Browsing by Author "Halake, Dabo Galgalo"

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Case Management of Substance Induced Psychosis Using Peplau’s Theory of Interpersonal Relations
(2017) Ogoncho, Isaac Machuki; Sanga, Philip; Halake, Dabo Galgalo
Substance induced psychosis is a form of psychosis that develops from the use of alcohol or other drugs. The symptoms for this form of psychosis can resolve within days or weeks though tendencies of relapsing occur with persistent use of the drugs. The purpose of this article was to examine Peplau’s theory of interpersonal relations as a framework to assist nurses in understanding and managing patients with substance induced psychosis. The theory involves a therapeutic process that is collaboratively undertaken by both the nurse and the patient towards resolving an identified health problem. The nurse-patient relationship evolves through three phases of orientation, working and termination. The nurse may function as a stranger, leader, teacher, resource person, surrogate and counsellor in helping the patient adopt a healthier behaviour. The nurse-patient relationship allows the patient to freely express their emotions, feelings and thoughts about a given health problem. This enhances understanding of the health problem and guides nurses to helping the patients meet their individual needs. Nursing practice should focus on strengthening interpersonal relationships with patients to improve health outcomes.
Determinants of cancer care pathways at Wajir County, Kenya: patient perspectives
(Researchecancer, 2025-02-12) Affey, Fatuma; Halake, Dabo Galgalo; Wainaina, Grace Muira; Osman, Hussein Ali; Ndukui, James G; Abdourahman, Houda; Abdihamid, Omar
Background: Cancer represents a major public health issue with substantial morbidity and mortality in low-resource settings such as Kenya. This study focuses on Wajir County in northern Kenya, a region with limited cancer care infrastructure and high unmet needs. Despite recent efforts to decentralize cancer care in Kenya, including establishing regional cancer centres in Garissa, Nakuru, and Mombasa, access to screening, diagnostics, and treatment remains constrained, particularly in rural areas. The absence of comprehen- sive cancer care pathways and a specialized oncology workforce in Wajir County exac- erbates challenges in early detection, treatment, and palliative care. The study evaluated the availability of cancer care services at Wajir County Referral Hospital (WCRH), includ- ing screening, diagnostic services, treatment modalities, and referral systems. The study further explores the gaps in cancer care, focusing on patient perspectives, and proposes potential solutions to address these challenges. Methods: This study used mixed-methods (qualitative and quantitative) methods to understand cancer care from the perspective of patients at WCRH. It involved adult patients (over 18) with a confirmed cancer diagnosis who were receiving treatment or follow-up care between February and April 2024. Data were gathered through inter- views and surveys, with research assistants helping with language translation and com- munity navigation. The study collected information on demographics, cancer types, and prevalence rates, which were analysed using descriptive statistics. The qualitative data focused on patients' experiences with cancer awareness, treatment, and care gaps, and were analysed for common themes. Ethical approval was obtained, and informed consent was given by all participants. Results: This study involved 25 cancer patients (12 males, 13 females) receiving treat- ment at WCRH. The most common cancers were esophageal (44%), cervical (28%), breast (24%), and prostate (8%). Delays in diagnosis were significant, with 12% of patients wait- ing over 6 years, 24% waiting 4–6 years, and 40% waiting 1–3 years before seeking care. Most diagnoses were made at WCRH (64%), with others diagnosed at the Garissa Can- cer Centre (22%) or in Nairobi (20%). Diagnostic tools available at WCRH included pap smears, mammograms, PSA tests, ultrasound, CT scans, and biopsies. However, access to these tools was limited, with barium swallow (32%) being the most frequently used for esophageal cancer, followed by pap smears, biopsies, and ultrasound (16% each). Patient awareness of cancer screening was higher for cervical (68%) and breast cancer (60%) but lower for prostate cancer (32%) and esophageal cancer (4%). Despite awareness, only 8% had previously undergone screening. Regarding treatment, most patients (80%) were aware of surgical options, while fewer knew about chemo- therapy (28%) or palliative care (12%). When treatment was unavailable at WCRH, most patients preferred the Garissa Cancer Centre (80%) or Nairobi (52%). Financial challenges were the primary barrier to treatment for 88% of patients, and patients suggested improving local cancer care, subsidizing treatment, and enhancing early detection and screening services. Conclusion: The findings indicate a high burden of late-stage cancer diagnoses, insufficient cancer screening and treatment services, and limited access to cancer care pathways and patient navigation systems. These results underscore the urgent need for improved cancer care pathways, enhanced awareness, and increased healthcare capacity to reduce cancer morbidity and mortality in northern Kenya. This study contributes to understanding the cancer care landscape in Wajir County and provides a foundation for future health policy initiatives aimed at bridging existing gaps in cancer care.
