Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

A systematic review of portable electronic technology for health education in resource-limited settings.

PubMed

McHenry, Megan S; Fischer, Lydia J; Chun, Yeona; Vreeman, Rachel C

2017-08-01

The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent

Breast Camps for Awareness and Early Diagnosis of Breast Cancer in Countries With Limited Resources: A Multidisciplinary Model From Kenya

PubMed Central

Moloo, Zahir; Ngugi, Anthony; Allidina, Amyn; Ndumia, Rose; Mutuiri, Anderson; Wasike, Ronald; Wahome, Charles; Abdihakin, Mohamed; Kasmani, Riaz; Spears, Carol D.; Oigara, Raymond; Mwachiro, Elizabeth B.; Busarla, Satya V.P.; Kibor, Kibet; Ahmed, Abdulaziz; Wawire, Jonathan; Sherman, Omar; Saleh, Mansoor; Zujewski, Jo Anne; Dawsey, Sanford M.

2016-01-01

Background. Breast cancer is the most common cancer of women in Kenya. There are no national breast cancer early diagnosis programs in Kenya. Objective. The objective was to conduct a pilot breast cancer awareness and diagnosis program at three different types of facilities in Kenya. Methods. This program was conducted at a not-for-profit private hospital, a faith-based public hospital, and a government public referral hospital. Women aged 15 years and older were invited. Demographic, risk factor, knowledge, attitudes, and screening practice data were collected. Breast health information was delivered, and clinical breast examinations (CBEs) were performed. When appropriate, ultrasound imaging, fine-needle aspirate (FNA) diagnoses, core biopsies, and onward referrals were provided. Results. A total of 1,094 women were enrolled in the three breast camps. Of those, 56% knew the symptoms and signs of breast cancer, 44% knew how breast cancer was diagnosed, 37% performed regular breast self-exams, and 7% had a mammogram or breast ultrasound in the past year. Of the 1,094 women enrolled, 246 (23%) had previously noticed a lump in their breast. A total of 157 participants (14%) had abnormal CBEs, of whom 111 had ultrasound exams, 65 had FNAs, and 18 had core biopsies. A total of 14 invasive breast cancers and 1 malignant phyllodes tumor were diagnosed Conclusion. Conducting a multidisciplinary breast camp awareness and early diagnosis program is feasible in different types of health facilities within a low- and middle-income country setting. This can be a model for breast cancer awareness and point-of-care diagnosis in countries with limited resources like Kenya. Implications for Practice: This work describes a novel breast cancer awareness and early diagnosis demonstration program in a low- and middle-income country within a limited resource setting. The program includes breast self-awareness and breast cancer education, clinical exams, and point-of-care diagnostics for

Kenya.

PubMed

1985-07-01

Kenya's 1st census, in 1948, counted 5.8 million people, the 1979 census counted 15.3 million, and the government estimates the 1984 population at 19.4 million. Development planning began in 1966; the current 5-year plan (1984-1988) stresses manpower, capital, and land development, mainly in the West. The government considers population growth an obstacle to meeting educational, health, housing, food, and employment needs. Kenya's high 4% growth rate results from a high birth rate and a declining death rate. The government intends to reduce population growth to 3.3% by 1988 by 1) informing Kenyans of the benefits of small families and 2) making family planning services easily available, especially in rural areas. Life expectancy is currently 52.9 years and infant mortality is 82/1000. Most health problems relate to childbearing, communicable diseases, malnutrition, and poor sanitation. The current development plan strives to expand services in 1) staff training, information, and education, 2) monitoring and evaluation, 3) contraceptive delivery, and 4) increasing family planning acceptors. Kenyan women desire 7 children and usually have 8. The government is trying to improve the status of women through education and employment, with the expectation of reducing fertility levels. Abortion for contraceptive purposes is illegal; sterilization and contraceptives are available. Neither emigration nor immigration are significant in Kenya. 90% of the people live on 20% of the land. Urban growth is increasing too rapidly and the government's policies to correct the population distribution inequity include 1) urban development, mainly in Western Kenya; 2) encouraging agricultural development; 3) development of export-oriented, resource based, and labor intensive industries; 4) funding development sites outside of Nairobi and Mombasa; 5) stimulating growth in undeveloped areas; 6) improving roads, rails, and ports; and 7) providing adequate water, housing, and energy.

Electronic Resource Management and Design

ERIC Educational Resources Information Center

Abrams, Kimberly R.

2015-01-01

We have now reached a tipping point at which electronic resources comprise more than half of academic library budgets. Because of the increasing work associated with the ever-increasing number of e-resources, there is a trend to distribute work throughout the library even in the presence of an electronic resources department. In 2013, the author…

Characterisation of adopters and non-adopters of dairy technologies in Ethiopia and Kenya.

PubMed

Kebebe, E G; Oosting, S J; Baltenweck, I; Duncan, A J

2017-04-01

While there is a general consensus that using dairy technologies, such as improved breeds of dairy cows, can substantially increase farm productivity and income, adoption of such technologies has been generally low in developing countries. The underlying reasons for non-adoption of beneficial technologies in the dairy sector are not fully understood. In this study, we characterised adopters and non-adopters of dairy technologies in Ethiopia and Kenya based on farmers' resources ownership in order to identify why many farmers in Ethiopia and Kenya have not adopted improved dairy technologies. As compared to non-adopters, farmers who adopt dairy technology own relatively more farm resources. The result signals that differences in resource endowments could lead to divergent technology adoption scenarios. Results show that a higher proportion of sample smallholders in Kenya have adopted dairy technologies than those in Ethiopia. Except for the use of veterinary services, fewer than 10% of sample farmers in Ethiopia have adopted dairy technologies-less than half the number of adopters in Kenya. The higher level of dairy technology adoption in Kenya can be ascribed partly to the long history of dairy development, including improvements in the value chain for the delivery of inputs, services and fluid milk marketing. Interventions that deal with the constraints related to access to farm resources and input and output markets could facilitate uptake of dairy technology in developing countries.

Information Communication and Technology for Water Resource Management and Food Security in Kenya: A Case Study of Kericho and Uasin Gishu Districts

ERIC Educational Resources Information Center

Omboto, P. I.; Macharia, J.; Mbagaya, Grace; Standa, F. N.

2011-01-01

Recent reports on Kenya have indicated food insecurity and destruction of water catchments as serious problems facing the country. Despite the tremendous strides in Information and Communication Technology (ICT), the country has not taken advantage of the technology to improve food security by effectively managing her water resources. A survey on…

Perceptions and Attitudes of Health Professionals in Kenya on National Health Care Resource Allocation Mechanisms: A Structural Equation Modeling

PubMed Central

Owili, Patrick Opiyo; Hsu, Yi-Hsin Elsa; Chern, Jin-Yuan; Chiu, Chiung-Hsuan Megan; Wang, Bill; Huang, Kuo-Cherh; Muga, Miriam Adoyo

2015-01-01

Background Health care resource allocation is key towards attaining equity in the health system. However, health professionals’ perceived impact and attitude towards health care resource allocation in Sub-Saharan Africa is unknown; furthermore, they occupy a position which makes them notice the impact of different policies in their health system. This study explored perceptions and attitudes of health professionals in Kenya on health care resource allocation mechanism. Method We conducted a survey of a representative sample of 341 health professionals in Moi Teaching and Referral Hospital from February to April 2012, consisting of over 3000 employees. We assessed health professionals’ perceived impact and attitudes on health care resource allocation mechanism in Kenya. We used structural equation modeling and applied a Confirmatory Factor Analysis using Robust Maximum Likelihood estimation procedure to test the hypothesized model. Results We found that the allocation mechanism was negatively associated with their perceived positive impact (-1.04, p < .001), health professionals’ satisfaction (-0.24, p < .01), and professionals’ attitudes (-1.55, p < .001) while it was positively associated with perceived negative impact (1.14, p < .001). Perceived positive impact of the allocation mechanism was negatively associated with their overall satisfaction (-0.08) and attitude (-0.98) at p < .001, respectively. Furthermore, overall satisfaction was negatively associated with attitude (-1.10, p <.001). On the other hand, perceived negative impact of the allocation was positively associated with overall satisfaction (0.29, p <.001) but was not associated with attitude. Conclusion The result suggests that health care resource allocation mechanism has a negative effect towards perceptions, attitudes and overall satisfaction of health professionals who are at the frontline in health care. These findings can serve as a crucial reference for policymakers as the Kenyan

A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

PubMed Central

2011-01-01

Background Kenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle). Methods Qualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred. Results The scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach. Conclusion The introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better

China's Cooperation in Education and Training with Kenya: A Different Model?

ERIC Educational Resources Information Center

King, Kenneth

2010-01-01

This is the first detailed study of the character and particularity of China's rapidly growing education and training cooperation with Kenya. Set against the 50-year history of Kenya's engagement with China, it pays special attention to the human resources targets of the Forum for China-Africa Cooperation (FOCAC) from 2000. It argues that the…

Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

PubMed Central

Burke, Thomas F; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D

2014-01-01

Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings. PMID:25260371

The cost of health professionals' brain drain in Kenya.

PubMed

Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony

2006-07-17

Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment. Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and

The cost of health professionals' brain drain in Kenya

PubMed Central

Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony

2006-01-01

Background Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. Methods The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. Results The total cost of educating a single medical doctor from primary school to university is US$ 65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$ 43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. Conclusion Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill

Adolescent Experience of Menstruation in Rural Kenya.

PubMed

Secor-Turner, Molly; Schmitz, Kaitlin; Benson, Kristen

2016-01-01

Although menstruation is a universal experience, girls in resource-poor areas face unique challenges related to menstruation management. In Kenya, girls miss nearly 3.5 million learning days per month because of limited access to sanitary products and lack of adequate sanitation. Global priorities to address gender inequality-especially related to education-often do not consider the impact of poverty on gendered experiences, such as menstruation. The aim of the study was to describe the experiences of menstruation from the perspective of adolescent girls living in rural Kenya. Data for this qualitative study were collected through 29 individual interviews with adolescent girls and separate field observations. Descriptive content analysis was used to identify themes reflective of the data from the individual interviews and field notes. Four themes were developed to summarize the data: (a) receiving information about menstruation, (b) experiences of menstruation, (c) menstrual hygiene practices, and (d) social norms and the meaning of menstruation. Findings from this study describe the impact of menstruation on the lives of adolescent girls in rural Kenya. Menstrual hygiene management and its associated challenges may impact girls' academic continuity. Experiences of menstruation also reinforce gender inequality and further marginalize girls in low-income, rural areas of Kenya. Consideration of menstruation is critical to promote health and academic continuity for girls in rural Kenya.

The use of mobile devices as assistive technology in resource-limited environments: access for learners with visual impairments in Kenya.

PubMed

Foley, Alan R; Masingila, Joanna O

2015-07-01

In this paper, the authors explore the use of mobile devices as assistive technology for students with visual impairments in resource-limited environments. This paper provides initial data and analysis from an ongoing project in Kenya using tablet devices to provide access to education and independence for university students with visual impairments in Kenya. The project is a design-based research project in which we have developed and are refining a theoretically grounded intervention--a model for developing communities of practice to support the use of mobile technology as an assistive technology. We are collecting data to assess the efficacy and improve the model as well as inform the literature that has guided the design of the intervention. In examining the impact of the use of mobile devices for the students with visual impairments, we found that the devices provide the students with (a) access to education, (b) the means to participate in everyday life and (c) the opportunity to create a community of practice. Findings from this project suggest that communities of practice are both a viable and a valuable approach for facilitating the diffusion and support of mobile devices as assistive technology for students with visual impairments in resource-limited environments. Implications for Rehabilitation The use of mobile devices as assistive technology in resource-limited environments provides students with visual impairments access to education and enhanced means to participate in everyday life. Communities of practice are both a viable and a valuable approach for facilitating the diffusion and support of mobile devices as assistive technology for students with visual impairments in resource-limited environments. Providing access to assistive technology early and consistently throughout students' schooling builds both their skill and confidence and also demonstrates the capabilities of people with visual impairments to the larger society.

Implementing CORAL: An Electronic Resource Management System

ERIC Educational Resources Information Center

Whitfield, Sharon

2011-01-01

A 2010 electronic resource management survey conducted by Maria Collins of North Carolina State University and Jill E. Grogg of University of Alabama Libraries found that the top six electronic resources management priorities included workflow management, communications management, license management, statistics management, administrative…

Extension Agents and Conflict Narratives: A Case of Laikipia County, Kenya

ERIC Educational Resources Information Center

Bond, Jennifer

2016-01-01

Purpose: This work investigated the narratives of development extensionists in relation to natural resource conflict, in order to understand the competing discourses surrounding the wicked problems of natural resource management in Laikipia County, Kenya. Methodology: Q methodology was used to elicit the conflict narratives present among extension…

"Talkin' about a revolution": How electronic health records can facilitate the scale-up of HIV care and treatment and catalyze primary care in resource-constrained settings.

PubMed

Braitstein, Paula; Einterz, Robert M; Sidle, John E; Kimaiyo, Sylvester; Tierney, William

2009-11-01

Health care for patients with HIV infection in developing countries has increased substantially in response to major international funding. Scaling up treatment programs requires timely data on the type, quantity, and quality of care being provided. Increasingly, such programs are turning to electronic health records (EHRs) to provide these data. We describe how a medical school in the United States and another in Kenya collaborated to develop and implement an EHR in a large HIV/AIDS care program in western Kenya. These data were used to manage patients, providers, and the program itself as it grew to encompass 18 sites serving more than 90,000 patients. Lessons learned have been applicable beyond HIV/AIDS to include primary care, chronic disease management, and community-based health screening and disease prevention programs. EHRs will be key to providing the highest possible quality of care for the funds developing countries can commit to health care. Public, private, and academic partnerships can facilitate the development and implementation of EHRs in resource-constrained settings.

Selection of Electronic Resources.

ERIC Educational Resources Information Center

Weathers, Barbara

1998-01-01

Discusses the impact of electronic resources on collection development; selection of CD-ROMs, (platform, speed, video and sound, networking capability, installation and maintenance); selection of laser disks; and Internet evaluation (accuracy of content, authority, objectivity, currency, technical characteristics). Lists Web sites for evaluating…

Guidance and Counselling: What Is the Level of Human and Physical Resource Preparedness in Providing Effective Services in Secondary Schools in Bureti Sub County, Kericho County, Kenya?

ERIC Educational Resources Information Center

Cheruiyot, David Kipkorir; Orodho, John Aluko

2015-01-01

The gist of this study was to examine the human and resource preparedness to provide effective guidance and counselling (G&C) services in secondary schools in Bureti Sub County, Kericho County, Kenya. The study used combinations of descriptive survey and correlation research designs. Stratified sampling technique was employed to select 20…

Implementation of a cloud-based electronic medical record for maternal and child health in rural Kenya.

PubMed

Haskew, John; Rø, Gunnar; Saito, Kaori; Turner, Kenrick; Odhiambo, George; Wamae, Annah; Sharif, Shahnaaz; Sugishita, Tomohiko

2015-05-01

Complete and timely health information is essential to inform public health decision-making for maternal and child health, but is often lacking in resource-constrained settings. Electronic medical record (EMR) systems are increasingly being adopted to support the delivery of health care, and are particularly amenable to maternal and child health services. An EMR system could enable the mother and child to be tracked and monitored throughout maternity shared care, improve quality and completeness of data collected and enhance sharing of health information between outpatient clinic and the hospital, and between clinical and public health services to inform decision-making. This study implemented a novel cloud-based electronic medical record system in a maternal and child health outpatient setting in Western Kenya between April and June 2013 and evaluated its impact on improving completeness of data collected by clinical and public health services. The impact of the system was assessed using a two-sample test of proportions pre- and post-implementation of EMR-based data verification. Significant improvements in completeness of the antenatal record were recorded through implementation of EMR-based data verification. A difference of 42.9% in missing data (including screening for hypertension, tuberculosis, malaria, HIV status or ART status of HIV positive women) was recorded pre- and post-implementation. Despite significant impact of EMR-based data verification on data completeness, overall screening rates in antenatal care were low. This study has shown that EMR-based data verification can improve the completeness of data collected in the patient record for maternal and child health. A number of issues, including data management and patient confidentiality, must be considered but significant improvements in data quality are recorded through implementation of this EMR model. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Development of Electronic Resources across Networks in Thailand.

ERIC Educational Resources Information Center

Ratchatavorn, Phandao

2002-01-01

Discusses the development of electronic resources across library networks in Thailand to meet user needs, particularly electronic journals. Topics include concerns about journal access; limited budgets for library acquisitions of journals; and sharing resources through a centralized database system that allows Web access to journals via Internet…

From Tedious to Timely: Screencasting to Troubleshoot Electronic Resource Issues

ERIC Educational Resources Information Center

Hartnett, Eric; Thompson, Carole

2010-01-01

The shift from traditional print materials to electronic resources, in conjunction with the rise in the number of distance education programs, has left many electronic resource librarians scrambling to keep up with the resulting inundation of electronic resource problems. When it comes to diagnosing these problems, words do not always convey all…

Changing household responses to drought in Tharaka, Kenya: vulnerability, persistence and challenge.

PubMed

Smucker, Thomas A; Wisner, Ben

2008-06-01

Drought is a recurring challenge to the livelihoods of those living in Tharaka District, Kenya, situated in the semi-arid zone to the east of Mount Kenya, from the lowest slopes of the mountain to the banks of the Tana River. This part of Kenya has been marginal to the economic and political life of Kenya from the colonial period until the present day. A study of more than 30 years of change in how people in Tharaka cope with drought reveals resilience in the face of major macro-level transformations, which include privatisation of landownership, population growth, political decentralisation, increased conflict over natural resources, different market conditions, and environmental shifts. However, the study also shows troubling signs of increased use of drought responses that are incompatible with long-term agrarian livelihoods. Government policy needs to address the challenge of drought under these new macro conditions if sustainable human development is to be achieved.

The AMPATH Nutritional Information System: Designing a Food Distribution Electronic Record System in Rural Kenya

PubMed Central

Lim, Jason LitJeh; Yih, Yuehwern; Gichunge, Catherine; Tierney, William M.; Le, Tung H.; Zhang, Jun; Lawley, Mark A.; Petersen, Tomeka J.; Mamlin, Joseph J.

2009-01-01

Objective The AMPATH program is a leading initiative in rural Kenya providing healthcare services to combat HIV. Malnutrition and food insecurity are common among AMPATH patients and the Nutritional Information System (NIS) was designed, with cross-functional collaboration between engineering and medical communities, as a comprehensive electronic system to record and assist in effective food distribution in a region with poor infrastructure. Design The NIS was designed modularly to support the urgent need of a system for the growing food distribution program. The system manages the ordering, storage, packing, shipping, and distribution of fresh produce from AMPATH farms and dry food supplements from the World Food Programme (WFP) and U.S. Agency for International Development (USAID) based on nutritionists' prescriptions for food supplements. Additionally, the system also records details of food distributed to support future studies. Measurements Patients fed weekly, patient visits per month. Results With inception of the NIS, the AMPATH food distribution program was able to support 30,000 persons fed weekly, up from 2,000 persons. Patient visits per month also saw a marked increase. Conclusion The NIS' modular design and frequent, effective interactions between developers and users has positively affected the design, implementation, support, and modifications of the NIS. It demonstrates the success of collaboration between engineering and medical communities, and more importantly the feasibility for technology readily available in a modern country to contribute to healthcare delivery in developing countries like Kenya and other parts of sub-Saharan Africa. PMID:19717795

Forests and competing land uses in Kenya

NASA Astrophysics Data System (ADS)

Allaway, James; Cox, Pamela M. J.

1989-03-01

Indigenous forests in Kenya, as in other developing countries, are under heavy pressure from competing agricultural land uses and from unsustainable cutting. The problem in Kenya is compounded by high population growth rates and an agriculturally based economy, which, even with efforts to control birth rates and industrialize, will persist into the next century. Both ecological and economic consequences of these pressures need to be considered in land-use decision making for land and forest management to be effective. This paper presents one way to combine ecological and economic considerations. The status of principal forest areas in Kenya is summarized and competing land uses compared on the basis of ecological functions and economic analysis. Replacement uses do not match the ecological functions of forest, although established stands of tree crops (forest plantations, fuel wood, tea) can have roughly comparable effects on soil and water resources. Indigenous forests have high, although difficult to estimate, economic benefits from tourism and protection of downstream agricultural productivity. Economic returns from competing land uses range widely, with tea having the highest and fuel wood plantations having returns comparable to some annual crops and dairying. Consideration of ecological and economic factors together suggests some trade-offs for improving land allocation decisions and several management opportunities for increasing benefits or reducing costs from particular land uses. The evaluation also suggests a general strategy for forest land management in Kenya.

