Intimate partner violence (IPV) is prevalent in Kenya, yet few studies have examined the role of health care providers (HCPs) in addressing IPV. Interviews with 18 Kenyan HCPs explored how they recognize and support IPV victims, including barriers to care. HCPs most commonly see victims of physical abuse. Medical responses to victims included counseling, treatment, and referrals, although rural HCPs reported fewer available services than in urban settings. HCPs attributed the limited response to IPV victims to unclear laws and fragmented care, especially in a culture where IPV remains largely unspoken and underreported. These results underscore the need for increased training on IPV assessment and response for HCPs in Kenya, with emphasis on standardized care guidelines for victims.
Clinical presentation, management and outcome of cardiopulmonary resuscitation at Tenwek hospital: The oCPRTen StudySir, Cardiopulmonary resuscitation (CPR) is a lifesaving intervention for sudden cardiac arrest (SCA), however wide variations in CPR quality between healthcare systems and geographic locations are well-recognized. [1][2][3] Because of limited data from resource limited rural areas of developing countries such as Kenya on the outcomes of CPR, we examined the clinical presentation, management, and outcomes of patients who underwent CPR in a rural Kenyan hospital.Modified Utstein reporting templates were used to collect data on all patients who underwent CPR at Tenwek Hospital during the 6-month study period. We collected demographic and clinical variables including admission diagnosis, immediate cause of SCA, location of SCA, initial rhythm during CPR, and outcomes during CPR. Tenwek Hospital Ethics Committee approved the study.Data were summarized using mean and standard deviation or percentages as appropriate. We used independent t-test, chisquare test or Fischer's exact test as appropriate to compare variables between groups. A P-value <0.05 was considered statistically significant.Of the 90 patients who underwent CPR, 48 (53%) were females and 29 (32%) were older than 45 years. Medicine (n = 38; 42%) followed by surgery (n = 22; 24%) had the highest number of resuscitations. Most resuscitations were recorded in the critical care units [high dependency unit (n = 26; 29%) and intensive care unit (n = 25; 28%)] and infectious diseases were the most common principal diagnosis (n = 25; 28%). Respiratory arrest was the most common immediate cause of SCA (n = 38; 42%) and asystole was the most common initial rhythm (n = 42; 47%). Defibrillation was attempted in 5(5.6%) and respiratory support was given in 82 (91%) patients. Only 31(34%) patients survived resuscitation of whom only 10 (11%) were discharged alive from hospital.There were no differences by age, sex, admitting service, admitting diagnosis, time of CPR, or the number of chest compression cycles in patients who survived than those who did not (Table 1). However, individuals without asystole as the initial rhythm were more likely to survive than those with asystole (P = 0.04).To our knowledge this is the first study that has examined the outcome of CPR in resource-limited rural Kenya. We found a high risk of death among patients who had SCA and underwent CPR within the hospital. Our finding that patients with asystole were
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