PHD-Department of Community Resource Management and Extension

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    Predictors of Youth Livelihood Outcomes in Kamukunji Sub-County, Nairobi County, Kenya
    (Kenyatta University, 2016-11) Njuguna, Christine Wambui
    Youth are faced by challenges of unemployment, underemployment and working poverty which influence their livelihood outcomes. These challenges facing youth have drawn global attention. The purpose of the study was to determine the predictors of youth livelihood outcomes in Kamukunji Sub-County, Nairobi County. Specifically, the study sought to establish the relationship between individual attributes of youth and youth livelihood outcomes, to determine the relationship between household characteristics of youth and youth livelihood outcomes, to explore the influence of typology of livelihood strategies on youth livelihood outcomes, to analyze the influence of youth focused interventions on youth livelihood outcomes and to establish predictors of youth livelihood outcomes in Kamukunji Sub-County. Anchored on Department for International Development (DFID) livelihoods framework and the General Systems Theory the study applied cross-sectional survey research design to gather data from 201 youth and 11 state and non-state actors. Data collection tools included structured questionnaire, key informant interview schedule and focus group discussion guide. Analysis was conducted using descriptive frequencies and inferential statistics namely Chi-square, Analysis of Variance (ANOVA) and ordered logistic regression. Findings from inferential statistics established a relationship between individual attributes and youth livelihood outcomes (χ2= 44.47; d.f. =14; ρ<0.01). Specifically, age (p<0.05), marital status (p<0.05), household headship (p<0.01), individual savings (p<0.05), individual assets (p<0.01) were important predictors of youth livelihood outcomes. A relationship also exists between household characteristics and youth livelihood outcomes (χ2= 203.18; d.f. =12; p<0.01) whereby aggregate household monthly income (p<0.01), paternal education (p<0.05) parental influence (p<0.05), number of dependants (p<0.01) and household assets (p<0.01) were important predictors of youth livelihood outcomes. As a whole, livelihood strategies did not influence youth livelihood outcomes (χ2= 12.32; d.f. =12; ρ>0.05). However, specific livelihood strategies whose parameters attained statistical significance were: wage employment (β=0.74, p<0.05) and arts/talent (β=0.26, p<0.05). Finally, there was a relationship between youth focused livelihood interventions and youth livelihood outcomes (χ2= 18.70; d.f. =7; p<0.05) so that membership in youth groups (p<0.01), financial institutions (p<0.01) and state funds (p<0.01) were important positive influences of youth livelihood outcomes. In conclusion, it emerged that individual attributes, household characteristics and youth focused interventions were important predictors of youth livelihood outcomes. It is recommended that state and non-state actors should conduct needs assessment before formulating intervention programs based on individual attributes and household characteristics of youth. State and non-state actors should implement elaborate and expansive business incubation and mentorship programs for youth. To improve livelihood outcomes for all youth, development agencies should ensure that youth focused interventions target all typologies of livelihood strategies undertaken by the youth.
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    Influence of Provider Initiated Calls on Uptake of Cervical Cancer Screening in Kirinyaga County, Kenya
    (Kenyatta University, 2021) Monicah, Wambugu W.; Margaret Keraka; Anthony Wanyoro
    Every day women die from cervical cancer in the world with majority of deaths occurring in developing countries like Kenya. In Kenya, cervical cancer screening uptake is low at 3.2% for all women (GLOBOCAN 2018), below the 25% projection by National Cervical Cancer Prevention Program. Kirinyaga County like the rest of Kenya has no effective reminder mechanism to enhance uptake of cervical cancer screening. This study examined the influence of provider-initiated call reminders on uptake of cervical cancer screening. Using a single blinded randomized controlled trial study design; „two-stage‟ random sampling was used to select eligible women from a sampling frame of 19572 within four randomly selected Wards of Kirinyaga Central sub-county. Participants were randomly allocated to the control (received placebo calls) and intervention (received call reminders) arms at a ratio of (1:1). The data collection tools were interviewer administered questionnaires, Key informant guides and a checklist .The intervention was three provider initiated calls that contained; five education points on cervical cancer, reminder to attend screening and answers for two questions on cervical cancer and screening. Thematic content was used to analyze qualitative data. Categorical variables were summarized using descriptive statistics to proportions and frequencies while measures of central tendency were used to summarize continuous variables. Inferences were drawn using logistic regressions to determine factors associated with uptake of cervical screening and effects of the intervention. The final sample analyzed was 173. The mean ages of participants was 40.4 ± 9.4, majority had attained secondary