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Research Papers
Strengthening accountability in strategic health purchasing arrangements for primary health care in Uganda
Effective Strategic Health Purchasing (SHP) is pivotal for making progress towards the achievement of Universal Health Coverage (UHC), as we implement Primary Health Care (PHC). This qualitative study examined accountability and SHP arrangements and how they influence PHC performance. Using document reviews, 43 key informant interviews, and insights from policy dialogs, the study analyzed accountability practices across financial management, contracting, performance monitoring, health benefit specification, and provider payment mechanisms. Read More
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Research Papers
Factors associated with the nutritional status of children (6-30 months old) in home-based and centre-based child care centres in Embakasi East, Nairobi, Kenya
Early childhood nutrition is critical for healthy growth, yet this study found that limited caregiver knowledge, poor feeding practices, and inadequate hygiene contribute to malnutrition among children aged 6–30 months in an informal settlement in Nairobi. Using a cross-sectional mixed-methods design across 26 childcare centres, the study showed that although most caregivers and parents had secondary education, children’s diets were dominated by carbohydrate-rich foods with low intake of animal protein, and many children were fed less frequently than WHO recommendations. Malnutrition rates
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Research Papers
Sociodemographic determinants of fathers’ acceptance of the human papillomavirus (HPV) vaccine of adolescent girls in Kesses (rural) and Kapseret (urban), Uasin Gishu County, Kenya
This study examined socio-demographic factors influencing fathers’ acceptance of HPV vaccination for their adolescent daughters in Kenya, where paternal consent is essential but understudied. Using questionnaires from 375 fathers and qualitative interviews with fathers and community health workers, the study found low vaccine uptake, with only 36.8% of daughters vaccinated. Logistic regression showed that fathers’ employment status and geographical location significantly predicted acceptance. Despite most fathers being educated and married, vaccine uptake remained low, highlighting the nee
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Research Papers
Prevalence of stress, anxiety, depression, and reported self-esteem among mothers of children with autism spectrum disorder
This cross-sectional study assessed the mental health of 246 mothers of children with autism spectrum disorder (ASD), revealing high prevalence rates of psychological distress. Using the DASS‑21 and Rosenberg Self‑Esteem Scale, the study found that 84.1% of mothers experienced depression, 77.2% anxiety, 74% stress, and 67.9% low self-esteem, with mean scores indicating moderate severity across all conditions. These findings highlight the substantial emotional burden faced by mothers raising children with ASD and underscore the need for mental health support to be integrated into rehabilita
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Research Papers
Aging Alone in the City: Systemic Exclusion, Social Isolation, and Loneliness among Older Refugees in Nairobi, Kenya
This study explored the mental health and psychosocial wellbeing of older refugees experiencing protracted urban displacement in Nairobi, Kenya, drawing on focus group discussions with 53 refugees from the DRC, Ethiopia, Somalia, and South Sudan. Using a framework analysis, the study found that systemic exclusion—driven by policy gaps such as delays in implementing Kenya’s 2021 Refugees Act—created forced dependency and significant distress. Displacement disrupted social networks, leading to profound social isolation, while participants described loneliness as an emotional expression of
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Research Papers
Association between self-care practices and glycemic control among adults with type 2 diabetes mellitus in Douala, Cameroon: A mixed-methods study
This mixed‑methods cross-sectional study assessed how self‑care practices relate to glycemic control among 230 adults with type 2 diabetes attending two hospitals in Douala, Cameroon. Only 21.3% achieved good glycemic control, while most had poor control. Logistic regression showed that better dietary practices and adequate foot care were significantly associated with improved glycemic outcomes, findings that were supported by qualitative data highlighting barriers such as high food costs, limited healthy food availability, and expensive monitoring supplies. Overall, the study underscores
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Research Papers
Determinants of COVID-19 vaccine uptake amongst traders in Wakulima Market, a cross-sectional study in Nairobi City County, Kenya
This cross-sectional mixed‑methods study examined factors influencing COVID‑19 vaccine uptake among 353 traders at Wakulima Market in Nairobi, supported by qualitative insights from 30 county health officials. Findings from multiple linear regression showed that contextual, individual, and perceptual factors each significantly increased vaccine uptake, with perceptual factors having the strongest effect. Baseline uptake was low, but improvements in any of these domains were associated with measurable increases in acceptance. Overall, the study highlights that traders’ vaccination decisio
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Research Papers
Effect of socio-demographic factors on focused antenatal care services utilization among pregnant women at an informal settlement health centre in Nairobi, Kenya
This cross-sectional study assessed how socio-demographic factors influence the use of Focused Antenatal Care (FANC) among 272 expectant women in their third trimester at Lunga Lunga Health Centre in Nairobi. Only 9.9% met the recommended eight visits. Logistic regression showed that women with multiple parities, without spouses, and those identifying as Muslim were significantly less likely to complete the recommended visits. Overall, low FANC utilisation in this informal settlement was strongly linked to marital status, parity, and religion, highlighting the need for targeted sensitisation a
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