Problem statement: Induction of labor has been associated with poor maternal and perinatal outcomes compared with spontaneous labor (Guerra et al, 2009). Despite this, studies show that it is the fastest growing medical procedure. Up to 25% of all deliveries at term are conducted through induction of labor (WHO, 2011) Purpose of the study: The main purpose of the study was to determine the outcome of induction of labor in women who delivered through induction of labor, taking into consideration the demographic factors, social-economic factors, institutional factors and health indication for induction. Study design: This was a cross- sectional institutional based study to determine the outcome of induction of labor in women at Kenyatta National Hospital. Social, demographic, health and institutional related factors were explored. Population and sample: The study population consisted of women admitted to postnatal wards at Kenyatta National Hospital after delivery through induction of labor. A systematic sampling procedure was used to select 42 study participants. Data collection: A structured pretested questionnaire was used to collect quantitative data and key informant interview guide for qualitative data. Data analysis: Collected data was analyzed using the SPSS for quantitative data and Nvivo for qualitative data. Findings: In this study it was found that the outcome of induction of labor is influenced by age, parity, gestation, type of employment and women being given information on the nature of the procedure. It was also found that parity is significant in determining the time taken between induction and delivery. The most common indication for induction was post-term and pre-eclampsia. It was established that pain management and client information on the procedure were wanting. It was established that the rate of caesarean section after induction of labor was more than six times (38%) the rate in the country (6%). Majority of the women took more than 24 hours to deliver after induction of labor. There were minor maternal complications following induction of labor during the study but 19.5% babies developed complications that influenced the attitude of the mothers toward induction. Recommendations: The department of reproductive health should strive to reduce the rate of caesarean (38%), time taken between induction of labor and delivery and neonatal complications. The doctors and nurses should perform pain management interventions during induction of labor. Health workers should also improve on client involvement during induction of labor. Benefits of findings: The findings may be used by the hospital to evaluate the protocols on induction of labor. It also contributes to the body of knowledge on induction of labor and can be utilized by other researchers.

Job satisfaction is an important determinant of the level of organizational commitment that is exhibited by employees in a particular organization. The purpose of this study was to establish the perceived relationship between job satisfaction and organizational commitment among community based organizations in Mathare constituency in Nairobi Kenya. The study took the form of a descriptive cross sectional survey of community based organizations in Mathare constituency. The population of the study included all the community based organizations operating in Mathare constituency. The sample size involved 110 respondents. Primary data was collected for the study from employees of 24 CBOs through questionnaire in form of job satisfaction index and organizational commitment. The data collected was analyzed using descriptive statistics. The findings reveal that there is low perceived job satisfaction among the employees of community based organizations operating in Mathare constituency in Nairobi. This manifests itself in form of unfair pay for work done, inequitable distribution of duties and responsibilities, subjective judgments from supervisors, lack of fair rules to guide operations and lack of recognition when one performs better. Employees who are not satisfied with their jobs have low organizational commitment as they are more likely to leave the organization any time an opportunity arises. They also don’t have any attachment with the organization since they do not feel as part of the organization. Low job satisfaction leads to low organizational commitment. The study recommends that the community based organizations should establish ways of improving job satisfaction among their employees in order to enhance organizational commitment.

