International Research Journal of Rongo University http://journals.rongovarsity.ac.ke/index.php/IJORU <p>IJORU is a peer-reviewed, open-access journal that encourages scholarly discourse across various disciplines. It publishes original research articles, review papers, case studies, conceptual papers, and conference proceedings in areas such as Agricultural and Environmental Sciences, Social Sciences and Humanities, Education, Business, Economics, and Management, Science, Technology, and Innovation, Health and Medical Sciences, Information and Communication Technology, and Indigenous Knowledge and Cultural Studies. The journal accepts manuscripts and publishes on a rolling basis.</p> Rongo University en-US International Research Journal of Rongo University 3005-7221 <p><strong>Creative Commons (CC)</strong> <strong>BY Attribution</strong></p> EFFECTIVENESS OF THE EAST AFRICAN COURT OF JUSTICE AS A VANGUARD FOR REGIONAL INTEGRATION http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/127 <p><em>This Paper seeks to navigate the exactitude of compliance and enforcement mechanisms taking place in the East African Community (EAC) through the lens of the East African Court of Justice (EACJ), with a particular focus on the efficiency of its authority and functionality. The paper extrapolates thoughts on the perceptions of legal mirages, myths and realities and the extent to which existing regional institutional frameworks shift to practical enforcement and adherence to EAC Treaty obligations. By borrowing from a deep analysis of regionalism and relevant case material, this Paper sets to and finds a gaping disconnect involving regulation and their operationalization. While the EAC Treaty provides an imperfect policy framework for operationalization and judicial enforcement, Partner States repeatedly exhibit a regular pattern of selective compliance; brushing off legal obligations by consistently bypassing mandatory regional requirements either in favor of international pursuits or jingoist alternatives seen in Globalisation agendas and which have in turn led to the weakening of the effectiveness, legitimacy and authority of the EACJ and which in turn ends up limiting institutional credibility. The paper then concludes by arguing that without stronger community enforcement, outright political commitment and sweeping community law reforms, the EACJ’s role as a safeguard of regional integration will remain constrained. Lastly, the Paper goes on to recommend a few insights that seek to contribute towards a broader debate on the effectiveness of the mandates of Regional Integration. </em></p> Kezzy Ray Oluoch Kenneth Kaunda Kodiyo Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-09-14 2026-09-14 4 2 1 13 10.64535/ijoru.v4i2.127 PERCEPTION OF NURSING STUDENTS ON SIMULATION AS A LEARNING STRATEGY AT NURSING TRAINING COLLEGES IN NAIROBI COUNTY, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/128 <p><em>Simulation is a teaching and learning strategy used in nursing education for the preparation of nursing students for clinical practice. The nursing education principally centre on nursing knowledge, and assisting learners acquire the necessary skills and attitudes associated with nursing practice to care for patients as they deal with and handle real- life situations. The nursing students’ views are shaped by heavily by practical realities and clinical experience. This study sought to determine the perception of nursing students on simulation as a learning strategy at selected nursing training colleges in Nairobi County Kenya. The following specific objective was to assess the perception of nursing students towards integration of simulation program as a learning strategy at nursing training colleges in Nairobi County, Kenya. The study was guided by the theory of experiential learning, postulated by Kolb (1984). The study adopted a descriptive exploratory design in a quantitative approach. The target Population for the study was 1067 consisting of diploma nursing students training at medical colleges in Nairobi County. The stratified random sampling technique was used in this study and the sample size was 210 participants. The stratification was based on college block system and clinical rotation placements. The study population was stratified by the year of study. The number of students respondents per year of study was determined by the weight of classroom of the total population. The self-administered questionnaires were subjected to a reliability test through a pilot study in which the questionnaires were administered and later responses cross-checked through the test -retest. The pilot study also helped