Haron Njiru | None - Academia.edu (original) (raw)
Papers by Haron Njiru
Iron deficiency poses a significant public health challenge during pregnancy. However, optimal up... more Iron deficiency poses a significant public health challenge during pregnancy. However, optimal uptake of antenatal micronutrients is hampered by lack of knowledge. We investigated the effect of health education on knowledge of women regarding antenatal Iron and Folic Acid Supplements (IFAS). In a 9-month trial, antenatal care clinics received a maternal IFAS awareness package, which included education for both health workers and pregnant women and health Information Education and Communication (IEC) materials. The study found that IFAS knowledge improved from 44.8% to 81.1%, a 36-percentage point increase. To enhance IFAS knowledge, hence uptake, the study recommends targeted health education emphasizing IFAS benefits, management of IFAS side effects, along with providing standardized information materials to the clinics.
PubMed, Nov 1, 2008
Setting: Nairobi, the capital of Kenya. Objective: To promote standardised tuberculosis (TB) care... more Setting: Nairobi, the capital of Kenya. Objective: To promote standardised tuberculosis (TB) care by private health providers and links with the public sector. Design and methods: A description of the results of interventions aimed at engaging private health providers in TB care and control in Nairobi. Participating providers are supported to provide TB care that conforms to national guidelines. The standard surveillance tools are used for programme monitoring and evaluation. Results: By the end of 2006, 26 of 46 (57%) private hospitals and nursing homes were engaged. TB cases reported by private providers increased from 469 in 2002 to 1740 in 2006. The treatment success rate for smear-positive pulmonary TB treated by private providers ranged from 76% to 85% between 2002 and 2005. Of the 1740 TB patients notified by the private sector in 2006, 732 (42%) were tested for human immunodeficiency virus (HIV), of whom 372 (51%) were positive. Of the 372 HIV-positive TB patients, 227 (61%) were provided with cotrimoxazole preventive treatment (CPT) and 136 (37%) with antiretroviral treatment (ART). Conclusion: Private providers can be engaged to provide TB-HIV care conforming to national norms. The challenges include providing diagnostics, CPT and ART and the capacity to train and supervise these providers.
Frontiers in Public Health
IntroductionWe examined the contribution of community health workers as frontline responders for ... more IntroductionWe examined the contribution of community health workers as frontline responders for the community-based surveillance in Somalia during the first year of the COVID-19 pandemic for detection of COVID-19 cases and identification of contacts.MethodsWe retrieved COVID-19 surveillance data from 16 March 2020 to 31 March 2021 from the health ministry’s central database. These data were collected through community health workers, health facilities or at the points of entry. We compared the number of suspected COVID-19 cases detected by the three surveillance systems and the proportion that tested positive using the chi-squared test. We used logistic regression analysis to assess association between COVID-19 infection and selected variables.ResultsDuring the study period, 154,004 suspected cases of COVID-19 were detected and tested, of which 10,182 (6.6%) were positive. Of the notified cases, 32.7% were identified through the community-based surveillance system, 54.0% through th...
American Journal of Public Health, 2010
The study reported on in this letter was approved by the institutional review board of the Univer... more The study reported on in this letter was approved by the institutional review board of the University of Pennsylvania.
BMJ Open
IntroductionIron deficiency is the most prevalent micronutrient deficiency in pregnancy globally ... more IntroductionIron deficiency is the most prevalent micronutrient deficiency in pregnancy globally responsible for nearly 120 000 maternal deaths per year and a fifth of maternal mortality. Over 46% of pregnant women in Africa and 62% of pregnant women in Kenya are anaemic. Anaemia has severe economic and health consequences. Daily iron and folic acid supplementation (IFAS) is an efficacious strategy recommended in pregnancy to reduce the risk of anaemia and improve maternal and neonatal survival. However, most pregnant women do not consume IFAS as recommended. Limited knowledge on IFAS, its benefits and its connection with anaemia, and mitigation of its side effects lead to poor consumption. The main objective of this trial is to determine the effectiveness of public health education on uptake of antenatal IFAS.Methods and analysisA stepped wedge cluster randomised trial with antenatal clinics as units of randomisation. Twelve clusters will be randomised to receive the intervention a...
