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Item 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, OmarBackground: 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.Item : SUSTAINABLE DEVELOPMENT GOAL NO. 17: EXPLORING WAYS IN WHICH PUBLIC PRIVATE PARTNERSHIP (PPP) CAN FOSTER SUSTAINABLE GROWTH AND CORPORATE GOVERNANCE. A CASE OF KENYAN UNIVERSITIES(Umma University, 2025-02-06) Wanjau, Jackson; Maguta, AnnThe 2030 Agenda for Sustainable Development with its 17 Sustainable Development Goals and 169 targets was adopted by the UN’s 193 member states in September 20155. Sustainable Development Goal (SDG) 17 calls for strengthening the means of implementation and revitalizing the Global Partnership for Sustainable Development5. In particular, it calls for investing and fortifying the global partnerships to achieve sustainable development. The UN 2030 Agenda is global in nature and expects cooperation by both developed and developing countries to ensure no state is left behind. Thus the importance of SDG Goal 17 that encourages partnerships between different stakeholders viz: Public Sector, Private Sector, International Agencies and Civil Society organizations. The Goal of this Research Paper was to examine how Public Private Partnerships (PPP) can foster Sustainable Growth and Corporate Governance in Kenyan Universities.The study was guided by the following objectivesItem Challenges of Sustainable Development in Societies: A Systematic Literature Review(Umma University, 2025-02-06) Wanjau, Jackson; Maguta, AnnSustainable development is a relatively new policy dimension in most countries especially for the developing world. The year 2030 Agenda which was adopted by the 193 member states of the United Nations at the General Assembly held in September, 2015 provides for 17 sustainable Development Goals (SDGs). These goals set out all aspects of trans-formative development from inclusive economic, social and environmental matters. The 17 Sustainable Development Goals (SDGs), further, sets out the benchmark for states to gauge themselves towards the collective sustainable development. The objective of this paper is to examine some of the identified buildings blocks and challenges of sustainable development. Design/methodology/approach In writing this paper, a comprehensive Systematic Literature Review of 10 peer-reviewed scientific journal articles, including a content analysis, was conducted.Item BUILDING BACK-BETTER THROUGH CLIMATE FINANCE AS A TOOL FOR ENVIRONMENTAL DIPLOMACY: A SYSTEMATIC LITERATURE REVIEW(Umma University, 2025-02-06) WANJAU, JACKSON; MAGUTA, ANNIn the recent times, the world has been trying to incorporate Climate Finance as a tool for Environmental Diplomacy in environmental agreements despite the fact that it is usually regarded as the most complex diplomatic process. According to National Geographic Society (2024), diplomacy refers to representatives of different groups discussing such issues as conflict, trade, the environment, technology, or maintaining security. Environmental diplomacy aspect commenced at the 1992 UN Conference on Environment and Development (UNCED) in Rio de Janeiro commonly referred to as the “Earth Summit”. This was a major gathering of heads of state where nearly 180 nations participated. As an upshot of UNCED conference, governments could no longer ignore environmental matters in the greater aspects of national policy and further it became clear that everyone has a stake in the condition of the environment.Item Influence of Cultural Competence Training among Health Care Workers on Patient Satisfaction and Health Outcomes in Diverse Communities(Asian Journal of Research in Nursing and Health, 2024-10-30) Musembi Mary; Affey, FatumaThis study aimed at exploring impact of cultural competence training on enhancing patients satisfaction and improving health outcomes within such communities. Study Design: Analytical-cross sectional study design approach was applied in this study, both qualitative and quantitative methods were utilized to collect data. Relationship between cultural competence training and its effects on patient satisfaction and health outcomes was examined as well as mechanisms through which cultural competence training influences healthcare delivery in diverse settings was explored. Place and Duration of Study: The study was conducted in Kiambu Level 5 Hospital in Kiambu County, Kenya. This region hosts a mixed population with varying cultures, and it is a level 5 hospital with high referrals of various cases from different parts of the county. The area provided conducive environment for this study since it borders Nairobi and its populationItem Home and School Based Parental Involvement as Predictors of Access and Retention in Public Primary Schools in Kajiado County, Kenya(2024-10-11) Kerei K. Beatrice,; Nangithia Robert; and Mwai M. JosephParental involvement in children's education has consistently been associated with improved academic performance. Despite government efforts to provide free primary education, many public schools in Kenya still faces challenges related to access and retention. The issue is more pronounced in regions