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Search Results: 1 - 10 of 1217 matches for " Lucy Gitonga "
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Essential Maternal and Newborn Care Skills Training for Midwives: Their Impact on Reducing Maternal and Neonatal Mortalities in Kenya  [PDF]
Lucy Gitonga
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.61009
Abstract: Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning. Little is known about how CPD participants put the experience and the new knowledge into practice and whether it has impact on patient care outcomes. The primary objective of this study was to evaluate the effectiveness of CPD of Midwives on Essential Maternal and Newborn care skills on maternal and neonatal mortality in Embu County, Kenya. The study was an interventional non-randomized pretest post test study design of midwives from the participants of the 2010 ministry of health training on essential maternal and newborn care skills. Sixty (60) midwives working in maternity unit of Embu level five hospitals were targeted. The study was carried out in two phases. Phase one involved environmental scanning of the factors that support good performance in the workplace using a questionnaire. Phase two involved evaluation of the impact by testing a hypotheses using data collected by use of questionnaires, evaluation checklist and chart audit. Data were analyzed using qualitative content analysis and presented using percentages and frequency tables. Chi-square test and correlation analysis were used to show the association between variables, which are midwives essential maternal and newborn care skills and maternal and neonatal mortality. A chi-square χ2 = 14.143, df = 9 and a coefficient = 0.357. This coefficient is less than p-value at Alpha 0.05 and therefore is not significant, proving that the essential maternal and neonatal care skills do not contribute to reduction in mortalities as such two variables are almost independent of each other, whether one exists does not necessitate the existence of another nor does it reduce maternal and neonatal mortalities in Kenya.
Perceptions and Use of Herbal Remedies among Patients with Diabetes Mellitus in Murang’a North District, Kenya  [PDF]
Joshua Mwangi, Lucy Gitonga
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.43024
Abstract: Diabetes mellitus is a chronic disease with a world wide distribution. Use of herbal remedies has been on increase with World Health Organization estimating that 80 percent of the world’s population presently uses some form of herbal medicine for some aspect of primary health care. Objectives of this study were therefore to determine the perceptions people with diabetes mellitus have towards herbal remedies, to determine the extent to which they use herbal remedies and also to establish whether there is any association between the perceptions people have on herbal remedies and use of herbal remedies. The study was carried out in Murang’a District, in Mathioya and Kangema Constituencies where five community health units were purposively selected to participate in the study based on their level of establishment in community health strategy. Data was collected using interview schedules. SPSS was used for data analysis. Significant findings from this study were: a significant number of the respondents (15%) were diagnosed with diabetes mellitus when already admitted in the wards prior to which period they had no idea that they were diabetic, over 86% of those interviewed were given information on diabetes management on diagnosis and they attend hospital clinics for follow-up regularly and therefore this means that the reason for seeking alternative modes of treatment is not due to lack of information on diabetes but due to other reasons, 12.4% of those interviewed admitted using herbal remedies as part of their management of diabetes. Recommendations made following the study were: the government of Kenya through Ministry of Health should encourage rigorous screening of clients and population in general for diabetes to ensure diabetes is diagnosed early and put under appropriate management and that the government of Kenya through Ministry of Health should put up a campaign educating diabetic patients on the potential dangers associated with combining herbal remedies with contemporary medicines due to their interactions.
Perspectives of Continuing Professional Development (CPD) for Kenyan Midwives  [PDF]
Lucy Gitonga, Njogu Samson Muriuki
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.42015
Abstract: Continuing Professional Development (CPD) provides an important strategy for reduction of maternal morbidity and mortality with the aim of attaining Millennium Development goals (MDG) four and five. However, there is lack of information about how Kenyan midwives understand and perceive CPD and how this is situated in the practice and social context. This research aimed to explore Kenyan midwives’ experience and perceptions of CPD. A descriptive explorative approach gathered focus group discussion and questionnaire data on beliefs, opinions, and perceptions, demotivating and motivating factors to CPD of a total of 25 midwives in a level five hospital in Kenya. Questionnaires were piloted and self-administered after cleaning and focus groups taped and transcribed verbatim. Data were analyzed thematically using inductive approach with the aid of SPSS computer program. Results: Four key themes emerged from the data: Midwives’ views of CPD, their motivators for undertaking CPD, the choices they made around CPD, their demotivators for undertaking CPD. Congruence with the issues evident in the literature were: the difficulties with role diversity, the importance of CPD in personal and professional growth, the importance of flexible modes of study and the importance of a supportive culture for ongoing learning. The study findings helped in identifying gaps in the literature about Kenyan midwives’ perspectives on CPD.
