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Papers by WILLIAM NYABOLA OKEDI

International Journal of Medicine and Public Health, Aug 9, 2022

Introduction: Health care associated infections including COVID-19 are drawing attention from pat... more Introduction: Health care associated infections including COVID-19 are drawing attention from patients, insurers and Governments worldwide because of the magnitude of the problem i.e. morbidity, mortality and treatment, although these are preventable. Literature review shows there is very little published information on hand washing practices of health care workers in Kenya. This study provides important inputs for planning, policy making and informs future research areas and methods. Methods: A cross sectional study design was conducted in Matayos, Teso South and Teso North sub-counties of Busia County. The study covered 33 consenting health workers in 7 health facilities. An interview guide and observation checklist were used to collect data and to ascertain availability of hygiene and sanitation facilities. Thematic analysis was used to analyze qualitative data while quantitative data was analyzed using descriptive statistics. Results: That there was no policy on hand hygiene in 6 (86%) health facilities; awareness about hand hygiene was high; knowledge on critical moments for hand hygiene was unsatisfactory but nurses scored better. Only 44% respondents knew effectiveness of alcohol-based sanitizer; on disposal of waste, maternity wards ranked highest 6(87.7%) complying. Laxity in enforcing obligatory use of hand hygiene was high only 2(28.6 %.) of facilities complying. Respondents attributed reduction in diarrheal infections and improvements in sanitation during covid-19 pandemic to rigorous hand hygiene practices. Found that hand hygiene compliance by health care workers can reduce infections in health facilities. That lack of piped water, erratic supply of soap, sanitizers and dependency on external partners were perceived to be important barriers for the sustainability of hand washing practices. Conclusion: The hand hygiene initiative has occupied a new and important place in the minds of health workers, policy makers and communities due to its contribution in the prevention and control of one of the most serious diseases of the 21 st century. The initiative has presented a compelling case for investment in preventive and promotive health and demonstrated the power of the old adage "prevention is better than cure". Purposeful partnerships and collaborations are powerful tools to achieve common goals. The study also exposed various systemic weaknesses within the public health sector and the political leadership that needs to be addressed to ensure sustainability of hand hygiene.

Book Publisher International (a part of SCIENCEDOMAIN International), Jun 23, 2022

