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Publications


2017

Muthwii, F, M.Chege, M.Muiva.  2017.  FACTORS ASSOCIATED WITH SEVERITY OF NEONATAL SEPSIS DURING ADMISSION IN KENYATTA NATIONAL HOSPITAL PAEDIATRIC WARDS, KENYA: A DESCRIPTIVE CROSS-SECTIONAL STUDY . East African Medical Journal . Vol. 91 No. 2 January 2017 Abstract

East African Medical Journal Vol. 91 No. 2 January 2017
FACTORS ASSOCIATED WITH SEVERITY OF NEONATAL SEPSIS DURING ADMISSION IN KENYATTA NATIONAL HOSPITAL PAEDIATRIC WARDS, KENYA: A DESCRIPTIVE CROSS-SECTIONAL STUDY
F. Muthwii, M.Chege, M.Muiva,University of Nairobi, College of Health Sciences, School of Nursing Sciences, P.O. Box 19676-00202 Nairobi, Kenya and M.Habtu, Mount Kenya University, College of Health Sciences, Department of Public Health, P.O. Box P.O.Box 5826 Kigali, Rwanda, Jomo Kenyatta University of Agriculture and Technology, College of Health Sciences, Department of Public Health, P.O. Box 19676-00202 Kigali, Rwanda Request for reprints to: F. Muthwii , University of Nairobi, College of Health Sciences, School of Nursing Sciences, P.O. Box 19676-00202 Nairobi, Kenya. fkaluu77@gmail.com
FACTORS ASSOCIATED WITH SEVERITY OF NEONATAL SEPSIS DURING ADMISSION IN KENYATTA NATIONAL HOSPITAL PAEDIATRIC WARDS, KENYA: A DESCRIPTIVE CROSS-SECTIONAL STUDY F. MUTHWII, M.CHEGE, M.MUIVA and M.HABTU, ABSTRACT Background: Neonatal sepsis is a major cause of neonatal mortality. In the year of 2012, it accounted for 44% of all deaths of underfive years old children globally. Statistics indicate that 98% of the global, one million deaths as a result of neonatal sepsis occur in Africa. Neonatal sepsis contributes to 69% of neonatal mortality in Nigeria and 28% of neonatal mortality in Kenya. Objective: To establish factors associated with severity of neonatal sepsis among patients admitted in Kenyatta National Hospital Paediatric Wards. Design: The study adopted a descriptive cross-sectional design. Setting: The study was carried out in paediatric wards of Kenyatta National Hospital (KNH), Kenya. Subjects: Data was obtained from consenting mothers whose neonates had been admitted with neonatal sepsis and healthcare workers who worked within the paediatric wards. A total of 107 respondents were selected by systematic sampling method in which every alternate participant was selected. A semi-structured questionnaire was used to gather data on maternal and neonatal characteristics and environmental factors. In addition, three focused group discussions comprising nurses, doctors and clinical officers were conducted. Chi-square test was used to determine the factors associated with severity of neonatal sepsis (NNS) during admission. Results: Binary logistic regression analysis was performed to determine predictors of severe NNS. Of the 107 patients with neonatal sepsis, 37.4% had severe neonatal sepsis during admission.After multiple logistic regression analysis, the following factors were found to be independently associated with severe NNS: Neonates aged 8 to 28 days [AOR=2.89; 95%CI=1.07-7.99; P=0.047]compared to those neonates aged less than 8 days; Mothers with primary level of education [AOR=4.57; 95%CI=1.18-17.67; P=0.028]compared to those with tertiary education; primipara mothers [AOR=4.64; 95%CI=1.74-12.37; P=0.002]than multipara mothers and greenish amniotic fluid during labor [AOR=3.11; 95%CI=1.05-9.24; P=0.041]compared to clear amniotic fluid. Conclusion: The study found that severity of NNS was still high. The factors associated with severe NNS were; primiparity, maternal low economic status and poor antenatal clinic attendance. The study thus recommends that newborns at risk of developing severe neonatal sepsis should get prophylactic treatment and mothers be included in specialized programs geared towards reduction of the severity of NNS.

