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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 Unveiling the hidden battle: Impact of Charlson comorbidities index on critical illness rate and mortality among hospitalized COVID-19 patients, comparing vaccinated and unvaccinated individuals in Kenya: A retrospective study(African Journal of Medical and Health Sciences, 2024-01) Isinta, M. Elijah; Kitagwa, W.; Halake, Dabo G; Wang, YouxinFatal outcomes were observed in hospitalized COVID-19 patients, particularly among those who were unvaccinated and had comorbidities. Robust research is needed to validate these findings in both vaccinated and unvaccinated groups. The study, involving 1792 COVID-19 patients, explored the links between comorbidities and fatal outcomes. This single-center retrospective cohort study employed Cox proportional hazard regression to analyze the impact of comorbidities on COVID-19 fatalities, adjusting for age, sex, smoking and vaccination status. Males experienced severe illness (75%) or mortality (76.8%). Notably, most people admitted to the ICU were over 31 years old (96.2%), with individuals over 60 years old facing the highest fatality rate (61.6%). The proportion of ICU admissions increased with the Charlson Comorbidities Index (CCI), with CCI 1-3 at 51.0% and CCI >4 at 52.6%. Mortality linked to CCI was 55.4% for CCI 1-3 and 52.6% for CCI >4. The risk of ICU admission and mortality both increased with higher CCIs. Common comorbidities such as obesity, cardiovascular diseases, diabetes, chronic liver disease, chronic pulmonary obstructive disease, cancer/malignancy, chronic kidney disease and hypertension predicted critical illness and mortality among COVID-19 patients. The area under the receiver operating characteristic curve (AUC-ROC) for predicting critical illness was 0.90 (95% CI: 0.89-0.93), and for mortality, it was 0.90 (95% CI: 0.88-0.91). Additional factors, such as HIV and rheumatoid arthritis, independently predicted critical illness and mortality. The risk of critical illness and mortality showed an increase with the Charlson Comorbidities Index, both among vaccinated and unvaccinated individualsItem Towards drought impact-based forecasting in a multi-hazard context(Elsevier, 2022-01-26) Boult, Victoria L.; Black, Emily; Abdillahi, Halima Saado; Bailey, Meghan; Harris, Clare; Kilavi, Mary; Kniveton, Dominic; MacLeod, David; Mwangi, Emmah; Otieno, George; Rees, Elizabeth; Rowhani, Pedram; Taylor, Olivia; Todd, Martin C.The lives and livelihoods of people around the world are increasingly threatened by climate related risks as climate change increases the frequency and severity of high-impact weather. In turn, the risk of multiple hazards occurring simultaneously grows and compound impacts become more likely. The World Meteorological Organization (WMO) proposed the use of multi-hazard impact-based forecasting (IbF) to better anticipate and reduce the impacts of concurrent hazards, but as yet, there are few operational examples in the humanitarian sector. Drought is particularly susceptible to multi-hazard influences. However, challenges encountered in the development of drought IbF systems – including poor understanding of compound impacts and specific hazard-focused mandates – raise important questions for the feasibility of multi-hazard IbF as envisioned by the WMO. With these challenges in mind, we propose an interim approach in which real-time assessment of dynamic vulnerability provides a context for drought-based IbF. The incorporation of dynamic vulnerability indicators account for the local effects of non-drought hazards, whilst the use of a drought-based system facilitates effective intervention. The proposed approach will improve our understanding of compound events, enhance adoption of IbF in the humanitarian sector, and better mitigate the impacts of concurrent hazards.