education 57.4% and were of a low economic status 78.4%. Only 14.6% of women aged 25 years and above at baseline had ever been screened for cervical cancer and only 6.04% were on the recommended regular screening schedule. Participants who attended cervical cancer screening at end line were 67% from the intervention arm and 22.4% from the control arm. Provider initiated call reminders increased the probability of uptake of cervical cancer screening by 11 times (OR 11.04; CI 95% 8.56-26.89; p<0.001). There was a significant mean difference in perception on cervical cancer before and after the call reminders; perceived susceptibility(t=8.46,df=86,p=0.001); seriousness, (t=8.93,df=86,p=0.001);perceived benefits (t=8.13,df=86,p=0.001); barriers (t=3.46,df=86, p=0.001) in the intervention arm. There was also a significant mean difference of knowledge level on cervical cancer before and after intervention p<0.001 in the intervention arms. On the multivariate analysis, increased knowledge on cervical cancer increased chances of screening uptake by up to 7.09 times (OR 7.09; CI 95%3.72-11.95; P<0.001). High perception of being susceptible to cervical cancer increased the chances of screening uptake by up to 4.26 times (OR 4.26 P<0.0001). Forgetting was the major reason participants gave for not attending the scheduled screening. This study concluded that, many women residing in the study county had not been screened for cervical cancer despite being at risk. Calling those women to remind them to attend screening had potential to increase uptake of screening. Knowledge and perception on cervical cancer increased after using call reminders. The management of Kirinyaga County and the Ministry of Health should adopt a reminder system like the provider initiated calls in order to enhance cervical cancer screening uptake. Further studies should be conducted on the number of voice calls necessary for an optimal attendance for cervical cancer screening; national enrollment into routine screening and pathway analysis of factors associated with enrollment into routine screening.
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    Analysis of intimate partner violence among women survivors in shelter homes in Kenya
    (2014-09-01) Kabaria-Muriithi, Joan
    Intimate partner violence (lPV) is a form of gender based violence that involves the range of sexual, psychological, economic and physically coercive acts used against men and women by their current or former intimate partners. Women are more vulnerable to IPY. However, not much is understood about the vice and the associated patterns of risk. The purpose of the study was to analyze the predisposing factors associated with IPV and to assess the severity of IPV on women survivors in shelter homes in Kenya. The specific objectives of the study were to: determine the survivors' perception of predisposing factors that make women susceptible to IPV; establish the levels of severity of IPV on women survivors in shelter homes in Kenya; investigate the relationship between predisposing factors and severity of IPV from women seeking support services from shelters available in Kenya and to identify the coping strategies for women survivors of IPV. The Feminist theory by Dobash & Dobash and walker (1979) was used to conceptualize various risk factors that predispose women to IPV. The study was conducted in Nairobi and Nakuru which had the only two available women shelter homes in Kenya providing support services for IPV survivors. A survey design was employed. The study sample comprised 230 women survivors who had visited the shelters homes. Primary data was collected with the use of interview schedules for IPV survivors and key informant interview guide for service providers as well as Focus Group Discussion guides for Community Health Workers. Secondary data was also generated using records in the shelter homes. Data analysis for quantitative data was done using the Statistical Package for . Social Sciences (SPSS) while the qualitative data was sorted and analyzed mathematically based on the objectives. Chi-square results revealed a significant relationship between severity of IPV and women survivors' education (p=0.003), Number of children (p=0.005), marital status (p=0.006) witnessing of inter-parental violence (p=0.05), perpetrators' upbringing (p=0.040), perpetrators' occupation (p=0.007), use of alcohol (p=0•.002), use of other substances and drugs (p=O.OOO), experience of violence in childhood (p=O.O13) and perpetrators' education level (p=0.012). On multivariate analysis, the strongest predisposing factors to severity of IPV were found to be the number of children born to the women survivors (p=O.OOl), perpetrator level of education (p=0.054) and perpetrator use of alcohol (p=O.OO1). The study concluded that IPV is a serious social and economic vice that requires a proactive role of state, non-state actors, community members and active participation of both the survivors and perpetrators in order to address it. The study recommended that there was need to enforce the existing National Policy Framework on Gender Based Violence, which provides an important structure for the management of severity of IPV. There was also need for strengthening of the collaboration between the relevant government departments, shelter homes, religious leaders and community leaders in the management of IPV. The result of this would be reduction in the occurrence and severity of TPV.
