Search results for: S. B. Otieno
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17

Search results for: S. B. Otieno

17 Health Hazards of Performance Enhancing Drugs

Authors: Austin Oduor Otieno

Abstract:

There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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16 Projected Uncertainties in Herbaceous Production Result from Unpredictable Rainfall Pattern and Livestock Grazing in a Humid Tropical Savanna Ecosystem

Authors: Daniel Osieko Okach, Joseph Otieno Ondier, Gerhard Rambold, John Tenhunen, Bernd Huwe, Dennis Otieno

Abstract:

Increased human activities such as grazing, logging, and agriculture alongside unpredictable rainfall patterns have been detrimental to the ecosystem service delivery, therefore compromising its productivity potential. This study aimed at simulating the impact of drought (50%) and enhanced rainfall (150%) on the future herbaceous CO2 uptake, biomass production and soil C:N dynamics in a humid savanna ecosystem influenced by livestock grazing. Rainfall pattern was predicted using manipulation experiments set up to reduce (50%) and increase (150%) ambient (100%) rainfall amounts in grazed and non-grazed plots. The impact of manipulated rainfall regime on herbaceous CO2 fluxes, biomass production and soil C:N dynamics was measured against volumetric soil water content (VWC) logged every 30 minutes using the 5TE (Decagon Devices Inc., Washington, USA) soil moisture sensors installed (at 20 cm soil depth) in every plots. Herbaceous biomass was estimated using destructive method augmented by standardized photographic imaging. CO2 fluxes were measured using the ecosystem chamber method and the gas analysed using LI-820 gas analyzer (USA). C:N ratio was calculated from the soil carbon and Nitrogen contents (analyzed using EA2400CHNS/O and EA2410 N elemental analyzers respectively) of different plots under study. The patterning of VWC was directly influenced by the rainfall amount with lower VWC observed in the grazed compared to the non-grazed plots. Rainfall variability, grazing and their interaction significantly affected changes in VWC (p < 0.05) and subsequently total biomass and CO2 fluxes. VWC had a strong influence on CO2 fluxes under 50% rainfall reduction in the grazed (r2 = 0.91; p < 0.05) and ambient rainfall in the ungrazed (r2 = 0.77; p < 0.05). The dependence of biomass on VWC across plots was enhanced under grazed (r2 = 0.78 - 0.87; p < 0.05) condition as compared to ungrazed (r2 = 0.44 - 0.85; p < 0.05). The C:N ratio was however not correlated to VWC across plots. This study provides insight on how the predicted trends in humid savanna will respond to changes influenced by rainfall variability and livestock grazing and consequently the sustainable management of such ecosystems.

Keywords: CO2 fluxes, rainfall manipulation, soil properties, sustainability

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15 Optimizing Inanda Dam Using Water Resources Models

Authors: O. I. Nkwonta, B. Dzwairo, J. Adeyemo, A. Jaiyola, N. Sawyerr, F. Otieno

Abstract:

The effective management of water resources is of great importance to ensure the supply of water resources to support changing water requirements over a selected planning horizon and in a sustainable and cost-effective way. Essentially, the purpose of the water resources planning process is to balance the available water resources in a system with the water requirements and losses to which the system is subjected. In such situations, Water resources yield and planning model can be used to solve those difficulties. It has an advantage over other models by managing model runs, developing a representative system network, modelling incremental sub-catchments, creating a variety of standard system features, special modelling features, and run result output options.

Keywords: complex, water resources, planning, cost effective and management

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14 Optimising the Reservoir Operation Using Water Resources Yield and Planning Model at Inanda Dam, uMngeni Basin

Authors: O. Nkwonta, B. Dzwairo, F. Otieno, J. Adeyemo

Abstract:

The effective management of water resources is of great importance to ensure the supply of water resources to support changing water requirements over a selected planning horizon and in a sustainable and cost-effective way. Essentially, the purpose of the water resources planning process is to balance the available water resources in a system with the water requirements and losses to which the system is subjected. In such situations, water resources yield and planning model can be used to solve those difficulties. It has an advantage over other models by managing model runs, developing a representative system network, modelling incremental sub-catchments, creating a variety of standard system features, special modelling features, and run result output options.

