Master of Public Health
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Item The effect of the Body Pump transformation program on weight loss among adult women in Harare, Zimbabwe(Adventist University of Africa, 2025-05) Marange, Talent MelodyThe escalating prevalence of obesity, particularly among adult women in Harare, Zimbabwe, presents a significant public health challenge, with 30% classified as overweight and 15% obese according to the 2021 Zimbabwe Demographic and Health Survey. This study evaluated the efficacy of the Body Pump Transformation Program, a 16-week intervention combining physical activity, nutrition, and sleep education, in promoting weight loss and improving health outcomes among 25 women aged 25–53 in Harare. Utilizing a one-group pre-test-post-test quasi-experimental design, the program aimed to address the multifaceted nature of obesity through structured exercise, dietary guidance, and sleep hygiene practices, grounded in Social Cognitive Theory to enhance self-efficacy and community support. Results demonstrated an average weight loss of 2.90 kg, with significant variability (range: -15.8 to 23.0 kg), indicating diverse individual outcomes. Participants exhibited high adherence to the program’s components, with physical activity engagement rated as “always” (mean: 4.28), dietary habits consistently practiced (mean: 4.24), and healthy sleep patterns maintained (mean: 4.30). Key findings include strong attendance at Body Pump classes (4–4.5 days/week), consistent dietary practices such as limiting processed foods, and adherence to sleep hygiene, all contributing to the program’s success. Repeated measures ANOVA analysis confirmed significant weight and weight circumference losses month after month during the 4-month experimental period. This implies that the body pump transformation program was effective. The paired t-test analysis showed a significant improvement in the implementation of the body pump transformation program components. All participants implemented the requirements of the body pump classes and adhered to dietary practices and sleep hygiene across all magnitudes of average weight loss, thus, the Spearman correlation coefficient showed no significant relationship between program implementation and reduction in body weight. Participants reported enhanced self-esteem, emotional well-being, and community support, though challenges like scheduling conflicts and dietary education gaps were noted. The study underscores the potential of holistic interventions to combat obesity in urban African settings, offering insights for tailored public health strategies. Limitations include the small sample size and lack of a control group, suggesting caution in generalizing findings. Recommendations include integrating flexible scheduling and enhanced nutrition workshops to improve accessibility and effectiveness.Item Exploratory descriptive qualitative research of factors influencing male involvement in antenatal care services at Mangochi District Hospital, Malawi(Adventist University of Africa, 2025-05) Gwengwe, IdaMale involvement in antenatal care services is currently being encouraged in most Sub-Saharan countries, including Malawi, as an approach to address maternal mortality. Despite the benefits associated with men attending ANC services, in Sub-Saharan Africa, the involvement of male spouses in ANC services is low, with attendance rates ranging from 5% to 31%. About two-thirds of men in the region (61.7%) visit the clinics only once. Malawian men also rarely attend ANC services with their partners ranging from 3.2% to 19%. However, documentation on the reasons for the low male involvement in the country is scanty. The purpose of this research is to explore factors influencing male attendance in antenatal care services during pregnancy at Mangochi District Hospital, Malawi. An exploratory descriptive qualitative research design was employed to explore factors influencing the involvement of male partners in antenatal care services during pregnancy. Using purposive sampling, the research recruited 40 participants which included couples attending ANC services, pregnant women whose male spouses were not attending ANC services and staff nurses providing ANC services. Focus group discussions, in-depth interviews, and key-informant interviews were used to collect data, using semi-structured interview guides with probes. The research used thematic analysis to analyse data by emerging themes and their sub-themes. Among others, the research findings revealed that social and structural factors including men’s perceived benefits of their spouses’ ANC attendance, societal and cultural expectations, socioeconomic barriers special treatment which women receive when they are escorted by their male spouses, attitude of health care providers prior ANC preparations, distance to the antenatal clinic, time spent at ANC clinic and unfriendly facility environment are key factors influencing male partner participation in ANC. These factors either promote or hinders men from attending their spouses’ ANC visits, as they would directly and indirectly affect men’s attitudes and subjective norms towards their participation in ANC services. However, the special treatment which women receive when they are escorted by their male spouses greatly motivate men to be attending ANC services at Mangochi district hospital. The research then recommends that addressing these social and structural factors would improve pregnancy outcomes and ultimately reducing preventable maternal deaths.Item Healthcare workers’ perception of pandemic preparedness at a tertiary hospital in Southern Malawi(Adventist University of Africa, 2025-05) Manda Rose Bubily KamangaThe occurrence of pandemics has highlighted the need for early response and hospital preparedness in order to avert overwhelming consequences for countries with low and high economies. human immunodeficiency virus (HIV), and Coronavirus disease have devastating effects on humanity. The Coronavirus pandemic took countries with low and high economies by storm, exposing