Evaluation of Midwives’ and Nurses’ Continuing Professional Development in Reducing Maternal and Neonatal Mortality in Embu County, Kenya  [PDF]
Lucy K. Gitonga, Njogu Samson Muriuki
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.46041

Continuing professional development (CPD) is one of the principal means by which health professionals (Nurses and midwives) maintain, improve, and broaden the knowledge and skills required for optimal patient care and safety, to be more specific reduction of maternal and neonatal mortality and morbidity. However, the lack of a widely accepted instrument to assess the impact of CPD activities on clinical practice thwarts researchers’ assessment of the effectiveness of CPD activities. The objective of the study is to develop a theory and practice-based, valid, reliable national instrument to assess the impact of accredited CPD activities on reducing maternal and neonatal mortality in Kenya using an integrated model for the study of healthcare professionals’ behavior through environmental scanning of the factors that promote good performance. The researcher will analyze the instruments identified in a systematic review of factors motivating and demotivating nurses and midwives’ behaviours using criteria that reflect the literature on measurement development of CPD leaders and providers’ priorities. The outcome of this phase will be an inventory of instruments using a competence-based model. Working from this inventory, the most relevant items for assessing the concepts listed will be selected. Then, the researcher will verify whether these items are acceptable or need modification, what aspects need revision, and whether important items are missing and should be added. The outcome of this phase will be a new national instrument integrating the most relevant tools to fit our integrated model of healthcare professionals’ behavior. Two data collections are planned: 1) pretesting of the new instrument, to assess its reliability and validity and 2) a study using the instrument before and after CPD activities with randomly selected groups, one acting as control group to assess measurement effect. The researcher will conduct individual interviews and focus groups with CPD providers and leaders to identify anticipated barriers and enablers for implementing the new instrument in CPD practice. Drawing on the results from the previous phases, we will use consensus-building methods with the decision makers to develop a plan to implement the new instrument.

Integration of Cervical Cancer Screening Services in the Routine Examinations Offered in the Kenyan Health Facilities: A Systematic Review  [PDF]
Florence Munoru, Lucy Gitonga, Moses Muraya
Open Journal of Obstetrics and Gynecology (OJOG) , 2019, DOI: 10.4236/ojog.2019.95065
Abstract: Cervical cancer is the second most common cancer among women and the leading cause of deaths among women worldwide. In Kenya, uptake of screening services is at 3.2% below the targeted of 70%. Therefore, there is need to study the factors that lead to low uptake of the screening services. One way of increasing the uptake of the screening services is its integration with other routine services, thus leading to a reduction in morbidity and mortality rates associated with the disease. The objective of this study was to review and examine the importance of integrating cervical cancer screening services in the routine examinations offered in the Kenyan health facilities. A retrospective study design was adopted by this study. The review of articles, journals, strategic plans was done from the year 2012 to 2017. Data sources included Medline, PMC, Library, Pubmed, Google scholar, cancer prevention plans and strategies. About 28 data sources were reviewed with 78.5% indicating that increased knowledge and creation of awareness on cervical cancer would greatly improve the utilization of the screening services. More than 87% of the information collected among published work in Kenya demonstrated that knowledge on importance cervical cancer screening is inadequate. The primary results of this study suggest that all women of reproductive age (WRA) should undergo cervical cancer screening as a routine service. An integration approach should be adopted, to enhance knowledge on cervical cancer and the importance of screening, causes, preventive and treatment options. The study recommends that, the Government of Kenya through the Ministry of health should include cervical cancer screening as a routine procedure for all WRA.
