Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its community health strategy in response to challenges faced with the implementation of grassroots primary health care initiative. Implementation of community health programs is often inconsistent, and they vary widely in many attributes. The purpose of this study was to explore factors influencing performance of community health workers in Vihiga County, Western Kenya in light of the political devolution. Methods: The study was a cross-sectional study design that involved a quantitative method of data collection. A sample of 309 participants was selected through cluster and simple random sampling. A self-administered and -structured questionnaire was used to gather data, s, and those who were not able to respond individually were guided by the research assistants. Results: The community health workers were 75.2% females and 24.8% males. Performance was significantly associated with not being employed, (OR = 2.4; 95% CI, 1.4–4.4), secondary education (OR = 0.7; 95% CI, 0.5–1.1), lack of conflict resolution mechanism (OR = 2.2; p = 0.017), lack of support (OR = 1.5; p = 0.03), and community health work not seen as important (OR = 1.5; p = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; p = 0.050) and poor road network (OR = 0.361; p = 0.000). Conclusions: These findings offer a deeper understanding of the interaction between CHWs contextual situations, structural challenges, and performance. Addressing influential factors of CHWs performance in multi-task settings is important in preventing overtaxing their work capacity and to maintain quality performance as countries move towards universal health coverage. Strategies for incentivizing, attracting, and sustaining men in CHWs is important to broaden perspectives about this critical role in society.

Availability of medicines is an important aspect in health care provision. Many countries however, are still battling with the problem of stock outs of essential medicines to an extent that patients go without appropriate treatment. This research sought to determine the influence of health care financing on availability of medicines. Descriptive cross sectional research design was used. All the nine sub county hospitals in Bungoma County were sampled. Census sampling was done to sample sub county pharmacists, medical superintendents, procurement officers and health administrative officers. Four officers were sampled in each sub county, making a total of 36 respondents for the study. Additionally, the head of procurement department in the county, the chief officer for health and sanitation and the county pharmacist were sampled, hence a total of 39 respondents. Semi structured questionnaires; in-depth interview guides and a checklist were data collection tools. Data was analyzed using descriptive statistics appropriately then presented in tables. Data of qualitative nature was reported in narrative form. The overall percentage availability of medicines in the county was at 63.35% while the mean stock out period was 51.30 days in a 90 days review period. The key financing challenges identified were allocation of inadequate funds for medicines and irrational budgeting which contributed to the low medicines availability. The total allocation for health care was about Kshs 2.6 Billion, out of which only Ksh 120 million (4.6%) was for medicines. A budgetary deficit of between 30 to 40% was reported in more than half of the health facilities. 90.6% of respondents agreed that inadequate funding was the main reason for stock out of medicines. 71.9% of respondents further strongly agreed that allocation of funds for medicines should be as per the quantification needs to curb this problem.

Motorcycle crash injuries were the second most common cause of both emergency department visits and hospital admissions.The findings showed that motorcycle injury cases contributed to greater radiological diagnostic service use, operating theater use for minor and major surgical procedures, and intensive care unit admissions, demonstrating the extent to which motorcycle crashes contribute to increased use of public health system resources.

Introduction motorcycle injuries comprise considerable morbidity, disability and mortality of road traffic casualties. The study aimed to assess the pattern and characteristics of motorcycle crash injuries that sought care at the Emergency Departments in Tier III hospitals in Kisumu City during a six-month period from May to November 2019. Methods this was a cross-sectional study of all motorcycle injury patients presenting to three tier III public and private hospitals in Kisumu City. Using a structured questionnaire, data were collected on human and injury characteristics. Multiple logistic regression model was used to determine the predictors of fatality. Statistical significance was set at p<0.05. Results a total of 1073 of motorcycle crash injury patients sought and obtained care at the hospitals. The majority (73.6%) were males. Seventy-three cases resulted in death (case-fatality rate of 6.80%. The age range was 2-84 years, with a mean of 29.6 years (± SD 12.19). Majority, (43.3%) were aged 21-30 years. Most of the crashes occurred during the daytime (79.1%). Of all motorcycle riders and pillion passengers 30.6% wore helmets at the time of the crash. Head injuries (43.6%) were the most common. Injury seventy scores (ISS) ranged from 1 to 51. Glasgow comma scale <3, un-helmeted patients and major trauma (ISS > 16), significantly influenced mortality (P< 0.001). Conclusion these findings confirmed and strengthened the documented substantial morbidity, mortality that motorcycle crashes place on individuals and society, contribute to the body of literature on motorcycle injuries and potentially assist in policy decisions on motorcycle transport safety.