Kenya School of Government

Malaria vector resistance to insecticides is a major threat to the recent progresses in malaria control highlighting the need for continuous epidemiological surveillance in Kenya. WHO tube bioassay tests were used against 0.1% bendiocarb and 0.75% permethrin on Anopheles gambiae s.l. to determine phenotypic resistance. Real-time Polymerase chain reaction (RT-PCR) was used to identify G119S Acetylcholinesterase (ace1R) and L1014S mutation. Anopheles arabiensis was the most prevalent species, with a frequency of 72% in Malava, 76% in Lurambi, 68% in Mumias East and 58% in Ikolomani. Possible resistance to bendiocarb was observed in all study sites. An. arabiensis exhibited possible resistance across all sites, while Anopheles gambiae sensu stricto showed phenotypic resistance in Lurambi with 87.5% mortality, but fully susceptible in Malava with 100% mortality. The G119S mutation frequency ranged from 0.6% to 2.2% in An. arabiensis while An. gambiae s.s. had a frequency of 0.0% to 1.5%. The frequency of allele was high in An. arabiensis as compared to An. gambiae s.s. across study sites with no significant deviation from Hardy-Weinberg equilibrium. There is widespread insecticide resistance in malaria vectors within Kakamega County, with Anopheles arabiensis being the most prevalent species in the County. The detection of bendiocarb possible resistance in An. arabiensis across all sites and resistance in Anopheles gambiae s.s. suggests a challenge for vector control. The low frequency of the G119S ace-1R mutation indicates that resistance may be due to metabolic rather than target-site mechanisms.

The purpose of this study was to analyse the impact of digitising manual processes on operational efficiency in Kenya's State Department for Lands and Physical Planning, amid varying effectiveness of public service digitisation efforts and concerns over whether anticipated improvements in service delivery and efficiency are being realised. The research employed a qualitative case study design, collecting data through semi-structured interviews with 10 key informants from the department. Thematic analysis was employed in identifying patterns and drawing conclusions from the interview transcripts. Findings indicated that digitisation significantly enhanced operational efficiency by reducing processing times, minimising errors, and improving inter-departmental coordination. Digital services, including online land title registration and payment systems, increased accessibility for citizens, particularly in rural areas. However, the digital divide, exacerbated by limited internet connectivity and low digital literacy in rural regions, hindered equitable access and full adoption of these services. In conclusion, while digitisation has yielded substantial benefits in efficiency and service delivery, persistent challenges related to infrastructure and the digital divide must be addressed. The study recommends prioritising system integration, broadening digital literacy initiatives for citizens, resolving rural connectivity gaps, and providing ongoing staff training to maximise the use of digital tools. Greater investment in digital infrastructure, targeted interventions, and robust policy measures are also essential to narrow the digital divide. Further research is advised on the long-term impact of digital transformation in public services, focusing on accessibility, infrastructure, and integrating emerging technologies for better service delivery.

BackgroundPoor access to antenatal care (ANC), skilled delivery, and postnatal checks within 48 h of delivery are linked to adverse pregnancy outcomes. In Kenya, unequal use of these services has caused significant regional disparities, with 15 out of 47 counties being high priority.ObjectivesTo evaluate the effectiveness of a digital health solution to improve maternal and newborn health (MNH) uptake.MethodsFrom July 2017 to March 2019, we implemented an integrated community and hospital digital health information system, in ten health facilities and four community health units in Turkana County, Northern Kenya. We used a non-randomized before-after household survey. We assessed the proportion of mothers attending at least four antenatal visits, receiving skilled delivery, and receiving postnatal checks within 48 h at baseline and 12 months post-intervention. Statistical comparisons included p-values and 95% confidence intervals, accounting for clustering at the CHU level. These findings were compared with data from the Kenya Health Information System for the study subcounty and Turkana County.ResultsAmong a catchment population of 4,300 women of reproductive age (WRA), 692 and 608 women were interviewed at baseline and endline, respectively. STONE-HMIS® led to 5%, 23%, and 16% improvements in 4th antenatal care visits, skilled delivery, and postnatal checks within 48 h, respectively. For the same period, subcounty and county data showed that 57.7% and 65.8% of WRA attended at least 4 ANC visits, 39.5% and 67.8% delivered with skilled assistance, and 23.5% and 24% had postnatal checks.ConclusionsIntegrating digital health systems at provider and community levels, aligned with health system priorities, showed marked improvements MNH indicators in an underserved, remote area.