ENHANCING PASTORALIST WOMEN'S KNOWLEDGE OF DANGER SIGNS THROUGH HOME-BASED LIFE-SAVING SKILLS INTERVENTION IN NORTHERN KENYA: A QUASI-EXPERIMENTAL STUDY
(Umma University, 2024-02-22) Halake, Dabo Galgalo; Maranga, Elijah
Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. The study participants were recruited using purposive sampling based on the eligibility criteria that the pregnancy is less than 16 weeks gestational period and willingness to participate in the study. We used household registers to recruit the participants from the two sub-counties. At baseline, 128 participants were enrolled in each arm of the study while 246 participants were interviewed during the end-line survey with the intervention arm having 126 participants and control groups 120 respectively. In the study, we implemented sensitization of pregnant women of reproductive age on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. At the same time, the control group continued with routine services. The trained community health volunteers (CHVs) implemented the intervention for nine months. Descriptive statistics was used to analyze demographic data. The chi-square test and Difference-in-Difference analysis were used to compare the intervention's proportion differences and net effect. Results: At baseline, no significant differences in the knowledge level existed. Proportions of women who were knowledgeable of >3 danger signs increased significantly during pregnancy [(89.7%) vs. (62.5%), p<.0001], birth [(86.5%) vs. (75.0%), p=.022], postpartum [(92.1%) vs. (74.2%), p<.000] and neonatal period [(96.8%) vs. (66.7%), p<.0001] in the intervention group than the control group at end-line. Discussion & Conclusion: These results imply that it is possible to improve knowledge of obstetric danger signs among women from hard-to-reach pastoralist communities as part of home- based life-saving skills interventions. Our work contributes to the United Nation’s sustainable development goal 3, which focuses on equity and commitment to reaching people needing health services regardless of where they live and their circumstances.
The Role of Mobile Health in Supporting Cancer Prevention, Detection, Treatment and Palliative Care in Low and Middle Income Countries: A Scoping Review
(Public Health Research, 2017) Halake, Dabo Galgalo; Ogoncho, Isaac Machuki
Cancer is one of the non-communicable diseases with high morbidity and mortality rates, particularly in low-and-middle income countries. Increasing cancer burden is attributable to lifestyle risk factors, poor health system infrastructures, rapid population growth and ageing. These challenges are predicted to persist for years to come; thus the cancer burden is feared to become a major public health crisis hence need for innovative approaches to manage it. Though the widespread use of mobile health technologies in low and middle income countries can potentially address these challenges, evidence on mobile health use has not been fully explored. This study aim to examine the existing published and unpublished literature on the use of mobile technology-based interventions designed to support cancer prevention, detection, treatment and palliation in LMICs. The study adapted a scoping review approach using Arksey & O’Malley (2005) methodological framework. Six electronic databases; Medline, EMBASE, PsycINFO, PubMed, Web of Science and WHO Global Health Library were systematically searched for relevant studies between 1990 to 2014. The search also included additional sources from trial registers, Google, Google Scholar and reference lists. The search yielded 523 articles of which 16 were reviewed, one of these being an ongoing trial. The key findings revealed that mHealth technologies had significantly contributed to the positive outcomes in the cancer care in various contexts with all mobile technology-based features used showing improvement in care delivery. The cell phones were the common mobile device used (46.6% of the studies) followed by Smartphone (26.6%), while SMS was a commonly used mHealth feature. Mobile health interventions predominantly targeted cancer screening and diagnosis in the continuum of care, with less focus on treatment and palliation support. In conclusion, mobile health interventions have a high potential to transform cancer services in low resource settings. However, there is a paucity of evidence on mobile health interventions for cancer care. Most of the reviewed studies were descriptive, hence the need for robust studies with multidimensional focus, including control of risk factors, treatment compliance and palliative care.