EK Mmboneiza, Chege MN, Omuga BO.  2017.  Assessment of Parents’ Perception of Quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital. Asia Pac J Oncol Nurs. 2017 Jan-Mar; (4(1):):29–37.. Abstractassessment_of_parents_perception_of_quality_of_pediatric_oncology_inpatient_care_at_kenyatta_national_hospital.pdf

Assessment of Parents’ Perception of Quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital

Eunice Mmbone Keiza, MSN, Margaret Njambi Chege, and Blasio Osogo Omuga

Asia Pac J Oncol Nurs. 2017 Jan-Mar; 4(1): 29–37.
doi: 10.4103/2347-5625.199071

Abstract
Objective:
Adequate knowledge of parents’ perception of quality of pediatric cancer care helps to identify the areas of care improvement which would contribute to disease outcome in regard to the quality of life and satisfaction with the care provided. The aim of the study was to assess the parents’ perception of the quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital.
Methods:
A cross-sectional descriptive quantitative and qualitative study was undertaken using a pretested semi-structured questionnaire and a focused group discussion guide. Assessment of parents’ perception of quality of care was done in relation to the institution's structures and care delivery processes. These included the ward environment, resources for cancer treatment, care processes, service providers, and parents’ knowledge empowerment. Participants were systematically selected. Parents’ perception was defined as satisfaction or dissatisfaction with the care provided. Data were analyzed using SPSS version 20.0 (Armonk, NY: IBM Corp.) and presented as frequencies and percentages. Chi-square was used to test the significant association between variables. Level of significance was set at a P ≤ 0.05.
Results:
A total of 107 respondents were interviewed and 57.9% were satisfied with the overall quality of care they received. The determinants of overall satisfaction in this study were found to be related to resources for cancer treatment (odds ratio [OR] =3.10; 95% confidence interval [CI] =1.39–6.90; P = 0.005), care delivery processes (OR = 2.87; 95% CI = 1.28–6.43; P = 0.009), and the ward environment (OR = 2.59; 95% CI = 1.17–5.74; P = 0.018).
Conclusions:
The parents were moderately satisfied with the oncology care services their children received. The gaps identified in service delivery included those related to the availability of the required resources for efficient care delivery and also educational as well as psychosocial needs of the parents.
Keywords: Parents, pediatric oncology, perception, quality of care

2016

Mawia, D, Chege MN, Oyieke J.  2016.  Early growth in preterm infants after hospital discharge in rural Kenya: longitudinal study. Pan African Medical Journal. 24:158 doi:(10.11604/pamj.2016.24.158.7795) Abstractearly_growth_in_preterm_infants_after_hospital_discharge_in_rural_kenya_longitudinal.pdf

Abstract
Introduction: Prematurity is the single most important cause of mortality during the neonatal period. The early growth of these infants has been shown to be a predictor of their later growth and neurodevelopmental outcomes. The objective of this study was to establish the determinants of early growth in preterm infants after hospital discharge at the Kitui District Hospital, Kenya. Methods: A short longitudinal study design was adopted to execute the study. During the period of April and June 2014, all the preterm infants who were discharged from the Kitui District
Hospital Newborn Unit were enrolled in the study by obtaining written informed consent from their guardians. The anthropometric measurements of these infants were taken at discharge and repeated two weeks later at the Pediatric Outpatient Clinic and the Maternal Child health Clinic. A questionnaire guided interview was held with the guardians to establish infant and maternal characteristics which influenced the infants' early growth. Results: A total of 112 participants were enrolled for the study with 106 (94.4%) of them being available for reassessment after two
weeks. Majority (72.6%) had deficit in growth by failing to attain the recommended WHO average weight gain of 15g/kg/day. Most of the mothers (63.4%) were between the ages of 20-29 years with half of them being first time mothers. Many of them (66.1%) had only attained primary education and were married (66.1%) to self-employed husbands (56%). Conclusion: Most of the preterm infants at discharge were females who were born between 33 and 36 weeks gestation. Growth deficit was present in the majority and gestational age at birth was a major determinant of the early growth in these preterm infants.

