Entrepreneurship Skills as a Factor Influencing Adoption of Innovations along Mango Value Chains in Meru County, Kenya

The study used a descriptivesurvey design. The study was carried out in Meru County, Kenya. Population of the study comprised of 13,574 farmers, traders and exporters, 404 farmers, 12 traders and 2 exporters. Both secondary and primary data was collected. Primary data was collected from the respondents using a structured questionnaire with both open and close ended questions. Both qualitative and quantitative data were used in the analysis. Quantitative data obtained from the field was analyzed using descriptive and inferential techniques. The descriptive techniques used means and frequencies while the inferential technique used were regression and correlation to establish relationship between variables in the study and inferences made. Frequency tables and charts were used to present the findings. The study found out that entrepreneurial skills played a role on the innovations adoption along the mango value chain. However, a linear association does not exist as between entrepreneurship skills and innovation in mango. The researcher concludes that with such a steady growth in yields and development in mango farming in Meru County, Kenyan mango supply chain appears to be promising. In the adoption of new innovations and there is need to train the growers on entrepreneurship. Education tours should be organized for the value chain members to countries such as India and Brazil so that they learn what their contemporaries in these countries are doing and adopt more skill

Personality traits as markers of psychosis risk in Kenya: Assessment of temperament and character

Specific personality traits have been proposed as a schizophrenia-related endophenotype and confirmed in siblings at risk for psychosis. The relationship of temperament and character with psychosis has not been previously investigated in Africa. The study was conducted in Kenya, and involved participants at clinical high-risk (CHR) for psychosis

Predictors of Adequate Ambulatory Anticoagulation among Adult Patients in a Tertiary Teaching and Referral Hospital in Kenya

Background: Local anticoagulation services are inadequate and substantially underutilized despite compelling evidence showing that their appropriate use significantly reduces the risk of thromboembolic complications. Objectives: To determine the predictors of adequate ambulatory anticoagulation services in Kenyatta National Hospital. Methodology: A cross sectional study between December 2014 and April 2015 among 102 adult outpatients on anticoagulation using consecutive sampling was done. Information abstracted into a predesigned data collection tool included participants’ sociodemographic characteristics, regular sources of supply of anticoagulant, clinic pre-appointment reminders, indications of treatment and international normalized ratio tests. Data were analyzed using IBM Statistical Package for Social Sciences version 21.0 and logistic regression was used to determine independent predictors of adequate anticoagulation, which was defined as international normalized ratio ranging 2 - 3. Results: Females were majority (76.5 %) and only 27.5 % of patients  had adequate anticoagulation control. The indication of warfarin for heart valve surgery (p=0.014) and deep venous thrombosis (p=0.021) were associated with adequate anticoagulation. Age above 60 years was associated with poor anticoagulation (p=0.006). Logistic regression revealed that the independent predictor of adequate anticoagulation was warfarin use due to heart valve surgery (OR=3.1; 95% CI: 1.2 – 7.9, p=0.017). Conclusions: Ambulatory anticoagulation control in the hospital is poor. Further investigation is required to find out the reasons behind adequate anticoagulation in heart valve surgery patients. Key Words: Ambulatory anticoagulation, anticoagulant, outpatient, international normalized ratio tests

Interpersonal Psychotherapy’s problem areas as an organizing framework to understand depression and sexual and reproductive health needs of Kenyan pregnant and parenting adolescents: a qualitative study

Background: Peripartum adolescents experience signifcant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents’ responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addressing the mental health needs of adolescents during the perinatal period. The paper aims to understand the sources of psychological distress in peripartum adolescents and map these to Interpersonal Psychotherapy’s (IPT) problem areas as a framework to understand depression. Method: We conducted interviews in two Nairobi primary care clinics with peripartum adolescents ages 16–18 years (n=23) with experiences of depression, keeping interpersonal psychotherapy framework of problem areas in mind. We explored the nature of their distress, triggers, antecedents of distress associated with an unplanned pregnancy, quality of their relationships with their partner, parents, and other family members, perceived needs, and sources of support. Results: We found that the interpersonal psychotherapy (IPT) framework of interpersonal problems covering grief and loss, role transitions, interpersonal disputes, and social isolation was instrumental in conceptualizing adolescent depression, anxiety, and stress in the perinatal period. Conclusion: Our interviews deepened understanding of peripartum adolescent mental health focusing on four IPT problem areas. The interpersonal framework yields meaningful information about adolescent depression and could help in identifying strategies for addressing their distress

A step-wise community engagement and capacity building model prior to implementation of mhGAP-IG in a low- and middle-income country: a case study of Makueni County, Kenya

