Referral systems in health care have been globally recognized as the pillars and influencers of the demand for health services and their consumption time (Amoah and Philips, 2017). Although studies have been conducted to enlighten on why despite the existence of referral guidelines, their adherence is minimal; no such study has been conducted at Kenyatta National Hospital despite it being at the peak of the Kenyan health referral chain. This study sought to address this gap at Kenyatta National Hospital, Accident and Emergency department and whether its referral cases could be handled by lower levels of care, in a bid to solve its overcrowding situation. The main objective of the study was to assess the determinants of referral cases in a national hospital ─ a case study of Kenyatta National Hospital and to make policy recommendations on Referral Strategy 2019-2023 based on findings. Data from a sample size of 311 randomly selected participants was analyzed after being collected using a structured questionnaire. After conducting necessary descriptive statistics, diagnostic tests and a probit regression using STATA; It was observed that 65.9% of the respondents received referral letters; with 39.3% of those being from public health facilities (level 1 to level 6), and 32.6% of them being patient self-request referrals. It is also important to note that 62.4% of respondents resided in Nairobi County, with the overwhelming majority of respondents using private transport means to KNH (80%), with only 17.4% using ambulance services to the facility. Nairobi County also has the largest referrals to KNH (62.4%). There are indeed several significant factors that determine referral cases to KNH; among them being the age (p< 0.05), residence of patients (p< 0.05), as well as their mode of transportation (p< 0.05) to the hospital. Gender, source of income and education level are observed to have an insignificant impact on the likelihood of receiving a referral letter to KNH. The presence of the National Hospital Insurance Fund (NHIF) is most likely the ‘equalizer’ so that economic factors have less influence on access to referral care at KNH. The study recommends greater investment by national and county governments in lower-level institutions, especially outside Nairobi County, to increase their quality of care and build trust in local facilities thus reduce the numerous incidences of self-referrals. A policy brief based on study findings has also been submitted to Kenyatta National Hospital to aid actualize the current referral strategy 2019-2023.

Lengo la utafiti huu limekuwa ni kuchunguza na kuchanganua utambulisho wa jinsia katika kazi za John Habwe za Maumbile si Huja na Paradiso. Mada hii imechaguliwa kutokana na uelewa kuwa kazi za kifasihi huibua utambulisho wa jinsia tofauti. Dira ambayo imetuongoza kufanya utafiti huu ni nadharia ya Ufeministi wa Kiafrika. Tumechagua nadharia hii kuchunguza na kuchanganua utambulisho wa jinsia kwa kuchunguza uhusiano wao katika mazingira ya Kiafrika kwa kuwa imeandikwa kwa msingi wa Kiafrika. Nadharia hii huonyesha jinsi asasi za jamii za Kiafrika huchangia katika dhuluma za kijinsia. Pia, nadharia hii hutoa mapendekezo ya namna ya kupigania ukombozi, usawa na haki ya jinsia katika jamii. Malengo ambayo tumeshughulikia ni kubainisha jinsi asasi za jamii kupitia tamaduni zake zinavyoathiri mazingira ya utambulisho wa jinsia, kuangazia namna jinsia za kike na kiume zinavyoathirika kutokana na changamoto zinazopitia katika harakati za kutaka kujitambua na kutambulishwa na kudhihirisha mabadiliko ya mielekeo ya jamii kupitia fasihi kama nyenzo muhimu inayochangia mabadiliko hayo. Mbinu ambayo tumetumia katika utafiti huu ni ile ya kukusanya matini za data ya utafiti kutoka vitabuni maktabani. Matokeo ya utafiti wetu ni kuwa, asasi za jamii kama vile, ndoa, dini, utamaduni, uchumi, siasa na uongozi huchangia dhuluma za jinsia. Aidha, tumeona kuwa kuna njia anuwai zinazoweza kutumiwa kuleta ukombozi na usawa wa jinsia. Vile vile, tumegundua kuwa harakati za jinsia kutaka kujitambua na kutambuliwa na jamii zinachangia mabadiliko katika mielekeo ya jamii kutokana na mabadiliko katika majukumu ya jinsia kama yanavyowekewa msingi na utamaduni wa Kiafrika.

