Theses and Dissertations

Vaccination Coverage and its Associated Factors among Children Aged 2 - 5 Years in Eldas Sub County, Wajir County

2026-07-30T09:11:22Z

Vaccination Coverage and its Associated Factors among Children Aged 2 - 5 Years in Eldas Sub County, Wajir County Abdi, Cathra Childhood vaccination is crucial intervention to reduce the morbidity and mortality of vaccine-preventable diseases. It has been estimated that vaccination campaigns prevent almost 3 million deaths globally each year. However, in 2018, 19.4 million children worldwide missed all necessary vaccinations. In Africa, routine vaccination coverage remains particularly low. In Kenya, the North Eastern region has the lowest vaccination coverage; (41%). The study aimed to establish vaccination coverage and its associated factors among children aged between 2 and 5 years in Eldas Sub-County, Wajir County. The specific objectives entailed establishing individual level factors associated with complete vaccination coverage, assessing status of routine vaccination and to determine health system level factors associated with complete vaccination coverage among children aged 2 to 5 years in Eldas sub county, Wajir County. A cross-sectional design was employed on sample size of 367 caregivers. Respondents were chosen using probability proportion to size and systematic random sampling strategies. A structured questionnaire and key informants’ guide were deployed for data collection. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.0 with descriptive and inferential statistics generated. Chi-square test examined the relationship between categorical variables at confidence interval of 95%. Demographic findings showed that households were majorly male led with majority practicing Islami religion (98.1%) and 8.37% never attended school. A considerate percentage (40.1%) was in monogamous marriage arrangement, with only 23.2% in polygamous marriage. Sixty seven percent (67.9%) were unemployed while 23.2% earned between Ksh 6,001 and 12,000 a month. Radio ownership among caregivers was quite low. More than 21% (78 caregivers) attended to non-biological children. Caregivers with formal education were 3.47 times more likely to comply and have their children complete vaccination schedule (95% CI = 1.18 – 9.57, P = 0.032). Children of those earning more than Kshs 24000 a month were 3.18 times more likely to complete vaccination (95% CI = 1.27 – 11.67, P < 0.001) while those earning g between Kshs. 12000 - 24000 per month were 2.96 times more likely to complete vaccination (95% CI = 1.15 - 10.39, P = 0.002). Children with caregivers aware of vaccination's purpose were 4.51 and 2.57 times more likely, respectively, for complete vaccination (95% CI = 1.36 – 12.75, P < 0.001; 95% CI = 1.18 – 8.62, P = 0.031). Children born with skilled birth attendants were 5.36 times more likely for complete vaccination (95% CI = 2.15 – 13.21, P < 0.001). Children from places 1 – 5 km or 5 – 10 km from the hospital were 4.28 and 2.57 times more likely, respectively, for complete vaccination (95% CI = 1.28 – 14.87, P = 0.009; 95% CI = 1.54 – 6.88, P = 0.024). Content analysis was adopted in summarizing qualitative findings. More than ninety six percent (96.2%) of the children had been vaccinated atleast once. Distant location and lack of knowledge on immunization time were cited as major barriers to complete vaccination. Around 78.5% of the studied children reported experiencing a medical issue, 42.9% opined that atleast they were late on immunization schedule. Absence of personal issues among caregivers was associated with 2.29 increased likelihood of completing vaccination (95% CI = 1.41 - 3.75, P < 0.001). Knowledge on immunization further improved completion of immunization schedule by 5.53%. Qualitative findings also revealed a considerably high coverage attributed to strong community engagement and healthcare team dedication. The high coverage implied increasing level of access, awareness and system strength in delivering immunization solutions to the children. The notable health system factors included lifestyle, information, access and logistics, income level, education and awareness. However, misinformation, societal beliefs, low economic capacity, language barrier and nomadic lifestyle contributed to vaccine hesitancy among caregivers. The study concluded that individual level factors associated with complete vaccination status were education, occupation, income level, and ownership of electronic devices significantly influenced complete vaccination status among children aged 2 to 5 years in Eldas sub-county, Wajir County. However, vaccination completeness performance was below the recommended set target by WHO and the Ministry of Health. Health system related predictors that explained complete vaccination status included availability of skilled healthcare professional, presence of well-equipped public healthcare facilities and caregivers’ proximity to those facilities. It was suggested that the County Health Department should implement education outreach programs, support caregivers, enhance vaccination accessibility for lower-income families, use media for awareness campaigns, and address clinic shortages to improve vaccination coverage. It also recommends implementing subsidies or incentives to bridge economic gaps, leveraging electronic devices for vaccination knowledge, and enhancing healthcare infrastructure. MSc in Public Health

