Estimating the economic impact of gender-based violence on women survivors: A comparative study of support program interventions in Makueni and Naivasha, Kenya.

OBJECTIVE: To estimate the economic cost of GBV from the perspective of a women survivor who sought help from two identified programs (Makueni GBVRC and Life Bloom Services International [LBSI]). DESIGN: A mixed method research design combining qualitative and quantitative approaches. SITE: Makueni GBVRC in Makueni County, overseen by the Makueni County government, and LBSI in Naivasha, Nakuru County, a non-profit organization devoted to serving local communities. PARTICIPANTS: Study participants include women survivors of GBV, aged 18 and above, actively seeking services at Makueni GBVRC and LBSI. INTERVENTIONS: The study adopts a qualitative approach to delve into the intricate economic costs of GBV on survivors. Additionally, quantitative data analysis employs an accounting model to ascertain the financial implications. MAIN MEASUREMENTS: The costs analyses were done from the perspective of the women survivors. An accounting model was utilized to evaluate the cost of GBV on selected survivors. Furthermore, the research explores the enduring consequences for survivors, including psychological trauma and susceptibility to stress-related diseases. RESULTS: The findings reveal substantial economic costs linked to GBV, adversely affecting survivors, their children, and society at large. These costs encompass direct expenditures on medical care, legal representation, and counseling, as well as indirect costs, such as lost productivity. CONCLUSIONS: Beyond immediate and indirect costs, the study underscores the existence of opportunity costs-what survivors and affected children could attain in the absence of GBV.

Assessment of neonatal resuscitation skills among healthcare workers in Uasin Gishu County, Kenya.

Objective: Neonatal resuscitation is key in preventing neonatal mortality. The objective of this study was to assess the competence of healthcare workers in basic neonatal resuscitation at six hospitals in Uasin Gishu County in Kenya. Methods: This was a cross-sectional study of healthcare workers based on the labor and delivery wards. Results: Of the 46 healthcare workers who were assessed with a written examination and skills assessment, 85% were nurses. While 46% were able to pass the written examination, none demonstrated all required steps of newborn resuscitation during the skills assessment by simulation. No significant associations were present between the pass rate of the written examination and years of experience, role, or prior in-service training. All of the hospitals had the basic equipment required for neonatal resuscitation. Conclusion: There is a need to further develop the neonatal resuscitation skills among healthcare workers in the labor and delivery wards in Uasin Gishu County, Kenya.

Unmet need for primary healthcare and associated individual and household-level factors in Kenya: results from a national survey.

OBJECTIVE: To determine the prevalence of unmet need for primary healthcare and associated individual and household-level factors in Kenya. DESIGN: The data for this study are drawn from the 2016 Kenya Integrated Household Budget Survey (KIHBS). A multistage sampling technique involving a systematic selection of clusters at the national level and final selection of households was used. SETTING: This study was conducted in Kenya. The KIHBS is a nationally representative survey on a wide range of indicators to assess the progress made in improving the living standards of the population at the national level. PARTICIPANTS: A total of 9447 households comprising 15 539 household members who reported a sickness or injury over the 4 weeks preceding this survey were included in this study. The study respondents comprised of the household heads. PRIMARY OUTCOME MEASURE: The primary outcome of this study is unmet need for primary healthcare defined as an unexpressed demand for primary healthcare following a reported sickness or injury over the 4 weeks preceding this survey. RESULTS: About one in every five study participants experienced an unexpressed demand for primary care. The odds of having unmet need for primary healthcare were 68% higher among participants without health insurance coverage compared with those with health insurance (adjusted OR 1.68; p<0.001; 95% CI 1.34 to 2.09) and 45% higher among households headed by single or unmarried persons compared with the those who were in a marital union (adjusted OR 1.45; p<0.05; 95% CI 1.06 to 1.98). CONCLUSIONS: Our findings show that there is still a considerable unexpressed demand for primary care services despite widespread implementation of Universal Health Coverage (UHC) in Kenya, with households without a health insurance cover bearing the highest burden. Therefore, the design of UHC reforms in Kenya should focus on embedding social health protection to escalate the demand for primary healthcare services.