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Research Papers
Gender disparities and barriers to access and use of essential health services in Ethiopia: Designing primary health care through gender lens.
This exploratory qualitative study investigated gender-related barriers to accessing maternal and child health (MCH) services in Ethiopia’s primary health care system, despite national efforts to improve health service delivery through the “Optimizing Ethiopian Health Extension Program” strategy. Conducted across nine districts with 221 participants, the study revealed that socio-cultural norms, gender power imbalances, and institutional gaps hinder women’s access to MCH services. Women’s heavy household workloads, limited decision-making power, and low male awareness of MCH needs fu
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Research Papers
Cost-Effectiveness of Youth-Friendly Health Services in Health Post Settings in Jimma Zone, Ethiopia
This study evaluated the cost-effectiveness of implementing Youth-Friendly Health Services (YFHS) in rural health posts in Jimma Zone, Ethiopia, to improve adolescent sexual and reproductive health (SRH). Using an ingredient-based costing approach and modeling health outcomes through disability-adjusted life years (DALYs) averted, the study found that YFHS reached nearly five times more adolescents than routine services and significantly improved health outcomes, including increased antenatal care and contraceptive use. The intervention averted 52.11 DALYs at an incremental cost-effectiveness
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Research Papers
The Vaccine Trust Framework: mixed-method development of a tool for understanding and quantifying trust in health systems and vaccines
This study developed and validated a contextually grounded Vaccine Trust Framework to better understand and measure trust in vaccines across low- and middle-income countries. Using an exploratory sequential mixed-methods approach, ethnographic research in Nigeria, Kenya, and Pakistan informed the creation of a framework encompassing four domains—health system promise, health system delivery, vaccine promise, and vaccine delivery—across 15 measurable dimensions. A nationally representative survey of caregivers in Kenya and Pakistan confirmed the framework’s validity, showing strong associ
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Research Papers
The impact and social return on investment (SROI) of health workforce training in fragile, conflict-affected settings—a study of the Maridi Health Sciences Institute (MHSI) in South Sudan
This study evaluated the long-term social impact of pre-service health workforce training at Maridi Health Sciences Institute (MHSI) in South Sudan, particularly in fragile and conflict-affected settings. Using Social Return on Investment (SROI) analysis, researchers gathered data from 596 respondents through literature reviews, focus group discussions, and key informant interviews. The study found that MHSI significantly benefited graduates, communities, and government stakeholders, with improved professionalism, healthcare access, and sustained outcomes lasting over five years. The SROI rati
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Research Papers
Facilitators and barriers of Community Case management of Malaria implementation in Homabay, Busia and Kakamega Counties, Kenya
This mixed-methods study assessed the facilitators and barriers to the uptake of Community Case Management of malaria (CCMm) in Kenya, where trained community health volunteers (CHVs) provide malaria diagnosis and treatment at the household level. Among 528 surveyed households, 72% had received malaria services, and 85% expressed satisfaction with CHV services. Key facilitators included availability of malaria commodities, functional referral systems, and support supervision. However, barriers such as stockouts of diagnostic kits and antimalarials, myths about mosquito nets, and poor road acce
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Research Papers
Bridging the policy-action gap: a scoping review of climate-resilient malaria control policies in Kenya and Zambia with recommendations for strengthening the WHO framework
This study examined policy-action gaps in climate-resilient malaria control strategies in Kenya and Zambia, where climate change has intensified malaria risks through altered weather patterns and extended mosquito breeding seasons. Using a systematic literature review guided by the PRISMA model, the study analyzed 19 peer-reviewed articles and policy documents published since 2010. It identified key challenges including weak health infrastructure, inadequate funding, poor integration of climate data, and fragmented stakeholder coordination. The lack of clear implementation metrics and cross-se
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Research Papers
Documenting Lived Experiences of Youths During the COVID-19 Pandemic: Implications for Policy and Program Considerations for Youth in Six Selected Counties, Kenya
This qualitative study explored the lived experiences of adolescents and young adults aged 15–35 across six counties in Kenya during the COVID-19 pandemic, focusing on social, economic, educational, and healthcare impacts. Through 11 focus group discussions and 5 key informant interviews, the study revealed widespread disruptions in relationships, increased gender-based violence, teenage pregnancies, and economic hardships that led to child labor and crime. Educational inequalities worsened due to limited access to virtual learning, while healthcare service disruptions hindered youth-friendl
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Research Papers
Last mile delivery of COVID-19 vaccination to populations aged 15 years and above in Nyeri County, Kenya, March 2021-June 2022
This paper highlights the strategies and interventions that facilitated the successful rollout of COVID-19 vaccination in Nyeri County, Kenya, following the arrival of the AstraZeneca vaccine in March 2021. The county formed a COVID-19 Vaccine Deployment Committee to lead planning and implementation, including capacity building for healthcare workers and expanding vaccination sites from 5 to 17. Despite initial system challenges, outreach efforts and supplemental immunisation activities significantly boosted vaccine uptake. By June 2022, 67.7% of the targeted adult population had received at l
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