Commonly cited incentives in the community implementation of the emergency maternal and newborn care study in western Kenya.

BACKGROUND: Mortality of mothers and newborns is an important public health problem in low-income countries. In the rural setting, implementation of community based education and mobilization are strategies that have sought to reduce these mortalities. Frequently such approaches rely on volunteers within each community. OBJECTIVE: To assess the perceptions of the community volunteers in rural Kenya as they implemented the EmONC program and to identify the incentives that could result in their sustained engagement in the project. METHOD: A community-based cross sectional survey was administered to all volunteers involved in the study. Data were collected using a self-administered supervision tool from all the 881 volunteers. RESULTS: 881 surveys were completed. 769 respondents requested some form of incentive; 200 (26%) were for monetary allowance, 149 (19.4%) were for a bicycle to be used for transportation, 119 (15.5%) were for uniforms for identification, 88 (11.4%) were for provision of training materials, 81(10.5%) were for training in Home based Life Saving Skills (HBLSS), 57(7.4%) were for provision of first AID kits, and 39(5%) were for provision of training more facilitators, 36(4.7%) were for provision of free medication. CONCLUSION: Monetary allowances, improved transportation and some sort of identification are the main incentives cited by the respondents in this context.

NUTRIENT INTAKE AMONG PREGNANT TEENAGE GIRLS ATTENDING ANTE-NATAL CLINICS IN TWO HEALTH FACILITIES IN BUNGOMA SOUTH DISTRICT, WESTERN KENYA.

OBJECTIVE: To assess the adequacy of nutrientintake including proteins, energy, calcium, iron, folate and vitamin C and identify the factors associated with nutrient intake. DESIGN: Cross sectional study. SETTING: Healthy facility based. Bungoma District Hospital and Bumula Health centre. SUBJECTS: Teenage pregnant girls attending Antenatal Clinic participated after providing written consent, with girls under 18 years being considered as emancipated minors. A standardised interviewer administered Food Frequency Questionnaire was used to asses the dietary intake. Nutrient calculator was used to determine the nutrient intake of the study participant. RESULTS: The intakes of all selected nutrients were significantly lower than the RDA. Protein intake was significantly associated with Education (OR: 0.537; 95% CI: 0.318-0.907), income (OR: 0.049; 95% CI: 0.919-0.128) and perceived food shortage (OR: 0.617; 95% CI: 0.389-0.890). Energy intake was significantly associated with income (p = 0.007, OR: 2.103; 95%CI: 1.225-3.608). Iron intake was significantly associated with perceived food shortage (OR: 2.548; 95% CI: 1.632-3.980). Hookworm affected calcium intake (OR: 3.074; 95% CI: 1.089-8.698) and malaria parasites affected folate intake (OR: 0.355; 95% CI: 0.226-0.557). Those with hookworm were 3 times more likely to have inadequate calcium intake as compared to those without. CONCLUSION: All the nutrients selected were lower than the Required Dietary Allowance. Level of education, income, Hookworm and malaria affected intake of various nutrients.