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Purpose The purpose of this study was to investigate on managing market risk and financial performance, experience from microfinance institutions (MFIs) in Kenya. Design/methodology/approach This study used positivism philosophy and used explanatory non-experimental research designs. The targeted population was all the 13 registered deposit-taking MFIs in Kenya and a census approach was used. The study used secondary data which was collected and analyzed from microfinance Institutions annual audited financial reports for the period between 2014 to 2018. This study was anchored on two theories, namely, resource-based value theory and extreme value theory. Findings The results indicated that interest rate and financial leverage risk had a positive significant effect on the financial performance of MFIs in Kenya. Foreign exchange risk was found to have a negative significant effect on the financial performance of MFIs. However, inflation rate risk was found to have no significant effect on the financial performance of MFIs. Research limitations/implications This study recommended that the chief executive officers of MFIs should use the mechanism of identifying market risk variables, especially Interest rate, financial leverage and foreign exchange risks to enable them to put the necessary measures to mitigate those risks and enhance the financial performance of MFIs in Kenya. Originality/value This study is unique as it touches the microfinance industry which has a steady fast growth in assisting accessibility of financial services to small and medium enterprises. Most of the previous study concentrated on other industry in the financial sector.

Purpose – The purpose of this paper is to establish the effect of ISO 9001 implementation on the performance of organizations in Kenya. It specifically targeted organizations listed on the Nairobi Securities Exchange (NSE) which is the leading securities exchange in East Africa. Design/methodology/approach – The survey made use of web content analysis to collect data from these organizations’ web sites. Data were collected on net profit, turnover and net assets over a four-year period (2010-2013). The research used statistical data analysis to investigate the association between ISO 9001 implementation and performance. Findings – Results of the survey reveal that ISO 9001 certification influenced return on net assets of the organizations thereby influencing their performance. There was significant differences in net asset value among organizations with ISO 9001 certification and those that did not possess the certification. On profit and revenue, there were no significant differences between the ISO 9001 certified and non-certified organizations. Research limitations/implications – The research findings are limited to those organizations listed in the NSE and may not be generalized to other organizations. The study is further limited by the number of organizations participating in the study which was 20. Practical implications – The findings of the study provide justification for adoption of ISO 9001 standard in organizations in all key sectors of the Kenyan economy for sustained quality management practices. The ISO 9001 certified companies will enhance their quality management practices to achieve the successes documented in this paper while those yet to embrace the standards will draw lessons from such successes which may offer them compelling arguments to adopt them. Originality/value – Since the adoption and uptake of ISO certification in Kenya over a decade ago, no study has been carried out that directly relates ISO certification to organizational performance. This study will thus be useful as a starting point in documenting the ISO standard’s impact.

Sub-Saharan Africa (SSA) bears the heaviest burden of the HIV epidemic. Health workers play a critical role in the scale-up of HIV programs. SSA also has the weakest information and communication technology (ICT) infrastructure globally. Implementing interoperable national health information systems (HIS) is a challenge, even in developed countries. Countries in resource-limited settings have yet to demonstrate that interoperable systems can be achieved, and can improve quality of healthcare through enhanced data availability and use in the deployment of the health workforce. We established interoperable HIS integrating a Master Facility List (MFL), District Health Information Software (DHIS2), and Human Resources Information Systems (HRIS) through application programmers interfaces (API). We abstracted data on HIV care, health workers deployment, and health facilities geo-coordinates. Over 95% of data elements were exchanged between the MFL-DHIS and HRIS-DHIS. The correlation between the number of HIV-positive clients and nurses and clinical officers in 2013 was R2=0.251 and R2=0.261 respectively. Wrong MFL codes, data type mis-match and hyphens in legacy data were key causes of data transmission errors. Lack of information exchange standards for aggregate data made programming time-consuming.

Bacteraemia is a leading cause of morbidity in sickle cell anaemia (SCA), but information from studies in Africa is limited. We evaluated 890 admissions from 648 SCA patients at a tertiary hospital in Tanzania. Bacteraemia was present in 43 admissions (4·8%); isolates included Staphylococcus aureus (12/43; 28%), non-Typhi Salmonella (9/43; 21%), Streptococcus pneumoniae (3/43; 7%) and Salmonella Typhi (2/43; 5%). Compared to SCA patients without bacteraemia, SCA patients with bacteraemia had significantly lower haemoglobin [71 g/l vs. 62 g/l, odds ratio 0·72 (95% confidence interval 0·56-0·91), P < 0·01]. Further exploration is needed of the relationship between anaemia and bacterial infections in SCA in Africa.

Background:The World Health Organization has declared Sickle Cell Anemia (SCA) a public health priority. There are 300,000 births/year, over 75% in Africa, with estimates suggesting that 6 million Africans will be living with SCA if average survival reaches half the African norm. Countries such as United States of America and United Kingdom have reduced SCA mortality from 3 to 0.13 per 100 person years of observation (PYO), with interventions such as newborn screening, prevention of infections and comprehensive care, but implementation of interventions in African countries has been hindered by lack of locally appropriate information. The objective of this study was to determine the incidence and factors associated with death from SCA in Dar-es-Salaam.Methods and Findings:A hospital-based cohort study was conducted, with prospective surveillance of 1,725 SCA patients recruited from 2004 to 2009, with 209 (12%) lost to follow up, while 86 died. The mortality rate was 1.9 (95%CI 1.5, 2.9) per 100 PYO, highest under 5-years old [7.3 (4.8-11.0)], adjusting for dates of birth and study enrollment. Independent risk factors, at enrollment to the cohort, predicting death were low hemoglobin (

Approximately 280 000 children are born with sickle cell anemia (SCA) in Africa annually, yet few survive beyond childhood. Falciparum malaria is considered a significant cause of this mortality. We conducted a 5-year prospective surveillance study for malaria parasitemia, clinical malaria, and severe malarial anemia (SMA) in Dar-es-Salaam, Tanzania, between 2004 and 2009. We recorded 10 491 visits to the outpatient clinic among 1808 patients with SCA and 773 visits among 679 patients without SCA. Similarly, we recorded 691 hospital admissions among 497 patients with SCA and 2017 in patients without SCA. Overall, the prevalence of parasitemia was lower in patients with SCA than in patients without SCA both at clinic (0.7% vs 1.6%; OR, 0.53; 95% CI, 0.32-0.86; P = .008) and during hospitalization (3.0% vs 5.6%; OR, 0.46; 95% CI, 0.25-0.94; P = .01). Furthermore, patients with SCA had higher rates of malaria during hospitalization than at clinic, the ORs being 4.29 (95% CI, 2.63-7.01; P < .001) for parasitemia, 17.66 (95% CI, 5.92-52.71; P < .001) for clinical malaria, and 21.11 (95% CI, 8.46-52.67; P < .001) for SMA. Although malaria was rare among patients with SCA, parasitemia during hospitalization was associated with both severe anemia and death. Effective treatment for malaria during severe illness episodes and further studies to determine the role chemoprophylaxis are required.