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Background Data on breast healthcare knowledge, perceptions and practice among women in rural Kenya is limited. Furthermore, the role of the male head of household in influencing a woman’s breast health seeking behavior is also not known. The aim of this study was to assess the knowledge, perceptions and practice of breast cancer among women, male heads of households, opinion leaders and healthcare providers within a rural community in Kenya. Our secondary objective was to explore the role of male heads of households in influencing a woman’s breast health seeking behavior. Methods This was a mixed method cross-sectional study, conducted between Sept 1st 2015 Sept 30th 2016. We administered surveys to women and male heads of households. Outcomes of interest were analysed in Stata ver 13 and tabulated against gender. We conducted six focus group discussions (FGDs) and 22 key informant interviews (KIIs) with opinion leaders and health care providers, respectively. Elements of the Rapid Assessment Process (RAP) were used to guide analysis of the FGDs and the KIIs. Results A total of 442 women and 237 male heads of households participated in the survey. Although more than 80% of respondents had heard of breast cancer, fewer than 10% of women and male heads of households had knowledge of 2 or more of its risk factors. More than 85% of both men and women perceived breast cancer as a very serious illness. Over 90% of respondents would visit a health facility for a breast lump. Variable recognition of signs of breast cancer, limited decision- autonomy for women, a preference for traditional healers, lack of trust in the health care system, inadequate access to services, limited early-detection services were the six themes that emerged from the FGDs and the KIIs. There were discrepancies between the qualitative and quantitative data for the perceived role of the male head of household as a barrier to seeking breast health care. Conclusions Determining level of breast cancer knowledge, the characteristics of breast health seeking behavior and the perceived barriers to accessing breast health are the first steps in establishing locally relevant intervention programs.

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that target the disadvantaged household groups.

This study aimed at evaluating the effect of organizational culture on strategy implementation in Private chartered universities in Kenya. The objective of this study was to ascertain the effect of hierarchy culture on the strategy implementation in Private chartered universities in Kenya. A cross-sectional survey research design was adopted and it used both quantitative and qualitative data as it seeks the effect of organizational culture on the implementation of corporate strategy. The accessible population included University and students’ leaders. This study used both stratified random sampling and the target sample size was 194 employees. The statistical package for social sciences (SPSS) version 21 was used to describe the relationships between dependent and independent variables.  The study used correlation and regression techniques as well as the analysis of variance (ANOVA) to test the study hypotheses.  A multiple linear regression model was also used to derive inferential statistical indicators like the correlation, coefficient of determination, F-statistics, t-test statistic, and the p-value.  In this research Pearson’s correlation analysis was used to test for the existence of multicollinearity.  Normality testing was done to compare the cumulative distribution of the data.  Factor analysis was also carried out on all items in each variable in order to reduce the measurable and observable variables. The key finding based on the tests conducted in the study was that the variable: Hierarchy culture had an effect on the dependent variable: Strategy implementation. The p-value published showed that there was a positive effect of hierarchy culture on strategy implementation in Private chartered universities in Kenya

This study aimed at investigating the effect of organizational culture and strategy implementation process of Private chartered universities in Kenya. The cross-sectional survey research design was adopted and it used both quantitative and qualitative data as it seeks the effect of organizational culture on the implementation of corporate strategy. The accessible population included Registrars, Deans, Directors, Heads of Departments, academic staff, and students’ leaders. This study used both stratified random sampling and the target sample size was 198 employees. The statistical package for social sciences (SPSS) version 21 was used to analyze data.  The competing values framework was adopted to identify the organizational culture types that are displayed in Private chartered universities. A multiple linear regression model was also used to derive inferential statistical indicators.  Normality testing was done to compare the cumulative distribution of the data with the expected cumulative normal distribution and it bases its P value on the largest discrepancy. Two versions of Breusch-Pagan tests were conducted to test the null hypothesis on whether heteroscedasticity or homoscedasticity was present. Based on the regression analysis it was clear that the null hypothesis was rejected and the alternative hypothesis accepted. The conclusion was that Clan culture had a significant influence on the strategy implementation process of Private chartered universities in Kenya.  The results established that there was a linear positive relationship between Clan culture and strategy implementation which implies that an increase in Clan culture would lead to a linear increase in Strategy implementation in Private chartered universities in Kenya.