LC Ng éno, VK Mukthar, SJ Kulei, Chege M.  2016.  Determinants of pneumococcal conjugate vaccine uptake among children attending immunisation services at Kenyatta National Hospital, Nairobi, Kenya. East African Medical Journal. Abstract

East African Medical Journal 2016

Open Access Subscription or Fee Access
Determinants of pneumococcal conjugate vaccine uptake among children attending immunisation services at Kenyatta National Hospital, Nairobi, Kenya
LC Ng éno, VK Mukthar, SJ Kulei, M Chege

Abstract

Objective: To establish the determinants of pneumococcal conjugate vaccine uptake among children brought to Kenyatta National Hospital.
Design: A cross-sectional hospital-based quantitative and qualitative study
Setting: Kenyatta National hospital which is the largest teaching and referral hospital in East and Central Africa situated in Nairobi, Kenya.

Subjects: The respondents were the parents/guardians of children less than two years of age attending immunisation services at KNH and those admitted in the peadiatric wards with pneumonia.
Results: The study established that the determinants of uptake of Pneumococcal Conjugate Vaccine are age(OR 5.8, CI 1.4-23.4, p=0.014), level of education (OR 5.8, CI 1.5-22.4, p=0.01), parity (OR 0.2, CI 0.1-0.7, p=0.017), occupation (OR 6.5, CI 1.5-27.6, p=0.011), family income (OR 8.8, CI 1.4-55.6, p=0.001), knowledge (OR 6.5, CI 1.1-15.2, p=0.011) and attitude (OR 6.3, CI 1.9-26.8, p=0.001).
Conclusion: The study concluded that factors of the caregivers/parents that are statistically significant to the uptake of Pneumococcal Conjugate Vaccine uptake are Income, parity, education leve, age and occupation. Also a friendly attitude from health personnel was shown to motivate parents/guardians’ adherence to vaccination schedules

2014

Nyaberi, Z, Oyieke J, Chege M, Mwaura, F; Wamalwa J, Gitonga M.  2014.  Correlates of Undiagnosed Depression among Diabetic Patients on Follow-Up at a Regional Referral Hospital in Western Kenya. Global Journal of Interdisciplinary Social Sciences. Vol.3(6):24-30. Abstractcorrelates_of_undiagnosed_depression_among_diabetic_patients.pdf

Abstract
The prevalence of diabetes mellitus in Kenya is estimated to be 4.66%. The comorbidity of diabetes and depression is associated with poor outcomes. The study aimed at determining the prevalence and factors associated with depression among diabetics. A cross-sectional survey was conducted among 181 diabetics attending clinic at a referral hospital in western Kenya. A questionnaire was used to collect data on the independent variables. Beck’s Depression Inventory (BDI-II) was used to assess depression symptoms.
Depression was observed in 19% of the participants. Female gender, being single, urban residence, low income and no family support were significantly associated with depression. Others are; longer duration of illness, difficulties adhering to treatment and alcohol consumption (p<0.05). A significant proportion of diabetic patients have comorbid depression. Integration of mental health services into diabetics care setting will lead to detection and early treatment of depression.
Keywords: Undiagnosed Depression, Diabetes Mellitus

2013

Ndambuki, JM, EUNICEODHIAMBO, Chege M, MIRIE WAITHIRA.  2013.  Factors influencing Quality Management of Medication by Nurses at Kenyatta National Hospital Paediatric Wards. Nairobi, Kenya.. Journal of Biology, Agriculture and Healthcare. Vol.3,( No.18, 2013):93-98.factors_influencing_quality_management.pdf
Chege1, M, Mwaniki P, Abuya T.  2013.  Evaluation of a Tool for Assessing Clinical Competence of Msc Nurse Students. Journal of Biology, Agriculture and Healthcare. Vol.3,(No.13, 2013):53-59.7552-9841-1-pb.pdf