like Kajiado county where socioeconomic and cultural dynamics, including nomadic pastoralist lifestyles, can affect children’s schooling. This study therefore, sought to investigate home and school based parental involvement as predictors of access and retention in public primary schools in Kajiado County, Kenya. The study was guided by Epstein’s Six Types of Parental Involvement Model. Using a descriptive survey design, the study collected data from 10 schools, targeting 100 teachers. The Krejcie and Morgan Table from 1970 was utilized to determine a sample size of 80 respondents, who were selected through simple random sampling techniques. Data was collected using a structured questionnaire, which was first piloted to assess its validity and reliability. Descriptive statistics was used to analyse the data. The findings revealed that parental financial contributions, involvement in learning, provision of resources and participation in academic activities affects pupils access and retention. The study recommends several strategies to improve access and retention in Kajiado County public primary schools.Item Financial Inclusion and Stock Market Developmentin Kenya; ACase of Kajiado County(Blue Print Academic Publishers, 2024-09-22) Munene, Wanja Agnes; Koech, AlexThe Group of Twenty (G20) recognizes that financial inclusion as a key enabler in the fight against poverty. In effort to alleviating poverty in Kenya, the government identified the stock market as a key avenue in mobilizing resources. The Development of its stock market is thus vital avenue that could be used to mobilize investment funds required for implementation of vision 2030 projects. However, the stock market is contributing less than one percent of growth financing against the government expectation of ten percent. This study therefore, sought to investigate the effect of financial inclusion on stock market development in Kenya. The specific objectives were to determine the effects of access to financial services, usage of financial services, quality of the products and the service delivery on stock market development in Kenya. Using stratified random sampling, a sample size of 482respondents was drawn from a target population.Multiple regression Model was employed in order to determine the relationship between financial inclusion and stock market participation in Kenya. The study found out there was a strong positive relationship between financial access, usage and product quality and stock market development.Also, financial access(β=.061, p<0.05), usage(β=.083, p<0.05)and product quality(β=.476, p<0.05)has a positive and statistically significant effect on stock market development in Kenya.In addition, the study found that most of the responses on advanced financial literacy questions were performed below average indicating low financial literate levels among the respondents.The study recommends that the county government initiate programs that will enhance financial inclusion in the county, this will not only enhance stock market development but also other market sectors.Item INVESTIGATION OF DECLINE OF ISLAM IN MUMIAS REGION OF KAKAMEGA COUNTY(2023-11-19) OMUKABA, OMAR RAMADHANIslamic religion first spread into Africa from the Arabian Peninsula during the early seventh century. Today, 40 percent of the African population is Muslims. The East African region consist of a significant number of Muslims particularly along the Indian Ocean coastline. In Kenya, Muslims account to 11 percent of the population (Census, 2019). Islam penetrated to interior of Kenya and stepped its fit in Mumias Western Kenya in late 19th century. Its spread in the region was spearheaded by King Nabongo Mumia of the Wanga kingdom who embraced in its early stage. In early 20th century Christian missionaries invaded the region spreading Christianity which led to weakening of Islam in the region. This study has investigated the downfall of Islam in Mumias region of Kakamega County, Kenya. The study aimed to examine the factors behind the decline of Islam in Mumias region and discuss the efforts of revival. The study was guided by the theory of islamization developed by Bunger (1972) and conflict theory suggested by Marx. The design employed was exploratory and descriptive survey design with a methodology of a mixed method approach during which both qualitative and quantitative data were collected through questionnaires and interview schedules. The quantitative data obtained was analyzed systematically with the help of the SPSS version 21 and presented with the help of frequency tables and percentages. While the qualitative data collected was analyzed and presented thematically in a narrative form. The target population was 399,145 respondents from the entire Mumias region. The researcher used both purposive and simple random sampling to get sample size of 100 respondents for the study. Ethical consideration was a priority by seeking permission from the relevant authority to carry out the study and confidentiality assured to all respondents. The study findings have established several reasons that led to deterioration of Islam in Mumias region such as lack of