Background: Globally male involvement on maternal health services remains a challenge to effective health care. Maternal deaths arise from pregnancy, childbirth and postnatal complications and this can be reduced by involving men. Benefits of male involvement have been acknowledged in developed countries, however there still continues to be a challenge in creating a space for and engaging men in maternal health. In Kenya male involvement in maternity care is one of the strategies for improving the maternal health and reducing maternal mortalities. Objective: This study explored socio demographic, cultural and health facility factors associated with male partner involvement on maternal care services during perinatal period in Mumias East and West sub counties, Kakamega County, Kenya. Methods: The data was collected using a pre tested structured questionnaire administered to 422 respondents (husband and wife). Four focus group discussions were conducted in groups of nine. Descriptive statistics was used to analyze socio demographic characteristics and inferential statistics using Kappa test, chi-square, odd ratio and Regression analysis using Statistical Package for Social Sciences (SPSS) version 21. Null hypothesis was tested at 5% significance level. The study revealed that women initiated to seek antenatal care, but men eventually decide. Decision making power of men was grounded on education (p= 0.001, OR 2.030), occupation (P= 0,001, OR= 2.103) and living together (OR= 1.989). Social cultural factors of husbands also had influence on male partner involvement. Kappa test was 0.9945 implying agreement between husband and wife responses. Regression analysis, at 5% significance level predicted that male participated by providing support (p=0.001). Space (p= 0.001) at the health facility had negative influence on whether the man stayed with wife during labour. Conclusion: Improving the levels of education and income of male partners, addressing cultural beliefs and practices, and sensitizing men on complications associated with pregnancy and child birth can contribute significantly in enhancing male partner involvement in

Purpose. The main objective was to establish determinants of maternal health care utilization and specifically to assess the trends of maternal health care utilization and determine the predictors of maternal health care service utilization in the era of free maternity policy in Busia County. Methodology. It was a cross-sectional study design. The study was conducted between February and April 2019. The research targeted mothers within childbearing age of 15-49 years and a sample size of 634 mothers was used. Quantitative data were analyzed using SPSS version 22.0. Descriptive statistics was used to describe results on socio-demographic characteristics while inferential statistics employed bivariate and multivariate logistic regressions to investigate determinants of maternal health care utilization. Odds ratio was used to test the strength of association, and a p-value of ≤ 0.05 considered as statistically significant.  Results. In 2010, FANC increased by 5.6% from 2010 (pre-free maternity period) to 2017 (post-free maternity era). There was also an increase of 2.2% cases of health facility deliveries during pre-free maternity period (2010) and post-free maternity period (2017). Eleven predictors of maternal health care utilization were identified. Among them were respondent being a farmer (OR = 2.6; 95% CI: 1.4-4.8; p = 0.002), the status of the infrastructure of the nearest health facility maternity being good (OR = 3.2; 95% CI: 1.1-9.6; p = 0.03), fare for the public vehicle being USD 0.2 (OR = 3.4; 95% CI: 1.6-7.1; p = 0.001), all maternal health services being available in the nearest health facility (OR = 3.1; 95% CI: 1.8-5.4; p<0.0001), difficulty to attend MCH services due to non-suitability of working days (OR = 2.7; 95% CI: 1.5-4.7; p=0.0008), there being some services that clients pay for (OR = 3.3; 95% CI: 1.5-7.4; p=0.004), services being provided by nurses (midwives) (OR = 2.3; 95% CI: 1.0-4.9; p=0.04) , baby checkup being done within 24 hours by nurses (OR = 18.8; 95% CI: 8.0-44.0; p<0.0001. In conclusion, free maternity care program has led to increased utilization of facility ANC visits and deliveries in the study area. Barriers related to utilization of maternal health care services included unreliable transport especially at night, limited infrastructure and low socio-economic status of the women in the study area. National and county governments need to put in place strategies which will help them to jointly assess, map and plan investments to improve utilization of maternal health care services through prioritizing investments in human resource, infrastructure and commodities based on the anticipated demand for such services. A unique contribution to theory, practice, and policy: The study findings identified key factors that are unique to the mothers in Busia County on predisposing factors, enabling factors and the need characteristics that determine utilization of maternal health care in the era of Free Maternity services in the study area. These results contribute to both maternal health care utilization and policy change that could directly meet the social setting, geographical location and cultural needs of the people of Busia County.