2012

Kimani, S, Kainga S, Chege M, Wagoro M.  2012.  PCNA Annual Symposium Abstracts. Abstract

Cardiovascular diseases are a major cause of mortality and morbidity worldwide. In a sub Saharan Africa cardiovascular and other metabolic diseases including diabetes are increasingly causing significant socio-economic and health burden. The increase has severely affected our health care systems already struggling with the burden of tropical and communicable diseases. Patients with diabetes are 2-4 times likely to develop cardiovascular disease and/or stroke. Although the risk factors for cardiovascular disease among type 2 diabetes may be known, there is inadequate information concerning diabetic patients attending Kenyatta National Hospital (KNH).

Chege, MN.  2012.  A study of how commercial sex workers care for and arrange for future support to their children: case of Kibera, Nairobi. Abstract

Childcare is necessary for child survival growth and development. It is influenced by certain factors such as the maternal health status and resource availability. It has been estimated that 50-80% of Kenya's commercial sex workers are HIV positive. They are the primary caregivers for their children. Yet while considerable body of research in Kenya has focused on commercial sex workers as a high-risk group for the fatal HIV/AIDS and on their role in relation to HIV epidemic, no data were available on how they care and plan for future support for their children. This descriptive cross-sectional survey was carried out among 385 commercial sex workers in Kibera Slum in Nairobi Kenya, between July and December 2000. The aim of this study was to evaluate the commercial sex workers' childcare practices and how they plan for future support of their children. The study respondents were women aged between 18 and 19 years. They all had children whose age groups included the 0-18 years. Data were collected over a period of 18 weeks, using a structured questionnaire, observations of the under five years old children, verification of child health card and focus group discussions. Data were analysed using Statistical Package for Social Sciences (SPSS). The results indicated that 81.2% of the study population lived with their children despite the fact that 74.1% practiced prostitution at home. In this study 89.9% of the study population had taken their children to school. However continuous education was undermined by lack of school fees (52.5% and truancy (46.6%) with more of the illiterate mothers (65%) reporting school dropouts. A larger proportion (42.2%) of the respondents who practiced prostitution at home (42.2%) reported more school dropouts of their children than those who practiced elsewhere. Results of health promotion indicated that 96.8% of the under five years old children were fully immunized. More respondents who knew their HIV status discussed HIV/STDs with their children than those that did not know 25.3, p < 0.001). Focus group discussions showed that, health-seeking behaviour for the children was hampered by use of alcohol by the mothers and to some extent, health care cost. Health seeking behaviour for the mothers was significantly associated with respondent's knowledge of own HIV status 6.1, p < 0.05). Support for commercial sex workers in bringing up their children, was minimal. Only 43.9% received support from extended families. The illiterate mothers were less likely to be supported by relative (OR 2.64, p < 0.01). Possession of assets was positively associated with having an extra income generating activity 17.8, p < 0.001). Those respondents with secondary education were more likely to possess assets for future support of their children compared to those without (OR 1.9, p < 0.05). Generally, the commercial sex workers of Kibera slums made no provisions for future support of their children. Alcohol consumption and low education undermined their efforts to provide better care to their children and to secure resources. This underlines the need for continuous health education among commercial sex workers and establishment of systems that will assist them to invest in the education of their children.

NJAMBI, DRCHEGEMARGARET.  2012.  Peripheral Neuropathy among Patients with Type Diabetes mellitus attending Kenyatta National Hospital. Abstract

