The global problem of access to improved sanitation and water management practices has been compounded by the gap existing between knowledge and practice as well as attitude. The aim of this study was to assess households' knowledge and attitude on water, sanitation, and hygiene practices through a school health programme. Semistructured questionnaires, focus group discussions, key informant interviews, and observation checklist were used to obtain information from 95 households which were systematically sampled. It was found that a school programme may not improve the gap between knowledge, attitude, and practice but may be good for future generations. This was found to be due to sociocultural issues which impede hygiene transformation. The implication is that health programmes must find innovative ways of bridging this gap in order to bring change in households through culture sensitive interventions.
We sought to determine the knowledge and attitude of public health workers (PHWs) with respect to emerging and re-emerging zoonotic diseases and the practice of one health approach in the surveillance of zoonoses in the community. A cross-sectional study was conducted in 12 randomly selected districts of Nyanza province, Kenya. One hundred and ten randomly-selected PHWs were assessed using a structured questionnaire. Data were collected on their knowledge, attitudes and practices about common zoonotic diseases. Eighty-nine (81%) questionnaires were received back. Eighty-seven (98%) said they discuss zoonotic diseases with the local villagers during their community health work. The most commonly discussed disease was rabies (n=39). Seventy-six (85%) respondents reported ever discussing zoonoses with their veterinary colleagues. Over 85% of the PHWs asked for refresher training on H1N1, and 51% require training on highly pathogenic avian influenza (H5N1). Despite fair knowledge of rabies among the PHWs in Nyanza province, there is need for improving their attitude of the emerging and reemerging zoonoses. There is also need to improve their practice in terms of collaboration with the veterinarians in zoonoses surveillance in the community.
Provision of safe water, adequate sanitation, and hygiene has been lauded as one way of preventing diarrheal infections and improving health especially in developing countries. However, lack of safe water, inadequate sanitation, and poor hygiene practices in most parts of rural Kenya have posed a challenge that exposes the populace to diarrhea cases and possible deaths. In this regard, many nongovernmental organizations and governmental agencies have tried to provide water, sanitation, and hygiene services with poor results. This study was conducted using qualitative research methods in Central Nyakach in Kisumu County, Kenya. The methods were focus group discussions (FGD), key informant interviews (KII), and observation of homesteads. The data were then analyzed thematically. Findings revealed that water issues are gendered and its use is socially and culturally categorized. Water storage is affected by traditions such as use of a clay pot, while sanitation and hygiene issues are ritualized and bound by taboos. Latrines are majorly constructed by men and sharing the same with in-laws and older children is prohibited. Children faeces are thrown out in the open fields as a means of disposal and hand washing with soap is nonexistent, since it is believed that doing so would make a person lose the ability to rear livestock. The implications of these findings are that some of these sociocultural practices have a profound effect on health of the population. This affects health care delivery through high incidence rates of disease, encourages "unhealthy" environments through open defecation and pollution, and negates the government's commitment to national and international policies on universal health care provision.
The study assessed the implementation of Kenya comprehensive school health pilot intervention program. This pilot program has informed the Kenya Comprehensive School Health Policy which is a critical document in the achievement of Millennium Development Goals relating to child health, gender equality, universal education and environmental sustainability. The study was based on focus group discussions, field observations and in-depth interviews with government officers who implemented the pilot program. The findings were categorized into implementation process, what is working well, what is not working well and lessons learned. During the course of the study, it was noted that involvement of all stakeholders enhances program ownership and sustainability but if they are not well coordinated or where supportive supervision and monitoring is not carried out, then some components of the comprehensive school health program may not be sustainable. We learnt that comprehensive school health program increases students’ enrolment, attendance and retention, factors that are very important in a country’s human resources development. The study has shown that although the formulation of a policy may be participatory and bottom-top, the implementation requires allocation of enough resources and coordination to bridge the gap between policy formulation and implementation.
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