Research Square (Research Square), Jun 7, 2022

Introduction Health care associated infections including Covid-19 are drawing attention from pati... more Introduction Health care associated infections including Covid-19 are drawing attention from patients, insurers and Governments worldwide because of the magnitude of the problem i.e. morbidity, mortality and treatment, although these are preventable. Literature review shows there is very little published information on hand washing practices of health care workers in Kenya. This study provides important inputs for planning, policy making and informs future research areas and methods. Methods A cross sectional study design was conducted in Matayos, Teso South and Teso North sub-counties of Busia County. The study covered 33 consenting health workers in 7 health facilities. An interview guide and observation checklist were used to collect data and to ascertain availability of hygiene and sanitation facilities. Thematic analysis was used to analyze qualitative data while quantitative data was analyzed using descriptive statistics. Results That there was no policy on hand hygiene in 6 (86%) health facilities; awareness about hand hygiene was high; knowledge on critical moments for hand hygiene was unsatisfactory but nurses scored better. Only 44% respondents knew effectiveness of alcohol based sanitizer; on disposal of waste, maternity wards ranked highest 6(87.7%) complying. Laxity in enforcing obligatory use of hand hygiene was high only 2(28.6%.) of facilities complying. Respondents attributed reduction in diarrheal infections and improvements in sanitation during covid-19 pandemic to rigorous hand hygiene practices. Found that hand hygiene compliance by health care workers can reduce infections in health facilities. That lack of piped water, erratic supply of soap, sanitizers and dependency on external partners were perceived to be important barriers for the sustainability of hand washing practices. Conclusion 1. The hand hygiene initiative has occupied a new and important place in the minds of health workers, policy makers and communities due to its contribution in the prevention and control of one of the most serious diseases of the 21st century. 2. The initiative has presented a compelling case for investment in preventive and promotive health and demonstrated the power of the old adage "prevention is better than cure". 3. Purposeful partnerships and collaborations are powerful tools to achieve common goals. The study also exposed various systemic weaknesses within the public health sector and the political leadership that needs to be addressed to ensure sustainability of hand hygiene. The Coronavirus Disease 2019 (COVID-19) outbreak was declared a Public Health Emergency of International Concern (PHEIC) on 30th January 2020 and a pandemic on 11th March 2020. The Director General of the World Health Organization (WHO) requested all countries to adopt a "whole-of-Government, whole-of-Society" approach built around a comprehensive strategy to prevent infections, save lives and minimize impact (1). Coronavirus disease 2019 (COVID-19) that originated in China has spread globally, causing unprecedented socioeconomic disruptions and overtaking the capacity and resources of health systems worldwide. The WHO Africa regional o ce reports indicate that as of 13th November 2020, there were 6,107,353 cumulated reported cases, and 151,084 deaths (2). Although covid-19 prevention vaccines have been developed and approved for emergency use, it is not yet available to the majority of people in developing countries, especially Africa, where supply chain systems are still insu cient and remain vulnerable to potential international industrial and transport shutdowns (2). The situation is exacerbated by the endemic challenges of inadequate essential equipment and human resources within the health systems. Therefore preventive measures are the priority approach to control the transmission of cases as the virus is highly contagious via the respiratory route (droplets from infected persons, widely spread by coughing or sneezing) and via contact with contaminated surfaces. Community transmission and spread can be decreased through non-pharmaceutical interventions (NPIs) which includes practicing social distancing, avoiding group gatherings, regular and diligent hand washing with soap and water or sanitizer as well as community mask wearing (3). Current evidence indicates that the COVID-19 virus is transmitted through respiratory droplets or contact. Contact transmission occurs when contaminated hands touch the mucosa of the mouth, nose, or eyes; the virus can also be transferred from one surface to another by contaminated hands, which facilitates indirect contact transmission (1). Consequently, hand hygiene is extremely important to prevent the spread of the COVID-19 virus. It also interrupts transmission of other viruses and bacteria causing common colds, u and pneumonia, thus reducing the general burden of disease. Although awareness of the importance of hand hygiene in preventing infection with the COVID-19 virus is high, access to hand hygiene facilities that include alcohol-based sanitizers, soap and water is often in short supply in schools, community and in health care facilities, especially in low-and middle-income countries. WHO and UNICEF estimate that globally three (3) billion people lack hand hygiene facilities at home and two out of ve health care facilities lack hand hygiene at points of care(1). Further, the WHO Africa regional o ce (2) reports that access to hygiene facilities has become increasingly challenging as a result of stock-outs of supplies. However, WHO notes that when hand hygiene is provided free of charge and is made obligatory by public health authorities, acceptability and adherence to hand hygiene practices are improved, including in public health emergencies of international concern (2, 3). Hand hygiene is the most effective single measure to reduce the spread of infections through multimodal strategies, including access to appropriate supplies (4). To enhance the prevention of COVID-19, the World Health Organization (5) made the following nine recommendations to member states:-1. One or several hand hygiene stations (either for handwashing with soap and water or for hand rubbing with an alcohol-based hand rub) should be placed in front of the entrance of every public (including schools and

Health, 2021

The Kenya Ministry of Health restructured the health sector in 2009 with the goal of promoting an... more The Kenya Ministry of Health restructured the health sector in 2009 with the goal of promoting and improving the health status of all citizens. It established the Hospital Management Services Fund to be managed at the facility level by the Hospital Management Committees (HMCs). Since the establishment of the HMCs at the county level following the devolution of health services in 2016, no evaluation has been done to assess their performance in Busia County. We assessed the criteria, selection process, orientation, induction, and the performance of the HMCs in Busia and considered their implications for Kenya and similar contexts in Africa. Data were collected by purposive sampling of all HMC members in six level 4 and one level 5 hospitals through Focus Group Discussions and key informant interviews. Documents collected both at the facility and county levels were analysed and used appropriately. All seven hospitals evaluated did not fully comply with the National Guidelines. Three (43%) of the hospitals nominated persons with educational levels below the required O-level certification. Another 3 (43%) contravened the Constitution of Kenya (2010) by excluding persons with disabilities and minorities. The study identified systemic commissions and omissions in the recruitment process, leading to anxiety and frustrations by members of HMCs, staff and the catchment population of the respective hospitals. In conclusion, the nominated HMC members have no legitimacy to assume their roles and responsibilities as they have not been gazetted, appointed, oriented, and facilitated.

1. BackgroundDecentralization has become an increasingly important concept in development theory ... more 1. BackgroundDecentralization has become an increasingly important concept in development theory and practice in the world since the 1970s. Decentralization is generally understood to be referring to policies and processes that shift the locus of decision-making and management to the local level, Hellington (2005). According to Elamon (2004), decentralization is particularly attractive because some forms of it promise direct accountability of public institutions; improved management of resources; more reliable information for planning and a more effective interagency collaboration and coordination. Furthermore, it is argued that local officials and community leaders have better knowledge and information about the local context and are therefore more aware of what can work best within the resource constraints while contributing to the achievement of the broader social, economic and development goals of central government.In the health sector, the impetus for decentralization has its ...

Promotion & Education, 1999

Center for Global …, 2007

cgdev.org