Electronic Resources Evaluation Central: Using Off-the-Shelf Software, Web 2.0 Tools, and LibGuides to Manage an Electronic Resources Evaluation Process

ERIC Educational Resources Information Center

England, Lenore; Fu, Li

2011-01-01

A critical part of electronic resources management, the electronic resources evaluation process is multi-faceted and includes a seemingly endless range of resources and tools involving numerous library staff. A solution is to build a Web site to bring all of the components together that can be implemented quickly and result in an organizational…

Do GPs use electronic mental health resources? - a qualitative study.

PubMed

Austin, David; Pier, Ciaran; Mitchell, Joanna; Schattner, Peter; Wade, Victoria; Pierce, David; Klein, Britt

2006-05-01

The Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs' acceptance and use of EMHRs. Semistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients. Few GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information. General practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.

Evaluation criteria for district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W

2005-01-01

There has been no comprehensive evaluation of the district health management information systems (DHMISs) since the establishment of these systems by the Ministry of Health (MoH), in Kenya. This is partly due to lack of defined criteria for evaluating the systems. The objective of this study is to design evaluation criteria for assessing the viability, sustainability and ultimate contribution of DHMIS in the management of the district health system (DHS) in Kenya. This descriptive cross-sectional study was undertaken in three DHSs in Kenya. Empirical evidence was collected through interviews, complemented by a comprehensive review of relevant literature, reports and operational manuals of various health information systems in Kenya. A set of evaluation criteria for DHMISs in Kenya was designed for each of the three phases of implementation: phase one-pre-implementation evaluation criteria (categorized as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; phase two-concurrent (operational) implementation evaluation criteria to be applied during implementation of the new system; phase three-post-implementation evaluation criteria (classified as internal-quality of information; external-resources and managerial support; ultimate-systems impact) to be applied after operating the implemented system for at least 3 years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to its implementation; concurrent (operational) implementation evaluation criteria should be used to ascertain the status of the on-going implementation with the view to either fine-tune or abandon it altogether before more resources are used on it; and post-implementation evaluation criteria

Major incidents in Kenya: the case for emergency services development and training.

PubMed

Wachira, Benjamin W; Smith, Wayne

2013-04-01

Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

Responses to and resources for intimate partner violence: qualitative findings from women, men, and service providers in rural Kenya.

PubMed

Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A; Turan, Janet M

2014-03-01

Intimate partner violence (IPV) is reported by one in three women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by sociocultural, economic, and institutional factors. This article explores actions taken by victims, available support services, and barriers to the utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through nine focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV but often viewed it as a "normal" part of local culture. Further barriers to women accessing services included logistical challenges and providers who were undertrained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources-including the health clinic-to address violence among women of childbearing age.

Esophageal cancer in Kenya

PubMed Central

Odera, Joab Otieno; Odera, Elizabeth; Githang’a, Jessie; Walong, Edwin Oloo; Li, Fang; Xiong, Zhaohui; Chen, Xiaoxin Luke

2017-01-01

Kenya belongs to a high incidence region known as Africa’s esophageal cancer (EC) corridor. It has one of the highest incidence rates of EC worldwide, but research on EC in Kenya has gone highly unnoticed. EC in Kenya is unique in its high percentage of young cases (< 30 years of age). In this review, we show the current status of EC in the country. We mainly focus on significant risk factors such as alcohol drinking, genetic factors, malnutrition and hot food/drink. Future directions in the study and prevention of EC in Kenya are also discussed. PMID:29082268

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

PubMed Central

Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-01-01

ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Conclusions Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. PMID:29669709

Genetic Diversity of Cowpea (Vigna unguiculata (L.) Walp.) Accession in Kenya Gene Bank Based on Simple Sequence Repeat Markers.

PubMed

Wamalwa, Emily N; Muoma, John; Wekesa, Clabe

2016-01-01

Increased agricultural production is an urgent issue. Projected global population is 9 million people by mid of this century. Estimation projects death of 1 million people for lack of food quality (micronutrient deficit) and quantity (protein deficit). Majority of these people will be living in developing countries. Other global challenges include shrinking cultivable lands, salinity, and flooding due to climate changes, new emerging pathogens, and pests. These affect crop production. Furthermore, they are major threats to crop genetic resources and food security. Genetic diversity in cultivated crops indicates gene pool richness. It is the greatest resource for plant breeders to select lines that enhance food security. This study was conducted by Masinde Muliro University to evaluate genetic diversity in 19 cowpea accessions from Kenya national gene bank. Accessions clustered into two major groups. High divergence was observed between accessions from Ethiopia and Australia and those from Western Kenya. Upper Volta accessions were closely related to those from Western Kenya. Low variation was observed between accessions from Eastern and Rift Valley than those from Western and Coastal regions of Kenya. Diversity obtained in this study can further be exploited for the improvement of cowpea in Kenya as a measure of food security.

Responses to and Resources for Intimate Partner Violence: Qualitative Findings from Women, Men, and Service Providers in Rural Kenya

PubMed Central

Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A.; Turan, Janet M.

2014-01-01

Intimate partner violence (IPV) is reported by one in five women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by socio-cultural, economic, and institutional factors. This paper explores actions taken by victims, available support services, and barriers to utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through 9 focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV, but often viewed it as a “normal” part of local culture. Further barriers to women accessing services included logistical challenges and providers who were under-trained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources – including the health clinic - to address violence among women of child-bearing age. PMID:24255067

Use of personal digital assistants for data collection in a multi-site AIDS stigma study in rural south Nyanza, Kenya.

PubMed

Onono, M A; Carraher, N; Cohen, R C; Bukusi, E A; Turan, J M

2011-09-01

To describe the development, cost effectiveness and implementation of a PDA based electronic system to collect, verify and manage data from a multi-site study on HIV/AIDS stigma and pregnancy in a rural, resource-poor area. We worked within a large prevention of mother-to-child-transmission (PMTCT) program in nine rural health facilities to implement a PDA-based data collection system and to study the feasibility of its use in a multisite HIV research study in rural Kenya. The PDAs were programmed for collecting screening and eligibility data, and responses to structured interviews on HIV/AIDS stigma and violence in three local languages. Between November 2007 and December 2008, nine PDAs were used by Clinic and Community Health Assistants to enrol 1,270 participants on to the PMTCT program. Successes included: capacity-building of interviewers, low cost of implementation, quick turnaround time of data entry with good data quality, and convenience. Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote rural health facilities in Kenya. However, appropriate and frequent data backup protocols need to be established and paper forms are still needed as backup tools in resource-poor settings.

Use of Electronic Resources for Psychiatry Clerkship Learning: A Medical Student Survey.

PubMed

Snow, Caitlin E; Torous, John; Gordon-Elliott, Janna S; Penzner, Julie B; Meyer, Fermonta; Boland, Robert

2017-10-01

The primary aim of this study is to examine medical students' use patterns, preferences, and perceptions of electronic educational resources available for psychiatry clerkship learning. Eligible participants included medical students who had completed the psychiatry clerkship during a 24-month period. An internet-based questionnaire was used to collect information regarding the outcomes described above. A total of 68 medical students responded to the survey. Most respondents reported high utilization of electronic resources on an array of devices for psychiatry clerkship learning and indicated a preference for electronic over print resources. The most commonly endorsed barriers to the use of electronic resources were that the source contained irrelevant and non-specific content, access was associated with a financial cost, and faculty guidance on recommended resources was insufficient. Respondents indicated a wish for more psychiatry-specific electronic learning resources. The authors' results suggest that a demand exists for high-quality electronic and portable learning tools that are relevant to medical student education in psychiatry. Psychiatry educators are usefully positioned to be involved in the development of such resources.

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

PubMed Central

Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise

2016-01-01

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335

Success Factors for Community-Based Natural Resource Management (CBNRM): Lessons from Kenya and Australia

NASA Astrophysics Data System (ADS)

Measham, Thomas G.; Lumbasi, Jared A.

2013-09-01

Recent concerns over a crisis of identity and legitimacy in community-based natural resource management (CBNRM) have emerged following several decades of documented failure. A substantial literature has developed on the reasons for failure in CBNRM. In this paper, we complement this literature by considering these factors in relation to two successful CBNRM case studies. These cases have distinct differences, one focusing on the conservation of hirola in Kenya on community-held trust land and the other focusing on remnant vegetation conservation from grazing pressure on privately held farm land in Australia. What these cases have in common is that both CBNRM projects were initiated by local communities with strong attachments to their local environments. The projects both represent genuine community initiatives, closely aligned to the original aims of CBNRM. The intrinsically high level of "ownership" held by local residents has proven effective in surviving many challenges which have affected other CBNRM projects: from impacts on local livelihoods to complex governance arrangements involving non-government organizations and research organizations. The cases provide some signs of hope among broader signs of crisis in CBNRM practice.

Kenya Country Analysis Brief

EIA Publications

2016-01-01

Kenya currently does not produce any hydrocarbons, although the country has the potential to become an oil producer most likely after 2020. Over the past few years, several commercial oil discoveries have been made in Kenya, but the country faces obstacles that have caused production delays. Negotiations over a joint export pipeline route with its neighbor Uganda is in flux, while sustained low oil prices have slowed down exploration drilling activity in Kenya.

Assessing Ongoing Electronic Resource Purchases: Linking Tools to Synchronize Staff Workflows

ERIC Educational Resources Information Center

Carroll, Jeffrey D.; Major, Colleen; O'Neal, Nada; Tofanelli, John

2012-01-01

Ongoing electronic resource purchases represent a substantial proportion of collections budgets. Recognizing the necessity of systematic ongoing assessment with full selector engagement, Columbia University Libraries appointed an Electronic Resources Assessment Working Group to promote the inclusion of such resources within our current culture of…

Recentralization within decentralization: County hospital autonomy under devolution in Kenya

PubMed Central

Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

2017-01-01

Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

PubMed

Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-04-18

complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. ©Naomi Muinga, Steve Magare, Jonathan Monda, Onesmus Kamau, Stuart Houston, Hamish Fraser, John Powell, Mike English, Chris Paton. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

Nurse management of hypertension in rural western Kenya: implementation research to optimize delivery.

PubMed

Vedanthan, Rajesh; Kamano, Jemima H; Horowitz, Carol R; Ascheim, Deborah; Velazquez, Eric J; Kimaiyo, Sylvester; Fuster, Valentin

2014-01-01

Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and insufficient human resource capacity is among the contributing factors. Thus, a critical component of hypertension management is to develop novel and effective solutions to the human resources challenge. One potential solution is task redistribution and nurse management of hypertension in these settings. The aim of this study is to investigate whether nurses can effectively reduce blood pressure in hypertensive patients in rural western Kenya and, by extension, throughout sub-Saharan Africa. An initial phase of qualitative inquiry will assess facilitators and barriers of nurse management of hypertension. In addition, we will perform usability and feasibility testing of a novel, electronic tablet-based integrated decision-support and record-keeping tool for the nurses. An impact evaluation of a pilot program for nurse-based management of hypertension will be performed. Finally, a needs-based workforce estimation model will be used to estimate the nurse workforce requirements for stable, long-term treatment of hypertension throughout western Kenya. The primary outcome measure of the impact evaluation will be the change in systolic blood pressure of hypertensive individuals assigned to nurse-based management after 1 year of follow-up. The workforce estimation modeling output will be the full-time equivalents of nurses. This study will provide evidence regarding the effectiveness of strategies to optimize task redistribution and nurse-based management of hypertension that can be applicable to noncommunicable disease management in low- and middle-income countries. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Electronic Resource Management 2.0: Using Web 2.0 Technologies as Cost-Effective Alternatives to an Electronic Resource Management System

ERIC Educational Resources Information Center

Murray, Adam

2008-01-01

Designed to assist with the management of e-resources, electronic resource management (ERM) systems are time- and fund-consuming to purchase and maintain. Questions of system compatibility, data population, and workflow design/redesign can be difficult to answer; sometimes those answers are not what we'd prefer to hear. The two primary functions…

Analysis of Human Resources Management Strategy in China Electronic Commerce Enterprises

NASA Astrophysics Data System (ADS)

Shao, Fang

The paper discussed electronic-commerce's influence on enterprise human resources management, proposed and proved the human resources management strategy which electronic commerce enterprise should adopt from recruitment strategy to training strategy, keeping talent strategy and other ways.

You Have "How Many" Spreadsheets? Rethinking Electronic Resource Management

ERIC Educational Resources Information Center

Rux, Erika; Borchert, Theresa

2010-01-01

As libraries face a veritable explosion of electronic resources and as the interconnectedness of print and online resources becomes increasingly complicated, many librarians are challenged to find efficient and cost-friendly ways to manage these resources. In this article, the authors describe how a team of people from various library departments…

Kenya geothermal private power project: A prefeasibility study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-10-01

Twenty-eight geothermal areas in Kenya were evaluated and prioritized for development. The prioritization was based on the potential size, resource temperature, level of exploration risk, location, and exploration/development costs for each geothermal area. Suswa, Eburru and Arus are found to offer the best short-term prospects for successful private power development. It was found that cost per kill developed are significantly lower for the larger (50MW) than for smaller-sized (10 or 20 NW) projects. In addition to plant size, the cost per kill developed is seen to be a function of resource temperature, generation mode (binary or flash cycle) and transmissionmore » distance.« less

Electronic Resources and Mission Creep: Reorganizing the Library for the Twenty-First Century

ERIC Educational Resources Information Center

Stachokas, George

2009-01-01

The position of electronic resources librarian was created to serve as a specialist in the negotiation of license agreements for electronic resources, but mission creep has added more functions to the routine work of electronic resources such as cataloging, gathering information for collection development, and technical support. As electronic…

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could

Electronic Resources: Selection and Bibliographic Control.

ERIC Educational Resources Information Center

Pattie, Ling-yuh W., Ed.; Cox, Bonnie Jean, Ed.

This book is a baseline guide for professionals and library school students on issues that concern the selection and bibliographic control of electronic resources, from both conceptual and pragmatic standpoints. The book includes the following articles: (1) "Foreward" (Lois Mai Chan); (2) "Introduction" (Ling-yuh W. (Miko)…

Environmental security: a geographic information system analysis approach--the case of Kenya.

PubMed

Bocchi, Stefano; Disperati, Stefano Peppino; Rossi, Simone

2006-02-01

Studies into the relationships between environmental factors and violence or conflicts constitute a very debated research field called environmental security. Several authors think that environmental scarcity, which is scarcity of renewable resources, can contribute to generate violence or social unrest, particularly within states scarcely endowed with technical know-how and social structures, such as developing countries. In this work, we referred to the theoretical model developed by the Environmental Change and Acute Conflict Project. Our goal was to use easily available spatial databases to map the various sources of environmental scarcity through geographic information systems, in order to locate the areas apparently most at risk of suffering negative social effects and their consequences in terms of internal security. The analysis was carried out at a subnational level and applied to the case of Kenya. A first phase of the work included a careful selection of databases relative to renewable resources. Spatial operations among these data allowed us to obtain new information on the availability of renewable resources (cropland, forests, water), on the present and foreseen demographic pressure, as well as on the social and technical ingenuity. The results made it possible to identify areas suffering from scarcity of one or more renewable resources, indicating different levels of gravity. Accounts from Kenya seem to confirm our results, reporting clashes between tribal groups over the access to scarce resources in areas that our work showed to be at high risk.

Lake Naivasha, Kenya

NASA Technical Reports Server (NTRS)

2008-01-01

If you live in Europe and buy roses, there is a good chance that they were grown in Kenya specifically, in one of the colossal greenhouses that blot out the once wild shores of Lake Naivasha, 90km north-west of Nairobi. Some 25% of Europe's cut flowers come from Kenya. After a tentative start in the 1980s the industry is now the country's third-largest foreign-currency earner, bringing in $120m a year. But the recent violence in Kenya is having a major impact on the flower growers. A local trade union says 3,000 of the 30,000 workers employed in Naivasha's flower farms have abandoned their jobs. Kenya emerged as a flower power when Israel scaled down its own industry. It has since lost business to neighboring Ethiopia, which offers tax breaks and better security, but Naivasha's perfect intensity of sunlight and days of near-constant length should keep it on top.

The ASTER image was acquired February 2, 2008, covers an area of 25 x 26.6 km, and is located near 0.8 degrees south latitude, 36.4 degrees east longitude.

The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

PubMed

Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

2015-01-01

Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half

Developing a National-Level Concept Dictionary for EHR Implementations in Kenya.

PubMed

Keny, Aggrey; Wanyee, Steven; Kwaro, Daniel; Mulwa, Edwin; Were, Martin C

2015-01-01

The increasing adoption of Electronic Health Records (EHR) by developing countries comes with the need to develop common terminology standards to assure semantic interoperability. In Kenya, where the Ministry of Health has rolled out an EHR at 646 sites, several challenges have emerged including variable dictionaries across implementations, inability to easily share data across systems, lack of expertise in dictionary management, lack of central coordination and custody of a terminology service, inadequately defined policies and processes, insufficient infrastructure, among others. A Concept Working Group was constituted to address these challenges. The country settled on a common Kenya data dictionary, initially derived as a subset of the Columbia International eHealth Laboratory (CIEL)/Millennium Villages Project (MVP) dictionary. The initial dictionary scope largely focuses on clinical needs. Processes and policies around dictionary management are being guided by the framework developed by Bakhshi-Raiez et al. Technical and infrastructure-based approaches are also underway to streamline workflow for dictionary management and distribution across implementations. Kenya's approach on comprehensive common dictionary can serve as a model for other countries in similar settings.

Quantification of print, radio and television exposure among previous blood donors in Kenya: an opportunity for encouraging repeat donation in a resource-limited setting?

PubMed

Basavaraju, S V; Mwangi, J; Kellogg, T A; Odawo, L; Marum, L H

2010-10-01

Blood services in sub-Saharan Africa experience blood shortages and low retention of voluntary, non-remunerated donors. To boost collections by encouraging repeat donations, the Kenya National Blood Transfusion Service is exploring the likelihood of reaching previous donors through targeted print, radio and television advertising. We analysed data from a national AIDS Indicator Survey to determine whether previous donors have significant exposure to media. Respondents reporting history of blood donation had significantly higher exposure to print, radio and television media than those without history of blood donation. Targeted media campaigns encouraging repeat donation are likely to reach previous donors even in resource-limited settings.

Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; English, Michael C

2012-01-17

Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them. Global health research should provide benefits that address both the micro and macro level issues of justice in order to

Kenya: Current Conditions and the Challenges Ahead

DTIC Science & Technology

2010-10-06

Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 Kenya...Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33%, indigenous beliefs 10%, Muslim 10

Kenya: Current Conditions and the Challenges Ahead

DTIC Science & Technology

2010-02-04

Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit...Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman

Grappling with HIV Transmission Risks: Narratives of Rural Women in Eastern Kenya Living with HIV

PubMed Central

Kako, Peninnah M.; Stevens, Patricia E.; Karani, Anna K; Mkandawire-Valhmu, Lucy; Banda, Anne

2011-01-01

As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, under-resourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance, while being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and post-colonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women's narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed. PMID:22137546

Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya.

PubMed

Ali, Zipporah

2016-01-01

In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015-2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya's successful experience.

Use of traditional versus electronic medical-information resources by residents and interns.

PubMed

Phua, Jason; Lim, T K

2007-05-01

Little is known about the information-seeking behaviour of junior doctors, with regard to their use of traditional versus electronic sources of information. To evaluate the amount of time junior doctors spent using various medical-information resources and how useful they perceived these resources to be. A questionnaire study of all residents and interns in a tertiary teaching hospital in July and August 2004. In total, 134 doctors returned the completed questionnaires (response rate 79.8%). They spent the most time using traditional resources like teaching sessions and print textbooks, rating them as most useful. However, electronic resources like MEDLINE, UpToDate, and online review articles also ranked highly. Original research articles were less popular. Residents and interns prefer traditional sources of medical information. Meanwhile, though some electronic resources are rated highly, more work is required to remove the barriers to evidence-based medicine.

Household headship and child nutrition: a case study in western Kenya.