Horizontal violence is a real entity within the health care facilities. The objective of this study was to explore prevalence and factors contributing to violence among nurses at their place of work and the effect violence had on their interrelationship and performance in provision of maternal-child and family planning services in the health facilities that directly serve their surrounding communities. The study design was a cross-sectional descriptive study of nurses working in health facilities with Maternal-Child Health and Family Planning (MCH/FP) clinics of Nairobi City County. Seven health centres that had MCH/FP and cervical cancer screening clinics were chosen for the study. The sampling frame comprised a comprehensive itemized list of all nurses in the fourteen health facilities with MCH/FP and cervical cancer screening clinics. Simple random sampling method was used to come up with seven health facilities with MCH/FP clinics. A sample of 170 participants was recruited for the study out of a calculated sample of 187. Quantitative data was collected using a self-administered structured questionnaire and an observational checklist. Each nurse included in study sample filled a questionnaire. SPSS version 17.0 was used to analyse quantitative data. Inferential statistics using Chi-square, and correlation were used to determine the relationship between the dependent variables and the independent variables. Results and findings of the study indicated that 77.6% (n=132) of the participants reported experiencing many of the negative behaviors associated with horizontal violence and 22.4% (n=38) of the participants had not experienced horizontal violence in last twelve months preceding this study. The prevalence of horizontal violence among the participants was 36.2% or 362 nurses per 1000. The following horizontal violence behaviors were experienced by participants: gossiped (51.8%), shouted at (34%), humiliated (30%), intimidated (24.7%), threatened (20%), excessively criticized (19%) and sexually harassed (4%). The study findings indicated that there were statistically significant differences between age of the participants and humiliation, p=0.005; work experience of the participants and humiliation, p=0.039; professional qualification and threat experience, p=0.031; and professional qualification and intimidation, p=0.034. There were no statistically significant differences between the demographic profiles of the participants and the following horizontal violence behaviors: gossiping, shouting, excessive criticisms, and sexual harassment. The study findings revealed that nonphysical violence was very high among nurses accounting for 76%. Of the non-physical violence gossiping was the most experienced among nurses in the workplace. However, there was no statistically significant difference between horizontal violence behavior of gossiping and demographic profiles of the participants such gender, age, work experience and professional qualification. The findings demonstrate that horizontal violence occurs and that nurses were victims of violence and some nurses were perpetrators of violence amongst themselves as well. The findings are expected to assist policy makers, managers, and nurses on how to intervene in order to control workplace violence among nurses.

This study sought to investigate the effect of national grid connection to the SMEs in Mbita town. Findings from various studies have indicated that many SMEs have embraced various strategies in their effort to improve productivity but the source of power to run modern machinery remains a challenge, resulting in well-formulated SMEs that fail at the effort of trying to expand or add value to their existing products and services. This study departed from the previous studies looking into several causes of rural underdevelopment but instead endeavoured to establish the impact that connection to the national grid had on the SMEs. To achieve the main objective, a descriptive survey of SMEs in Mbita town conducted from a population frame of 280 businesses operating in and around Mbita town. The target population was all the SMEs in town plus its environment. Statistical inferences using correlation and regression analysis indicated that a high reliability was achieved by the data collection instrument. Both tests of correlation using asymptotic significance indicated a strong relationship between connection to the national grid and value addition services in the town. The study recommends that the government in concert with electricity service providers to reduce installation costs as well as introduce subsidies to help more SMEs connect to the national grid. Awareness campaigns were also recommended on the advocacy to help more people connect to the national grid. This enabled a conclusion to be made that connection to the national grid was the motivation for value addition services as well as expansion of SMEs in Mbita town.

Green manufacturing has emerged as a key approach for manufacturing firms seeking to become environmentally sustainable and globally competitive. As a developing country, Kenya has to balance both operational and environmental performance. The objective of this study was to determine the extent of Green Manufacturing Practices' adoption by food processing firms in Mombasa County, Kenya. A descriptive research design was adopted for this study. It targeted a population of food processing firms in Mombasa County listed by Kenya Association of Manufacturers (KAM). A sample of 66 firms was taken. The data was collected using questionnaires. The results obtained indicated that green manufacturing practices adoption was at implementation stage as most food processing had considered adoption. The study also established that the major perceived benefits of adopting green manufacturing are; reduction of waste water, reduction of frequency of environmental accidents and reduction in scrap rate. Lastly, the major factors influencing adoption of green manufacturing were found to be; organization capabilities and awareness, desire for economic benefit, government rules and legislation, and high waste generation. The study recommends that the management in food processing firms should focus and allocate more resources towards pollution prevention practices than pollution control practices, as these results in greater product innovation and thus higher firm performance. They should also strive at achieving green manufacturing through remanufacturing and substitution, this will enhance efficiency and synergy in the industry, environment performance and reduce waste to achieve cost savings. Finally, the managers should act fast and implement green manufacturing practices since there are potential benefits which will result in sales growth.