A Management Blueprint for Overcoming Challenges Associated with the Implementation of Construction Projects in Lamu County

2026-07-30T08:40:47Z

A Management Blueprint for Overcoming Challenges Associated with the Implementation of Construction Projects in Lamu County Mburu, Samuel Thande Kenya’s 2010 Constitution introduced devolution, creating 47 counties tasked with delivering localized development. Yet, in Lamu County, the implementation of construction projects has faced persistent challenges, undermining service delivery and socio-economic transformation. The objectives under study included: i.) To assess factors affecting the implementation of construction projects in Lamu County, (ii) To determine the challenges associated with project funding, managerial involvement, public participation, and devolution policies in the implementation of construction projects in Lamu County, (iii) To establish ways of overcoming the challenges facing the implementation of construction projects in Lamu County, and (iv) To develop a management blueprint for the implementation of construction projects in Lamu County. The research adopted a descriptive design, targeting all 390 employees of the Lamu County Government across eight ministries, who were involved in the delivery of construction projects. Data were collected through questionnaires and interviews, analyzed using SPSS for quantitative insights, and thematic analysis for qualitative perspectives. Findings revealed that project funding remains inconsistent, with budgets prepared but often inadequately aligned to project needs, while disbursements from the national treasury are frequently delayed or insufficient. Managerial involvement was found to be limited, with weak oversight, poor coordination, and inadequate technical capacity among county staff. Public participation, though mandated by law, was largely tokenistic, with citizens consulted but rarely empowered to influence decisions. Effective participation requires inclusivity, transparency, continuous engagement, and feedback mechanisms that ensure community input shapes outcomes. Devolution policies, while designed to empower counties, were hindered by conflicting national-county mandates and weak policy coherence. The study contributes a context-specific management blueprint integrating financial planning, participatory governance, leadership accountability, and policy alignment. Practically, this blueprint offers county governments, policymakers, and development partners a structured framework to enhance project success rates, reduce resource wastage, and strengthen citizen trust. For Kenya’s devolved units, the implications are significant: aligning budgets with realistic funding flows, institutionalizing meaningful public participation, and building managerial capacity are critical to sustainable project delivery. By situating Lamu’s experience within broader national challenges, the study provides actionable strategies for improving development outcomes in marginalized counties and advancing Kenya’s devolution agenda. Master of Construction Project Management

Enhancing Compliance of Construction Projects to Construction Industry Regulations in Kenya: A Case of Nairobi City County