Keywords: complex, water resources, planning, cost effective, management

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13 Modelling Public Knowledge and Attitude towards Genetically Modified Maize in Kenya

Authors: Ezrah Kipkirui Tonui, George Otieno Orwa

Abstract:

A survey of 138 farmers was conducted in Rift valley, Kenya, in November and December 2013 in three counties (Uasin-gishu, Elgeyo-marakwet, and Tranzoia) to determine public knowledge and attitude towards genetically modified (GM) maize. Above two third (70%) of the respondents had knowledge of GM maize, mostly those educated and male. Female was found to be having low knowledge on GM maize. Public acknowledged the technology’s potential positive impacts, with more than 90% willing to adopt and more than 98% willing to buy GM seedlings at any given price. A small percentage less than 3% were of a negative opinion about willing to buy and adopt GM seeds. We conclude that GM technology has a role to play in food security in Kenya. However, the public needs more information about the technology, which can be provided through established sources of information and training. Finally, public knowledge and attitude on GM maize should be studied on a regular basis, and the survey population broadened to 47 counties.

Keywords: public, knowledge, attitudes, GM maize, Kenya

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12 Fertility Transition in Sub-Saharan Africa: The Role Family Planning Programs

Authors: Vincent Otieno, Alfred Agwanda, Anne Khasakhala

Abstract:

Among the neo-Malthusian adherents, it is believed that rapid population growth strain countries’ capacity and performance. Fertility have however decelerated in most of the countries in the recent past. Scholars have concentrated on wide range of factors associated with fertility majorly at the national scale with some opining that analysis of trends and differentials in the various fertility parameters have been discussed extensively. However, others believe that considerably less attention has been paid to the fertility preference- a pathway through which various variables act on fertility. The Sub-Saharan African countries’ disparities amid almost similarities in policies is a cause of concern to demographers. One would point at the meager synergies that have been focused on the fertility preference as well, especially at the macro scale. Using Bongaarts reformulation of Easterlin and Crimmins (1985) conceptual scheme, the understanding of the current transition based on the fertility preference in general would help to provide explanations to the observed latest dynamics. This study therefore is an attempt to explain the current fertility transition through women’s fertility preference. Results reveal that indeed fertility transition is on course in most of the sub-Saharan countries with huge disparities in fertility preferences and its implementation indices.

Keywords: fertility preference, the degree of implementation index, sub-Saharan Africa, transition

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11 Assessment of Drainage Water Quality in South Africa: Case Study of Vaal-Harts Irrigation Scheme

Authors: Josiah A. Adeyemo, Fred A. O. Otieno, Olumuyiwa I. Ojo

Abstract:

South Africa is water-stressed being a semi-arid country with limited annual rainfall supply and a lack of perennial streams. The future implications of population growth combined with the uncertainty of climate change are likely to have significant financial, human and ecological impacts on already scarce water resources. The waste water from the drainage canals of the Vaal-Harts irrigation scheme (VHS) located in Jan Kempdorp, a farming community in South Africa, were investigated for possible irrigation re-use and their effects on the immediate environment. Three major drains within the scheme were identified and sampled. Drainage water samples were analysed to determine its characteristics. The water samples analyzed had pH values in the range of 5.5 and 6.4 which is below the normal range for irrigation water and very low to moderate salinity (electrical conductivity 0.09-0.82 dS/m). The adjusted sodium adsorption ratio values in all the samples were also very low (<0.2), indicating very low sodicity hazards. The nitrate concentration in most of the samples was high, ranging from 4.8 to 53 mg/l. The reuse of the drainage water for irrigation is possible, but with further treatment. Some suggestions were offered in the safe management of drainage water in VHS.

Keywords: drainage canal, water quality, irrigation, pollutants, environment

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10 Reimagining the Potential of Street Lighting Infrastructure in Nairobi City

Authors: Clifford Otieno Ochieng, Nsenda Lukumwena

Abstract:

Cities worldwide and most notably those in the global south, including Nairobi City are experiencing accelerated population growth and urban sprawl, accompanied with multiple socioeconomic challenges’ which in turn increase the pressure on already limited infrastructure such as public lighting and on limited financial resources. Based on this premise, through reimaging the value of street lighting infrastructure, the study attempts to highlight the affordance and affordability of streetlights and suggests them as a tool to optimally address limited financial resources that characterize cities in the global south. As a methodology, the paper reviews and analyzes literature available online including Nairobi city budgets; reports from Kenya Power, World Health Organization and United Nations; and articles on enterprise level Internet of Things (IoT) solutions. In conclusion, this study illustrates that streetlights can go well beyond their traditional roles of illuminating cities at night. They can be as suggested in this paper charging stations, communication network terminals and disease prevention nodes.