in validation of the instruments through amending unclear and obscure questions and discarding ineffective and non-functional questions. Data was collected using a closed-ended self-administered questionnaire. Data was analysed through descriptive (frequency, percentages, mean, and standard deviation) and inferential statistics (correlation coefficient, coefficient of determination, analysis of variance, and model coefficients). Pearson correlation coefficient was at a significant level of 0.01. SPSS software was used to compute analysis. The findings were that integration of simulation programs significantly influences simulation as a learning strategy for nursing students. The findings gave an R-Square of 0.868 with the standard error of estimate being 0.128. This implies that using the composite score, integration of simulation program, classification simulation, clinical experience as well as benefits of simulation significantly influences simulation as a learning strategy for nursing students. Results also provided a p-value = 0.000 &lt; 0.05. This further confirms that the predictors positively and significantly influence simulation as a learning strategy for nursing students. The study concludes that the integration of simulation programs significantly influences simulation as a learning strategy among nursing students. The study strongly recommends that nursing educators should make simulation an integral part of their teaching for nursing students as embracing an integral approach will improve students' learning approach, formulation of a policy framework on the classification of simulation approaches, learners should know the classifications and practice them effectively. Students should practice clinical skills so as to generate experience that would yield positive results, the nursing colleges should embrace simulation learning strategy as it has a lot of benefits to learners.</em></p> Cecilia Rapando Mary Sambu Richard Okero Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-09-14 2026-09-14 4 2 14 24 10.64535/ijoru.v4i2.128 FINANCIAL LITERACY TRAINING AS A CORRELATE OF TEACHERS' INSTRUCTIONAL ATTENDANCE IN PUBLIC PRIMARY SCHOOLS IN KAKAMEGA COUNTY, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/132 <p><em>Instructional attendance defined as teachers' sustained physical presence in, and active engagement with, lesson preparation, delivery, learner assessment and discipline is widely recognized as a major correlate of quality teaching and learning in public primary schools. Despite growing Teachers Service Commission (TSC) investment in post-service welfare programmes, there remains limited empirical evidence on whether such programmes improve instructional attendance, a gap acute in Kakamega County, Kenya, where a 2025 quality assurance assessment found only 38% of expected instructional time was utilized. It was probable that TSC's financial literacy training programme contributed to this situation. This study sought to establish whether TSC financial literacy training is associated with teachers' instructional attendance in the county's public primary schools. The study adopted a correlational design within a convergent parallel mixed-methods framework, anchored on the Integrative Life Planning Theory. The target population comprised 10,104 TSC-employed teachers from 916 public primary schools across the county's 13 sub-counties. Applying Slovin's formula at 95% confidence yielded a sample of 385 teachers via multi-stage stratified sampling by sub-county and location; 13 head teachers' association chairpersons served as key informants. Data were collected through teacher questionnaires and head-teacher interviews. Validity and reliability were established through expert review, piloting, test-retest analysis (r &gt; 0.70), and a Cronbach's alpha of 0.879. A 93.4% response rate yielded 360 usable questionnaires, and all 13 head teacher interviews achieved thematic saturation. Quantitative data were analyzed using t-tests, Pearson correlation, and Hayes' PROCESS macro (Model 4, 5,000 bootstrap resamples); qualitative data were analyzed thematically using Braun and Clarke's (2006) six-phase approach, with findings integrated at interpretation. Ethical considerations that include informed consent, voluntary participation and confidentiality of the source of information were adhered to throughout the study. Findings revealed that 43.3% of teachers had attended financial literacy training, and trained teachers recorded significantly higher mean instructional attendance (77.2%) than untrained teachers (70.6%) (t(358) = 3.42, p = .001, Cohen's d = 0.40). Mediation analysis showed that 