East African Journal of Health and Science

The Psychological Burden of Cancer in Nairobi County, Kenya

Phillip Soita — 2025-06-17

Cancer is a major public health concern globally, and Kenya is no exception(Deo et al., 2022). Incidence and mortality rates associated with cancer are steadily increasing worldwide (Sung et al., 2021). While significant attention has been directed toward physical and economic impacts, the psychological dimensions remain under-addressed, especially in low- and middle-income countries. This study explores the psychological burden experienced by cancer patients in Nairobi County, Kenya, examining the emotional, social, and mental health challenges, alongside coping mechanisms and the support systems available to them. The study's broad objective was: to assess the psychological burden among cancer patients in Nairobi County and explore coping mechanisms and barriers to psychosocial support whereas the specific objectives were: to determine the prevalence of anxiety and depression among cancer patients; To examine the coping mechanisms employed by cancer patients; To identify the barriers to accessing psychosocial support and to assess mental health service utilization in Nairobi’s cancer care facilities. Employing a mixed-methods approach, the study sampled 200 patients from leading cancer treatment facilities in Nairobi. Results reveal high levels of anxiety, depression, and stigma, compounded by limited access to psychosocial care. The findings highlight an urgent need for integrated mental health services and policy reform

Clinical Etiology and Histopathologic Correlation of Exfoliative Erythroderma at the Kenyatta National Hospital

Karen Waithera Wainaina — 2025-06-25

Background: Exfoliative erythroderma is a dermatologic emergency characterised by diffuse skin redness and scaling involving at least 70% body surface area. It is a clinical presentation that is usually indicative of an underlying primary process. Once a clinical diagnosis of exfoliative erythroderma is made, prompt supportive measures should be instituted while seeking to identify the underlying cause of this presentation. The correlation between clinical and histopathological diagnoses has not been determined for the Kenyan population. Purpose of the study: To assess the frequency of causes of exfoliative erythroderma and their histopathologic correlation at Kenyatta National Hospital. Methodology: This was an ambispective study conducted in Kenyatta National Hospital wards and clinics. All adult patients with exfoliative erythroderma who meet the study criteria will be included. A total sample size of 94 patients was included in the study. Descriptive analysis was done where demographic, clinical and histopathological factors were summarised using mean and standard deviation as well as median and interquartile range. A sensitivity analysis was performed to correlate clinical findings and histopathological findings. Results: The median age was 45 (interquartile range: 30 – 60 years, and 53% of them were male. Clinical causes of EE revealed that most of the patients with EE were due to psoriasis (38.3%), followed by malignancies (21.3%) and eczema (18.1%). Clinical findings revealed that the common causes of EE included dermatoses (57.45%), with psoriasis (24.2%) followed by eczema (18.1%). Malignancies (21.3%) were the second most common group and the commonest systemic disease, followed by drug reactions (12.7%). HIV was present in 7.5% of the cases. The findings showed that 63% (n =57) of the patients had a biopsy done, although the frequency was lower in the retrospective arm, 57% (n =42), compared to the prospective arm of the study, 88% (n =15). The findings from the histopathological findings revealed that 39.2% were malignancies, followed by psoriasis 25.5%) and immunobullous disease (17.7%). The sensitivity analysis revealed that immunobullous (100%) and malignancy (92.3%) had a high level of sensitivity as well as specificity, which was 97.7% and 92.6%, respectively, although eczema and psoriasis were least correlated with histopathological findings. Conclusion: Clinical findings were better correlated with malignancy and immunobullous findings with high sensitivity and specificity, although the other histopathology findings, such as psoriasis and eczema, were poorly correlated. Thus, there is a continued need to adopt a biopsy‐first protocol for all new presentations of EE to maximise diagnostic yield.

Prevalence and Factors Associated with Psoriatic Arthritis among Psoriasis Patients on Follow-up at the Dermatology and Rheumatology Units, Kenyatta National Hospital, Kenya

Jane Achungo — 2025-06-26

Background: Psoriatic arthritis (PsA) is a serious and potentially debilitating condition that frequently occurs in individuals with psoriasis. The burden of PsA ranges between 6 – 42 percent globally and occurs in approximately 30% of patients with psoriasis. However, the burden of PsA has not been fully investigated within the local context. Purpose of the study: To determine the prevalence and factors associated with psoriatic arthritis among psoriasis patients on follow-up at the Dermatology and Rheumatology units, Kenyatta National Hospital. Methodology: This was a cross-sectional study conducted at Kenyatta National Hospital. A consecutive sampling technique was used to sample 80 patients diagnosed with psoriasis. A structured questionnaire was used to collect data. The CASPAR criteria were used to screen for PsA. The prevalence of PsA was obtained as a proportion of patients with PsA over the total sample size and expressed as a percentage. Bivariate and multivariable analyses were done to investigate factors associated with PsA using binary logistic regression. A STATA version 16 was used to analyse the data. Results: The Majority of the patients were male (65%), 47.5% were aged between 31 and 49 years, with the youngest being four years and the oldest being 75 years. Further, 52.5% had psoriasis for more than 48 months, and 33.8% had a family history of psoriasis. The average PASI score was 11.5 (SD=8.9). The common type of psoriasis was plaque (70%), and the common site of psoriasis included the extremities (78.8%). The prevalence of psoriasis arthritis was 23(28.8%) with a 95%CI: 19.4% to 40.2%. The common psoriatic arthritis subtypes included polyarticular arthritis (39.1%), spondylarthritis (26.1%), and oligoarticular arthritis (21.7%). The multivariable analysis revealed that significant factors associated with Psoriatic Arthritis include gender (females, aOR = 10.11, 95% CI: 1.12, 91.61, p = 0.040), history of smoking (aOR = 21.37, 95% CI: 2.45, 186.71, p = 0.006), nail involvement (aOR = 5.44, 95% CI: 2.69, 42.1, p = 0.006), onycholysis morphology (aOR = 11.39, 95% CI: 1.42, 91.50, p = 0.022), Oil drops (aOR = 12.11, 95% CI: 1.44, 34.12, p = 0.034), and the PASI score (aOR = 2.11, 95% CI: 1.34, 6.11, p < 0.001). Conclusion and recommendations: Psoriatic arthritis (PsA) burden is high, with polyarticular arthritis being the most common subtype. Female gender, smoking history, nail involvement, onycholysis morphology, Oil drops, and a higher PASI score are key contributors to the likelihood of developing PsA. Early monitoring for these factors is recommended.

Factors Affecting Utilisation of Partograph among Healthcare Workers in Bukoba District Council, Kagera Region, Tanzania

Mangi Job Ezekiel — 2025-06-30

The World Health Organization (WHO) acknowledges that the effective use of partograph helps prevent maternal and neonatal deaths, identify abnormalities, and inform appropriate labour management. In Tanzania, the national Emergency Obstetric Neonatal Care (EmoNC) assessment has consistently reported low utilisation of partographs. However, little is known about the local factors hindering partograph use. Therefore, this study assessed factors affecting the utilisation of partographs among healthcare workers in Health facilities in Bukoba DC in the Kagera region. To address this, a quantitative descriptive cross-sectional design was adopted. The sample size for this study comprised 224 nurses and 79 clinicians recruited from Bukoba DC. Stratified random sampling was utilised to select study participants from the identified health facilities. Data were collected through structured questions, and data analysis was achieved through descriptive and multivariate analysis using the Statistical Package for Social Science (SPSS version 27). The study found that 80.8% of healthcare workers (HCW) used the partograph, while 19.2% did not. Its use was correlated with age and educational attainment. HCWs who were 27 years of age or older were 10% less likely than those under 26 to use the partograph (AOR = 0.904, CI 95% = 0.834-0.979, p = 0.013). Compared to those with less than two years of college education, HCWs with three years or more were 1.1 times more likely to do it (AOR = 1.141, CI 95% = 1.054-1.235, p = 0.001). HCWs who performed 6–10 deliveries in a 24-hour shift were also 9.6% less likely to use the partograph than those who performed 1–5 deliveries. Similarly, compared to those in the reproductive and child health (RCH) department, healthcare workers in the labour ward unit were 9.9% less likely to use the partograph (AOR = 0.901, CI 95% = 0.822-0.988, p = 0.027). The study shows that while most healthcare workers use partographs, there are gaps in knowledge and attitudes about their use, especially in reducing maternal and newborn deaths. To improve this, facilities should prioritise resources, implement continuous training, and ensure regular availability of partograph forms and monitoring equipment.

