Self-medication with Antimicrobials Perceptions among the Households in Nyalenda Informal Settlement, Kisumu County, Kenya: Post-Community Mobilization Intervention

Self-medication is very common especially in developing countries and is documented to be associated with many health risks including antibiotic resistance.Antibiotic resistance is shrinking the range of effective antibiotics and is currently listed as a global health problem.This study investigated the perceptions of self-medication with antimicrobials (SMWA) after community mobilization intervention amongthe households in Nyalenda B, an informal settlement, within Kisumu County, Kenya.This enabled the study to establish the magnitude of SMWA and the perceptions that persist given such intervention within the region. Data was collected through structured questionnaires administered to 380 households. Focus group discussions (FGDs) were also facilitated and targeted purposively-selected 30 CHVs. Descriptive and binary logistic regression analyses were used to determine the associationbetween socio-demographic characteristics and the perceptions influencing SMWA. The study established that 316 households had used antimicrobials of which 20.9% were self-medicating with antimicrobials.Age (OR=0.647, 95% CI=0.431, 0.973, P=0.037) is significantly related to SMWA, use of NHIF for outpatient services(OR=1.772, 95% CI=0.652, 2.887, P=0.133)and use of Universal Healthcare Services (OR=1.165, 95% CI=0.922, 1.472, P=0.201)may have contributed to SMWA reduction but not significantly as compared to other socio-demographic factors. Likewise, sources of information or advice on self-medication (OR=0.732, 95% CI=0.613, 0.873, P=0.001) and illness or symptoms of illness (OR=1.324, 95% CI=1.129, 1.554, P=0.001) may significantly influence SMWA as compared to other SMWA perceptions. Community mobilization using empowerment as a strategy and implemented through participatory learning and action is a successful method for reduction of SMWA level and development of SMWA perceptions with an experiential value especially when strengthened with structural modification. SMWA is a serious problem in developing countries and so such intervention should be prolonged and continuous to offer sustained changes in public perception and attitudes towards the misuse of antimicrobials

Systems of Communicating Sexual and Reproductive Health Issues between Hearing Parents and Their Deaf Adolescent Children in Western Kenya

Background:Deaf adolescent children face greater challenges in accessing information, particularly on sexual and reproductive health (SRH) than those with other forms of disability. Parents therefore represent the first source of information for such children. However, the extent of this and systems of communication used by these parents remain largely unknown. Therefore, it is against thisbackdrop that we sought to study systems of parents communicating SRH issues to their children. Methods:A mixed method design was used to collect quantitative and qualitative data on the system of communication used by the sign-language illiterate parents respectively, their Original ResearchArticle perceptions on such discussions and the choice of system of communication. A sample size of 384 parent-child pairs was selected using systematic probability sampling for the quantitative component of the study. For the qualitative component, respondents were recruited using a purposive convenience sampling method which though non-representative, allowed the investigator to choose participants best suited for the intended objective.The study was carried out in ten schools; randomly selected from a sample frame comprising of a list of primary and secondary schools for deaf children within the former Nyanza region of western Kenya. Data was collected using anonymized questionnaires and Focus Group Discussions (FGDs).Results:Majority of the male parents 90 (23.4%) were in the age range of 51-60 years, while most female parents 134 (34.8%) were in the age category of 40-50 years. Nearly 70% (67%) of the children were in the age range of 15-19 years. Overall, use of picture came out as the main mode/format of communication (33%);with females using it more (23%) compared to males 12.3%. Lip-reading (children reading the lips of their parents), was principally used by male parents. 32(8.3%)parents falling within the age group 41-50 and 51-60 years felt that the information they had on SRH was inadequate. More so, in a qualitative interview, most parents were not satisfied that they had provided enough information to their children on matters of SRH due to communication barrier. Some of the emerging themes from the FGDs were: parents lack a proper approach of conveying SRH information to their deaf adolescent children, unresponsiveness/lack of interest by deaf adolescent children, wrong translation of information conveyed and insufficient time with their deaf adolescent children to pass across these messages.Conclusion: Children with hard hearing are less likely to get adequate information on SRH than their counterparts with no hearing impairment

Health Care Seeking Behavior among Caregivers of Sick Children Who Had Severe Malarial Anaemia

Aims: The western region in Kenya is holoendemic to malaria and experience stable P. falciparum malaria transmission. The use of health care options has a direct influence on the outcome of severe malaria. As such, the current study will assess the health care seeking behavior among caregivers of sick children who had severe malarial anaemia (SMA) inwestern Kenya.Study Design:Cross section study.Place and Duration of Study:The study was conducted at Jaramogi Odinga Oginga Teaching and Referral Hospital (JOOTRH) between September 2014 to July 2015. Methodology: It was open to all children ≤10 years (n=271) admitted and diagnosed with SMA (hemoglobin <5.0 g/dl and any density of P. falciparum. Caregivers were interviewed on the health care options before seeking care at a heath facility, when the childstarted to get sick, if they took child to another health centre/dispensary/private hospital before coming to JOOTRH Results: Majority of the caregivers interviewed, 80.07% (217) had attained Primary education. Majority of the caregivers were in the age category of19-24 75(27.67%) years and 25-29 years 75 Original ResearchArticle (27.67%). 74.90% (203) of their children were below five years and 25.09% (68) were above 5 years. 61.62% (167. Majority of the caregivers gave some remainder drugs before presenting to a heath facility 32.5% (88). A good number bought drugs at drug stores/pharmacies 27.7% (75). None visited a traditional healer. A minority used herbs 10% (27). There were no statistically significant differences between most of the pre-hospitalization measures taken s with regard to patient’s gender and age, and caretaker’s level of education. Caregivers who chose to give herbs to their sick children took longer in deciding to take their children to hospital. This was however statistically significant between those who used herbs and those who bought drugs only (median 4 days vs. 3 days, respectively, p = 0.0063). There was no significant difference in the delay of child admission at JOOTRH between caregivers who had had primary education only and those with a minimum of secondary education (p = 0.9842). Conclusion:Self-medication is a common practice before seeking care at a heath facility. There is need for community awareness for correct and comprehensive information about drawbacks associated with self-medication practices. Since safety continues to be a major issue with the use of herbal remedies, it becomes imperative, therefore, that relevant regulatory authorities put in place to ensure that all herbal medicines are safe and of suitable quality.