The International Journal of Tuberculosis and Lung Disease
Nairobi, the capital of Kenya. To promote standardised tuberculosis (TB) care by private health p... more Nairobi, the capital of Kenya. To promote standardised tuberculosis (TB) care by private health providers and links with the public sector. A description of the results of interventions aimed at engaging private health providers in TB care and control in Nairobi. Participating providers are supported to provide TB care that conforms to national guidelines. The standard surveillance tools are used for programme monitoring and evaluation. By the end of 2006, 26 of 46 (57%) private hospitals and nursing homes were engaged. TB cases reported by private providers increased from 469 in 2002 to 1740 in 2006. The treatment success rate for smear-positive pulmonary TB treated by private providers ranged from 76% to 85% between 2002 and 2005. Of the 1740 TB patients notified by the private sector in 2006, 732 (42%) were tested for human immunodeficiency virus (HIV), of whom 372 (51%) were positive. Of the 372 HIV-positive TB patients, 227 (61%) were provided with cotrimoxazole preventive trea...
Journal of health care for the poor and underserved, 2018
Kenya has undergone rapid urbanization as people migrate to the cities in search of economic oppo... more Kenya has undergone rapid urbanization as people migrate to the cities in search of economic opportunities. This has given rise to informal settlements characterized by overcrowding, poor infrastructure, and inadequate social amenities. A cross-sectional study on water, sanitation, and hygiene (WASH) status was carried out in Mathare, an informal settlement in Nairobi. A random sample of 380 households was used. The average household size was five people, and 26% of the household heads had completed secondary or higher level of education. The main source of income (70%) was self-employment with 41% of the households living on less than 1.5 USD per day. The WASH situation in the urban slums is below the minimum standard recommended by the World Health Organization (WHO). There is need to improve the situation by improving and installing basic infrastructure including water, sanitation, and solid waste collection.
Journal of Health Communication
The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and s... more The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and spread to two health districts where the nongovernmental organization Global Communities had been implementing community-led total sanitation (CLTS) since 2012. By December 2014 the county had 928 Ebola cases (422 of them confirmed) and 648 deaths. Before the epidemic, CLTS was triggered in 155 communities, and 98 communities were certified as Open Defecation Free (ODF). Using mixed quantitative and qualitative methods, we determined that no cases of EVD were found in ODF communities and in only one CLTS community that had not reached ODF status. No differences were found between EVD and non-EVD communities in tribe, religion, ethnic group, or major sources of Ebola information. Radio was the most common source of information for all communities, but health workers were the most trusted information sources. CLTS ODF communities attributed their avoidance of EVD to Water, Sanitation, and Hygiene behaviors, especially hand washing with soap and disposal of feces that they learned from CLTS prior to the epidemic. Communities that got EVD blamed their strong initial resistance to Ebola response messages on their distrust that Ebola was real and their reliance on friends and family for advice. A strong inverse correlation between EVD and CLTS with or without ODF emerged from the regression analysis (R =-.6).
Journal of Health Communication, Mar 1, 2017
The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and s... more The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and spread to two health districts where the nongovernmental organization Global Communities had been implementing community-led total sanitation (CLTS) since 2012. By December 2014 the county had 928 Ebola cases (422 of them confirmed) and 648 deaths. Before the epidemic, CLTS was triggered in 155 communities, and 98 communities were certified as Open Defecation Free (ODF). Using mixed quantitative and qualitative methods, we determined that no cases of EVD were found in ODF communities and in only one CLTS community that had not reached ODF status. No differences were found between EVD and non-EVD communities in tribe, religion, ethnic group, or major sources of Ebola information. Radio was the most common source of information for all communities, but health workers were the most trusted information sources. CLTS ODF communities attributed their avoidance of EVD to Water, Sanitation, and Hygiene behaviors, especially hand washing with soap and disposal of feces that they learned from CLTS prior to the epidemic. Communities that got EVD blamed their strong initial resistance to Ebola response messages on their distrust that Ebola was real and their reliance on friends and family for advice. A strong inverse correlation between EVD and CLTS with or without ODF emerged from the regression analysis (R =-.6).
Obstetrical & Gynecological Survey, 2011
American Journal of Public Health, 2010
References 1. Schulte JM, Nolt BJ, Williams RL, Spinks CL, Hellsten JJ. Violence and threats of v... more References 1. Schulte JM, Nolt BJ, Williams RL, Spinks CL, Hellsten JJ. Violence and threats of violence experienced by public health field-workers. JAMA. 1998;280(5): 439442. 2. Keinan G. Effects of stress and tolerance of ambiguity on magical thinking. J Pers Soc Psychol. ...