Quality of Life and Associated Factors among Patients Diagnosed with Pemphigus Vulgaris Attending Clinic at Kenyatta National Hospital

Leah Wangari Karanja — 2025-07-01

Background: Pemphigus vulgaris (PV) is a rare autoimmune disorder that affects the skin and mucous membranes. Prevalence of PV ranged from 0.38 to 30 per 100,000 people, with more than 50% of these patients having a low quality of life. The visible nature of PV lesions can lead to emotional distress, affecting self-esteem and body image. PV patients may face social isolation due to misunderstandings about the disease's contagiousness. However, the quality of life of these patients has not been exhaustively investigated. Purpose of the study: To determine the quality of life and associated factors among patients diagnosed with pemphigus vulgaris attending the dermatology clinic at Kenyatta National Hospital. Methodology: This was an analytical cross-sectional study utilising quantitative and qualitative approaches conducted at Kenyatta National Hospital. A consecutive sampling technique was used to sample 76 PV patients attending the dermatology clinic. The quality of life was assessed using the Dermatology Life Quality Index (DLQI). A structured questionnaire including these validated tools and patient-specific information such as demographic and clinical characteristics, depression level and quality of life. Descriptive analysis was done where the mean DLQI score was calculated and scores were characterised using the DLQI validated scoring, which was summarised using frequencies and percentages. Student t-test and ANOVA were conducted to investigate differences in DLQI scores based on patient characteristics and presenting symptoms. Significance was assessed at a p-value less than 0.05. Performed using Stata version 17. Thematic analysis was performed, where themes and subthemes were obtained. Conducted using Dedoose v7.1.1. Results: The average age was 47.9±14.2 years, and 69.7% were female. Clinical characteristics revealed that 48.7% had the disease for between 2 – 5 years, and 31.6% had a family history of autoimmune disorders. Common symptoms included blisters (65.8%) and itching (42.1%). Strong social support was seen in 52.6% of the patients. The mean DLQI score for the 76 patients in this study was 13.0 (Standard Deviation [SD] ± 7.7), indicating a medium to high impact of the disease on their quality of life. Further, 26.3%, 34.2% and 22.4% had medium impact, high impact, and very high impact. Female patients, inpatients, social support, duration of disease, current medication, family history, as well as presenting with itching, were associated with a higher impact on their quality of life. There was also limited knowledge of disease and treatment experiences, and emotional coping was a key identified theme. Conclusions and recommendations: There is a significant impact of PV on patients' quality of life, particularly among females, those on active medication, and those with a family history of autoimmune disorders. Itching exacerbates symptoms, and limited knowledge about PV's autoimmune nature is prevalent. There is a need for patient education on PV’s causes and management.

Prevalence of Depression and Associated Factors among Adult Patients Admitted to Medical and Surgical Wards at Bossaso Town Hospitals, Puntland, Somalia

Safia Mohamed Salaad — 2025-07-02

Depression disorder presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, poor concentration, problems with thinking and making decisions. Further, to the best of our knowledge, no study has been conducted to determine depression and associated factors among adult patients admitted to medical and surgical wards in the study area. Objective: To assess the prevalence of depression and associated factors among adult patients admitted to medical and surgical wards at Bossaso town hospitals, Puntland, Somalia. Method: A hospital-based cross-sectional study design was conducted among 416 patients admitted to medical and surgical wards from June 2022 to July 2022. Three hospitals were selected using simple random sampling. Sample frame: The study participants were selected by using a simple random sampling technique using hospital registration books. Depression was assessed Patient Health Questionnaire - 9 item. Data was coded and entered into EpiData version 3.1 software and exported to SPSS version 20 for analysis. Logistic regression model was used to identify independent predictors of depression, and a statistically significant result was determined at a p-value less than 0.05. Results: The prevalence of depression was found to be 20.9% (95% CI: 16., 24.0). In the multivariable logistic regression, female sex (AOR = 2.1, 95% CI: 1.14-4.0), duration of hospital stays 1-2 week (AOR = 2.7, 95% CI: 1.45-5.31), admission at surgical ward (AOR = 2.6, 95% CI: 1.48-4.56), previous history of mental illness (AOR=2.5,95% (1.41-4.75) and being cigarette smoking (AOR = 3.0,95% CI: 1.60-5.68) were factors significantly associated with depression. Conclusion: The prevalence of depression among admitted patients was high. Female sex, duration of hospital stays, admission to surgical ward, previous history of mental illness and being cigarette smoking were factors significantly associated with depression

Hygiene and Safety Measures Practised by Roadside Meat Vendors of Namawojjolo and Lukaya Food Markets, Uganda

Annet Nanfuka — 2025-07-04

Handling and preparation of roadside roasted meats may often be compromised, considering the general conditions of the makeshift structures and the common minimal education levels of vendors. The study’s objectives were to assess hygiene and safety practices applied in handling, preparing, and vending of roadside roasted meats. Conducted in October 2024 at Namawojjolo and Lukaya, two major food markets along central Uganda's busiest highways, the research used an observational checklist and questionnaires to collect data from 90 meat vendors selling roasted beef, chicken, or goat meat on compliance with best known practices. Descriptive results on hygienic and handling practices were generated, and scores above 70% were used as a hallmark for best practice. Only 6.7% instituted complete sanitation and hygienic practices, while 88.9% did not store leftover meat in refrigerators. Among them, 67.8% kept meat in clean containers, 5.6% stored utensils on clean shelves, and 6.7% had clean roasting areas. Most (93.3%) separate raw meat from ready-to-eat meat, and 37.8% had stalls without rodents. Hygienically, 75.6% wore aprons while working, among whom 85.3% were considered clean aprons, 46.7% had hair covered, 91.1% had short and clean fingernails, 93.3% washed hands with soap, 1.1% covered food while presenting to customers, and 11.1% wore jewellery while working. Training on food safety was undertaken by 63.3% and 78.9% served food in paper bags. Personal hygiene practices of most vendors were fairly good, but most lacked sanitation facilities and demonstrated relatively low knowledge of best and acceptable practices in meat handling. There is a need for more sensitisation and provision of sanitation facilities to vendors to improve both the quality and safety of roadside vendor products

Evaluating the Antimicrobial Activity of Crude Extracts from Leaves, Flowers and Roots of Iris versicolor and Nerium oleander Plants Against Escherichia coli and Staphylococcus aureus

Too Lily Chepkemoi — 2025-07-08

Bacterial infections are prevalent in most parts of Kenya and cause diseases like pneumonia, typhoid, cholera, and meningitis. This has contributed to unsustainable socio-economic development following the emergence of antimicrobial-resistant strains of bacteria and, hence, the need for alternative strategies that are effective against bacteria and environmentally safe. This study evaluated the antimicrobial activity of crude extracts from leaves, flowers and roots of Iris versicolor and Nerium oleander plants against Escherichia coli and Staphylococcus aureus. The plant parts were macerated and extracted to obtain phytochemicals that were then identified under different classes of compounds by treating them with varying reagents following standard laboratory procedures. To assess antimicrobial activity, discs were infused with an antimicrobial compound derived from the leaf, flower, and root extracts of N. oleander and I. versicolor at a concentration of 1000 µg/ml. Bacterial isolates (inoculum) were then introduced into plates containing Mueller-Hinton agar media. Infused discs were dispensed aseptically on the plates. The discs were pressed to ensure contact between the agar and the disc and incubated at 37 °C for 24 hrs. The Kirby-Bauer method was used to assess the antibacterial efficacy of the plant extracts against the bacterial strains Staphylococcus aureus and Escherichia coli. The crude plant extracts showed a greater zone of inhibition ranging from 2.5 mm to 3.2 mm in diameter, irrespective of the plant part and the test micro-organism. The methanolic crude extract of N. oleander leaves showed a greater zone of inhibition against Staphylococcus aureus at 3.1 mm and 2.9 mm against E. coli. The zone inhibited by the crude extract on S. aureus showed no growth of the micro-organisms; this was observed on all the crude extracts, irrespective of the extracting solvent, on both E. coli and S. aureus. The methanolic crude extract of N. oleander flowers showed a greater zone of inhibition against S. aureus at 2.9 mm. The hexane crude extract of I. versicolor leaves showed the least zone of inhibition against E. coli at 2.2 mm in diameter. This showed that the plant crude extracts exhibited much higher activity against S. aureus, followed by E. coli

Case Report on Right Pulmonary Embolism with Pulmonary Hypertension and Cor Pulmonale with a Differential Diagnosis of Pulmonary Tuberculosis

Nana Antwi-Boasiako Ansong — 2025-07-08

A pulmonary embolism is an acute emergency resulting from blood clots being released into the lung vasculature. In patients receiving medical care, the frequency of pulmonary embolisms (PE) ranges from 0.14% to 61.5%, and the death rate from PE is between 40% and 69.5% (2). Pulmonary embolism is most frequently caused by thrombi from deep veins, especially in the lower extremities. Additional factors that might lead to pulmonary embolism include air embolus, amniotic fluid embolus, fat embolus, which is typically connected to the fracture of big bones, and deep vein thrombosis of the upper limbs, pelvis, renal, and from the right. The disease normally affects the lungs and may lead to Cor pulmonale and pulmonary hypertension. This short case report presents a 43-year-old male with a chronic history of cough productive of bloody sputum, weight loss, and a recent history of syncope. History and clinical examination findings were suggestive of pulmonary tuberculosis complicated by pulmonary thromboembolism. Investigations done were suggestive of pulmonary embolism. Conclusion: An unusual presentation of tuberculosis and pulmonary embolism in a 43-year-old male in a tertiary hospital in Ghana

Assessment of Socio-Demographic and Economic Characteristics and Nutritional Status of Children in Navakholo Sub-County, Kakamega County, Kenya

Hazel Awuor Okech — 2025-07-09

Child undernutrition remains a major public health concern in Kenya, especially in rural areas where food production does not always lead to improved nutritional outcomes. Despite national and county-level progress, localised disparities persist, highlighting the need for sub-county-level evidence. This study assessed the nutritional status of children aged 12–60 months and examined the influence of socio-demographic and socio-economic factors on stunting, wasting, and underweight in Navakholo Sub-County, Kakamega County. A cross-sectional study was conducted among 384 agricultural households using structured questionnaires and anthropometric assessments, with nutritional status classified using WHO child growth standards. Bivariate and multivariate logistic regressions were used to assess associations. Stunting prevalence was 23.4%, underweight 4.9%, wasting 1%, and overweight 5.5%. Stunting was significantly associated with Protestant religion (AOR=5.697; CI=1.881–17.260), geographic location—children in Shinoyi-Shikomari-Esumeiya Ward had reduced odds (AOR=0.324; CI=0.130–0.806)—and household head education, with the highest risk among children whose household heads had no formal education (AOR=21.012; CI=1.180–374.085). Wasting was associated with household income between KES 7,000–9,000 (AOR=5.143; CI=1.345–19.667) and tertiary education of the household head (AOR=12.110; CI=1.001–146.568). Underweight was associated with caregiver age 42–49 years (AOR=0.080; CI=0.009–0.688), having two (AOR=4.345; CI=2.259–8.356) or three or more children under five (AOR=8.951; CI=2.504–31.996), and was least likely among children in Bunyala East (AOR=0.070; CI=0.016–0.305). Localised disparities in child nutrition in Navakholo Sub-County are driven by socio-demographic and economic factors, highlighting the need for targeted, context-specific interventions

