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Introduction
Skills and Expertise
Publications
Publications (89)
The 21st century presents significant global health challenges that necessitate an integrated health workforce capable of delivering person-centered and integrated healthcare services. Interprofessional collaboration (IPC) plays a vital role in achieving integration and training an IPC-capable workforce in sub-Saharan Africa (SSA) has become impera...
Background
The COVID-19 pandemic exposed weaknesses in healthcare systems and disparities in healthcare access across sub-Saharan Africa (SSA). The insights of frontline healthcare professionals (HCPs), and healthcare researchers involved with the response to COVID in SSA are crucial to ensuring that health systems are optimally prepared for the ne...
The 21st century presents significant global health challenges that necessitate an integrated health workforce capable of delivering person-centered and integrated healthcare services. Interprofessional collaboration (IPC) plays a vital role in achieving integration and training an IPC-capable workforce in Sub-Saharan Africa (SSA) has become impera...
We sought to evaluate the impact of transitioning a multi-country HIV training program from in-person to online by comparing digital training approaches implemented during the pandemic with in-person approaches employed before COVID-19. We evaluated mean changes in pre-and post-course knowledge scores and self-reported confidence scores for learner...
Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported in many countries following early COVID-19 pandemic response measures (‘lockdowns’). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and...
Introduction
We sought to evaluate the impact of transitioning a multi-country HIV training program from in-person to online by comparing digital training approaches implemented during the pandemic with in-person approaches employed before COVID-19.
Methods
We evaluated mean changes in pre-and post-course knowledge scores and self-reported confiden...
Background
Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolesc...
Background. Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. Methods. We conducted a 6-countr...
BACKGROUND: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. METHODS: We conducted a 6-countr...
Background:
Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.
Methods:
We conducted a 6-cou...
Background
Pregnant adolescent girls and young women (AGYW, aged 12–24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region.
Methods
We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
Importance: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. / Objective: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. / Design, Setting,...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children and adolescents; and these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in impr...
Introduction
There is a need to scale-up mental health service provision in primary health care. The current extent of integration of mental health in primary care is pertinent to promoting and augmenting mental health at this level. We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify e...
Introduction:
The COVID-19 pandemic has forced a new look (or modernization) for both the obligations and approaches to achieve best-practices in global health learning. These best-practices have moved beyond traditional, face-to-face (F2F), classroom-based didactics to the use of innovative online, asynchronous and synchronous instructional desig...
Background: Limited data is available on the treatment outcomes of HIV infected adolescents and young adults (AYA) in sub-Saharan Africa. HIV-infected adolescents and young adults (AYA) are at high risk of developing antiretroviral treatment failure. Objective: To determine the clinical, immunological and virologic outcomes of AYA at a tertiary hos...
Background: In 2011, 3.4 million children were living with HIV worldwide1. Objectives: Describe the characteristics of pediatric patients enrolled into the HIV program at the Kibera community health center between January 2012 and March 2013. Determine the proportion of enrolled paediatric patients lost to follow up. Determine the correlates associ...
Background: Early Infant Male Circumcision (EIMC) is part of sustainable HIV prevention strategies in Kenya. The goals of the national EIMC program are to circumcise at least 40% of all newborn male infants delivered at hospitals offering the service and keep the rate of moderate and adverse events below 2%. Objectives: To determine the proportion...
Background:
Limited data is available on the treatment outcomes of HIV infected adolescents and young adults (AYA) in sub-Saharan Africa. HIV-infected adolescents and young adults (AYA) are at high risk of developing antiretroviral treatment failure.
Objective:
To determine the clinical, immunological and virologic outcomes of AYA at a tertiary...
Background:
In 2011, 3.4 million children were living with HIV worldwide1.
Objectives:
Describe the characteristics of pediatric patients enrolled into the HIV program at the Kibera community health center between January 2012 and March 2013. Determine the proportion of enrolled paediatric patients lost to follow up. Determine the correlates ass...
Background:
Early Infant Male Circumcision (EIMC) is part of sustainable HIV prevention strategies in Kenya. The goals of the national EIMC program are to circumcise at least 40% of all newborn male infants delivered at hospitals offering the service and keep the rate of moderate and adverse events below 2%.
Objectives:
To determine the proporti...
Background:
Adequate adherence to antiretroviral therapy (ART) is key to the successful treatment of children and adolescents living with HIV. Continuous ART Adherence is the key factor for virologic suppression and stability of the immune system and prevents the occurrence of opportunistic infections. Children and adolescents struggle with adhere...
Mother-to-child transmission (MTCT) of Hepatitis B virus (HBV) is responsible for more than one third of chronic HBV infections worldwide. Antiretroviral therapy (ART) naïve HBV/HIV co-infected mothers have a high tendency of transmitting the two viruses. This study aimed to determine prevalence & predisposing factors of HBV infections among HAART-...
Tuberculosis (TB) is the leading cause of mortality as a single infectious agent globally with increasing numbers of case notification in developing countries. This study seeks to investigate the clinical and socio-demographic factors of time to TB treatment interruption among Tuberculosis patients in Kiambu County, 2016–2019. We retrospectively an...
Introduction: We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify available service resources, cadres, and developmental partners as well as existing barriers and facilitators in the delivery of mental health services in general and specifically for peripartum adolescents in primary hea...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of SARS-CoV-2 infection among children and adolescents; however, these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifes...