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    Predictors of hiv self disclosure to sexual partners by Sero-positive adults in informal settlements: a case of Central division, Nairobi County, Kenya
    (2014-08-20) Ndayala, Phoebe Didi
    The purpose of the study was to determine the predictors of HIV self disclosure to sexual partners by sero-positive adults, in Central division, Huruma location, Nairobi County, Kenya. The objectives of the study were to examine the prevalence of HIV self disclosure among PLWHA, and to analyze the relationships between self-disclosure of HIV sero-positive status and the following factors: individual factors of PLWHA; anticipated and enacted consequences of HIV disclosure; sexual practices and cultural factors among PLWHA. The study was a cross-sectional descriptive survey with a sample of 232 PLWHA drawn from HIV support groups in the study area. Data were collected using questionnaires and Focus Group Discussions (FGDs). Qualitative data were analyzed using content analysis and quantitative data by use of SPSS. Research findings showed that 50.5% of PLWHA had disclosed their sero-positive status mainly to regular sexual partners. Chi-square results revealed significant relationships between HIV self disclosure and financial constraints (p=0.003); employment status (p=0.001); condom use in last sexual encounter (p=0.001); type of sexual relationship (p=0.024); discussion of HIV testing with partner (p=0.039); knowledge of sexual partners’ HIV sero status (p=0.011); method of finding out sexual partners sero status (p=0.039); gender power control in sexual relations (p=0.010); isolation by friends after HIV self-disclosure (P=0.011); being spoken ill of by friends (p=0.006); consequences of disclosure at the workplace (P=0.011); women roles in sexual relations (p=0.001); community beliefs on HIV (p=0.019) and exclusion from rite of wife inheritance (p=0.002). Further analysis using Binary Logistic regression determined eight (8) positive predictors of self-disclosure of HIV sero-positive status to sexual partners. The positive predictors were: regular sexual relationship (AOR=2.703; p= 0.046), employment status (AOR=1.691; p=0.001), gender power control in sexual relations (AOR=4.129; p= 0.011), discussion of HIV testing with partner (AOR=2.560; p=0.002), anticipated consequences of disclosure from the religious group and (AOR=3.949; p= 0.015) anticipated positive consequences from the workplace (AOR=1.955; p= 0.001), enacted consequences of disclosure from the workplace (AOR=1.990; p=0.002) and expected violent reaction to disclosure by partner (AOR=3.374; p=0.005). The factors that emerged as negative predictors or barriers to HIV self-disclosure to sexual partners were enacted consequences of disclosure from friends (AOR=0.136; p=0.001) and exclusion from the rite of wife inheritance of PLWHA (AOR=0.410; p=0.002). It was concluded that four main factors were positively associated HIV self-disclosure among the study participants. These included (1) the nature of relationship with the sexual partner(s); (2) anticipated positive outcomes of disclosure from the religious group; (3) Enacted positive consequences at the workplace; not expecting job loss; or being in informal employment; and (4) experiencing financial constraints. The study recommended: promotion of HIV self-disclosure to sexual partners by PLWHA; Safe sexual practices; provider initiated testing and counseling of sexual partners, training of PLWHA with communication skills and strategies to cope with negative consequences of HIV self-disclosure, promotion of community acceptance of PLWHA and cultural practices that promote self-disclosure of HIV sero-positive status to sexual partners among PLWHA.
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    Predictors of Self-efficacy in HIV Prevention among People Living with HIV and AIDS in Thika District, Kiambu County, Kenya
    (2014-02-24) Kieru, Jane Njeri; Ngige, L.W.; Msangi, G. N.
