Association between Socioeconomic and Psychological Experiences of Parents with Children on Leukemia Treatment in Kenyatta National Hospital, Kenya.

OBJECTIVE: The survival rate for children with leukemia has increased dramatically since the late 1990s; treatment effects of the disease can be extremely stressful for families. Research on psychological and socioeconomic effects of leukemia treatment had been conducted in Western countries, but little is known within Africa including Kenya. METHODS: This was a cross-sectional study with a sample of 62 out of 72 parents of children undergoing leukemia treatment at Kenyatta National Hospital. Data were collected between May and August 2015 using structured questionnaires while qualitative data were collected using focus group discussions. This manuscript is based on quantitative data which were entered into EpiData version 3.1 and analyzed using SPSS version 20. Psychological distress index was created by counting the number of psychological experiences reported by respondents. Kendall's tau-b was used to test the association between the psychological distress index and socioeconomic characteristics; P ≤ 0.05 was considered statistically significant. RESULTS: The respondents experienced anxiety, shock, and fatigue. Spending a higher proportion of family's income was associated with higher psychological distress index (P = 0.009). The economic challenge led to significantly heightened tension in the family (P = 0.021). CONCLUSIONS: Financial challenge is a major cause of psychological distress thus needs for financial support through collaboration with government institutions, for example, NHIF, development agencies, and nongovernment organization who can contribute toward the treatment cost. Need to decentralize effective leukemia treatment centers. Psychological support and counseling should be done to alleviate tension. The nurse needs to be empathetic when caring for the child and family as well as to apply the ethical principles of justice and beneficence so that the child gets the best care despite the financial challenge.

Factors associated with acceptability of HIV self-testing among health care workers in Kenya.

Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIVST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing. A post-intervention survey was conducted among 765 HCWs. Forty-one percent attended the information session; of those, 89% took the HIVST kits and of those, 85% self-tested. Thirty-four percent of surveyed HCWs used the HIVST to test themselves. Of those who took the HIVST kit and had partners, 73% gave the kit to their partner and 86% of them indicated their partner self-tested. Factors positively associated with use of the HIVST on self were being female, being single, and being a HCW from Homa Bay Hospital (located in a high HIV prevalence area). HIVST is acceptable to HCWs and their partners. However, strategies are needed to increase HCWs attendance at pre-implementation information sessions.

Safeguarding maternal and newborn health: improving the quality of postnatal care in Kenya.

OBJECTIVE: To assess changes in the quality of care following the introduction of a new postnatal package. DESIGN: Using a pre-test, post test design to observe client-provider interactions with women 0-6 weeks postpartum. SETTING: Four health facilities in a rural district, eastern Kenya. PARTICIPANTS: Health providers and postpartum women. INTERVENTION: Introduction of comprehensive postnatal package of care, with three targeted assessments within 48 h of birth, 1-2 weeks and 6 weeks, to providers working in maternity and maternal and child health clinics. Main outcome measure Improved quality of postnatal counselling. RESULTS: Increased mean scores for counselling on danger signs in the newborn (0.24-1.39) and infant feeding (1.33-2.19) were noted. The total quality of care index for the newborn increased overall but remained lower than desired (from 3.37 to 6.45 out of 11). Essential maternal care index improved (3.4-8.72 out of 23). More women accepted a family planning method at 6 weeks (35-63%). CONCLUSIONS: The introduction of new comprehensive postnatal care package improved performance of providers in counselling in maternal and newborn complications, infant feeding and family planning. Additional studies looking at the postpartum family planning needs for women living with HIV would also be useful. However, providers would benefit from additional clinical skills for managing maternal and newborn complications during the critical period following childbirth.