2nd East Africa Neuroscience Conference, 18-19 June 2012, Nairobi,
Kenya
Peripheral Neuropathy among Patients with Type Diabetes mellitus attending
Kenyatta National Hospital
Stephen Kainga1
,2, Margaret Chegel, Miriam Wagoro\ Samuel Kiman!' ~
'University of Nairobi and 2Ministry of Medical Services, Government of Kenya.
Diabetes mellitus (DM) has become the epidemic of the 21st century with the
poorest nations bearing the greatest burden. DM affects both central and peripheral
nerves causing dysfunctional sensory activity with peripheral neuropathy (PN)
being the most common complication. Peripheral neuropathy has been associated
with lower limbs pain and ulceration among diabetic patients resulting to increased
morbidity, disability and reduced quality of life. Objective: We determined the
prevalence ofPN among patients with type 2 DM attending Kenyatta National
Hospital. Methods: We carried out descriptive cross-sectional study involving 147
patients with DM attending the KNH. Clinical history and physical findings were
captured using questionnaires and a focused physical examination. Data was
analyzed using SPSS software (version 17). Statistical significance was set at a cut
off value of 0.05. Results: Based on history and signs of peripheral numbness and
pain, 60 (41.1 %) participants with DM had PN. Peripheral neuropathy was
significantly associated with coexistence of DM and hypertension. Furthermore,
the duration of DM, participants' age and difficulties in healthcare financing were
significantly associated with PN. However, our study did not elicit any association
between smoking, alcohol consumption and prevalence of PN among the
participants. Conclusion: Our findings underscore the role ofDM on the
occurrence ofPN, the main cause of morbidity, disability, and reduced quality of
life among patients. Early diagnosis and adequate management of DM can
significantly reduce diabetic neuropathy and should be incorporated

2010

2009

NJAMBI, DRCHEGEMARGARET.  2009.  Risk Factors for Cardiovascular Disease in Patients With Type 2 Diabetes at Kenyatta National Hospital, Kenya. Abstract

Risk Factors for Cardiovascular Disease in Patients With Type 2 Diabetes at Kenyatta National Hospital, Kenya
Samuel Kimani, BScN, MSc, Stephen Kainga, BScN, lV1argaret Chege, MPH, PhD, Miriam Wagoro, BScN,
MScN, University of Nairobi, Nairobi, Kenya.

Background: Cardiovascular diseases are a major cause of mortality and morbidity worldwide. In a sub Saharan Africa cardiovascular and other metabolic diseases including diabetes are increasingly causing significant socio-economic and health burden. The increase has severely affected our health care systems already struggling with the burden of tropical and communicable diseases. Patients with diabetes are 2--4 times likely to develop cardiovascular disease and/or stroke. Although the risk factors for cardiovascular disease among type 2 diabetes may be known, there is inadequate information concerning diabetic patients attending Kenyarta National Hospital (KNH).

Objective: To determine risk for cardiovascular disease among patients with type 2 diabetes at KNH.
Methods: This was a cross-sectional study involving 147 participants diagnosed with type 2 diabetes.
Participants were recruited consecutively after provision of written consent. The socio-demographics and
relevant clinical data were obtained. Cardiovascular assessment, heart rate, blood pressures, lipid profile,
and anthropometric parameters were obtained using standard clinical methods.

Results: Majority (63.3%) of the participants were hypertensive and suffered diabetes for more than 10 years. Additionally, they had higher (p < 0.05) total cholesterols; however, only 26.5% were on anti-lipidernia
therapy. The use of angiotensin converting enzyme inhibitors was associated with reduced (P < 0.05) risk of
hypertension. Further, a significant number (69.2%) of participants added salt to food regularly and exhibited
significantly (p < 0.05) higher anthropometric parameters and psychological stress.

Conclusion: Our study underscores the role of diabetes, hyperlipidemia, psychological stress, higher
anthropometric parameters and high dietary salt intake as risk factors for cardiovascular disease among

NJAMBI, DRCHEGEMARGARET.  2009.  Impact of Student and Teacher Characteristics on Perfomance of Diploma Nursing Graduates'. Abstract