Adverse Birth Outcomes in Kenya: Prevalence and Key Health-Related Predictive Factors- A Cross-Sectional Analysis of KDHS 2022 Data

Vincent Kiprono Mukthar, PhD — 2025-07-10

Background: Adverse birth outcomes (ABOs) including low birth weight, stillbirths, and early neonatal deaths remain a major public health concern in Kenya, contributing significantly to maternal and child morbidity and mortality. This study aimed to assess the prevalence and health-related predictors of ABOs using data from the 2022 Kenya Demographic and Health Survey (KDHS). Methods: A cross-sectional analysis was conducted using data from 17476 women aged 15–49 who had given birth in the five years preceding the survey. Adverse Birth Outcomes were defined as any occurrence of low birth weight, stillbirth, or early neonatal death. Statistical analyses included descriptive, bivariate, and multivariable binary logistic regression using SPSS version 28, accounting for sampling weights and survey design. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to identify significant predictors. Results: The prevalence of Adverse Birth Outcomes was 11.1% which was contributed by 8% of preterm babies, 2.3% Low Birth Weight and 2.0% Neonatal Births. The key health-related factors that predict Adverse Birth Outcomes included number of ANC visits {with higher odds to those who scheduled ANC visits(≥8) (AOR = 2.947; 95% CI: 1.734–5.006), compared to women who had less than three visits}, timing of the first ANC visits {delaying the first ANC visit until after the first trimester resulted in lower odds of Adverse Birth Outcomes (ABOs) – AOR: 0.673; 95% CI: 0.412–0.729}, and parity/birth order{Multiparity exerted a protective effect among multiparous women showing decreased odds of adverse outcomes compared with primiparous women-AOR = 0.507; 95% CI: 0.461–0.559}. Conclusions: Adverse Birth Outcomes of over 10% of the population in Kenya remain a significant concern. Among the health-related factors that predict Adverse Birth Outcomes are the frequency of ANC visits (a paradoxical finding that demonstates that ANC visits frequency is significantly associated with higher ABOs), the timing of initiation of ANC visits and parity, which should be the focus of implementing targeted interventions to improve birth outcomes

Perceptions of Healthcare Providers on Quality of Services and Their Satisfaction During Implementation of Free Maternity Services Policy in a National Referral Hospital, Kenya

Christine Mwikali Musee, PhD — 2025-07-10

In Kenya, the Ministry of Health policies shape healthcare affordability and access. A free maternity policy was announced with executive directives for immediate implementation without considering hospital human resource capacities, processes and financial requirements. Subsequently, the study site experienced a 100% increase in hospital deliveries under constrained human resources, supplies, infrastructure and other resources. Thus, objectives assessed the perceptions of healthcare providers on the quality of services and their satisfaction during the implementation of the free maternity services policy in a national referral hospital, Kenya. Through a cross-sectional design, this survey purposively collected data from 50 doctors and nurses using questionnaires, with quantitative and qualitative aspects, and 20 Key informants, being managers and/or team leaders (till saturation was achieved). Quantitative data was analysed using Stata version 12 to yield frequencies and percentages, and qualitative data was thematically coded and analysed using NVivo version 15. Some opinions have been quoted directly. Findings obtained showed response rate of 50(100%); skills, personal preparedness, deployment, support-supervision (p value 0.05), workload, job satisfaction, capacity to cope with increased patients, availability of various resources, cleaning agents, cleanliness (p value 0.003), and quality of care were rated between excellent-poor. Key informants said, “…the workload is very high. We are doing our best and living one day at a time…access to healthcare has increased…it is not sustainable…with overstretched infrastructure, no supplies…mothers are sharing beds, confidentiality and privacy is remarkably reduced…litigations…complaints may increase...’In conclusion, there was a mismatch between the increased number of clients and the already existing strains in staffing, resources, and infrastructure. Although the majority of healthcare providers faced a myriad of challenges during this period, they identified the capacity to provide quality services and expressed satisfaction.

Timeliness and Appropriateness of Maternal Care and Its Influence on Perinatal Outcomes: A Community-Based Study in Kakamega County, Kenya

Catherine Mutonyi Simiyu — 2025-07-17

Background: Perinatal mortality remains a critical concern in Sub-Saharan Africa, with Kenya reporting rates above global targets. Lurambi and Butere sub-counties in Kakamega County exhibit perinatal mortality rates nearly double the national average, despite increased facility-based deliveries. Objectives: The study aimed to assess how the timeliness and appropriateness of maternal care influence perinatal outcomes in these high-burden settings. Methodology: A community-based cross-sectional design was employed. Quantitative data were collected from 520 mothers who delivered within the past two years using structured questionnaires, while qualitative data were gathered through key informant interviews with healthcare workers. Maternal care was assessed across the antenatal, intrapartum, and postnatal periods. Quantitative data were analysed using SPSS, and logistic regression was applied to identify predictors of perinatal mortality. Qualitative data from key informant interviews were manually analysed by coding responses into thematic categories. The resulting themes were organised and interpreted about the Three Delays Model, highlighting issues relevant to delays in receiving appropriate maternal and newborn care. Results: Revealed that while 78 percent of mothers attended four or more antenatal visits, only 39 percent received the full care package. Inadequate labour monitoring was significantly associated with perinatal death (AOR = 0.1; 95 percent CI: 0.04 to 0.43), as was lack of timely postnatal care (AOR = 51.2; 95 percent CI: 12.0 to 218.9). Newborns experiencing delayed or inappropriate facility care were nearly three times more likely to die (AOR = 0.3; 95 percent CI: 0.1 to 0.6). Systemic challenges included staff shortages, poor documentation, and weak referral mechanisms. Conclusions: The Third delay contributes to perinatal death. The quality and responsiveness of antenatal care are more critical than mere attendance. Intrapartum care showed poor labour monitoring, increasing the risk of adverse events. Delays in postnatal checkups and inadequate management of newborn complications raised the risk of death. Recommendations: Strengthen the quality and responsiveness of antenatal services, enhance intrapartum care and timely postnatal checkups and improve management of newborn complications, specifically during referrals

Diversity, Patterns of Distribution, and Bayesian Projected Trends of the Ecological Impact of Invasive Alien Plant Species in the Mount Cameroon Region

Ndam Lawrence Monah, PhD — 2025-07-21

Invasive alien plant species (IAS) are a major threat to biodiversity, ecosystem function, and sustainable land use, especially in tropical hotspots like the Mount Cameroon region. Despite its ecological significance, comprehensive data on the diversity, distribution, and projected impacts of IAS in this region have been lacking. This study systematically inventoried IAS, analysed their spatial and habitat distributions, assessed their effects on native plant communities, and modelled future expansion trends. Between September 2019 and November 2021, a field survey was conducted across 120 permanent plots (1,000 m² each) in four representative sites—Buea, Bakingili, Limbe, and Idenau-covering roadsides, farmlands, and forests. Species identification, cover estimation, and habitat characterisation followed standardised protocols. Diversity indices (Shannon-Wiener, evenness, richness, Sørensen similarity) were calculated for invaded and uninvaded plots. GIS mapping and Bayesian hierarchical modeling were employed to assess spatial patterns, environmental drivers, and project IAS expansion from 2020 to 2030. A total of 25 IAS from 16 families and 24 genera were identified, with Asteraceae and Poaceae being most salient. Annual herbs constituted 70% of the IAS flora. Species richness and evenness were highest in Buea (H’=2.57, S=17, E=0.91) and lowest in Bakingili. Roadsides and farmlands exhibited significantly higher IAS abundance than forests (p=0.036). Bayesian projections indicated a progressive expansion of IAS, with Chromolaena odorata, Tithonia diversifolia, and Eleusine indica expected to be the most aggressive invaders, and the cumulative IAS-occupied area projected to exceed 75,000 m² by 2030. Invaded sites showed marked declines in native species diversity and evenness. These findings highlight the urgent need for targeted, site-specific management interventions, particularly along roadsides and for rapidly expanding species. Integrating field inventories, GIS, and Bayesian modeling provides robust insights for prioritising eradication and control strategies to mitigate the ecological and economic impacts of IAS in the Mount Cameroon region.