PubMed

Onyango, A; Tucker, K; Eisemon, T

1994-12-01

The effect of female household headship on child nutrition has been hypothesized by some to be negative, based on the assumption that mothers alone will be poorer and will have greater demands on their time and resources. On the other hand, there is some evidence in Kenya that the nutritional status of children of female heads may be better than that of children of male heads, suggesting that when women have more control over resources, more goes to the children. In Kenya, de facto female headship is common due to male labor migration. This study examines the relationship between child nutrition and de facto female vs male household headship in western Kenya through the examination of family income and decision making patterns. Women in male-headed households had greater financial responsibility for household maintenance. Female heads assumed more farming responsibilities and had higher remittances from husbands. Husbands of female heads purchased food and other goods in the city for use by the household. Male headed households produced more food crops and used a larger proportion of them for home consumption. In this study, children of female heads consumed a greater variety of foods. Despite a greater prevalence of stunting, there was a lower prevalence of low weight for age among children of female heads. However, in statistical analyses, headship did not relate significantly to nutritional intake or status. In attempting to understand the possible factors influencing the relationship between headship and nutritional status, we found trade-offs in the ways families were coping, which appeared to balance some of the negative and positive effects of each situation.

The Akhonya Dental Project: a new charity aiming to provide oral health education and preventative care in Kenya.

PubMed

Barber, S

2010-01-09

Kenya is a country plagued by HIV and lacking in adequate healthcare resources, and despite dental caries remaining the most common disease in the world, there is estimated to be only one dentist per 100,000 population in Kenya. Evidence suggests that many Kenyans are unaware of the causes of dental disease and half of the population are unaware of measures that can be taken to prevent dental disease. Oral health education is a clearly vital for improving the health of the Kenyan population. The Akhonya Dental Project is a new charity which aims to provide oral health education, prevention and treatment for AIDS orphans in rural Kenya. This article describes the ethos of the charity and long-term aim to increase oral health awareness in the region.

Effects of Electronic Information Resources Skills Training for Lecturers on Pedagogical Practices and Research Productivity

ERIC Educational Resources Information Center

Bhukuvhani, Crispen; Chiparausha, Blessing; Zuvalinyenga, Dorcas

2012-01-01

Lecturers use various electronic resources at different frequencies. The university library's information literacy skills workshops and seminars are the main sources of knowledge of accessing electronic resources. The use of electronic resources can be said to have positively affected lecturers' pedagogical practices and their work in general. The…

Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya.

PubMed

Rafferty, Ellen R; Schurer, Janna M; Arndt, Michael B; Choy, Robert K M; de Hostos, Eugenio L; Shoultz, David; Farag, Marwa

2017-01-01

Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0-11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production.

Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya

PubMed Central

Arndt, Michael B.; Choy, Robert K. M.; de Hostos, Eugenio L.; Shoultz, David; Farag, Marwa

2017-01-01

Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0–11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production. PMID:28832624

Factors associated with cholera in Kenya, 2008-2013

PubMed Central

Cowman, Gretchen; Otipo, Shikanga; Njeru, Ian; Achia, Thomas; Thirumurthy, Harsha; Bartram, Jamie; Kioko, Jackson

2017-01-01

Introduction Kenya experienced widespread cholera outbreaks in 1997-1999 and 2007-2010. The re-emergence of cholera in Kenya in 2015 indicates that cholera remains a public health threat. Understanding past outbreaks is important for preventing future outbreaks. This study investigated the relationship between cholera occurrence in Kenya and various environmental and demographic factors related to water, sanitation, socio-economic status, education, urbanization and availability of health facilities during the time period 2008-2013. Methods The primary outcome analyzed was the number of cholera cases at the district level, obtained from the Kenya Ministry of Health's national cholera surveillance records. Values of independent variables were obtained from the 2009 Kenya Population and Housing Census and other national surveys. The data were analyzed using a zero-inflated negative binomial regression model. Results Multivariate analysis indicated that the risk of cholera was associated with open defecation, use of unimproved water sources, poverty headcount ratio and the number of health facilities per 100,000 population (p < 0.05). No statistically significant association was found between cholera occurrence and education, percentage of population living in urban areas or population density. Conclusion The Sustainable Development Goals and Kenya's blueprint for development, Kenya Vision 2030, call for access to sanitation facilities and clean water for all by 2030. Kenya has made important economic strides in recent years but continues to be affected by diseases like cholera that are associated with low socio-economic status. Further expansion of access to sanitation facilities and clean water is necessary for preventing cholera in Kenya. PMID:29515719

Factors associated with cholera in Kenya, 2008-2013.

PubMed

Cowman, Gretchen; Otipo, Shikanga; Njeru, Ian; Achia, Thomas; Thirumurthy, Harsha; Bartram, Jamie; Kioko, Jackson

2017-01-01

Kenya experienced widespread cholera outbreaks in 1997-1999 and 2007-2010. The re-emergence of cholera in Kenya in 2015 indicates that cholera remains a public health threat. Understanding past outbreaks is important for preventing future outbreaks. This study investigated the relationship between cholera occurrence in Kenya and various environmental and demographic factors related to water, sanitation, socio-economic status, education, urbanization and availability of health facilities during the time period 2008-2013. The primary outcome analyzed was the number of cholera cases at the district level, obtained from the Kenya Ministry of Health's national cholera surveillance records. Values of independent variables were obtained from the 2009 Kenya Population and Housing Census and other national surveys. The data were analyzed using a zero-inflated negative binomial regression model. Multivariate analysis indicated that the risk of cholera was associated with open defecation, use of unimproved water sources, poverty headcount ratio and the number of health facilities per 100,000 population (p < 0.05). No statistically significant association was found between cholera occurrence and education, percentage of population living in urban areas or population density. The Sustainable Development Goals and Kenya's blueprint for development, Kenya Vision 2030 , call for access to sanitation facilities and clean water for all by 2030. Kenya has made important economic strides in recent years but continues to be affected by diseases like cholera that are associated with low socio-economic status. Further expansion of access to sanitation facilities and clean water is necessary for preventing cholera in Kenya.

The Relevancy of Graduate Curriculum to Human Resource Professionals' Electronic Communication.

ERIC Educational Resources Information Center

Hoell, Robert C.; Henry, Gordon O.

2003-01-01

Electronic communications of human resource professionals and the content of 23 university human resource management courses were categorized using the Human Resource Certification Institute's body of knowledge. Differences between proportion of topics discussed and topics covered in curricula suggest some topics are over- or undertaught.…

Constraints affecting dairy goats milk production in Kenya.

PubMed

Mbindyo, C M; Gitao, C G; Peter, S G

2018-01-01

In Kenya, the population of dairy goats is about 200,000 and 80% of these are reared in Mount Kenya region. They provide a quick source of milk for consumption or sale, which has an immense value especially to poor households. The small land sizes required for their rearing are especially useful in these highly populated areas. Although much research has been done on problems faced by dairy cattle farmers, limited information is available on problems faced by dairy goat farmers. Therefore, the objective of this study was to determine the constraints affecting dairy goat production in Mount Kenya region. In a cross-sectional survey, 157 farmers were interviewed on major constraints using a semi-structured questionnaire. The results from the questionnaires showed that the main problems experienced by these farmers were as follows: lack of market of milk and goats 45% (71/157), diseases 33% (52/157), high cost of concentrates 25% (38/157), lack of feed 19% (30/157), problems of unreliable buck rotation program 16.5% (26/157), and insecurity 1.8% (3/157). The study revealed that dairy goat farmers in the region faced by a number of challenges and therefore, our recommendation is there is a need for farmers to be trained on innovative ways of value chain addition and other strategies to market their milk. Additionally, the government should put resources to salvage the milk plant and association members should put firm measures to improve management. Creation of farmer awareness, treatment, and disease control measures should be instituted to improve productivity.

Modeling the impact of development and management options on future water resource use in the Nyangores sub-catchment of the Mara Basin in Kenya

NASA Astrophysics Data System (ADS)

Omonge, Paul; Herrnegger, Mathew; Fürst, Josef; Olang, Luke

2016-04-01

Despite the increasing water insecurity consequent of competing uses, the Nyangores sub-catchment of Kenya is yet to develop an inclusive water use and allocation plan for its water resource systems. As a step towards achieving this, this contribution employed the Water Evaluation and Planning (WEAP) system to evaluate selected policy based water development and management options for future planning purposes. Major water resources of the region were mapped and quantified to establish the current demand versus supply status. To define a reference scenario for subsequent model projections, additional data on urban and rural water consumption, water demand for crop types, daily water use for existing factories and industries were also collated through a rigorous fieldwork procedure. The model was calibrated using the parameter estimation tool (PEST) and validated against observed streamflow data, and subsequently used to simulate feasible management options. Due to lack of up-to-date data for the current year, the year 2000 was selected as the base year for the scenario simulations up to the year 2030, which has been set by the country for realizing most flagship development projects. From the results obtained, the current annual water demand within the sub-catchment is estimated to be around 27.2 million m3 of which 24% is being met through improved and protected water sources including springs, wells and boreholes, while 76% is met through informal and unprotected sources which are insufficient to cater for future increases in demand. Under the reference scenario, the WEAP model predicted an annual total inadequate supply of 8.1 million m3 mostly in the dry season by the year 2030. The current annual unmet water demand is 1.3 million m3 and is noteworthy in the dry seasons of December through February at the irrigation demand site. The monthly unmet domestic demand under High Population Growth (HPG) was projected to be 1.06 million m3 by the year 2030. However

Electronic Commerce Resource Centers. An Industry--University Partnership.

ERIC Educational Resources Information Center

Gulledge, Thomas R.; Sommer, Rainer; Tarimcilar, M. Murat

1999-01-01

Electronic Commerce Resource Centers focus on transferring emerging technologies to small businesses through university/industry partnerships. Successful implementation hinges on a strategic operating plan, creation of measurable value for customers, investment in customer-targeted training, and measurement of performance outputs. (SK)

Survey report: Kenya.

PubMed

Van Der Tak, J

1986-06-01

In Kenya, women still average about 8 children each, but the average family size desired by ever-married women dropped by 1 child, from 7.2 to 6.2, between 1978-84. The percentage of currently married women using contraception more than doubled, from 7 to 17%. These are highlights of trends revealed by comparison of the recently released results of the Kenya Contraceptive Prevalence Survey of 1984 with the Kenya Fertility Survey of 1977-78. The latest trends in Kenya's fertility and family planning can be expected to be of worldwide interest in view of the country's record high population growth rate of 4.2% a year. Estimated at 21 million in 1986, the population of Kenya is projected by the UN to quadruple to 83 million by 2025 and could reach as high as 116 million by 2100, according to the World Bank. Among the reasons cited for the failure of Kenya's government family planning program, established in 1968, are bureaucratic snarls, shortages of supplies and trained personnel, and short business hours and long waits in clinics that are not always easily accessible in rural areas. These problems are now being dealt with, but there remains the obstacle of a persistent desire for large families among the population. Over 80% of the 6581 women aged 15-49 interviewed in the 1984 survey knew of at least 1 contraceptive method. The survey report terms the more than doubling of current contraceptive use between 1978-84 as a major success for the family planning program. Yet, the 1984 level is low. Also, the contraceptive mix shifted toward less effective methods. Among currently married women using contraception, the proportion using modern methods was down from 61% in 1978 to 52% in 1984, with oral contraceptive (OC) use dropping from 29 to 19% of the total and rhythm increasing from 16 to 25%. Fertility change was negligible. There was a slight increase in children ever born among women 45-49 from 7.9-8.2 per woman, along with a small decrease in the current total

Prioritization of Zoonotic Diseases in Kenya, 2015

PubMed Central

Bitek, Austine; Osoro, Eric; Pieracci, Emily G.; Muema, Josephat; Mwatondo, Athman; Kungu, Mathew; Nanyingi, Mark; Gharpure, Radhika; Njenga, Kariuki; Thumbi, Samuel M.

2016-01-01

Introduction Zoonotic diseases have varying public health burden and socio-economic impact across time and geographical settings making their prioritization for prevention and control important at the national level. We conducted systematic prioritization of zoonotic diseases and developed a ranked list of these diseases that would guide allocation of resources to enhance their surveillance, prevention, and control. Methods A group of 36 medical, veterinary, and wildlife experts in zoonoses from government, research institutions and universities in Kenya prioritized 36 diseases using a semi-quantitative One Health Zoonotic Disease Prioritization tool developed by Centers for Disease Control and Prevention with slight adaptations. The tool comprises five steps: listing of zoonotic diseases to be prioritized, development of ranking criteria, weighting criteria by pairwise comparison through analytical hierarchical process, scoring each zoonotic disease based on the criteria, and aggregation of scores. Results In order of importance, the participants identified severity of illness in humans, epidemic/pandemic potential in humans, socio-economic burden, prevalence/incidence and availability of interventions (weighted scores assigned to each criteria were 0.23, 0.22, 0.21, 0.17 and 0.17 respectively), as the criteria to define the relative importance of the diseases. The top five priority diseases in descending order of ranking were anthrax, trypanosomiasis, rabies, brucellosis and Rift Valley fever. Conclusion Although less prominently mentioned, neglected zoonotic diseases ranked highly compared to those with epidemic potential suggesting these endemic diseases cause substantial public health burden. The list of priority zoonotic disease is crucial for the targeted allocation of resources and informing disease prevention and control programs for zoonoses in Kenya. PMID:27557120

Communication for HIV/AIDS prevention in Kenya: social-cultural considerations.

PubMed

Muturi, Nancy

2005-01-01

The acquired immune deficiency syndrome (AIDS) epidemic is spreading fast in Africa in spite of the various efforts and resources put in place to prevent it. In Kenya, reproductive health programs have used the mass media and other communication interventions to inform and educate the public about the disease and to promote behavior change and healthy sexual practices. This effort has led to a discrepancy between awareness and behavioral change among people of reproductive age. In this article I examine the discrepancy in Kenya from a communications perspective addressing social cultural and related factors contributing to the lack of change in behavior and sexual practices. I draw on the theoretical framework of Grunig's model of excellence in communication, the importance of understanding and relationship building between programs and their stakeholders. Data were gathered qualitatively using focus groups and in-depth interviews among men and women in rural Kenya. Key findings indicate that although awareness of sexually transmitted diseases (STDs) including human immunodeficiency virus (HIV)/AIDS is high in Kenya, a majority of the population, particularly those in the rural communities, lack understanding of the communicated messages. They also lack the knowledge of other ways of transmitting HIV particularly among those not sexually involved. Cultural beliefs, values, norms, and myths have played a role in the rapidly increasing epidemic in the rural communities and yet HIV/AIDS communication programs have not addressed these factors adequately. I conclude that successful behavior change communication must include strategies that focus on increasing understanding of the communicated messages and understanding of the audience through application of appropriate methodologies. Building a relationship with the audience or stakeholders through dialogues and two-way symmetrical communication contributes toward this understanding and the maintenance of the newly

Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

PubMed

Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

2012-01-01

Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business

Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

PubMed Central

Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

2012-01-01

Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have

Estimated burden of fungal infections in Kenya.

PubMed

Guto, John Abuga; Bii, Christine C; Denning, David W

2016-08-31

Kenya is a developing country with a high rate of tuberculosis (TB) and a moderate HIV infection burden. No estimate of the burden of fungal diseases in Kenya is published. We used specific populations at risk and fungal infection frequencies from the literature to estimate national incidence or prevalence of serious fungal infections. Used sources were: 2010 WHO TB statistics, Kenya Acquired Immunodeficiency Syndrome (AIDS) Epidemic Update 2012, Kenya Facts and figures 2012, Kenya Demographic and Health Survey 2008-2009. Of Kenya's population of ~40 million, 43% are under 15 years old and approximately 594,660 Kenyan women get >4 episodes Candida vulvovaginitis annually (2,988/100,000). The HIV/AIDS population at risk of opportunistic infections (OI) is 480,000 and the OI estimates include 306,000 patients with oral thrush (768/100,000), 114,000 with oesophageal candidiasis (286/100,000), 11,900 with cryptococcal meningitis (29/100,000) and 17,000 patients with Pneumocystis pneumonia (42/100,000). Chronic pulmonary aspergillosis following TB has a prevalence of 10,848 cases (32/100,000). The adult asthma prevalence is 3.1% and assuming 2.5% have allergic bronchopulmonary aspergillosis then 17,696 (44/100,000) are affected.  Invasive aspergillosis, candidaemia and Candida peritonitis are probably uncommon. Tinea capitis infects 9.6% of children in Kenya, while fungal keratitis and otomycoses are difficult to estimate. At any one time, about 7% of the Kenyan population suffers from a significant fungal infection, with recurrent vaginitis and tinea capitis accounting for 82% of the infections. These estimates require further epidemiological studies for validation.

A Seasonal Air Transport Climatology for Kenya

NASA Technical Reports Server (NTRS)

Gatebe, C. K.; Tyson, P. D.; Annegarn, H.; Piketh, S.; Helas, G.

1998-01-01

A climatology of air transport to and from Kenya has been developed using kinematic trajectory modeling. Significant months for trajectory analysis have been determined from a classification of synoptic circulation fields. Five-point back and forward trajectory clusters to and from Kenya reveal that the transport corridors to Kenya are clearly bounded and well defined. Air reaching the country originates mainly from the Saharan region and northwestern Indian Ocean of the Arabian Sea in the northern hemisphere and from the Madagascan region of the Indian Ocean in the southern hemisphere. Transport from each of these source regions show distinctive annual cycles related to the northeasterly Asian monsoon and the southeasterly trade wind maximum over Kenya in May. The Saharan transport in the lower troposphere is at a maximum when the subtropical high over northern Africa is strongly developed in the boreal winter. Air reaching Kenya between 700 and 500 hPa is mainly from Sahara and northwest India Ocean flows in the months of January and March, which gives way to southwest Indian Ocean flow in May and November. In contrast, air reaching Kenya at 400 hPa is mainly from southwest Indian Ocean in January and March, which is replaced by Saharan transport in May and November. Transport of air from Kenya is invariant, both spatially and temporally, in the tropical easterlies to the Congo Basin and Atlantic Ocean in comparison to the transport to the country. Recirculation of air has also been observed, but on a limited and often local scale and not to the extent reported in southern Africa.

Building cancer nursing skills in a resource-constrained government hospital.

PubMed

Strother, R M; Fitch, Margaret; Kamau, Peter; Beattie, Kathy; Boudreau, Angela; Busakhalla, N; Loehrer, P J

2012-09-01

Cancer is a rising cause of morbidity and mortality in resource-constrained settings. Few places in the developing world have cancer care experts and infrastructure for caring for cancer patients; therefore, it is imperative to develop this infrastructure and expertise. A critical component of cancer care, rarely addressed in the published literature, is cancer nursing. This report describes an effort to develop cancer nursing subspecialty knowledge and skills in support of a growing resource-constrained comprehensive cancer care program in Western Kenya. This report highlights the context of cancer care delivery in a resource-constrained setting, and describes one targeted intervention to further develop the skill set and knowledge of cancer care providers, as part of collaboration between developed world academic institutions and a medical school and governmental hospital in Western Kenya. Based on observations of current practice, practice setting, and resource limitations, a pragmatic curriculum for cancer care nursing was developed and implemented.

Effectiveness of a Mobile Short-Message-Service–Based Disease Outbreak Alert System in Kenya

PubMed Central

Njeru, Ian; Zurovac, Dejan; Tipo, Shikanga O; Kareko, David; Mwau, Matilu; Morita, Kouichi

2016-01-01

We conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings. PMID:26981628

Using a Decision Grid Process to Build Consensus in Electronic Resources Cancellation Decisions

ERIC Educational Resources Information Center

Foudy, Gerri; McManus, Alesia

2005-01-01

Many libraries are expending an increasing part of their collections budgets on electronic resources. At the same time many libraries, especially those which are state funded, face diminishing budgets and high rates of inflation for serials subscriptions in all formats, including electronic resources. Therefore, many libraries need to develop ways…

Checklist Manifesto for Electronic Resources: Getting Ready for the Fiscal Year and Beyond

ERIC Educational Resources Information Center

England, Lenore; Fu, Li; Miller, Stephen

2011-01-01

Organization of electronic resources workflow is critical in the increasingly complicated and complex world of library management. A simple organizational tool that can be readily applied to electronic resources management (ERM) is the use of checklists. Based on the principles discussed in The Checklist Manifesto: How to Get Things Right, the…

Kenya's Maligned African Press: A Reassessment.

ERIC Educational Resources Information Center

Scotton, James F.

Kenya's dozen or more newspapers and 50 news sheets edited and published by Africans in the turbulent 1945-52 preindependence period were condemned as irresponsible, inflammatory, antiwhite, and seditious by the Kenya colonial government, and this characterization has been accepted by many scholars and journalists, including Africans. There is…

Socio-economic effects of khat chewing in north eastern Kenya.