Keywords: affordance, Nairobi, developing economies, IoT, smart street lights, smart cities

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9 Admission Control Policy for Remanufacturing Activities with Quality Variation of Returns

Authors: Sajjad Farahani, Wilkistar Otieno, Xiaohang Yue

Abstract:

This paper develops a model for the optimal disposition decision for product returns in a remanufacturing system with limited recoverable inventory capacity. In this model, a constant demand is satisfied by remanufacturing returned products which are up to the minimum required quality grade. The quality grade of returned products is uncertain and remanufacturing cost increases as the quality level decreases, and remanufacturer wishes to determine which returned product to accept to be remanufactured for reselling, and any unaccepted returns may be salvaged at a value that increases with their quality level. Accepted returns can be stocked for remanufacturing upon demand requests, but incur a holding cost. A Markov decision problem is formulated in order to evaluate various performance measures for this system and obtain the optimal remanufacturing policy. A detailed numerical study reveals that our approach to the disposition problem outperforms the current industrial practice ignoring quality grade of returned products. In addition, we identify conditions under which this improvement is the highest.

Keywords: green supply chain management, matrix geometric method, production recovery, reverse supply chains

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8 Impact of HIV/AIDS on Food Security in Pala Sub-Location, Bondo District, Kenya

Authors: S. B. Otieno, Were Fred, E. W. Kabiru, K. Waza

Abstract:

Background: HIV/AIDS is leading to the loss of labor through sickness and subsequent death, this is leading to the neglect of farm and off-farm activities, with the subsequent loss of potential income and food security. The situation is sensitive to seasonal labour peaks in agriculture. This study was done to determine the impact of high HIV prevalence in farming systems and food security in Pala Bondo District, Kenya. Methods: In this study, 386 respondents were randomly chosen in Pala Sub-Location. The respondents and key informants were interviewed using structured questionnaire. The data were entered and analyzed using SPSS version 16. Results: It was established that majority of respondents (67%) were between 18 and 35 years {χ2 = (1, N = 386) = 13.430, p = 0.000} (chimney effect). The study also established that 83.5% of respondents were married {χ2 = (1, N= 370) = 166.277 p = 0.000} and predominant occupation being farming and fishing (61%), while 52.8% of farm labour was by hand, 26% by oxen, and 4.9% mechanized. 73.2% of respondents only farm 0.25 to 2 acres, 48% mentioned lack of labour in land preparation {χ2 ((1,N = 321) = 113.146, p = 0.000), in planting {χ2 (1, N = 321) = 29.28, p = 0.000}. Majority of respondents lack food from January to June, during which 93% buy food. Conclusion: The high HIV prevalence in Pala has affected the farm labour leading to food insecurity.

Keywords: food security, HIV, AIDS, labour

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7 Nutrients Removal from Industrial Wastewater Using Constructed Wetland System

Authors: Christine Odinga, Fred Otieno, Josiah Adeyemo

Abstract:

A study was done to establish the effectiveness of wetland plants: Echinocloa pyramidalis (L) and Cyperus papyrus (L) in purifying wastewater from sugar factory stabilization pond effluent. A pilot-scale Free Water Surface Wetland (FWSCW) system was constructed in Chemelil sugar factory, Kenya for the study. The wetland was divided into 8 sections (cells) and planted with C. papyrus and E. pyramidalis in alternating sequence. Water samples and plant specimen were taken fortnightly at inlets and outlets of the cells and analysed for total phosphates and total nitrates. The data was analysed by use of Microsoft excel and SPSS computer packages. Water analysis recorded a reduction in the nutrient levels between the inlet pond nine and the final outlet channel to River Nyando. The plants grown in the wetland experienced varied increases and reductions in the level of total foliar nitrogen and phosphorous, indicating that though the nutrients were being removed from the wetland, the same were not those assimilated by the plants either. The control plants had higher folia phosphorous and nitrogen, an indication that the system of the constructed wetland was able to eliminate the nutrients effectively from the plants.

