Browsing by Author "Morema, Everlyne Nyanchera"

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Characteristics of injuries among children attending public primary schools in Kisumu Municipality, Kenya.
(Donnish Journal of Nursing and Midwifery, 2015-05-18) Nyangahu, Drusilla N.; Odero, Wilson; Ogonda, Lilian; Senghor, Morris Shisanya; Morema, Everlyne Nyanchera
Injuries remain a major killer of children throughout the world. On average, for children in the age group 5-14 years, injury accounts for more than a quarter (27 %) of all deaths worldwide. In addition to these deaths, many other children sustain injuries that require hospitalization, outpatient treatment and sometimes result in disability. In Kenya, injuries are the third leading cause of mortality after malaria and HIV/AIDS and are the fifth leading cause of morbidity among patients attending health care facilities. Approximately 16.8 % of reported injury cases in Kisumu occur among children less than 15 years of age and accounting for 28.7 % of the total injury admissions. Although children less than 15 years of age fall within the primary school age, not much is known about the nature and factors that contribute to the occurrence of injuries among primary school children in Kisumu and programs focusing on their prevention are lacking. Methods: This was a cross-sectional study that aimed to describe the characteristics of injuries among primary school children in Kisumu Municipality. A random sample of 492 pupils aged 11 to 18 years; from 18 schools was interviewed using a structured questionnaire to collect information on the incidence of injuries during the three month period prior to the interview. Results: The most common cause of these injuries was due to falls on the same level (33.9 %). Majority of these pupils were injured while playing (48.8 %), at home (40.9 %) with cuts or open wounds being the most common injury that was sustained (42.1 %). However, injuries caused by fire / hot fluids were associated with gender (P < 0.002) with 76% of the pupils who reported having sustained these injuries being girls. Furthermore, gender was associated with occurrences of injuries at home (P < 0.001) with 115 out of the 201 (57.2%) children who reported having been injured while at home being girls. Almost half of the pupils sought medical care and a quarter of the pupils were hospitalized. Two-thirds of the pupils (66.5 %) received first aid which was mostly administered by a friend or family. More than half (56.7 %) of the pupils were absent from school due to the injury. Although 95.7 % of the pupils reported being taught about road safety in school, only 24 % of the pupils demonstrated a high level of awareness regarding road safety by being able to give a correct response regarding traffic lights and zebra crossing. The information obtained from this study will shed more light on the extent and characteristics of injuries occurring among primary school children and can be used to develop and implement injury prevention and safety promotion policies in primary schools. Conclusion: These findings suggest that most children in primary schools are affected by injuries sustained while playing at home; and girls are at a higher risk of burn injuries than boys. Moreover, there is a low level of awareness of road safety rules and regulations among the primary school pupils. Interventions such as adequate supervision by caregivers while children are playing and review of teaching strategies for road safety education for schools could aid in the reduction of injuries among the pupils.
Determinants of maternal satisfaction with spinal anaesthesia care for caesarian delivery at the Kisumu County Hospital
(IOSR Journal of Nursing and Health Science, 2017-02-01) Senghor, Morris Shisanya; Morema, Everlyne Nyanchera
Elective and emergency caesarean sections are increasing in the low income countries. Over the last fifteen years or so, spinal anaesthesia has been gradually escalated in Kenyan Hospitals. In Kisumu County Hospital (KCH), the cases of caesarean sections done under spinal anaesthesia have increased tremendously from one in every ten to seven in every ten cases in a span of 7 years. Despite documented safety for the procedure, complications can highly influence the mother’s perception of quality of care. This study was therefore undertaken to evaluate patient satisfaction after spinal anaesthesia for caesarean section. A crosssectional study of patients who underwent caesarean section under spinal anaesthesia in the operating rooms of KCH was conducted. Post-operative survey of patients on the day after surgery was conducted by collecting pre-operative and intra-operative data on a structured questionnaire. Post-operative data, including satisfaction and understanding the anaesthetist’s explanation regarding anaesthesia and satisfaction in receiving spinal anaesthesia were inquired by trained data personnel. A total of 99 pregnant patients, with age ranging from 17 to 40 years, were surveyed: Overall, 85 (85%) of the mothers interviewed were satisfied and 15 (15%) were dissatisfied the anaesthesia care they received. Income range (OR: 23.1; 95% CI: 2.77-192; P<0.001) and marital status (OR: 4.42; 95% CI 1.32-14.9; P<0.011) were significant demographic determinant of satisfaction with maternal satisfaction with anaesthesia care. Neonatal outcomes were also demonstrated to be associated with satisfaction were; neonate’s birth weight (OR: 3.29; 95% CI: 1.01-10.71; P:0.04) and APGAR score at 10 minutes (OR:4.74; 95% CI: 1.24-18.03; P:0.02). In comparison to studies elsewhere, maternal satisfaction in the surveyed population was low. Structured communication by anaesthesia team, exceptional clinical skill of the anaesthesia practitioners and prevention of side effects might improve patient satisfaction.