    It has been shown that PLWHA are living longer due to increasing availability and uptake of antiretroviral therapy (ART). There has been limited research on whether PLWHA adopt safer sexual and reproductive practices as focus has been primarily on HIV negative persons. The purpose of this study was to determine predictors of self-efficacy in HIV prevention among PLWHA in Thika district, Kiambu County; „a case of prevention with positives‟. Specific objectives included: to assess socio-demographic characteristics of PLWHA, determine attitude towards sexual and reproductive behaviour, establish sexual and reproductive practices, identify barriers to safe sexual and reproductive behaviour and to analyze the decision making patterns on sexual and reproductive behaviour and determine the predictors of self-efficacy in HIV prevention. The study was guided by Health Belief Model and General Systems Theory. The study employed a cross-sectional survey research design. Three divisions of Thika district were chosen purposively namely: Ruiru, Thika Municipality and Kamwangi. The sample size comprised 239 PLWHA. The data were collected using interview guides, focus group discussions and key informant interviews. Both qualitative and quantitative data analyses were used. Chi-square results yielded significant relationship between self-efficacy in HIV prevention and gender (p=0.000), marital status (p=0. 001), monthly income (p=0. 043), employment status (p=0. 037), attitude towards HIV-negative people (p=0.002), attitude towards reproductive behaviour (p=0. 049), number of sexual partners (p=0.000), type of sexual partner (p=0.000), awareness of HIV-status of sexual partner (p=0.025), HIV disclosure (p=0.003), number of children born after testing HIV positive (p=0.034), partner‟s condom refusal (p=0.028), alcohol and drug abuse (p=0.000), financial constraints (p=0.000), condom fatigue (p=0.002), decision on whether to use condoms (p=0.050), and which type of condoms used (p=0.010). Further analysis by use of Binary Logistic Regression showed positive predictors of self-efficacy in HIV prevention namely: gender (p=0.050), monthly income (p=0.002), attitude towards reproductive behaviour (p=0.007), number of children born after testing sero-positive (p=0.0.029), financial constraints and condom fatigue (p=0.046). Negative predictors were number of sexual partners (p=0.001) and alcohol and drug abuse (p=0.021). It was concluded that females, middle income earners, positive attitude towards reproductive behaviour, having more than one child after testing sero-positive and those not facing challenges condom fatigue and financial constraints predicted high self-efficacy in HIV prevention. On the contrary, having multiple partners and indulging in alcohol and drug abuse predicted low self-efficacy in HIV prevention. It was recommended that there was need to promote inclusion of both men and women in HIV and AIDS programs, ensure sustainable income generating activities, promote sexual behaviour change programmes within the community targeting PLWHA, ensure effective provision of alcohol and drug abuse counselling sessions among PLWHA and strengthen consistent use of condoms. These might increase self-efficacy in HIV prevention among PLWHA thus reducing the number of new HIV cases.
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    The Extent of Physical Education Teachers’ Compliance With The Professional Code of Ethics and Conduct in Tanzania
    (2013-08-14) Mabagala, Stephen
    Every profession considers the development and application of the Professional Code of Ethics and Conduct (PCEC) as a means of maintaining acceptable professional standards. As for the teaching profession, teachers are suppos ed to exhibit high level of professionalism by showing high ethical and moral standards in their relationships with other educational stakeholders . This is also imperative for PE teachers since their work involves close interactions with students in and ou tside the classroom and school contexts when they double their duties as teachers and coaches. The purpose of this study was to determine the compliance level of PE teachers with PCEC in Tanzania. The study utilized descriptive survey design and was conduc ted in secondary schools and teachers colleges in Tanzania. The target population was 5,948, which included 54 PE teachers, 5,844 students, 21 heads of institutions and 29 TSD officials. The sample comprised 809 respondents, who were purposively selected d epending on their involvement in PE, administrative role as heads of institutions or as officials responsible for teacher conduct and discipline. Instruments for da ta collection were questionnaires . The instruments were pre - tested in two secondary schools. Data were analyzed using descriptive statistics; while hypotheses were tested using independent t - test and ANOVA to test the significance difference between variables at p ≤ 0.0 5 level of significance, with the help of SPSS version 19. Findings revealed t hat PE teachers had high knowledge on PCEC (M = 4.41, SD= .32). There were significant differences in knowledge on PCEC across educational levels (p = .000), institutional ownership (p =.011), and institutional level (p = .019). There were no significant d ifferences in knowledge on PCEC across age ( p=.056 ), gender (p = .926), marital status (p = .153), teaching experience (p = .258) and location (p =.252). Findings also revealed that PE teachers complied with PCEC at high level (M = 4.11, SD = .53). Complia nce with PCEC differed significantly across educational levels (p =.002), and institutional variables (p < .05). There were no significant differences in compliance with PCEC across age (p = .868), gender (p = .502), marital status (p = .208) and teaching experience (p =. 