Preparedness and Nurse-Associated Factors of Forensic Nursing Care among Nurses at Kenyatta National Hospital’s Accident and Emergency Department

Christopher M. Obuya — 2025-07-24

The approach to the fight against violence, a global menace with both health and legal consequences, is multipronged. The discipline of nursing can effectively contribute through forensic nursing. This sub-speciality focuses on bridging the gap between legal and health systems for potential forensic patients. Establishing the level of preparedness of nurses to provide forensic nursing care and identifying nurse-related factors, particularly in Accident and Emergency (A&E) departments, in the face of high incidences of violence in our neighbourhoods should be prioritised. The A&E department, as the port of entry for victims/survivors of violence at Kenyatta National Hospital (KNH), was purposely selected for the study. A convergent mixed-method research design was employed for the study, whereby a sample of (n=81) respondents selected by a consecutive sampling technique completed filling a modified Knowledge Questionnaire over Forensic Nursing Practice (KQFNP), over eight weeks for quantitative data. Key informant interviews were conducted and data were captured manually among seven (n=7) purposely selected sections in charge of collecting complementary qualitative data. The Chi-square test of significance p<.05 was used in hypothesis testing, while logistic regression analysis was used to predict determinants of preparedness, with findings presented using tables and figures. Qualitative data were transcribed, thematically analysed, and presented in verbatim and narrations. A majority (81.5%, n=66) of study respondents had a low level of preparedness to provide forensic nursing care, a finding reinforced by key informants (KI-1)… “Assessment and identification of forensic patients are limited to sexual assault clients. Our focus is basically on clinical care.” The years of experience post-licensure (Fisher exact value= 9.838; p value= 0.006), training in forensic evidence collection and preservation (Fisher exact value= 9.933; p value= 0.002), and training in expert witnessing in the courts of law (Fisher exact value= 6.488; p value= 0.019) were statistically significantly associated with preparedness. Those trained in evidence collection and preservation, and expert witnessing were 6.8 times and 16.3 times more likely to be prepared compared to untrained (COR= 6.750; 95% CI =2.018-22.582; P=0.002) and (COR= 16.250; 95% CI =1.557-169.618; P=0.020) respectively. The majority of nurses in the A&E department at KNH have low levels of preparedness to provide forensic nursing care. The years of experience post licensure, training in forensic evidence collection, and expert witnessing were statistically significantly associated with preparedness. Develop and implement targeted in-service educational initiatives to address gaps in formal training in forensic nursing. Tailor training interventions leveraging on identified demographic factors.

Forecasting Years Lived in Poor Health in Kenya: A Comparative Analysis of ARIMA and LSTM Models with Implications for East African Health Policy

Andrew Karani — 2025-07-31

Kenya's life expectancy increased from 55.5 to 64.7 years (1990-2024), but years lived in poor health (GAP) have not declined proportionally, creating substantial public health planning challenges. Evidence-based forecasting of GAP trends is essential for health system resource allocation, yet no systematic forecasting methodologies exist for East African health systems. This study compared ARIMA and LSTM forecasting models for predicting Kenya's GAP trends and established methodological frameworks for health system planning across East Africa. Comparative time series analysis was conducted using Global Burden of Disease Study 2021 data spanning 1990-2021 for Kenya, Uganda, and Tanzania health systems, with 32 annual observations for each country. ARIMA and LSTM models were developed and validated using identical specifications, with performance evaluated using RMSE, MAE, and Diebold-Mariano statistical tests for significance. ARIMA significantly outperformed LSTM in Kenya (RMSE: 5.67 vs 6.66, p<0.001), reflecting stable health system patterns suitable for systematic planning, while LSTM demonstrated superior performance in Uganda (RMSE: 8.47 vs 15.03) and Tanzania (RMSE: 7.30 vs 10.10), indicating more complex health dynamics requiring sophisticated modelling approaches. Kenya's predictable GAP patterns enable reliable ARIMA-based forecasting for health system planning, while regional variations necessitate context-specific methodological approaches across East African health systems. This study provides the first systematic GAP forecasting framework for East Africa, offering health policy makers evidence-based tools for resource allocation while establishing methodological foundations for public health planning that can strengthen health systems across the region

Last mile delivery of COVID-19 vaccination to populations aged 15 years and above in Nyeri County, Kenya, March 2021-June 2022

Nelson Muriu — 2025-08-06

Background: The COVID-19 pandemic in 2019 wreaked havoc on global economies and nearly paralysed health systems in some areas. Though mortality was moderate in African countries, the pangs of the disease were felt through the disruption of economic activities. Experimenting for vaccines started by December 2019 and Pfizer and AstraZeneca vaccines were authorised for emergency use in the same month. Mass immunisation campaigns started immediately. Kenya received its first vaccine consignment, AstraZeneca, on March 6, 2021 and commenced the rollout campaigns. This paper aims to highlight strategies and interventions towards the successful implementation of COVID-19 vaccination in Nyeri County. Interventions: Nyeri established the COVID-19 Vaccine Deployment Committee (CVDC), mandated to provide technical leadership, planning and strategising on the implementation process. The vaccination roll-out strategies that were adopted included capacity building of healthcare workers and establishment of COVID-19 vaccination static sites, among others. There is a paucity of data in the county on how strategic interventions affected vaccination coverage, as a campaign of such magnitude has not been carried out previously. Additionally, there was a lot of system downtime in the initial phases of the vaccination exercise, leading to manual registration, which could have led to a loss of data. Nyeri county population is varied; some sub-counties have a good road network connectivity, which could contribute to better access to vaccination. Results: Nyeri County had a total of 791,910 persons and had targeted to vaccinate 510,023 persons aged 15 years and above, from March 2021 to June 2022. 67.7% (95% CI: 67.55% - 67.81%) of persons were given the first dose of Covid 19 vaccine, while 40.3% (95% CI: 40.2% - 40.4%) of persons were given at least two doses of the COVID-19 vaccine. Increase in vaccination static sites from 5 to 17 resulted in an upward trend in vaccine uptake between March 2021 and June 2022, where 27,263 people received the first dose. Outreaches conducted brought an additional 55,071 individuals to be vaccinated. Supplemental Immunisation Activities contributed to 85,149 persons on the COVID-19 vaccine first dose. More females, at 55.20% (95% CI: 55.04%, 55.37%), accepted the vaccine than males at 44.80% (95% CI: 44.63% - 44.96%). Persons above 50 years returned for the second dose in comparison to ages below 40 years. Lessons learnt: Aggressive roll-out campaigns, involving stakeholders at the onset of vaccine roll-out and targeted demand creation, placed the country at the forefront in the last-mile vaccine delivery. Conclusion and implications: More than two-thirds of the adult population in Nyeri County received at least 1 dose of the COVID-19 vaccine during that period. Documentation of best practices will help policymakers implement strategies that will deliver vaccines to the last mile. Counties struggling with low coverage can use some of the best practices to improve the uptake of vaccines.

A Case Study Paper on the Prevalence and Impact of Childhood Trauma with Violence

Obiajurum Anthonia Odili — 2025-08-14

Maria Johnson is a 40-year-old, Biracial African American and Caucasian social worker who was referred by her primary care provider (PCP) with a complaint of heightened anxiety as well as persistent nightmares. As her ability to function at work and maintain friendships has decreased. Ms. Johnson lived with her husband of 20 years up until 8 months ago, at which time he abruptly ended their relationship to immediately entered a new relationship a couple of months later. They have a 20-year-old daughter together who is currently living independently as a college student, who Ms. Johnson believes has been greatly affected by their separation. She states that the feeling of her daughter losing a two-parent household has caused her an alarming amount of stress, fear, and anxiety. She has been feeling unusually fatigued, accompanied by difficulty focusing. She has repeatedly sought out reassurance from her mother and sister, but found that she could not be consoled by them as she worried about being “too much of a burden.” A few months prior to this session, Ms. Johnson began to avoid leaving the house. She had a fear that she would get kidnapped. Initially, she refused to go to the grocery store because the area she recently moved to had three recent kidnappings of a child and 2 women. She then began to get her groceries delivered, but refused to have contact with the delivery person. That soon progressed to her only working from home and not going in the field to see clients, which led to a demotion. Ms. Johnson added, “This is getting out of control, I honestly feel like something bad is going to happen to me”. She then added, “The only time my mind is at ease is when I am at home or with my daughter.” Ms. Johnson has a history of childhood trauma, including domestic violence and parental substance abuse. As a teenager, she experienced domestic violence and parental substance abuse, which added to her trauma history. Over the years, she has managed to suppress those early childhood memories for years, but began experiencing symptoms after she moved into her new home post-separation, triggering memories of her past experiences. Ms. Johnson goes on to express how she always struggled with her biracial identity, as she was often caught between two different cultures. This led to her not feeling accepted by either culture. Her experiences of cultural expectations and racism have contributed to her feelings of isolation and trauma. At her initial session, Ms. Johnson said she was “extremely anxious and got easily startled”, which started after her husband left. She reported feeling worthless, guilty, hopeless, and having constant thoughts about death. She lost 15 pounds and was fatigued from poor sleep patterns.

An Analysis of Geospatial Patterns and Diarrhoeal Prevalence in Children Under Five: A Case Study of Matungulu and Mavoko Sub-Counties, Kenya

Winfred Mbinya Manetu — 2025-08-14

Despite ongoing advancements in prevention efforts, diarrhoea remains a critical public health challenge, particularly threatening the health of infants and young children. The rising prevalence of childhood diarrhoea, especially in developing nations, has emerged as a pressing concern within public health discourse. This study examined both the prevalence and spatial distribution of diarrhoea-related illness among children under the age of five, with the goal of enhancing the monitoring and implementation of effective intervention programs. Data were collected from 398 mothers or caregivers of children under five years through a structured survey. The prevalence rate was determined by dividing the number of reported diarrhoea cases by the total number of children in the sampled households. To analyse spatial distribution patterns, the study employed spatial statistical techniques, including Moran’s I and Getis-Ord Gi*. Findings indicated a high two-week prevalence rate of childhood diarrhoea, affecting 34% of children under five in Mavoko and Matungulu Sub-Counties. Mavoko reported a higher rate at 37%, compared to 27% in Matungulu. Hotspot analysis using Moran’s I and Getis-Ord Gi* identified the western parts of Mavoko, specifically Athi River, Mlolongo, and sections of Katani and Kinanie, as areas with significantly high diarrhoea prevalence. These spatial insights highlight the need for geographically targeted interventions. The study recommends prioritising high-prevalence hotspots through improved access to safe water, expansion of sewerage systems, enhanced waste management, and strengthened hygiene promotion programs. Such targeted measures, combined with sustained surveillance and community engagement, could significantly reduce disease burden and improve child health outcomes within and beyond the study area

