A5051779530- Global Maternal and Child Health
- Healthcare Systems and Reforms
- Health Policy Implementation Science
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Child Nutrition and Water Access
- Global Health Care Issues
- Family and Patient Care in Intensive Care Units
- Interprofessional Education and Collaboration
- Global Health Workforce Issues
- Community Health and Development
- Healthcare Quality and Management
- ICT in Developing Communities
- Emergency and Acute Care Studies
- Tuberculosis Research and Epidemiology
- COVID-19 epidemiological studies
- Evaluation and Performance Assessment
- Health Systems, Economic Evaluations, Quality of Life
- Mobile Health and mHealth Applications
- Breastfeeding Practices and Influences
- Nursing education and management
- Geriatric Care and Nursing Homes
- Global Public Health Policies and Epidemiology
- Pharmaceutical Practices and Patient Outcomes
- Healthcare Systems and Challenges
Kenya Medical Research Institute
2013-2025
Wellcome Trust
2009-2025
Liverpool School of Tropical Medicine
2024-2025
Pwani University
2025
University of Oxford
2020-2023
Amsterdam Institute for Global Health and Development
2020
University of Nairobi
2020
University of Amsterdam
2020
Vrije Universiteit Amsterdam
2020
The University of Melbourne
2020
While health worker strikes are experienced globally, the effects can be worst in countries with infrastructural and resource challenges, weak institutional arrangements, underdeveloped organizational ethics codes, unaffordable alternative options for poor. In Kenya, there have been a series of public post devolution period. We explored perceptions experiences frontline managers community members 2017 prolonged workers' strikes.We employed an embedded research approach one county Kenyan...
Abstract Health systems are faced with a wide variety of challenges. As complex adaptive systems, they respond differently and sometimes in unexpected ways to these We set out examine the challenges experienced by health system at sub-national level Kenya, country that has recently undergone rapid devolution, using an ‘everyday resilience’ lens. focussed on chronic stressors, rather than acute shocks examining responses organizational capacities underpinning those responses, view...
Abstract Background Maternal and neonatal outcomes in, Kakamega County is characterized by a maternal mortality rate of 316 per 100,000 live births 19 1,000 births. In 2018, approximately 70,000 occurred in the county, with 35% at home, 28% primary care facilities, 37% hospitals. A child health service delivery redesign (SDR) that aims to reorganize newborn services being implemented Kenya improve progress these indicators. Research has shown women’s ability make decisions (voice, agency,...
Although considerable efforts are directed at developing international guidelines to improve clinical management in low-income settings they appear influence practice rarely. This study aimed explore barriers guideline implementation the early phase of an intervention four district hospitals Kenya.We developed a simple interview guide based on characterisation informed by review major theories uptake guidelines. In-depth interviews, non-participatory observation, and informal discussions...
We have reported the results of a cluster randomized trial rural Kenyan hospitals evaluating effects an intervention to introduce care based on best-practice guidelines. In parallel work we described context study, explored process and perceptions intervention, undertook discrete study health worker motivation because this was felt likely be important contributor poor performance in public sector hospitals. Here, use data from these multiple studies insights gained being participants...
Clinical leadership is recognized as a crucial element in health system strengthening and policy globally yet it has received relatively little attention low middle income countries (LMICs). Moreover, analyses of clinical tend to focus on senior-level individual leaders, overlooking wider constellation middle-level leaders delivering care practice way affected by their context. Using the theoretical lens 'distributed leadership', this article examines how practised context Kenyan county...
Kenyan neonatal nurses are asked to do the impossible: bridge gap between international standards of nursing and circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few given pressing need. Despite these conditions, a single nurse can be tasked looking after forty sick babies for whom very close care is necessity. Our 18-month ethnography explores this uniquely stressful environment order understand how operate under such...
Nursing practice is a key driver of quality care and can influence newborn health outcomes where nurses are the primary givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments characterized by heavy workloads, insufficient staffing regular medical emergencies, which compromise ability provide care. Task shifting has been promoted as one strategy for making efficient use human resources addressing these issues. We aimed understand nature neonatal...
Lucy Gilson and colleagues draw on experiences from Kenya South Africa to consider the practice, benefits, challenges of research co-production for strengthening health systems
People should be at the center of health system performance assessment.Populations can provide critical insight on quality care, confidence in services, and outcomes.• However, today's measurement approaches overlook key dimensions population perspective such as system.Surveys are rarely standardized to enable cross-country comparison.
Abstract Effective management and leadership are essential for everyday health system resilience, but actors charged with these roles often underprepared undersupported to perform them. Particular challenges have been observed in interpersonal relational aspects of managers’ work, including communication skills, emotional competence supportive oversight. Within the Resilient Responsive Health Systems (RESYST) consortium Kenya, we worked two county hospital teams adapt a package development...
Despite major efforts to achieve universal health coverage (UHC), progress has lagged in many African and Asian countries. A key strategy pursued by countries is the use of insurance increase access affordability. However, evidence on association between UHC mixed. We analysed nationally representative cross-sectional data collected 2022 2023 Ethiopia, Kenya, South Africa, India, Laos. described public private sociodemographic factors used logistic regression examine associations status...
Primary health care (PHC) is central to attainment of the Sustainable Development Goals, yet comparable cross-country data on key aspects primary have not been widely available. This study analysed from People's Voice Survey, which was conducted in 2022 and 2023 14 countries. We documented usual source across countries examined associations with core PHC services, quality ratings, system confidence. found that 75% respondents had a care, 40% accessed public sector at level. 44% rated their...
Purpose The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid managerial roles complex healthcare settings affected by professional, practical norms. Design/methodology/approach authors conducted a case study two district hospitals, involving repeated interviews with eight mid-level complemented 51 frontline workers 6 senior managers, 480 h ethnographic field observations. analysed theorised data combining inductive...
Purpose The purpose of this paper is to provide a situational overview the facility-based maternal and perinatal morbidity mortality audits (MPMMAs) in SSA, their current efficacy at reducing rates related childbirth. Design/methodology/approach This scoping literature review based on synthesis secondary literature. Findings Not all countries SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, done national scale, there no clear best practice for...
How health facilities are managed determines their performance and service delivery. Management capacity of comprises the competency managers at individual level management support work environment in institutions. Evidence shows this influences delivery facility. For LMICs, there evidence gaps as existing is scarce, varied assessment PHC report a measurement gap due to scarcity tools contextualised LMIC setting. Our review aims address these by mapping summarising literature on its...
Fixed-dose combinations (FDCs) – 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly sub–Saharan Africa, where is major cause of disease burden poorly controlled. This study explored acceptability FDCs among patients, caregivers, healthcare workers. We conducted semi-structured in-depth interviews with 58 participants from...
Abstract Introduction Risk stratification of pregnancies informs clinical care globally. Yet recent research has cast doubt on the ability currently used population‐level risk measures to accurately predict poor outcomes at individual level. We examine assumption that existing forms can successfully identify women likely develop complications during delivery in a rural setting Kenya. Methods conducted prospective observational study 19,653 pregnant Kakamega County Western Women were...
<title>Abstract</title> <bold>Background</bold>: Kenya has identified Primary Health Care Networks (PCNs) as a key reform to strengthen (PHC) delivery. It enacted the Act of 2023 facilitate their implementation. PCNs were piloted in Kisumu and Garissa counties 2020 rolled out nationally 2023. This study examined implementation experience PCN Kenya. <bold>Methods</bold>: We used cross-sectional qualitative process evaluation design. collected data at national level five purposefully selected...