Background
Delayed cord clamping (DCC) is a placental to new-born transfusion strategy recommended by obstetric and gynaecological societies. Though not widely adopted, umbilical cord milking (UCM) may achieve faster transfusion when DCC cannot be performed such as when a neonate requires resuscitation.
Methods
Pragmatic, two-arm, randomized clini...
Objective
To evaluate the association between obstetric and medical risk factors and stillbirths in a Kenyan set‐up.
Methods
A case‐control study was conducted in four hospitals between August 2018 and April 2019. Two hundred and fourteen women with stillbirths and 428 with live births at more than >28 weeks of gestation were enrolled. Data collec...
In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes.
Robust research is criti...
Abstract
Background
Addressing adolescent pregnancies associated health burden demands new ways of organizing maternal and child mental health services to meet multiple needs of this group. There is a need to strengthen integration of sustainable evidence-based mental health interventions in primary health care settings for pregnant adolescents. T...
Introduction: Africa bears the greatest burden of stillbirth and yet, there is a paucity of data from this setting. The aim of this study was to determine the association between quality of intrapartum care and fresh stillbirth in Nairobi, Kenya. Methods and materials: This was a case control study in 4 tertiary public hospitals in Nairobi county f...
Introduction:
About 2.6 million stillbirths per year occur globally with 98% occurring in low and middle income countries including Kenya where an estimated 35,000 stillbirths occur annually. Most studies have focused on the direct causes of stillbirth. The aim of this study was to determine the association between antenatal care utilization and q...
Background
The burden of stillbirth in Africa is high. The burden of stillbirth in Kenya is unknown, and very few studies have investigated the association between medical and obstetric risk factors and the occurrence of stillbirth in a Kenyan setting. The aim of this study was to evaluate the association between obstetric and medical risk factors...
Background:
Tuberculosis (TB) is the most common opportunistic infection and the leading cause of death in people living with HIV (PLHIV). HIV-infected children are at a higher risk of TB infection and disease compared to those without HIV. Isoniazid preventive therapy (IPT) is an effective intervention in preventing progression of latent TB infec...
Background: Peripartum adolescents remain underserved and poorly connected with health services in Kenya. Mental health interventions are not programmatically well-integrated within primary health care settings in Kenya. Task-sharing and task-shifting are well known strategies to address paucity of workforce and services needed in SSA. These strate...
Following the publication of the original article [1], the authors reported the following typesetting errors:
Background
Preterm birth occurs among 9.6% of births worldwide and is the leading cause of long-term neurodevelopmental disabilities among children and also responsible for 28% of neonatal deaths. No single etiological factor is responsible for preterm birth, but various risk factors have been identified. Prior studies have reported that compromise...
Human beings are in the midst of profound changes to their ecology. More than 50% of the global population now live in urban areas, and this demographic shift is reshaping the way that humans—along with the flora and fauna we interact with—live and die. Across eastern Africa, for instance, cities are now the major centres of livelihood opportunitie...
Background:
Examining skilled attendance throughout pregnancy, delivery and immediate postnatal period is proxy indicator on the progress towards reduction of maternal and neonatal mortality in developing countries.
Methods:
We conducted a cross-sectional baseline survey of households of mothers with at least 1 child under-5 years in 2012 within...
MEPI was a $130 million competitively awarded grant by President's Emergency Plan for AIDS Relief (PEPFAR) and National Institutes of Health (NIH) to 13 Medical Schools in 12 Sub-Saharan African countries and a Coordinating Centre (CC). Implementation was led by Principal investigators (PIs) from the grantee institutions supported by Health Resourc...
Background
Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed usi...
Mean emergency readiness loss by stage.
(TIFF)
Human resources at facilities.
(DOCX)
Retained placenta clinical cascade.
(TIF)
Facility accessibility and delivery volume.
(DOCX)
Durable goods at facilities.
(DOCX)
Hemorrhage clinical cascade.
(TIF)
Facility demographics.
(DOCX)
Consumable supplies at facilities.
(DOCX)
Expanded clinical cascades: Medical treatments.
(DOCX)
Expanded clinical cascades: Manual procedures.
(DOCX)
Strategic resources for multiple basic emergencies.
(DOCX)
Sepsis clinical cascade.
(TIF)
Availability of signal function tracer items by type.
(DOCX)
As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality...
Background: The University of Nairobi (UoN) College of Health Sciences (CHS)
established Partnership for Innovative Medical Education in Kenya (PRIME-K)
programme to enhance health outcomes in Kenya through extending the reach of
medical training outside Nairobi to help health sciences students enhance their handson
skills. The institution partnere...
Background:
Effective leadership is a cornerstone of successful healthcare delivery in resource limited settings throughout the world. However, few programs in Africa prepare healthcare professionals with the leadership skills vital to the success of the healthcare systems in which they work. One such program, the Afya Bora Consortium Fellowship i...
The purpose of this paper was to examine the development of pharmacy education in Kenya since independence. Websites of the Pharmacy and Poison Board of Kenya and the Commission for University Education as well as those of the universities offering pharmacy education were used to obtain information such as the framework for establishment of program...
HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship...