Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers’ practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR = 3.66; 95%CI: 1.63-8.26; P = 0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker’s involvement in provision of smoking cessation care in Kenya.
Objective: To establish the operational feasibility and effectiveness of using locally available foods to prevent malnutrition and improve child growth in Kenyan children. Design: Quasi-experimental design with an intervention group of children in all villages in one region and a non-intervention group of children in all villages in an adjacent region. The intervention was the distribution of a monthly food ration for the index child, a separate family ration, and group education on appropriate complementary feeding and hygiene. Setting: Rural villages in the arid lands of eastern Kenya with a high prevalence of child malnutrition. Subjects: All children in the target villages aged 6-20 months with weight-forlength Z-score (WHZ) greater than 22 at baseline. Results: Children in the intervention and non-intervention groups had similar baseline anthropometric measures. The caregivers in the intervention group confirmed that the intended amounts of food supplements were received and child nutrient intake improved. During the 7-month intervention period there were significant group differences in pre-post Z-score changes between the intervention and non-intervention groups for weight-for-age (0?82, P , 0?001) and weight-for-height (1?19, P , 0?001), but not for height-for-age (20?20, P 5 0?09), after adjusting for multiple covariates. Compared with the non-intervention group, the intervention group had a lower prevalence of wasting (0 % v. 8?9 %, P 5 0?0002) and underweight (6?3 % v. 23?0 %, P , 0?0001). Infectious morbidity was similar in both groups. Conclusions: The findings suggest that the distribution of locally available foods is operationally feasible and improves child weight gain and decreases acute malnutrition in Kenyan children.
Introduction: Adherence to dietary prescriptions among patients with chronic kidney disease is known to prevent deterioration of kidney functions and slow down the risk for morbidity and mortality. This study determined factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis. Methods: A mixed-methods study, using parallel mixed design, was conducted at the renal clinics and dialysis units at the national teaching and referral hospitals in Kenya from September 2018 to January 2019. The study followed a QUAN + qual paradigm, with quantitative survey as the primary method. Adult patients with chronic kidney disease on hemodialysis without kidney transplant were purposively sampled for the quantitative survey. A sub-sample of adult patients and their caregivers were purposively sampled for the qualitative survey. Numeric data were collected using a structured, self-reported questionnaire using Open Data Kit "Collect software" while qualitative data were collected using in-depth interview guides and voice recording. Analysis on STATA software for quantitative and NVIV0 12 for qualitative data was conducted. The dependent variable, "adherence to diet prescription" was analyzed as a binary variable. P values < 0.1 and < 0.05 were considered as statistically significant in univariate and multivariate logistic regression models respectively. Qualitative data were thematically analyzed. Results: Only 36.3% of the study population adhered to their dietary prescriptions. Factors that were independently associated with adherence to diet prescriptions were "flexibility in the diets" (AOR 2.65, 95% CI 1.11-6.30, P 0.028), "difficulties in following diet recommendations" (AOR 0.24, 95% CI 0.13-0.46, P < 001), and "adherence to limiting fluid intake" (AOR 9.74, 95% CI 4.90-19.38, P < 0.001).
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