87.5% of this effect operated indirectly through reduced financial stress, with the direct pathway statistically non-significant (</em><em>β</em><em> = .022, p = .648). The null hypothesis was therefore rejected, confirming a statistically significant relationship between financial literacy training and instructional attendance, an effect stronger among rural teachers and those with higher post-training knowledge retention. The study concludes that financial literacy training improves instructional attendance primarily by alleviating teachers' financial anxiety rather than through direct application of financial skills, and recommends that TSC reframe such training as a stress-reduction intervention, incorporating practical action-planning, peer support, and mobile delivery models to reach financially vulnerable rural teachers</em>.</p> Kepher Essau Onyino Beatrice Atieno Nyakan Julius Maiyo Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-10-10 2026-10-10 4 2 25 34 10.64535/ijoru.v4i2.132 EVALUATION OF HEALTH RECORDS MANAGEMENT PRACTICES AND THE FUNCTIONALITY OF ARCHIVAL WORKFLOW SYSTEMS AMONG SELECTED HOSPITALS IN MIGORI AND KISUMU COUNTIES, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/135 <p><em>Effective health records management is essential for efficient healthcare systems. However, outdated infrastructure, limited user integration, and inefficient data retrieval continue to impede healthcare service delivery in Kenyan hospitals, raising the question: to what extent do records management practices predict archival workflow functionality in public hospitals? This study was grounded in Records Management Theory, which conceptualizes records as assets moving through a defined lifecycle creation, use, maintenance, and disposition governed by policies and standards to ensure accessibility, integrity, and accountability. Building on this lens, the study's conceptual framework positions records management practices, retrieval speed and ease, records handling, and archival software use as independent variables predicting archival workflow functionality as the dependent variable, with government policies and standard operating procedures as intervening variables consistent with the theory's emphasis on regulatory oversight across the records lifecycle. The framework further incorporates system reliability, user acceptance, and user requirements, including data confidentiality and security, as dimensions shaping user trust and satisfaction, thereby identifying where adjustments are needed. A cross-sectional survey of 265 healthcare workers at Kisumu and Migori referral hospitals, sampled proportionately across professional cadres using Slovin's formula, tested these relationships using descriptive statistics, chi-square tests, and logistic regression. Findings showed generally favorable standard operating procedures compliance (64.4%), retrievability (57.8%), and software evaluations (65.1–73.1%), alongside strong support for system modernization (87.9–91.5%), though user feedback integration remained moderate. Regular disposal of outdated records, a core lifecycle stage under Records Management Theory, was significantly associated with workflow functionality (χ²=33.25, p=0.032), while standard operating procedures compliance (OR=1.52, p=0.045) and user-friendly, secure archival software (OR=1.84, p=0.011) emerged as significant predictors, affirming the theory's premise that structured, policy-governed management of records across their lifecycle drives system functionality. These results underscore the need to modernize archival workflow systems, strengthen data security, and deepen user participation. The study recommends standardized, automated archival workflows supported by ongoing capacity building and routine system reviews in Kenyan public hospitals.</em></p> Julius O. Ominde Lamek Ronoh Anne Mugalavai Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-06-10 2026-06-10 4 2 35 45 10.64535/ijoru.v4i2.135 ASSESSMENT OF THE WATER QUALITY AND SEASONAL VARIATION USING PHYSICOCHEMICAL PARAMETERS FROM SELECTED DAMS AND WATER PANS IN WEST POKOT COUNTY, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/136 <p><em>West Pokot County lies within the arid and semi-arid regions of Kenya, with the area experiencing erratic annual rainfall, high temperatures hence prone to high evaporation rates. Water resources in the area are not well developed, and as a result, the county faces frequent incidents of water scarcity and pollution. This study aimed to evaluate the potability of water by assessing temporal and spatial variation of physicochemical parameters in three dams (Siyoi Muruny, Nakuyen and Sook) and three water pans (Pampa, Kitalakapel and Limangole) from four sub-counties of West-Pokot county.