serious deficiencies in the handling of outbreaks. Similarly, in countries with a low economy, the pandemic exposed their dependency on countries with high economies, lack of preparedness as well as resources to handle outbreaks. The absence of proper infrastructure, staff, resources such as equipment, and guidelines were prominent, and every government swiftly tried to come up with specific guidance for containing it. Many countries in the Sub-Saharan African region including Malawi, and across the globe have adopted checklist in an effort to manage the pandemic. The measures implemented in one way or the other brought some relief to health institutions and the whole country. The study examined hospital preparedness and response to pandemics at one of the tertiary hospitals in Malawi. Healthcare workers (HCWs) who were or are assigned to the pandemic unit managing cases using a questionnaire adopted from the WHO preparedness checklist. Data was collected in April 2024, cleaned and by STATA version 17.0. Descriptive statistics characterize populations. Frequencies, percentages were used to determine the hospital’s level of preparedness. This was essential for better solutions to potential future pandemics to save lives.Item Prevalence and determinants of tobacco smoking among college students in Bobo-Dioulasso, Burkina Faso(Adventist University of Africa, 2025-05) Kambou, Marcellin OlloGlobally, tobacco consumption represents a critical threat to public health, contributing to a range of preventable diseases (WHO). In Burkina Faso, as many nations with limited economic resources, tobacco use among young people, particularly college students, is an emerging issue with serious implications for public health (STEPS). This research seeks to examine the rate of tobacco use and explore the key factors influencing smoking behavior among college students in Bobo-Dioulasso, Burkina Faso. By examining the factors related with the uptake of tobacco in this population, the study seeks to provide insights that could inform targeted health interventions. A survey was conducted among students enrolled in four higher education institutions in Bobo-Dioulasso. Authorization was granted by the schools and from respondents themselves to conduct the study. To ensure representativeness, a stratified random sampling technique was utilized to recruit participants, and data collection was conducted using self-completed questionnaires, by a total of 387 college students, which gathered information on family and environmental influence, demographic factors, and potential determinants such as peer influence, and exposure to tobacco advertising. Descriptive statistics, chi-square tests, and logistic regression were employed to analyze the collected data. The findings revealed a smoking prevalence of 6.2% among college students in Bobo-Dioulasso, with boys smoking more than girls, suggesting the situation is alarming. Factors such as peer pressure and living with smoker in a family were identified as key factors influencing smoking behavior among college students. Tobacco smoking among college students in Bobo-Dioulasso represents a growing public health challenge. The findings underscore the importance of implementing targeted interventions that focus on the specific factors identified in the study, such as peer influence and family influence. Comprehensive tobacco control strategies, including education campaigns and policy implementation, are essential to reduce smoking prevalence and its associated health risks in this population.Item Assessment of knowledge, perception, and infrastructure as determinants of waste management practices among selected communities in Montserrado County, Liberia(Adventist University of Africa, 2025-05) Zayzay, Amelia JoeWaste management in Montserrado County, particularly Monrovia, remains a critical challenge despite regulatory efforts. Over 90% of waste is improperly disposed of, exacerbated by rapid urbanization, inadequate infrastructure, and gaps in public knowledge and perception regarding waste disposal risks. This study investigates the relationship between knowledge, perception, and infrastructure as determinants of waste management behavior. The study aims to assess the influence of knowledge, perception, and infrastructure on waste management practices in Montserrado County. A quantitative, cross-sectional design was used, surveying 383 households in Monrovia (20.78%) and Paynesville (79.22%). Quota sampling ensured representation across socioeconomic groups. Data were collected via structured questionnaires. The findings reveal that waste management knowledge and infrastructure have a significant relationship with and do influence residents’ waste management practices, while perception does not have a statistically significant impact. The combination of knowledge, perception, and infrastructure shows a strong predictive relationship with waste management practices. These results highlight the critical role of education and infrastructure availability in promoting effective waste management behaviors. Strengthening infrastructure is key to improving waste management Practices. Authorities should invest in waste collection points, recycling facilities, and regular waste disposal schedules to enhance community participation and environmental sustainability.Item A comparative analysis of knowledge, attitudes and practices on occupational safety and health compliance among small-scale bakeries in Harare, Zimbabwe(Adventist University of Africa, 2023-04) Busangavanye, GelienThis study sought to analyze the knowledge, attitudes, and practices on Occupational Safety and Health compliance among small-scale bakeries. Data were collected from 137 participants from the small-scale bakeries in Willowvale industrial area, Harare, Zimbabwe period (September to October 2021). Questionnaires, interviews, observation checklists and heat and light measurements were used for data collection. Negative binomial regression was used to assist in establishing the strength of the relationship between variables and