Riara University

Background: Health professional regulatory bodies oversee and enforce standards in healthcare to safeguard patient safety and prevent harm. However, international consistency in these regulations remains limited. The Kenya health sector relies on various bodies to enforce standards among professionals and institutions, albeit constrained by financial and human resources that hinder effective oversight. This study aimed to assess how regulatory practices- such as licensing, training oversight, inspection of practice, and quality assurance mechanisms- affect the quality of healthcare provided by private providers. Methods: The study targeted 108 healthcare providers from 36 private health facilities, primarily nurses and clinical officers. A sample of 86 participants was drawn using purposive sampling. The data were collected using a structured questionnaire. Results: The licensing of health professionals, training, inspection of practice, and quality assurance mechanisms collectively influenced 47.9% of the variation in service quality. Statistical analysis revealed significant associations between licensing (p=0.003), practice inspections (p=0.01), quality assurance (p=0.001), and service quality. Conclusions: Regulatory bodies play a crucial role in ensuring healthcare standards; however, their effectiveness hinges on tailored strategies that address local challenges and foster collaborative efforts towards sustainable quality improvement in healthcare services. Routine inspections, conducted in a supportive manner, are likely to ensure ongoing adherence to standards. Moreover, adequate resource allocation for regulatory compliance and continuous quality improvement activities, including the formation of internal quality improvement (QI) teams and the maintenance of regular QI meetings and assessments, was deemed essential.

Consumer behavior is undergoing a gradual shift, moving away from frequent brand switching towards a loyalty-centered approach. While past research has individually investigated customer-enabling factors (customer switching costs, customer involvement, customer commitment, and customer relationship proneness) and their impact on brand loyalty, there exists a research gap on how these factors collectively influence brand loyalty among millennials. There is also scarce studies of African origin exploring CRP influence on loyalty. This study's primary objective was to explore customer enabling factors customers to influence brand loyalty concerning toothpaste among millennials attending private universities in Kenya. Previous research suggests that customer commitment, involvement, switching costs, and CRP influence brand loyalty to varying extents, sometimes displaying negative correlations. Through a descriptive research design, Social Exchange Theory was used to ground the study targeting a sample of 399 millennials enrolled at 19 chartered private universities in Kenya. A self-administered Likert scale questionnaire was distributed through a multi-stage sampling technique and data analyzed using Structural Equation Modeling and Confirmatory Factor Analysis via Maximum Likelihood method. Results revealed that customer commitment and switching costs influence is statistically significant on brand loyalty. Millennials are more likely to engage with a brand when the consumer-vendor-brand relationship is robust. Brand managers need to boost CRP and use relevant communication to boost commitment and involvement of millennials. They need to leverage switching costs by capitalizing on associated benefits these costs bring to customer to nurturing mutually beneficial long-term relationships. For future research, it was recommended to focus on the Generation Z cohort to investigate the impact of brand loyalty on non-convenience products.

This essay forms part of my guest lecture to be delivered at the prestigious University of Johannesburg, South Africa, in August 2023. It is a scholarly arrangement within the broader partnership framework for research and internationalization of ideas. In this essay, I note that in the last decade, the relationship between African states and the rest of the world led by the US and China has burgeoned, albeit, remains skewed. I have likened this relationship to the analogy of a “butterfly”, in which case the western powers (led by the US and her allies) are akinto the “thorax” (center), while the African states represents the “wings” in the periphery. Further, the African diplomatic interaction with the emerging powers, notably, China and India, is no different from that of western powers. Before delving into the core of the lecture- which is, _Africa in the international system_, I have provided a framework of understanding how the global system works using a political philosophy prism. That is, ‘_existence’/ or_‘_inexistence’_ of African states in the global system. Closely tied to the philosophy of existence and truth, is the analysis of international system dynamism. The science of international system dynamism is explained using the British political geographer- Sir Halford J. Mackinder’s 1904 geographical pivot of history. Based on this theoretical framework and thinking of post-Mackinder world order, I have debunked the falsehood peddled by the western apologists, by bringing the audience to the understanding of the various versions of ‘_truth’_ and the role of intellectuals in rejecting a decorated ‘_truth’_ about the composition of the global system. I conclude by calling upon intellectuals who care for Africa’s progress to cause what I coin, a ‘_constructive disruption’_ in the global system. This disruption should be aimed at transforming African states from the comfort zone of interstate _stability_ and _durability _being witnessed today_, _into_ a _state of _being_ in competition with each other. I argue, moving away from this _arm chair_status, African states will resolve the problem of intrastate conflict and give birth to an African Hegemone that is badly needed on the continent. The phenomenon of African Hegemone would eventually form part of the bargain on the international table to enable African states access to permanent membership (_veto_ powers) into the United Nations Security Council (UNSC).