Youth represent un-tapped potential within the fight against antimicrobial resistance (AMR). This commentary describes the co-creation process of the Youth Manifesto on AMR which seeks to generate consensus on how equitable engagement of youth can be realised, despite policy, power and funding challenges. The Youth Manifesto on antimicrobial resistance (AMR) provides a blueprint for how the change-making potential of youth can be harnessed to promote equitable and sustainable action on AMR from a global, One Health perspective.

ABSTRACT Background Data are limited on the impact of chronic underlying conditions on COVID-19 treatment outcomes in sub-Saharan Africa. Objectives Determine the effect of underlying conditions on COVID-19 severity and treatment outcomes in Kenya. Methods We conducted a retrospective cohort study using routine medical records from Kenya’s three large COVID-19 treatment centers. We examined two outcomes: mortality and clinical severity. Patients with lower respiratory tract illness without tachypnoea or difficulty in breathing were considered to have mild COVID-19. Underlying conditions were based on documentation in medical records. Logistic regression models assessed associations between underlying conditions and COVID-19 severity and mortality. Results Among the 1,123 hospitalized COVID-19 patients included in the analysis, 59% (n = 664) had at least one underlying condition, 24.9% (n = 261) had severe disease, and 32.5% (n = 365) died. Hypertension (61.1%; n = 409), diabetes (38.9%; n = 258), and HIV (14.2%; n = 94) were the most common underlying conditions. Deaths were significantly higher among hospitalized COVID-19 patients with underlying conditions (35.4%) than those without (28.3%) (p = 0.01). The adjusted odds of severe COVID-19 were 50% higher among patients with hypertension (adjusted odds ratio [aOR] 1.50; 95% confidence interval [CI] 1.11–2.02). Mortality during COVID-19 hospitalization was nearly threefold higher among patients with heart disease (aOR 2.82; 95% CI 1.18–6.74) and 37% higher among patients with diabetes (aOR 1.37; 95% CI 1.00–1.88). Conclusion Patients with underlying conditions hospitalized for COVID-19 were more likely to die than those without. Hypertension was independently associated with disease severity, while heart disease and diabetes were independently associated with death during COVID-19 treatment.

Rental income tax compliance is important as it has a direct impact on revenue for most governments around the world. The Kenya Revenue Authority has, of late, failed to meet its revenue targets, particularly rental income tax targets. The purpose of the study was to determine the effect of dispute resolution reform on rental income tax compliance among residential landlords in Ruaka Town, Kiambu County, Kenya. The theory that guided this study was Procedural Justice Theory. An explanatory research design was adopted. The target population was 2103 residential landlords in Ruaka Town, Kiambu County, and a sample size of 336 respondents was calculated using the Yamane formula. Primary data was collected using a structured questionnaire. A pilot study was done to test the validity and reliability of the research instrument. Both descriptive statistics and inferential statistics were carried out with the help of the SPSS software. Inferential statistics such as Pearson correlation and multiple regression analysis were used to test the relationship between the study's dependent variable and the independent variables. The beta coefficient results revealed that Dispute resolution reform had a positive and significant effect on rental income tax compliance (β = 0.099, p = .020). The significant positive effect of dispute resolution reform suggests that the government should strengthen tax dispute mechanisms by ensuring fairness, transparency, and accessibility in conflict resolution processes. Future researchers could investigate the effects of attitude and perception, which are behavioral factors that might be analyzed to find their relative effect on the taxpayers in compliance with the rental income tax.