religious knowledge, learning in missionary sponsored schools, marriage to nonmuslims, poverty among Muslims, Influence from parents and colleagues who are not Muslims or who have converted from Islam, misconception about Islam, lack of committed and consistent propagators (Duat) and lack of Islamic institutions like schools and hospitals among others. The results also indicate that downfall of Islam contributes to reduction of Muslim followers. There are some efforts put forward to improve the situation like; propagation of the religion, interreligious dialogues though very little and a few Islamic NGOs that operate in the region among others.Item Prevalence, Effect and Management of Cancer Pain at Garissa, Kenya(IOSR Journal of Nursing and Health Science, 2018-12-25) Affey, Fatuma; Mwenda, Catherine; Too, Wesley; Elmi, MohamedHigh prevalence, negative effect and suboptimal cancer pain management has been reported from resource-limited countries such as Kenya. Precisely, trends of cancer cases are on the increase at Garissa County in Kenya, yet no data exist on the prevalence, effect and management of cancer pain. This study was to examine the prevalence, effect and cancer pain management of adult patients at Garisssa County Referral Hospital. A descriptive cross sectional survey was employed and 94 cancer patients from both outpatient on follow up care and inpatient were recruited to participate. MBPI (Modified Brief Pain Inventory) and ECOG (Eastern Cooperative Oncology Group) tools were used for data collection. Pain Management Index was calculated and significant levels were set at P<0.05 for all tests. Mean age of participants was 50years, composed of 42(44.7%) male and 52 (55.3%) female. Cancers of Breast and prostate were most prevalent with (25%) female and (14%) male respectively. Prevalence of cancer pain was 78% with majority reporting moderate to severe pain and undertreatment with PIM of (p-value < 0.05). Participants accounting 76.9% male and 66.7% female reported cancer pain interference with ability to walk and 91% male and 70% female reported that pain interfered with their mood. Male participants reported to experience more psychological, physical and social pain than female participants. A total of 81.9% (77) participants incorrectly utilised WHO analgesic ladders, 65% (61) and 77.6% (73) considered alternative therapy of Quran and Somali herbs respectively for pain management. This study found a high prevalence of cancer pain with negative impact and suboptimal cancer pain management.Item 'XANNUN’ NURSING CARE MODEL FOR CANCER PAIN MANAGEMENT AMONG ADULT PATIENTS AT GARISSA COUNTY REFERRAL HOSPITAL (GCRH), KENYA(2019) Affey, FatumaNursing care models allows concept application of not only the physical treatment of pain but also synthesis the significance of social-cultural practices, psychological and spiritual pain relief. Cancer pain has high prevalence and negative impact on the quality of life of patients at Garissa County due to limited access to healthcare facilities and unique pastoral lifestyle of the community. This necessitated the development of ‗Xannun‘ model of nursing care for holistic pain management that is clinically proficient and culturally competent. Phase one of the utilised triangulation method approach to recruit 94 cancer patients, 84 clinical nurses and 15 key informants, while phase two was the actual development and testing of Xannun nursing care model. Various sampling procedures that included random, purposive and snowball and recruit participants voluntarily was done. Modified Brief Pain Inventory (MBPI) tool combined with focus group discussion and Eastern Cooperative Oncology Group (ECOG) performance status was used to obtain data from participants. The sample population was 188 participants. Cancer patients had a mean age of 51years, with prevalence of pain at 78 % (73) that ranged from moderate to severe. A total of 78 % (66) of clinical nurses had no tool for pain assessment, 83.2 % (70) of them did not know how to utilise WHO analgesic ladder. Majority of patients 82 % (78) were on incorrect WHO analgesic ladder with negative PMI (p-value < 0.05) of under treatment. Majority of patients considered alternative treatment for cancer pain such as Quran recitation and Somali herbs accounting for 65% (61) and 77.6% (73) respectively. Almost all KI 93% (14) indicated the inadequate availability of pain medication. Phase two, Delphi survey to gain expert opinion was used. Experts‘ opinion of 80% of respondents agreed that the ‗Xannun‘ nursing model captured the challenges of cancer pain management and 60% of them predicted that the model could be utilised. However, 100% of the experts suggested that the model will bring a positive change, though 90% of them upheld that there will be potential challenges of implementing such a model. This study found high prevalence of cancer pain, suboptimal pain care, Knowledge deficit among nurses and inaccessibility of pain medication associated with the dynamic of a nomadic lifestyle. Thus, this study recommends the implementation of ―Xannun‖ Nursing Care model at GCRH, for a better approach of cancer pain management.