School of Public Health

Effects of a school-based programme on learners’ rabies awareness in Machakos, Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Effects of a school-based programme on learners’ rabies awareness in Machakos, Kenya Shepelo, Getrude Peter; Kibegwa, Felix Matura; Mbindyo, Christine Minoo; Muthiru, Ann Wambui; Abuom, Tequiro Okumu; Buluku, Elizabeth; Salee, Damaris Nthenya; Gichuki, Paul; Maingi, Ndichu; Ombui, Nyarongi Jackson Rabies is a fatal zoonotic disease causing an estimated 59000 annual human deaths globally and approximately 523 in Kenya, with children disproportionately affected. Despite evidence that school-based educational interventions effectively increase rabies awareness and prevention among children, its implementation in Kenya is limited. This study aimed at utilizing an education programme to increase rabies awareness among primary school learners and evaluate their knowledge uptake. A quasi-experimental study was conducted among 210 learners from four primary schools (two urban, two rural). Pre-tested questionnaires assessed rabies awareness before and after rabies training sessions. Differences between urban and rural schools were assessed using χ2 tests, while Wilcoxon signed-rank test was used for pre- and post-training scores. Post-training, overall knowledge scores improved from 6.14 to 7.61(p < 0.001), with significant increase in learners’ knowledge on rabies transmission, zoonosis, and the importance of annual dog vaccination. Attitudes and perceptions improved from 3.23 to 4.03 (p < 0.001), particularly health-seeking behaviour and reporting post dog bite. In conclusion, school-based rabies education significantly improved learners’ awareness. Being the first report of such intervention in Kenya, it could serve as a model for other zoonoses

Benefits and challenges of voucher-based transport for skilled birth attendance in Kitui County, Kenya: the health stakeholders’ perspectives

Thu, 01 Jan 2026 00:00:00 GMT

Benefits and challenges of voucher-based transport for skilled birth attendance in Kitui County, Kenya: the health stakeholders’ perspectives Mbuthia, Zipporah; Koros, Hillary; Mukethe, Theresia; Owino, Allan; Kihuha, Jesse; Wangire, Caroline; Gatimu, Moses; Kiamba, Angeline; King, Julia; Hlongwana, Khumbulani; Ginindza, Themba; Kisia, James Background Reducing maternal, newborn and child mortality remains one of the top global public health priorities. Each year, approximately 303,000 mothers, globally, die during delivery. Stillbirths and neonatal deaths within the first 28 days of life are estimated at 2.6 million and 2.7 million, respectively. Rural residents face challenges in accessing health care due to difficulties in transportation. Given the voucher-based transport’s potential to address inaccessibility to health services, this study explored the health stakeholders’ perspectives on the benefits and challenges of this intervention. Methods Using an exploratory qualitative design, this study was conducted in Kitui County located in the lower Eastern part of Kenya. The study was conducted from July to August 2023, with data collection occurring over a twoweek period in August 2023. Participants were purposively drawn from the six wards in Kitui South Sub County. The interview guide included questions on views, experiences, challenges, and perspectives on voucher-based transport system for skilled birth attendance. Data triangulation was ensured through audio-recorded Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). All audio recordings were transcribed verbatim, coded and thematically analyzed, using a holistic approach. Results Perceived benefits of Skilled Birth Attendance (SBA) champions model included improved access to delivery services, improved health outcomes and socioeconomic and awareness benefits. The perceived challenges and concerns of the SBA model included economic and sustainability challenges, infrastructure and connectivity challenges, as well as administrative and logistical challenges. Conclusions Overall, the SBA Champions model has proven effective in improving access to maternal services within the community, but prevailing challenges and sustainability issues need to be addressed. Additionally, the study provided strategic information to inform policy makers about the model and strengthen MCH policy.

Effect of COVID-19 pandemic on ART access and timely initiation in people living with HIV in 31 countries: a regression discontinuity design study

