RÉSUMÉ
Background: Insufficient contraceptive use among 15–25-year-olds leads to unwanted pregnancies, unsafe abortions, disabilities, infant mortality, and high teen pregnancy rates, with Kenya's high rate of teen pregnancies despite efforts. Methods: Analytical cross-sectional study design was used and 361 teenage girls between 15-19 years in the selected electoral wards at Kuria West Sub County in Migori County, Kenya. Data was collected using administered structured questionnaire, and key informant interview. Quantitative data analysis was conducted using statistical package for the social sciences (SPSS) version 26.0 and involved univariate and bivariate analysis. Bivariate analysis was done through logistic regression was used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis. Results: More than two third 249 (69.0%) of respondents had utilized contraceptives such as condoms (33.3%), injection (25.3%), implants (22.9%), and pills (15.7%). Religious affiliation (?2=5.576, df=1, p=0.018) was significantly associated with utilization of the contraceptives. Additionally, religion supports the use of contraceptives (?2=0.061, df=1, p=0.804), culture prohibits the use of contraceptives (?2=1.496, df=2, p=0.473), discuss contraceptive methods with family (?2=1.423, df=2, p=0.491), and difficult to engage in sexual discussions with my parents/guardian (?2=2.707, df=2, p=0.258) had no statistical relationship with utilization of the contraceptives. Conclusions: Central and county government, stakeholders and NGOs should organize health education targeting parents, community and the society which should include, schedules and benefits/importance of utilization of FP services to counter the cultural beliefs.
RÉSUMÉ
Background: Nakuru county has 41.9 neonatal deaths per 1000 live births, more than double the national average of 19. This study examined Nakuru level 5 hospital neonatal mortality risk factors. Methods: A retrospective mismatched case-control study was used. The 429 neonates (143 cases and 286 controls) were estimated assuming a 1:2 case-to-control ratio and 18% prevalence of exposure among controls. Binary logistic regression measured dependent-independent variable correlation. Results: The study found that high parity, high number of stillbirths, positive HIV, HBsAg, syphilis, pregnancy-induced hypertension, antepartum hemorrhage, PROM 18hours, and maternal peri-partum increased the risk of neonatal. Similarly, mothers who had fewer ANC visits throughout their pregnancy had a higher risk of neonatal mortality compared to mothers who attended more than three ANC clinics, with mortality risk reducing by 69% and 59% for 1-2 visits and more than 3 visits, respectively, compared to non-attendance. Vaginal aided birth had an or of 2.188 and vaginal unassisted OR=4.533 compared to caesarian delivery. Antibiotics and prenatal dexamethasone decreased maternal mortality. Antibiotics lowered NMR or 0.381. Newborns admitted from referral facilities or labor wards had or 1.11 and or 6.220 death rates. Low birth weight, admission weight, gain weeks, and congenital defects increased mortality. In this study, birthweight decreased newborn mortality. Conclusions: The study concluded that maternal characteristics, neonatal complications are key to improving neonatal outcomes. The study recommends regular training of staff working in the maternity and newborn unit on emergency care and neonatal resuscitation.
RÉSUMÉ
Background: A large percentage of the new cases of HIV/AIDs in Kenya are attributed to Key Populations (KPs). In Kenya, KPs contribute 33% of all new infections of HIV. It is with this realization that in 2017 the government of Kenya launched The Pre-Exposure Prophylaxis (PrEP) for HIV. The study aimed at assessing the factors influencing adherence to PrEP by KPs in Matayos sub-county, Busia County, Kenya. Methods: An analytical cross-sectional study that utilized a mixed-method data collection approach (n=343) was used to assessing the factors influencing adherence to PrEP by KPs in Matayos sub-county, Busia County, Kenya. Results: The level of adherence to PrEP using the Morisky Medical Adherence Scale-4 was established to be 37% among all KPs and 36%, 37% and 52% among CSWs, MSMs and PWIDs respectively. Chi-square analysis revealed significant relationship between Level of education (p=0.05), marital status (p=0.001), KP category (p=0.034), occupation (p=0.014), stigma (p=0.00), the perceptions of side effects (p=0.011), facility accessibility (P= 0.00), side effects (p=0.001) and adherence to PrEP. Among the MSMs condom use was established to have association to PrEP adherence (p=0.00). Conclusions: The study concluded that socio-demographic, individual characteristics, and clinical factors influence adherence to pre-exposure prophylaxis among key populations. The study recommended that key populations need more information on how to use pre-exposure prophylaxis, how it works, the side effects, what to do in case they experience the side effects and why adherence to pre-exposure prophylaxis is important.