Background: The World Health Organization developed the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) as guidelines for innovative utilization of available resources in low- and middle-income countries (LMICs) in order to accelerate the reduction of the mental health treatment gap. The mhGAP-IG calls for each country to contextualize the guide to their social, cultural and economic context. The objective of this paper is to describe a model for a stepwise approach for implementation of mhGAP-IG in a rural Kenyan setting using existing formal and informal community resources and health systems. Methods: We conducted an analysis of mental health services in Makueni County, one of the 47 counties in Kenya, in order to understand the existing gaps and opportunities in a low-resource setting. We conducted stakeholder analysis and engagement through interactive dialogue in order for them to appreciate the importance of mental health to their communities. Through the process of participatory Theory of Change, the stakeholders gave their input on the process between the initiation and the end of the process for community mental health development, with the aim of achieving buy-in and collective ownership of the whole process. We adapted the mhGAP-IG to the local context and trained local human resources in skills necessary for the implementation of mhGAP-IG and for monitoring and evaluating the process using instruments with good psychometric properties that have been used in LMICs. Results: We were able to demonstrate the feasibility of implementing the mhGAP-IG using existing and trained community human resources using a multi-stakeholder approach. We further demonstrated the feasibility to transit seamlessly from research to policy and practice uptake using our approach. Conclusions: An inclusive model for low resource settings is feasible and has the potential to bridge the gap between research, policy and practice. A major limitation of our study is that we did not engage a health economist from the beginning in order to determine the cost-effectiveness of our proposed model, occasioned by lack of resources to hire a suitable one

Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya

Background In order to develop a context appropriate in mental health system, there is a need to document relevant existing resources and practices with a view of identifying existing gaps, challenges and opportunities at baseline for purposes of future monitoring and evaluation of emerging systems. The World Health Organization Assessments Instrument for Mental Health Systems (WHO-AIMS) was developed as a suitable tool for this purpose. Our overall objective of this study, around which research questions and specific aims were formulated, was to establish a baseline on mental health system as at the time of the study, at Makueni County in Kenya, using the WHO-AIMS. Methods To achieve our overall objective, answer our research questions and achieve specific aims, we conducted a mixed methods approach in which we did an audit of DHIS records and county official records, and conducted qualitative interviews with the various officers to establish the fidelity of the data according to their views. The records data was processed via the prescribed WHO-Aims 2.2 excel spreadsheet while the qualitative data was analyzed thematically. This was guided by the six domains stipulated in the WHO AIMS. Results We found that at the time point of the study, there were no operational governance, policy or administrative structures specific to mental health, despite recognition by the County Government of the importance of mental health. The identified interviewees and policy makers were cooperative and participatory in identifying the gaps, barriers and potential solutions to those barriers. The main barriers and gaps were human and financial resources and low prioritization of mental health in comparison to physical conditions. The solutions lay in bridging of the gaps and addressing the barriers. Conclusion There is a need to address the identified gaps and barriers and follow up on solutions suggested at the time of the study, if a functional mental health system is to be achieved at Makueni County

Entrepreneurship Skills as a Factor Influencing Adoption of Innovations along Mango Value Chains in Meru County, Kenya

The study used a descriptivesurvey design. The study was carried out in Meru County, Kenya. Population of the study comprised of 13,574 farmers, traders and exporters, 404 farmers, 12 traders and 2 exporters. Both secondary and primary data was collected. Primary data was collected from the respondents using a structured questionnaire with both open and close ended questions. Both qualitative and quantitative data were used in the analysis. Quantitative data obtained from the field was analyzed using descriptive and inferential techniques. The descriptive techniques used means and frequencies while the inferential technique used were regression and correlation to establish relationship between variables in the study and inferences made. Frequency tables and charts were used to present the findings. The study found out that entrepreneurial skills played a role on the innovations adoption along the mango value chain. However, a linear association does not exist as between entrepreneurship skills and innovation in mango. The researcher concludes that with such a steady growth in yields and development in mango farming in Meru County, Kenyan mango supply chain appears to be promising. In the adoption of new innovations and there is need to train the growers on entrepreneurship. Education tours should be organized for the value chain members to countries such as India and Brazil so that they learn what their contemporaries in these countries are doing and adopt more skills</jats:p

Utility, barriers and facilitators to the use of connected health to support families impacted by paediatric cancer: a qualitative analysis

Aim As healthcare systems are increasingly burdened, the efficiencies and cost savings offered by connected health (CH, i.e. two-way communicative healthcare technologies such as eHealth or mHealth) present an attractive solution for supporting families impacted by cancer. More research is required, however, to examine attitudes towards CH to better facilitate its use in practice. This study seeks to examine the utility, barriers and facilitators of CH use for families affected by paediatric cancer living in Ireland. Methods Healthcare professionals (n = 5) and parents of children with cancer (n = 7) completed semi-structured interviews on their experiences of and attitudes to CH via Microsoft Teams. A reflexive thematic approach to analysis was employed. Results CH was perceived to provide support for a number of current needs with themes of ‘shifting responsibilities’, ‘individualisation of care’ and ‘knowledge as power’. Through facilitating communication, information sharing and monitoring of child health, CH was perceived to support decreased parental burden and increased parental control, with positive child outcomes thought likely. Perceived barriers and facilitators to the use of CH included the ‘importance of trust’, ‘pace of change’ and ‘access’. Conclusion While results suggest an acceptance of CH across key stakeholders, barriers and facilitators should be considered to support effective implementation. While further analysis of the efficacy of CH to support families impacted by paediatric cancer is needed, these findings highlight key areas where CH may be effectively employed