IntroductionTraining, as an additive human resources intervention is decisive to organizational performance. Employees require constant update of formal and informal knowledge alongside positive attitudes that have been defined as necessary in motivation leading to effectiveness in performance hence workplace training is tied to achieving organizational aims and objectives. The objective of this study was to determine the influence of training on motivation among health workers in Narok County, Kenya.MethodsA cross-sectional study utilizing a self administered questionnaire, targeting 237 health workers and 21 health managers was used. Data analysis was done using SPSS version 21 using descriptive statistics. Factor analysis was done on the training perception in relation to motivation.ResultsMajority of the respondents rated their motivation between 7 and 9 in the current health facility (35.4%), Sub-county (33.8%) and County (32.9%) with the median motivation level of 5. Majority of health workers 194 (81.9%) had received a form of training, of whom 191 (98.5%) indicated that on-job training was relevant to their tasks and that it motivated 192 (99.0%) of them to perform better due to coining skills to motivation. Training significantly predicted general motivation (p-value = 0.013), job satisfaction (p-value = .001), intrinsic job satisfaction (p-value = .001) and organisational commitment (p-value <.001).ConclusionThe researchers concluded that there is a relationship between training and motivated health workforce in Narok County and recommended strengthening of current training initiatives by ensuring trainings are more regular and involvement of health workers in discussing their career development prospects.

IntroductionWorld Health Organization estimates that deaths resulting from diabetes will rise above 50% by the year 2020; hence urgent action is needed to reverse the trend notably through nutrition and lifestyle intervention among populations at risks. Studies have established that nutritional environment and physiology of the mother affects neonate's health at infancy and later in life thus this study sought to investigate the risk factors for development of gestational diabetes focusing age, weight, family history and pre-existing medical condition which could be modified to improve population health.MethodsA retrospective cohort study design was used. Subjects were sampled from selected maternity facilities in Nairobi and were subjected to oral glucose test to ascertain Gestational Diabetes mellitus (GDM) status. A questionnaire was administered to a sample of 238 respondents. Quantitative data was then analyzed as descriptive statistic, univariate and multivariate regression.ResultsAverage age for mothers with GDM was high with a mean of 33.06 (95% C.I: 31.59-34.52) compared to a mean of 27.9 (95% C.I: 27.01-28.78) for non-GDM mothers. Weight before pregnancy was high with mean of 74.04 (95% C.I: 70.82-77.30) among mothers with GDM compared to mean of 60.27 (95% C.I:58.59-61.96) among non-GDM mothers. Mothers with diabetic history in the family had twice the risk of developing GDM (OR= 2.27; 95% C.I: 1.23-4.17) compared to those who did not observe diabetic history in the family.ConclusionGestational diabetes cases are relatively high. Age advancement; high weight and diabetic history in family are determining factors for development of diabetes among pregnant women.

Background: Rewards are used to strengthen good behavior among employees based on the general assumption that rewards motivate staff to improve organizational productivity. However, the extent to which rewards influence motivation among health workers (HWs) has limited information that is useful to human resources (HRs) instruments. This study assessed the influence of rewards on motivation among HWs in Narok County, Kenya.Methods: This was a cross-sectional study done in two sub-counties of Narok County. Data on the rewards availability, rewards perceptions and influence of rewards on performance, as well as motivation level of the HWs, was collected using a self-administered questionnaire with HWs. SPSS version 21 was used to analyze descriptive statistics, and factor analysis and multivariate regression using Eigen vectors was used to assess the relationship between the reward intervention and HWs' motivation.Results: A majority of HWs 175 (73.8%) had not received a reward for good performance. Only 3 (4.8%) of the respondents who received rewards were not motivated by the reward they received. Overall, reward significantly predicted general motivation (p-value = 0.009). Conclusion:In Narok County, the HR's instruments have not utilized the reward system known to motivate employees. In the study area, hard work was not acknowledged and rewarded accordingly. In addition, there were not sufficient opportunities for promotion in the county. An increased level of reward has the potential to motivate HWs to perform better. Therefore, providing rewards to employees to increase motivation is a strategy that the Narok County health system and its HR management should utilize.

IntroductionEffective supportive supervision is widely recognized as essential for optimal management of medicines in government health facilities and also in contributing towards improved access and utilization of health services. This study sought to examine the extent supportive supervision for medicines management in government health facilities from a health worker perspective.MethodsA cross-sectional study was done targeting health workers managing medicines in government health facilities in Kiambu County. One hundred and thirty eight respondents took part in the study which explored the quality of supportive supervision from a health worker's perspective, and also examined the factors influencing their contentment with the level of supervision received. A statistical analysis was done using SPSS 21 and Excel 2013.ResultsSupervisory visits from all levels of health management were not regularly done, standard checklists were not routinely used, and action plans irregularly developed and followed up. Only 54 (38.6%) respondents were satisfied with the levels of supportive supervision that they received, with satisfaction significantly differing across the professional cadres, χ2 (12, n = 138) = 29.762, p = .003; across the different tiers of health facilities, rs (138) = 0.341, p < .001; and with the education levels of the respondents, rs (138) = 0.381, p < .001.ConclusionThe study concluded that supportive supervision for medicines management that government health facilities received was still inadequate, and health workers were dissatisfied with the level of supervision that they received. The study recommends a review of the support supervision policy at the county level to address the unearthed inefficiencies and improve supervision for medicines management in government health facilities.

Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS.The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescent...