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Measuring the Effect of Different Modes of Mobile Phone-Based Antenatal Family Planning Counseling on the Intention for Early Postpartum Family Planning Uptake in Western Kenya: A Pragmatic Factorial Randomized Control Trial
(Ethiopian Journal of Reproductive Health (EJRH), 2025-01-24) Shisanya, Morris Senghor; Kipmerewo, Mary; Morema, Everlyne; Ouma, Collins
INTRODUCTION: The Maternal and Child Health care continuum offers a key opportunity to integrate postpartum family planning (PPFP) interventions, particularly through antenatal counseling. This study assessed the impact of mobile phone-based antenatal family planning counseling on the intention for early PPFP among postpartum mothers in Western Kenya.
METHODOLOGY: This pragmatic factorial randomized controlled trial assessed the effectiveness of family planning counseling delivered by nurses and community health workers using a mobile phone-based tool, compared to routine counseling, on the intention for early postpartum family planning among postpartum mothers in Kisumu County, Western Kenya. Ordinal regression identified predictors of intention, while ANOVA evaluated the effectiveness of counseling modalities, with significance set at P < 0.05. Tukey’s post hoc test and partial eta² were used to determine differences between study arms and effect size, respectively.
RESULTS: The mean intention for early PPFP on a 7-point Likert scale was 6.59±0.87 for the nurses’ arm, 6.05±0.86 for the community arm, and 6.03±0.69 for the control arm. ANOVA revealed a significant difference in mean intention scores between the arms (F(2,243)=12.43, P<0.0001). Tukey’s post hoc test showed significantly higher mean intention in the nurses’ arm compared to both the community (P<0.0001) and control arms (P<0.0001) with a medium effect size (partial eta² = 0.06 to <0.14). The combined mean intention for the two intervention arms (6.22±0.85) was significantly higher than the control arm (P=0.012) with a small effect size (partial eta² = 0.026). There was no significant difference between the community and control arms (P=0.986).CONCLUSION: Mobile phone-based antenatal family planning counseling by nurses was more effective in increasing intention for early postpartum family planning for participants in Kisumu County compared to community-based and routine delivery of counseling. Therefore, more efforts should be directed toward empowering nurses with mobile phone-based antenatal family planning counseling tools to enhance intention for early postpartum family planning.
KESOZI Digital Twin: Physics-Informed Neural Network for Independent Estimation and Prediction of Childhood Diarrheal Disease Burden in Kenya, Somaliland, and Zimbabwe
(2026-06-24) Agumba, John Onyango; Namusonge, Lucy Natecho; Ogendo, Joshua Ondura; Takavarasha, Musiiwa; Mohamad Ahmed Hassan; Senghor, Morris Shisanya; Waswa, Lydia; Pembere, Anthony
Childhood diarrheal disease remains a leading cause of morbidity and mortality among children under five years in sub-Saharan Africa, particularly in settings affected by inadequate sanitation, climate variability, malnutrition, and limited healthcare access. Conventional forecasting approaches are often constrained by sparse surveillance data, weak spatial representation, and
limited incorporation of mechanistic disease dynamics. This study presents a Physics-Informed Multimodal Artificial Intelligence Digital Twin framework that integrates Physics-Informed Neural Networks, Graph Neural Networks, diffusion-reaction epidemiological modeling, multimodal fusion learning, and Digital Twin simulation to estimate and predict childhood
diarrheal disease burden in Kenya, Somaliland, and Zimbabwe. Using public epidemiological, environmental, climate, sanitation, and synthetic proof-of-concept datasets, the framework modeled temporal disease dynamics, spatial transmission, pathogen-attributed burden, and outbreak trajectories while enforcing epidemiological consistency through physics-informed optimization. Results demonstrated robust forecasting performance, enhanced spatial transmission modeling, uncertainty-aware predictions, and realistic outbreak simulations across the three countries. Rotavirus, Shigella, and Cryptosporidium were identified as major contributors to modeled mortality burden, while unsafe water exposure, poor sanitation, malnutrition, and climate-sensitive transmission substantially increased disease risk. Compared with a Bayesian baseline model, the multimodal framework achieved superior nonlinear risk characterization, geospatial learning, and temporal prediction. These findings highlight the potential of scientific machine learning and digital twin systems for infectious disease surveillance, outbreak forecasting, climate-health analytics, and evidence-based public health decision-making in low-resource African settings.
