Browsing by Author "Maingi, Nancy"

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    Determinants of Contraceptive Uptake among Youths Aged 18-25 Years in Nakuru County
    (2016) Maingi, Nancy; Githaiga, J.; Okova, R.; Karonjo, J.; Ndungu, E.
    Introduction Globally, there are over 1.8 billion young people and nearly 90 percent of whom live in developing countries. The age-range 18 to 24 is a period when most people begin to actively explore their sexuality (UNFPA, 2009). Most people become sexually active before their 20th birthday (UNFPA, 2009). One in every 10 births and one in 10 abortions worldwide and one in six births in developing countries is to women aged between 18-19 years (UNFPA, 2009). In sub-Saharan Africa, 75 percent of young women report having had sex by age 20(UNFPA, 2009).Despite continued investments in adolescent sexual and reproductive health (SRH) programs worldwide, challenges still exist in adequately meeting the SRH information and service needs of this subset of the population. These challenges are more pronounced in sub- Saharan Africa which, among the major regions of the world, has the greatest proportion of adolescent girls who have begun childbearing (Gupta &Mahy 2003). In Kenya 15% of women age 15-19 have already had a birth while 18 percent have begun childbearing (had a live birth or are pregnant with their first child). The percentage of women who have begun childbearing increases rapidly with age, from about 3 percent among women age 15 to 40 percent among women age 19 (KDHS, 2014-15). Materials and Methods Descriptive cross-section study on youths 18-25years in the Nakuru County ; Systematic random sampling was used in selection of 189 respondents. Results The findings revealed that 59% of the respondents were married while 16% were married, 55 % were self- employed, 33 % are employed either in public or private sector while 13 % were un employed. Fifty one percent of the respondents have never used family planning .The study showed that 42.3 %of the respondents use condoms while 1.1 % use implants . Fifty three percent of the respondents said they did not use contraceptives because of religion and culture, while 19 % said they are not sexually active. Seventy four percent of the respondents learnt of contraceptives from hospital/health workers. Fifty eight percent of the respondents said the distance to the hospital was 1-5km while 42 % said it is above 5km. Majority of the respondents 56% disliked the approach used by the health. Twenty nine percent acknowledged that they had been denied FP services by health care workers because of age. Discussion and Conclusion Forty four percent of the respondents were uncomfortable with environment the services were offered. This support observation of Johnross (2002) that lack of privacy can violate women's sense of modesty and make it more difficult for them to participate actively in selecting a contraceptive method. 59 % of the respondents wait for more than 1 hour,24 % for 30 minutes while17% % said they wait for one hour before being served. Availability and accessibility of different contraceptive methods influence the use of different contraceptive methods. Demographic attributes that include age, gender, level of literacy, marital status, number of children and desire for more children are major determinants of contraceptives usage. Social, cultural aspects such as religious affiliations and the stigma surrounding young people’s sexuality may deter them from seeking family planning services as some contraceptive methods go contrary to cultural beliefs
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    Determinants of Place of Delivery among Women of Child Bearing Age Seeking Child Welfare Services in Kandara Sub County, Murang’a County
    (2015) Gachathi, Daniel Muya; Okova, Rosemary; Mwangangi, Francisca; Maingi, Nancy
    Introduction Worldwide, half a million women die each year from pregnancy and childbirth related complications. Over 90% of these deaths occur in developing countries, including Sub-Saharan Africa (Oguntunde et al., 2010). KDHS 2010, indicates Maternal Mortality Rate (MMR) of 488/100,000 has been reported. Skilled assistance during childbirth is central to reducing maternal mortality despite it remaining below 50% since the early 1990s, (KDHS 2008/2009) Study by KNBS indicates that 43 percent of births in Kenya take place in health facilities, while 56 percent of births take place at home. Methods Data was collected using interviewer-led questionnaire on 323 women .Predictors of the woman’s most recent place of delivery were explored in an exploratory risk factor analysis using multiple logistic regressions. Data was collected from 1st April to April 22nd 2015. Results Women who had attained more education level (48.9%) preferred delivering in hospitals than at home. Majority (80%) of women were married and all of them opted for health facility delivered this could be attributed to an assured support from their husbands. A good proportion (39.3%) of the women relied on their husband for financial support. Many women 56.7% claimed that lack of information on service delivery, lack of information about services offered in hospitals encouraged many women to deliver at home. It was clear from the study findings that lack of satisfaction with service delivery discouraged most women to deliver at the hospitals. On the other hand, the findings revealed that lack of respect of cultural beliefs by the health workers encouraged women delivery at home to a moderate extent. Walking long distances to hospitals encouraged most of the women to deliver at home to a great extent. High travelling costs is a barrier to use of maternity services offered in hospitals also discouraged most77% women to deliver in hospitals. Poor infrastructure , roads encouraged most 45.2% women to deliver at home. Discussion and Conclusion The study findings indicate that there is a significant positive effect on choice of place of birth and the determinants under study namely: Socio-demographic characteristics, knowledge on safe delivery, accessibility to delivery services and attitude towards health facilities.