Impact of Student and Teacher Characteristics on Performance of Diploma Nursing Graduates' In The Nursing Council Registration Examination
Authors:
Gachuiri Grace Wangechi, MScN University of Nairobi, School of Nursing Sciences
Prof. Karani Anna, University of Nairobi, School of Nursing Sciences
Dr Che e Margarete, University of Nairobi, School of Nursing Sciences
Abstract
Necessitated by poor performance recorded in recent years, this descriptive study sought to establish the
impact of students and teacher characteristics on performance in the Nursing registration examination.
The study combined both qualitative and quantitative methods. Quantitative data was collected using
self-administered semi structured questionnaires from 75 KRCHNgraduates working at Kenyatta National
Hospital.
The study areas were purposively selected and the study subjects selected through simple random sampling.
Qualitative data was collected using a study guide from lecturers' Secondary data on past performance in the
examination was used to supplement the findings.
The data was subjected to Pearson product moment correlation to establish the relationship between nurse
graduate, teacher characteristics and performance in the NCKexamination. Results of the study showed a
very strong correlation (r=l, p

NJAMBI, DRCHEGEMARGARET.  2009.  Factors Influencing Ethical Decision Making .Among Psychiatric Nurses At Mathari Hosprtal In Nairobi. Abstract

Factors Influencing Ethical Decision Making Among Psychiatric Nurses At Mathari Hosprtal In Nairobi
Authors:
Mageto Gacheri Irene, (MScN, BScN) - Lecturer, Department of Nursing, Presbyterian University of East
Africa.
Prof. Joyce 0 Musandu (Late) (PhD, MScN, DAN, KRN, KRM, KRCHN)- former Director and
Senior Lecturer, School of Nursing sciences. University of Nairobi.
Dr Margaret N Chege, (PhD, MPHE, BScN, DAN, RN/RM/PHN) - Lecturer, School of Nursing Sciences,
University of Nairobi
Dr James Mwaura (PhD, MSc, BScN) - Lecturer, and Head of Medical I Surgical Nursing School of
Nursing Sciences, University of Nairobi
Abstract
Ethical decision making is the process of trying to distinguish right from wrong in situations without clear guidelines. While
ethical dilemmas confront nurses in all areas of nursing practice, those. that occur in psychiatric nursing care settings are
more challenging than those occurring in other areas of nursing. This is because the decrease in mental ability of psychiatric
patients leads to vulnerability which evokes ethical difficulties for the psychiatric nurses.
This was a descriptive cross-sectional study aimed at identifying the factors that influence ethical decision making among
psychiatric nurses in Kenya. It was carried out at Mathari Hospital in Nairobi. The study aimed at identifying factors that
influence the process of ethical decision making by the psychiatric nurses in their clinical practice. The study hypothesis was
that there is no relationship between nurses' demographic characteristics and the way they make ethical decisions.
Quantitative data was collected using a self administered questionnaire which was developed and distributed to 152 randomly
sampled psychiatric nurses at Mathari hospital. Qualitative data was collected via a focused group discussion which comprised
of eight nurse managers. Data was categorized and coded according themes. Data entry was done by use of statistical package
for social sciences (version 16.0) Descriptive and inferential statistics were used as appropriate for data analysis. Qualitative
data from
focused group discussions was analyzed manually.
Overall the results of this study showed that factors influencing nurses ethical decision making were professional experience (r
= 0.0.40, p=O.Ol), workload (rho=0.227, p=0.042), psychiatric nursing experience(r= 0.037, p= 0.01) and gender (rho=0.277,p=
0.013). Knowledge and skills obtained through psychiatric care specializations should be considered when posting nursing
staff to the psychiatric care areas. Further ethnographic research is recommended to identify what other aspects of the
clinical environment affect ethical decision making by the care givers.