Patients Related Factors Associated with Non-Adherence to Antihypertensive Medication among Patients at Chuka Referral Hospital, Kenya  [PDF]
Charity Ngugi Gikunda, Lucy Gitonga
Open Journal of Clinical Diagnostics (OJCD) , 2019, DOI: 10.4236/ojcd.2019.93007

Antihypertensive medication is one way to manage hypertension but many hypertensive patients do not optimize drug therapy to achieve blood pressure control. Hypertensive medication non-adherence continues to become a contributing factor to hypertensive complications like heart attacks, heart failure, stroke, kidney disease. Prevalence of non-adherence to antihypertensive treatment is not known but it’s thought to be increasing. Associated factors of non-adherence are complex, are both internal and external to the patient but are difficult to extrapolate. This can partly be because the determinants of non-adherence to hypertensive may have a locality effect due to many factors such as culture and health system in a given locality. Hence, studies from one region may not have a cross-application. Therefore, there is the need to study the factors associated with non-adherence at a local scale. Descriptive study design was adopted to guide the implementation of the study. The population comprised of 575 people among doctors, pharmacists, nurses, record officers and hypertension patients. The respondents were identified through simple random sampling and a sample size of 81 patients was achieved and 10 health care providers including doctors, pharmacists, record officers and nurses were also interviewed through census method. Data was collected between the month of April and May 2019. Questionnaires were used as data collection t

Facilitators to Immediate Post Partum Intra Uterine Contraceptive Device Uptake among Mothers Delivering in Meru Hospital  [PDF]
Consolata Kirigia, Lucy Gitonga, Moses Mahugu Muraya
Open Journal of Obstetrics and Gynecology (OJOG) , 2019, DOI: 10.4236/ojog.2019.94042
Abstract: Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were
Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device Uptake among Mothers Delivering at Meru Hospital  [PDF]
Consolata Kirigia, Lucy Gitonga, Moses Mahugu Muraya
Open Journal of Obstetrics and Gynecology (OJOG) , 2019, DOI: 10.4236/ojog.2019.93032
Abstract: Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices at 3.8%. Low uptake of 3.4% was reported in Meru Hospital and lack of literature on immediate Post Partum Intra Uterine Contraceptive Device (PPIUCD) uptake. Immediate Post Partum Intra Uterine Contraceptive Device is a long acting reversible contraceptive device inserted into the uterus immediately within 48 hours after delivery. The objective was to assess Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers delivering in Meru Hospital. Descriptive research design was used and a population of 289 mothers was targeted. Sample size of 74 respondents was selected using simple random sampling. Questionnaires and interview schedules were used to collect data. The collected data were entered and analyzed using Statistical Package for Social Science windows version 23.0. Descriptive analysis was used to obtain frequencies and percentages. Chi-square was used to test the relationship of study variables and presented in tables. The qualitative data were analyzed thematically. The findings revealed that provider related barriers such as none provision of the services and untimely counseling for the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic and reproductive characteristics also played a role in low uptake. Using the chi square test, there was a significant relationship, P = 0.001 between young age of the mothers, unemployment (53%), low parity (56%) and low uptake. Preference for other alternative contraceptives (25.8%) such as hormonal methods was a barrier to the uptake. Therefore, barriers to PPIUCD uptake are provider related, alternative methods of contraception and client related such as lack of information, unemployment, young age and low parity. The findings will inform Meru hospital management on barriers to
Determination of Plasmodium Parasite Life Stages and Species in Images of Thin Blood Smears Using Artificial Neural Network  [PDF]
Lucy Gitonga, Daniel Maitethia Memeu, Kenneth Amiga Kaduki, Mjomba Allen Christopher Kale, Njogu Samson Muriuki
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.42014
Abstract: Malaria is a leading cause of deaths globally. Rapid and accurate diagnosis of the disease is key to its effective treatment and management. Identification of plasmodium parasites life stages and species forms part of the diagnosis. In this study, a technique for identifying the parasites life stages and species using microscopic images of thin blood smears stained with Giemsa was developed. The technique entailed designing and training Artificial Neural Network (ANN) classifiers to perform the classification of infected erythrocytes into their respective stages and species. The outputs of the system were compared to the results of expert microscopists. A total of 205 infected erythrocytes images were used to train and test the performance of the system. The system recorded 99.9% in recognizing stages and 96.2% in recognizing plasmodium species.
Detection of plasmodium parasites from images of thin blood smears  [PDF]
Daniel Maitethia Memeu, Kenneth Amiga Kaduki, A. C. K. Mjomba, Njogu Samson Muriuki, Lucy Gitonga
Open Journal of Clinical Diagnostics (OJCD) , 2013, DOI: 10.4236/ojcd.2013.34034
Abstract: Malaria is the leading cause of morbidity and mortality in tropical and subtropical countries. Conventional microscopy is the Gold standard in the diagnosis of the disease. However, it is prone to some shortcomings which include time consumption and difficultness in reproducing results. Alternative diagnosis techniques which yield superior results are quite expensive and hence inaccessible to developing countries where the disease is prevalent. Thus in this work, an accurate, speedy and affordable system of malaria detection using stained thin blood smear images was developed. The method uses Artificial Neural Network (ANN) to test for the presence of plasmodium parasites in thin blood smear images. Images of infected and non-infected erythrocytes were acquired, pre-processed, relevant features extracted from them and eventually diagnosis was made based on the features extracted from the images. Diagnosis entailed detection of plasmodium parasites. Classification accuracy of 95.0% in detection of infected erythrocyte was achieved with respect to results obtained by expert microscopists. The study revealed that artificial neural network (ANN) classifiers trained with colour features of infected stained thin blood smear images are suitable for detection. It was further shown that ANN classifiers can be trained to perform image segmentation.
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