The Role of Nutrition Therapy in Recovery from Severe Burns: A Case Report from Muhimbili National Hospital, Mloganzila

Arafa E. Mkumbo — 2025-08-19

Background: Severe burn injuries are associated with profound hypermetabolic and catabolic responses that significantly increase nutritional requirements. Effective nutritional management is crucial for promoting wound healing, minimising complications, and improving recovery outcomes, especially in resource-limited settings. Purpose: This case report aims to highlight the practical and individualised nutritional strategies used to manage a patient with extensive burn injuries in a low-resource ICU setting. Methods: A 30-year-old male was admitted to Muhimbili National Hospital–Mloganzila following a motor traffic accident, sustaining deep second-degree burns over 53% of his total body surface area (TBSA), including the trunk, back, forearms, lower limbs, and buttocks. Upon admission, he presented with fluid imbalance, hypoalbuminemia, and functional feeding limitations. Nutritional needs were calculated using the Curreri formula, and a tailored nutrition care plan was developed. Fluid resuscitation followed the Parkland formula. Meals were provided from both hospital and home sources, supplemented with high-protein oral feeds, zinc (15 mg), and vitamin C (500 mg). Caregiver involvement and nursing support were integrated into the feeding process. Key Results: The individualised nutrition plan, supported by interdisciplinary collaboration and caregiver education, contributed to achieving target nutritional intake and clinical improvements. The patient showed gradual recovery with stabilised albumin levels, improved wound healing, and reduced complications. Conclusion: In resource-limited settings, effective burn nutrition therapy is feasible using locally available foods, targeted supplementation, and multidisciplinary coordination. Early assessment, tailored interventions, caregiver engagement, and regular monitoring are critical to successful burn recovery outcomes

Mapping Health Research Capacity Building Initiatives in Kenya: A Scoping Review

Beatrice Amy Nesidai — 2025-08-20

Health research capacity building (HRCB) is fundamental to the development of resilient health systems, the production of locally relevant evidence, and the advancement of evidence-based policy in low- and middle-income countries such as Kenya. Despite notable progress, Kenya’s HRCB landscape remains fragmented, donor-dependent, and heavily concentrated in urban academic institutions, with limited national coordination or systematic evaluation. This scoping review aimed to comprehensively map HRCB initiatives implemented in Kenya between 2010 and 2025, identifying key thematic areas, geographical coverage, and institutional actors. The review followed the Arksey and O’Malley methodological framework, augmented by the Joanna Briggs Institute (JBI) guidelines and the PRISMA 2020 checklist. Eligibility criteria were defined using the Population–Concept–Context (PCC) framework, focusing on individuals, institutions, and programs engaged in research training, mentorship, infrastructure development, policy engagement, and collaboration within the Kenyan context. A total of 110 records were identified through systematic searches of peer-reviewed databases (PubMed, Google Scholar, ResearchGate) and grey literature sources, including reports from government agencies, academic institutions, and development partners. After screening and full-text review, 31 studies were included in the final synthesis. Data were charted using thematic matrices and analysed narratively. Five key themes emerged: training and mentorship, institutional strengthening, research networks and collaborations, research-to-policy linkages, and equity considerations, including regional and gender disparities. While programs such as CARTA, Afya Bora, and KEMRI-led initiatives demonstrated impact, challenges included inadequate rural reach, persistent gender imbalances, limited sustainability, and weak national ownership. Findings reveal a lack of standardised monitoring indicators and minimal integration of HRCB into broader health and education systems. This review underscores the urgent need for a coordinated national HRCB framework that promotes inclusivity, local leadership, and long-term sustainability. Such efforts are essential to optimise Kenya’s research ecosystem, bridge capacity gaps, and align research development with national health priorities and global goals.

Documenting Lived Experiences of Youths During the COVID-19 Pandemic: Implications for Policy and Program Considerations for Youth in Six Selected Counties, Kenya

Fidelina Ndunge — 2025-08-26

Background: The COVID-19 pandemic profoundly impacted various segments of society, with adolescents and young adults bearing a significant brunt of its effects. Measures implemented to curb the spread of the virus directly influenced the livelihoods of these demographics. To comprehensively understand their experiences, we conducted a qualitative study across six counties in Kenya, focusing on three age categories: 15–18 years, 19–25 years, and 26–35 years, through eleven focus group discussions (FGDs). Objectives: The study aimed at exploring the lived experiences of adolescents and youths during the COVID-19 pandemic in six selected counties in Kenya, with a focus on social, economic, educational and healthcare impact. Design: The study was a cross-sectional study employing a qualitative approach using Focus group discussions (FGDs) and key informant interviews (KIIs). Participants: A total of 11 FGDs with youth aged 15–35 years and 5 KIIs with county policymakers were conducted. Participants were purposively sampled from rural, urban, and peri-urban settings and included individuals affiliated with youth networks and organisations. Results: Findings revealed disruptions in interpersonal relationships, economic hardships leading to increased tensions within households, and a surge in gender-based violence, teenage pregnancies, cases of female genital mutilation (FGM), and transactional sex. Economically, parents faced income reductions, job losses, and challenges in self-employment due to restrictive measures, exacerbating financial strains and prompting some to resort to child labour or crime. Microfinancing loans and business model adaptations, including digitalisation and social entrepreneurship, emerged as coping mechanisms. Moreover, the pandemic exacerbated educational inequalities, with limited access to virtual learning platforms and devices leading to increased dropout rates and poor academic performance, particularly among disadvantaged youths. From a healthcare perspective, service disruptions hinder the provision of youth-friendly services, resulting in delayed or inadequate medical attention and exacerbating health issues among young people. The pandemic's multifaceted impacts, encompassing familial and societal pressures, underscore the urgent need for proactive interventions to support youth resilience and well-being. Conclusion: Leveraging coping strategies identified in this study can inform collaborative efforts between government, non-state actors, and young people to develop sustainable mechanisms that transcend mere healthcare responses to future pandemics. Building robust partnerships and holistic approaches are essential to mitigate the adverse effects on youth and foster resilience in the face of future crises

Quality and Effect of Maternal Death Reviews on Annual Trends of Maternal Mortality Ratio at a Tertiary Referral Hospital in Western Kenya

Willys Ochieng — 2025-08-29

Introduction: The Global maternal mortality ratio remains high despite various strategies to lower it. More than two-thirds of global maternal deaths occur in Sub-Saharan Africa. Kenya’s maternal mortality ratio estimate is 355 deaths per 100,000 live births. To achieve below 70 deaths per 100,000 live births by 2030, Kenya’s Ministry of Health recommended the use of maternal death reviews as a mortality reduction strategy. The quality of MDR is an area of concern as to whether it achieves its desired goal. We sought to assess the quality and effect of maternal death reviews on annual trends of maternal mortality ratio at a tertiary hospital in Western Kenya between 2019 and 2023. Methods: A five-year retrospective chart review of 111 maternal death review forms was done, with variables being completeness of the forms, timeliness of review, and notification of maternal deaths. Statistical analyses were done using R version 4.4.1. To assess for quality, variables were dichotomised into either a yes or a no. Completeness sought to review if all sections of the review form were filled, while timeliness aimed to establish if a death was either notified within 24hours or not, and also reviewed by at least 40 percent of the relevant committee. Results: Median (Interquartile range) age of the parturients who had maternal death was 26 (22,33) with gestational age median of 33(30,37) weeks. Only 7% of the forms were complete, with 57.6% notified and 16.2% reviewed within seven days as per Ministry of Health guidelines. Across the five years, the average quality score was 1.89 (47.3%) with no effect on either decline or increase of maternal mortality ratio (P=0.482). Conclusion: The Quality of Maternal death reviews didn’t meet the set standards. As a result, no impact was observed on the maternal mortality trends as a result of the reviews over the period of evaluation. Recommendation: We recommend electronic notification of all maternal deaths and filling of all the forms, as this will ensure compliance with timeliness and completeness of filling of maternal death review forms.

Beyond the Scorecard: Performance Appraisal as a Strategic Lever for Public Health Officer Involvement in RTI Prevention

Sharon Muteheli — 2025-09-04

Introduction: Road traffic injuries (RTIs) remain a critical public health challenge globally, with low- and middle-income countries (LMICs) like Kenya bearing a disproportionate burden. In Nairobi County, RTIs are among the top causes of morbidity and mortality, highlighting the need for effective prevention strategies. Public Health Officers (PHOs) are key actors in these efforts, yet their participation is influenced by organisational factors, including performance appraisal (PA) systems. While PA is often treated as a routine administrative process, this study explores its strategic potential to enhance PHO motivation, accountability, and alignment with RTI prevention goals. Drawing on global and regional evidence, the study examines how elements such as feedback, goal-setting, and transparency within PA systems impact PHO engagement, aiming to inform policies that strengthen public health workforce performance in Kenya and similar settings. Methods: The current study adopted a descriptive cross-sectional study design using both quantitative and qualitative approaches. Data was collected from a saturated sample of 120 PHOs operating in Nairobi County and 6 supervisors. Quantitative data were analysed descriptively and presented in the form of tables. Qualitative data were analysed using deductive thematic analysis and presented in verbatim quotes. Results: Performance appraisal systems that provided timely feedback (72.3%), involved PHOs in goal setting (74.6%), and used results for career development and recognition (75.8%) boosted participation in RTI prevention. Conclusion: The study concludes that leadership support, organisational structure, and performance appraisal systems play a critical role in shaping the participation of Public Health Officers (PHOs) in road traffic injury (RTI) prevention. Supportive leadership practices, a clear organisational structure, and an effective performance appraisal system are enablers for enhancing participation of PHOs in RTI prevention. Therefore, addressing organisational barriers and investing in leadership, structure, and performance systems is essential for empowering PHOs to effectively contribute to RTI prevention efforts and broader public health goals.