NJAMBI, DRCHEGEMARGARET.  2009.  Evaluating Mentorship Practices Among Nursing Students In Selected Kenyan Universities. Abstract

Evaluating Mentorship Practices Among Nursing Students In Selected Kenyan Universities
Ms. ESTHER GICHIGI, Compl~ted MScN (2009) At University of Nairobi School of Nursing Sciences
PROF. ANNAKARANI, Prof. at University of Nairobi, School of Nursing Sciences pRo MARGARET CHEGE, A lecturer at University of Nairobi School of Nursing Sciences
Abstract.
Mentorship programs are offered to support students in program completion, confidence building and transitioning
to further education or the work force. However mentoring relationships have been faced by challenges such as
inadequate knowledge and negative attitude. This study aimed at evaluating knowledge, attitude and perceived
benefits on mentorship among the nursing students in Kenyan universities.
The study was conducted in September, 2009. A descriptive cross sectional survey used both qualitative and
quantitative methods to gather information. The study participants were students from University of Nairobi
(U.O.N)and Kenya Methodist University (K.E.M.U).Asample of 188 students was selected from a total population
of 403 in both universities.
The data Were coded, entered and analyzed using statistical package for social sciences (SPSS). Presentation
of data was done in form of descriptive statistics, frequency distribution and graphs. Pearsons chi square tests
were used to compare the two groups. The tests level of significance was set at 5%. Results showed that there
was a significance difference between mentorship programmes in the two institutions ( 0 2= 17.02, d.f=l, P <
0.001) . Fourty four (72%) of the students at K.E.M.Ufelt that the program had positive impact on students'
development while only 26(21%)at the U.O.Nhad similar attitude.
To maximize on the benefits of mentorship for both institutions, clear policies and guidelines should be put
in place. Evaluation of the mentorship programs and their impact on students' development should be done
regularly. Further studies on ways to improve mentorship are recommended.
INTRODUCTION
Mentorship is a supportive relationship established between two individuals where knowledge,
skills and experience are shared .The mentee or protege is someone seeking guidance in developing
specific competencies, self awareness and skills in early intervention. The mentor is a person who
has expertise in the areas of need identified by the mentee and is able to share the wisdom in a
nurturing way (Alliance for excellent education, 2005).
Mentorship can also be referred to as the provision of model performance by persons with wisdom
from whom advice and guidance can be sought (European Region of world conference for physical
therapy, 2003).It is also considered as pairing students with adult volunteers or older students
who provide friendship, guidance and support as student navigate new and ever more challenging
circumstances (Val, 1994).

NJAMBI, DRCHEGEMARGARET.  2009.  Presented A Scientific Paper titled . Commun Statist. Theor. Meth. Vol. 16, No. 10, 3095 . : Kisipan, M.L. Abstract
n/a

2008

NJAMBI, DRCHEGEMARGARET.  2008.  Nov.2008 : Presented a scientific paper titled: . Commun Statist. Theor. Meth. Vol. 16, No. 10, 3095 . : Kisipan, M.L. Abstract
n/a

2004

NJAMBI, DRCHEGEMARGARET.  2004.  Attended the 11th International Ottawa Conference on Medical Education on 2004 in Barcelona where co- presented the research work. Commun Statist. Theor. Meth. Vol. 16, No. 10, 3095 . : Kisipan, M.L. Abstract
n/a

2003

NJAMBI, DRCHEGEMARGARET.  2003.  Chege, M.N. (2003): Health Seeking Behaviour of Commercial Sex workers. Kenya Nursing Journal, December; 2003. Commun Statist. Theor. Meth. Vol. 16, No. 10, 3095 . : Kisipan, M.L. Abstract
n/a

2002

NJAMBI, DRCHEGEMARGARET.  2002.  Chege, M.N., Kabiru, E.W., Mbithi, J.N. and J.J. Bwayo (2002): Childcare Practices of Commercial Sex Workers. East African Medical Journal, July; 79 (7): 382-389.. PMID: 12638835 [PubMed - indexed for MEDLINE. : Kisipan, M.L. Abstract