Iron deficiency poses a significant public health challenge during pregnancy. However, optimal up... more Iron deficiency poses a significant public health challenge during pregnancy. However, optimal uptake of antenatal micronutrients is hampered by lack of knowledge. We investigated the effect of health education on knowledge of women regarding antenatal Iron and Folic Acid Supplements (IFAS). In a 9-month trial, antenatal care clinics received a maternal IFAS awareness package, which included education for both health workers and pregnant women and health Information Education and Communication (IEC) materials. The study found that IFAS knowledge improved from 44.8% to 81.1%, a 36-percentage point increase. To enhance IFAS knowledge, hence uptake, the study recommends targeted health education emphasizing IFAS benefits, management of IFAS side effects, along with providing standardized information materials to the clinics.
PubMed, Nov 1, 2008
Setting: Nairobi, the capital of Kenya. Objective: To promote standardised tuberculosis (TB) care... more Setting: Nairobi, the capital of Kenya. Objective: To promote standardised tuberculosis (TB) care by private health providers and links with the public sector. Design and methods: A description of the results of interventions aimed at engaging private health providers in TB care and control in Nairobi. Participating providers are supported to provide TB care that conforms to national guidelines. The standard surveillance tools are used for programme monitoring and evaluation. Results: By the end of 2006, 26 of 46 (57%) private hospitals and nursing homes were engaged. TB cases reported by private providers increased from 469 in 2002 to 1740 in 2006. The treatment success rate for smear-positive pulmonary TB treated by private providers ranged from 76% to 85% between 2002 and 2005. Of the 1740 TB patients notified by the private sector in 2006, 732 (42%) were tested for human immunodeficiency virus (HIV), of whom 372 (51%) were positive. Of the 372 HIV-positive TB patients, 227 (61%) were provided with cotrimoxazole preventive treatment (CPT) and 136 (37%) with antiretroviral treatment (ART). Conclusion: Private providers can be engaged to provide TB-HIV care conforming to national norms. The challenges include providing diagnostics, CPT and ART and the capacity to train and supervise these providers.
Frontiers in Public Health
IntroductionWe examined the contribution of community health workers as frontline responders for ... more IntroductionWe examined the contribution of community health workers as frontline responders for the community-based surveillance in Somalia during the first year of the COVID-19 pandemic for detection of COVID-19 cases and identification of contacts.MethodsWe retrieved COVID-19 surveillance data from 16 March 2020 to 31 March 2021 from the health ministry’s central database. These data were collected through community health workers, health facilities or at the points of entry. We compared the number of suspected COVID-19 cases detected by the three surveillance systems and the proportion that tested positive using the chi-squared test. We used logistic regression analysis to assess association between COVID-19 infection and selected variables.ResultsDuring the study period, 154,004 suspected cases of COVID-19 were detected and tested, of which 10,182 (6.6%) were positive. Of the notified cases, 32.7% were identified through the community-based surveillance system, 54.0% through th...
American Journal of Public Health, 2010
The study reported on in this letter was approved by the institutional review board of the Univer... more The study reported on in this letter was approved by the institutional review board of the University of Pennsylvania.
BMJ Open
IntroductionIron deficiency is the most prevalent micronutrient deficiency in pregnancy globally ... more IntroductionIron deficiency is the most prevalent micronutrient deficiency in pregnancy globally responsible for nearly 120 000 maternal deaths per year and a fifth of maternal mortality. Over 46% of pregnant women in Africa and 62% of pregnant women in Kenya are anaemic. Anaemia has severe economic and health consequences. Daily iron and folic acid supplementation (IFAS) is an efficacious strategy recommended in pregnancy to reduce the risk of anaemia and improve maternal and neonatal survival. However, most pregnant women do not consume IFAS as recommended. Limited knowledge on IFAS, its benefits and its connection with anaemia, and mitigation of its side effects lead to poor consumption. The main objective of this trial is to determine the effectiveness of public health education on uptake of antenatal IFAS.Methods and analysisA stepped wedge cluster randomised trial with antenatal clinics as units of randomisation. Twelve clusters will be randomised to receive the intervention a...