This study was conducted to investigate the effect of tax awareness on Value Added Tax (VAT) compliance among registered manufacturing firms in Nakuru East, Kenya, with a focus on the moderating role of perceived taxpayer trust. The study employed an explanatory research design, utilizing both descriptive and inferential analyses. Data was collected from 204 respondents using a structured questionnaire with a 5-point Likert scale. The sample was drawn from a target population of 415 manufacturing firms in Nakuru East, employing simple random sampling, and Data analysis included descriptive and inferential statistics. Descriptive statistics revealed high levels of tax awareness and perceived taxpayer trust among respondents. Regression analysis revealed that tax awareness (β = 0.35, p < 0.05) and perceived taxpayer trust (β = 0.40, p < 0.05) significantly influenced VAT compliance. Perceived taxpayer trust was found to moderate the relationship between tax awareness and VAT compliance, indicating its crucial role in shaping taxpayer behavior. To enhance compliance, tax authorities should prioritize taxpayer education programs that focus on VAT regulations, deadlines, and penalties. Clear communication channels, such as workshops, seminars, and digital platforms, can bridge knowledge gaps and empower taxpayers to meet their obligations. Additionally, tailored educational materials for small and medium-sized enterprises (SMEs) are essential, as these firms often face resource constraints.

This paper presents a collaborative research initiative between the City College of Calamba (CCC) and the Information, Investment Promotions and Employment Services Office (IIPESO). The study responds to the pressing issue of the skills gap that separates higher education outcomes from industry needs within local economic hubs. Specifically, it investigates how academic programs align—or fail to align—with employer expectations, and how collaborative approaches can enhance workforce readiness. The primary purpose of this study was to identify current hiring practices, future talent requirements, and employer perceptions of CCC graduates. Using a qualitative, exploratory research design, a Focus Group Discussion (FGD) was conducted during a job fair in Calamba City. Employers from diverse sectors participated, sharing insights on technical proficiencies, soft skills, and institutional partnerships. Thematic analysis revealed a strong demand for adaptability, problem-solving, communication, and digital literacy, alongside continued emphasis on theoretical knowledge. Employers praised CCC graduates’ discipline and work ethic but highlighted the need for more practical exposure, structured internship programs, and regular curriculum updates. Findings suggest that sustained collaboration among the academe, industry, and government is essential for cultivating a future-ready workforce and ensuring sustainable local economic growth. This paper contributes actionable insights for policy and practice, offering CCC and IIPESO a roadmap to enhance their strategic role in addressing workforce challenges.

Tax compliance is an important government policy for Kenya, as tax revenue is the single largest source of government revenue. According to KRA reports, the informal sector employs around 15 million people and represents 83% of the country's total labour force, and has tremendous revenue potential. However, despite there being many administrative reforms to enhance tax compliance, the PAYE compliance level has remained low, with KRA falling short of meeting the revenue collection targets for the past three years. Particularly, in the Ruiru town in April 2020 report, a total of 220 SMEs that are registered filed nil returns, while others did not file the returns at all. The overall goal of this research was to determine the effect of tax knowledge on Pay as You Earn (PAYE) tax compliance among micro, small, and medium-sized businesses in Ruiru Town. The study was influenced by Vroom's expectancy theory. The study's target population consisted of 597 micro, small, and medium firms in Ruiru Town. The specific responders were the managers of SMEs. The sample size was 239 managers of SMEs in Ruiru Town, chosen using stratified and purposive sampling methods. This study used primary data obtained through the use of a questionnaire. Quantitative data were analyzed using both descriptive and inferential statistics. Descriptive statistics included mean, standard deviation, percentages, and frequencies. To demonstrate the relationship between variables, inferential statistics such as regression and correlation analysis were performed. The statistical program for social sciences (SPSS version 22) was used to compute and analyze research results. The study discovered that knowledge had a favorable and significant impact on pay-as-you-earn tax compliance among micro, small, and medium-sized businesses in Ruiru Town. In order to boost tax compliance and, consequently, government revenue generation, the research recommended that measures be made to enhance taxpayer knowledge. In order for business owners to be aware of the legal and technical facets of tax administration, the Kenyan government should also make sure that they receive adequate training on the tax system.