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Generalized Linear Models for Rainfall Patterns in the Presence of Temperature Trends in Different Climatic Zones in Kenya
(The International Institute for Science, Technology and Education, 2015) Murage, Peter G.; Mung’atu, Joseph; Orwa, George
Rainfall and temperature series impact heavily on the performance of a country’s agricultural production as a component of the economy especially in a developing country like Kenya. These series were analyzed to study the evolution of their mean variability. In particular, this study sought to model the Temporal Rainfall Patterns in different Zones in Kenya considering temperature trends as indicators of the rainfall variations. In achieving this objective, a broad statistical approach was used, based on inference on their entire series to predict the mean amount of rainfall using the Maximum and Minimum temperatures processes. Data on different counties in Kenya regarding rainfall and temperature was obtained from the respective weather stations. The study then came up with zones dependent on rainfall using cluster Analysis. Models specific to each created zone were fitted and included the Poisson, Quasi-Poisson and Negative Binomial models which belong to the broad class of Generalized Linear Models (GLMs). Using the AIC criterion, we identified Negative Binomial model as the best model for the variability of rainfall patterns in these Zones as maximum and minimum temperatures changes, and the discussion about them made thereof.
Perceptions of Stakeholders on Community Health Volunteers’ Contribution to Immunization Uptake in Pokot South SubCounty, Kenya
(African Journal of Health Sciences, 2022-06-22) Lopar, Samuel K.; Lotulya, Ting’aa S.
In developing countries, community health volunteers (CHVs) are instrumental in increasing immunization uptake. In Kenya, reports indicate that basic vaccination coverage reduced from 77% in 2008 to 71% in 2014 and the proportion of children fully immunized in West Pokot is only 31%. Little is known about the contribution of CHVs in the uptake of immunization services in Pokot South, Sub-County. The study, therefore, sought to establish the perceptions of CHVs contribution to the uptake of immunization services in Pokot South, Sub-County of West Pokot County. MATERIALS AND METHODS A mixed-methods approach was adopted in the study. The study employed a multistage sampling method to select villages, community units and households. The sample size was calculated using Yamane’s formula, resulting in 184 CHVs and 356 caregivers. Data were collected using structured questionnaires and key informant interview schedules. Quantitative data were analysed using SPSS, version 21.0. Odds ratios with a 95% confidence interval were calculated to test the significance of the association between each independent and the dependent variable. P-value ≤ 0.05 was considered statistically significant. Qualitative data were analysed thematically. RESULTS Nearly all (96.2%) of the CHVs were recruited between 2008 and 2015. Moreover, the majority of the members of the community (92.1%) knew their CHVs. Over half (57.3%) were satisfied with the work done by the CHVs. The major challenges faced by CHVs in their work are poor community support (104, 31.2%) and poor transport (79, 23.7%). From the interviews, the community positively perceives the role of CHVs in the promotion of health in the study area. CONCLUSION The community in Pokot South Sub-County of West Pokot believes that CHVs have made positive contributions to health care in the area. Recognition and respect for CHVs at the community level motivates them to play more active roles in community health interventions, despite the harsh environment in which they volunteer their services. African Journal of Health Sciences Volume 35, Issue No.3, May - June 2022 299 RECOMMENDATION There is a need to strengthen further the partnerships between health facilities and CHVs. The MOH and CHEWs should also adhere to the recommended number of days for targeted and continuous training for CHVs and improve quality supervision and monitoring of CHVs.
