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Background: Female Genital Mutilation/Cutting (FGM/C) is a harmful traditional practice with severe health complications, deeply rooted in many sub-Saharan African countries. In Kenya, the prevalence of FGM/C is 15% in women aged between 15 and 49 years. The Kenyan Somalis practice FGM/C with a prevalence above 90%. FGM/C practice continues to persist in Alungu village, Mandera County in the North Eastern of Kenya despite efforts by anti-FGM programs. However, the underlying factors behind FGM practice in the area have not been explored. Objective: To assess factors contributing to female genital mutilation practice among women living in Alungu village of Mandera County, Kenya. Methods and materials: This study utilised a descriptive cross sectional design. The study population was women of reproductive age (from 18 to 49 years) who resided in Alungu village in Mandera County, Kenya. A study sample of 98 women was selected using simple random sampling technique. Data was collected using a researcher-administered questionnaire and analysed using the Statistical Package for Social Science (SPSS). Results: Most of the respondents were aged 35 - 44 (45.8%), married (100%), had no formal education (74.7%) and had no formal employment (89.2%). All participants agreed that traditional beliefs, customs and rite of passage to womanhood contributed to FGM, 90.4% of the participants acknowledged that FGM is a symbol of ethnic identity and inclusivity. Factors affecting prevention of and response to FGM were low involvement of women in anti-FGM programs (91.6%); support for FGM by local leaders and elders (100%); failure by authorities to take action against those perpetuating FGM (100%); indifference to FGM practice continuation among local religious and political leaders (96.4%) and poor enforcement of existing laws against FGM (100%). Conclusion: A wide range of socio-cultural factors did contribute to FGM practice among women living in Alungu village, Mandera County.
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BACKGROUND: Female genital mutilation (FGM) is one of the most harmful traditions still practiced in many parts of the developing world, including Kenya. The practice leads to permanent and irreversible health damages; however, knowledge and attitude of women towards its obstetric effects is scarce. AIM: The objective of this study was to determine knowledge and attitude of women towards obstetric effects of FGM among Maasai women. METHODS: A hospital-based cross-sectional study was conducted at Loitokitok Sub-County Hospital among 64 Maasai women who had undergone FGM. Systematic sampling was employed to identify the respondents. Data were collected using a pretested semistructured questionnaire and analyzed through Statistical Package for the Social Sciences (SPSS) version 20.0 based on frequencies and percentages. Qualitative data were coded and categorized and thematic analysis was done. RESULTS: Half of the women were knowledgeable on obstetric effects of FGM. Majority of them, 81% (n=52), sustained perineal tears during childbirth while 53% (n=34) had postpartum hemorrhage. Majority of the respondents, 81% (n=51), had negative attitude towards FGM and 87% (n=31) would not encourage their daughters to be circumcised. Most of them, 64% (n=23), disagreed that circumcision made one a respectable woman. CONCLUSION: Obstetric effects of FGM were fairly known and there was negative attitude towards FGM practice.
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BACKGROUND: Death of a baby in-utero is a very devastating event to the mother and the family. Most stillbirths occur during labor and birth with other deaths occurring during the antenatal period. Millions of families experience stillbirths, yet these deaths remain uncounted, and policies have not been clearly stipulated to address this issue. The aim of the study was to identify the possible causes of stillbirths as recorded in the medical records. METHODS: A retrospective study looking at medical records of women who experienced stillbirths between 1(st) January 2009 and 31(st) December 2013 at Nyeri Provincial General Hospital, Kenya. The hospital records containing cases of stillbirths were retrieved and data abstraction forms were used to collect data and information. RESULTS: Both fresh and macerated stillbirths were equally common. The stillbirth rate was 12.2 per 1,000 births. There was significant association between stillbirths and the clients who were referred and reason for referral, (p=0.029) and (p=0.005), respectively. The number of ANC visits during pregnancy was also significant (p=0.05). Mode of delivery and the reason for cesarean section were significantly associated with stillbirths, (p=0.003) and (p=0.032), respectively. The type of labor and delivery complications experienced was associated with stillbirths (p= 0.022). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: There were several factors associated with stillbirths thus efforts should be made to establish approaches aimed at prevention. Addressing the causes of stillbirths will contribute to reduction of perinatal mortality.
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BACKGROUND: Globally, life-threatening diseases are on the rise, indicating the need for palliative care, an approach of ensuring quality of life for the patient and his or her family. Education and training is one of the ways of ensuring staff competency in providing palliative care. AIMS: This study sought to explore challenges faced by both public and private faith-based training institutions offering palliative care. METHODS: This was a qualitative study in both public and private training institutions, which were selected randomly. Six institutions were selected for the study. One palliative care trainer in each institution was interviewed using a semi-structured interview guide. Information was recorded, transcribed and thematic analysis was done. Data were presented in the form of narration. RESULTS: Many institutions had incorporated palliative care into their curricula. However, these institutions faced challenges, including few allocated hours and few members of staff trained in palliative care. Clinical area employees were not well equipped with knowledge on palliative care. CONCLUSION: Challenges exist in both public and private institutions. Institutions should allow for more training hours in palliative care.
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Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação , Ensino , Currículo , Hospitais Privados , Hospitais Públicos , Humanos , Entrevistas como Assunto , QuêniaRESUMO
INTRODUCTION: Uncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Data on adequacy of blood pressure control in Kenya is scarce. This study aimed at assessing the level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital. METHODS: Data regarding blood pressure, antihypertensive medication use, and comorbidities was abstracted from medical records of 452 hypertensive patients seen in Nyeri Provincial General Hospital between January and March 2013. Adequate blood pressure control was defined as a systolic pressure<140 mmHg (<130 mmHg for diabetic hypertensive patients) and a diastolic pressure<90 mmHg (<80 mmHg for diabetic hypertensive patients). Data was entered and analyzed using STATA 9 (StataCorp, Inc, Texas, USA). RESULTS: Only 33.4% of patients had a blood pressure within the recommended limits. In multivariate analysis, using a calcium channel blocker was significantly associated with good blood pressure control (OR, 2.1; 95% CI, 1.4, 3.3). On the other hand, old age (≥60 years), being diabetic, and the use of three or more antihypertensive drugs were associated with reduced odds of good blood pressure control (OR, 0.64; 95% CI, 0.43; OR, 0.54; 95% CI, 0.36, 0.81; and OR, 0.41; 95% CI, 0.26, 0.64, respectively). CONCLUSION: Poorly controlled blood pressure is an important public health concern among hypertensive patients in this region. Elderly patients, those with diabetes, and those on multidrug regimens are at higher risk for poor blood pressure control and warrant closer attention.