The International Journal of Tuberculosis and Lung Disease
Nairobi, the capital of Kenya. To promote standardised tuberculosis (TB) care by private health p... more Nairobi, the capital of Kenya. To promote standardised tuberculosis (TB) care by private health providers and links with the public sector. A description of the results of interventions aimed at engaging private health providers in TB care and control in Nairobi. Participating providers are supported to provide TB care that conforms to national guidelines. The standard surveillance tools are used for programme monitoring and evaluation. By the end of 2006, 26 of 46 (57%) private hospitals and nursing homes were engaged. TB cases reported by private providers increased from 469 in 2002 to 1740 in 2006. The treatment success rate for smear-positive pulmonary TB treated by private providers ranged from 76% to 85% between 2002 and 2005. Of the 1740 TB patients notified by the private sector in 2006, 732 (42%) were tested for human immunodeficiency virus (HIV), of whom 372 (51%) were positive. Of the 372 HIV-positive TB patients, 227 (61%) were provided with cotrimoxazole preventive trea...
Journal of health care for the poor and underserved, 2018
Kenya has undergone rapid urbanization as people migrate to the cities in search of economic oppo... more Kenya has undergone rapid urbanization as people migrate to the cities in search of economic opportunities. This has given rise to informal settlements characterized by overcrowding, poor infrastructure, and inadequate social amenities. A cross-sectional study on water, sanitation, and hygiene (WASH) status was carried out in Mathare, an informal settlement in Nairobi. A random sample of 380 households was used. The average household size was five people, and 26% of the household heads had completed secondary or higher level of education. The main source of income (70%) was self-employment with 41% of the households living on less than 1.5 USD per day. The WASH situation in the urban slums is below the minimum standard recommended by the World Health Organization (WHO). There is need to improve the situation by improving and installing basic infrastructure including water, sanitation, and solid waste collection.
Journal of Health Communication
The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and s... more The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and spread to two health districts where the nongovernmental organization Global Communities had been implementing community-led total sanitation (CLTS) since 2012. By December 2014 the county had 928 Ebola cases (422 of them confirmed) and 648 deaths. Before the epidemic, CLTS was triggered in 155 communities, and 98 communities were certified as Open Defecation Free (ODF). Using mixed quantitative and qualitative methods, we determined that no cases of EVD were found in ODF communities and in only one CLTS community that had not reached ODF status. No differences were found between EVD and non-EVD communities in tribe, religion, ethnic group, or major sources of Ebola information. Radio was the most common source of information for all communities, but health workers were the most trusted information sources. CLTS ODF communities attributed their avoidance of EVD to Water, Sanitation, and Hygiene behaviors, especially hand washing with soap and disposal of feces that they learned from CLTS prior to the epidemic. Communities that got EVD blamed their strong initial resistance to Ebola response messages on their distrust that Ebola was real and their reliance on friends and family for advice. A strong inverse correlation between EVD and CLTS with or without ODF emerged from the regression analysis (R =-.6).
Journal of Health Communication, Mar 1, 2017
The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and s... more The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and spread to two health districts where the nongovernmental organization Global Communities had been implementing community-led total sanitation (CLTS) since 2012. By December 2014 the county had 928 Ebola cases (422 of them confirmed) and 648 deaths. Before the epidemic, CLTS was triggered in 155 communities, and 98 communities were certified as Open Defecation Free (ODF). Using mixed quantitative and qualitative methods, we determined that no cases of EVD were found in ODF communities and in only one CLTS community that had not reached ODF status. No differences were found between EVD and non-EVD communities in tribe, religion, ethnic group, or major sources of Ebola information. Radio was the most common source of information for all communities, but health workers were the most trusted information sources. CLTS ODF communities attributed their avoidance of EVD to Water, Sanitation, and Hygiene behaviors, especially hand washing with soap and disposal of feces that they learned from CLTS prior to the epidemic. Communities that got EVD blamed their strong initial resistance to Ebola response messages on their distrust that Ebola was real and their reliance on friends and family for advice. A strong inverse correlation between EVD and CLTS with or without ODF emerged from the regression analysis (R =-.6).
Obstetrical & Gynecological Survey, 2011
American Journal of Public Health, 2010
References 1. Schulte JM, Nolt BJ, Williams RL, Spinks CL, Hellsten JJ. Violence and threats of v... more References 1. Schulte JM, Nolt BJ, Williams RL, Spinks CL, Hellsten JJ. Violence and threats of violence experienced by public health field-workers. JAMA. 1998;280(5): 439442. 2. Keinan G. Effects of stress and tolerance of ambiguity on magical thinking. J Pers Soc Psychol. ...