&nbsp; Samples of water were collected during wet and dry seasons of 2025; Apri and November respectfully and transported in ice boxes to the lab for analysis using standard AOAC procedures after in situ measurements had been taken using respective portable parameters. Water quality index (WQI) was calculated using the Weighted Arithmetic Index Method (AIM). The results were then analyzed descriptively and statistically by use of one-way ANOVA and t-test to find both temporal and spatial variabilities as well as significant differences (p≤</em><em>0.05) and a comparison made with the set standards by World Health Organization (WHO). The pH (4.0-7.9) revealed seasonal variability with high acidity during the dry season at Nakuyen (4.0) and Pampa (5.0) indicating intense organic matter decomposition and reduced buffering. Water temperature were lower during the wet season (12.8 °C–31 °C) and specifically, Kitalakapel Pan (15.02 ± 2.33 °C) and highest at Pampa Pan (21.38 ± 1.83 °C). During the dry season, temperatures increased with Pampa Pan recording highest (29.02 ± 1.73 °C)</em><em> probably due to increased solar radiation, reduced inflow, and higher evaporation rates which </em><em>influences many physical, chemical, and biological processes in aquatic systems. The WHO does not set a strict universal temperature limit for natural surface waters used for domestic purposes. The WHO does not prescribe a strict health-based guideline value for Electrical Conductivity (EC) in drinking water but UN WWAP (2010) recommends a maximum of 1,000 µS/cm, all wet season values were within recommended limits and lower than dry season which recorded slightly above limit value at Pampa (1005±37.19</em><em>). Dissolved Oxygen (DO) concentrations were higher during the wet season ranging from 8.50±0.82 to 9.89±0.90. Biochemical Oxygen Demand (BOD)’s recommended levels should be ˂</em><em>5 mg/L, the values ranged from 6.30±0.58 to 7.92± 0.78 mg/L during the dry season. The WHO recommends that COD levels be ˂</em><em> 50 mg/L to maintain acceptable water quality and it ranged from. 53.96±9.12 to 62.08±5.57 during the dry season. Total Suspended Solids (TSS) was higher during the wet season with values ranging from 37.80±3.70 to 57.94±2.40.</em><em> Water Quality Index (WQI) </em><em>values classified all sources as very poor during wet season and unsuitable during the dry season after ranking WQI using </em><em>5-point Likert scale</em><em>. Water pans recorded worse quality than dams (p &lt; 0.05). </em><em>This pollution suggests high anthropogenic influence and floods. It is therefore recommended that proper attention needs to be given to the dams and pans by appropriate authorities as well as continuous monitoring to prevent poor health implication on the households relying on this water for domestic use, livestock and irrigation</em>.</p> Susan Jepkoech Tarus John Kituyi Lusweti Mary Tanui Rono Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-02 2026-11-02 4 2 46 56 10.64535/ijoru.v4i2.136 EVALUATION OF POLLUTANT LOAD ON NITRATES, PHOSPHATES AND FLUORIDE AND SEASONAL VARIATION FROM SELECTED DAMS AND WATER PANS IN WEST POKOT COUNTY, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/147 <p><em>In Kenya most local communities particularly in rural and semi-arid areas suffer the most due to lack of access to potable water. West Pokot is one county experiencing this problem largely due their agricultural practices of pastoralism and livestock watering around the dams and pans. This study aimed to evaluate the quality of water by assessing concentration and temporal variation of nitrates (NO<sub>3</sub><sup>-</sup>), phosphates (PO<sub>4</sub><sup>3-</sup> ), and fluorides (F<sup>-</sup>) in three dams (Siyoi Murung, Nakuyen and Sook) and three water pans (Pampa, Kitalakapel and Limangole) in six wards of West-Pokot. Samples of water were collected in April 2025 to represent wet season and December 2025 to represent the dry season and analyzed using standard AOAC procedures. The results were then analyzed descriptively and statistically using one way ANOVA and t-test at P</em><em>≤</em><em>0.05 significance for spatial variation between dams and water pans. Comparisons were made with the set standards by World Health Organization (WHO). The results showed mean ranges of NO<sub>3</sub><sup>-</sup>, and PO<sub>4</sub><sup>3-</sup>were within WHO standards for Sook dam and allowable levels in Siyoi Muruny. Pamba pan recorded the highest</em> <em>NO<sub>3</sub><sup>-</sup> [24.2 ± 0.15 mg/L] seasonal variations and showed significant difference between wet and dry season (P</em><em>≤</em><em>0.05</em><em>). The high level of pollutants in wet season could be due to storm water run offs carrying a higher load of contaminants while in dry season it is likely due to the increased solubility of ions because of the elevated water temperature causing higher evaporation rate. The levels of F<sup>- </sup>alarmingly exceeded the recommended limits in all sites but no F<sup>- </sup>was detected during the dry season at Sook dam.