Tobacco is consumed worldwide and has been cultivated in Africa since the end of the 16th century though commercial cultivation began around the 19th century. The expansion of tobacco farming has been encouraged and financed by major cigarette companies around the world especially in developing countries. In Kenya, tobacco is currently grown for commercial and non-commercial purposes in Nyanza, Western, Central and Eastern Provinces supported by BAT (K) and Mastermind K, which are the leading cigarette companies (Kibwage et al, 2009). While there are many advantages to tobacco farming such as salaries and wages for employees and farm workers, and government revenue through taxes; it may also have adverse effects. According to Effroymson and FitzGerald (2002), tobacco growing not only provides funds for basic existence but keeps the poor entrenched in a cycle of poverty. The objectives of this study was to identify socio-economic challenges faced by contracted smallholder tobacco farmers in Giaki, coping mechanisms employed by contracted tobacco farmers in dealing with tobacco farming challenges in Giaki and to establish contracted smallholder tobacco farmers who re willing to stop tobacco farming in Giaki. A total of 86 respondents were sampled from the study using snowball sampling. Structured interview schedules and focus group discussions were used to gather data. The main socio-economic challenges identified during processing and cultivation of the crop was tobacco pests and diseases, labour shortages and health problems. Among the problems faced during marketing of tobacco crop, the most mentioned problem was that the tobacco company charged exorbitant prices for farm inputs like seeds, fertilizers, chemicals and even firewood; delayed payments, low prices and poor tobacco leaf grading system. Tobacco farmers in this area engage in other off-farm activities to boost their tobacco cultivation earnings. Also, farmers have diversified their farming to enable them sustain food for the household. Most farmers would prefer to shift from tobacco farming and adapt other alternative crops as tobacco cultivation is both time and labour intensive. The study recommends that the contracting tobacco company should be encouraged to renegotiate the contract given to farmers so that farmers can purchase inputs for themselves. Also, farmers should be trained on better methods of processing and cultivation of tobacco crop to improve the grade of the harvested crop. As most farmers engaged in tobacco farming due to availability of loans and ready market, this study also recommends diversification for loan options for other businesses like small scale industries. More sociological research should be done on the extent to which Tobacco companies are willing to help smallholder tobacco farmers solve socio-economic challenges faced in Giaki. Impact of tobacco farming on livelihood of contracted tobacco farmers in comparison with nontobacco farmers in Giaki and the role played by the government in solving socio-economic challenges of small scale tobacco crop farmers in Giaki.

The fifth Millennium Development Goal calls for a reduction in the maternal mortality ratio by 75% between 1990 and 2015, with a key indicator being the proportion of births attended to by skilled health personnel (United Nations 2007). In Sub-Saharan Africa approximately 40% of women deliver with a skilled attendant. In Sub-Saharan Africa, little research has been carried out on the experience of quality in facility-based delivery care and factors associated with delivery care. This was a cross sectional descriptive study that focuses on experience and associated factors of delivery care by postnatal mothers in the Kenyatta National Referral Hospital in Nairobi, Kenya. The main objective was to describe the experience of quality in delivery care among women who delivered in the health facility; and their perception of the care. Systematic sampling was employed to recruit post-natal mothers who delivered in KNH labour ward and four postnatal wards. A total of 109 participants were recruited into the study, postnatal wards were purposely selected. Training of research assistant was done before data collection. Data was collected using structured and semi-structured questionnaires to respondents within 48 hours after delivery. Qualitative data was collected by use of case studies and key informant interviews. Data was analyzed using ANOVA. Research results were presented in frequency distribution tables, graphs and charts. P-values were used to calculate the statistical significance of the results obtained The average age of the participants was 26 years (SD 4.5), close to thirty eight percent (37.6%) of the participants had a parity of three. Most (95.4%) of the deliveries were uncomplicated and five (4.6%) participants had complicated births. Views and experiences of recently delivered women were elicited using a five-point Likert scale questionnaire focusing on four dimensions of participants’ intrapartumexperience. The participants attending KNH for second delivery viewed providers as respectful (p = 0.043), effective in explaining labor and delivery (p = 0.019) and seeking patient consent before procedures (p = 0.008). Most participants (87.7%) agreed that they were treated respectfully, accorded privacy and asked to consent to procedures, prior to the initiation of these procedures. Ninety percent of participants agreed that the health providers explained what to expect during labor, listened to participants concerns and clearly explained to clients their condition. However 8% of the respondents disagreed with this statement. Most participants (n = 102, 93.6%) said they would recommend delivery services at KNH to friends or family, although 6% of them said they would not recommend. In conclusion, the study showed majority of the participants rated most of the delivery care aspects highly and therefore had a good experience of delivery care though few aspects were rated poorly. There is need for the hospital management to increase the staff patient ratios in labour ward to care for women in labour especially with the increase in numbers of mothers delivering in the institution following provision of free maternity services by the government. The management also needs to plan on increasing the number of beds in labour rooms and also delivery rooms as well provision of privacy in these rooms.

