Browsing by Author "Opon, Shadrack Ochieng"

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    Contribution of Health Workers and Patient Characteristics on Adherence to Antenatal Clinic Appointments in Public Hospitals: A Case of Homabay and Kisumu County Referral Hospitals, Kenya
    (PAMJ - One Health, 2020-12-21) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    Introduction: missed appointments account for about 56% of wasted health resources in the world. There is about 42% missed appointment rate in African medical setting. Antenatal clinics in Kenya experience about 44% missed appointment rate accounting for about 22% of wasted health resources. About 1.7 million children born between 2013 and 2017 did not receive all prescribed vaccines. About 42% and 35% of antennal appointments in Homabay and Kisumu Counties were missed in 2019. The study assessed contribution of health workers and patient characteristics on adherence to antenatal clinic appointments in public hospitals. Methods: a crosssectional research design was employed in Homabay and Kisumu County hospitals. The study included 2 hospital managers per hospital, 70 and 63 antenatal clients in Homabay and Kisumu County hospitals respectively. Patients were stratified and proportionately sampled, while hospital managers were purposively sampled. Sample size was determined using Yamane Formula. Key informant interview and selfadministered structured questionnaire were used to collect data, and analysis done using SPSS tool. Results: findings showed, in Homabay and Kisumu County hospitals respectively, that: 50 (71.4%) and 20 (40%) missed appointments due to inadequate staff responsiveness towards their needs; 50 (71.4%) and 28 (56%) due to staff attitude. Single and separated antenatal clients miss more appointments compared to married and cohabiting clients. Conclusion: there is low adherence to appointments in antenatal clinics in Homabay and Kisumu County hospitals because of poor staff attitude, inadequate staff responsiveness; and lack of sufficient education on the importance of antenatal care among mothers
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    Influence of Organizational and Access Factors on Adherence to Appointments in Antenatal Clinics in Homa Bay and Kisumu County Referral Hospitals, Kenya
    (2021-08-21) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    Introduction: the world wastes about 40% of health resources, and African medical setting has about 42% missed appointment rate. Kenya has 44% missed appointment rate in antenatal clinics, wasting about 22% of health resources. Five hundred and two thousand eight hundred and sixty (502,860) children were not immunized in 2017. Homabay and Kisumu Counties with 91/1000 and 149/1000 under-five mortality rates, recorded 42% and 35% missed appointment rates in antenatal clinics respectively in 2019. This study assessed influence of organizational and access factors on adherence to appointments in antenatal clinics. Methods: the study adopted cross-sectional research design across two hospitals, purposively sampled (Homabay and Kisumu County Hospitals) because of high under-five mortality and high HIV prevalence rates. Stratified and proportionate sampling were used to sample patients, and purposive sampling for hospital managers. Yamane Formula was used to determine sample size. The study comprised 133 antenatal patients (Homabay County Hospital 70, Kisumu County Hospital 63) and two hospital managers per hospital. Self- administered structured questionnaire and key informant interview were used to collect data. Results: study revealed in Homabay and Kisumu County hospitals respectively, as follows: 55 (78.6%) and 35 (70%) antenatal clients missed their appointments because of waiting time; 55 (78.6%) and 30 (60%) due to facility operating hours; and 55 (78.6%) and 25 (50%) due to opportunity cost of seeking services; and 55 (78.6%) and 20 (40%) due to facility proximity. Conclusion: there is high missed appointment rates in antenatal clinics in Homabay and Kisumu County hospitals because of poor organization of antenatal services, opportunity cost and facility location.
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    Provision of Essential Health Package in Public Hospitals: A Case of Homabay County Hospitals, Kenya
    (Pan African Medical Journal, 2016-08-26) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja
    Introduction: Essential Health Packages (EHP) delivery is likely to strengthen service delivery. Healthcare utilization rate is 77% for the sick. 44% and 18% who don't seek care are hindered by cost and distance respectively. The overall child mortality rate in Kenya is 121/1000. In Homabay County, child mortality rate is 91/1000, and maternal mortality rate of 583/100000. The study looked into the provision of EHP in public hospitals in Homabay County. Methods: cross-sectional research design was used. Two hospitals were conveniently due to their municipality location. The study targeted 213 Health workers and 350 patients. Stratified sampling and proportionate sampling was used among different health workers. Sample size was determined by Yamane Formula. The study sampled 138 health workers and 186 patients. Questionnaire and key interview guide were used to collect data. Results: there are inadequate health workers based on 138 (100%) health workers. Insufficient drugs were reported by 138 (100%) health workers, and 120 (64.5%) patients. 115 (83.3%) health workers say ambulances are not operational. 26 (18.8%) health workers noted lack medical equipment, 138 (100%) are aware of patients referred elsewhere due to lack of medical equipment. 153 (82.3%) and 135 (72.6%) patients' health access is hindered by cost and distance respectively. 159 (85.5%) patients don't always find services needed. 159 (85.5%) patients affected by long waiting time. Conclusion: low service provision/utilization rate in Homabay County results from lack of health workers, inadequate drugs, poor health infrastructure, and lack of access in terms of affordability, availability and distance.
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    The Effect of Patient Reminders in Reducing Missed Appointment in Medical Settings: A Systematic Review
    (PAMJ - One Health, 2020-06-05) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    Missed appointments are a problem to healthcare professionals worldwide. There is up to nearly 42% missed appointment rate in medical setting globally. Reducing missed appointment rates improves the efficiency of health services and health outcomes of patients. Missed appointment rates can be reduced by reminding patients about their medical appointments in advance. A simple way of doing this is via electronic notification to the patients´ phones. The aim of this paper is to review the effect of patient reminders in reducing missed appointment rates. The methodology was conducted based on the PRISMA guidelines for systematic reviews. Literature search was conducted extensively using Google Scholar and PubMed databases based on terms such as cell phone reminders, electronic notification reminders, missed appointment rates, clinic attendance and SMS reminders. Geographical and publication biases were assessed. The result of the review showed that 95% studies reviewed reported a positive effect of patient reminders on appointment rates, with an average of 41% reduction in missed appointment rates and 34% increase in clinic attendance rates in all the studies. The review revealed that patient reminders reduce missed appointment rates and improve clinic attendance rates. Multiple reminders produce better outcomes. Reducing missed appointment rates also improve the efficiency of health care facilities.