Maxwell Omondi

Inappropriate utilization of higher-level health facilities and ineffective management of referral processes in resource-limited settings is increasingly becoming a concern in health care management in developing countries. This is characterized by self-referral and frequent bypassing of the nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. On July 1, 2021, Kenyatta National Hospital (KNH) did enforce the referral guidelines that required patients have a formal referral letter to KNH to reduce the number of walk-ins and allow KNH to function as a referral facility as envisioned by Kenya 201 constitution and KNH legal statue of 1987. Study Objective: To determine the effect of referral guidelines on patterns of orthopaedic and trauma admissions to KNH. Methodology: This was a quasi – experimental design. Data abstraction was d...

Tertiary hospitals in resource-limited countries treat patients referred but in most cases are the first level of care for the vast majority of patients. As a result, the tertiary facility effectively functions as a primary health care facility. The urban phenomenon of widespread self-referral is associated with low rates of formal referral from peripheral health facilities.Study ObjectiveTo determine the patterns of orthopaedic and trauma admissions to Kenyatta National Hospital.MethodologyThis was descriptive study design. Sample size was 905 patient charts for 2021FindingsThe mean age was 33.8 years (SD 16.5) with range of 1 - 93 years. Majority 66.3% were between 25 – 64 years with those above 65 years being 40 (4.4%). Children 0-14 years comprised 10.9% of the admissions. Of the 905 admissions, 80.7% were accident and trauma-related admissions while 17.1% were non-trauma related admissions. About 50.1% were facility referrals while 49.9% were walk-ins. Majority of admissions we...

Childhood immunization remains one the primary health care core component and the most effective public health interventions for controlling and eliminating life-threatening vaccine preventable diseases in the world. According to 2014 Kenya National Demographic and Health Survey (KDHS), a few children of ages 12 to 23 months in Kenya presented below average in terms of vaccination coverage of children who are fully immunized. Delayed vaccinations would increase the risk for vaccine preventable diseases in the community, therefore the information obtained from this study is to help policy makers come up with sound strategies to increase immunization coverage from 57%- 90% as recommended by World Health Organization. The broad objective of the study was to determine reasons influencing low vaccination coverage between children of ages 12 to 23 months in Narok South sub-county, Narok County in Kenya. This is to contribute to the reduction of morbidity and mortality caused by infectious...

Background: Mother to child transmission of HIV/AIDS accounts to almost 90% of HIV infections in children. ARV prophylaxis is one of the key interventions in the prevention of mother to child transmission of HIV and its goal is to reduce the HIV transmission from a HIV infected pregnant woman to the child during pregnancy, childbirth and breastfeeding. National PMTCT programme is facing many challenges and key amongst them is the low uptake of ARV prophylaxis. Failure to use ARV prophylaxis leads to more HIV transmission from mother to child ante-natally, intra-partum and postpartum. Many factors affect the uptake of ARV prophylaxis amongst HIV positive pregnant women and these include client as well as institutional factors.

Background: Gender-based violence (GBV) is an endemic perpetrated mainly against women and children that results in physical, sexual or psycho-social harm. Globally about one in three women experience GBV in her lifetime while in Kenya about 50 % of women experience GBV in their lifetime, which is currently among the highest rates in the world. While various report exists highlighting various forms of GBV in Kenya, data are skewed on the trends and correlates of GBV in Kenya. Objective : This retrospective study characterized the survivors of GBV attending a major Gender Violence Recovery Center (GVRC) in Nairobi Kenya and evaluated the trends and factors associated with GBV between 2006 and 2009. Methods: This study, obtained permission from the hospital to retrieve data from past records of d 384 GBV survivors who were recruited from different parts of Kenya. A sociodemographic based questionnaire and Patient Health Questionnaire (PHQ-9) were used to gather information relevant to...

Background: The World Health Organization report indicates that in 2013~35 million people worldwide lived with HIV and AIDS. Of these, 3.2 million were children age <15 years. The proportion of women living with HIV has remained stable, at slightly <52% of the global figure. There are 13 high burden countries which account for 75% of the estimated 1.5 million pregnant women living with HIV in lowand middle-income countries. Furthermore, most of the HIV-infected children live in sub-Saharan Africa and were infected by their mothers through mother-to-child transmission (MTCT). Despite these statistics, social and demographic characteristics that are associated with MTCT rate at 18-24 months remains unknown. This study aimed to describe the social and demographic characteristics of HIV mother-infant pair and their association with MTCT rate at 18-24 months in Vihiga, Kakamega, Bungoma and Busia Counties, Kenya. Method: A retrospective cohort study using prospectively collected da...