PubMed

Aden, A; Dimba, E A O; Ndolo, U M; Chindia, M L

2006-03-01

The khat habit is a widespread phenomenon which has in the past two decades spread to parts of Western Europe and North America from Eastern Africa and the Arabian Peninsula. Although khat has been identified as one of the most commonly abused substances in Kenya, restrictions on cultivation, trade and usage have been non-existent since its legalisation in 1977. To describe the socio-economic effects of khat chewing in Ijara District in the North Eastern Province of Kenya. Cross sectional study. Ijara District, North Eastern Kenya. Fifty respondents were interviewed. Eighty eight percent of the respondents were khat chewers, and the majority (80%) had family members who engaged in the khat habit. There was a general lack of education on the negative effects of khat chewing. Due to reported mood changes and withdrawal symptoms when not chewing khat, many respondents used more than half of their domestic budgets on khat, but few (28%) perceived this as a waste of resources. Fifty four percent of khat chewers typically started the habit during the day, implying a waste of time for productive work. However, only 40% of the persons interviewed admitted that the drug affected work performance negatively. The khat habit was associated with strain on family relationships, anti-social behaviour and health effects such as insomnia. In spite of the negative socio-economic impact of khat in Ijara District, khat consumption remains a widespread habit.

Arbovirus Prevalence in Mosquitoes, Kenya

PubMed Central

Sutherland, Laura J.; Muiruri, Samuel; Muchiri, Eric M.; Gray, Laurie R.; Zimmerman, Peter A.; Hise, Amy G.; King, Charles H.

2011-01-01

Few studies have investigated the many mosquito species that harbor arboviruses in Kenya. During the 2006–2007 Rift Valley fever outbreak in North Eastern Province, Kenya, exophilic mosquitoes were collected from homesteads within 2 affected areas: Gumarey (rural) and Sogan-Godud (urban). Mosquitoes (n = 920) were pooled by trap location and tested for Rift Valley fever virus and West Nile virus. The most common mosquitoes trapped belonged to the genus Culex (75%). Of 105 mosquito pools tested, 22% were positive for Rift Valley fever virus, 18% were positive for West Nile virus, and 3% were positive for both. Estimated mosquito minimum infection rates did not differ between locations. Our data demonstrate the local abundance of mosquitoes that could propagate arboviral infections in Kenya and the high prevalence of vector arbovirus positivity during a Rift Valley fever outbreak. PMID:21291594

E-Nursing: electronic nursing resources on your desktop.

PubMed

Kendall, Sandra; Massaralla, Susan; Hynes-Gay, Patricia; Vincent, Leslie

2003-01-01

E-Nursing represents an innovative approach to nursing education that has the potential to support professional practice throughout the institution. This paper details the benefits, design and promotion of an electronic nursing resource collection. How to divide responsibility, cost and expertise in such a project is also discussed. Preliminary usage statistics validate E-Nursing as a point-of-care education tool for nurses at Mount Sinai Hospital. A planned approach to implementation has been an effective means of introducing E-Nursing in an institution that previously relied on traditional hard-copy resources housed in the hospital's library.

Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

PubMed

Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

2011-01-01

IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges.

Lessons learned developing a diagnostic tool for HIV-associated dementia feasible to implement in resource-limited settings: pilot testing in Kenya.

PubMed

Kwasa, Judith; Cettomai, Deanna; Lwanya, Edwin; Osiemo, Dennis; Oyaro, Patrick; Birbeck, Gretchen L; Price, Richard W; Bukusi, Elizabeth A; Cohen, Craig R; Meyer, Ana-Claire L

2012-01-01

To conduct a preliminary evaluation of the utility and reliability of a diagnostic tool for HIV-associated dementia (HAD) for use by primary health care workers (HCW) which would be feasible to implement in resource-limited settings. In resource-limited settings, HAD is an indication for anti-retroviral therapy regardless of CD4 T-cell count. Anti-retroviral therapy, the treatment for HAD, is now increasingly available in resource-limited settings. Nonetheless, HAD remains under-diagnosed likely because of limited clinical expertise and availability of diagnostic tests. Thus, a simple diagnostic tool which is practical to implement in resource-limited settings is an urgent need. A convenience sample of 30 HIV-infected outpatients was enrolled in Western Kenya. We assessed the sensitivity and specificity of a diagnostic tool for HAD as administered by a primary HCW. This was compared to an expert clinical assessment which included examination by a physician, neuropsychological testing, and in selected cases, brain imaging. Agreement between HCW and an expert examiner on certain tool components was measured using Kappa statistic. The sample was 57% male, mean age was 38.6 years, mean CD4 T-cell count was 323 cells/µL, and 54% had less than a secondary school education. Six (20%) of the subjects were diagnosed with HAD by expert clinical assessment. The diagnostic tool was 63% sensitive and 67% specific for HAD. Agreement between HCW and expert examiners was poor for many individual items of the diagnostic tool (K = .03-.65). This diagnostic tool had moderate sensitivity and specificity for HAD. However, reliability was poor, suggesting that substantial training and formal evaluations of training adequacy will be critical to enable HCW to reliably administer a brief diagnostic tool for HAD.

Measures for Electronic Resources (E-Metrics). Complete Set.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC.

The Association of Research Libraries (ARL) E-Metrics study was designed as an 18-month project in three phases: an inventory of what libraries were already doing about data collection for electronic resources and an identification of any libraries that could provide best practice; identifying and testing data elements that could be collected and…

Kenya: Current Conditions and the Challenges Ahead

DTIC Science & Technology

2010-12-09

Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket...15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33%, indigenous beliefs 10%, Muslim 10%, other 2% Languages: English

Girls' Attitudes towards Science in Kenya

ERIC Educational Resources Information Center

Chetcuti, Deborah A.; Kioko, Beriter

2012-01-01

This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences…

Inequity in costs of seeking sexual and reproductive health services in India and Kenya.

PubMed

Haghparast-Bidgoli, Hassan; Pulkki-Brännström, Anni-Maria; Lafort, Yves; Beksinska, Mags; Rambally, Letitia; Roy, Anuradha; Reza-Paul, Sushena; Ombidi, Wilkister; Gichangi, Peter; Skordis-Worrall, Jolene

2015-09-15

burden borne by the poorest when seeking care in resource-constrained settings such as India and Kenya. The large proportion of service users, particularly in India, relying on money received from family members to finance care seeking suggests that access would be more difficult for those with weak social ties, small social networks or weak bargaining positions within the family - although this requires further study.

The Impact of Out-Migration on the Nursing Workforce in Kenya

PubMed Central

Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes

2011-01-01

Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982

An exploration of opportunities and challenges facing cervical cancer managers in Kenya

PubMed Central

2013-01-01

Background Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes. Findings Four themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya. Conclusion Kenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored. PMID:23566436

A comparison of smartphones to paper-based questionnaires for routine influenza sentinel surveillance, Kenya, 2011-2012.

PubMed

Njuguna, Henry N; Caselton, Deborah L; Arunga, Geoffrey O; Emukule, Gideon O; Kinyanjui, Dennis K; Kalani, Rosalia M; Kinkade, Carl; Muthoka, Phillip M; Katz, Mark A; Mott, Joshua A

2014-12-24

For disease surveillance, manual data collection using paper-based questionnaires can be time consuming and prone to errors. We introduced smartphone data collection to replace paper-based data collection for an influenza sentinel surveillance system in four hospitals in Kenya. We compared the quality, cost and timeliness of data collection between the smartphone data collection system and the paper-based system. Since 2006, the Kenya Ministry of Health (MoH) with technical support from the Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC) conducted hospital-based sentinel surveillance for influenza in Kenya. In May 2011, the MOH replaced paper-based collection with an electronic data collection system using Field Adapted Survey Toolkit (FAST) on HTC Touch Pro2 smartphones at four sentinel sites. We compared 880 paper-based questionnaires dated Jan 2010-Jun 2011 and 880 smartphone questionnaires dated May 2011-Jun 2012 from the four surveillance sites. For each site, we compared the quality, cost and timeliness of each data collection system. Incomplete records were more likely seen in data collected using pen-and-paper compared to data collected using smartphones (adjusted incidence rate ratio (aIRR) 7, 95% CI: 4.4-10.3). Errors and inconsistent answers were also more likely to be seen in data collected using pen-and-paper compared to data collected using smartphones (aIRR: 25, 95% CI: 12.5-51.8). Smartphone data was uploaded into the database in a median time of 7 days while paper-based data took a median of 21 days to be entered (p < 0.01). It cost USD 1,501 (9.4%) more to establish the smartphone data collection system ($17,500) than the pen-and-paper system (USD $15,999). During two years, however, the smartphone data collection system was $3,801 (7%) less expensive to operate ($50,200) when compared to pen-and-paper system ($54,001). Compared to paper-based data collection, an electronic data collection system

Institutional Characteristics Influencing Bachelor of Science Nursing Student Performance in the Nursing Council of Kenya Licensure Examinations in Kenya

ERIC Educational Resources Information Center

Okanga, Anne Asiko; Ogur, John Okoth; Arudo, John

2017-01-01

Kenya has seen a paradigm shift in nursing education sector recording high rates of enrolment of students to training while their performance in Nursing Council of Kenya (NCK) examination remained variable and unpredictable. This study evaluated performance of BSc nursing students in NCK examinations by examining institutional characteristics in…

7 CFR 319.56-45 - Shelled garden peas from Kenya.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United States from Kenya only under the following conditions and in accordance with all other applicable...

Kenya: Current Conditions and the Challenges Ahead

DTIC Science & Technology

2009-05-14

Traditional African Banjo 1 MGPK Mazingira Greens Party of Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1...Ethnic Divisions: Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1

E-Resources Management: How We Positioned Our Organization to Implement an Electronic Resources Management System

ERIC Educational Resources Information Center

White, Marilyn; Sanders, Susan

2009-01-01

The Information Services Division (ISD) of the National Institute of Standards and Technology (NIST) positioned itself to successfully implement an electronic resources management system. This article highlights the ISD's unique ability to "team" across the organization to realize a common goal, develop leadership qualities in support of…

Area Handbook Series Kenya, A Country Study,

DTIC Science & Technology

1983-06-01

has included the provision of free seed, interest-free credit to permit purchase of pesticides and to secure tractor plowing, and a number of increases...Hanover, New Hampshire: AUFS, 1980. Caplan, Basil . "Kenya’s Pragmatism Pays Off," Banker [London], 129, No. 3, March 1979, 29-32. Carroll, Jane. "Kenya

Child Sexual Abuse in Tanzania and Kenya

ERIC Educational Resources Information Center

Lalor, Kevin

2004-01-01

Objective: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. Methods: Contacts were made with academics, government…

Potential resource and toxicity impacts from metals in waste electronic devices.

PubMed

Woo, Seung H; Lee, Dae Sung; Lim, Seong-Rin

2016-04-01

As a result of the continuous release of new electronic devices, existing electronic devices are quickly made obsolete and rapidly become electronic waste (e-waste). Because e-waste contains a variety of metals, information about those metals with the potential for substantial environmental impact should be provided to manufacturers, recyclers, and disposers to proactively reduce this impact. This study assesses the resource and toxicity (i.e., cancer, noncancer, and ecotoxicity) potentials of various heavy metals commonly found in e-waste from laptop computers, liquid-crystal display (LCD) monitors, LCD TVs, plasma TVs, color cathode ray tube (CRT) TVs, and cell phones and then evaluates such potentials using life cycle impact-based methods. Resource potentials derive primarily from Cu, Sb, Ag, and Pb. Toxicity potentials derive primarily from Pb, Ni, and Hg for cancer toxicity; from Pb, Hg, Zn, and As for noncancer toxicity; and from Cu, Pb, Hg, and Zn for ecotoxicity. Therefore, managing these heavy metals should be a high priority in the design, recycling, and disposal stages of electronic devices. © 2015 SETAC.

The introduction of new policies and strategies to reduce inequities and improve child health in Kenya: A country case study on progress in child survival, 2000-2013.

PubMed

Brault, Marie A; Ngure, Kenneth; Haley, Connie A; Kabaka, Stewart; Sergon, Kibet; Desta, Teshome; Mwinga, Kasonde; Vermund, Sten H; Kipp, Aaron M

2017-01-01

As of 2015, only 12 countries in the World Health Organization's AFRO region had met Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Kenya was one of the countries selected for an in-depth case study due to its insufficient progress in reducing under-five mortality, with only a 28% reduction between 1990 and 2013. This paper presents indicators, national documents, and qualitative data describing the factors that have both facilitated and hindered Kenya's efforts in reducing child mortality. Key barriers identified in the data were widespread socioeconomic and geographic inequities in access and utilization of maternal, neonatal, and child health (MNCH) care. To reduce these inequities, Kenya implemented three major policies/strategies during the study period: removal of user fees, the Kenya Essential Package for Health, and the Community Health Strategy. This paper uses qualitative data and a policy review to explore the early impacts of these efforts. The removal of user fees has been unevenly implemented as patients still face hidden expenses. The Kenya Essential Package for Health has enabled construction and/or expansion of healthcare facilities in many areas, but facilities struggle to provide Emergency Obstetric and Neonatal Care (EmONC), neonatal care, and many essential medicines and commodities. The Community Health Strategy appears to have had the most impact, improving referrals from the community and provision of immunizations, malaria prevention, and Prevention of Mother-to-Child Transmission of HIV. However, the Community Health Strategy is limited by resources and thus also unevenly implemented in many areas. Although insufficient progress was made pre-2015, with additional resources and further scale-up of new policies and strategies Kenya can make

Correlates of default from anti-tuberculosis treatment: a case study using Kenya's electronic data system.

PubMed

Sitienei, J; Kipruto, H; Mansour, O; Ndisha, M; Hanson, C; Wambu, R; Addona, V

2015-09-01

In 2012, the World Health Organization estimated that there were 120,000 new cases and 9500 deaths due to tuberculosis (TB) in Kenya. Almost a quarter of the cases were not detected, and the treatment of 4% of notified cases ended in default. To identify the determinants of anti-tuberculosis treatment default. Data from 2012 and 2013 were retrieved from a national case-based electronic data recording system. A comparison was made between new pulmonary TB patients for whom treatment was interrupted vs. those who successfully completed treatment. A total of 106,824 cases were assessed. Human immunodeficiency virus infection was the single most influential risk factor for default (aOR 2.7). More than 94% of patients received family-based directly observed treatment (DOT) and were more likely to default than patients who received DOT from health care workers (aOR 2.0). Caloric nutritional support was associated with lower default rates (aOR 0.89). Males were more likely to default than females (aOR 1.6). Patients cared for in the private sector were less likely to default than those in the public sector (aOR 0.86). Understanding the factors contributing to default can guide future program improvements and serve as a proxy to understanding the factors that constrain access to care among undetected cases.

Preparing for human papillomavirus vaccine introduction in Kenya: implications from focus-group and interview discussions with caregivers and opinion leaders in Western Kenya.

PubMed

Friedman, Allison L; Oruko, Kelvin O; Habel, Melissa A; Ford, Jessie; Kinsey, Jennine; Odhiambo, Frank; Phillips-Howard, Penelope A; Wang, Susan A; Collins, Tabu; Laserson, Kayla F; Dunne, Eileen F

2014-08-16

Cervical cancer claims the lives of 275,000 women each year; most of these deaths occur in low-or middle-income countries. In Kenya, cervical cancer is the leading cause of cancer-related mortality among women of reproductive age. Kenya's Ministry of Public Health and Sanitation has developed a comprehensive strategy to prevent cervical cancer, which includes plans for vaccinating preteen girls against human papillomavirus (HPV) by 2015. To identify HPV vaccine communication and mobilization needs, this research sought to understand HPV vaccine-related perceptions and concerns of male and female caregivers and community leaders in four rural communities of western Kenya. We conducted five focus groups with caregivers (n = 56) and 12 key-informant interviews with opinion leaders to explore cervical cancer-related knowledge, attitudes and beliefs, as well as acceptability of HPV vaccination for 9-12 year-old girls. Four researchers independently reviewed the data and developed codes based on questions in interview guides and topics that emerged organically, before comparing and reconciling results through a group consensus process. Cervical cancer was not commonly recognized, though it was understood generally in terms of its symptoms. By association with cancer and genital/reproductive organs, cervical cancer was feared and stigmatized. Overall acceptability of a vaccine that prevents cervical cancer was high, so long as it was endorsed by trusted agencies and communities were sensitized first. Some concerns emerged related to vaccine safety (e.g., impact on fertility), program intent, and health equity. For successful vaccine introduction in Kenya, there is a need for communication and mobilization efforts to raise cervical cancer awareness; prompt demand for vaccination; address health equity concerns and stigma; and minimize potential resistance. Visible endorsement by government leaders and community influencers can provide reassurance of the vaccine's safety

Factors Hindering the Deployment of Female Teachers to Headship Positions in Public Primary Schools in Nambale Sub-County, Kenya

ERIC Educational Resources Information Center

Mukolwe, Joseph O.; Okwara, Michael; Ajowi, O. Jack

2016-01-01

Worldwide, women representation in management and leadership positions is marginal. Despite immense academic advancement by women, few of them do advance to management positions. In Kenya, women make up a critical portion of human resource base. However, they are grossly underrepresented at leadership positions. This situation is reflected in…

The HIV and AIDS Tribunal of Kenya

PubMed Central

2016-01-01

Abstract Established under Section 25 of the HIV Prevention and Control Act of 2006, the HIV and AIDS Tribunal of Kenya is the only HIV-specific statutory body in the world with the mandate to adjudicate cases relating to violations of HIV-related human rights. Yet, very limited research has been done on this tribunal. Based on findings from a desk research and semi-structured interviews of key informants conducted in Kenya, this article analyzes the composition, mandate, procedures, practice, and cases of the tribunal with the aim to appreciate its contribution to the advancement of human rights in the context of HIV. It concludes that, after a sluggish start, the HIV and AIDS Tribunal of Kenya is now keeping its promise to advance the human rights of people living with and affected by HIV in Kenya, notably through addressing barriers to access to justice, swift ruling, and purposeful application of the law. The article, however, highlights various challenges still affecting the tribunal and its effectiveness, and cautions about the replication of this model in other jurisdictions without a full appraisal. PMID:27781008

Availability of mobile phones for discharge follow-up of pediatric Emergency Department patients in western Kenya

PubMed Central

Cheptinga, Philip; Rusyniak, Daniel E.

2015-01-01

Objective. Mobile phones have been successfully used for Emergency Department (ED) patient follow-up in developed countries. Mobile phones are widely available in developing countries and may offer a similar potential for follow-up and continued care of ED patients in low and middle-income countries. The goal of this study was to determine the percentage of families with mobile phones presenting to a pediatric ED in western Kenya and rate of response to a follow-up phone call after discharge. Methods. A prospective, cross-sectional observational study of children presenting to the emergency department of a government referral hospital in Eldoret, Kenya was performed. Documentation of mobile phone access, including phone number, was recorded. If families had access, consent was obtained and families were contacted 7 days after discharge for follow-up. Results. Of 788 families, 704 (89.3%) had mobile phone access. Of those families discharged from the ED, successful follow-up was made in 83.6% of cases. Conclusions. Mobile phones are an available technology for follow-up of patients discharged from a pediatric emergency department in resource-limited western Kenya. PMID:25780757

Availability of mobile phones for discharge follow-up of pediatric Emergency Department patients in western Kenya.

PubMed

House, Darlene R; Cheptinga, Philip; Rusyniak, Daniel E

2015-01-01

Objective. Mobile phones have been successfully used for Emergency Department (ED) patient follow-up in developed countries. Mobile phones are widely available in developing countries and may offer a similar potential for follow-up and continued care of ED patients in low and middle-income countries. The goal of this study was to determine the percentage of families with mobile phones presenting to a pediatric ED in western Kenya and rate of response to a follow-up phone call after discharge. Methods. A prospective, cross-sectional observational study of children presenting to the emergency department of a government referral hospital in Eldoret, Kenya was performed. Documentation of mobile phone access, including phone number, was recorded. If families had access, consent was obtained and families were contacted 7 days after discharge for follow-up. Results. Of 788 families, 704 (89.3%) had mobile phone access. Of those families discharged from the ED, successful follow-up was made in 83.6% of cases. Conclusions. Mobile phones are an available technology for follow-up of patients discharged from a pediatric emergency department in resource-limited western Kenya.

"They make money off of us": a phenomenological analysis of consumer perceptions of corruption in Kenya's HIV response system.

