Publications

1. "Perceptions of medical brain drain among young doctors in Kenya: a cross-sectional survey"The Kenyan health-care system has been subject to brain drain—the emigration of people with technical skills. The views of young doctors who remain in Kenya and provide health-care services are unknown. Our aim was to assess the perceptions of medical brain drain among young doctors in Kenya. We did a descriptive cross-sectional study between March and May, 2012. We gave semi-structured self-administered questionnaires to doctors aged 50 years or younger in all seven provinces of Kenya with multi-stage sampling (doctors aged 50 years and younger were randomly selected from government provincial, district, and private hospitals in each of Kenya's seven provinces). Data were entered on Epi-data (version 3.1) and percentages calculated with SPSS (version 17).We invited 1571 doctors to participate in the study, of whom 288 took part. 260 (90%) were not satisfied with their pay and 244 (85%) have thought, or are thinking of seeking employment outside of Kenya. Major reasons include poor economic returns (n=124, 43%), general job dissatisfaction (n=72, 25%), and dissatisfaction with social or political conditions (n=24, 8%). Potential solutions for prevention of medical brain drain include improved pay (n=220, 76%), increased funding for health services (n=204, 71%), and more opportunities to have input on policy changes (n=108, 38%). Medical brain drain could be addressed by involving young doctors in key health policy-making decisions. The Kenyan Government should pay young doctors well to prevent medical brain drain and increase health-care funding as per the Abuja declaration.

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2. "KNOWLEDGE AND UPTAKE OF MODERN CONTRACEPTIVE METHODS AMONG POST-CESAREAN SECTION PATIENTS IN AN URBAN HOSPITAL IN ELDORET, KENYA"Cesarean section is a life-saving mode of delivery in view of compelling indications. However, it poses a substantial amount of risk to future pregnancies if they are not well spaced out, thus the importance of family planning through modern contraceptive methods. The aim of this study was to determine the knowledge and uptake of these modern contraceptive methods among post Cesarean section patients in an urban hospital in Eldoret, Kenya. A cross-sectional study carried out among 250 post Cesarean section patients in the post natal clinic of the Moi Teaching and Referral Hospital, Kenya over a nine month period (September 2012 to June 2013). A researcher administered questionnaire highlighting socio-demographic variables and information on knowledge and uptake of various modern contraceptive methods was used. Epidata 3.1 software was used for data entry and STATA 13 used for data analysis. Of the 250 post-Cesarean section patients, 233 (93.2%) were knowledgeable on one or more forms of modern contraception, 165 (66.0%) were willing and offered one of the various forms of modern contraception, with 128 (51.2%) of the willing patients accepting it due to child spacing so as to avoid future delivery complications. Of the 85 patients not willing to use the modern contraceptive methods, 50 (58.8%) attributed their refusal due to side effects. The uptake of modern contraceptive methods among post-Cesarean section patients was relatively high as compared to patients who deliver vaginally, possibly due to family planning counseling post-surgery, though the counseling still needs further intensification.

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