INTRODUCTIONDespite a global decrease of maternal mortality by 44% in the past two decades, 99% of the global 830 women that die daily from preventable causes related to pregnancy and childbirth still occur in poor and rural communities in developing countries.1 Fortunately, the risk of death from a birth complication can be detected early and averted if a woman attends the minimum four quality antenatal clinic (ANC) visits often referred to as focused antenatal care (FANC). Methods:Descriptive cross-sectional design was used to study 326 postnatal mothers in three primary health facilities. Systematic sampling technique was used. We collected data using a researcher-administered structured questionnaire and focused group discussion. Quantitative data analysis was conducted using statistical package for Social Sciences (SPSS) version 20.0 and involved univariate and bivariate analysis. Chi-square were used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis. Results: IBP utilization was low 48.2% (95% CI (42.7%-58.6%) despite high ANC attendance. Identifying a blood donor was the least utilized component (25%

Despite high sexual activity among adolescent girls in Kenya, contraceptive uptake is very low with only about 26 percent sexually active adolescent girls currently using a contraceptive method. This exposes them to HIV infections and unplanned pregnancies which consequently lead to school dropouts, unsafe abortions, and lack of employment opportunities. This cross-sectional study aimed at assessing the utilization of contraceptives among secondary school adolescent girls in Karuri Town Council, Kiambu County. Overall, 421 girls aged between 13.0 to 19.0 years took part in the study. Findings showed that despite majority (77.5%) of the adolescent girls having had sexual debut by the age of 15 years, contraceptive utilization was very low at 43%. The results revealed that age of the adolescent, knowledge of contraceptives options, perception and accessibility of the contraceptives had positive significant effect on contraceptive utilization. Adolescents aged 18 years and above were more likely to utilize contraceptives as compared to those of a lesser age (p ≤ 0.001; OR: 9.870 (95% CI: 3.781-25.763)). Those with knowledge on contraceptives were OR 3.2 times more likely to use contraceptives (p = 0.025), similarly, accessibility was significantly associated with increased contraceptive utilization (p = 0.34, 95% CI: 1.054-4.187). Adolescents who perceived use of contraceptives as wise were more likely to use a contraceptive than those of a divergent opinion (OR: 2.053 (95% CI: 1.024-4.115), p = 0.041). This revealed that high level of knowledge on contraceptives did not always amount to practice. There is therefore a need to develop age specific reproductive health messages to guide school education curriculum as well as parent or guardian-child communication.

Background: Birth preparedness is the advance preparation made by an expectant mother which ensures access to skilled care. In Africa, the risk of pregnancy related deaths is 300 times more than in the developed world. In Kenya, out of 10 expectant mothers who access antenatal care services only 4 deliver in a health facility.Methods: This was a descriptive cross sectional study conducted at outpatient Maternal Child Health and Family Planning Clinic at Kerugoya County Hospital. The study utilized convenience sampling technique to determine the study population. The research instruments were an In-depth interview guide and semi-structured questionnaires. Data was managed using SPSS and analysis done using descriptive statistics and Chi-square tests. Statistical significance was set at p<0.05.Results: A sample of 202 women participated in the study. 47.5% of the participants were adequately prepared for birth. Having a higher level of education was significantly associated with birth preparedness (p=0.021). The number of children per woman had a significant influence on level of birth preparedness with women who had no children less likely to be prepared for birth compared to those with one or more children (p=0.002). Clients who attended Antenatal Care (ANC) at least 3 times were prepared for birth compared to those who visited either once or twice (p=0.027).Conclusions: Overall, women of reproductive age lack birth preparedness. There is therefore need to enhance birth preparedness awareness campaigns at ANC visits targeting women in their third trimester.

Background: Despite much effort and successes in the management of diarrhoea, the disease has remained among the top five causes of mortality and morbidity in Kenya, particularly among infants and children below five years. Advent of HIV/AIDS and the harsh economic situation is Kenya has led to increase in diarrhoea diseases. This study was conducted to determine the mother’s knowledge, attitude and practice in the management of diarrheal diseases among children under five years of age.Methods: This was a cross-sectional study conducted at Lurambi sub-County, Kakamega County. Systematic sampling technique was used to determine the study population. The research instruments were; observational checklists, an in-depth interview schedule, self-administered semi-structured questionnaires and focused group discussions. Quantitative data analysis was conducted using SPSSand involved univariate and bivariate analysis. Qualitative data was analyzed by thematic content analysis.Results: Overall, 88% mothers each with at least one child under five years took part in the study. 84% of the respondents had knowledge of the causes of diarrhoea; however only 31% knew methods of diarrhoea prevention. 41% of the respondents managed diarrhoea cases with non-recommended home remedies such as salt and sugar solutions. The study also established that 37% of the health workers were not trained on diarrhoea management despite them being directly involved in the case management.Conclusions: Overall, the research identified a gap between knowledge and practice. There is need for improving home based case management and implementing a community strategy for diarrhoea management.

Nearly half of the world's population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth's perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 -24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants' perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider's attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is; youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider's perspectives on