DR. NJOROGE PETER K.

This was a Survey of Parents' Knowledge, Attitude and Practice of sex education to their own adolescents. The study was conducted between January and March in three divisions of Kiambaa Division of Kiambu District, Central Province of Kenya. This study area is located about 20 km from the city of Nairobi. The study population were parents with at least one child in adolescence. Depending on availability either one or both parents were included in the study. The study instrument was structured, mainly pre-coded questionnaire. The data was obtained through personal interviews conducted from house La ho u sc . The sample population was made up of 729 parents, 70.4% of whom were females. The survey found that 46.3% of parents gave sex education to their own adolescents, majority of them giving it to those of their sex only. Parents gave their adolescents sex education from a mean age (of the adolescent) of 10.33 years (SD=3.51) and the practice was associated with Parents Social, Economic and Demographic factors. 'Of these factors, knowledge that own adolescents received sex education from sources other than the parent had highest odds ratio 10R=4.l8). Age of the parent was the only other factor with odds for the practice (OR=.l.03 ). The level of sex education given to adolescents was higher for girls than for boys. The level of practice to boys was associated with age and socio-economic status (SES) inde~ of the parent. Knowledge of sex education among parents was high and associated with a parents' sex and SES index. Males scored signi ficantly higher than females and parents of Jow SES scored significantly higher than those of high SES index. The attitude to sex education was positive, with nearly all parents feeling that sex education for adolescents was appropriate and that it should be given by own parents, starting from a mean age of 10.61 years (SD=2. 84) and that it should include contraceptive education. The study recommended further studies on parents to understand why the level of practice is unmatched with the high levels of knowledge and attitude and to determine why those parents who know that their adolescents receive sex education from other sources are more likely to give sex education to their adolescents than those who did not. 'Other recommendations were: a study to assess the feasibility of using PTA' s to impart sex education to adolescents in schools, beginning Family Life education in primary schools at standard four (corresponding to age .10-11 years),and establishing of community based centres for sex education counselling for parents with adolescents and adolescents out of school.

Antibody responses to a conventional rabies preexposure regimen of a new purified Vero cell rabies vaccine (PVRV) and a human diploid cell vaccine (HDCV) were compared in 80 healthy Kenyan veterinary students. Forty-three of the students received the PVRV and 37 received the HDCV on days 0, 7, and 28. Antibody responses were monitored using the rapid fluorescent-focus inhibition test (RFFIT) and an inhibition enzyme immunoassay (INH EIA) on days 0, 7, 28, and 49. Both vaccines elicited a rapid antibody response. A good correlation between the RFFIT titers and the INH EIA titers was obtained (r = 0.90). Our results also showed that the INH EIA was more reproducible and might therefore be a suitable substitute for the more expensive and less reproducible RFFIT. The geometric mean titers determined by both tests in the two groups of students were statistically similar during the test period. The RFFIT and the INH EIA gave comparable geometric mean titers, which differed significantly only on day 28 in the PVRV group. The effect of the new PVRV is comparable to that of the more expensive HDCV, as determined by the present test systems. The PVRV could therefore be the vaccine of choice, especially in tropical rabies-endemic areas, where the high cost of the HDCV has confined its use to a privileged few.

OBJECTIVE: To assess the quality of care provided by the Kisumu Municipal health facilities, with special reference to Maternal and Child health services (MCH). DESIGN: A descriptive cross-sectional survey. SETTING: Kisumu Municipal Health facilities. SUBJECTS: Four hundred and eighty two mothers were interviewed in a household survey. RESULTS: A total of 482 mothers were interviewed in the household survey. Out of these, only 40.4%, 53.7% and 45.7% had respectively used Municipal facilities for antenatal services (ANC), immunisation and treatment of their children the last time they required such a service. This translates to by-pass rates for Municipal health facilities of 59.5%, 46.3% and 54.3% respectively for the three services. By-pass was higher for the more central urban catchment areas than the more peripheral ones, a finding that was associated with the socio-economic status of the respondents and the relative location of the municipal facilities vis-a-vis competing facilities, mainly the District and Provincial hospitals. The main reasons cited for by-pass were poor care (21%), lack of drugs and supplies (17%) and lack of/poor laboratory services (12%). From the facility audit, most of the clinics had a reasonable capacity to offer basic health care with only three scoring less than 50% in the scale used. The worst areas were in availability of drugs, equipment and management issues. There was a strong relationship between the perceived quality of care and utilisation of MCH services as well as by-pass. The capacity of the facilities to offer care was however not associated with utilisation of MCH services or by-pass. CONCLUSION: There is under-utilisation of Municipal health facilities for MCH services. This is related to the perceived poor quality of care in the facilities. Perception of quality is influenced by a person's socio-economic status especially education.