PubMed

Kagotho, Njeri; Bunger, Alicia; Wagner, Kristen

2016-09-05

Problems with misallocation and redirection of critical resources and benefits intended for PLHIV are not uncommon in Kenya. This study explores corruption in Kenya's HIV response system and the implications for health outcomes from the perspective of people living with HIV (PLHIV). Although they might not be directly responsible for health care fund management, PLHIV and their advocacy efforts have been central to the development of HIV system response and they have a vested interest in ensuring proper governance. This phenomenological study was conducted in 2012 in Kiambu County in Kenya. The study was designed to capture the experiences of a select group of individuals living with HIV and AIDS and subsequent effects on intergenerational wealth transmission. Four focus groups were conducted with self-convened HIV/AIDS peer support groups. Findings related to corruption emerged unexpectedly, albeit consistently, across all four focus groups. To validate core themes within the data, including corruption, two coders independently reviewed and coded the data. Participants described incidences of resource misallocation, theft, and denial of services across three thematic levels namely at the interpersonal, provider, and institutional levels. Participants described the negative influence of corruption on their health and financial well-being, and propose: (1) strengthening legal protections for assets belonging to PLHIV, (2) direct representation of PLHIV within service agencies, (3) and addressing information asymmetries to inject transparency into the response system. Our findings add to the growing literature that identifies advocacy among individuals and families impacted by HIV and AIDS to be a useful tool in drawing attention to harmful practices in the HIV response infrastructure; consistent with this movement, communities in Kenya demand greater control over programmatic interventions both at the national and local levels.

Social capital and health in Kenya: A multilevel analysis.

PubMed

Musalia, John

2016-10-01

Despite the acknowledgment that social capital is an important predictor of good health and overall well being in wealthy countries, little empirical research has been conducted in developing countries, particularly in Africa, to examine this relationship. This study examines the association between cognitive (trust) and structural (membership in organization) social capital on health at both the individual and contextual levels. Health was measured using answers to a subjective question on physical health and anxiety/worry suffered by individuals within the last 30 days. This study utilized Afrobarometer data collected in Kenya in 2005 to examine this relationship using multilevel logistic statistical modeling. Upon controlling for socioeconomic and demographic factors, social capital was found to be significantly associated with anxiety/worry and physical health in Kenya. Membership in organizations was associated with increased odds (OR = 1.34, 95%CI: 1.02-1.76) of physical health problems, while individual trust was associated with a 6% (OR = 0.94, 95%CI: 0.90-0.99) reduction in the likelihood of physical health problems. Conversely, generalized trust was associated with a 37% reduction in the odds (OR = 0.63, 95%CI: 0.40-0.99) of anxiety/worry, while individual trust was associated with a 5% reduction (OR = 0.95, 95%CI: 0.90-1.00) of anxiety/worry. With the exception of membership in an organization that exacerbates physical health, both individual level trust and generalized trust were associated with better health outcomes in Kenya. The availability of social organizations at the contextual level was associated with worsening anxiety/worry although the effect size was small. These results show that social capital, particularly trust, is a concept that can apply to different social and cultural contexts and can potentially be harnessed to improve health in settings that suffer from resource poverty. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study

PubMed Central

Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-01-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes. PMID:28207061

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

PubMed

Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-03-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

An Evaluation of Electronic Product Design Education Using Hypermedia-Resourced Learning Environments

ERIC Educational Resources Information Center

Page, Tom; Thorsteinsson, Gisli

2006-01-01

The work outlined here provides a comprehensive report and formative observations of the development and implementation of hypermedia resources for learning and teaching used in conjunction with a managed learning environment (MLE). These resources are used to enhance teaching and learning of an electronics module in product design at final year…

Strategic Planning for Electronic Resources Management: A Case Study at Gustavus Adolphus College

ERIC Educational Resources Information Center

Hulseberg, Anna; Monson, Sarah

2009-01-01

Electronic resources, the tools we use to manage them, and the needs and expectations of our users are constantly evolving; at the same time, the roles, responsibilities, and workflow of the library staff who manage e-resources are also in flux. Recognizing a need to be more intentional and proactive about how we manage e-resources, the…

Financing Education in Kenya.

ERIC Educational Resources Information Center

Olembo, Jotham Ombisi

1986-01-01

This article focuses on the financing of education in Kenya. It reviews government, parental, community, and international efforts aimed at improving education during a period of economic austerity. (JDH)

Utilization of Cloud Computing in Education and Research to the Attainment of Millennium Development Goals and Vision 2030 in Kenya

ERIC Educational Resources Information Center

Waga, Duncan; Makori, Esther; Rabah, Kefa

2014-01-01

Kenya Educational and Research fraternity has highly qualified human resource capacity with globally gained experiences. However each research entity works in disparity due to the absence of a common digital platform while educational units don't even have the basic infrastructure. For sustainability of Education and research progression,…

Instructional Supervision in Public Secondary Schools in Kenya

ERIC Educational Resources Information Center

Wanzare, Zachariah

2012-01-01

This article reports some findings of study regarding practices and procedures of internal instructional supervision in public secondary schools in Kenya. The findings are part of a large-scale project undertaken in Kenya to determine the perceptions of headteachers, teachers and senior government education officers regarding the practices of…

Qualitative study of the role of men in maternal health in resource-limited communities in western Kenya.

PubMed

Brubaker, Kathryn; Nelson, Brett D; McPherson, Heather; Ahn, Roy; Oguttu, Monica; Burke, Thomas F

2016-12-01

To better understand the beliefs of men and women in western Kenya regarding the appropriate role of men in maternal health and to identify barriers to greater involvement. Between June 1 and July 31, 2014, a cross-sectional qualitative study enrolled lay men, lay women, and community health workers from Kisumu and Nyamira counties in western Kenya. Semi-structured focus group discussions were conducted and qualitative approaches were utilized to analyze the transcripts and identify common themes. In total, 134 individuals participated in 18 focus group discussions. Participants discussed the role of men and a general consensus was recorded that it was a man's duty to protect women during pregnancy. When discussing obstacles to male involvement, female participants highlighted gender dynamics and male participants raised financial limitations. There was considerable discrepancy between how men described their roles and how they actually behaved, although educated men appeared to describe themselves as performing more supportive behaviors compared with male participants with less education. It is suggested that interventions aimed at increasing male involvement should incorporate the existing culturally sanctioned roles men perform as a foundation upon which to build, rather than attempting to construct roles that oppose prevailing norms. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Developing Humanities Collections in the Digital Age: Exploring Humanities Faculty Engagement with Electronic and Print Resources

ERIC Educational Resources Information Center

Kachaluba, Sarah Buck; Brady, Jessica Evans; Critten, Jessica

2014-01-01

This article is based on quantitative and qualitative research examining humanities scholars' understandings of the advantages and disadvantages of print versus electronic information resources. It explores how humanities' faculty members at Florida State University (FSU) use print and electronic resources, as well as how they perceive these…

Agriculture and development in Africa: the case of Kenya.

PubMed

Hyden, G

1987-01-01

The Government of Kenya has successfully developed macroeconomic policies that overcome constraints in the domestic and international environments and have a relatively well-functioning public sector. At present, the major challenge facing Kenya concerns the ability of the government to improve agricultural productivity given the weakness of its research services and peasant resistance to development. The response to the 1984 drought indicates that the Government of Kenya has the formal structures in place to deal with emergencies, yet the absence of reliable statistics on grain production, marketing, and on-farm storage led to serious miscalculations of the severity of the drought. Government of Kenya has been reluctant to experiment with institutional forms that reduce the opportunity for direct political control, especially over agricultural marketing. Privatization of the grain trade or the establishment of cooperatively owned local dairies has been proposed but rejected as too risky. New policies and concerted action, at both the government and community levels, tend to be in response to threat or hardship rather than a result of a dynamic strategy. Given this tendency to avoid experimentation with alternative political forms, socioeconomic development in Kenya may be limited in the years ahead.

Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial.

PubMed

Lester, Richard T; Ritvo, Paul; Mills, Edward J; Kariri, Antony; Karanja, Sarah; Chung, Michael H; Jack, William; Habyarimana, James; Sadatsafavi, Mohsen; Najafzadeh, Mehdi; Marra, Carlo A; Estambale, Benson; Ngugi, Elizabeth; Ball, T Blake; Thabane, Lehana; Gelmon, Lawrence J; Kimani, Joshua; Ackers, Marta; Plummer, Francis A

2010-11-27

Mobile (cell) phone communication has been suggested as a method to improve delivery of health services. However, data on the effects of mobile health technology on patient outcomes in resource-limited settings are limited. We aimed to assess whether mobile phone communication between health-care workers and patients starting antiretroviral therapy in Kenya improved drug adherence and suppression of plasma HIV-1 RNA load. WelTel Kenya1 was a multisite randomised clinical trial of HIV-infected adults initiating antiretroviral therapy (ART) in three clinics in Kenya. Patients were randomised (1:1) by simple randomisation with a random number generating program to a mobile phone short message service (SMS) intervention or standard care. Patients in the intervention group received weekly SMS messages from a clinic nurse and were required to respond within 48 h. Randomisation, laboratory assays, and analyses were done by investigators masked to treatment allocation; however, study participants and clinic staff were not masked to treatment. Primary outcomes were self-reported ART adherence (>95% of prescribed doses in the past 30 days at both 6 and 12 month follow-up visits) and plasma HIV-1 viral RNA load suppression (<400 copies per mL) at 12 months. The primary analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT00830622. Between May, 2007, and October, 2008, we randomly assigned 538 participants to the SMS intervention (n=273) or to standard care (n=265). Adherence to ART was reported in 168 of 273 patients receiving the SMS intervention compared with 132 of 265 in the control group (relative risk [RR] for non-adherence 0·81, 95% CI 0·69-0·94; p=0·006). Suppressed viral loads were reported in 156 of 273 patients in the SMS group and 128 of 265 in the control group, (RR for virologic failure 0·84, 95% CI 0·71-0·99; p=0·04). The number needed to treat (NNT) to achieve greater than 95% adherence was nine (95% CI 5·0-29·5

Diet of Theropithecus from 4 to 1 Ma in Kenya

PubMed Central

Cerling, Thure E.; Chritz, Kendra L.; Jablonski, Nina G.; Leakey, Meave G.; Manthi, Fredrick Kyalo

2013-01-01

Theropithecus was a common large-bodied primate that co-occurred with hominins in many Plio-Pleistocene deposits in East and South Africa. Stable isotope analyses of tooth enamel from T. brumpti (4.0–2.5 Ma) and T. oswaldi (2.0–1.0 Ma) in Kenya show that the earliest Theropithecus at 4 Ma had a diet dominated by C4 resources. Progressively, this genus increased the proportion of C4-derived resources in its diet and by 1.0 Ma, had a diet that was nearly 100% C4-derived. It is likely that this diet was comprised of grasses or sedges; stable isotopes cannot, by themselves, give an indication of the relative importance of leaves, seeds, or underground storage organs to the diet of this primate. Theropithecus throughout the 4- to 1-Ma time range has a diet that is more C4-based than contemporaneous hominins of the genera Australopithecus, Kenyanthropus, and Homo; however, Theropithecus and Paranthropus have similar proportions of C4-based resources in their respective diets. PMID:23733967

Lake Naivasha, Kenya

NASA Image and Video Library

2008-02-29

If you live in Europe and buy roses, the chance is good that they were grown in Kenya -- specifically, in one of the colossal greenhouses that blot out the once wild shores of Lake Naivasha, 90km north-west of Nairobi. Image from NASA Terra satellite.

Review of surgical management of cystic hydatid disease in a resource limited setting: Turkana, Kenya.

PubMed

Cooney, Rachel M; Flanagan, Kevin P; Zehyle, Ebehard

2004-11-01

Cystic hydatid disease is a zoonotic infection of humans caused by infection with the larval stage of Echinococcus granulosus. The prevalence rate (5-10%) in Turkana, Northern Kenya is among the highest worldwide. With an increase in foreign travel and migration of peoples, practitioners need to be aware of diseases common in these countries and their rarer manifestations. The objective of this study was to review the management of this disease in a poorly resourced high-prevalence area. The surgical records of Kakuma Mission Hospital, Turkana from July 1981 to May 2002 were reviewed. A total of 710 (female : male, 3 : 2) surgical procedures for hydatid disease were recorded, the average age being 27 years (range, 3-65 years). There were 663 patients, and therefore 47 patients had repeat procedures. A total of 52.8% (n = 375) had hepatic cysts (248 right sided, 30 left sided, 97 site undefined), and 10.1% (n = 72) had multiple abdominal cysts. Other intra-abdominal sites included 8.16% mesenteric (n = 58), 2.9% retroperitoneal (n = 21), 3.5% spleen (n = 25), the abdominal wall (n = 4). There was no information on the site of disease in 5.9% of cases (n = 42). More unusual sites were retro-orbital, gluteal, zygomatic, brachial, parotid, uterine, tibial and foot. The largest volume of cyst fluid was 7 l. There was one intraoperative death and one postoperative death recorded. Endocystectomy +/- a scolicidal was the commonest procedure performed. However, 165 percutaneous aspiration injection of a scolicidal agent and reaspiration procedures were performed, six being on pregnant women. This is one of the largest series of surgical hydatid patients from Africa and demonstrates the wide diversity in cyst location.

Uptake and Effectiveness of a Trivalent Inactivated Influenza Vaccine in Children in Urban and Rural Kenya, 2010 to 2012.

PubMed

Katz, Mark A; Lebo, Emmaculate; Emukule, Gideon O; Otieno, Nancy; Caselton, Deborah L; Bigogo, Godfrey; Njuguna, Henry; Muthoka, Philip M; Waiboci, Lilian W; Widdowson, Marc-Alain; Xu, Xiyan; Njenga, Moses K; Mott, Joshua A; Breiman, Robert F

2016-03-01

In Africa, recent surveillance has demonstrated a high burden of influenza, but influenza vaccine is rarely used. In Kenya, a country with a tropical climate, influenza has been shown to circulate year-round, like in other tropical countries. During 3 months in 2010 and 2011 and 2 months in 2012, the Kenya Medical Research Institute/Centers for Disease Control and Prevention-Kenya offered free injectable trivalent inactivated influenza vaccine to children 6 months to 10 years old in 2 resource-poor communities in Kenya-Kibera and Lwak (total population ~50,000). We conducted a case-control study to evaluate vaccine effectiveness (VE) in preventing laboratory-confirmed influenza associated with influenza-like illness and acute lower respiratory illness. Of the approximately 18,000 eligible children, 41%, 48% and 51% received at least 1 vaccine in 2010, 2011 and 2012, respectively; 30%, 36% and 38% were fully vaccinated. VE among fully vaccinated children was 57% [95% confidence interval (CI): 29% to 74%] during a 6-month follow-up period, 39% (95% CI: 17% to 56%) during a 9-month follow-up period and 48% (95% CI: 32% to 61%) during a 12-month follow-up period. For the 12-month follow-up period, VE was statistically significant in children <5 years and in children 5 to <10 years old (50% and 46%, respectively). In Kenya, parents of nearly half of the eligible children <10 years old chose to get their children vaccinated with a free influenza vaccine. During a 12-month follow-up period, the vaccine was moderately effective in preventing medically attended influenza-associated respiratory illness.

Documenting human rights violations against sex workers in Kenya.

PubMed

Lukera, MaryFrances

2007-12-01

The human rights of sex workers are an increasing concern for prominent women's rights organizations such as the Federation of Women Lawyers (FIDA). As FIDA-Kenya's MaryFrances Lukera writes, documenting human rights abuses against sex workers is critical to responding to Kenya's HIV epidemic.

Kenya: The December 2007 Elections and the Challenges Ahead

DTIC Science & Technology

2008-02-15

Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 KENDA Kenya National...13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33

'You have a swelling': The language of cancer diagnosis and implications for cancer management in Kenya.

PubMed

Githaiga, Jennifer Nyawira; Swartz, Leslie

2017-05-01

To examine the ramifications of language as a vehicle of communication in the Kenyan healthcare system. (1) A review of literature search on language access and health care in Kenya, using Scopus, Web of Science, Ebscohost, ProQuest and Google Scholar electronic databases. (2) Two illustrative case studies from a Nairobi based qualitative research project on family cancer caregivers' experiences. Evidence from the case studies shows that language barriers may hinder understanding of cancer diagnoses and consequently, the nature of interventions sought by family members as informal caregivers of cancer patients. Findings demonstrate the significance of language in understanding cancer diagnosis as a basis for treatment seeking behaviour and specifically in light of the critical role played by informal caregivers in under resourced health care contexts. (1) The assumption that English and Swahili are adequate in communication in Kenyan health care contexts ought to be reviewed. (2) Further research and assessment of language needs as a basis for training of language interpreters in the Kenyan health care system is a necessity. Copyright © 2017 Elsevier B.V. All rights reserved.

The Electron Microscopy Outreach Program: A Web-based resource for research and education.

PubMed

Sosinsky, G E; Baker, T S; Hand, G; Ellisman, M H

1999-01-01

We have developed a centralized World Wide Web (WWW)-based environment that serves as a resource of software tools and expertise for biological electron microscopy. A major focus is molecular electron microscopy, but the site also includes information and links on structural biology at all levels of resolution. This site serves to help integrate or link structural biology techniques in accordance with user needs. The WWW site, called the Electron Microscopy (EM) Outreach Program (URL: http://emoutreach.sdsc.edu), provides scientists with computational and educational tools for their research and edification. In particular, we have set up a centralized resource containing course notes, references, and links to image analysis and three-dimensional reconstruction software for investigators wanting to learn about EM techniques either within or outside of their fields of expertise. Copyright 1999 Academic Press.

Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

PubMed Central

Strother, R. Matthew; Ndiangui, Francis; Chumba, David; Jacobson, William; Dodson, Cecelia; Resnic, Murray B.; Strate, Randall W.; Smith, James W.

2016-01-01

Background Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service. Objectives, methods and outcomes Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to a resource-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme. Conclusion Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment. PMID:28879100

Use of poisons information resources and satisfaction with electronic products by Victorian emergency department staff.

PubMed

Luke, Stephen; Fountain, John S; Reith, David M; Braitberg, George; Cruickshank, Jaycen

2014-10-01

ED staff use a range of poisons information resources of varying type and quality. The present study aims to identify those resources utilised in the state of Victoria, Australia, and assess opinion of the most used electronic products. A previously validated self-administered survey was conducted in 15 EDs, with 10 questionnaires sent to each. The survey was then repeated following the provision of a 4-month period of access to Toxinz™, an Internet poisons information product novel to the region. The study was conducted from December 2010 to August 2011. There were 117 (78%) and 48 (32%) responses received from the first and second surveys, respectively, a 55% overall response rate. No statistically significant differences in professional group, numbers of poisoned patients seen or resource type accessed were identified between studies. The electronic resource most used in the first survey was Poisindex® (48.68%) and Toxinz™ (64.1%) in the second. There were statistically significant (P < 0.01) improvements in satisfaction in 26 of 42 questions between surveys, and no decrements. Although the majority of responders possessed mobile devices, less than half used them for poisons information but would do so if a reputable product was available. The order of poisons information sources most utilised was: consultation with a colleague, in-house protocols and electronic resources. There was a significant difference in satisfaction with electronic poisons information resources and a movement away from existing sources when choice was provided. Interest in increased use of mobile solutions was identified. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Technical Communicator: A New Model for the Electronic Resources Librarian?

ERIC Educational Resources Information Center

Hulseberg, Anna

2016-01-01

This article explores whether technical communicator is a useful model for electronic resources (ER) librarians. The fields of ER librarianship and technical communication (TC) originated and continue to develop in relation to evolving technologies. A review of the literature reveals four common themes for ER librarianship and TC. While the…

Characterization of Vibrio cholerae bacteriophages isolated from the environmental waters of the Lake Victoria region of Kenya.

PubMed

Maina, Alice Nyambura; Mwaura, Francis B; Oyugi, Julius; Goulding, David; Toribio, Ana L; Kariuki, Samuel

2014-01-01

Over the last decade, cholera outbreaks have become common in some parts of Kenya. The most recent cholera outbreak occurred in Coastal and Lake Victoria region during January 2009 and May 2010, where a total of 11,769 cases and 274 deaths were reported by the Ministry of Public Health and Sanitation. The objective of this study is to isolate Vibrio cholerae bacteriophages from the environmental waters of the Lake Victoria region of Kenya with potential for use as a biocontrol for cholera outbreaks. Water samples from wells, ponds, sewage effluent, boreholes, rivers, and lakes of the Lake Victoria region of Kenya were enriched for 48 h at 37 °C in broth containing a an environmental strain of V. cholerae. Bacteriophages were isolated from 5 out of the 42 environmental water samples taken. Isolated phages produced tiny, round, and clear plaques suggesting that these phages were lytic to V. cholerae. Transmission electron microscope examination revealed that all the nine phages belonged to the family Myoviridae, with typical icosahedral heads, long contractile tails, and fibers. Head had an average diameter of 88.3 nm and tail of length and width 84.9 and 16.1 nm, respectively. Vibriophages isolated from the Lake Victoria region of Kenya have been characterized and the isolated phages may have a potential to be used as antibacterial agents to control pathogenic V. cholerae bacteria in water reservoirs.