The historical relationship between Iran and South Africa dating to ancient times ignites flames of solidarity for countries that have suffered the predicament of global isolation and apartheid, respectively. However, there are long-standing fears that their common radical anti-imperial agenda of disrupting the structure of international order would isolate them further from the “thorax” of the global system to the periphery. It is not clear yet, the implications of this renewed geopolitical and geostrategic realignment on the contemporary world order on which that asymmetry seems to rest. I argue that the direction the Iran-South Africa partnerships will take in this renewed realignment depends largely on the ability of each side to manage the unequal political power dynamics that exist between the counterparts. On this note, I conclude by suggesting, the demand for reform within the aegis of the south-south solidarity, including, reframing the concept of Third Worldism will require the removal of the structural imbalances that more often frustrate the development of countries outside the “thorax.”

Ameloblastoma is a benign jaw tumor that can grow to a very huge size with high rate of recurrence. The large tumors pose a challenge during resection and reconstructive surgery. We present a massive ameloblastoma of the mandible that was surgically treated with the aid of 3D printed model.

ABSTRACT How has the COVID-19 pandemic affected democratic processes? This paper seeks to examine the dilemma of public health crises during elections. We investigate how the pandemic and government-adopted measures to curb the spread of the virus have given room for abuse of democratic processes, especially in countries holding elections. Our study focuses on the May 2020 elections in Burundi, as it was one of the first countries to hold an election at the height of the COVID-19 pandemic. Burundi has experienced disputes in previous elections that have resulted in violence. The May 2020 election period thus became an opportunity to examine if the country had learned from its previous challenges. However, as global attention shifted to dealing with the deadly coronavirus, not only have election cycles been affected, but leaders have also found ways to close off the process from observers and the media. This study finds that the COVID-19 pandemic affects pre-and post-election processes by undermining efforts to instill sustainable democratic practices such as elections.

This article contests that the classical regional integration theoretical frameworks are too broad to bring out conceptual clarity and explain the emerging interstate tensions. The paper identifies two specific indicators that together can explain the dynamics: economic domination and institutional (interest groups) domination. It evaluates the applicability of the Onditi’s dominatarian theory by constructing an alternative thinking framework— regional trade dominance (RTD), to explain the dynamics of the regional integration based on trade data from the East African Community (EAC) Development Strategy, 2016–2021. The paper addresses this conceptual-policy lacuna by demonstrating how Kenya’s economic performance and institutional (interest groups) leverages have sustained its dominant interest, leading to interstate cynicism and mistrust. The persistent mistrust driven by the perceived asymmetric power balance among the EAC Partner States points to the importance of framing the debate in a way that constructs the outcome of the regional integration to accommodate both powerful states and those perceived weak. In this case, the RTD analytical framework, offers the option for constructing the outcome of a regional integration, either as a noun, dominance or as an act of domination.

The LAPSSET project is a mega undertaking with heavy investment. Like any other public infrastructure depends entirely on fund availability and proactive involvement of respective governments, particularly Kenya, given its role as the base of the port in Manda. Unfortunately, the mind-set in the region are fixated to believe that hegemonic tendencies of Kenya will divert the initial idea of connecting Africa. Moreover, given the high costs involved compared to most country’s GDP in the region, cooperation with other sub-regions beyond Eastern Africa is indispensable. This article assess the feasibility of the LAPSSET project within the regional political dynamics.