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    Determinants of Postpartum Care Uptake among Women (18 – 49 Years) in Kandara Sub County Muranga County – Kenya
    (2015) Kamau, M.; Maingi, Nancy; Okova, R.; Karonjo, J.
    Introduction Worldwide, half a million women die each year from pregnancy and childbirth related complications. Over 90% of these deaths occur in developing countries, including Sub-Saharan Africa (Oguntunde et al., 2010). KDHS 2010, indicates Maternal Mortality Rate (MMR) of 488/100,000 has been reported. Skilled assistance during childbirth is central to reducing maternal mortality despite it remaining below 50% since the early 1990s, (KDHS 2008/2009) Study by KNBS indicates that 43 percent of births in Kenya take place in health facilities, while 56 percent of births take place at home. Methods Data was collected using interviewer-led questionnaire on 323 women .Predictors of the woman’s most recent place of delivery were explored in an exploratory risk factor analysis using multiple logistic regressions. Data was collected from 1st April to April 22nd 2015. Results Women who had attained more education level (48.9%) preferred delivering in hospitals than at home. Majority (80%) of women were married and all of them opted for health facility delivered this could be attributed to an assured support from their husbands. A good proportion (39.3%) of the women relied on their husband for financial support. Many women 56.7% claimed that lack of information on service delivery, lack of information about services offered in hospitals encouraged many women to deliver at home. It was clear from the study findings that lack of satisfaction with service delivery discouraged most women to deliver at the hospitals. On the other hand, the findings revealed that lack of respect of cultural beliefs by the health workers encouraged women delivery at home to a moderate extent. Walking long distances to hospitals encouraged most of the women to deliver at home to a great extent. High travelling costs is a barrier to use of maternity services offered in hospitals also discouraged most77% women to deliver in hospitals. Poor infrastructure , roads encouraged most 45.2% women to deliver at home. Discussion and Conclusion The study findings indicate that there is a significant positive effect on choice of place of birth and the determinants under study namely: Socio-demographic characteristics, knowledge on safe delivery, accessibility to delivery services and attitude towards health facilities.
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    Factors Contributing To Abortions among Youths Aged 18 -25 in Rift Valley Provincial General Hospital Nakuru
    (2016) Maingi, Nancy; Ndungu, J.; Ndungu, E.; Okova, R.