Kenya: The December 2007 Elections and the Challenges Ahead

DTIC Science & Technology

2008-09-17

NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 KENDA Kenya National Democratic...Ethnic Divisions: Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions

Evaluation criteria for the district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W; Odero, Wilson W O

2005-03-01

The District Health Management Information Systems (DHMISs) were established by the Ministry of Health (MoH) in Kenya more than two decades ago. Since then, no comprehensive evaluation has been undertaken. This can partly be attributed to lack of defined criteria for evaluating them. To propose evaluation criteria for assessing the design, implementation and impact of DHMIS in the management of the District Health System (DHS) in Kenya. A descriptive cross-sectional study conducted in three DHSs in Kenya: Bungoma, Murang'a and Uasin Gishu districts. Data was collected through focus group discussions, key informant interviews, and documents' review. The respondents, purposely selected from the Ministry of Health headquarters and the three DHS districts, included designers, managers and end-users of the systems. A set of evaluation criteria for DHMISs was identified for each of the three phases of implementation: pre-implementation evaluation criteria (categorised as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; concurrent implementation evaluation criteria to be applied during implementation of the new system; and post-implementation evaluation criteria (classified as internal - quality of information; external - resources and managerial support; ultimate - systems impact) to be applied after implementation of the system for at least three years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to it; concurrent (operational) - implementation evaluation criteria should be used to monitor the process; and post-implementation evaluation criteria should be applied to assess the system's effectiveness.

Redesign of Library Workflows: Experimental Models for Electronic Resource Description.

ERIC Educational Resources Information Center

Calhoun, Karen

This paper explores the potential for and progress of a gradual transition from a highly centralized model for cataloging to an iterative, collaborative, and broadly distributed model for electronic resource description. The purpose is to alert library managers to some experiments underway and to help them conceptualize new methods for defining,…

7 CFR 319.56-54 - French beans and runner beans from Kenya.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 5 2014-01-01 2014-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...

7 CFR 319.56-54 - French beans and runner beans from Kenya.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 5 2012-01-01 2012-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...

7 CFR 319.56-54 - French beans and runner beans from Kenya.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 5 2013-01-01 2013-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...

Globalisation and Higher Education Funding Policy Shifts in Kenya

ERIC Educational Resources Information Center

Wangenge-Ouma, Gerald

2008-01-01

This paper identifies, examines and discusses higher education funding policy shifts that have taken place in Kenya. The paper argues that even though Kenya's higher education funding policy shifts, from free higher education to cost-sharing, and privatisation and commercialisation, are (to a greater extent) products of the country's encounter…

Kenya: The December 2007 Elections and the Challenges Ahead

DTIC Science & Technology

2008-04-04

Peoples Democratic Party Traditional African Banjo 1 MGPK Mazingira Greens Party of Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour...Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45

Children as a resource: environmental degradation and fertility.

PubMed

Joekes, S

1994-06-01

Through the use of case studies from Kenya, Malaysia, Mexico, and Morocco, the influence of environmental degradation on women's livelihoods and fertility is broadly examined. The aim is to show how the environment impacts on women's childbearing decisions, and the consequences. The evidence appears to support the notion that environmental pressures on women will contribute to higher fertility, under conditions of gender division of labor, a very low social status for women, and women's limited educational opportunity. The Kenya experiences were among rural villages in various agro-ecological zones in Embu, on the slopes of Mt. Kenya, and involved coping strategies with poor soils and very little rainfall. The Malaysian research focused on river communities in the rain forests of Limbang River Basin in Sarawak and the logging industry and government regulation of tribal land use rights. In mountainous Tetouan and A1 Hoceimain, Moroccan populations struggle with poor social services and little rainfall. The study areas in Morocco and Kenya had very high population growth, but declining growth rates nationally. The study areas suffered from deforestation, declines in water quality and availability, and soil erosion and depletion. Family planning services would be welcome: 1) when women do not have to solely bear the responsibility for the additional work involved in environmentally degraded areas; and 2) when the value of children is not increased. Policy must recognize that where rigid gender division of labor is prominent, children are a crucial resource for women in the provision of household support. The Morocco case exemplified the extremes of men's refusal to ease women's workloads with time and labor saving technology. Family planning promotion in such situations must be accompanied by provision of alternative resources to address the adverse environmental impacts on women. Blaming women for environmental problems and family planning promotion will fail to

Community health worker interventions are key to optimal infant immunization coverage, evidence from a pretest-posttest experiment in Mwingi, Kenya.

PubMed

Nzioki, Japheth Mativo; Ouma, James; Ombaka, James Hebert; Onyango, Rosebella Ongutu

2017-01-01

Immunization is a powerful and cost-effective health intervention which averts an estimated 2 to 3 million deaths every year. Kenya has a high infant and under five mortality and morbidity rates. Increasing routine child immunization coverage is one way of reducing child morbidity and mortality rates in Kenya. Community Health Workers (CHWs) have emerged as critical human resources for health in developing countries. The Community Strategy (CS) is one of the CHW led interventions promoting Maternal and Child Health (MCH) in Kenya. This study sought to establish the effect of CS on infant vaccination Coverage (IVC) in Mwingi west sub-county; Kenya. This was a pretest - posttest experimental study design with 1 pretest and 2 post-test surveys conducted in intervention and control sites. Mwingi west and Mwingi north sub-counties where intervention and control sites respectively. Sample size in each survey was 422 households. Women with a child aged 9-12 months were main respondents. Intervention site end-term evaluation indicated that; the CS increased IVC by 10.1% (Z =6.0241, P <0.0001), from a suboptimal level of 88.7% at baseline survey to optimal level of 98.8% at end term survey. Infants in intervention site were 2.5 times more likely to receive all recommended immunizations within their first year of life [(crude OR= 2.475, P<0.0001; 95%CI: 1.794-3.414) (adj. OR=2.516, P<0.0001; 95%CI: 1.796-3.5240)]. CS increased IVC in intervention site to optimal level (98.8%). To improve child health outcomes through immunization coverage, Kenya needs to fast-track nationwide implementation of the CS intervention.

Microcredit for people affected by HIV and AIDS: insights from Kenya.

PubMed

Datta, Dipankar; Njuguna, James

2008-07-01

Consequences of HIV and AIDS are exponential in Kenya, touching not only the health of those infected, but also depleting socioeconomic resources of entire families. Access to financial services is one of the important ways to protect and build economic resources. Unfortunately, the norm of financial viability discourages microfinance institutions from targeting people severely impacted by HIV and AIDS. Thus, HIV and AIDS service NGOs have been increasingly getting involved in microcredit activity in recent years for economic empowerment of their clients. Despite limited human resources and funding in the area of microcredit activity, these NGOs have demonstrated that nearly 50% of their microcredit beneficiaries invested money in income-generating activities, resulting in enhancement to their livelihood security. In the short term these NGOs need to improve their current practices. However, this does not mean launching microfinance initiatives within their AIDS-focused programmes, as financial services are best provided by specialised institutions. Longer-term cooperation between microfinance institutions and other AIDS service organisations and donors is necessary to master appropriate and rapid responses in areas experiencing severe impacts of HIV and AIDS.

Matching safety to access: global actors and pharmacogovernance in Kenya- a case study.

PubMed

Moscou, Kathy; Kohler, Jillian C

2017-03-23

The Kenyan government has sought to address inadequacies in its National Pharmaceutical Policy and the Pharmacy and Poisons Board's (PPB) medicines governance by engaging with global actors (e.g. the World Health Organization). Policy actors have influenced the way pharmacovigilance is defined, how challenges are understood and which norms are requisite to address drug safety issues. In this paper, we investigate the relationship between specific modes of engagement among global (exogenous) and domestic actors at the national and sub-national level to identify the positive or negative effect on pharmacovigilance and pharmacogovernance in Kenya. Pharmacogovernance is defined as the manner in which governing structures; policy instruments; institutional authority (e.g., ability to act, implement and enforce norms, policies and processes) and resources are managed to promote societal interests for patient safety and protection from adverse drug reactions (ADRs). Qualitative research methods that included key informant interviews and document analysis, were employed to investigate the relationship between global actors' patterns of engagement with national actors and pharmacogovernance in Kenya. Global actors' influence on pharmacogovernance and pharmacovigilance priorities in Kenya (e.g., legislation and adverse drug reaction surveillance) was positively perceived by key informants. We found that global actors' engagement with state actors produced positive and negative outcomes. Engagement with the PPB and Ministry of Health (MOH) that was characterized as dependent (advocacy, empowerment, delegated) or interdependent (collaborative, cooperative, consultative) was mostly associated with positive outcomes e.g., capacity building; strengthening legislation and stakeholder coordination. Fragmentation (independent engagement) hindered risk communication between public, private, and NGO health programs. A framework for assessing pharmacogovernance would support policy

Kenya's Plans for Its Children.

ERIC Educational Resources Information Center

Chege, Nancy

1995-01-01

This article looks into the reasons behind Kenya's rapidly declining fertility rates over the last decade. Examines such factors as economic conditions, Westernization, contraceptive use, and formal education programs. (LZ)

An Elective Pharmaceutical Care Course to Prepare Students for an Advanced Pharmacy Practice Experience in Kenya

PubMed Central

Miller, Monica L.; Ogallo, William; Pastakia, Sonak D.

2013-01-01

Objective. To develop a prerequisite elective course to prepare students for an advanced pharmacy practice experience (APPE) in Kenya. Design. The course addressed Kenyan culture, travel preparation, patient care, and disease-state management. Instructional formats used were small-group discussions and lectures, including some Web-based presentations by Kenyan pharmacists on disease states commonly treated in Kenya. Cultural activities include instruction in conversational and medical Kiswahili and reading of a novel related to global health programs. Assessment. Student performance was assessed using written care plans, quizzes, reflection papers, a formulary management exercise, and pre- and post-course assessments. Student feedback on course evaluations indicated that the course was well received and students felt prepared for the APPE. Conclusion. This course offered a unique opportunity for students to learn about pharmacy practice in global health and to apply previously acquired skills in a resource-constrained international setting. It prepares students to actively participate in clinical care activities during an international APPE. PMID:23610478

The estimated incidence of induced abortion in Kenya: a cross-sectional study.

PubMed

Mohamed, Shukri F; Izugbara, Chimaraoke; Moore, Ann M; Mutua, Michael; Kimani-Murage, Elizabeth W; Ziraba, Abdhalah K; Bankole, Akinrinola; Singh, Susheela D; Egesa, Caroline

2015-08-21

The recently promulgated 2010 constitution of Kenya permits abortion when the life or health of the woman is in danger. Yet broad uncertainty remains about the interpretation of the law. Unsafe abortion remains a leading cause of maternal morbidity and mortality in Kenya. The current study aimed to determine the incidence of induced abortion in Kenya in 2012. The incidence of induced abortion in Kenya in 2012 was estimated using the Abortion Incidence Complications Methodology (AICM) along with the Prospective Morbidity Survey (PMS). Data were collected through three surveys, (i) Health Facilities Survey (HFS), (ii) Prospective Morbidity Survey (PMS), and (iii) Health Professionals Survey (HPS). A total of 328 facilities participated in the HFS, 326 participated in the PMS, and 124 key informants participated in the HPS. Abortion numbers, rates, ratios and unintended pregnancy rates were calculated for Kenya as a whole and for five geographical regions. In 2012, an estimated 464,000 induced abortions occurred in Kenya. This translates into an abortion rate of 48 per 1,000 women aged 15-49, and an abortion ratio of 30 per 100 live births. About 120,000 women received care for complications of induced abortion in health facilities. About half (49%) of all pregnancies in Kenya were unintended and 41% of unintended pregnancies ended in an abortion. This study provides the first nationally-representative estimates of the incidence of induced abortion in Kenya. An urgent need exists for improving facilities' capacity to provide safe abortion care to the fullest extent of the law. All efforts should be made to address underlying factors to reduce risk of unsafe abortion.

Africanizing Science in Post-colonial Kenya: Long-Term Field Research in the Amboseli Ecosystem, 1963-1989.

PubMed

Lewis, Amanda E

2017-11-08

Following Kenya's independence in 1963, scientists converged on an ecologically sensitive area in southern Kenya on the northern slope of Mt. Kilimanjaro called Amboseli. This region is the homeland of the Ilkisongo Maasai who grazed this ecosystem along with the wildlife of interest to the scientists. Biologists saw opportunities to study this complex community, an environment rich in biological diversity. The Amboseli landscape proved to be fertile ground for testing new methods and lines of inquiry in the biological sciences that were generalizable and important for shaping natural resource management policies in Kenya. However, the local community was in the midst of its own transformation from a primarily transhumant lifestyle to a largely sedentary one, a complex political situation between local and national authorities, and the introduction of a newly educated generation. This article examines the intersection of African history and field science through the post-colonial Africanization of Kenyan politics, the broadening of scientific practices in Amboseli in previously Western-occupied spaces to include Kenyan participants, and an increasing awareness of the role of local African contexts in the results, methods, and implications of biological research. "Africanization" as an idea in the history of science is multifaceted encompassing not just Africans in the scientific process, but it needs an examination of the larger political and social context on both a local and national level.

Availability and Use of Instructional Materials in the Teaching of Conflict and Conflict Resolution in Primary Schools in Nandi North District, Kenya

ERIC Educational Resources Information Center

Tuimur, Hilda Ng'etich; Chemwei, Bernard

2015-01-01

This paper examines the availability and use of instructional resources necessary for teaching Conflict and Conflict Resolution as a topic in Social Studies subject in primary schools in Nandi North District in Kenya. The study was carried out through descriptive survey. The study population included Social Studies teachers in Kosirai Division of…

The Acquisition and Management of Electronic Resources: Can Use Justify Cost?

ERIC Educational Resources Information Center

Koehn, Shona L.; Hawamdeh, Suliman

2010-01-01

As library collections increasingly become digital, libraries are faced with many challenges regarding the acquisition and management of electronic resources. Some of these challenges include copyright and fair use, the first-sale doctrine, licensing versus ownership, digital preservation, long-term archiving, and, most important, the issue of…

Barriers to Participation in Adult Literacy Programs in Kenya

ERIC Educational Resources Information Center

Muiru, John; Mukuria, Gathogo

2005-01-01

To compete internationally, adapt to new technologies, and attain higher levels of efficiency and productivity, a country needs a highly literate populace. However, in Kenya, literacy stands at less than 65% of the population. With such a low rate of literacy, most development is hampered. In order for Kenya to make progress in political, social,…

Reflecting on the Challenges of Applied Theatre in Kenya

ERIC Educational Resources Information Center

Okuto, Maxwel; Smith, Bobby

2017-01-01

In this article the authors draw on their own experience and research in applied theatre in Kenya in order to reflect on challenges currently facing practitioners working in the country. In order to outline the range of challenges faced by practitioners, issues related to the wider landscapes of government and politics in Kenya are explored,…

Implementing school malaria surveys in Kenya: towards a national surveillance system

PubMed Central

2010-01-01

Objective To design and implement surveys of malaria infection and coverage of malaria control interventions among school children in Kenya in order to contribute towards a nationwide assessment of malaria. Methods The country was stratified into distinct malaria transmission zones based on a malaria risk map and 480 schools were visited between October 2008 and March 2010. Surveys were conducted in two phases: an initial opportunistic phase whereby schools were selected for other research purposes; and a second phase whereby schools were purposively selected to provide adequate spatial representation across the country. Consent for participation was based on passive, opt-out consent rather than written, opt-in consent because of the routine, low-risk nature of the survey. All children were diagnosed for Plasmodium infection using rapid diagnostic tests, assessed for anaemia and were interviewed about mosquito net usage, recent history of illness, and socio-economic and household indicators. Children's responses were entered electronically in the school and data transmitted nightly to Nairobi using a mobile phone modem connection. RDT positive results were corrected by microscopy and all results were adjusted for clustering using random effect regression modelling. Results 49,975 children in 480 schools were sampled, at an estimated cost of US$ 1,116 per school. The overall prevalence of malaria and anaemia was 4.3% and 14.1%, respectively, and 19.0% of children reported using an insecticide-treated net (ITN). The prevalence of infection showed marked variation across the country, with prevalence being highest in Western and Nyanza provinces, and lowest in Central, North Eastern and Eastern provinces. Nationally, 2.3% of schools had reported ITN use >60%, and low reported ITN use was a particular problem in Western and Nyanza provinces. Few schools reported having malaria health education materials or ongoing malaria control activities. Conclusion School malaria

Molecular Characterization of Giardia duodenalis in Children in Kenya.

PubMed

Mbae, C; Mulinge, E; Guleid, F; Wainaina, J; Waruru, A; Njiru, Z K; Kariuki, S

2016-03-22

Giardia duodenalis is an important intestinal protozoan in humans worldwide with high infection rates occurring in densely populated and low resource settings. The parasite has been recorded to cause diarrhea in children. This study was carried out to identify G. duodenalis assemblages and sub-assemblages in children presenting with diarrhea in Kenya. A total of 2112 faecal samples were collected from children aged ≤ 5 years and screened for the presence of Giardia cysts using microscopy. A total of 96 (4.5%) samples were identified as Giardia positive samples and were genotyped using glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi) and β-giardin loci. The three markers successfully genotyped 72 isolates and grouped 2 (1.4) isolates as Assemblage A, 64 (88.9) as Assemblage B and 7 (9.7%) consisted of mixed infections with assemblage A and B. A further analysis of 50 isolates using GDH Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) categorized 2 assemblage A isolates as sub-assemblage AII while 6 and 14 assemblage B isolates were categorized into sub-assemblage BIII and BIV respectively. A mixed infection with sub-assemblage BIII and BIV was recorded in 28 isolates. Over half (55.6%) of Giardia infections were recorded among the children between 13 to 48 months old. This paper reports the first data on the assemblages and sub-assemblages of Giardia duodenalis in children representing with diarrhea in Kenya.

Methodology to Model and Understand the Complexities of Social, Economic,and Governance Interactions for Regional Assessment in Kenya

DTIC Science & Technology

2012-07-01

factors, including its declining tourism -based economy and its predominantly non-Muslim population surrounded by many predominantly Muslim countries...natural resources such as tea, coffee, wheat, sugarcane, fruit, dairy products, and meats. However, it is tourism that results in a large percentage of...the annual income for Kenya, and with the increasing level of corruption and violence, tourism has begun to decrease as foreigners choose to not visit

Video Killed the Radio Star: Language Students' Use of Electronic Resources-Reading or Viewing?

ERIC Educational Resources Information Center

Kiliçkaya, Ferit

2016-01-01

The current study aimed to investigate language students' use of print and electronic resources for their research papers required in research techniques class, focusing on which reading strategies they used while reading these resources. The participants of the study were 90 sophomore students enrolled in the research techniques class offered at…

The fertility decline in Kenya.

PubMed

Robinson, W C; Harbison, S F

1995-01-01

In Sub-Saharan Africa Kenya is a prime example of a country experiencing a rapid decline in fertility and greater contraceptive prevalence. These changes have occurred since 1980 when fertility was high at 8.0 children per woman. In 1993 the total fertility rate (TFR) was 5.4, and the growth rate declined to about 2.0%. This transition is swifter than any country in contemporary Asia or historical Europe. The likely projection for Kenya is attainment of replacement level fertility during the 2020s and a leveling of population at about 100 million persons. Fertility has declined the most in urban areas and central and eastern regions. Bongaarts' proximate determinants (TFR, total marital fertility rate, total natural marital fertility rate, and total fecundity) are reduced to the proportion of currently married women using contraception, the proportion in lactational nonfecund status, and the proportion currently married. Actual fertility change is accounted for by total fertility change of 3.0 children. Lactational infecundability accounts for 0.5 potential births, and changes in marital fertility account for 1.0 reduced births per woman. About 70% of fertility reduction is accounted for by contraception and abortion. During 1977-78 80% of fertility control was due to lactational nonfecundity, 10% to nonmarriage, and 10% to contraception. In 1993 lactational nonfecundity accounted for 50% of the reduction, nonmarriage for 20%, and abortion about 30%. Future fertility is expected to be dependent on contraceptive prevalence. Kenya has experienced the Coale paradigm of preconditions necessary for demographic transition (willing, ready, and able). High fertility in Africa is not intractable. Creating the change in attitudes that leads to readiness is linked to education, health, and exposure to modernizing media and urban lifestyles. The public sector family planning program in Kenya has created the opportunity for access and availability of contraception. The key

Selection and Presentation of Commercially Available Electronic Resources: Issues and Practices.

