study was carried out in Trans-Nzoia East Sub-county, Trans-Nzoia County, Kenya. It adopted a descriptive survey research design. The study sample incorporated: adult learners, adult education teachers and the Sub-County Director of Adult and Continuing Education (DACE). A sample size of 97 respondents was identified through random (stratified and simple) and purposive sampling. Data was collected using closed ended and open ended questionnaires, and a semi-structured interview. Data was analyzed using descriptive statistics: frequencies and percentages and presented in tables. Based on the findings of the study, this paper recommends more effort in the policy making, organization and implementation of adult education to realize improved participation.

Factors Affecting the Implementation of Procurement Policies and Procedures in Public Entities in Kenya, A Case of Trans-Nzoia County

Factors Affecting the Implementation of Procurement Policies and Procedures in Public Entities in Kenya, A Case of Trans-Nzoia County

Influence of Process Plan on Agricultural Cooperative Societies Performance in Kenya

Process plan implementation plays a key role in the organizational performance especially the coffee cooperative societies. Coffee cooperative societies enable the pooling of resources towards betterment of livelihood of rural folk particularly the farmers. The study was carried out in order to establish the level of contribution of process plan towards the performance of agricultural cooperatives specifically the coffee cooperative societies in Trans Nzoia County, Kenya. The study utilized structured questionnaire administered to 346 coffee farmers. The respondents were arrived at using purposive and simple random sampling techniques. Data were analysed using Spearman’s correlation coefficient together with regression. It was established that process plan had positive statistical significance on the organizational performance (P &lt; 0.05), hence community development practitioners and agricultural extension officers should enhance utilization of process plan in the agricultural cooperative societies.

Effects of Socio-Cultural Factors on Use of Technology in Smallholder Dairy Commercialization Projects in Transnzoia County, Kenya

In response to population growth, diminishing income and increased land sub-division, the demand for livestock products, such as milk is growing in Trans-Nzoia County. The growing demand offers opportunities for smallholders to realize better income hence improved livelihoods. Whereas the growing demand for milk is widely recognized, the dairy sector has not been able to produce adequate milk to satisfy this demand, mainly due to low production and productivity of milk. Most development projects are directed to the smallholder farmers with a populace of 75-80% of the Agricultural Sector in the country to re-direct their energies to help change livelihoods. Projects and/or programmes have been used based on the identified needs in different approaches fill the gap to increase milk production and productivity by use of new and tested technologies. There was likelihood of low use of technologies (Smallholder Dairy Commercialization Project (SDCP) report 2016). The overall objective of this study was to look into the effects of socio-cultural factors on use of technology in smallholder dairy commercialization projects among smallholder dairy farmers in Trans Nzoia County, Kenya. It was designed to (i) to evaluate socio-cultural factors affecting the use of technology among smallholder dairy farmers; (ii) to determine extent of effects of socio-cultural factors on use of Smallholder Dairy technology; and (iii) to establish the relationship between socio-cultural factors and Smallholder Dairy farmers' technology use. Data was collected through structured questionnaire administered to a random sample of smallholder dairy groups within Dairy Commercialization Areas (DCAs). The analytical approach used was regression and correlations based on the number of variables and form of relationship; and LSD multiple mean separation, and ANOVA p-value and general linear model to analyse for differences on socio-cultural factors in technology use, excel analysis where applicable and simple percentages thereof. Graphs indicating different levels of the factors against technology use were drawn using computer program. A scatter plot of was plotted fitted with regression line, equation and coefficient of determination (R2) to determine unit measure for possible incremental and variability in use as a result of effects. The findings showed that socio-cultural factors affect technology use. Effects differ with each technology and there is relationship between socio-cultural factors and technology use. There were significant differences in use between technologies and interaction between intervening factors in use at p (&lt; 0.05). Regression equation and (R2) explained a unit of 1.4914 incremental unit offered and a 76 % variability as result of relationship between socio-cultural factors and technology use. The study therefore shall deepen the understanding on the socio-cultural factors at the levels of farm households, in the dairy industry and the institutions and policies on farmers' decision to use technologies. This will provide insights into the levels of use, technologies of preference and relative factors affecting them thereof; both technical and farmer levels.