</em><em> This suggests that heavy rainfall facilitates the leaching of fluoride-rich volcanic ash and weathered rock minerals into open water sources</em><em> and the extremely high concentrations suggests</em><em> the mobilization of fluoride-bearing minerals from the underlying volcanic rocks.</em><em> This study advocates control measures to be taken to avoid the dams and water pans manifesting serious environmental pollution leading to health risks.</em></p> Susan Jepkoech Tarus John Kituyi Lusweti Mary Tanui Rono Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-06 2026-11-06 4 2 57 66 10.64535/ijoru.v4i2.147 REPRESENTATION OF SKIN TONE IN KENYAN DIGITAL MEDIA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/148 <p><em>Representation refers to how individuals are depicted and given prominence in the media. It examines the qualities, characteristics, roles, behaviours and meanings assigned to those groups. Repeated depictions of individuals with various skin tones shape audience perceptions of beauty, identity and social status and may reinforce or challenge colourist ideologies. This study investigates the manifestation of colourism in Kenyan Afro-pop YouTube music videos. It focuses on the representation of people of different skin tones in Kenyan Afro-pop music videos on YouTube and analyses how colourism is expressed through their portrayal. The study employed a content analysis design. Data was gathered through direct observation (watching) of music videos uploaded on YouTube. The music videos studied are those produced between 2022 and 2026 and garnering over ten million views, to ensure relevance and widespread reach. A total of 11 music videos were sampled using census. Findings reveal a significant imbalance in the representation of skin tones. Light-skinned women are predominantly featured and idealised as the standard of beauty, while brown-skinned individuals receive a fair representation, they are not as favourably represented as their light-skinned counterparts. Dark-skinned women are often marginalised or hyper sexualized, especially in genres known for explicit content. In contrast, dark-skinned men are celebrated as strong and masculine, while light-skinned men are sometimes portrayed as soft or effeminate. The study concludes that Afro-pop YouTube music videos reinforce colourist ideals. It recommends that content creators be more intentional in their casting and narrative choices to promote diverse and inclusive representations of beauty</em>.</p> Mikal Akoth Ongachi Maureen Adoyo Carolyne Kokeyo Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-06 2026-11-06 4 2 67 74 10.64535/ijoru.v4i2.148 THE EXPRESSION OF COLOURISM THROUGH LYRICS IN KENYAN MUSIC VIDEOS ON YOUTUBE http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/150 <p><em>Colourism</em><em>, which is </em><em>discrimination based on variations in skin tone</em> <em>remains a </em><em>controversial</em> <em>yet</em><em> influential form of bias in media representation. This study examines how colourism is constructed and communicated through lyrics in Kenyan music videos available on YouTube. </em><em>The unit of analysis is the lyrical content of the songs, with limited contextual attention to the visual presence of performers only in</em> <em>so</em> <em>far as it illuminates the meanings attached to the lyrics.</em> <em>Using a qualitative content analysis design,</em> <em>guided by thematic coding</em><em> data were collected through direct observation of selected videos released between </em><em>January </em><em>2022 and </em><em>June </em><em>2025. To ensure contemporary relevance and broad </em><em>cultural</em><em> reach, the study focused on videos that had accumulated more than ten million views</em><em> at the moment of data collection</em><em>. Forty music videos were purposively sampled </em><em>targeting an even representation </em><em>from five popular Kenyan music genres</em><em>: </em><em>&nbsp;Afro-pop, Gengetone, hip-hop, Swahili music influenced by Bongo Flava, and indigenous genres </em><em>(</em><em>particularly Ohangla and Benga</em><em>)</em><em>. The findings indicate that