"Promote locally led initiatives to fight female genital mutilation/cutting (FGM/C)" lessons from anti-FGM/C advocates in rural Kenya.

BACKGROUND: Female Genital Mutilation/cutting (FGM/C) is a tradition rooted in culture and involves the partial or total removal or other injury to the female genital organs for non-medical reasons. In Kenya, initiatives to abandon the practice have included 'alternative' ritualistic programmes (ARPs) combined with intensive community sensitisation about FGM/C to achieve attitudinal and behavioural changes. While there are indications of the effectiveness of these interventions, FGM/C continues to be practiced within certain groups in Kenya. This study explored the views of anti-FGM/C advocates on the barriers and facilitators to tackling FGM/C within the Meru community in Kenya. METHODS: Data were obtained using 4 Focus Groups (FGs) with 30 anti-FGM/C advocates from Tigania East and West in Meru county. Thematic framework analysis guided the analysis based on four main questions: 1) How has the cultural meaning of FGM/C evolved over time? 2) What are the perceptions in relation to the effectiveness of anti-FGM/C interventions? 3) How effective are interventions and campaigns to end FGM/C in Meru county? 4) What actions are perceived as the most likely to bring about change? RESULTS: There has been a substantial shift in the culture of FGM/C and the number of families carrying out the practice in Meru county has decreased in recent years. Participants noted five actions likely to bring about change; 1) reviving and supporting ARPs, 2) encouraging fathers' involvement in the upbringing of their daughters,3) inclusion of the topic of FGM/C in the current education curriculum and public fora, 4) strengthening the community policing strategy -Nyumba Kumi, 5) and setting up community centers for orphans. CONCLUSION: Our findings demonstrate the significance of locally led initiatives to fight FGM/C. It also became clear that change would have to start at the family level with parents, particularly fathers, taking on a more active role in the lives of their daughters. Providing education about FGM/C to communities, particularly young men coupled with keeping girls in school appeared to be some of the most effective ways of fighting FGM/C. At the community level, the church became particularly crucial in challenging the practice of FGM/C.

Kenya and distance education: a model to advance graduate nursing.

Africa is faced with a myriad of challenges, such as HIV/AIDS, malaria, tuberculosis, and a variety of political and historical complications that have affected the educational system for advanced nursing practice. In Kenya, the current situation in the higher education sector does not give nurses an opportunity to pursue graduate education after they have acquired the basic diploma in nursing due to limited government support and the type of education system existing in the country today. Although distance education has been available in Kenya for professionals such as teachers, in public universities, this kind of opportunity is unreachable for nurses who are working and need to further their education. Nurses desire to have access to advanced practice education to equip them with the relevant knowledge to cope and address the complex health issues arising in the management and care of patients. A collaborative model is presented as a potential solution for this need. Four major constituents are identified including hospitals and agencies, communities of interest, Kenyan universities and international education partners. Each has a part to play including contributions to information, communication of opinion and expertise, money and support, infrastructure and in-kind resources. Distance education is cost-effective and will help in building capacity at various levels of nursing including leadership in clinical practice, teaching, administration and research.

Using podcasts to help students apply health informatics concepts: benefits and unintended consequences.

Despite requirements for robust health informatics education, a multitude of educators and policy analysts report that programs are not adequately preparing nurses to handle the bevy of technologies that will be a part of their practice. A series of 14 "Podcasted" exemplars were developed to help graduate online students visualize the application of health informatics concepts in real-world settings and to determine the impact of podcasting on student cognition, engagement, and satisfaction. Although no significant differences in student cognition scores or student engagement were found between course conditions, course satisfaction was significantly higher in Podcasted weeks of the course. Also, student engagement was positively correlated with aspects of course satisfaction and overall cognition scores under both course conditions. This result suggests that student engagement plays an important mediating role in improving cognition. Students' use of podcasting did produce a temporary drop in scores for one group; therefore, more research is needed to understand these unintended consequences. With distance/online education becoming mainstream, it is imperative that faculty deploy and confirm ways to improve student cognition, engagement, and satisfaction.

Kenyan nurses' involvement in managing hospitalized diabetic patients.

Diabetes is a global public health concern because the incidence, prevalence and financial burden are rapidly increasing. Clinical nursing research in developing countries is rare. This study examines nurses' involvement in the management of diabetic patients in a western Kenya Hospital. A descriptive exploratory design is used, data were collected in structured interviews with 15 registered nurses using an investigator-designed instrument. Content analysis produced eight categories of nurses' involvement in managing hospitalized diabetic patients. Facilitators and barriers to managing diabetic care are presented from the perspective of the nurse, hospital, patient, family and community. Workforce redesign is needed to cope with nursing shortages.