IntroductionUncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Data on adequacy of blood pressure control in Kenya is scarce. This study aimed at assessing the level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital.MethodsData regarding blood pressure, antihypertensive medication use, and comorbidities was abstracted from medical records of 452 hypertensive patients seen in Nyeri Provincial General Hospital between January and March 2013. Adequate blood pressure control was defined as a systolic pressure < 140 mmHg (< 130 mmHg for diabetic hypertensive patients) and a diastolic pressure < 90 mmHg (< 80 mmHg for diabetic hypertensive patients). Data was entered and analyzed using STATA 9 (StataCorp, Inc, Texas, USA).ResultsOnly 33.4% of patients had a blood pressure within the recommended limits. In multivariate analysis, using a calcium channel blocker was significantly associated with good blood pressure control (OR, 2.1; 95% CI, 1.4, 3.3). On the other hand, old age (≥ 60 years), being diabetic, and the use of three or more antihypertensive drugs were associated with reduced odds of good blood pressure control (OR, 0.64; 95% CI, 0.43; OR, 0.54; 95% CI, 0.36, 0.81; and OR, 0.41; 95% CI, 0.26, 0.64, respectively).ConclusionPoorly controlled blood pressure is an important public health concern among hypertensive patients in this region. Elderly patients, those with diabetes, and those on multidrug regimens are at higher risk for poor blood pressure control and warrant closer attention.

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Background: Death of a pregnant woman is very devastating for the family and the community at large. Most of the causes of death are preventable through various strategies such as birth preparedness. When there is preparation early in advance, delays which can lead to morbidities or mortalities can be averted. Despite the strategy being in place for over 20 years, there are factors which affect its practice. This study sought to establish the factors affecting birth preparedness among pregnant women attending public antenatal clinics in Maori County.Methods: This was a descriptive cross-sectional study employing quantitative method though use of interviewer-administered questionnaire and qualitative method using focus group discussion. The study was carried out among pregnant women attending public ANC clinics in Migori County. Data analyzed using Strata version 11software. Results:The factors which affected birth preparedness were marital status (p=0.004), residence (p<0.001), maternal occupation (p=0.01) and the partner's level of education (p=0.001). Also, the type of health facility attended by the respondent was significantly associated with birth preparedness (p<0.001). Conclusion:There are socio-demographic, economic and socio-cultural factors affecting birth preparedness.

Background Female genital mutilation (FGM) is one of the most harmful traditions still practiced in many parts of the developing world, including Kenya. The practice leads to permanent and irreversible health damages; however, knowledge and attitude of women towards its obstetric effects is scarce. Aim The objective of this study was to determine knowledge and attitude of women towards obstetric effects of FGM among Maasai women. Methods A hospital-based cross-sectional study was conducted at Loitokitok Sub-County Hospital among 64 Maasai women who had undergone FGM. Systematic sampling was employed to identify the respondents. Data were collected using a pretested semistructured questionnaire and analyzed through Statistical Package for the Social Sciences (SPSS) version 20.0 based on frequencies and percentages. Qualitative data were coded and categorized and thematic analysis was done. Results Half of the women were knowledgeable on obstetric effects of FGM. Majority of them, 81% (n=52), sustained perineal tears during childbirth while 53% (n=34) had postpartum hemorrhage. Majority of the respondents, 81% (n=51), had negative attitude towards FGM and 87% (n=31) would not encourage their daughters to be circumcised. Most of them, 64% (n=23), disagreed that circumcision made one a respectable woman. Conclusion Obstetric effects of FGM were fairly known and there was negative attitude towards FGM practice.

Addressing poor pregnancy and childbirth outcomes such as still births, pre-term births and neonatal deaths have continued to be a major global challenge. Nations and organisations have invested much effort and resources to promote safe pregnancy and childbirth. Objective: To identify factors contributing to adverse pregnancy outcomes among women seeking care in public health facilities in the Keiyo district of Kenya. Methods: A descriptive cross-sectional design was used employing both quantitative and qualitative methods. Three hundred and eighty four women of reproductive age (15-49 years) attending public health facilities for Maternal and Child Health/Family Planning (MCH/FP) were interviewed. Results: There are several factors which cause adverse pregnancy outcomes. Socioeconomic and demographic factors that were associated with poor pregnancy outcomes include low education level, lack of formal employment and multiparity. Other factors included pre-term birth, preexisting medical conditions, illnesses during pregnancy and obstetric emergencies. The lengthy referral pattern also was a contributory factor. Conclusions: There are several factors that contribute to poor pregnancy outcomes. Social mobilisation of the community on reproductive health issues should be done through health education to enhance proper basic obstetric care and emergency obstetric care. Health facilities should be well staffed and well equipped in order to avoid poor pregnancy outcomes, which may occur as a result of delays owing to lack of staff or equipment. There should be a well defined referral system to enable timely referrals.