469). Moreover, the findings indicated that ECD were prevalent (M = 3.04, SD = .79) in the implementation of PCEC. There were no significant differences in ECD faced by PE teachers across demographic variables (p > .05). However, there wer e significant differences in ECD faced by PE teachers across institutional variables (p < .05). It was concluded that PE teachers have adequate knowledge on PCEC and comply with it at high level. It was further concluded that PE teachers encounter ECD in i mplementing PCEC. Based on the findings, it was recommended that the Ministry of Education and school administrators should improve PE and sport programmes in schools and colleges, and should encourage and facilitate teachers‟ in - service professional devel opment courses. Moreover, teachers should be encouraged to obtain copies of PCEC. Further studies should be carried out across all teachers in different subject specializations to determine their compliance level with PCEC. Moreover, studies should also be conducted on the role of PE and sport in schools and colleges in enhancing work commitment and collaboration among teachers
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    Evaluation of street children rehabilitation programmes in Uasin Gishu district, Kenya
    (2011-07-19) Wakhu-Wamunga, Florence M.; Ngige, L.W.; Tumuti, D.W.
    The purpose of this study was to evaluate the street children rehabilitation programmes in Uasin Gishu District with the aim of providing information that can be useful to policy makers in the area of child welfare. The objectives of the study were to: (i) Determine how the programmes were initiated, (ii) Establish the context in which the street children rehabilitation programmes operate, (iii) Establish the resources used in the rehabilitation process, (iv) Determine the strategies used to rehabilitate the street children, (v) Evaluate the extent to which programme objectives had been achieved, (vi) Assess the social impact of the rehabilitation programmes on the street children community and the larger community of Eldoret town. Stufflebeam's improvement - oriented model of evaluation was adapted for the study. The naturalistic / pluralistic research design was used for the study. Both quantitative and qualitative modes of inquiry were employed in the research. The sample constituted 223 respondents. Data were collected by means of interviews, questionnaires, focus group discussions, spot observations and document analysis. Data were analysed using both quantitative and qualitative approaches. The results showed that the three centres were initiated and established by foreign missionaries with the aim of providing shelter, food, clothing, education and health care to street children in surrounding towns. Majority (53.3%) of the children in the centres were teenagers who had left home at a very early age. Sugoi home had no children below the age of 10 years. The main reason why these children had been on the streets was poverty which was a consequence of ethnic clashes of 1992. The management of the centres employed staff from the local community on contract. Staff turnover was quite high with an average time of 1.7 years spent at the centres. The staff had no skills in handling children in need of special protection. Rescue Centre had volunteers who came to teach children craft skills. All the centres had set rules and routines the children had to adhere to. This helped instil a sense of responsibility. Education therapy was employed in all centres. The character of street children and the character expected of them at the institutions determined the way the children were handled by staff. The staff had improper attitudes towards the children. They handled the children like delinquents in a correctional centre. The children were also involved in religious activities for there spiritual development. At Bindura and Sugoi centres, the children were involved in manual and farm work. Despite all the work that was going on at the centres, there was no monitoring of progress made by children. The strategies employed at the centres can be classified as interpersonal cognitive problem solving skills and behavioural social skills training. The centres had made some achievements in that the basic physiological needs of the children were met and, there was observed positive behaviour change in the children. The children were disciplined, clean and trustworthy. There are those who had been employed in various places while others had become evangelists and musicians. Some children from Rescue Centre had been assigned to others homes, reintegrated back into their families, or adopted. The centres had made some achievements in that the basic physiological needs of the children were met and, there was observed behaviour change in the children. The local community had also developed a change of attitude towards street children. They made donations towards the centres and gave volunteer service. Despite the achievements made, the centres still faced a lot of challenges such us inadequate funds and facilities, unskilled employees, lack of guidelines on rehabilitation, dependency syndrome from poor parents, increase in the number of street children and runaways. It is recommended that the government provides financial funding human resources for the running of these institutions