Keywords: wetlands, constructed, plants, nutrients, wastewater, industrial

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6 The Effects of Soil Chemical Characteristics on Accumulation of Native Selenium by Zea mays Grains in Maize Belt in Kenya

Authors: S. B. Otieno, T. S. Jayne, M. Muyanga

Abstract:

Selenium which is an-antioxidant is important for human health enters food chain through crops. In Kenya Zea mays is consumed by 96% of population hence is a cheap and convenient method to provide selenium to large number of population. Several soil factors are known to have antagonistic effects on selenium speciation hence the uptake by Zea mays. No investigation in Kenya has been done to determine the effects of soil characteristics (pH, Tcarbon, CEC, Eh) affect accumulation of selenium in Zea mays grains in Maize Belt in Kenya. About 100 Zea mays grain samples together with 100 soil samples were collected from the study site, put in separate labeled Ziplocs and were transported to laboratories at room temperature for analysis. Maize grains were analyzed for selenium while soil samples were analyzed for pH, Cat Ion Exchange Capacity, total carbon, and electrical conductivity. The mean selenium in Zea mays grains varied from 1.82 ± 0.76 mg/Kg to 11±0.86 mg/Kg. There was no significant difference between selenium levels between different grain batches {χ (Df =76) = 26.04 P= 1.00} The pH levels varied from 5.43± 0.58 to 5.85± 0.32. No significant correlations between selenium in grains and soil pH (Pearson’s correlations = - 0.143), and between selenium levels in grains and the four (pH,Tcarbon,CEC,Eh) soil chemical characteristics {F (4,91) = 0.721 p = 0.579} was observed.It can be concluded that the soil chemical characteristics in the study site did not significantly affect the accumulation of native selenium in Zea mays grains.

Keywords: maize, native, soil, selenium

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5 Environmental Impact Assessment of OMI Irrigation Scheme, Nigeria

Authors: Olumuyiwa I. Ojo, Kola Amao, Josiah A. Adeyemo, Fred A. O. Otieno

Abstract:

A study was carried out to assess the environmental impact of Kampe (Omi) irrigation scheme with respect to public health hazards, the rising water table, salinity and alkalinity problems on the project site. A structured questionnaire was used as the main tool to gather information on the effect of the irrigation project on the various communities around the project site. The different sections of the questionnaire enabled the gathering of information ranging from general to more specific information. The results obtained from the study showed that the two effects are obvious: the 'positive effects' which include increasing the socioeconomic development of the entire communities, resulting in an increase in employment opportunities and better lifestyle and the 'negative effects' in which malaria (100% occurrence) and schistosomiasis (66.7%) were found to be active diseases caused by irrigation activities. Increase in height of water table and salinity is eminent in the irrigation site unless adequate drainage is provided. The collection and experimental analyses of representation soil and water samples from each scheme were used to assess the current status of each receptor. Results obtained indicate the absence of soil with sodium adsorption ration (SAR) values ranging from 3.0 to 3.89, exchangeable sodium percentage (ESP) ranged from 3.8% to 5.5% while pH values ranged from 6.60 to 7.00. Drainage facilities of the project site are inadequate, therefore making it difficult to leach the soil and flood history is occasional.

Keywords: irrigation, impact, soil analysis, Nigeria

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4 Determinants of Selenium Intake in a High HIV Prevalence Fishing Community in Bondo District, Kenya

Authors: Samwel Boaz Otieno, Fred Were, Ephantus Kabiru, Kaunda Waza

Abstract:

A study was done to establish determinants of selenium intake in a high HIV prevalence fishing community in the Pala Bondo district, Kenya. It was established that most of the respondents (61%) were small holder Farmers and Fishermen {χ2 (1, N=386) p<0.000}, and that most of them (91.2%) had up to college level education {χ2.(1, N=386) p<0.000}, while the number of males and females were not significantly different {χ (1, N=386) p=0.263} and 83.5% of respondents were married {χ2 (1, N=386) p=0.000}. The study showed that adults take on average 2.68 meals a day (N=382, SD=0.603), while children take 3.02 meals (N=386, SD=1.031) a day, and that in most households (82.6%) food is prepared by the women {χ2 (1, N=386) p=0.000} and further that 50% of foods eaten in that community are purchased {χ2 (1, N=386)=0.1818, p=0.6698}. The foods eaten by 75.2% of the respondents were Oreochromis niloticus, Lates niloticus, and Sorghum bicolour, 64.1% vegetables and that both children and adults eat same types of food, and further that traditional foods which have become extinct are mainly vegetables (46%). The study established that selenium levels in foods eaten in Pala sub-locations varies with traditional vegetables having higher levels of selenium; for example, Laurnea cornuta (148.5 mg/kg), Cleome gynandra (121.5 mg/kg), Vignia ungulata (21.97 mg/kg), while Rastrineobola argentea (51 mg/kg), Lates niloticus (0), Oreochromis niloticus (0) Sorgum bicolour (19.97 mg/kg), and Sorgum bicolour (0). The study showed that there is an inverse relationship between foods eaten and selenium levels {RR=1.21, p=0.000}, with foods eaten by 75.2% of respondents (Oreochromis niloticus/Lates niloticus) having no detectable selenium. The four soil types identified in the study area had varying selenium levels with pleat loam (13.3 mg/kg), sandy loam (10.7 mg/kg), clay (2.8 mg/kg) and loam (4.8 mg/kg). It was concluded from this study that for the foods eaten by most of the respondents the selenium levels were below Daily Reference Intake.

Keywords: determinants, HIV, food, fishing, Selenium

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3 Removal of Heavy Metals from Municipal Wastewater Using Constructed Rhizofiltration System

Authors: Christine A. Odinga, G. Sanjay, M. Mathew, S. Gupta, F. M. Swalaha, F. A. O. Otieno, F. Bux

Abstract:

Wastewater discharged from municipal treatment plants contain an amalgamation of trace metals. The presence of metal pollutants in wastewater poses a huge challenge to the choice and applications of the preferred treatment method. Conventional treatment methods are inefficient in the removal of trace metals due to their design approach. This study evaluated the treatment performance of a constructed rhizofiltration system in the removal of heavy metals from municipal wastewater. The study was conducted at an eThekwni municipal wastewater treatment plant in Kingsburgh - Durban in the province of KwaZulu-Natal. The construction details of the pilot-scale rhizofiltration unit included three different layers of substrate consisting of medium stones, coarse gravel and fine sand. The system had one section planted with Phragmites australis L. and Kyllinga nemoralis L. while the other section was unplanted and acted as the control. Influent, effluent and sediment from the system were sampled and assessed for the presence of and removal of selected trace heavy metals using standard methods. Efficiency of metals removal was established by gauging the transfer of metals into leaves, roots and stem of the plants by calculations based on standard statistical packages. The Langmuir model was used to assess the heavy metal adsorption mechanisms of the plants. Heavy metals were accumulated in the entire rhizofiltration system at varying percentages of 96.69% on planted and 48.98% on control side for cadmium. Chromium was 81% and 24%, Copper was 23.4% and 1.1%, Nickel was 72% and 46.5, Lead was 63% and 31%, while Zinc was 76% and 84% on the on the water and sediment of the planted and control sides of the rhizofilter respectively. The decrease in metal adsorption efficiencies on the planted side followed the pattern of Cd>Cr>Zn>Ni>Pb>Cu and Ni>Cd>Pb>Cr>Cu>Zn on the control side. Confirmatory analysis using Electron Scanning Microscopy revealed that higher amounts of metals was deposited in the root system with values ranging from 0.015mg/kg (Cr), 0.250 (Cu), 0.030 (Pb) for P. australis, and 0.055mg/kg (Cr), 0.470mg/kg (Cu) and 0.210mg/kg,(Pb) for K. nemoralis respectively. The system was found to be efficient in removing and reducing metals from wastewater and further research is necessary to establish the immediate mechanisms that the plants display in order to achieve these reductions.