    Background Worldwide, unsafe abortion persists as a serious and continuing public health challenge (WHO, 2011). Unsafe abortion mainly endangers women in developing countries where it is highly restricted by law and countries where, although legally permitted, safe abortion is not easily accessible (WHO 2012). Of estimated 464,690 induced abortions in Kenya, majority is unsafe; involving girls and young women aged 10-24 years (APHRC, MOH, 2013). In Kenya, severe complications of unsafe abortions were most common among women aged 10- 19 (45%), divorced women (56%) (MOH, 2013) . The Cost of unsafe abortion to healthcare system is approximated at Ksh 250–300 million annually (CRR, 2010). In Nakuru provincial general hospital there were total of 604 abortions in 2014 out of which 63% involved the youth in the range of 18 to 25 years. Abortions are currently claiming 30-40% of maternal deaths in Kenya, far more than the worldwide average of 13% (WHO, 2011). Methods The study was a descriptive cross sectional study .Systematic random sampling technique was used to pick 192 participants. The sample was determined using the formula by W. G. Cochran (2011). Data collection was through questionnaires, key informant interview and focused group discussions. Ethical clearance was sought from Mount Kenya University ethics review committee. Results Majority 57.3% of the respondents have had an abortion while 42.7% have never had an abortion. 67% of the respondents had unprotected sex, 21% undertook abortion following rape, while 12% did it because of medical reasons. 33.3% respondents’ parents don’t know their daughters have had an abortion 37% of the respondents agreed they would never attempt an abortion again. 55.7% of the respondents think youths require guidance and counseling. 85.9% of the respondents are comfortable talking to a friend matters concerning sexuality, 9.4% are comfortable talking to parents, 3.6% would be comfortable talking to the teacher, while 1% would be comfortable talking to a health worker. On whether the respondents attributed their getting pregnant to the influence of the drugs, 61% attributed it to influence of the drugs, while 39% did not attribute it to drug influence. A key informant indicated, “reasons for inducing an abortion included: wanting to continue with studies, relationship problems and socio-cultural factors.” “Misoprostol was revealed to be the most frequently used method to end pregnancy while mechanical means, such as insertion of a foreign object or substance through the cervix and use of herbs were however commonly reported.” Key informant interview revealed that lack of information on sexual reproductive health (SRH) was a major issue among youths. Conclusion Use of drugs has a role to play in the high rate of abortions among youth 18-25 as 66.1% of youth were under influence of alcohol during their first sex and these affected the decision making and negotiating for safer sex. There is a dire need for sexual health education.
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    Implementation of Nursing Process among Nurses Working In In-Patients Wards in Rift Valley Provincial General Hospital, Nakuru County, Kenya
    (2016) Kamau, M.; Maingi, Nancy; Ndungu, E. W.; Karonjo, J. M.
    BACKGROUND The nursing process has been described as a theory of how nurses organize the care of individuals, families and communities and implement this using a nursing care plan (NCP). The extent of implementation of the nursing process in the clinical setting has not been extensively studied nor documented in many countries in Africa, Kenya included. This study therefore sought to determine knowledge, attitude and factors hindering implementation of nursing process in Rift Valley Provincial General Hospital. MATERIALS AND METHODS A descriptive cross sectional study design was carried out in Rift Valley Provincial General Hospital. Simple random sampling was used to select 148 nurses working in the in- patients wards in the hospital. Semi-structured questionnaire was used to collect data. Descriptive data was analyzed presented in charts, graphs and tables. RESULTS More than half (86, 58%) were diploma holders and (95, 62.7%) had worked for >10yrs at the hospital. Half (74, 50%) were able to list the components of NCP. Even though (42, 25.4%) said that they knew how to evaluate patient care using a NCP, only (7, 4.9 %) were able to come up with assessment data. Fifty four (33.8%) agreed that NCP should be used as an evidence of implementation of the nursing process. Only (12, 8%) used the NCP to manage patient care in the ward. 132 (89%) opined that in-service training on use of NCP was beneficial to implementation of the nursing process. However, majority (111, 74.9%) said this training was not being offered at the facility. Most (73, 47.2%) had learnt on nursing process last in college. CONCLUSION The nursing process is not well implemented at the in-patient wards of Rift Valley Provincial General Hospital. Lack of continuous in-service training on nursing process and use of NCP can be attributed to this. The study recommends in-service training on use of NCP by the nurse manager through continuous progress department.