Purpose – The purpose of the study was to find out the determinants of strategy implementation by the international reproductive health (RH) non-governmental organizations (NGOs) in Kenya for attainment of MDG 5 by 2015. The objectives of the study were to analyse the effects of the determinants of strategy implementation for attainment of the Millennium Development Goal (MDG) 5 by international RH NGOs operating in Kenya. This study was guided by three specific objectives: to analyse the effect of policy regulations on strategy implementation by international RH NGOs in attainment of MDG 5; to determine the effect of management competencies on strategy implementation by international RH NGOs in attainment of MDG 5 and to explore the effect of resource allocation on strategy implementation by international RH NGOs in attainment of MDG 5 by 2015 in Kenya. Design/methodology/approach – A cross-sectional descriptive study design was carried out from January to March 2012 in Nairobi, Kenya. The study populations comprised of programme staff and RH technical advisors for the international RH NGOs operating in Kenya and headquartered in Nairobi. The sampling design was a census method since all the ten international RH NGOs based in Nairobi were selected. Qualitative and quantitative methods of data collection were used using both closed and open-ended questionnaires. The quantitative data were analysed using SPSS version 20 for both descriptive and inferential analysis. Qualitative data were analysed descriptively. Measures of location and variability were used for analysis and hypothesis tested using Fisher ' s Exact test and regression analysis. Findings – The research findings showed that policy regulations, management competencies and the resource allocations determine successful implementation of the strategic plans. Inadequate resource allocations have a direct bearing on the implementation of the RH programmes which invariably affects the attainment of the MDG 5 by 2015. The study did not accept the null hypotheses and therefore showed that there is relationship between policy regulations, management competencies and resource allocations and the implementation of strategic management plans by international RH NGOs operating in Kenya. Originality/value – Although numerous studies acknowledge that strategies frequently fail not because of inadequate strategy formulation, but because of insufficient implementation, strategy implementation has received less research attention than strategy formulation. This paper addresses this gap.

The purpose of this study was to determine the effectiveness of behavioral and rational emotive behavior therapies (REBT) on conduct disorder among juvenile delinquents. This was a quasi-experimental study design with Kabete Rehabilitation School representing the experimental group and Wamumu Rehabilitation School representing the control group. A total of 94 respondents aged between 13 and 17 years from Kabete and Wamumu rehabilitation schools in Kenya participated in the study (47 for each study arm). A socio-demographic questionnaire was administered, in addition to a selfadministered Child Behavior Checklist (CBCL-YSR) Youth Self Report for ages 11-18 (2001) completed at baseline, midline (3 months post-intervention) and endline (6 months post intervention). CBCL is a standardized tool with a proven validity and reliability of 0.82. The two groups were comparable statistically with respect to key socio-demographic characteristics namely type of facility, age, employment status with the exception of class. Data was analyzed using Statistical Package for the Social Sciences version 20.0 (20). Presentations were done using profile plots and tables. The experimental group showed a steady decline in the mean CD scores over the study period from 19.96 (SD: 5.069) at baseline to mean of 8.26 (SD: 2.625) at endline (p < 0.0001). The control group had a rather staggered decline from mean of 14.94 (SD: 3.953) at baseline to 11.81 (SD: 4.332) at end-line (P > 0.05). Difference-in-differences (DiD) model was used to determine the efficacy of the intervention at post-treatment one and post-treatment two. The DiD estimators at midline was -1.393 (p < 0.0001) and at end-line was -1.204 (p < 0.0001) after controlling for class. The study established a statistically significant reduction of conduct disorder symptoms from a mean of 19.96 at baseline to 8.26 at post-treatment two and this was significant at p<0.001, indicating the effectiveness of behavioral and REBT therapies in treating conduct disorder. Based on the study findings, it is recommended that behavioral and REBT therapies be integrated in the juveniles' rehabilitation program.

Studies on juvenile delinquents have shown an overlap between delinquency and psychiatric disorder such as depression, post-traumatic stress disorders (PTSD, conduct disorders (CD) and attention deficit hyperactivity disorder (ADHD). This study investigated the prevalence of psychiatric morbidity among adolescent girls in selected rehabilitation schools in Kenya. The study sample had a total of 78 purposely selected adolescents in the two rehabilitation schools. The research found that the overall prevalence of depression was 66.7% that of anxiety disorder was 70.5%, while the prevalence of conduct disorder was 55.1%.In addition. This article has shown high presence of psychiatric morbidity among adolescent girls, incarcerated at Kirigiti and Dagoretti rehabilitation schools. These juvenile needs mental treatment as a key rehabilitation measure.