Situation Analysis of HIV, Hepatitis B, and Syphilis among Pregnant Women: A Case of Burco General Hospital, Somaliland
(East African Journal of Health and Science, 2025-06-05) Osman, Abdirisaq Muse; Namusonge, Lucy Natecho
Background: Sexually transmitted diseases like HIV, Hepatitis B and Sexually Transmitted Diseases like syphilis remain a public health concern, with 2.3 million deaths per year and 1 million people newly infected per day. This accounts for about 14% of deaths from infectious and parasitic diseases globally. These diseases can be vertically transmitted and have a particular burden on
pregnant and newborns, especially in low-income countries. Objectives: This study aims to determine the seroprevalence and determinants of HIV, Hepatitis B and Syphilis among pregnant women attending the obstetric department of Burco General Hospital, Somaliland. Methodology: quantitative research with a cross-sectional study design using semi-structured questionnaires and rapid test kits were used to screen 271 pregnant women attending the hospital. Both descriptive and analytic statistics were calculated using SPSS v20. Adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. Results: the prevalence of HIV, Hepatitis B, and Syphilis among pregnant women attending Burco General Hospital was 0.4%,
4.1%, and 3% respectively. The cross-reactivity of HIV/HBV was 9.1%. There was no significant risk factor outcome regarding sociodemographic and obstetric characteristics. Conclusion and recommendations: Infectious diseases are a public health burden among pregnant women in Burao. However, antenatal care provides an excellent opportunity to screen women for infections that are
common and treatable and can be transmitted vertically. Ministry of Health should adopt proper prevention and control intervention guidelines to reduce the risk of these three infections in line with WHO triple elimination guidelines.
Level of Water Governance in Schools and its Effect on Student Participation in Education
(International Journal of Research and Innovation in Social Science, 2021-06-12) Wambeye, K. M.; Wasike, D. W.; Ong’anyi, Paul Obino
Adequate access to water, hygiene and sanitation is every human’s and child’s right. These do not reflect national policies aspirations and are not adequate to student’s needs, affecting their health, well-being, performance and participation at school in Kenya. A cross-sectional survey design was adopted to sample from boarding schools that were sampled to take part in a study conducted in Bungoma County in the Western region of Kenya. Stratified sampling was employed in choosing the Schools while questionnaires, interview schedules, document analysis and focus groups were used to gather data. The model was not able to significantly predict the level of water governance in schools and its effect on student participation in education and hence concluded that every boarding secondary school should develop a drinking water access plan. This study provides an empirical pattern of participation in education influenced by WASH in schools.
Mechanism of Waste Management in Schools and its Effect on Student Participation in Education
(International Journal of Development Research, 2022-01-12) Wambeye, K. M.; Wasike, D. W.; Ong’anyi, Paul Obino
Waste management is pausing challenges to the environment especially in schools world over. In schools, water, sanitation and hygiene do not reflect national policies aspirations and are not adequate to student’s needs and hence affecting their health, well-being, performance and participation at school. An investigation into the mechanism of waste management in schools and its effect on student participation in education in Bungoma County, Kenya was done using a cross-sectional survey design approach. A sample of sixty five (65) boarding schools was chosen to take part while stratified sampling was employed in choosing the boarding Schools from the targeted population of 289 secondary schools. Questionnaires, interview schedules, document analysis and focus groups to gather data. Standard multiple linear regressions at α= .05 was used to examine waste disposal to see if it could predict participation in education in school. The model was not able to significantly predict the effect of waste management in schools on participation in education. It was concluded that engagement of school related groups need to encourage students to make waste reduction a part of their everyday life while increasing the flow of reusable and recyclable materials can even generate extra funds for school departments and groups.