This was a qualitative and quantitative study on opportunities and challenges faced by women with physical disabilities in accessing and utilizing public health services in Nairobi City County. The study sought to describe the difficulties encountered by women with physical disabilities while seeking healthcare services at public hospitals. It was guided by the critical disability theory which analysed disability issues and viewed the problems of disability explicitly as the product of unequal society. Data were collected through semi-structured interviews, key informant interviews, focus group discussions and observation. Analysis was done through thematic approach. The study findings suggest that the research subjects encounter several challenges as they approach public facilities for healthcare services. These challenges include lack of proper health facilities, poor infrastructure and insensitive medical personnel to concerns of PWDs. The findings also indicate that the main opportunities available for women with physical disabilities in accessing and utilizing services offered at public hospitals would be the building of more ramps, provision of wheelchairs, and provision of low beds. Other issues have to do with free medication, non-slippery floors and establishment of special wings for WWPDs. On the basis of these findings, the study concludes that lack of proper health facilities in public hospitals negatively affects women with physical disabilities in Nairobi City County. It is, therefore recommended that the administration in public hospitals should ensure facilities such as low beds and low toilets; special units for women with physical disabilities; ramps and floors that are adapted to disability; widen corridors and doorways and give priority services to the WWPDs in the public hospitals.

This study examined the implications of Strategic change of ownership on the strategic positioning of commercial banks in Kenya following the cross sectional study approach where six banks were sampled for the study. The study further examined the extent of change of ownership on the strategic positioning of the banks. The population of the study was banks in Kenya that have undergone strategic ownership change in the last five years (2008 to 2013). As provided by Central Bank Of Kenya website 6 commercial banks qualified for the study. The study was conducted through a cross sectional survey and there was no sampling since the population was small. The six commercial banks were Prime Bank Kenya Limited, CFC Stanbic Bank (K) Limited, Kenya Commercial Bank Limited, Jamii Bora Bank Limited, Equatorial Commercial Bank Limited and Ecobank Kenya Limited. Primary Data was collected from target respondents using a self-administered open ended interview guide. The guide is divided into three sections that had questions on bio data, strategic ownership changes in commercial banks and strategic positioning. The findings from the study revealed that indeed banks that had gone through change of ownership had made several internal adjustments that influenced the strategic positioning of the respective banks. The study further revealed that strategies preferred by banks for change of ownership are mergers or total acquisition. It further revealed the reasons that necessitated this ownership restructuring varied. Some respondents gave the need for improving capital base for ease of trade, while others preferred this avenue as a means to achieving their expansion strategy. The indicators applied to establish implications of change of ownership on the positioning of the firm are change in products and services, change in risk control measures and internal regulations, new approaches to customer recruitments and retention, changes in employee incentive schemes and changes in customer complaints handling mechanisms. The findings led to the conclusion that Strategic change of ownership has impacted positively on the strategic positioning of commercial banks affected by such changes.

Private universities in Kenya like other businesses operate in a competitive environment. Knowing how to satisfy their students who are their primary customers is important because it can lead to future business. The relationship between service quality and student satisfaction is important because if it is understood properly it can enable the right decisions to be made about service quality that lead to increase in student satisfaction. The study was carried out to find out whether there is a relationship between service quality and student satisfaction of private university students in Nairobi County. About 118 students were interviewed through a survey that was based on higher education service quality model HeDPERF. It was found that service quality is positively related to student satisfaction and that some of the most important aspects of an institution that students liked most were the reputation of the university and the nature of the programs offered. This means that universities have to improve on their service quality while at the same time improving on their reputation, variety and flexibility of programs offered in order to attract more students.