2026-07-30T08:38:50Z

Enhancing Compliance of Construction Projects to Construction Industry Regulations in Kenya: A Case of Nairobi City County Kipchirchir, David Lagat This study critically examined regulatory compliance within Kenya's construction sector, driven by escalating concerns regarding project implementation and the persistent high incidence of building failures. The primary objective was to develop a framework to enhance regulatory compliance, thereby improving quality and safety on construction sites and ultimately reducing building collapses. The study utilised a multi-theoretical lens to evaluate behavioural and institutional compliance drivers. The outcome variable, level of regulatory compliance, was conceptualised through three variables: registration status of a construction project (RS), conditions at the construction project site (PS), and the status of the workforce at the construction site (CW). Nine determinants of regulatory compliance were identified from existing literature as: suitability of the project legal framework (SLF), proactiveness of regulatory agencies (PRA), efficiency in regulatory processes (ERP), conduciveness of the construction task environment (CTE), characteristics of the project client (CPC), competency of project leaders (CPL), goodness of construction labour (GCL), stability of the prevailing economic environment (SEE), and adherence to ethical factors (AEF). The study employed a quantitative research strategy and a cross-sectional research design to investigate compliance drivers. The target population comprised all construction projects in Nairobi City County enumerated in the National Construction Authority (NCA) 2023 database. Primary data was gathered through questionnaires administered to a randomly selected sample of construction site supervisors representing 261 projects, while objective secondary data was sourced from the NCAs OPRS. Data analysis involved descriptive statistics, confirmatory factor analysis (CFA), correlation analysis, and multiple regression analysis (MRA). The study revealed a significant lack of compliance at the project registration stage, with only 26.22% of projects being registered. Furthermore, a medium compliance rate of 64.75% was observed for registered projects during implementation, falling short of the industry's vision of at least 90% compliance. It was established that SLF, PRA, CTE, CPC, CPL, and GCL collectively accounted for 67.8% of the variability in regulatory compliance. Several significant barriers to regulatory compliance were identified, including bureaucratic hurdles, corruption, and financial constraints. In response, the study recommends a regulatory framework that advocates for a strategic shift from a deterrence-based approach to a mixed, responsive, and service-oriented framework. This new approach emphasises regulators assisting in compliance and leveraging technology to promote adherence. Moreover, the study proposes the conferment of regulatory responsibilities upon the project client, granting legal recognition to Project Execution Plans (PEPs), and institutionalising the role of regulatory compliance champions within project structures. This research, therefore, significantly contributes to the understanding of regulatory compliance in the Kenyan construction industry and offers practical measures for its enhancement, ultimately fostering safer construction practices. PhD in Construction Project Management

Molecular Characterization of RNA Viruses in Sandflies from Select Regions in Kenya

2026-07-30T08:38:03Z

Molecular Characterization of RNA Viruses in Sandflies from Select Regions in Kenya Thiiru, Jane Wambui Phlebotomine sandflies are vectors of arboviruses from genera Phlebovirus, Vesiculovirus, and Orbivirus that cause febrile and neurological illnesses in humans and animals. However, the diversity and public health significance of Phelebotomine sandfly-associated viruses in Sub-Saharan Africa remain poorly understood, representing a critical surveillance gap. This retrospective study used metagenomic, virus isolation, next-generation sequencing, and metabarcoding to address this gap by characterizing RNA viruses and their sandfly vectors in Kenya, where unexplained febrile illnesses persist. Female sandflies, previously collected between September 2020 and July 2022 from Baringo, West Pokot, Nakuru, Kisumu, Kilifi, and Kwale counties, had been stored at –80°C to preserve RNA integrity prior to pooling and homogenization. Virus isolation was performed in Vero cells, with cytopathic effect (CPE)-positive samples subjected to next-generation sequencing. Supernatant super- pools were screened for RNA viruses using metagenomics, while genomic DNA from homogenate pellets of arbovirus-positive pools enabled sandfly species identification via metabarcoding. Metagenomic analysis revealed a diverse virome, including, West Nile virus Koutango lineage (WN-KOUTV), Bogoria virus (BOGV), Phlebotomine rhabdovirus and several insect-specific viruses from five families: Dicistroviridae, Chuviridae, Iflaviridae, Nodaviridae, and Negevirus. Genomic characterization of isolated WN-KOUTV and BOGV provided new insights into their phylogeny and potential public health relevance. Additionally, metabarcoding identified Sergentomyia species, including Sergentomyia schwetzi, Sergentomyia inermis, Sergentomyia sp. SERG.UNK. F. 1- 8, Sergentomyia squamipleuris, and other Phlebotominae species within each pool. The results highlight the ongoing circulation of medically important and insect-specific viruses in Kenyan sandflies, emphasizing the need for continued surveillance and vector control strategies to address undiagnosed febrile illnesses. These findings also demonstrate the utility of combining metagenomics and metabarcoding with traditional virological methods for comprehensive arbovirus surveillance. MSc Biotechnology