Rethinking the Human Resource (HR) Strategy in the Face of Systematic Failures in the Devolved Health Sector in Kenya
(International Journal of Advances in Management Research, 2022) Lopar, Samuel K.; Murimi, Michael; Kirande, Jairus; Kombo, Alice; Kipkorir, Bett
This viewpoint paper is about rethinking the human resources (HR) strategy in the face of systematic failures in the devolved health sector in Kenya. The paper gives a background introduction of the health sector of Kenya as defined and established by the constitution of Kenya, explains the sharing of functions devolved in the health sector, and explains the history of devolution of the health sector. Under the identification and justification of the study, the paper highlights how specialized skills in health service provision are concentrated in urban centers and emphasizes a lack of inter-county transfer of services. The paper further explains the distribution of healthcare service provision, the current management of HR, and the statement of specific problems in Kenya; such problems include outcry from healthcare providers, which is manifested by frequent strikes across the country over issues to do with salaries, promotions, and career development. The viewpoint of the authors is that the seven building blocks of the health sector in Kenya are vital. The six building blocks can be handled by county governments while one block that deals with the management of HR of the health sector should be reformed, strengthened, and handled by the national government, hence the paper proposes the introduction of a health service commission to manage human resource components of the health sector. Finally, boost the Ministry of Health’s effective control of the healthcare workforce by advancing and integrating policies relating to health systems, services, and cross-sectorial collaboration to revive primary healthcare services and attain universal health coverage
The Incidence Rate and Health-Care Factors Associated with LTFU, among Adult Patients Initiated on ART in Nakuru West Sub-County Health Facilities, Kenya
(open access Library Inc., 2022-01-29) Kibet, Grace; Arudo, John; Ashivira, Cyrus; Lopar, Samwel K.; Ogendo, Robina; Kabutbei, Lonah; Sakwa, Gregory
Background: The successful strengthening of antiretroviral therapy (ART) programmes globally has been reversed by loss to follow up (LTFU). The factors associated with LTFU still remain gainsay to many countries including Kenya, a critical barrier to effective scale-up of human immunodeficiency virus (HIV) services. Kenya is one of the four HIV high burden countries in Africa (alongside Mozambique and Uganda) with 29% adult HIV co-morbidities, overburdening the health care system and the country’s economy. UNAIDS targeted to achieve 90% in three key areas of HIV: identification in HIV positive patients; prompt linkage to treatment; and viral suppression by the year 2020. The second and third have not been met in Nakuru West Sub-County. This study aimed at determining the incidence rate and health-care factors associated with LTFU, among adult patients initiated on ART in Nakuru West Sub-County health facilities. Methods: A retrospective cohort study design using mixed method of data collection was employed. Records of 1131 participants enrolled/initiated on ART within 1st January 2016 to 31st December 2018 in the County Referral Hospital, Kapkures and Rhonda health centers were examined for three years to determine their outcomes. Data was collected using abstraction form extracted from the standard ART cohort register and master facility register and from key informants. Recorded interviews were transcribed and analyzed using standard qualitative method, to identify content and themes. A total of 9 key informants working in the CCC/HIV clinics were interviewed upon consenting. Kaplan-Meier technique was used to estimate time to LTFU after initiation of ART. Results: The overall incidence rate of 1611 (95% CI: 114.7 - 179.2) per 1000 person-years was revealed. In addition, the following variables were identified in the qualitative findings to be associated with LTFU: wrong/poor documentation, long waiting time, approaches in the implementation of the HIV/AIDS management policies (“Test and Treat” and “defaulter tracing”) and inadequate funds to support staffing and to manage support groups. Conclusions and Recommendations: In order to minimize LTFU and met UNAIDS targets, interventions should be geared towards close follow up supervision of all CCC patients by capturing correct contact addresses and updating patient records. In addition, this study recommends that, the Ministry of Health, Nakuru County Government, APHIA-PLUS and all other stakeholders should build capacity of health care personnel to improve provision of HIV care services, ensure availability of adequate resources and address challenges that impede the implementation of HIV and AIDS management policies, especially for newly enrolled patients who may not be prepared to start treatment or unwilling to disclose their status. This will, in turn, curb LTFU, enhance patient retention, patient survival and improve quality of life.
Dynamic Relationship between Public Debt and Exchange Rate Misalignment in Kenya
(Scientific Research Publishing, 2025-11-28) Nyoro, Ndindi; Njaramba, Stephen G.
Kenya’s sovereign debt has increased throughout the years to reach a figure of above Kenya Shilling 10 trillion. At the end of June 2023, the total public debt, excluding that which is guaranteed publicly and pending bills, stood at around Ksh. 5.39 trillion in external debt and domestic debt of Ksh. 4.90 trillion. As a result, the country is facing a debt crisis and fiscal distress due to high debt service. As the public debt is growing, the fiscal deficit has also been increasing, averaging about 5.2 percent of GDP as of the 2023/2024 fiscal year. The consequence is huge public debt, and more borrowing to refinance the existing debts. The problem is more pronounced on the external debts. This is because Kenya needs to earn more foreign currency to service the debt. This, however, is not happening as the exports continue to decrease and imports continue to expand. Consequently, the country faces a problem in its current account. The rate of exchange has also been observed as overvalued, creating a misalignment in the real exchange rate. This adversely affects trade and generates pressure and volatility in the exchange rate market, consequences that are undesirable for the stability and overall growth of the Economy. The situation leads to depreciation or loss of strength of the local currency. However, the monetary authority constantly intervenes to manage the exchange rate and prevent depreciation. This raises the question of whether the observed misalignment in the real exchange rate is related to the growth in the public debt. The study, therefore, sought to get more information on the dynamic relationship between public debt and the exchange rate misalignments in Kenya. It employed secondary time series data running from the year 1980, when the country adopted the floating exchange rate, to the year 2023. The study made use of the Vector Autoregressive Model to analyze the direction of causality and impact response. It is deduced from this study that the Budget Deficit is a strong determinant of Exchange Rate Misalignments. This means that persistent budget deficits fuel both external imbalances and public debt. Misalignments not only worsen the current account but are themselves affected by fiscal and external indicators. Rising external debt is influenced by fiscal and external sector pressures, necessitating coordinated macroeconomic management