Journal of Clinical Care and Medical Advancement

Performance of Community Health Volunteers in the Delivery of Healthcare Services During the Covid-19 Pandemic in Nakuru, Kenya: A Cross-Sectional Analysis

Salome Nyambura Gachathi — 2026-08-31

In many parts of the world, including Kenya, there is a critical shortage of trained healthcare workers. In response to this, the World Health Organization (WHO) has advocated for the utilization of volunteer community members to provide essential health services within their communities. While Community Health Volunteers (CHVs) in Kenya have demonstrated positive contributions to community health, there is a dearth of data on their performance during pandemics such as COVID-19. We assessed the performance of CHWs during the COVID-19 pandemic in Nakuru County. This was a cross-sectional descriptive study with mixed methods approach. Purposive sampling was utilized to select the study sites and random sampling to sample 260 CHV participants. A standardized data collection schedule was
used to collect data on key community health indicators from the District Health Information System 2 (DHIS2) in each sub-county which was used to compare CHVs’ performance before and during COVID-19. A structured questionnaire was filled out by CHVs to address the study objectives. Data was subjected to an Analysis of variance (ANOVA) test to determine differences in the periods at α=0.05.
The CHVs’ routine community services significantly improved during COVID-19. There were significant differences in Maternal and Neonatal Health (MNH) services groups as determined by the Analysis of variance test (F(2, 33) = 26.341, p < .001), child services groups as determined by Analysis of variance test (F(2, 33) = 15.042, p < .001), CHVs’ care of persons with known chronic conditions services groups as determined by Analysis of variance test (F(2, 33) = 39.799, p < .001) and significant difference in CHVs’ care of geriatrics services groups as determined by Analysis of variance test (F(2, 33) = 24.778, p < .001). Pre- and Post-pandemic policies should promote CHV service utilization and consider training, proper reporting of their indicators and continuous monitoring and evaluation (M&E). New service provision methodologies such as the application of technology should be integrated into the CHVs services.

Factors Influencing Adherence to HIV Post-Exposure Prophylaxis Among Healthcare Workers at AIC Kijabe Hospital

Boaz Odhiambo Omenda — 2026-08-31

Healthcare workers (HCWs) are at risk of HIV infection due to occupational exposure, making adherence to post-exposure prophylaxis (PEP) crucial in preventing HIV transmission. This study explored the barriers and benefits to PEP adherence among HCWs at AIC-Kijabe Hospital and identified mechanisms to improve adherence. It was a phenomenological qualitative research design that used semi-structured interviews to collect data from a purposive sample of 35 HCWs. The study was conducted in AIC-Kijabe Hospital. Data were collected through faceto-face interviews with HCWs who reported exposure to HIV and were initiated on PEP. Key informant interviews were also conducted, those of whom were Chronic Care Clinic (CCC) team members. The guide used was pilottested at AIC-Kijabe Naivasha Medical Centre to enhance its reliability and validity. The interviews were audio-recorded, with the consent of the participants. Deductive thematic analysis was employed to analyze the interview data. The transcribed interview was coded and categorized into themes and sub-themes. NVivo data analysis software was used to facilitate the organization and analysis process. Several barriers to PEP adherence were identified and they were based on Personal/ Individual drug-related, organizational, and interpersonal factors. Personal factors included forgetfulness, acceptance of stigma, and low-risk perception. Drug/Medicine-related were fear of side effects, and logistical challenges e.g. pill too big to swallow. Organizational/Institutional factors included process inefficiencies and institutional Stigma. Interpersonal factors like lack of social support. The perceived benefits noted by the participants included a reduction of the risk of HIV transmission to HCWs, their spouses, and patients. It also gave them peace of mind. Adherence to PEP was also viewed as an ethical duty and obligation. The findings underscore the importance of addressing multi-level barriers to PEP adherence among HCWs. Interventions should include educational programs to reduce stigma and improve risk perception, organizational reforms to streamline
PEP access, and provision of psychological and social support for HCWs.

Factors Influencing Preference for Repeat Elective Cesarean Section Among Low-Risk Women with Previous Unplanned Cesarean Delivery at Kijabe Hospital in Kenya