know which independent variable was a significant predictor of compliance with OSH standards. Statistical Package for Social Sciences SPSS, version 23 was used for data analysis. The majority of the participants were males 99% and their age range was 19-30 years. The study revealed that 83% of small-scale bakeries functioned outside the requirements of the Zimbabwean OSH legislation and regulations by failing to register their operations under the Factories and Works Act Chapter 14:08. OSH management structures were essentially not there and OSH programs implementation was very poor and minimum. Employees were unprotected from several hazards including heat exposure and poor lighting. The findings obtained from the study are not statistically significant. This is shown by the P values (P > | z |) obtained which are all greater than 0.05. In conclusion, several recommendations were made for improved OSH knowledge, attitude, practices and compliance in the small-scale bakery industry. These include, management taking responsibility of the employee’s safety and health through implementation of occupational safety and health programs including OSH training. Employees need to develop a positive attitude towards OSH and implement daily safety practices. The legislators should offer tailor made and considerate interventions for such operations with main thrust on awareness and training promotions to develop and foster the essential knowledge, attitudes as well as positive practices that will result in sustainable OSH compliance in small-scale bakery industry.Item Sources, types of stress, stress burnout, and their coping strategies among gospel ministers in Ghana(Adventist University of Africa, 2023-02) Amoako, Prince KwasiStress is a common issue that affects individuals in various fields, including the clergy. This study aimed to identify the sources and types of stress encountered by gospel ministers in Ghana and their coping strategies. The study used a cross-sectional descriptive research design and a quantitative approach to analyze data collected from a target population of 500 gospel ministers in the Central Region of Ghana. The sample population for the study was 217 ministers selected using the simple random technique and purposeful techniques. The research revealed that gospel ministers face stress from various sources, including meeting schedules, church programs, sermon preparation, church finances, and home and church demands. The study also identified acute stress, episodic stress, and chronic stress as the main types of stress encountered by ministers. While most of the ministers did not visit professionals to be diagnosed, they mentioned the stress they experienced. The study found a positive relationship between age, years of employment, marital status, and stress burnout. Coping strategies used by ministers included annual leave, reducing daily work schedules, delegating duties, quality sleep, regular physical exercise, religious activities, and seeking help from professionals, friends, and spouses. In conclusion, stress is a significant concern for clergy people and should be appropriately managed to avoid health challenges. The study recommends that ministers should regularly check their health status with medical practitioners to maintain their physical and mental well-being.Item Residents’ perception of factors affecting solid waste management practices: An assessment in Plumtree Town, Zimbabwe(Adventist University of Africa, 2023-04) Ndiweni, Yvonne DuduzileThis research assesses the residents’ perception of factors affecting solid waste management practices in Plumtree Town, Zimbabwe. The study revealed a medium positive correlation between stakeholder involvement and solid waste management practices, emphasizing the importance of engaging stakeholders in waste management processes to improve solid waste management practices. Furthermore, the research found that enabling factors had a medium positive correlation with solid waste management practices, underscoring the need for better infrastructure and equipment to support effective waste management practices. The study also identified financial constraints as major obstacles to solid waste management, highlighting the significance of addressing these issues to ensure adequate resources are available to support sustainable waste management practices. Future research recommendations include expanding the sample size to include a more diverse group of residents, evaluating the effectiveness of specific interventions aimed at improving solid waste management practices and exploring the role of technology in waste management practices. The study suggests increasing stakeholder involvement in waste management processes, improving enabling factors such as infrastructure and equipment, and enforcing compliance with relevant legislation and regulations to create a more sustainable and efficient waste management system that benefits both the environment and the community. Despite some limitations limited time frame which may not reflect changes in solid waste management practices or factors affecting them that may occur in the future, this research provides valuable insights into the perception of residents regarding solid waste management practices in Plumtree Town, Zimbabwe, and identifies key areas for future research.Item Determinants of dietary diversity among children aged 6–23 months in Mwenezi District, Zimbabwe(Adventist University of Africa, 2022-04) Huturume, TarusengaPoor dietary diversity during the complementary feeding period has detrimental effects on children’s growth, health, and development. During this period, a lack of a diverse diet increases the risk of malnutrition, morbidity, and mortality. Ensuring dietary diversity is critical to promoting child survival, adequate growth, and development. The study aimed to identify determinants of dietary diversity among children aged 6-23 months in Mwenezi district of Zimbabwe. The study examined determinants of dietary diversity at the child, caregiver, household, and community levels. The