ERIC Educational Resources Information Center

Jewell, Timothy D.

This report focuses on practices related to the selection and presentation of commercially available electronic resources. As part of the Digital Library Federation's Collection Practices Initiative, the report also shares the goal of identifying and propagating practices that support the growth of sustainable and scalable collections. It looks in…

Growing Up in Kenya: Rural Schooling and Girls. Rethinking Childhood.

ERIC Educational Resources Information Center

Mungai, Anne M.

This book examines the education of rural girls in Kenya and reports on a study of factors influencing girls' educational success or failure. Three chapters provide background on traditional values and practices affecting girls' education; describe Kenya's education system, including preprimary, primary (grades 1-8), secondary, university,…

Community health worker interventions are key to optimal infant immunization coverage, evidence from a pretest-posttest experiment in Mwingi, Kenya

PubMed Central

Nzioki, Japheth Mativo; Ouma, James; Ombaka, James Hebert; Onyango, Rosebella Ongutu

2017-01-01

Introduction Immunization is a powerful and cost-effective health intervention which averts an estimated 2 to 3 million deaths every year. Kenya has a high infant and under five mortality and morbidity rates. Increasing routine child immunization coverage is one way of reducing child morbidity and mortality rates in Kenya. Community Health Workers (CHWs) have emerged as critical human resources for health in developing countries. The Community Strategy (CS) is one of the CHW led interventions promoting Maternal and Child Health (MCH) in Kenya. This study sought to establish the effect of CS on infant vaccination Coverage (IVC) in Mwingi west sub-county; Kenya. Methods This was a pretest - posttest experimental study design with 1 pretest and 2 post-test surveys conducted in intervention and control sites. Mwingi west and Mwingi north sub-counties where intervention and control sites respectively. Sample size in each survey was 422 households. Women with a child aged 9-12 months were main respondents. Results Intervention site end-term evaluation indicated that; the CS increased IVC by 10.1% (Z =6.0241, P <0.0001), from a suboptimal level of 88.7% at baseline survey to optimal level of 98.8% at end term survey. Infants in intervention site were 2.5 times more likely to receive all recommended immunizations within their first year of life [(crude OR= 2.475, P<0.0001; 95%CI: 1.794-3.414) (adj. OR=2.516, P<0.0001; 95%CI: 1.796-3.5240)]. Conclusion CS increased IVC in intervention site to optimal level (98.8%). To improve child health outcomes through immunization coverage, Kenya needs to fast-track nationwide implementation of the CS intervention. PMID:29138657

Managing Electronic Resources: A Survey of Current Practices in Academic Libraries.

ERIC Educational Resources Information Center

Shaw, Beth Hansen

This document reports results of an online survey that examined practices and procedures in the management of electronic resources in 65 academic library reference departments. Responses are related to: (1) student population; (2) library use by community people; (3) number of public access workstations, workstations with World Wide Web access,…

A qualitative assessment of beliefs, attitudes, and behaviors related to diarrhea and water filtration in rural Kenya.

PubMed

De Ver Dye, Timothy; Apondi, Rose; Lugada, Eric; Kahn, James G; Sandiford-Day, Mary Ann; Dasbanerjee, Tania

2011-08-01

We qualitatively assessed beliefs, attitudes, and behaviors related to diarrhea and water filtration in rural Kenya. A public health campaign was conducted in rural western Kenya to give community members a comprehensive prevention package of goods and services, including a personal water filter or a household water filter (or both). Two months after the campaign, we conducted qualitative interviews with 34 campaign attendees to assess their beliefs, attitudes, and behaviors related to diarrhea and use of the filtration devices. Participants held generally correct perceptions of diarrhea causation. Participants provided positive reports of their experiences with using filters and of their success with obtaining clean water, reducing disease, and reducing consumption of resources otherwise needed to produce clean water. Several participants offered technical suggestions for device improvements, and most participants were still using the devices at the time of the assessment. Novel water filtration devices distributed as part of a comprehensive public health campaign rapidly proved acceptable to community members and were consistent with community practices and beliefs.

Progress in measles control--Kenya 2002-2007.

PubMed

2007-09-21

In 2000, countries represented by the World Health Organization (WHO) Regional Office for Africa established a goal to reduce, by the end of 2005, measles mortality to 50% of the 506,000 deaths from measles estimated in 1999. Strategies adopted included strengthening routine vaccination, providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), monitoring disease trends, and improving measles case management. In Kenya, an east African country with a population estimated at 33.4 million in 2005, the Kenya Expanded Programme on Immunization (KEPI) in the Ministry of Health began implementing these strategies in 2002 with a wide age range catch-up SIA and reduced the number of reported measles cases by >99%, from 11,304 in 2001 to 20 in 2004. A follow-up SIA, initially scheduled for July 2005, was postponed to 2006 to include concurrent distribution of long-lasting insecticide-treated bednets (LLINs). This report documents progress made in reducing measles morbidity and mortality in Kenya and describes the consequences of a large measles outbreak, beginning in September 2005, on the integrated measles follow-up SIA.

East Africa seminar and workshop of remote sensing of natural resources and environment

USGS Publications Warehouse

Deutsch, Morris

1975-01-01

Report on total program covering East Africa Seminar and Workshop on remote sensing of natural resources and the environment held in Nairobi, Kenya, March 21 April 3, 1974, attended by participants from 10 English-speaking African nations. Appendices are included for Seminar proceedings, workshop lectures and outlines, field trip reports and critiques by participants, and reports on potential applications of an operational earth resources satellite for the participating countries.

7 CFR 319.56-45 - Shelled garden peas from Kenya.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 5 2013-01-01 2013-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...

7 CFR 319.56-45 - Shelled garden peas from Kenya.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 5 2014-01-01 2014-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...

7 CFR 319.56-45 - Shelled garden peas from Kenya.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 5 2012-01-01 2012-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...

7 CFR 319.56-45 - Shelled garden peas from Kenya.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 5 2011-01-01 2011-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...

A political economy analysis of decision-making on natural disaster preparedness in Kenya.

PubMed

Rono-Bett, Karen C

2018-01-01

Most deaths from natural disasters occur in low- or middle-income countries; among them, countries in the Horn of Africa - where Kenya lies. Between September 2015 and September 2016, 23.4 million people in this region faced food insecurity because of the 2015 El Niño, characterised by floods and droughts. The importance of effective government decision-making on preparedness and response are critical to saving lives during such disasters. But this decision-making process occurs in a political context which is marred by uncertainty with other factors at play. Yet, good practice requires making investments on a 'no-regrets' basis. This article looks at the factors influencing Kenya's decision-making process for natural disasters, the preparedness for the 2015 El Niño as a case study. I explored what stakeholders understand by 'no-regrets investments' and its application. I assessed financial allocations by government and donors to disaster preparedness. Based on key informant interviews, focus group discussions and financial analyses, this article presents evidence at national and subnational levels. The findings indicate that in making decisions relating to preparedness, the government seeks information primarily from sources it trusts - other government departments, its communities and the media. With no existing legal frameworks guiding Kenya's disaster preparedness, the coordination of preparedness is not strong. It appears that there is a lack of political will to prioritise these frameworks. The no-regrets approach is applied predominantly by non-state actors. Because there have been 'non-events' in the past, government has become overcautious in committing resources on a no-regrets basis. Government allocation to preparedness exceeds donor funding by almost tenfold.

Determinants of under-five mortality in rural and urban Kenya.

PubMed

Ettarh, R R; Kimani, J

2012-01-01

The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

Social Exchange and Sexual Behavior in Young Women's Premarital Relationships in Kenya.

PubMed

Luke, Nancy; Goldberg, Rachel E; Mberu, Blessing U; Zulu, Eliya M

2011-10-01

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the linkages between a variety of young women's resources-including employment and material transfers from male partners-and sexual behaviors. Data on the first month of premarital relationships (N=551 relationships) were collected from a random sample of young adult women ages 18-24 in Kisumu, Kenya, using a retrospective life history calendar. Consistent with the hypotheses, results showed that young women's income increases the likelihood of safer sexual activities, including delaying sex and using condoms consistently. Material transfers from the male partner displayed the opposite effect, supporting the view that resources obtained from within the relationship decrease young women's negotiating power.

Towards a Practical Proposal for Multilingualism in Education in Kenya

ERIC Educational Resources Information Center

Oduor, Jane A. N.

2015-01-01

This article proposes multilingualism in education, where indigenous languages are used alongside English as the media of instruction in schools to eventually promote their use in Kenya. It begins by stating Kenya's language policy in education. It then states the responses given by some primary and secondary school teachers who were interviewed…

Benefits of family planning: an assessment of women's knowledge in rural Western Kenya.

PubMed

Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva

2014-03-18

The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.

A Study on Developing Evaluation Criteria for Electronic Resources in Evaluation Indicators of Libraries

ERIC Educational Resources Information Center

Noh, Younghee

2010-01-01

This study aimed to improve the current state of electronic resource evaluation in libraries. While the use of Web DB, e-book, e-journal, and other e-resources such as CD-ROM, DVD, and micro materials is increasing in libraries, their use is not comprehensively factored into the general evaluation of libraries and may diminish the reliability of…

Towards Near Real-time Convective Rainfall Observations over Kenya

NASA Astrophysics Data System (ADS)

Hoedjes, Joost; Said, Mohammed; Becht, Robert; Kifugo, Shem; Kooiman, André; Limo, Agnes; Maathuis, Ben; Moore, Ian; Mumo, Mark; Nduhiu Mathenge, Joseph; Su, Bob; Wright, Iain

2013-04-01

The existing meteorological infrastructure in Kenya is poorly suited for the countrywide real-time monitoring of precipitation. Rainfall radar is not available, and the existing network of rain gauges is sparse and challenging to maintain. This severely restricts Kenya's capacity to warn for, and respond to, weather related emergencies. Furthermore, the lack of accurate rainfall observations severely limits Kenya's climate change adaptation capabilities. Over the past decade, the mobile telephone network in Kenya has expanded rapidly. This network makes extensive use of terrestrial microwave (MW) links, received signal level (RSL) data from which can be used for the calculation of rainfall intensities. We present a novel method for the near-real time observation of convective rainfall over Kenya, based on the combined use of MW RSL data and Meteosat Second Generation (MSG) satellite data. In this study, the variable density rainfall information derived from several MW links is scaled up using MSG data to provide full rainfall information coverage for the region surrounding the links. Combining MSG data and MW link derived rainfall data for several adjacent MW links makes it possible to make the distinction between wet and dry pixels. This allows the disaggregation of the MW link derived rainfall intensities. With the distinction between wet and dry pixels made, and the MW derived rainfall intensities disaggregated, these data can then be used to develop instantaneous empirical relationships linking rainfall intensities to cloud physical properties. These relationships are then used to calculate rainfall intensities for the MSG scene. Since both the MSG and the MW data are available at the same temporal resolution, unique empirical coefficients can be determined for each interval. This approach ensures that changes in convective conditions from one interval to the next are taken into account. Initial results from a pilot study, which took place from November 2012

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; Mike, English C

2011-10-03

The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study

PubMed Central

2011-01-01

Background The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research. The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. Methods We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Results Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. Conclusion This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in

The introduction of new policies and strategies to reduce inequities and improve child health in Kenya: A country case study on progress in child survival, 2000-2013

PubMed Central

Brault, Marie A.; Ngure, Kenneth; Haley, Connie A.; Kabaka, Stewart; Sergon, Kibet; Desta, Teshome; Mwinga, Kasonde; Vermund, Sten H.; Kipp, Aaron M.

2017-01-01

As of 2015, only 12 countries in the World Health Organization’s AFRO region had met Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Kenya was one of the countries selected for an in-depth case study due to its insufficient progress in reducing under-five mortality, with only a 28% reduction between 1990 and 2013. This paper presents indicators, national documents, and qualitative data describing the factors that have both facilitated and hindered Kenya’s efforts in reducing child mortality. Key barriers identified in the data were widespread socioeconomic and geographic inequities in access and utilization of maternal, neonatal, and child health (MNCH) care. To reduce these inequities, Kenya implemented three major policies/strategies during the study period: removal of user fees, the Kenya Essential Package for Health, and the Community Health Strategy. This paper uses qualitative data and a policy review to explore the early impacts of these efforts. The removal of user fees has been unevenly implemented as patients still face hidden expenses. The Kenya Essential Package for Health has enabled construction and/or expansion of healthcare facilities in many areas, but facilities struggle to provide Emergency Obstetric and Neonatal Care (EmONC), neonatal care, and many essential medicines and commodities. The Community Health Strategy appears to have had the most impact, improving referrals from the community and provision of immunizations, malaria prevention, and Prevention of Mother-to-Child Transmission of HIV. However, the Community Health Strategy is limited by resources and thus also unevenly implemented in many areas. Although insufficient progress was made pre-2015, with additional resources and further scale-up of new policies and strategies Kenya can make

Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.

PubMed

Ettarh, Remare R; Kyobutungi, Catherine

2012-09-01

The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.

Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study.

PubMed

Rogers, Anna Joy; Weke, Elly; Kwena, Zachary; Bukusi, Elizabeth A; Oyaro, Patrick; Cohen, Craig R; Turan, Janet M

2016-07-11

Repeat HIV testing in late pregnancy has the potential to decrease rates of mother-to-child transmission of HIV by identifying mothers who seroconvert after having tested negative for HIV in early pregnancy. Despite being national policy in Kenya, the available data suggest that implementation rates are low. We conducted 20 in-depth semi-structured interviews with healthcare providers and managers to explore barriers and enablers to implementation of repeat HIV testing guidelines for pregnant women. Participants were from the Nyanza region of Kenya and were purposively selected to provide variation in socio-demographics and job characteristics. Interview transcripts were coded and analyzed in Dedoose software using a thematic analysis approach. Four themes were identified a priori using Ferlie and Shortell's Framework for Change and additional themes were allowed to emerge from the data. Participants identified barriers and enablers at the client, provider, facility, and health system levels. Key barriers at the client level from the perspective of providers included late initial presentation to antenatal care and low proportions of women completing the recommended four antenatal visits. Barriers to offering repeat HIV testing for providers included heavy workloads, time limitations, and failing to remember to check for retest eligibility. At the facility level, inconsistent volume of clients and lack of space required for confidential HIV retesting were cited as barriers. Finally, at the health system level, there were challenges relating to the HIV test kit supply chain and the design of nationally standardized antenatal patient registers. Enablers to improving the implementation of repeat HIV testing included client dissemination of the benefits of antenatal care through word-of-mouth, provider cooperation and task shifting, and it was suggested that use of an electronic health record system could provide automatic reminders for retest eligibility. This study

A review of measles control in Kenya, with focus on recent innovations.

PubMed

Manakongtreecheep, Kasidet; Davis, Robert

2017-01-01

Despite the existence of a highly effective measles vaccine and the decrease in worldwide deaths from measles by more than 79% from the 2000 baseline levels, measles today remains one of the leading causes of vaccine-preventable deaths in the world. The African region is a key player in the global fight against measles. Africa has made tremendous progress in its effort to immunize children and to control the disease, increasing its regional measles vaccination coverage from 56% in 2001 to 85% in 2010. The Republic of Kenya has been a strong follower of the World Health Assembly and Measles Elimination 2020 resolutions, which aims to eliminate measles from the country. Since the beginning of the 21st century, Kenya has faced many challenges, but also aid, in the form of new innovations, in their fight against measles. In 2002, Kenya started its first SIA using A-D syringes, and from 2003-2005, GAVI funded injection safety support (INS) to Kenya, as an effort to scale-up safe injection in sub-Saharan Africa. In 2016, the Kenya introduced Measles-Rubella (MR) combined vaccine in its nationwide SIA campaign, after recognizing that rubella is a disease that must be controlled along with measles. In 2009 and 2012 SIAs, Red Cross volunteers conducted H2H visits to promote immunization as well as document information from the community with regards to immunization, including the current coverage, to campaign management levels. Case-based surveillance, using real-time PCR, measles-specific IgM detection and Epi-link were used to confirm and map measles infection during outbreaks. Alternative serosurveys such as Dried Blood Spot and Urine sample surveys were also tested in Kenya. In 2013 and 2016, two studies were also conducted in Kenya on the use of SMS reminder system for routine immunization. These studies, which showed SMS to significantly improve the vaccination coverage, paved way for use of SMS in a larger scale in Kenya.

A review of measles control in Kenya, with focus on recent innovations

PubMed Central

Manakongtreecheep, Kasidet; Davis, Robert

2017-01-01

Despite the existence of a highly effective measles vaccine and the decrease in worldwide deaths from measles by more than 79% from the 2000 baseline levels, measles today remains one of the leading causes of vaccine-preventable deaths in the world. The African region is a key player in the global fight against measles. Africa has made tremendous progress in its effort to immunize children and to control the disease, increasing its regional measles vaccination coverage from 56% in 2001 to 85% in 2010. The Republic of Kenya has been a strong follower of the World Health Assembly and Measles Elimination 2020 resolutions, which aims to eliminate measles from the country. Since the beginning of the 21st century, Kenya has faced many challenges, but also aid, in the form of new innovations, in their fight against measles. In 2002, Kenya started its first SIA using A-D syringes, and from 2003-2005, GAVI funded injection safety support (INS) to Kenya, as an effort to scale-up safe injection in sub-Saharan Africa. In 2016, the Kenya introduced Measles-Rubella (MR) combined vaccine in its nationwide SIA campaign, after recognizing that rubella is a disease that must be controlled along with measles. In 2009 and 2012 SIAs, Red Cross volunteers conducted H2H visits to promote immunization as well as document information from the community with regards to immunization, including the current coverage, to campaign management levels. Case-based surveillance, using real-time PCR, measles-specific IgM detection and Epi-link were used to confirm and map measles infection during outbreaks. Alternative serosurveys such as Dried Blood Spot and Urine sample surveys were also tested in Kenya. In 2013 and 2016, two studies were also conducted in Kenya on the use of SMS reminder system for routine immunization. These studies, which showed SMS to significantly improve the vaccination coverage, paved way for use of SMS in a larger scale in Kenya. PMID:29296150

Assessment of Coastal Governance for Climate Change Adaptation in Kenya

NASA Astrophysics Data System (ADS)

Ojwang, Lenice; Rosendo, Sergio; Celliers, Louis; Obura, David; Muiti, Anastasia; Kamula, James; Mwangi, Maina

2017-11-01

The coastline of Kenya already experiences effects of climate change, adding to existing pressures such as urbanization. Integrated coastal management (ICM) is increasingly recognized as a key policy response to deal with the multiple challenges facing coastal zones, including climate change. It can create an enabling governance environment for effective local action on climate change by facilitating a structured approach to dealing with coastal issues. It encompasses the actions of a wide range of actors, including local governments close to people and their activities affected by climate change. Functioning ICM also offers opportunities for reducing risks and building resilience. This article applied a modified capitals approach framework (CAF), consisting of five "capitals," to assess the status of county government capacity to respond to climate change within the context of coastal governance in three county governments in Kenya. The baseline was defined in terms of governance relating to the implementation of the interrelated policy systems of ICM and coastal climate change adaptation (CCA). The CAF framework provided a systematic approach to building a governance baseline against which to assess the progress of county governments in responding to climate change. It identified gaps in human capacity, financial resource allocation to adaptation and access to climate change information. Furthermore, it showed that having well-developed institutions, including regulatory frameworks at the national level can facilitate but does not automatically enable adaptation at the county level.

Developing a Family-Based HIV Prevention Intervention in Rural Kenya: Challenges in Conducting Community-Based Participatory Research

PubMed Central

Puffer, Eve S.; Pian, Jessica; Sikkema, Kathleen J.; Ogwang-Odhiambo, Rose A.; Broverman, Sherryl A.