The goal of the study was to assess the influence of agency banking on the financial deepening of the Kenyan financial sector. The specific objectives included; determining the influence of the number of agents facilitating agency banking on the financial depth; determining the influence of the number of agency banking transactions on financial deepening and determining the influence of these transactions on financial deepening. A descriptive research design was employed to evaluate the objectives. The study targeted the entire financial sector, which comprises 43 commercial banks and 24 microfinance institutions. Data was gathered from the Central Bank of Kenya reports over the period 2011-2020 and analyzed using Statistical Package for Social Scientists. The period was considered because data on agency banking before 2011 was not readily available. Descriptive statistics and multiple linear regression were used. The results revealed that the number of agents, the number banking transactions conducted through agency banking and value of agency banking transactions had a significant and positive effect on financial deepening of the Kenyan financial sector. In particular, the regression estimations showed that a unit increase in the number of agents would increase financial deepening by a factor of 5.71; a unit increase in the number of agency banking transactions would enhance financial deepening by a factor of 3.13 and a unit increase in the value of agency banking transactions would improve financial depth by a factor of 0.493. In sum, the results revealed that agency banking exerts a positive and significant influence on the financial depth of Kenyan financial sector. In light of these findings, it was concluded that the presence of agency banking in Kenya is noticeable and is playing its role in enhancing access of financial services. This study suggests a number of recommendations that can be implemented to foster the expansion of agency banking such as ; conducive political regulatory framework, development of financial literacy programs and development of prerequisite infrastructure.

Production processes for most goods and services of every country depend on energy with oil inclusive. However, for a country like Uganda with few alternative sources of energy, over dependency on oil imports is likely to increase the cost of production which may implicitly and adversely affect the country’s growth. Therefore, this study extends a theoretical framework developed by Solow (1957) to investigate the impact of oil imports on economic growth in Uganda. First, it assesses the trend analysis of oil imports and GDP growth which is adopted as a measure of economic growth. Second, a long-run and short-run relationship between oil imports and economic growth is then examined. While using the World Bank data on World Development Indicators, this study further adopts the ARDL estimation strategy to examine the long-run and short-run effects of oil imports on economic growth in Uganda. The study findings reveal that the effect of oil imports on economic growth as measured by GDP growth is positive and statistically significant. In addition, other variables such as Human Capital and Gross Capital formation are also important in boosting Uganda’s economic growth. Though Gross Domestic Savings may be relevant for achieving faster economic growth in the short-run, the long-run results instead show that Gross Domestic Savings negatively impact on economic growth. Key words: Oil imports; Economic Growth; Uganda

Strategic partnership entails companies with a given degree of equal distribution of resources as well as information and the ability to develop together or share services or products. The realization of competitive edge is not achieved by only one specific company as it doesn’t have all the fundamental assets and skills to become entrepreneurial as well as creative in the economic markets which are very competitive and dynamic. Pricing pressure gaps in asset concentrations, product mix and increased competition has forced most entities across the world to consider forming strategic alliances as they bring on board cost and product differentiation synergies. The study’s objective was therefore to examine the role of strategic alliance on competitive advantage on real estate companies in Mombasa County. This study was anchored on the transaction theory, resource-based view theory and knowledge-based view theory. The study adopted a descriptive research design and the population was made of 81companies registered with Estate Agents Registration Board and also which had advanced in technology and had a website or be listed in major real estate websites in Mombasa County. The study using purposive sampling technique selected a sample of 67 real estate companies and using questionnaires to collect data from only the managers of the selected real estate firms. The data collected through the questionnaires was analyzed through descriptive statistics presented in tables. The study found that that real estate firms in Mombasa County used strategic alliances at a moderate extent and that strategic alliance affects competitive advantage of real estate firms in Mombasa County at a moderate extent respectively. The results also show that product differentiation was a moderate source of competitive advantage and that cost leadership was a great source of competitive advantage of real estate firms in Mombasa County respectively. The findings of the study will also benefit firms in other industries since they get to appreciate the role played by strategic alliance as a way of achieving competitive edge. This would boost the performance of the real estate companies in Mombasa County and this increases their competitive advantage. Future researchers will find the study’s findings as an important source for reference. These results can be compared with other sectors to determine the various ways institutions can react to competitive forces in their respective environments. Scholars can also use this study as a base on which the other similar research studies can be built upon. The study also focused on strategic alliance and competitive advantage, which was assessed through product differentiation and cost leadership. The study therefore recommends an additional research on effects of strategic alliances on other firm metrics like financial performance, strategy formulation, strategy implementation and organizational culture. The study also collected data from one respondent from the real estate companies. The study therefore did not obtain the views of other employees. The study recommends a similar study but which will cover all the employees of the real estate companies.