Keywords: wastewater treatment, Phragmites australis L., Kyllinga nemoralis L., heavy metals, pathogens, rhizofiltration

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2 Farmers Willingness to Pay for Irrigated Maize Production in Rural Kenya

Authors: Dennis Otieno, Lilian Kirimi Nicholas Odhiambo, Hillary Bii

Abstract:

Kenya is considered to be a middle level income country and usuaaly does not meet household food security needs especially in North and South eastern parts. Approximately half of the population is living under the poverty line (www, CIA 1, 2012). Agriculture is the largest sector in the country, employing 80% of the population. These are thereby directly dependent on the sufficiency of outputs received. This makes efficient, easy-accessible and cheap agricultural practices an important matter in order to improve food security. Maize is the prime staple food commodity in Kenya and represents a substantial share of people’s nutritional intake. This study is the result of questionnaire based interviews, Key informant and focus group discussion involving 220 small scale maize farmers Kenyan. The study was located to two separated areas; Lower Kuja, Bunyala, Nandi, Lower Nzoia, Perkerra, Mwea Bura, Hola and Galana Kulalu in Kenya. The questionnaire captured the farmers’ use and perceived importance of the use irrigation services and irrigated maize production. Viability was evaluated using the four indices which were all positive with NPV giving positive cash flows in less than 21 years at most for one season output. The mean willingness to pay was found to be KES 3082 and willingness to pay increased with increase in irrigation premiums. The economic value of water was found to be greater than the willingness to pay implying that irrigated maize production is sustainable. Farmers stated that viability was influenced by high output levels, good produce quality, crop of choice, availability of sufficient water and enforcement the last two factors had a positive influence while the other had negative effect on the viability of irrigated maize. A regression was made over the correlation between the willingness to pay for irrigated maize production using scheme and plot level factors. Farmers that already use other inputs such as animal manure, hired labor and chemical fertilizer should also have a demand for improved seeds according to Liebig's law of minimum and expansion path theory. The regression showed that premiums, and high yields have a positive effect on willingness to pay while produce quality, efficient fertilizer use, and crop season have a negative effect.

Keywords: maize, food security, profits, sustainability, willingness to pay

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1 Advancing Dialysis Care Access And Health Information Management: A Blueprint For Nairobi Hospital

Authors: Kimberly Winnie Achieng Otieno

Abstract:

Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care and managing health information efficiently. This paper explores strategic interventions to enhance dialysis care, access and streamline health information management, fostering an integrated and patient-centered healthcare system. Challenges at Nairobi Hospital: The Nairobi Hospital currently grapples with insufficient dialysis machines, resulting in extended turn around time in between dialysis sessions for patients. This issue stems from both staffing bottle necks and infrastructural limitations given our growing demand for renal care services. Paper-based records and fragmented information systems hinder the hospital’s ability to manage health data effectively. A lack of hospital systems integration with other facilities jeopardizes patient care access by posing challenges. These inefficiencies hinder collaborative efforts within the healthcare network. An investment in the expanding Nairobi Hospital dialysis facilities to communities is crucial with the high number of new cases of patients with chronic kidney disease. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access. This includes acquiring physical space within the greater Nairobi region, and the incorporation of mobile dialysis units to reach underserved areas. By decentralizing services, Nairobi Hospital can extend its reach and cater to a larger patient population. Community Outreach and Education: Implementing educational programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. it can amplify this effort by expanding Nairobi Hospital’s corporate social responsibility outreach program. Increasing the hospital’s footprint would also require an equal ramp up of staff recruitment. Support for continuous training programs will ensure that healthcare providers stay abreast of evolving practices, contributing to improved patient outcomes and service quality. Streamlining Health Information Management: Fully embracing a shift to 100% Electronic Health Records (EHRs) is a transformative step toward efficient health information management. Customizing these systems to Nairobi Hospital’s specific needs allows for seamless data recording, retrieval, and sharing among healthcare professionals. Doing so will help the hospital guarantee a continuum of care for patients transferring from other facilities. A 100% transition to digital record will also pose its own security threats. Ensuring robust security measures protects patient data and builds trust. Adherence to healthcare data privacy regulations is non-negotiable, and a comprehensive strategy for encryption, access controls, and regular audits should be implemented. Integrating systems to enable interoperability with other healthcare providers facilitates a cohesive healthcare network. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. Implementation Strategies: To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Prioritizing dialysis care improvements, at a local level, in the initial stages allows the hospital to address immediate patient needs, followed by the integration of health information management changes. Engaging hospital staff, patients, and local communities is paramount. Collaboration with government agencies, non-governmental organizations (NGOs), and international partners enhances support and resources for successful implementation. Conclusion: By strategically enhancing dialysis care access and streamlining health information management, Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in the evolving landscape of healthcare delivery.

Keywords: Africa, urology, diaylsis, healthcare

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