PURPOSE: To evaluate the factors influencing women&rsquo;s preferred mode of delivery among postnatal mothers in Kericho County Hospitals. METHODOLOGY: Descriptive cross-sectional design was adopted and mixed methods used for data collection. A total of 310 participants were randomly selected using a systematic sampling for quantitative and qualitative approach that used Focus Group Discussion among postnatal mothers in both sampled private and public facilities of Kericho County Hospitals. Data entry and analysis was done with mean and standard deviation computed with results presented in tables. The study used descriptive and inferential statistical analysis. To determine association of variables bivariate and multivariate logistic analysis was adopted. Odds ratios were calculated and the p-value of&lt;0.05 was considered statistically significant. FINDINGS: The preferred mode of delivery by most respondent was vaginal delivery at 81.3% and 18.7% wanted caesarean section. Bivariate analysis of variables showed that level of education p=0.002, marital status p=0.0001, occupation p=0.007. Cultural beliefs that prohibit certain mode of delivery among postnatal mothers had statistical significant of p=0.02. With focus group discussion, a major concern for almost all women was the severity, duration and patterns of labor pains. UNIQUE CONTRIBUTION OF THE STUDY: The study results showed that health provider&rsquo;s attitudes, care and support influenced their mode of birth. Most respondents showed confidence of been delivered by midwives as compared with other carders Cultural beliefs that prohibit certain mode of delivery was a variable that had significant association with preferred mode of delivery with a value of p=0.02. The findings will be useful in designing interventions and strategies that focuses individualized care of mothers during childbirth to meet individual needs and expectations.

Purpose: Early cervical cancer screening (CCS) and treatment is effective method of controlling the disease, however its uptake is poor. Women only screen for cervical cancer when they experience symptoms or when advised by healthcare workers. Main objective of the study was to assess knowledge, attitude and practices of cervical cancer screening among women in Kakamega County. Methodology: The target population was 208,905 women of reproductive age residing in Kakamega County. This was a quantitative research approach utilizing descriptive study design. An interviewer administered questionnaire was used to collect data. Multi-stage sampling was used to select 872 women aged 25-49 from 16 community units of Kakamega County. Participants were assured of confidentiality, voluntary participation and freedom to exit the study at any point. Descriptive statistics were used to analyze knowledge and attitude levels towards cervical cancer screening. Logistic regression along with odds ratios at 95% confidence intervals was used to analyze factors affecting uptake of screening. Findings: Majority (81%) of participants had heard of cervical cancer screening mainly from media and Health Care workers. Only 16 % and 13% had good knowledge about signs of and risk factors of cervical cancer respectively. More than 78% had positive attitude towards cervical cancer screening. Less than 22% of participants had been screened for cervical cancer previously. Uptake of cervical cancer screening was low, and there was poor knowledge on aspects of cervical cancer. Poor to average knowledge is not sufficient to enable women make decisive actions on CCS. Unique Contribution to Theory, Practice and Policy: Women should be encouraged to seek for more information about CCS through the various sources of media available to them. Healthcare providers need to be empowered further on delivering key information about CCS. The Ministry of Health should consider and strengthen alternative sources of information on CCS by use of Community Health Volunteers to complement health care providers. The government should further initiate a monitoring and evaluation program to track trends of factors barring uptake of CCS. A qualitative research need to be conducted to establish deeper factors associated with poor knowledge and uptake of CCS despite positive attitude.

Purpose: This study investigated factors that influence psychiatric clinical learning for diploma nursing students in western Kenya. Methodology: Cross-sectional research design was used with both qualitative and quantitative approaches in data collection. Study participants consisted of diploma nursing students on psychiatric clinical placement. Ten institutions that place their students at Kakamega County Referral Hospital for psychiatric experience were sampled. A total of 178 students, 10 lecturers and 3 psychiatric nurses participated in the study. Qualitative data was collected using interview guides; while quantitative data was collected using structured questionnaires. Descriptive statistics were used to analyse quantitative data while qualitative data was analysed thematically. The relationship between variables was set at a statistical significance of p-value < 0.05. Quantitative data was coded and entered the Statistical Package for Social Sciences version 25.0. Continuous variables were summarized using the Odds Ratio to measure the association between variables and presented in tables and figures to provide a pictorial description of the sample. Findings: The results showed that most students were theoretically prepared to participate in psychiatric clinical learning (67.8% - OR: 1.4: 95% p=0.3). Also, it was supported by the students having a positive attitude (66.1% - OR: 1.2; p=0.5) and being motivated (64.5% - OR: 1.5; p=0.2) towards clinical placement.  However, according to key informants’ findings, most students were not well prepared in practical skills for clinical placement at the psychiatric unit, which was due to inadequate or lack of simulative laboratory for practice at the college level. Nursing students were well prepared theoretically to engage in psychiatric clinical learning placement at Kakamega County Referral Hospital. It also, established that positive attitude and motivation from the nursing students towards clinical placement at the psychiatric unit promoted clinical learning experience and performance thereafter. However, most of the psychiatric nursing students were not well prepared with practical skills to handle mentally-ill patients Conclusion: This study revealed that Kenya Registered Community Health Nurse diploma students were well prepared theoretically to engage in psychiatric clinical learning placement. Recommendation: Medical colleges in Kenya should emphasise skill-based training on human anatomy and behaviour through simulation. Trainers should be required to lead the nursing students through skill-based training. Medical college management should make available practical based resources to trainers and students to promote a skill-based learning approach. Unique contribution to theory, practice and policy Practical skills should be given priority at the college level when preparing students for clinical placement for a holistic clinical learning experience. Positive attitude and motivation from the nursing students towards clinical placement at the psychiatric unit promoted clinical learning experience and performance thereafter.