the lyrics frequently associate lighter skin with inherent beauty</em><em> and romantic desirability</em><em>, whereas admiration for darker skin is often qualified or requires explicit justification</em><em>, or is basically through sexualisation</em><em> This study contributes to scholarship on colourism by demonstrating how popular Kenyan music may reproduce skin-tone hierarchies and shape perceptions of beauty in digital spaces. It concludes that widely viewed YouTube music videos can reinforce colourist ideals, potentially affecting viewers’ self-esteem and self-perception, especially among young audiences. The study therefore recommends that artists and other content creators adopt more deliberate and inclusive lyrical</em> <em>and narrative choices that acknowledge and celebrate diverse skin tones.</em></p> Josphat Ogweno Okech Mikal Akoth Ongachi Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-02 2026-11-02 4 2 75 85 10.64535/ijoru.v4i2.150 SEMANTIKI YA MAJINA YA WALUO NCHINI KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/151 <p><em>Majina ya watu katika jamii za Kiafrika hubeba maana zinazohusiana na utamaduni, historia na mazingira ya kijamii. Miongoni mwa Waluo wa Kenya, majina si alama za utambulisho pekee, bali pia huakisi mitazamo ya jamii kuhusu maisha na matukio yanayohusiana na kuzaliwa kwa mtoto. Ingawa tafiti mbalimbali zimechunguza majina ya Kiafrika kwa mitazamo tofauti ya kiisimu, tafiti chache zimejikita katika kuchanganua maana za majina ya Waluo kwa mtazamo wa kisemantiki. Makala hii inalenga kuchunguza ruwaza za kisemantiki katika majina ya watu miongoni mwa Waluo nchini Kenya ili kubainisha maana zinazojitokeza katika majina hayo. Data ilikusanywa kutoka orodha za majina katika afisi za usajili wa watoto katika Kaunti ya Migori, mahojiano ya wazungumzaji wa Dholuo, pamoja na maandishi kuhusu majina ya Kiafrika. Data zilichanganuliwa kwa kutumia Nadharia ya Ujinaishaji ya Mill (1970). Matokeo yanaonyesha kuwa majina ya Waluo huakisi matukio ya kuzaliwa, hali za kijamii, imani za kitamaduni na matarajio ya wazazi. Maana zilizobainika ni pamoja na maana za kihusishi, dhamirifu, kijamii na dhanishi. Makala hii inahitimisha kuwa majina ya Waluo huonesha uhusiano kati ya lugha, utamaduni na mawasiliano, na pia huhifadhi utambulisho na urithi wa kiutamaduni.</em></p> Jael Akinyi Owala Carren Nyandiba James Ontieri Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-02 2026-11-02 4 2 86 94 10.64535/ijoru.v4i2.151 ASSESSMENT OF EXISTING PARTNERSHIP STRUCTURES AND TRAINING DEFICIENCIES AMONG TRADITIONAL BIRTH ATTENDANTS IN MIGORI COUNTY, KENYA http://journals.rongovarsity.ac.ke/index.php/IJORU/article/view/152 <p><em>This study assessed existing partnership structures between Traditional Birth Attendants (TBAs) and formal healthcare providers and identified training deficiencies among TBAs across six competency domains in Migori County, Kenya. The study used a cross-sectional convergent mixed-methods design in four sub-counties—Nyatike (remote), Kuria West (cross-border), Rongo (semi-urban), and Suna West (mixed farming)—from September 2024 to February 2025. The quantitative component surveyed 150 actively practicing TBAs with at least two years of experience. In addition, 96 TBAs participated in 12 focus group discussions and 18 key informants (sub-county health officers, health facility in-charges, and community health volunteers) were interviewed. Only 22% (33/150) of TBAs reported any formal relationship with a health facility. Training coverage was critically low: 67% (100/150) had received no formal training in the preceding five years, and none had accredited certification. Knowledge assessment showed severe deficiencies across all six domains, ranging from 71% deficient in high-risk pregnancy recognition to 94% deficient in digital health literacy. Qualitative findings identified five overarching barriers: policy exclusion, geographic isolation, lack of funding, cultural preferences, and the digital divide. TBAs nevertheless expressed a strong desire for training. Partnership structures between TBAs and formal healthcare in Migori County are therefore largely informal and non-standardized, while training deficiencies are profound. Urgent investment in structured partnership frameworks, competency-based training, and culturally adapted digital tools is required to strengthen safe referral and maternal and neonatal care in underserved communities</em>.</p> Irene Achayo James Abila Lamek Ronoh Copyright (c) 2026 International Research Journal of Rongo University https://creativecommons.org/licenses/by-nc-nd/4.0 2026-11-02 2026-11-02 4 2 95 105 10.64535/ijoru.v4i2.152