No abstract

BackgroundNomadic lifestyle has been shown to be a significant factor in low immunization coverage. However, other factors which might aggravate vaccination uptake in nomadic pastoralists are poorly understood. Our study aimed at establishing the relative influence of social demographics, missed opportunities, and geographical mobility on severe under vaccination in children aged less than two years living in a nomadic pastoralist community of Kenya.MethodsWe used cross-sectional analytical study design. An interviewer-administered questionnaire was used to obtain quantitative data from 515 mothers with children aged less than two years. Under vaccination was the sum the total number of days a delayed vaccine was given after the recommended age range for each vaccine. Severe under vaccination was defined as those children who remained under-vaccinated for more than six months. Geographical mobility was assessed as household members who had gone to live or herd elsewhere in the previous 12 months, missed opportunity included questions on whether a child visiting a health facility had missed being vaccinated, while social demographic data included household size and mothers social demographics.ResultsThree-quarters of the mothers had no formal education. One-third of the children had been taken to a health facility and missed being vaccinated. Forty percent of the households had moved in the previous 12 months. Prevalence of missed opportunity was 30.1%; 42.2% of children had not received any vaccines by their first birthday, and 24.1% of children were severely under vaccinated.No significant association was found between social demographics and under-vaccination. Variables associated with under-vaccination were; movement of the whole family, (p = .015), missed opportunity, (p = <.001), lack of vaccines, (p = (.002), and location of health facility, (p = <.001). Movement of women and children made a significant contribution (p = 0.006) to severe under-vaccination. Children in households where women and children had moved were nine times more likely to be severely under-vaccinated than in those households where there was no movement.ConclusionGeographic mobility of women and children was a key determinant of severe under vaccination among nomadic pastoralists in Kenya.

Background: Children from nomadic pastoralist communities might not receive all the recommended doses of vaccines at age-appropriate times due to limited access to immunization services.  Skipped, delayed or missed vaccination doses result in under vaccination which in turn make children vulnerable to preventable diseases.  The purpose of present study was to establish completion timeliness and under-vaccination of all the recommended childhood vaccinations in a nomadic pastoralist community.Methods: Authors used a cluster sampling technique to identify children aged 0 to 24 months at the household level.  Vaccine completion was the accumulation of the required number of doses by infants irrespective of the timing. Timeliness was vaccines administered within the recommended age range. Under vaccination was the sum total of days a delayed vaccine was given after the recommended age range.Results: Completion of all individual antigens did not meet the target of 90%. The mean number of days a child remained under-vaccinated in days was: OPV0, 20 days; BCG, 39 days; measles vaccine, 47 days; PVC3, 121 days; pentavalent, 117 days, and rotavirus, 103 days.  Approximately 42% were severely under-vaccinated for more than six months. Vaccine-specific under-vaccination of more than six months was:  pentavalent 3, 20%; PCV 3, 14%; OPV 3, 9.5%; BCG, 3%, and measles vaccine 20%. Overall children remained under-vaccinated for 185 days.Conclusions: A significant proportion of children remained under vaccinated for extended periods leaving them at risk during a vulnerable period of their life.

Background and Aim Breast cancer is the leading cancer in terms of incidence in Kenya. We conducted a breast cancer awareness and screening pilot to assess feasibility of rolling out a national screening program in Kenya. Methods Conducted in Nyeri County during October–November 2019, the pilot had three phases; awareness creation, screening (clinical breast examination and/or imaging) and final evaluation (post‐screening exit interviews and retrospective screening data review). Descriptive statistics on awareness, screening process and outputs were derived. Results During the pilot, 1813 CBE, 217 breast ultrasounds and 600 mammograms were performed. Mammography equipment utilization increased from 11% to 83%. Of 49 women with suspicious lesions on mammography, only 22 (44.9%) had been linked to care 4 months after the campaign. Of 532 exit interview respondents; 95% (505/532) were ≥35 years of age; 80% (426/532) had been reached by the awareness campaign. Majority (75% [399/532]) had received information from community health volunteers; 68% through social groups. Majority (79% [420/532]) felt the campaign had changed their behavior on breast health. Although 77% (407/532) had knowledge on self breast examination (SBE); only 13% practiced monthly SBE. More than half (58% [306/532]) had previously undertaken a CBE. Approximately 70% (375/528) were unaware of mammography before the pilot; 86% (459/532) had never previously undertaken a mammogram. Fifty‐five percent (293/532) of respondents had screening waiting times of >120 min. Conclusion Community health workers can create breast cancer screening demand sustainably. Adequate personnel and effective follow‐up are crucial before national roll‐out of a breast cancer screening program.

The main goal of every Microfinance Institution (MFI) is to operate profitably in order to maintain its stability and improve growth and sustainability. This study focused on the factors influencing MFIs financial performance in Mere County. In every market there is increased competition from the various player in the market with an aim of convincing customers to purchase their products and services, this has not been an exception in micro finance institutions, thus the study objectives was to determine factors influencing microfinances performance. There are various sources of the reviewed literature such as National micro & small enterprises baseline (1999), Ministry of devolution & planning (May 2013) Meru county development profile among others as indicate in references. The study applied survey research using descriptive approach in order to find out or enquire the state of affairs that exist at present that causes this effect. The study was carried out in Meru Town and some of the micro finances such as SMEP, FAULU, KWFT, located in Meru were used in data collection by using simple random sampling to select the sample to be used, the target population was 956 which was minimized to a sample size of 274. Questionnaires were used in Data collection to gather the information which was directed to customers, credit managers and the branch manager of the various micro finances. After the data collected it was be analyzed by first coding by assigning numerical values to make them quantitative. Tables and pie charts were used in presentation of data, frequency distribution tables was used to show the number of respondents and their views for easier analysis. The findings and conclusion of this study are likely to be useful to micro finances and other scholars.