Liliane Kadievi Mugodo — 2026-08-31

Cesarean section (CS) rates have risen significantly over the past decade, with many countries surpassing the World Health Organization’s standard of 10-15%. Women with a previous cesarean- Robson group 5- contribute substantially to this increase. For low-risk women, vaginal birth after CS is a safe and cost-effective alternative that can reduce cesarean-related morbidity and ease the burden higher rates placed on the healthcare system. Despite these benefits, many women in Kenya still prefer repeat elective cesarean delivery in subsequent pregnancies. This study investigated the factors influencing this preference among low-risk women attending Kijabe Hospital. This qualitative phenomenological study involved 18 women with prior cesarean delivery attending the hospital. Participants were selected through purposive sampling based on predefined inclusion and exclusion criteria. Data was collected through in-depth interviews using a semi-structured interview guide and analyzed using inductive thematic analysis with the Dedoose software. Maternal reasons for preferring repeat CS included fear, personal preference versus the influence of loved ones, the convenience of simultaneous bilateral tubal ligation, and the desire to experience a vaginal birth. Prior birth experiences also shaped maternal choices of delivery modes. Traumatic vaginal interventions, an expressed low confidence in successful vaginal birth, and the considerations of risks over benefits were all influential. Participants also emphasized the importance of healthcare providers’ recommendations, noting counseling gaps and facility preparedness to offer VBAC services. Ultimately, reducing repeat cesareans among low-risk women requires a comprehensive strategy: Strengthening the support for VBAC services, improving the quality of patient-provider communication, and addressing the emotional and psychological impacts of prior birth trauma. Institutional policies that encourage comprehensive counseling and shared decision-making are key to encouraging safer, evidence-based birth practices.

Socio-Demographic and Environmental Factors Associated with Motorcycle Accidents: A Study at Nakuru Level 5 Hospital, Kenya

Evans K. Ngetich — 2026-08-31

Motorcycle accidents currently rank third among the leading causes of injuries resulting from road traffic accidents in Kenyan hospitals. This study aimed to assess the socio-demographic characteristics and perceived environmental factors influencing motorcycle accidents among patients seeking medical care at Nakuru Level 5 Hospital in Kenya. A cross-sectional study design was employed, and structured questionnaires were used to collect data. The study population comprised individuals who had been involved in motorcycle accidents and were seeking treatment at the hospital. The assessment included gathering socio-demographic information, roles played by participants during accidents, and environmental factors present at the time of the accidents. Data analysis was conducted using descriptive statistics. Out of the 150 questionnaires distributed, 136 were completed and returned, resulting in a response rate of 90.67%. The majority of participants fell into the age range of 25 to 29 years (59.23%), and the majority were male (82.96%). Most participants had attained a secondary level of education (51.29%) and had a monthly income ranging from KES 0 to KES 10,000 (52.96%). Furthermore, a significant percentage of the participants were involved in the “Boda Boda” business (89.23%). In terms of their roles during accidents, motorcycle riders accounted for 78.56%, followed by passengers (13.89%). Environmental factors indicated that accidents were more frequent during rainy weather (73.53%) and at night when visibility was impaired (73.53%). Interestingly, the majority of accidents (94.85%) occurred irrespective of the road condition, highlighting the need for improved road infrastructure. In conclusion, this study underscores the susceptibility of young adults, particularly male motorcycle riders, to accidents. It also reveals prevalent factors such as low education levels, low income, and engagement in the “Boda Boda” business among the participants.

Assessment of Knowledge, Attitudes, and Barriers Influencing Hormonal Contraceptive Utilization among Women Afflicted with Retroviral Disease Receiving Antiretroviral Therapy at a Referral Hospital in Kenya

Mbori Beldina Akinyi — 2026-08-31

Contraception among women living with HIV is crucial not only to avoid getting unplanned pregnancies but also minimize transmission of virus to either partner or unborn child. Uptake of contraception by such cohort of women is however governed by multiple factors. This study thus aimed to examine the knowledge, attitudes and barriers influencing hormonal contraceptive utilization among women living with HIV/AIDS and are on antiretroviral therapy. The study was a cross-sectional retrospective study carried out at the comprehensive Care Centre (CCC) at NCRTH from March 2023 to April 2023. Taro Yamane formula was used to determine the sample size. Simple random sampling was our method of sample determination. Use of structured questionnaires with close ended questions was our method of data collection. Data analysis was conducted using a statistical package for social sciences (SPSS) software version 26. Descriptive data was presented using frequency tables, bar graphs and percentages. The descriptive statistics done included mode, median and mean while the inferential statistics was done using chi-square analysis. P<0.05 was considered significant. Healthcare
providers were the main source (67.2%) of hormonal contraceptive knowledge followed by social media (14%) emerged as an influential platform, while traditional media had limited impact. Peer and partner influence played roles, with 61.06% making independent contraceptive decisions. Partners (30.09%) and healthcare providers (21.68%) also influenced decisions. Majority (82%) used contraceptives to avoid unwanted pregnancies, while 74.77% valued their benefits over side effects. Bleeding was the most common hormonal contraceptive side effect across the different methods, particularly in injectables (45.23%). Injectable, implant, and IUD users reported amenorrhea. Weight-related effects varied by method. Mood swings were prevalent, especially in implant users (14.86%). Chi-squared analysis indicated associations between methods and specific side effects; with injectables and mini pills having highest and lowest frequency of associated side effects respectively. Participants’ religious values (75%), affordability (70%), and lack of belief in contraceptive-related infertility (69%) were influential in contraceptive use decisions. No religion was found to outright deny contraceptive use. The factors influencing knowledge acquisition and decision-making on hormonal contraceptives among women
underscores the need for effective communication strategies, diversified information dissemination, and individualized healthcare guidance to empower women in making informed reproductive health choices.