Fri, 16 Jan 2026 00:00:00 GMT

Effect of COVID-19 pandemic on ART access and timely initiation in people living with HIV in 31 countries: a regression discontinuity design study Ben Farhat, ihane; Messou, Eugène; Borse, Rohidas; Varela Bustillo, Diana; Madimabe, Metsekae; Nash, Denis; Byakwaga, Helen; Shah, N Sarita; Ezechi, Oliver; Pujari, Sanjay; G Veloso, Valdiléa; Hobbins, Michael; Murenzi, Gad; Mkwashapi, Denna; Hogan, Brenna; Yong Choi, Jun; Minga, Albert; Crabtree- Ramírez, Brenda; Twizere, Christella; Diero, Lameck; Haw, Jason; Bolton-Moore, Carolyn; P Cortes, Claudia; Lee, Man-Po; Mbewe, Safari; Brazier, Ellen; M Humphrey, John; N Althoff, Keri; Bonnet, Fabrice; Barger, Diana; Jaquet, Antoine ABSTRACT Objectives The COVID-19 pandemic threatened global HIV Test and Treat Efforts. We assessed whether it affected (1) the number of antiretroviral therapy (ART) initiations and (2) the proportion of timely ART initiations in people living with HIV (PLWH) globally. Design Quasi-experimental, regression discontinuity design using routinely collected data from HIV clinics. Setting 360 HIV care clinics across primary and secondary levels of care, participating in the International epidemiology Databases to Evaluate AIDS consortium, in 31 countries in Asia, Africa and the Americas. Participants 177 391 PLWH (≥18 years old) who initiated ART 2 years before and 1 year after the onset of the COVID-19 pandemic in their country. Primary and secondary outcome measures The primary outcome was the number of ART initiations per week; the secondary outcome was the proportion of timely ART initiations (ie, ART initiated within 7 days of enrolment). We assessed changes in these outcomes in the 52 weeks after compared to the 104 weeks before the pandemic onset, defined using each country’s peak Oxford Stringency Index score between January and June 2020. Results Among 177 391 newly enrolled PLWH, 129 743 initiated during the pre-pandemic and 47 648 post- pandemic onset. 72.5% of ART initiations were timely pre-pandemic whereas 82.3% were during the pandemic. Absolute number of ART initiations remained stable during the pandemic period in 25 of 31 countries but decreased significantly in six countries: India (−5.0 p, 95% CI −9.2 to −0.7), Rwanda (−10.0 p, −18.6 to −1.4), Malawi (−33.4 p, −54.1 to −12.3), South Africa (−130.8 p, −188.6 to −73.1), Zimbabwe (−12.9 p, −20.0 to −5.8) and Togo (−19.6 p, −39.1 to −0.1). The proportion of timely initiations was stable in all countries except in Kenya (+4.2 pp, 95% CI +0.3 to +8.1) and in Mozambique (+2.7 pp, +0.5 to +4.9), where it increased significantlyConclusions A deeper understanding of the factors that contributed to sustaining ART initiations, particularly in settings with stringent public health and social measures, is needed. These insights should inform preparedness strategies, resource allocation and policy development toensure continuity of HIV services during future health emergencies, in line with World Health Organisation recommendations

Challenges and ppportunities in the implementation of integrated competency-based education in selected Kenya Medical Training College Campuses in Western Kenya

Fri, 27 Mar 2026 00:00:00 GMT

Challenges and ppportunities in the implementation of integrated competency-based education in selected Kenya Medical Training College Campuses in Western Kenya Masinde, Mukhwana Anthony; Kangethe, Simon; Sum, Psusma Tecla Competency-based education is a design of teaching and learning that emphasizes the demonstration and application of specific competencies or skills by learners. The practice of medicine becomes increasingly complex each passing year. Despite the affordance of CBE in preparing learners for the challenges of the 21st century, its implementation in Africa continues to be more challenging. This study examined the challenges and opportunities influencing the implementation of Integrated Competency-Based Medical Education (ICBME) in selected Kenya Medical Training College campuses in Western Kenya. The study was guided by Lev Vygotsky’s social constructivism theory, which explains learning as a socially mediated process shaped through interaction, collaboration, and guided practice. A cross-sectional descriptive survey design was adopted, focusing on quantitative data collected from tutors and diploma students in clinical medicine. The study was conducted in three randomly selected campuses (Busia, Kakamega, and Webuye) drawn from nine campuses in the region. A census approach yielded a target population of 396 respondents. Data were collected using structured questionnaires and analyzed using descriptive statistics (frequencies and percentages) and inferential statistics (Chi-square tests). Findings showed that inadequate resources was the dominant challenge, reported by 75.0% of tutors and 73.6% of students, followed by faculty shortages and large class sizes. Other constraints included resistance to change, limited clinical opportunities, assessment challenges, and financial limitations. Chi-square results indicated no significant differences between tutors and students across all challenge variables (p > 0.05), showing consistent perceptions across groups. Key opportunities included government support and healthcare partnerships (about 20% each), followed by technological advancements and faculty development programs. High agreement on the presence of opportunities (over 95% for both groups) reflected strong Journal of Research in Education and Technology 4(1) Received: January 24, 2026 Accepted: March 20, 2026 Published: March 27, 2026 Masinde et al. 52 Original Article 4(1), 2026 stakeholder awareness of enabling factors. The study concludes that ICBME implementation faces major structural and resource-related barriers, despite the presence of strong policy and institutional support mechanisms. It recommends targeted investment in infrastructure, expansion of clinical training opportunities and structured faculty development to strengthen implementation outcomes and produce competent healthcare graduates capable of meeting Kenya's Universal Health Coverage goals.