OBJECTIVE: To determine the childcare practices of commercial sex workers (CSWs). DESIGN: A descriptive cross-sectional survey was conducted between July and December 2000 during which a structured questionnaire was administered. SETTING: Kibera slum, Nairobi, Kenya. SUBJECTS: Three hundred eighty five CSWs and four focus group discussions (FGDs) held. Health cards from 126 under five years old children belonging to the respondents were reviewed for immunization status and regularity of growth monitoring. RESULTS: The mean age of the 385 CSWs surveyed was 32 +/- 7 years and mean duration of sex work was 6 +/- 4 years. The mean number of living children was 3.4 +/- 2 and 81.2% of the mothers lived with their children. Three quarters of the CSWs practised prostitution at home. The most common daily childcare activities by the mothers were food preparation (96.2%) and washing children's clothes (91.3%). Overall 96.8% of their under-five years old children were fully immunized and 80% of their under one year old children had their growth monitored monthly. About three quarters of the mothers with adolescent children educated them on HIV/STDs. Health seeking behaviour for the children was hampered by health care cost (71.4%) and consumption of alcohol by the mothers. Like other mothers, the CSWs encouraged their adolescent children to take up some adult roles such as maintaining a clean house (93.3%). However only 2.0% took time to converse or counsel the children. Focus group discussions (FGDs) with the CSWs showed that children were left unattended at night while the mothers went out in search of clients. Efforts to provide better education for the children were undermined by lack of funds (52.2%) and truancy (46.6%). One third of the study population had invested for the future maintenance of their children. CONCLUSION: There was more emphasis on physical, rather than psychological aspect of childcare. The practice of living with the children ensured that earnings from the sex trade were used for the immediate needs of the children such as food. However this practice had a negative influence on the children as the majority of the respondents conducted their sexual business at home with little or no privacy. Health seeking behaviour for the children was hampered by lack of funds and to some extent alcohol consumption by the mothers. Efforts to invest in the education of their children were undermined by lack of funds and truancy.

1999

NJAMBI, DRCHEGEMARGARET.  1999.  Chege M.N., Mwaniki P.K., Waweru C.M., Mwamburi R.L., Miano J.N, Kanjuga A., Karani A. , Syagga E., Macharia J. , Mwamuye J.N. Registered Theatre Nursing Clinical Log. Nursing Council of Kenya. Nairobi, May, 1999. PMID: 12638835 [PubMed - indexed for MEDLINE. : Kisipan, M.L. Abstract

OBJECTIVE: To determine the childcare practices of commercial sex workers (CSWs). DESIGN: A descriptive cross-sectional survey was conducted between July and December 2000 during which a structured questionnaire was administered. SETTING: Kibera slum, Nairobi, Kenya. SUBJECTS: Three hundred eighty five CSWs and four focus group discussions (FGDs) held. Health cards from 126 under five years old children belonging to the respondents were reviewed for immunization status and regularity of growth monitoring. RESULTS: The mean age of the 385 CSWs surveyed was 32 +/- 7 years and mean duration of sex work was 6 +/- 4 years. The mean number of living children was 3.4 +/- 2 and 81.2% of the mothers lived with their children. Three quarters of the CSWs practised prostitution at home. The most common daily childcare activities by the mothers were food preparation (96.2%) and washing children's clothes (91.3%). Overall 96.8% of their under-five years old children were fully immunized and 80% of their under one year old children had their growth monitored monthly. About three quarters of the mothers with adolescent children educated them on HIV/STDs. Health seeking behaviour for the children was hampered by health care cost (71.4%) and consumption of alcohol by the mothers. Like other mothers, the CSWs encouraged their adolescent children to take up some adult roles such as maintaining a clean house (93.3%). However only 2.0% took time to converse or counsel the children. Focus group discussions (FGDs) with the CSWs showed that children were left unattended at night while the mothers went out in search of clients. Efforts to provide better education for the children were undermined by lack of funds (52.2%) and truancy (46.6%). One third of the study population had invested for the future maintenance of their children. CONCLUSION: There was more emphasis on physical, rather than psychological aspect of childcare. The practice of living with the children ensured that earnings from the sex trade were used for the immediate needs of the children such as food. However this practice had a negative influence on the children as the majority of the respondents conducted their sexual business at home with little or no privacy. Health seeking behaviour for the children was hampered by lack of funds and to some extent alcohol consumption by the mothers. Efforts to invest in the education of their children were undermined by lack of funds and truancy.

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