Determinants of Hypertensive Crisis among Patients at Adult Emergency Department of Selected Public Hospitals in Jigjiga City, Somali Region, Eastern Ethiopia, 2022: A Case-Control Study

Abdishakour Deek Abdi — 2025-09-09

Background: Hypertension is a critical health issue that has the potential to cause considerable morbidity and mortality across the world. It has an estimated global population of 1.13 billion people. Hypertensive crises affect 1-2% of the population. In low-income nations like Ethiopia, hypertensive crisis is becoming a major health concern. However, limited studies have been conducted in Ethiopia. Objective: To assess determinants of hypertensive crisis among patients at the adult emergency department of selected public hospitals in Jigjiga city, Somali region, eastern Ethiopia. Methods: A hospital-based unmatched case-control study was conducted among 88 cases and 177 controls at the adult emergency department of selected public hospitals in Jigjiga city, from May 20 to July 5, 2022. Patients presented with hypertensive crisis were considered cases, and hypertensive patients, but without hypertensive crisis, were considered controls. Data were collected by trained nurses using a structured questionnaire and entered into Epi Data version 3.1 and exported into SPSS version 27 for analysis. Descriptive statistics were done and presented using text, frequency tables, charts, and graphs. Binary logistic regression was used, and variables with a p-value less than 0.05 were eligible for the final model. A multivariable logistic regression was also performed. Finally, a statistically significant level was declared at a p-value of less than 0.05. Result: The proportion of participants presented with a family history of hypertension was higher among cases than controls (62.5% and 47.5%) respectively and the likelihood ratio of hypertensive crisis was 3.3 times (AOR=3.359: 95% CI 1.298, 8.694) higher among participants with a family history of HTN compared to those without a family history of HTN. Conclusion: This study demonstrated a statistically strong association of DM, family history of HTN, regular follow-up and participants’ knowledge of HTN with HTN crisis. The government, health facilities, and health care workers should educate the public that regular follow-up can prevent hypertensive crisis, and give training to build communities’ knowledge on hypertension and give attention to DM Patients with hypertension.

Lymphatic Filariasis in Benue State: Progress towards Elimination Based on Mass Drug Administration of Ivermectine and Albendazole

Okete James Agada — 2025-09-17

The Federal Government of Nigeria, through the Ministry of Health, commenced mass drug administration of ivermectine (IVM) and albendazole (ALB) in all the 36 States of the Federation in 2011. The objective of this research was to assess the progress towards the elimination of LF in some endemic Local Government Areas of Benue State. While MDA is continuing in six Local Government Areas, in the year 2024, we assessed the impact of MDA on LF prevalence in six Local Government Areas that had achieved five effective annual rounds of MDA. In 2023, a baseline mapping exercise was conducted in the 20 accessible LGAs in Benue State. The results revealed that fifteen out of the twenty LGAs were endemic for LF, with prevalence ranging from 1.0%-7.0%. The number of persons treated with ivermectine and albendazole in the fifteen LGAs was documented during annual MDA, and population-based cluster surveys were conducted at least once in each LGA during the five years of treatment, to verify the reported geographic and programme MDA coverage. This is the number treated divided by the total population eligible to receive treatment (usually <5years). The survey results confirmed that in six LGAs (Ukum, Logo, Konshisha, Katsina-Ala, Gboko, and Otukpa), the coverage exceeded the target of 65% while the other nine LGAs did not reach the recommended coverage. A pre-transmission assessment survey (pre-TAS) was conducted in one sentinel site and at least one spot check site in Ukum, Logo, Konshisha, Katsina-Ala, Gboko, and Otukpa in 2024 and was found to have LF antigenemia (LF Ag) < 2% (range 0.0% to 1.99%). In 2024, transmission assessment surveys (TAS) were conducted in the six LGAs that had previously passed the Pre-transmission assessment survey. The results showed that the six Evaluation units had achieved the LF Ag threshold required to stop MDA. Benue State had made significant progress towards LF elimination with six LGAs qualifying to stop treatment. However, nine other area councils still require a further two years of mass drug administration with effective MDA coverage before these LGAs qualify for impact assessment.

Capacity Building as a Predictor of Service Provision among Community Health Promoters in Nandi County, Kenya

Chebet Risper — 2025-09-17

Capacity building is increasingly recognised as a cornerstone for strengthening community health systems, particularly in underserved regions where Community Health Promoters (CHPs) play a vital role in bridging the gap between households and formal healthcare services. This study examined the role of capacity building in enhancing the effectiveness of CHPs’ service provision in Nandi County, Kenya. The research adopted a descriptive design and targeted 1,567 CHPs across six sub-counties, from which a stratified random sample of 306 was drawn. Data were collected using a structured five-point Likert scale questionnaire that was pretested in Uasin Gishu County to ensure reliability and validity. A total of 287 responses were obtained, yielding a 93.8 percent response rate. Descriptive statistics indicated that although many CHPs had received some form of training, gaps persisted in the consistency, adequacy, and relevance of these capacity-building initiatives, which in turn affected their ability to deliver services effectively. Inferential analysis using Pearson correlation showed that capacity building had a statistically significant positive relationship with service provision (r = 0.518, p < 0.01), while regression analysis confirmed that capacity building was the strongest predictor among all facilitators, explaining a substantial portion of the variance in CHP performance outcomes. CHPs who accessed regular training, mentorship, and learning resources demonstrated greater confidence, improved efficiency, and stronger engagement with their communities. The findings underscore that beyond financial incentives, supplies, and job security, sustained investment in capacity building remains the most critical enabler of community health service delivery. The study concludes that institutionalising structured and continuous professional development programs for CHPs is essential for equipping them with the skills to respond to evolving health challenges, foster innovation, and build trust between communities and health systems. Policymakers and stakeholders are therefore urged to prioritise capacity building as a strategic pathway toward achieving universal health coverage in Kenya and similar contexts.

Assessing Tuberculosis Knowledge and Its Influence on Primary Healthcare Choice Among TB Patients: A Cross-Sectional Study in Nkoranza South Municipality of Ghana

Peter Kipo Leta — 2025-09-18

Background: Tuberculosis (TB) remains a major public health concern in Ghana, and delayed treatment and diagnosis have caused problems in controlling the disease. Patient knowledge regarding TB, its treatment, transmission, cause, and symptoms has been pinpointed as a determinant in triggering early healthcare-seeking behaviour. Thus, this study assessed tuberculosis knowledge and its influence on primary healthcare choice among TB patients in the Nkoranza South Municipality. Method: This cross-sectional study assessed the association between tuberculosis (TB) knowledge and Primary Healthcare Choice among TB patients. 286 TB patients aged 18 years and above, who received treatment between 2016 and 2020, participated in this study. Data were collected using a structured questionnaire. Descriptive statistics summarised socio-demographic, TB knowledge, and health-seeking behaviour variables. Fisher’s Exact Test and Logistic regression analysis were used to assess the associations and likelihood of seeking care at health facilities, respectively, with a significant threshold set at p<0.05 using SPSS version 26. Results: Out of the expected 297 respondents, 286 (96.3%) participated. Most respondents had high overall TB knowledge (88.1%). About 93% of respondents visit health facilities when they feel unwell. Major reasons for choosing where to access healthcare included easy accessibility (p<.001) and low cost (p = 0.049). On average, low TB knowledge (aOR = 0.16, 95%CI [0.04-0.60], p = 0.019), especially on treatment, was significantly associated with a lower likelihood of seeking care at a healthcare facility. Conclusion: This study found that while general TB knowledge among patients is high, gaps in areas such as knowledge about treatment significantly influence primary healthcare choices. Bridging these gaps in knowledge and access to services is crucial for improving early detection and treatment adherence, thereby strengthening TB control in Nkoranza South Municipality. Future studies should focus on designing and evaluating interventions that address structural barriers to accessing formal TB treatment.

Assessing Prevalence of Vaccination, Awareness, and Exposure to Risk Factors of Hepatitis B in Wa Municipality: A Descriptive Cross-Sectional Study

Florence Owusuaa Peprah — 2025-09-18

Background: Hepatitis B (HBV) in the Wa Municipality has increased over the past several years in Ghana, calling for urgent prevention and education interventions. This study evaluated awareness, vaccination coverage, and risk factors for HBV exposure in Wa Municipality, Ghana, to guide public health interventions. Methods: A cross-sectional study was conducted among 300 adults aged 18 years and above residing in Wa Municipality. A pre-tested questionnaire was used to collect information on demographic profile, knowledge about HBV, vaccination status, and history of exposure to major risk factors from January 1 to February 20, 2022. Statistical Package for Social Sciences (SPSS) version 22 was used to compute descriptive statistics and Pearson's correlation analysis. Results: The prevalence of full vaccination against HBV among respondents was 42%. The overall exposure to hepatitis B risk factors was 14.2%. Awareness of HBV was generally high, with about 81% exhibiting adequate awareness of risk factors, 92.6% of preventive measures and 80.6% of signs and symptoms of Hepatitis B. Statistically significant negative correlations were found between awareness of Hepatitis B exposure to risk factors (r = -0.282, p < 0.01), risk factors, (r = -0.251, p < 0.01) and preventive measures (r = -0.222, p < 0.01) and exposure to risk factors, and this increased awareness was linked with reduced risk exposure. Conclusion: Although Hepatitis B awareness is high in Wa Municipality, HBV vaccination is suboptimal. Targeted interventions must be implemented to optimise vaccination coverage and decrease HBV transmission in the Municipality. Future research must examine barriers to Hepatitis B vaccination, migration impact on HBV transmission, and the impact of interventions in progress.

