Browsing by Author "Liambila, Wilson"

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    PublicationOpen Access
    Family and provider perceptions of quality of care in the management of sick young infants in primary health care settings in four counties of Kenya.
    (MedRXiv, 2020-07-22) Abuya, Timothy; Mbugua, Samuel Mungai; Gitaka, Jesse; Gitau, Tabither; Odwe, George; Mwaura, Peter; Liambila, Wilson; Ndwiga, Charity; K’Oduol, Kezia; Warren, Charlotte E.
    Background Understanding the perceptions of quality of care given to sick young infants in primary health care settings is key for developing strategies for effective uptake and utilization of PSBI guidelines. The purpose of this study is to assess families’ and providers’ perceptions of care given to sick young infants at primary healthcare facilities in four diverse counties in Kenya. Methods A cross-sectional qualitative design involving in-depth interviews (23) and focus group discussions (25) with very young (15-18 years), young (19-24 years) and older (25-45 years) caregivers of young infants 0-59 days; and key informant interviews with community- and facility-based frontline health providers (14) in primary health care facilities. Qualitative data were captured using audio tapes and field notes, transcribed, translated, and exported into QSR NVivo 12 for analysis. A thematic framework approach was adopted to classify and analyze data. Results Perceived care given to SYIs was described around six domains of WHO’s framework for the quality of maternal and newborn health care: evidence-based practices for routine and emergency care; functional referral systems; effective communication; respect and preservation of dignity; availability of competent, motivated human resources; and availability of physical resources. Views of caregivers and providers regarding SYIs care at PHCs were similar across the four sites. Main hindrance to SYI care includes stockout of essential drugs, limited infrastructure, lack of functional referral system, inadequate providers which led to delays in receiving treatment, inadequate provider skills and poor provider attitudes. Despite these challenges, motivation and teamwork of health providers were key tenets in care provision. Conclusion The findings underscore the need to prioritize improving quality of SYIs services at PHCs by building capacity of providers through training, ensuring continuous supply of essential medicines and equipment, improving infrastructure including referral.
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    PublicationOpen Access
    Lessons learnt from community referral and follow up of sick young infants with Possible Severe Bacterial Infection in Turkana County, Kenya
    (MedRxiv, 2022-08-25) Gatungu, Daniel; Mbugua, Samuel; Mwaura, Peter; Oyiengo, Laura; Liambila, Wilson; Gitaka, Jesse; Emuria , Andrew
    Introduction Management of possible severe bacterial infections in young infants (0-59 days) requires timely identification of danger signs and prompt administration of efficacious antibiotic treatment. The Possible Severe Bacterial Infection guidelines underscore the importance of close follow up in an outpatient basis to ensure treatment adherence and early detection of illness-related complications. The purpose of this study was to strengthen the follow up and referral of sick young infants on day 4 and 8 by introducing community-led interventions that facilitated community health volunteers to identify sick young infants, conduct community reviews, link data with responsive facilities, and refer appropriately. Methods Six health facilities were included a a longitudinal, descriptive, mixed methods approach weaved around an initial formative context assessment and three-monthly assessments. Quantitative data was extracted from facility registers to identify gaps in follow up and referral feasibility. Qualitative data was through focus group discussions with community health volunteers and key informant interviews with frontline providers. Results Qualitative data provided insights into key barriers and facilitators of community follow up and referral. Barriers include community socio-cultural practices, competing tasks, dysfunctional community referral pathway, drivers of common infections, and unavailability of essential commodities. Key facilitators entail indication of competency in identification of danger signs in sick young infants, presence of older women, men, and community resource persons that can leveraged on in community engagement and sensitization, and mothers are the primary decision makers in care seeking. There was increased utilization of decision support tools and an increase in the number of sick young infants managed in dispensaries. The COVID-19 pandemic however negatively impacted community follow up and referral of sick young infants.