study was a quantitative cross-sectional design with a sample size of 417 children selected through multi-stage random sampling. As children are not able to report their food intake, their caregivers responded on their behalf. Data was gathered by five trained field assistants using an interviewer-administered questionnaire and was analyzed using Statistical Package for Social Sciences (SPSS 20 for windows). The study established a very low minimum dietary diversity, (21.3%) in Mwenezi district. Except for staples (grains, roots, and tubers), the consumption of other food groups was below 50%. Consumption of vitamin A-rich fruits, eggs, and dairy products were least consumed by children, ranging from 7-16%. Determinants at the child level were age, sex, and birth weight. Caregiver knowledge of IYCF was the only caregiver level determinant identified. Household level determinants included poultry possession, possession of a nutrition garden, and joint decision-making by both spouses while community level determinants were presence of child growth monitoring services and village savings and lending associations. Interventions to improve the quality of diets consumed by children ought to target child, caregiver, household and community levels for synergy and greater impact. These interventions should purpose to increase caregivers’ knowledge of age specific child feeding practices while also creating a conducive and supportive socio-economic environment for caregivers to plan and prepare diverse diets. A comprehensive social and behaviour change program using the care group model, employing a ‘‘whole of family approach’’ to improve feeding behaviors and practices, empowering women and engaging men to support joint decision making, production of a wide range of crops and vegetables and small animals will improve consumption of diverse diets by children in Mwenezi district.Item Factors associated with utilization of cervical cancer screening services among sexually active women in Gutu District, Zimbabwe(Adventist University of Africa, 2022-10) Moyo Theresa Avilla DianaCervical cancer is a prevalent type of cancer that ranks fourth among women and eighth overall. It disproportionately affects individuals residing in developing countries, where inadequate screening programs and poor uptake of traditional diagnostic methods such as pap smears or pelvic examinations are common. Early detection and timely treatment significantly improve the chances of a complete cure. In Zimbabwe, despite the availability of free cervical cancer screening services to all eligible women, rural women from the Gutu district exhibit low utilization rates. This research aims to investigate the underlying factors contributing to the inadequate uptake of cervical cancer screening services by rural women in the Gutu District. A cross-sectional study design with an exploratory approach was employed to investigate the subject matter at hand. Quantitative data was collected in May 2021 through a self-administered questionnaire. The sample size of 450 participants was acquired using a multistage stratified random sampling method. Findings from this investigation have revealed that rural women residing in the Gutu district lack fundamental knowledge regarding cervical cancer, where only half of the participants demonstrated awareness of its signs and symptoms. Furthermore, risk perception among the study's respondents remained limited, with only 36.7% acknowledging high susceptibility to developing cervical cancer. The outcomes of this research also indicate that multiple factors, including age, outreach availability, proximity to the VIAC centre, perceived severity of cervical cancer, and spousal support, independently influence the uptake of cervical cancer screening among rural women in the Gutu district. The study concludes that accessibility to cervical cancer screening services remains inadequate within the area of interest. To address this issue, measures such as enhancing risk communication, expanding screening sites, and increasing outreach activities are necessary to bring the service closer to individuals who require it. Additionally, there should be a concerted effort to prioritize rural women in cervical cancer screening programs, dispel any myths or misconceptions, and eliminate gender and cultural barriers.Item Practices and barriers to healthcare worker compliance with guidelines preventing nosocomial infections among severely acutely malnourished children at a national referral hospital nutrition unit in Uganda(Adventist University of Africa, 2023-05) Asiimwe Kyoma LydiaGlobally, malnutrition is a rapidly growing public health concern that is associated with high costs of healthcare and increased mortality. Undernutrition is associated with an overwhelming percentage of child deaths aged 5 years and below. The stakes are even higher when it comes to Severely acutely malnourished children. The condition is further complicated by nosocomial infection attacks hence increasing the risk of death. Nosocomial infections are common occurrence in facilities in Sub-Saharan Africa like Uganda and prevention measures and guidelines have been put in place for them. Nonetheless, nosocomial infections continue to be a difficulty in the management of severe acute malnutrition. There remains scanty information on the practices and barriers to the prevention of Nosocomial Infections among severely acutely malnourished children in Ugandan nutrition rehabilitation units. While there are standard recommendations on practices, the prevalence of nosocomial infections remains a concern. This study, therefore, looked into which practices are employed in the nutrition unit. How well and consistently the practices are carried out since poor execution and lapse in behaviour create a gap that hinders the success of nosocomial infection control. For this study 18 eligible healthcare workers employed by the nutrition unit were recruited to participate in this study as respondents since they interact with patients daily and are custodians of patients’ health. Informed consent was obtained from all participants before responding to any questions on the interview protocol. Additional information was obtained by observation with the guidance of an observation checklist. Document analysis of the IMAM and MIYCAN guidelines was carried out and the findings added to those of interviews and observation. Interview data and document analysis data were analyzed using the interactive model of data analysis. While observation data were analyzed using attached numeric scores that are interpreted on a Likert scale. The themes developed that informed the results and implications of the study were proper use of personal protective equipment, proper hygiene, health education, presence of environmental cues and routine surveillance were the practices mentioned. The themes under predisposing factors were skills gap, and poor knowledge while themes under barriers to a nosocomial-free hospital stay were limited financial and human resources as well as infrastructural setup. Results of the study indicate that despite some prevention practices being known, they are neither practised well nor consistently in the cases were they are well done and therefore are not effective. There is a lot of room for improvement. Practices such as cohorting patients according to arrival, giving systemic antibiotics to all patients and an active surveillance system are important prevention practices that were not mentioned and respondents. Recommendations following the finding of the study are for caretakers to heed advice and guidance offered during health education and to ask for help when needed to bridge the knowledge and skills gap. Healthcare workers carry out routine health education for patients and caretakers while on the ward and acquaint themselves with the guidelines used by the nutrition unit. Hospital authorities to avail appropriate environmental cues, ensure reliable access to supplies used in infection prevention, and offer training and retaining of health care workers on Infection prevent Control measures. To carry out IPC audits and put in place surveillance systems to monitor occurrence, actions taken and the prevalence of NIs. For future research, interventions and investigations of IPC behaviour change with a focus on consistence is ideal. Planning interventions in key areas such as hand washing and health education. Future surveillance studies through laboratory investigations to find out the prevalence of NIs among SAM children in nutrition units around Uganda.Item Occupational hazards and mitigating measures among healthcare workers in Shinyanga Regional Referral Hospital, Tanzania(Adventist University of Africa, 2023-04) Muhoja, Joel JamesThis study sought to identify occupational hazards and mitigating measures among Healthcare Workers in Shinyanga Regional Referral Hospital. The objective of the study was to assess risks associated with occupational health, identify factors (causes) of occupational health hazards among HCWs, and build the capacity of healthcare workers on measures to mitigate health hazards in their workplace. The study engaged 105 HCWs all from Shinyanga regional hospital. The study project imparted knowledge through lectures, discussions, questions and answers, and one-on-one consultations. Data were gathered through questionnaires and observation. The project’s data were analyzed about planned target objectives. All data were analyzed by using descriptive statistics comprising frequencies and percentages. This was done to examine participants’ knowledge of occupational health hazards and mitigating measures. The study found that HCWs in Shinyanga are at higher risk of being exposed to health risk factors due to insufficient and uneven provision of personal protective equipment. In addition, poor hospital waste management and disposal might accelerate needle-stick injuries by that Hepatitis B, Hepatitis C, and HIV to mention a few are spread from patients to HCWs. Moreover, the reporting on OHHs and new infections was too low. HCWs are the potential for national development and are well educated but not protected to play their roles effectively to constitute national economic development. Some HWCs including health facility in-charge, heads of departments, and specialists are more exposed to health risk factors than others due to overworking. Besides, the study found that the knowledge of HCWs on health risk factors is too low. This calls for external health development stakeholders to intervene in improving safety, health, and well-being.Item A comparative analysis of knowledge, attitudes and practices on occupational safety and health compliance among small-scale bakeries in Harare, Zimbabwe(Adventist University of Africa, 2023-04) Busangavanye, GelienThis study sought to analyze the knowledge, attitudes, and practices on Occupational Safety and Health compliance among small-scale bakeries. Data were collected from 137 participants from the small-scale bakeries in Willowvale industrial area, Harare, Zimbabwe period (September to October 2021). Questionnaires, interviews, observation checklists and heat and light measurements were used for data collection. Negative binomial regression was used to assist in establishing the strength of the relationship between variables and know which independent variable was a significant predictor of compliance with OSH standards. Statistical Package for Social Sciences SPSS, version 23 was used for data analysis. The majority of the participants were males 99% and their age range was 19-30 years. The study revealed that 83% of small-scale bakeries functioned outside the requirements of the Zimbabwean OSH legislation and regulations by failing to register their operations under the Factories and Works Act Chapter 14:08. OSH management structures were essentially not there and OSH programs implementation was very poor and minimum. Employees were unprotected from several hazards including heat exposure and poor lighting. The findings obtained from the study are not statistically significant. This is shown by the P values (P > | z |) obtained which are all greater than 0.05. In conclusion, several recommendations were made for improved OSH knowledge, attitude, practices and compliance in the small-scale bakery industry. These include, management taking responsibility of the employee’s safety and health through implementation of occupational safety and health programs including OSH training. Employees need to develop a positive attitude towards OSH and implement daily safety practices. The legislators should offer tailor made and considerate interventions for such operations with main thrust on awareness and training promotions to develop and foster the essential knowledge, attitudes as well as positive practices that will result in sustainable OSH compliance in small-scale bakery industry.Item Relationship between channels of communication, knowledge, and utilization of cervical cancer screening services among women in Chileka, rural Blantyre District, Malawi(Adventist University of Africa, 2023-01) Gunsaru, Charles FatsaniThe alarmingly high prevalence of cervical cancer and deaths due to it among women in Malawi implores a solution to reduce the disease. In their efforts towards the same, the Malawi government and other stakeholders provide free screening services and also have strived to increase the knowledge of the disease among women in the country which other studies have suggested positively affects the utilization of the services. Despite these efforts, the level of utilization of the services is still low. The purpose of this study, therefore, was to assess the moderating effect of channels of communication on the relationship between knowledge of cervical cancer and the utilization of the services among women in Traditional Authority (T/A) Kuntaja, rural Blantyre district, Malawi. This analytical cross-sectional study collected quantitative data using a questionnaire translated in Chichewa with closed-ended questions from 428 women aged between 30-49 years selected from 19 villages from T/A Kuntaja using multistage sampling. Data were analyzed using descriptive statistics, one-way analysis of variance, Pearson product-moment correlation coefficient, and moderated regression analysis. Findings revealed that the level of overall knowledge of cervical cancer among the women in the study area was 29% (very poor). The level of knowledge of the description and causes of the disease was average (79%) and above average (81%), respectively, whereas the level of knowledge of risk factors, symptoms, prevention, treatment, and side-effects of its treatment was very poor, ranging from 13% to 43%. In general, channels of communication did not make a significant difference in women’s knowledge of cervical cancer but it made a difference in their utilization of screening services. Knowledge of cervical cancer has a significant positive relationship with utilization of screening services but channels of communication have no significant moderating effect on this relationship. The level of knowledge of cervical cancer among the women in the study area could be increased when effective communication channels, uniquely designed and taking into consideration women’s specific socio-demographic characteristics. In addition, the information about cervical cancer communicated through these channels could enhance knowledge that can influence the utilization of screening services. Keywords: channels of communication, knowledge of cervical cancer, utilization of cervical cancer screening servicesItem Factors Contributing to Compliance of COVID-19 Safety Protocols among Students in Ikageng JSS, (Metsimotlhabe)(Adventist University of Africa, 2023-05) Nkadile, Emang MmaboipusoNoncompliance with COVID-19 safety protocols has been associated with poor health outcomes. The COVID-19 pandemic has had a profound impact on the education system, with schools around the world implementing various safety protocols to reduce the spread of the virus. Compliance with these protocols, such as wearing masks, practising social distancing, and frequent hand washing, is crucial to protecting the health and safety of students, teachers, and staff. However, compliance with these protocols among students has been a challenge in many educational settings. This paper explores the factors that contribute to compliance with COVID-19 safety protocols among students. The literature review suggests that several factors influence compliance with safety protocols, including individual factors, such as knowledge, attitudes, and beliefs, as well as contextual factors, such as social norms and information dissemination. Descriptive statistics were used to describe the factors that contribute to noncompliance. Studies indicate that students who have higher levels of knowledge about COVID-19 and its transmission are more likely to comply with safety protocols. Additionally, positive attitudes and beliefs towards safety protocols, as well as a sense of personal responsibility, have been associated with increased compliance. Social norms and information also play a significant role, as students are more likely to comply with safety protocols when they perceive that the information they have is sufficient. School support, such as well-laid infrastructure, clear communication of safety protocols and adequate resources for compliance, can also contribute to increased compliance. In conclusion, compliance with COVID-19 safety protocols among 55 students aged 12-17 years was influenced by various factors, including individual knowledge, attitudes, and beliefs, social norms and information dissemination, and institutional support. Understanding these factors can help educators and policymakers develop effective strategies to promote compliance with safety protocols and protect the health and well-being of students and staff.Item A Case-Control Study of Caregiver’s Feeding Knowledge and Practices, in Relation to Etiology of Diarrhea Among Children Aged 0-23 Months in Gokwe North District, Zimbabwe(Adventist University of Africa, 2023-03) Chiketa Takudzwanashe MosesDiarrhea prevalence among