Modified Conceptual Framework for Respectful Maternity Care for Promoting Quality in Health Facilities

Lucy Natecho Namusonge, PhD — 2025-09-18

Background: Respectful Maternity Care (RMC) is fundamental to improving maternal and neonatal health outcomes, yet mistreatment during childbirth remains widespread. Existing frameworks address either interpersonal mistreatment, structural delays, or quality standards, but often lack integration and clear evaluation pathways. Objective: This study presents a modified conceptual framework for RMC that unites training evaluation, systemic barriers, and patient experiences to guide quality improvement in Level 5 health facilities. Methods: The framework integrates three models: Kirkpatrick’s training evaluation model (linking provider learning to outcomes), Bowser & Hill’s landscape analysis (categorising disrespect and abuse), and the Three Delays model (addressing barriers to care). Principal Component Analysis (PCA) is proposed to enhance analytic rigour and weighting of variables. Results: The integrated framework demonstrates how provider training (reaction, learning, behaviour, results) influences women’s experiences of autonomy, dignity, and supportive environments, ultimately reducing delays and improving maternal and neonatal outcomes. Resource requirements—including staff training, supervision, and infrastructure—and cultural adaptations, such as respecting local birthing norms and promoting birth companionship, are essential for effective application. Recommendations: The framework guides implementation through structured steps: baseline assessments, stakeholder engagement, resource allocation, context-sensitive training protocols, and continuous monitoring and evaluation using Kirkpatrick’s four levels. Conclusion: By synthesising interpersonal, systemic, and evaluative dimensions, this model offers a robust and actionable tool for advancing RMC in resource-intensive settings. It provides policymakers, facility managers, and practitioners with a pathway to institutionalise respectful, equitable, and high-quality maternity care.

Dietary Practice and Nutrition Status of Under-5-Year-Old Orphans and Vulnerable Children in Isiolo County, Kenya

Gabriel Dokata Qalicha — 2025-09-23

Despite global advancements in child health, malnutrition is still the principal etiological factor underlying the elevated morbidity and mortality observed in children under five years of age, with orphans and vulnerable children (OVCs) constituting a demographically distinct cohort exhibiting heightened susceptibility. This community-based analytical cross-sectional investigation, undertaken within Isiolo County, Kenya, sought to quantitatively evaluate the nexus between specific dietary practices and the resultant nutritional status among this vulnerable subpopulation. Quantitative data were collected from OVCs and caregivers using semi-structured, researcher-administered questionnaires, while qualitative data were gathered through key informant interviews with child-care and administrative experts. Simple random sampling was used to select participants from three wards in Garbatulla. Data cleaning and analysis were conducted using SPSS version 29.0. Descriptive statistics were used for Level 1 analysis, while inferential statistics, including bivariate and multivariate regression analyses, were applied in Level 2 analysis. A p-value of < 0.05 was considered statistically significant. Qualitative data were analysed thematically to identify emerging patterns, complementing the quantitative findings. Anthropometric assessment, analysed against WHO growth standards, revealed a pronounced malnutrition prevalence of 40.2% (n=155/386), with pathologies distributed as wasting (32.9%, n=127), stunting (12.5%, n=48), and underweight (5.2%, n=20). Multivariate logistic regression modelling elucidated a statistically significant association between malnutrition and several modifiable dietary determinants: sufficient feeding frequency (Adjusted Odds Ratio [AOR] = 0.45; 95% CI: 0.24-0.81; p = 0.01), good dietary diversity score (AOR = 0.48; 95% CI:; 0.28–0.82 p = 0.032), and non-attainment of the minimum acceptable diet (AOR = 1.89; 95% CI:1.54-4.61; p=0.041), while a crude odds ratio indicated a 3.36-fold increased risk (95% CI: 1.59-4.41) for children exceeding 24 months of age. Consequently, these empirical findings necessitate the formulation of targeted nutritional interventions predicated on the promotion of dietary diversification, the implementation of responsive feeding protocols, and the structural reinforcement of support systems for at-risk households to ameliorate the disproportionate burden of malnutrition identified within this paediatric cohort.

Seroprevalence of Toxoplasma gondii and Cytomegalovirus IgG Antibodies among Sickle Cell Disease Patients Admitted at Pediatric Department of the Bugando Medical Center, Mwanza, Tanzania

Betrand Msemwa — 2025-09-24

Background: Sickle cell disease (SCD) is a life-threatening genetic disorder characterised by chronic hemolytic anaemia, recurrent vascular occlusion and progressive organ damage leading to reduced life expectancy and diminished quality of life. The immune deficiency in patients with SCD predisposes them to heightened susceptibility to serious bacterial, viral and parasitic infections such as Toxoplasma gondii and Cytomegalovirus. Objective: This study aimed to determine the burden of Cytomegalovirus and Toxoplasma gondii IgG antibodies among sickle cell patients admitted at the pediatric department of the Bugando Medical Centre in Mwanza, Tanzania. Methodology: A laboratory-based cross-sectional study involving 92 serum samples (-80°C) with Socio-demographic and other relevant information collected from sickle cell patients between June and August 2023 was used. Toxoplasma gondii and Cytomegalovirus specific IgG antibodies were detected using sandwich ELISA (Commercial ELISA kits, BioRad, USA). Descriptive data analysis was done using STATA version 15 software. Results: The median age was 1[IQR: 1.0 -1.5] years. More than half of the participants were male, 55.4 % (n=51) and were residing in the Mwanza region, 78.3% (n=72). The prevalence of Toxoplasma gondii and Cytomegalovirus IgG-specific antibodies was 28.3% and 19.6%, respectively. Drinking raw milk (p=0.044) and the presence of bilateral edema (p<0.001) were significantly associated with T. gondii infection. Bilateral edema (p<0.001) was also significantly associated with Cytomegalovirus infection. Conclusion and Recommendation: The study reported a low prevalence of toxoplasmosis and cytomegalovirus infections in this population. More studies with larger sample sizes are needed to show the actual prevalence of these two infections to design better prevention and management guidelines targeting sickle cell patients.

Community-Driven Nutrition Interventions in Arid Lands: Integrating Knowledge, Practices, and Capacity Building in Turkana County

Virginia Wanjiku Waithera — 2025-09-24

Malnutrition remains a critical public health challenge in arid and semi-arid lands (ASALs), where environmental shocks, socio-economic constraints, and limited dietary diversity exacerbate food insecurity. Turkana County, Kenya, exemplifies these challenges, with a poverty rate of 79.4% and the second-highest malnutrition burden in the country. Despite existing nutrition interventions, gaps persist in translating knowledge into practice due to cultural barriers, seasonal food shortages, and structural limitations. This study aimed to implement and evaluate community-driven nutrition interventions in Turkana County by integrating local knowledge, dietary practices, and capacity-building approaches to improve nutrition outcomes in arid land settings. It was conducted from October through December 2020 and used a descriptive cross-sectional design and focused on Loima and Turkana South sub-counties. A mixed-methods approach was employed by combining quantitative surveys (n=356) and qualitative focus group discussions (FGDs) across 10 community units. The study population included community health volunteers (CHVs) and long-term residents (>5 years), sampled through a multistage random sampling approach. Quantitative data were collected via semi-structured questionnaires, while FGDs explored perceptions of food security, dietary diversity, and coping strategies. Additionally, community participatory workshops were conducted to assess knowledge, attitudes, and practices on nutrition and develop action plans. Key findings revealed strong awareness of dietary diversity (72%) but limited practical application due to unemployment (45.8%), seasonal food scarcity (68%), and cultural barriers (e.g., 41% avoided eggs in pregnancy). Women showed a deeper understanding than men. Diets relied heavily on maize (89%), with low intake of animal protein (19%) and fruits/vegetables (23%). Though 9 indigenous fruits were valued, 78% faced preparation challenges. Post-workshop, participants demonstrated improved knowledge on dietary diversity and initiated home gardens and self-help groups. However, persistent barriers included a lack of seeds, irrigation, and financial resources. Post-intervention, 55% adopted home gardens and 38% joined self-help groups, but 63% lacked seeds and 58% lacked water access. While knowledge retention improved by 42%, resource gaps limited wider impact. Cultural taboos, such as avoiding eggs during pregnancy, further restricted dietary practices. Environmental challenges, drought, floods, and insecurity disrupted food production and market access. This study highlighted the critical need for integrated interventions combining nutrition education, climate-resilient agriculture, and economic empowerment to bridge the knowledge-practice gap. Therefore, there is a need to prioritise community-driven approaches in order to leverage local leadership and participatory learning for sustainable impact in ASALs.

Epidemiological Trends of Malaria in Hirshabelle, Somalia (2022–2025)

Ahmed Hassan Gomey — 2025-10-01

Background: Malaria is a major cause of illness and death in sub-Saharan Africa, and Somalia is one of the countries that is hit the hardest. The floodplains of the Shabelle River, together with irrigated farming and seasonal flooding in Hirshabelle State, make it easy for malaria to spread. Despite the use of insecticide-treated nets (ITNs), indoor residual spraying (IRS), and rapid diagnostic tests (RDTs), malaria is still a major public health problem in the area. Objective: The objective of this study was to analyse the epidemiological trends of malaria in Hirshabelle State, Somalia, from 2022 to 2025, focusing on annual incidence patterns by sex and age groups. Approaches: A retrospective analysis employed secondary data obtained from the Health Management Information System (HMIS) using the DHIS2 platform. The data consisted of confirmed malaria cases from healthcare facilities around Hirshabelle. A descriptive analysis was conducted in Stata 16.0 to examine the annual incidence, test positivity rate, and demographic distribution. Findings: From 2022 to 2025, there were 4,401 cases of malaria. The incidence rates fluctuated throughout time, recording the minimum rate in 2022 (0.38 per 1,000) and the maximum rate in 2023 (0.60 per 1,000). In 2024 (0.48 per 1,000) and 2025 (0.46 per 1,000), the rate experienced a slight decline. Females accounted for 67.4% of the cases, while children under five years accounted for 53.5% of the overall burden. The 5–14-year age cohort, albeit numerically inferior, exhibited the highest average annual incidence (2.17 per 1,000). Conclusion: Malaria in Hirshabelle continues to follow a cyclical pattern that is highly linked to how much rain occurs in a certain season. The continued high rates of illness among women and children, and other vulnerable groups, show that current treatments are not good enough. We need improved ways to stop the spread of malaria and aid in long-term control in Somalia. This includes better ways to prevent it, quicker access to diagnostic and treatment, and the use of climate-sensitive forecasting tools.

