School of Nursing

Determinants of Clinical Learning Environment: Evidence from BScN Students in Selected Public Universities in Kenya

2026-08-27T09:09:51Z

Determinants of Clinical Learning Environment: Evidence from BScN Students in Selected Public Universities in Kenya Murei, Sally; Mosol, Priscah; Osotsi, Franklin Background: A constructive clinical learning environment (CLE) with a focus on student learning needs is vital for nursing education. Understanding the features of a healthy CLE for under graduate nursing students continues to be a challenge for healthcare organizations and educators in application of theory to practice. Objective: The objective of the study was to investigate the determinants of the clinical learning environment as perceived by BScN students in selected public universities in Kenya Methods: A descriptive quantitative cross-sectional design was employed where data was collected from consenting participants from two selected public universities in Kenya, using a pre-tested modified clinical learning environment inventory tool. The target population comprised of 125 fourth-year Bachelor of Science nursing students. The census technique will be used in this study. Quantitative data will be analyzed using SPSS version 27 for frequencies mean and percentages then presented using tables, charts, and graphs Results: The findings indicate that ward leadership style had a significant influence on clinical learning environment (F = 9.09; t = 3.63; p = 0.000 <0.05), ward culture had an influence on the clinical learning environment (F = 8.46; t = 10.76; p = 0.000 <0.05) and supervisory relationship influenced clinical learning environment (F = 1.13; t = 1.98; p = 0.020 <0.05) Conclusions: Ward leadership style, positive ward culture and supervisory relationships can foster a supportive clinical learning environment Recommendations: Strengthening leadership support for students while creating a supportive learning environment that promotes and maintain a collaborative learning culture is needed

Sustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot

2025-09-03T08:07:58Z

Sustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot Adjagba, Alex Olateju; Oguta, James Odhiambo; Akoth, Catherine; Toweet, Solomon Kimutai; Okoth, Peter; Jackson, Debra Background Effective public financial management (PFM) is a foundational enabler of sustainable progress toward Universal Health Coverage (UHC). Achieving UHC requires not only increased funding for the health sector but also the efficient, equitable, and accountable use of resources. In 2019, Kenya piloted a UHC initiative across four counties to generate evidence to inform national scale-up. This study examines the PFM processes underpinning the pilot implementation, with a focus on how financial planning, budget execution, and accountability mechanisms influenced the delivery of UHC interventions at the county level. Methods This study employed a qualitative research design to explore PFM processes during the implementation of Kenya’s UHC pilot in four counties. Data were collected through 51 in-depth interviews and five focus group discussions with key stakeholders, including healthcare workers, patient representatives, and senior members of the County Health Management Teams (CHMTs). An inductive thematic analysis approach was employed to identify patterns and themes that emerged from the data. The analysis was facilitated using Dedoose software (Version 9.0.17), which enabled systematic coding and organization of the qualitative data. Results The UHC pilot program in Kenya featured a hybrid planning model, combining top-down directives from the national government with bottom-up inputs from county stakeholders. Despite this collaborative approach, county budgeting processes remained governed by the stipulations of the PFM Act. While counties welcomed additional UHC funds, the removal of user fees led to reduced facility-level revenue, increased service demand, and strain on human and material resources. Delays in fund disbursement, rigid budget structures, and limited financial autonomy further constrained implementation. These experiences underscore the need for a more coherent integration of PFM and health financing policies at the subnational level to ensure sustainable and equitable health service delivery. Conclusion The UHC pilot offers critical lessons for future health financing reforms. Addressing PFM bottlenecks—particularly those related to timely disbursement, budget flexibility, and local revenue generation—is essential to ensure the sustainability of UHC in Kenya and similar contexts. The study’s limitations necessitate further research before scaling up nationwide.

Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review

2024-04-22T07:05:59Z

Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review Zuniga, Julie; Mungai, Margaret; Chism, Lucy; Frost, Livia; Kakkar, Reha; Kyololo, O’Brien Background The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies. Purpose Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA. Methods This systematic review of the literature used, PRISMA to guide the search. Findings The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces. Discussion There were gaps in the interventions that have been proven successful in other global settings. Conclusion In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.

Corona virus disease 2019 pandemic contributed to pregnancy devastating outcomes in low income countries

2023-11-08T07:54:04Z

Corona virus disease 2019 pandemic contributed to pregnancy devastating outcomes in low income countries Yadufashije, Callixte; Muhimpundu, Liliane; Mwanzia, Lydia; Sangano, Georges Bahati Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments should develop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.