children under-five in Gokwe North district was estimated at 16.5% in 2018, surpassing the national average of 10% in the same period. The World Health Organization confirms that 54% of deaths due to diarrhea and other causes in under-fives have malnutrition as an underlying factor. The current study sought to investigate the possible relationship between the high diarrhea burden and Nutrition by examining the knowledge and practices of primary caregivers in the feeding of infants. The research followed a matched case-control study design. A Case was defined as the mother of a child who had had one or more episodes of diarrhea two weeks before the interview date. The selection of seven clinic catchment areas, 149 cases, and 149 controls was done through multi-stage sampling. Chi-Square tests for association and a binomial logistic regression model were conducted using SPSS version 16. Controls tended to be more knowledgeable than cases on the recommended IYCF practices. In the 0 to 5-month age group, practices that were significantly associated with diarrhea were mixed feeding (p=0.001), exclusively breastfeeding (p=0.000), and IYCF knowledge (p=0.001). For the 6 to 23 months age group significant associations were noted with the number of handwashing times (p=0.035), access to improved pit latrine (p=0.022), source of water for household use (p=0.007), type of container used (p=0.040), Mid Upper Arm Circumference (p=0.000) and IYCF Knowledge (p=0.001). Significant predictors of diarrhea in children of 0-5 months of age were IYCF knowledge [AOR 1.15, (CI 1.06; 1.24) P = 0.001], water source [AOR 20.9, (CI 1.77; 28.4) P = 0.016]. as well as the use of a nipple bottle [AOR 0.057, (CI 0.01, 0.48) P = 0.009]. For the 6 to 23-month age group significant predictors were IYCF Knowledge [AOR 1.034, (CI 1.01; 1.06) P = 0.001] and meal frequency [AOR 0.254, (CI 0.09; 0.71) P = 0.010]. Both IYCF and WASH practices were found to be having an association with diarrhea incidence in under-five children, particularly the 0-23-month age group. IYCF practices mostly affected the 0-5 months age range whereas as the child grows further into the 6-23 months range WASH-related factors have the greater influence in determining diarrhea.Item Customer Perceptions of Quality in Selected Healthcare Franchises in Kenya(Adventist University of Africa, 2023-04) Osiemo, Alice KwambokaThis thesis investigated customer perceptions of healthcare quality in selected healthcare franchises in Kenya, concentrating on sociodemographic characteristics and perceptions of reliability, assurance, tangibles, empathy, and responsiveness, including aspects such as ambience, equipment, staff appearance, and staff knowledge and courtesy. The study employed a cross-sectional design using a semi-structured telephone questionnaire, with a purposive sample of 302 customers from four franchises. Data analysis using SPSS version 28 revealed significant differences in customer perceptions of reliability quality (F(3,298)=4.56, p<0.01) and tangibles (F(3,298)=3.27, p<0.05) across age groups, with customers aged 31-40 years having the highest ratings (M=4.12, SD=0.68 and M=4.20, SD=0.71, respectively). Differences were also observed in perceptions of reliability (t(300)=2.36, p<0.05) and assurance (t(300)=2.12, p<0.05) between male and female customers, with males rating higher (M=4.08, SD=0.66 and M=4.17, SD=0.69, respectively). Responsiveness significantly differed among customers with different marital statuses (F(2,299)=3.83, p<0.05), with single customers having higher ratings (M=4.19, SD=0.72) compared to married and divorced/widowed/separated customers. Additionally, differences were identified in the assurance dimension among customers with varying education levels (F(2,299)=4.17, p<0.05), with bachelor's degree holders rating highest (M=4.21, SD=0.70). However, no significant differences were found across different residences (F(2,299)=1.25, p>0.05). The study recommends that healthcare franchise providers prioritize delivering quality healthcare services and tailor their practices to the diverse needs of different customer segments. The findings have implications for healthcare providers in Kenya seeking to improve service quality and customer satisfaction, contributing to the knowledge on healthcare franchising and offering valuable insights for healthcare franchise providers.Item Prevalence of Hypertension and Associated Risks among Gospel Workers of the Seventh-day Adventist Church in Northern Ghana Union Mission(Adventist University of Africa, 2017-04) Amponsem-Boateng, CeciliaThis study was conducted on 200 gospel workers who were mainly Seventh-day Adventists from the South Central, Ashanti South, Ashanti Central and the Central Ghana Conferences of Ghana, as means of addressing hypertension and its associated risks. It had a broad objective of determining the prevalence of hypertension and its associated risks, among Gospel workers of the Northern Ghana Union Mission (NOGH) of the Seventh-day Adventist Church, and specific objectives of firstly determining the level of knowledge on hypertension among them; secondly to identify the nature of management of hypertension among gospel workers; and lastly, to determine the risk factors associated with hypertension among the gospel workers. The study adopted the mixed method approach by using a combination of cross-sectional, descriptive and non-experimental survey design. Data was collected by using both quantitative and qualitative approaches. These were questionnaires, interviews, documentary analysis and field survey. The questionnaires which contributed the larger part were analyzed by using SPSS, while interviews response were interpreted as the respondents meant them. The results of the study discovered that the majority of the gospel workers had adequate knowledge about the causes and symptoms of hypertensive disease. Regardless of this high knowledge, there was a high prevalence rate (38%) of hypertension. Though some gospel workers claimed they were aware of being hypertensive and had adopted various