Health care waste management is undoubtedly an important element in healthcare. Proper health care waste management helps in promoting safety of health workers and waste handlers through the elimination of occupational hazards. Considering that part of the waste produced by health facilities can be hazardous, there is a dire need for all health facilities to comply to the stipulated healthcare waste management policies and guidelines. Kenya and other countries in Africa lag in implementing these policies and guidelines developed from the guide of World Health Organization (WHO). This implies that although many countries have the right policies and guidelines, weak health care waste management systems, challenges in financing and lack of the leadership’s goodwill have slowed down the implementation of the same. In this cross-sectional study, four health facilities in Machakos Sub County in Machakos County, Kenya were assessed to aid in meeting five main research objectives related to health care waste management: determining health workers’ training in HCWM, evaluating health workers’ knowledge in HCWM, assessing HCWM practices, investigating occupational health & safety measures in relation to HCWM and assessing financial aspects linked to HCWM. The health facilities involved in the study were Machakos Level 5, Bishop Kioko Level 4, Mutituni Level 3 and Katumani Level 2. Questionnaires were administered to medical specialists, medical officers, clinical officers, nurses and laboratory technicians (n=281). The findings of the study indicated that Machakos County has not invested significantly in proper HCWM as evidenced by the low level of training at a score of 37.1%, fair knowledge at a score of 50.72%, poor HCWM practices score of 25.8%, health workers fair occupational health & safety score of 65.0% and very poor financial aspect of HCWM score of 0%. The aggregate score on HCWM compliance was poor at 35.7%. In conclusion, there was poor compliance to the guidelines given in the National Health Care Waste Management Plan of 2008-2012 with surprising low score in financial aspects linked to HCWM noted in all health facilities in this study.

This dissertation examines the determinants of access to higher education in Uganda. The objective was to establish the major socio-economic determinants of access to higher education in Uganda. Using the Uganda National Household Survey 2016/17 dataset and applying logistic regression analysis, the findings show that household wealth, living in an urban area, and access to the internet significantly increase the chances of accessing higher education in Uganda. The effect of gender on access to higher education is weakly significant and males are less likely to access higher education than females, especially in rural areas. Given the findings, it is recommended that policymakers and development partners fund programs that increase household wealth and incomes. Policymakers should promote access to education for people living in rural areas through affirmative action. Policies like prioritizing allocation of government scholarships to individuals from rural areas will greatly improve their chances of accessing higher education. Lastly, internet use must be promoted and expanded, especially in areas without internet access.

A critical responsibility of strategic management theory and research is the improvement of institutional results. Practices around strategic management thus, are important to the management of public, private, and non-governmental organizations since they have a contribution to the sustenance of the environment. Government and its agencies the world over continue to implement traditions around strategic management with the sole aim of boosting the results of service delivery. This study revolves around two theories; 1) Resource Based View (RBV) theory and 2) Optimal Resource Allocation (ORA) theory. The main aim of this study was to investigate the strategic challenges in UHC implementation in the informal settlement in Kibera slums, Nairobi City County. Specifically, the study sought; to analyze the effect of ICT on implementation of universal health care coverage; to analyze how resource allocation influence on UHC implementation; to analyze the role of stakeholders’ engagement on implementation of universal health care coverage in the informal settlement in Kibera slums, Nairobi City County. The outcomes of this study, specifically the recommendations may enable private hospitals managers and stakeholders to comprehend how they can effectively manage the implementation of UHC. This study employed descriptive study design with employees in the public health institutions in Kibera slums targeted. Questionnaires were used in data collection. To run descriptive and inferential statistics, Social Packages for Social Sciences (SPSS,version 23.0) was used for quantitative data analysis. The study reported that resource allocation (r=0.380, p<0.00); stakeholders’ engagement (r=0.756, p<0.00); information communication technology (r=0.639, p<0.00); influence implementation of universal health care coverage in the informal settlement in Kibera slums, Nairobi City County. This study concluded that stakeholders play a crucial role UHC in health institutions and this has led to the achievement of the extensive and much needed support in the organization’s strategies implementation. Resource allocation is among the factors that affect implementation of UHC. Information Communication Technology improves delivery of services in. The study recommends that health institutions in Kibera slums should allocate substantial amount of financial resources in the budget for investment in ICT. Equity in resource distribution should be observed to enable workable UHC implementation. In order to ensure that strategic objectives, goals and targets are met leaders in the hospitals implementing UHC should motivate employees to ease UHC implementation.

