Evaluating changes in recovery in people living with severe and persistent mental illness after psychiatric rehabilitation services at Moi Teaching and Referral Hospital, Eldoret, Kenya.

Objective: People living with severe and persistent mental illness (SPMI) in Kenya lack access to recovery-based services. In this study, we assessed changes in recovery in people living with SPMI in Kenya 6 months after receiving services at the Moi Teaching and Referral Hospital Nawiri Recovery and Skills Centre (Nawiri).

Methods: A retrospective evaluation was conducted using a pretest/posttest design analyzing Nawiri care program data collected on admission and 6 months after discharge for recovery metrics.

FHIRing up OpenMRS: Architecture, Implementation and Real-World Use-Cases in Global Health.

HL7 FHIR was created almost a decade ago and is seeing increasingly wide use in high income settings. Although some initial work was carried out in low and middle income (LMIC) settings there has been little impact until recently. The need for reliable and easy to implement interoperability between health information systems in LMICs is growing with large scale deployments of EHRs, national reporting systems and mHealth applications.

Citizen engagement in national health insurance in rural western Kenya.

Effective citizen engagement is crucial for the success of social health insurance, yet little is known about the mechanisms used to involve citizens in low- and middle-income countries. This paper explores citizen engagement efforts by the National Health Insurance Fund (NHIF) and their impact on health insurance coverage within rural informal worker households in western Kenya. Our study employed a mixed methods design, including a cross-sectional household survey (n = 1773), in-depth household interviews (n = 36), six focus group discussions with community stakeholders and key informant interviews (n = 11) with policymakers.

"It is like an umbrella covering you, yet it does not protect you from the rain": a mixed methods study of insurance affordability, coverage, and financial protection in rural western Kenya.

Countries in Sub-Saharan Africa are increasingly adopting mandatory social health insurance programs. In Kenya, mandatory social health insurance is being implemented through the national health insurer, the National Hospital Insurance Fund (NHIF), but the level of coverage, affordability and financial risk protection provided by health insurance, especially for rural informal households, is unclear. This study provides as assessment of affordability of NHIF premiums, the need for financial risk protection, and the extent of financial protection provided by NHIF among rural informal workers in western Kenya.

Acceptability of prepayment, social solidarity and cross-subsidies in national health insurance: A mixed methods study in Western Kenya.

Introduction: Many low- and middle-income countries are attempting to finance healthcare through voluntary membership of insurance schemes. This study examined willingness to prepay for health care, social solidarity as well as the acceptability of subsidies for the poor as factors that determine enrolment in western Kenya.

Methods: This study employed a sequential mixed method design.

OpenMRS Analytics Engine: A FHIR Based Approach.

As the Electronic Health Record (EHR) data keeps growing in volume at an unprecedented rate, there is an increasing need for a more collaborative and scalable approach for designing and engineering clinical data pipelines. To address these two critical needs, we present a scalable analytics pipeline architecture, designed from the bottom-up to harness the power of FHIR (Fast Healthcare Interoperability Resources) for improving collaborative efforts in health data analytics and indicator reporting.

Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya.

Serum vitamin D status exerts effects on glucose-insulin-homeostatic states underlying Diabetes-Mellitus, Type 2 (T2DM). This has been described in white and Asian population where low Vitamin D levels predicted future impairments in beta cell function and worsening of insulin resistance. This study aimed to examine the relationship between serum vitamin D, insulin resistance and beta cell function in a sub population of black Kenyan T2DM patients.

Comparison of machine learning methods for predicting viral failure: a case study using electronic health record data.

Background: Human immunodeficiency virus (HIV) viral failure occurs when antiretroviral therapy fails to suppress and sustain a person's viral load count below 1,000 copies of viral ribonucleic acid per milliliter. For those newly diagnosed with HIV and living in a setting where healthcare resources are limited, such as a low- and middle-income country, the World Health Organization recommends viral load monitoring six months after initiation of antiretroviral treatment and yearly thereafter. Deviations from this schedule are made in cases where viral failure occurs or at the discretion of the clinician.