Childhood immunization remains one the primary health care core component and the most effective public health interventions for controlling and eliminating life-threatening vaccine preventable diseases in the world. According to 2014 Kenya National Demographic and Health Survey (KDHS), a few children of ages 12 to 23 months in Kenya presented below average in terms of vaccination coverage of children who are fully immunized. Delayed vaccinations would increase the risk for vaccine preventable diseases in the community, therefore the information obtained from this study is to help policy makers come up with sound strategies to increase immunization coverage from 57%- 90% as recommended by World Health Organization. The broad objective of the study was to determine reasons influencing low vaccination coverage between children of ages 12 to 23 months in Narok South sub-county, Narok County in Kenya. This is to contribute to the reduction of morbidity and mortality caused by infectious diseases of public health importance related to vaccine preventable disease. Methods: This was a cross-sectional descriptive study. The study used mixed methods, both quantitative and qualitative. A structured questionnaire was used to collect data on social demographic and social cultural factors, maternal health care utilization and knowledge. Key informative Interviews and Focus Group Discussions were used to collect qualitative data on 454 mothers/caretakers with children aged between 12-23 months reached in Narok South sub county. Results: The total number of mothers/caregivers who were interviewed were 454, with a response of 100%. Results of immunization coverage; BCG 73%, OPV1 59%, OPV2 51%, OPV3 49%, Penta1 58%, Penta2 51%, Penta3 50%, Measles 54% and Fully Immunized Children 47%. Further, 47% of the children in the sub-county were fully immunized and 53% were unimmunized. The SD mean for mothers/caregivers and children 31.4 and 17.0 respectively and over 70% of the mothers/caregivers had no formal education. There were significant association predictors with immunization coverage included maternal education (X2 =11.75, df=4 p value=0.02), distance to health facility (X2 =62.30, df=2 p value=0.00), also, there was strong significant association with childbirth ranking (OR=1.218, p value=0.04). Bivariate analysis, there was an association with mothers/caregivers’ who had more than one visits with fully immunized children (χ2=13.54, df =2 and p value =0.001), source of the immunization information OR=0.75 and p value=0.02 and, ultimately, there was association between mother’s/caregiver place of delivery with non-fully immunized children (X2=74.40,df=1 p value=0.01). Predictors of non-fully immunized children in the study population were; place of delivery, family size, education level, source of income, none attendance of Antenatal clinics, distance to the health facility, source of the vaccination information was associated with incomplete fully immunized children. Conclusion: The immunization coverage for the fully immunized child in the sub county was very low 47%, compared to national 77%. Key players in the immunization sector should identify children who are at risk, deploy reach every child strategy, encourage pregnant mothers to attend ANC, expand outreach services, increase funds allocation to health sector and build more health facilities to improve immunization coverage.

Tertiary hospitals in resource-limited countries treat patients referred but in most cases are the first level of care for the vast majority of patients. As a result, the tertiary facility effectively functions as a primary health care facility. The urban phenomenon of widespread self-referral is associated with low rates of formal referral from peripheral health facilities. Study Objective: To determine the patterns of orthopaedic and trauma admissions to Kenyatta National Hospital. Methodology: This was descriptive study design. Sample size was 905 patient charts for 2021 Findings The mean age was 33.8 years (SD 16.5) with range of 1 - 93 years. Majority 66.3% were between 25 – 64 years with those above 65 years being 40 (4.4%). Children 0-14 years comprised 10.9% of the admissions. Of the 905 admissions, 80.7% were accident and trauma-related admissions while 17.1% were non-trauma related admissions. About 50.1% were facility referrals while 49.9% were walk-ins. Majority of admissions were through Accident and Emergency Department 78.1%, Corporate Outpatient Care 14.9% and Clinic 7.0%. About 78.7% were emergency admissions while 20.8% were elective admissions. Approximately admissions 48.5% were due to Road Traffic Accidents, 20.9% due to falls and non-trauma related conditions represented 17.1%. Close to 44.8% were casual workers and 20.2% unemployed. Education level was also reviewed with 34.0% having primary education and 35.0% having secondary education. A significant proportion of female admissions (33.2%) were due to non-trauma conditions as compared to male admissions (12.8%) (p<0.001). Aadmissions for those aged 25 – 64 years were 3.5 more likely to have emergency admission as compared to those aged 0 – 14 years. Male were 65.1% less likely to have elective admissions compared to female (p<0.001). Those unemployed were 3.9 more likely to have emergency admission compared to businessmen/women. Vast majority (89.2%) of admissions were within Nairobi Metropolitan region