Insurance companies in Kenya have in the last decade experienced several challenges including low penetration, increased competition from existing and new players, informed customers, changes in regulation on capital requirements and split of composite companies. These challenges have necessitated managers of the firms to adopt change management practices to mitigate the threats and explore the opportunities in the operating environment. Some of the changes were in response to changes in regulation to ensure compliance, while the rest were in response to changing consumer needs to ensure customer satisfaction and improve operations. The study had two goals to establish if the firms had adopted strategic change management practices in the administration of changes and determination of their impact on the companies’ performance. The study adopted a census approach where information was gathered using structured questionnaires. The study noted that Kenyan insurance firms utilized strategic change management practices during implementation of change. It also further established that adopting these practices had a positive effect on performance of the insurance companies in Kenya as constituted by the balanced scorecard. The study concludes that effective communication created motivation to change, was key in minimizing resistance to change and had a positive influence on performance. Visible support from management ensured that adequate resources were available to support the change, and had a positive impact on results. Additionally, the human resource plan provided the organizations with the required human capital to support the change implementation and after change needs, which also influenced performance positively. The study recommends adoption of these practices to improve firms’ performance.

The proliferation of online dating sites and mobile phone apps in Kenya has seen a steady rise in the number of people using such platforms to initiate romantic relationships. The main objective of this inquiry was to assess the changing perceptions about online dating among the youth in Nairobi County. Further, the study also aimed at analyzing the major contributing factors fueling digital dating among the youth, and finally to establish the challenges related to digital dating practices. The study is a descriptive research design with a mixed-method approach where quantitative data was collected using the survey method and qualitative data was collected from the respondents using in-depth interviews. The instruments used for collecting the data included a questionnaire for the survey and an interview guide for in-depth interviews. This inquiry was guided by two theories namely, Uses and Gratifications theory and Social Information Processing (SIP) theory. The target population was Youth aged between 18-35 years and living within Nairobi County. The sample frame was based on a Facebook dating group, Kenya Singles Network that had 32124 members at the time of this study. The Taro Yamane formula was used to calculate the sample population. From the formula, 100 participants were earmarked for the survey which registered a response rate of 82%. Stratified Random sampling was used to obtain the 100 participants for the study. The structure of the survey questionnaire accommodated closed-ended questions in addition to a single open-ended question. The data collected from the open-ended question provided the basis, which the study relied on to purposively identify participants for the Qualitative study. Some of the respondents had unique and rich experiences, which informed their selection through purposive sampling. From the 15 selected participants, only 12 respondents were interviewed given the saturation point attainment hence translating to a response rate of 80%. For the quantitative approach, the data generated was analyzed using descriptive methods while the analysis of qualitative data was based on inductive analysis which involves studying the data collected through emerging themes and descriptions. The Likert Rating Scale was used to gauge the respondents’ attitudes and opinions on the various issues at hand. The analyzed quantitative data is presented in graphical representations of tables and a pie chart while the qualitative data is presented using narrative. From the data collected, the results indicate that online dating is gaining ground. For instance, the reduction of social stigma that was largely attached to online dating has contributed to the uptake of online dating. In addition, the growth in access to broadband internet and connected devices have also played a significant role in entrenching access to social networks among the youth in Nairobi, County. Still, the study also found that numerous challenges such as fraud, misrepresentation of user profiles, and safety of users among others continue to weigh down confidence among those engaged in online dating.