anti-hypertension management and prevention measures, there was still a poor health behavior and lifestyle among the gospel workers leading to the prevalence of hypertension. It was therefore concluded that, in the case of Gospel workers such as pastors, elders of churches and church financial officers where most activities are taken to be more spiritual in nature, less attention is typically paid to the prevention and management of lifestyle/medical conditions like hypertension. Based on the findings of the study and the conclusions, it is recommended that various measures, such as effective nutrition/health education on topics such as My-plate guidelines, as well as enlightenment on the causes and symptoms of hypertension, will be a step toward the reduction in the prevalence of hypertension. General improvement of the lifestyle and health behavior of gospel workers such as engaging in good dieting system, exercising regularly, and having enough rest. Part of a good prevention intervention would also include visiting the hospitals, clinics, and other health centers regularly to assess health status. Of course, it is also vital to report cases of hypertension to the health centers as another method to manage and prevent the prevalence of hypertension.Item Customer perceptions of quality in selected healthcare franchises in Kenya(Adventist University of Africa, 2023-04) Osiemo, Alice KwambokaThis thesis investigated customer perceptions of healthcare quality in selected healthcare franchises in Kenya, concentrating on sociodemographic characteristics and perceptions of reliability, assurance, tangibles, empathy, and responsiveness, including aspects such as ambience, equipment, staff appearance, and staff knowledge and courtesy. The study employed a cross-sectional design using a semi-structured telephone questionnaire, with a purposive sample of 302 customers from four franchises. Data analysis using SPSS version 28 revealed significant differences in customer perceptions of reliability quality (F(3,298)=4.56, p<0.01) and tangibles (F(3,298)=3.27, p<0.05) across age groups, with customers aged 31-40 years having the highest ratings (M=4.12, SD=0.68 and M=4.20, SD=0.71, respectively). Differences were also observed in perceptions of reliability (t(300)=2.36, p<0.05) and assurance (t(300)=2.12, p<0.05) between male and female customers, with males rating higher (M=4.08, SD=0.66 and M=4.17, SD=0.69, respectively). Responsiveness significantly differed among customers with different marital statuses (F(2,299)=3.83, p<0.05), with single customers having higher ratings (M=4.19, SD=0.72) compared to married and divorced/widowed/separated customers. Additionally, differences were identified in the assurance dimension among customers with varying education levels (F(2,299)=4.17, p<0.05), with bachelor's degree holders rating highest (M=4.21, SD=0.70). However, no significant differences were found across different residences (F(2,299)=1.25, p>0.05). The study recommends that healthcare franchise providers prioritize delivering quality healthcare services and tailor their practices to the diverse needs of different customer segments. The findings have implications for healthcare providers in Kenya seeking to improve service quality and customer satisfaction, contributing to the knowledge on healthcare franchising and offering valuable insights for healthcare franchise providers.Item Prevalence of hypertension and its risk factors among women aged 25 years or older in Kpone-Katamanso District, Ghana(Adventist University of Africa, 2017-04) Acheampong, KwabenaHypertension in Ghana is a common problem of enormous public and fiscal consequence because of its high occurrence and the severity of its complications. Population-based studies estimate the prevalence of hypertension in Ghana at 19% to 48% (Bosu, 2010).This study’s main objective was to determine the prevalence of hypertension and its associated risk factors among women aged 25 years or older in Kpone-Katamanso District, to determine socio-demographic characteristics and lifestyle factors associated with prevalence of hypertension, and determine co-morbidities and family related factors associated with prevalence of hypertension. In addition, assess the knowledge on cause, prevention and treatment of hypertension among the target population. This study employed across sectional study design. A total population of 216 consenting participants aged 25 years or older from four communities in Kpone Katamanso District were involved in the study. Data were collected from the study population by household visits using a pre-designed semi-structured questionnaire after taking their consent. The data were entered in SPSS version 20.0. to be presented in tables, and analyzed using Chi-square and binary logistic regression. The significance threshold was set at 0.05. A total of 73 out of 216 participants were hypertensive, giving the overall prevalence of 33.8%. Its prevalence increased with age (from 13.3% to 56.4%, p<0.000). Among hypertensive participants, the mean SBP reading was 145.75±14.13mmHg and the mean DBP reading was 93.70± 9.50mmHg whereas the non-hypertensive participants, the mean systolic blood pressure reading was 114.76 ± 9.13mmHg and the mean diastolic blood pressure reading was 72.73±7.24mmHg. Forty-six (21.3%) of the subject were previously diagnosed of hypertension (aware of hypertension status). The Binary logistic regression analysis showed that age 65 and above 8.788 [3.829-92.188: p˂0.000), obesity 5.513 [2.013-15.098: p˂0.001]) and family history of hypertension72.132 [19.43-267.613:p˂0.000] were found to be significantly associated with hypertension. The study established that the prevalence of hypertension was high and its associated risk factors included age, obesity and family history of hypertension. Women with a very high risk of developing hypertension like high systolic blood pressure, marked obesity, or a strong familial history of hypertension should undertake blood pressure screening regularly for early detection and prompt treatment.