Influence of Antenatal Family Planning Counselling on Attitude Towards Early Postpartum Family Planning: A Randomised Controlled Trial in Kenya
(East Africa Health Research Journal, 2025-06-09) Shisanya, Morris Senghor; Kipmerewo, Mary; Morema, Everlyne Nyanchera; Ouma, Collins
to understand the diverse aspects influencing women’s attitudes towards early PPFP to address them effectively. There is a lack of comparative studies on the effectiveness of interventions to improve attitudes towards early PPFP. Bridging this gap is vital for evidence-based FP promotion and better maternal and child health outcomes. This study, therefore, compared attitudes toward early PPFP across nurse-led, community-based, and routine ANC groups. Methods: The study was a randomised control trial conducted in Kisumu County among pregnant women. Three arms were established: nurses’ and community interventions and a control. Sample size was determined based on expected differences in contraceptive use postpartum. Multistage sampling involving purposive, cluster, and simple random sampling was used. The intervention involved providing antenatal information on postpartum family planning (PPFP) using a mobile phone-based tool. Attitudes towards PPFP were measured using Likert scales and analysed through ANOVA. The study aimed to assess the impact of interventions on attitudes towards early PPFP. Results: Most participants (96.4%) had a positive attitude towards early PPFP, though some factors were linked to reduced positivity. Higher education (OR 0.6, 95% CI, 0.4 to 0.9, P=.026), comorbidity (OR 0.2, 95% CI, 0.1 to 0.6, P=.006), and longer counselling waiting and turnaround times (OR 0.9, 95% CI, 0.8–1.0, P=.059) and (OR: 0.9, 95% CI: 0.9 to 1.0, P=.032) were associated with more negative attitudes, while good perceived health increased positivity (OR 3.1, 95% CI, 1.0 to 9.2, P=.043). There was no significant difference in attitude between study arms (F (2,243) =3.0, P=.053). Conclusion: The study found a generally positive attitude towards early PPFP among participants, but no significant difference in attitude between intervention and control arms. Negative attitudes were associated with comorbidities, longer waiting times, and counselling turnaround times. The study recommends improvements in counselling quality by optimising waiting and turnaround times.
Predictors of Generalized Anxiety Disorder (GAD) among health care providers during the COVID–19 pandemic at a regional teaching and referral hospital in Western Kenya
(PLoS ONE, 2024-12-05) Bundi, Jared Makori; Morema, Everlyne Nyanchera; Shisanya, Morris Senghor
Corona Virus Disease of 2019 (COVID-19) is an unprecedented challenge to health care systems globally and locally. The study aimed to assess generalized anxiety disorder and associated factors among health care providers (HCP) during COVID–19 pandemic. A total of 202 health care providers participated in the study. This was a hospital-based cross-sectional study. The survey questionnaire consisted of six components: demographic factors, occupational factors, psychological factors, socioeconomic factors, and the multi-dimensional scale of perceived social support (MSPSS). The symptoms of anxiety were measured by a standardized questionnaire, a 7–item Generalized Anxiety Disorder scale (GAD—7). Chi-Square statistic was used as a selection criterion for the predictors of generalized anxiety disorder to be included in the final binary regression analysis model at α<0.05. Among 202 health care providers interviewed, the overall prevalence of anxiety symptoms was 59.9%. Some of the aspects that reduced the risk of GAD were; being a younger HCP (OR 0.11, P = 0.004), fewer years of experience (OR 0.09, P = 0.008), availability of workplace precautionary measures (OR 0.06, P = 0.004), lower income level (OR = 0.04, P = 0.014), living alone (OR = 0.02, P = 0.008) and permanent employment terms (OR = 0.0001, P<0.0001). On the other hand, insufficient state of personal protective equipment (PPEs) (OR = 10.64, P = 0.033), having a family member as a COVID-19 contact (OR = 11.24, P = 0.023) and facing COVID-19 related stigma (OR = 8.06, P = 0.001) significantly increased the odds of GAD. The study result is a call to prioritize the health care providers’ psychological well-being by putting in place measures to preserve and enhance their resilience in order to ensure they work optimally and sustain service delivery during a pandemic.
Relationship between health care system setup and adherence to tuberculosis treatment in Western Kenya
(Quest Journals : Journal of Medical and Dental Science Research, 2017-02-12) Morema, Everlyne Nyanchera; Senghor, Morris Shisanya
Despite the concerted effort to detect and treat TB, there are still poor treatment outcomes in a significant number of the patients. These poor treatment outcomes have been significantly linked to poor adherence to TB treatment. Therefore, a cross sectional descriptive study was conducted in Kisumu East District to establish the relationship between health care system factors and TB treatment adherence among patients aged above 18 years attending TB clinics in Kisumu East District, in Western Kenya. A total sample of 250 respondents was surveyed. An interviewer administered structured questionnaire was used to collect data from the respondents on the social, demographic aspects of the patients and structural aspects of TB care. The data was analyzed using descriptive statistics for socio-demographic variables and bivariate analysis to determine the health care system factors that significantly predicted treatment adherence. P values, Odds Ratios with 95% confidence interval (CI) were used to demonstrate significance of association between the health system related predictors and adherence. Significance was assumed at P value ≤0.05. Behaviour of the health care workers (OR: 3.6; 95% CI1.1-12.1; P=0.031) and waiting time (OR: 7; 95%CI: 3-18; P<0.001) were the significant determinants of adherence related to health care set up. Health care system setup has a number of immediate modifiable predictors of adherence like waiting time and staff behaviour. It is important to establish the key predictors of adherence that are linked to health care system for quality TB treatment and care services in every TB care setting.