The Role of Health Unit Management Committees on Health Service Delivery in Health Centre IIIS; A Case of Sheema Municipality, Uganda

Wycliffe Bwebare — 2025-10-01

Countries across the World are working hard to improve health service delivery within communities. Ensuring healthy lives and promoting well-being of all at all ages is the major focus of Sustainable Development Goal 3, and target 3.8 was set to achieve this goal by 2030. This study focused on examining the role of Health Unit Management Committees in Health Service delivery. Specifically, to establish the effect of health unit management committees’ planning and budgeting on accessibility of quality health services; to determine the influence of health unit management committees’ motivation and incentives on health service delivery; to establish the effect of health unit management committees’ supervision and feedback on health service delivery in Sheema municipality, Uganda. A cross-sectional survey research design was employed, using a qualitative approach. The purposive sampling technique was used to select 131 respondents. Data collection methods included a questionnaire survey and an interview method. Quantitative data were analysed using descriptive analysis, Pearson correlation coefficient, and multiple linear regression with SPSS v.29. Qualitative data were analysed using thematic analysis supported by NVIVO software. The study found and concluded that Health Unit Management Committees’ planning significantly improves health service delivery (r = 0.536, β = 0.451, p < 0.05). The study also concluded that Health Unit Management Committees’ motivation and incentives significantly enhance health service delivery (r = 0.645, β = 0.327, p < 0.05). The study further concluded that Health Unit Management Committees’ supervision and feedback significantly improve health service delivery (r = .702, β = 0.544, p < 0.05). The study recommended that local governments, the Ministry of Health, and development partners should implement structured incentive schemes for HUMC members, including financial allowances, recognition, certificates, and capacity-building opportunities, to boost morale and commitment. Additionally, continuous supervision and feedback mechanisms should be institutionalised through regular visits, reporting frameworks, and timely feedback, while encouraging HUMCs to document and share their findings to improve health service delivery. Targeted training on supervision, leadership, and community engagement should further empower HUMCs to provide effective oversight and integrate their feedback into health planning, ultimately enhancing service delivery in Sheema District.

Revolutionising Obstetric Care with AI: The Mama Track Mobile Partograph

Penina Macha — 2025-10-02

Maternal and fetal health monitoring is critical in ensuring safe labour and delivery. Hence, the World Health Organization (WHO) is recommending the use of partographs for labour monitoring. Thus, various computer-aided diagnosis (CAD) systems have recently been developed and play a vital role in supporting obstetricians to evaluate the fetal state. Despite such advancement in the automation of CAD systems. However, prediction of fetal conditions, including prolonged labour, obstructed labour, postpartum haemorrhage, and fetal distress, has been a challenge due to not only visual misinterpretation of the recorded values but also gaps in training. This results in a significant inter-observer variability, which causes delayed interventions and increased maternal-fetal complications. In an attempt to address the challenge, this study has proposed an AI-based mobile partograph (Mama Track Mobile Partograph) that relies on deep learning models designed to assist obstetricians with real-time decision support and predictive analytics. The proposed approach has been evaluated using open-access datasets (CTU-UHB Intrapartum Cardiotocography Database), and the findings suggest that the proposed Mama Track Mobile Partograph has achieved a test set G‑mean of 0.6037, balanced sensitivity (~0.54) and specificity (~0.67), and overall accuracy (0.6257), highlighting its potential to mitigate inter-observer variability in traditional partograph interpretation. Therefore, Mama Track Mobile Partograph is not only a feasible AI solution but also an innovation that can eliminate factors leading to maternal and neonatal morbidity and mortality

Barriers and Enablers of Health Information Systems Interoperability in Kenya: A Scoping Review

Peter Munyao Kithuka — 2025-10-08

The integration and interoperability of health information systems (HIS) are essential for efficient, data-driven healthcare delivery. Although Kenya has expanded the use of Electronic Medical Records (EMRs) and mobile health (mHealth) platforms, the extent and effectiveness of interoperability across public and private sectors remain uncertain. This scoping review examined current literature on HIS interoperability in Kenya, identifying key barriers, enabling factors, and the types of systems involved between 2015 and 2025. Studies were included if published in English during this period, addressed Kenya’s HIS, and explored interoperability-related barriers, enablers, or implementation of interoperable platforms. Using the Arksey and O’Malley framework with Joanna Briggs Institute (JBI) refinements, the researchers searched PubMed, Google Scholar, and Scopus, identifying 138 records, of which 27 met the inclusion criteria. Data were charted using a literature matrix and synthesised thematically. Twelve key themes emerged. Barriers included inadequate technological infrastructure, lack of standardised data formats, limited digital health readiness, and fragmented governance. Enablers included strong leadership, intersectoral collaboration, user-centred design, community engagement, and adoption of modular or open-source tools. Interoperability gaps were especially evident in chronic disease and HIV services, notably in underserved urban settlements. EMRs, diagnostics platforms, and mHealth applications were the most frequently referenced systems. Despite progress, Kenya’s HIS landscape continues to face substantial challenges in achieving seamless interoperability. Strategic investments in infrastructure, regulatory alignment, workforce capacity, and policy coordination are required. Further research should explore rural and marginalised contexts, incorporate patient perspectives, and evaluate the long-term impact and scalability of interoperability initiatives.

Exploring Task-Shifting Approaches in Addressing Specialist Shortages to Enhance Access to Healthcare Services in Rural Kenya: A Systematic Review

Beatrice Amy Nesidai — 2025-10-08

Access to healthcare services in rural Kenya remains significantly constrained due to a chronic shortage of medical specialists, uneven distribution of resources, and weak health system structures. Task-shifting, the delegation of specific clinical responsibilities to non-specialist health workers, has emerged as a promising strategy to address these gaps. This systematic review aimed to evaluate how task-shifting influences access to healthcare services in rural Kenya by examining individual, systemic, and policy-level determinants. A total of 28 empirical studies published between 2020 and 2025 were systematically analysed using the PRISMA framework. The findings revealed that individual factors such as adequate training, clinical experience, positive attitudes, and self-efficacy significantly enhance the effectiveness of task-shifting. Human resource capacity, particularly the availability of trained non-specialists and consistent supervision, played a crucial role in ensuring service quality. Health system readiness, including functional infrastructure, referral systems, and medical supplies, emerged as critical enablers of successful task-shifting, while deficiencies in these areas limited intervention effectiveness. Furthermore, policy and governance frameworks influenced scalability and sustainability, with weak enforcement and ambiguous role definitions identified as major barriers in Kenya. Overall, the review found that task-shifting can significantly improve healthcare access in rural settings, but only when supported by comprehensive training, adequate system capacity, and strong regulatory frameworks. The study concludes that task-shifting is a viable solution to mitigate specialist shortages, but its success requires a holistic approach that addresses training, supervision, infrastructure, and policy enforcement. It recommends the development of standardised training programs, robust mentorship systems, investments in rural healthcare infrastructure, and the creation and enforcement of clear, context-specific task-shifting policies. These findings are critical for health policymakers and practitioners seeking to enhance equitable healthcare delivery in underserved regions of Kenya.

The Impact of Male Involvement on Enhanced Postnatal Mental Health Outcomes among Women in Resource-Constrained Settings: A Scoping Review

Lily Chepketer Ng’eno — 2025-10-09

Context: The psychological health of mothers after childbirth is an essential but often overlooked aspect of maternal and child health, especially among socioeconomically deprived groups (Mehan, 2025). There is evidence showing the correlation between the involvement of males’ roles maternal health and better health indicators. However, the data available on the males’ role in supporting maternal mental well-being after childbirth is limited. Objective: This scoping review seeks to outline the existing literature on male involvement in postnatal maternal mental health support in low-resource settings, identify barriers and facilitators, and outline existing intervention strategies alongside research gaps. Methods: Research was carried out for studies published from 2015 to 2025, utilising the Arksey and O’Malley framework with additional improvements suggested by Levac et al (2010). Studies from low- and middle-income countries examining male partners' roles in providing emotional, practical, and psychosocial support during the postpartum phase were considered eligible. Data were extracted using a standardised form and analysed thematically. Results: From 58 included studies, male involvement was consistently associated with improved maternal mental health outcomes, including reduced postpartum depression, lower anxiety levels, and greater use of mental health facilities. The most substantial barriers were stigma, entrenched gender stereotypes, and insufficient healthcare facilities specifically for males. The strongest facilitators were the education of communities, couple-oriented interventions, peer social support, and the incorporation of male involvement into standard maternal health facilities. There were significant findings for most questions, and coverage and geographical spread amplified their impacts—standard maternal health facilities. Most questions had significant findings, and coverage and geographical spread amplified their impacts. Summary: Regardless of the constraints placed by the availability of resources, involving men is an essential and often overlooked approach to improving the postpartum mental health of mothers. To encourage greater male involvement and improve maternal outcomes, there needs to be the inclusion of evidence-based and contextually appropriate interventions that mitigate the current structural and socio-cultural barriers.