2013-01-01

Community-based participatory research (CBPR) introduces new ethical challenges for HIV prevention studies in low-resource international settings. We describe a CBPR study in rural Kenya to develop and pilot a family-based HIV prevention and mental health promotion intervention. Academic partners (APs) worked with a community advisory committee (CAC) during formative research, intervention development, and a pilot trial. Ethical challenges emerged related to: negotiating power imbalances between APs and the CAC; CAC members’ shifting roles as part of the CAC and wider community; and anticipated challenges in decision making about sustainability. Factors contributing to ethical dilemmas included low access to education, scarcity of financial resources, and the shortage of HIV-related services despite high prevalence. PMID:23651936

Determining the level of awareness of the physicians in using the variety of electronic information resources and the effecting factors.

PubMed

Papi, Ahmad; Ghazavi, Roghayeh; Moradi, Salimeh

2015-01-01

Understanding of the medical society's from the types of information resources for quick and easy access to information is an imperative task in medical researches and management of the treatment. The present study was aimed to determine the level of awareness of the physicians in using various electronic information resources and the factors affecting it. This study was a descriptive survey. The data collection tool was a researcher-made questionnaire. The study population included all the physicians and specialty physicians of the teaching hospitals affiliated to Isfahan University of Medical Sciences and numbered 350. The sample size based on Morgan's formula was set at 180. The content validity of the tool was confirmed by the library and information professionals and the reliability was 95%. Descriptive statistics were used including the SPSS software version 19. On reviewing the need of the physicians to obtain the information on several occasions, the need for information in conducting the researches was reported by the maximum number of physicians (91.9%) and the usage of information resources, especially the electronic resources, formed 65.4% as the highest rate with regard to meeting the information needs of the physicians. Among the electronic information databases, the maximum awareness was related to Medline with 86.5%. Among the various electronic information resources, the highest awareness (43.3%) was related to the E-journals. The highest usage (36%) was also from the same source. The studied physicians considered the most effective deterrent in the use of electronic information resources as being too busy and lack of time. Despite the importance of electronic information resources for the physician's community, there was no comprehensive knowledge of these resources. This can lead to less usage of these resources. Therefore, careful planning is necessary in the hospital libraries in order to introduce the facilities and full capabilities of the

Oral health in Kenya.

PubMed

Kaimenyi, Jacob T

2004-12-01

This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.

A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach.

PubMed

Catalani, Caricia; Green, Eric; Owiti, Philip; Keny, Aggrey; Diero, Lameck; Yeung, Ada; Israelski, Dennis; Biondich, Paul

2014-01-01

With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context.

A Clinical Decision Support System for Integrating Tuberculosis and HIV Care in Kenya: A Human-Centered Design Approach

PubMed Central

Catalani, Caricia; Green, Eric; Owiti, Philip; Keny, Aggrey; Diero, Lameck; Yeung, Ada; Israelski, Dennis; Biondich, Paul

2014-01-01

With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context. PMID:25170939

Managing Selection for Electronic Resources: Kent State University Develops a New System to Automate Selection

ERIC Educational Resources Information Center

Downey, Kay

2012-01-01

Kent State University has developed a centralized system that manages the communication and work related to the review and selection of commercially available electronic resources. It is an automated system that tracks the review process, provides selectors with price and trial information, and compiles reviewers' feedback about the resource. It…

Kenya's Harambee Institutes of Technology.

ERIC Educational Resources Information Center

Kintzer, Frederick C.

1989-01-01

Reviews the history and current status of the Harambee Institutes of Technology in Kenya. Offers a critique of the parallel vocationalized system. Discusses the vocational-technical/general education controversy, diversification among types of schools, financing, and the 8-4-4 Plan. (DMM)

I've got 99 problems but a phone ain't one: Electronic and mobile health in low and middle income countries.

PubMed

Kumar, Pratap; Paton, Chris; Kirigia, Doris

2016-10-01

Mobile technology is very prevalent in Kenya-mobile phone penetration is at 88% and mobile data subscriptions form 99% of all internet subscriptions. While there is great potential for such ubiquitous technology to revolutionise access and quality of healthcare in low-resource settings, there have been few successes at scale. Implementations of electronic health (e-Health) and mobile health (m-Health) technologies in countries like Kenya are yet to tackle human resource constraints or the political, ethical and financial considerations of such technologies. We outline recent innovations that could improve access and quality while considering the costs of healthcare. One is an attempt to create a scalable clinical decision support system by engaging a global network of specialist doctors and reversing some of the damaging effects of medical brain drain. The other efficiently extracts digital information from paper-based records using low-cost and locally produced tools such as rubber stamps to improve adherence to clinical practice guidelines. By bringing down the costs of remote consultations and clinical audit, respectively, these projects offer the potential for clinics in resource-limited settings to deliver high-quality care. This paper makes a case for continued and increased investment in social enterprises that bridge academia, public and private sectors to deliver sustainable and scalable e-Health and m-Health solutions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Surveillance of HIV assisted partner services using routine health information systems in Kenya.

PubMed

Cherutich, Peter; Golden, Matthew; Betz, Bourke; Wamuti, Beatrice; Ng'ang'a, Anne; Maingi, Peter; Macharia, Paul; Sambai, Betsy; Abuna, Felix; Bukusi, David; Dunbar, Mathew; Farquhar, Carey

2016-07-20

The utilization of routine health information systems (HIS) for surveillance of assisted partner services (aPS) for HIV in sub-Saharan is sub-optimal, in part due to poor data quality and limited use of information technology. Consequently, little is known about coverage, scope and quality of HIV aPS. Yet, affordable electronic data tools, software and data transmission infrastructure are now widely accessible in sub-Saharan Africa. We designed and implemented a cased-based surveillance system using the HIV testing platform in 18 health facilities in Kenya. The components of this system included an electronic HIV Testing and Counseling (HTC) intake form, data transmission on the Global Systems for Mobile Communication (GSM), and data collection using the Open Data Kit (ODK) platform. We defined rates of new HIV diagnoses, and characterized HIV-infected cases. We also determined the proportion of clients who reported testing for HIV because a) they were notified by a sexual partner b) they were notified by a health provider, or c) they were informed of exposure by another other source. Data collection times were evaluated. Among 4351 clients, HIV prevalence was 14.2 %, ranging from 4.4-25.4 % across facilities. Regardless of other reasons for testing, only 107 (2.5 %) of all participants reported testing after being notified by a health provider or sexual partner. A similar proportion, 1.8 % (79 of 4351), reported partner notification as the only reason for seeking an HIV test. Among 79 clients who reported HIV partner services as the reason for testing, the majority (78.5 %), were notified by their sexual partners. The majority (52.8 %) of HIV-infected patients initiated their HIV testing, and 57.2 % tested in a Voluntary Counseling and Testing (VCT) site co-located in a health facility. Median time for data capture was 4 min (IQR: 3-15), with a longer duration for HIV-infected participants, and there was no reported data loss. aPS surveillance using new

Two-stage rifting in the Kenya rift: implications for half-graben models

NASA Astrophysics Data System (ADS)

Mugisha, F.; Ebinger, C. J.; Strecker, M.; Pope, D.

1997-09-01

The Kerio sub-basin in the northern Kenya rift is a transitional area between the southern Kenya rift, where crustal thickness is 30 km, and the northern Kenya rift, where crustal thickness is 20 km. The lack of data on the shallow crustal structure, geometry of rift-bounding faults, and rift evolution makes it difficult to determine if the crustal thickness variations are due to pre-rift structure, or along-axis variations in crustal stretching. We reprocessed reflection seismic data acquired for the National Oil Corporation of Kenya, and integrated results with field and gravity observations to (1) delineate the sub-surface geometry of the Kerio sub-basin, (2) correlate seismic stratigraphic sequences with dated strata exposed along the basin margins, and (3) use new and existing results to propose a two-stage rifting model for the central Kenya rift. Although a classic half-graben form previously had been inferred from the attitude of uppermost strata, new seismic data show a more complex form in the deeper basin: a narrow full-graben bounded by steep faults. We suggest that the complex basin form and the northwards increase in crustal thinning are caused by the superposition of two or more rifting events. The first rifting stage may have occurred during Palaeogene time contemporaneous with sedimentation and rifting in northwestern Kenya and southern Sudan. The distribution of seismic sequences suggests that a phase of regional thermal subsidence occurred prior to renewed faulting and subsidence at about 12 Ma after the eruption of flood phonolites throughout the central Kenya rift. A new border fault developed during the second rifting stage, effectively widening the basin. Gravity and seismic data indicate sedimentary and volcanic strata filling the basin are 6 km thick, with up to 4 km deposited during the first rifting stage.

Community Environment and Education of Girls: The Case of Communities in Marsabit County, Kenya

ERIC Educational Resources Information Center

Muyaka, Jafred

2018-01-01

The study sought to investigate the role of the community in inhibiting girls' access and participation in formal education in Marsabit County-Kenya. As one of the marginalized counties in Kenya, the county had among the highest rate of illiteracy in Kenya with 68 per cent of residents with no formal education. The study involved a total of 128…

In the shadowlands of global health: Observations from health workers in Kenya

PubMed Central

Prince, Ruth J.; Otieno, Phelgona

2014-01-01

During the past decade, donor funding for health interventions in Kenya and other African countries has risen sharply. Focused on high-profile diseases such as HIV/AIDS, these funds create islands of intervention in a sea of under-resourced public health services. This paper draws on ethnographic research conducted in HIV clinics and in a public hospital to examine how health workers experience and reflect upon the juxtaposition of ‘global’ medicine with ‘local’ medicine. We show that health workers face an uneven playing field. High-prestige jobs are available in HIV research and treatment, funded by donors, while other diseases and health issues receive less attention. Outside HIV clinics, patient's access to medicines and laboratory tests is expensive, and diagnostic equipment is unreliable. Clinicians must tailor their decisions about treatment to the available medical technologies, medicines and resources. How do health workers reflect on working in these environments and how do their experiences influence professional ambitions and commitments? PMID:25203252

In the shadowlands of global health: observations from health workers in Kenya.

PubMed

Prince, Ruth J; Otieno, Phelgona

2014-01-01

During the past decade, donor funding for health interventions in Kenya and other African countries has risen sharply. Focused on high-profile diseases such as HIV/AIDS, these funds create islands of intervention in a sea of under-resourced public health services. This paper draws on ethnographic research conducted in HIV clinics and in a public hospital to examine how health workers experience and reflect upon the juxtaposition of 'global' medicine with 'local' medicine. We show that health workers face an uneven playing field. High-prestige jobs are available in HIV research and treatment, funded by donors, while other diseases and health issues receive less attention. Outside HIV clinics, patient's access to medicines and laboratory tests is expensive, and diagnostic equipment is unreliable. Clinicians must tailor their decisions about treatment to the available medical technologies, medicines and resources. How do health workers reflect on working in these environments and how do their experiences influence professional ambitions and commitments?

Understanding the Impacts of Climate Change in the Tana River Basin, Kenya

NASA Astrophysics Data System (ADS)

Muthuwatta, Lal; Sood, Aditya; McCartney, Matthew; Sandeepana Silva, Nishchitha; Opere, Alfred

2018-06-01

In the Tana River Basin in Kenya, six Regional Circulation Models (RCMs) simulating two Representative Concentration Pathways (RCPs) (i.e., 4.5 and 8.5) were used as input to the Soil and Water Assessment Tool (SWAT) model to determine the possible implications for the hydrology and water resources of the basin. Four hydrological characteristics - water yield, groundwater recharge, base flow and flow regulation - were determined and mapped throughout the basin for three 30-year time periods: 2020-2049, 2040-2069 and 2070-2099. Results were compared with a baseline period, 1983-2011. All four hydrological characteristics show steady increases under both RCPs for the entire basin but with considerable spatial heterogeneity and greater increases under RCP 8.5 than RCP 4.5. The results have important implications for the way water resources in the basin are managed. It is imperative that water managers and policy makers take into account the additional challenges imposed by climate change in operating built infrastructure.

The Contribution of the Secondary School Curriculum to Peace in Kenya

ERIC Educational Resources Information Center

Chiriswa, Andika Patrick; Thinguri, Ruth

2015-01-01

The Kenya Government recognizes the role of peace in socio economic development as emphasized in the national anthem while the national goals of education endeavour to promote national unity, sustainable development, peace, respect for diversity, and international consciousness among others. The Kenya vision 2030 underscores the need for peace and…

Effectiveness of Communication on Students Discipline in Secondary Schools in Kenya

ERIC Educational Resources Information Center

Kindiki, Jonah Nyaga

2009-01-01

The influence of communication on student discipline in secondary schools is an issue of continued debate in Kenya. This study was necessitated by the growing concern by education stakeholders in Kenya over the rising reports of student indiscipline in secondary schools. The study utilized qualitative approach with questionnaires, interviews and…

Electronic Information Resources in Undergraduate Education: An Exploratory Study of Opportunities for Student Learning and Independence.

ERIC Educational Resources Information Center

McDowell, Liz

2002-01-01

This qualitative interview-based study examines lecturer perspectives on the roles of electronic information resources in undergraduate education. Highlights include electronic academic libraries; changes toward more constructivist approaches to learning; information quality on the Web; plagiarism; information use; information literacy; and…

Availability, Level of Use and Constraints to Use of Electronic Resources by Law Lecturers in Public Universities in Nigeria

ERIC Educational Resources Information Center

Amusa, Oyintola Isiaka; Atinmo, Morayo

2016-01-01

(Purpose) This study surveyed the level of availability, use and constraints to use of electronic resources among law lecturers in Nigeria. (Methodology) Five hundred and fifty-two law lecturers were surveyed and four hundred and forty-two responded. (Results) Data analysis revealed that the level of availability of electronic resources for the…

Orthobunyavirus antibodies among humans in selected parts of the Rift Valley and northeastern Kenya.

PubMed

Odhiambo, Collins; Venter, Marietjie; Swanepoel, Robert; Sang, Rosemary

2015-05-01

Ngari, Bunyamwera, Ilesha, and Germiston viruses are among the mosquito-borne human pathogens in the Orthobunyavirus genus, family Bunyaviridae, associated with febrile illness. Although the four orthobunyaviruses have been isolated from mosquito and/or tick vectors sampled from different geographic regions in Kenya, little is known of human exposure in such areas. We conducted a serologic investigation to determine whether orthobunyaviruses commonly infect humans in Kenya. Orthobunyavirus-specific antibodies were detected by plaque reduction neutralization tests in 89 (25.8%) of 345 persons tested. Multivariable analysis revealed age and residence in northeastern Kenya as risk factors. Implementation of acute febrile illness surveillance in northeastern Kenya will help to detect such infections.

Determinants of Secondary School Learners Performance in Christian Religious Education in Lelan Sub County, Kenya

ERIC Educational Resources Information Center

Akaranga, Stephen; Simiyu, Patrick Cheben

2016-01-01

In Kenya, Christian Religious Education is taught and examined by the Kenya National Examinations Council in the Kenya Certificate of Secondary Education at the end of the four years of Secondary Education cycle. The teaching of this subject in Secondary Schools ensures that learners are offered an opportunity to develop morally and spiritually…

Human aflatoxin exposure in Kenya, 2007: a cross-sectional study

PubMed Central

Yard, Ellen E.; Daniel, Johnni H.; Lewis, Lauren S.; Rybak, Michael E.; Paliakov, Ekaterina M.; Kim, Andrea A.; Montgomery, Joel M.; Bunnell, Rebecca; Abudo, Mamo Umuro; Akhwale, Willis; Breiman, Robert F.; Sharif, Shahnaaz K.

2013-01-01

Aflatoxins contaminate approximately 25% of agricultural products worldwide. They can cause liver failure and liver cancer. Kenya has experienced multiple aflatoxicosis outbreaks in recent years, often resulting in fatalities. However, the full extent of aflatoxin exposure in Kenya has been unknown. Our objective was to quantify aflatoxin exposure across Kenya. We analysed aflatoxin levels in serum specimens from the 2007 Kenya AIDS Indicator Survey – a nationally representative, cross-sectional serosurvey. KAIS collected 15,853 blood specimens. Of the 3180 human immunodeficiency virus-negative specimens with ≥1 mL sera, we randomly selected 600 specimens stratified by province and sex. We analysed serum specimens for aflatoxin albumin adducts by using isotope dilution MS/MS to quantify aflatoxin B1-lysine, and normalised with serum albumin. Aflatoxin concentrations were then compared by demographic, socioeconomic and geographic characteristics. We detected serum aflatoxin B1-lysine in 78% of serum specimens (range = Kenya, and it could be substantially impacting human health. Wide-scale, evidence-based interventions are urgently needed to decrease exposure and subsequent health effects. PMID:23767939

Rethinking Staff Development in Kenya: Agenda for the Twenty-first Century.

ERIC Educational Resources Information Center

Wanzare, Zachariah; Ward, Kenneth L.

2000-01-01

Provides an overview of current staff development practices and procedures in Kenya and suggests that teachers and head teachers need staff development opportunities to grow professionally, although current inservice training programs in Kenya are skewed to meet the needs of only a few teachers. Discusses the role of the head teacher in…

Influence of Gender Streamed (Boys' and Girls' Only) Classes on Coeducational Secondary Schools' Mathematics Teachers Perceptions in Nakuru, Uasingishu, Kericho and Baringo Counties of Kenya

ERIC Educational Resources Information Center

Barmao, Anne C.; Changeiywo, Johnson M.; Githua, Bernard N.

2015-01-01

The skills acquired in mathematics provide a country with a human resource that is highly educated and able to tackle most of the country's social economic problems. However, the performance of students at the KCSE mathematics examinations in Kenya has been dismal for many years. In addition, majority of the girls in particular have been…

The policy-practice gap: describing discordances between regulation on paper and real-life practices among specialized drug shops in Kenya.

PubMed

Wafula, Francis; Abuya, Timothy; Amin, Abdinasir; Goodman, Catherine

2014-09-16

Specialized drug shops (SDSs) are popular in Sub-Saharan Africa because they provide convenient access to medicines. There is increasing interest in how policymakers can work with them, but little knowledge on how their operation relates to regulatory frameworks. This study sought to describe characteristics and predictors of regulatory practices among SDSs in Kenya. The regulatory framework governing the Kenya pharmaceutical sector was mapped, and a list of regulations selected for inclusion in a survey questionnaire. An SDS census was conducted, and survey data collected from 213 SDSs from two districts in Western Kenya. The majority of SDSs did not comply with regulations, with only 12% having a refrigerator and 22% having a separate dispensing area for instance. Additionally, less than half had at least one staff with pharmacy qualification (46%), with less than a third of all interviewed operators knowing the name of the law governing pharmacy.Regulatory infringement was more common among SDSs in rural locations; those that did not have staff with pharmacy qualifications; and those whose operator did not know the name of the pharmacy law. Compliance was not significantly associated with the frequency of inspections, with over 80% of both rural and urban SDSs reporting an inspection in the past year. While compliance was low overall, it was particularly poor among SDSs operating in rural locations, and those that did not have staff with pharmacy qualification. This suggested the need for policy to introduce levels of practice in recognition of the variations in resource availability. Under such a system, rural SDSs operating in low-resource setting, and selling a limited range of medicines, may be exempted from certain regulatory requirements, as long as their scope of practice is limited to certain essential services only. Future research should also explore why regulatory compliance is poor despite regular inspections.

Maternal Education and Immunization Status Among Children in Kenya.

PubMed

Onsomu, Elijah O; Abuya, Benta A; Okech, Irene N; Moore, DaKysha; Collins-McNeil, Janice

2015-08-01

Child morbidity and mortality due to infectious diseases continues to be a major threat and public health concern worldwide. Although global vaccination coverage reached 90 % for diphtheria, tetanus and pertussis (DTP3) across 129 countries, Kenya and other sub-Saharan countries continue to experience under-vaccination. The purpose of this study was to examine the association between maternal education and child immunization (12-23 months) in Kenya. This study used retrospective cross-sectional data from the 2008-2009 Kenya Demographic and Health Survey for women aged 15-49, who had children aged 12-23 months, and who answered questions about vaccination in the survey (n = 1,707). The majority of the children had received vaccinations, with 77 % for poliomyelitis, 74 % for measles, 94 % for tuberculosis, and 91 % for diphtheria, whooping cough (pertussis), and tetanus. After adjusting for other covariates, women with primary, secondary, and college/university education were between 2.21 (p < 0.01) and 9.10 (p < 0.001) times more likely to immunize their children than those who had less than a primary education. Maternal education is clearly crucial in ensuring good health outcomes among children, and integrating immunization knowledge with maternal and child health services is imperative. More research is needed to identify factors influencing immunization decisions among less-educated women in Kenya.

Cancer genetics education in a low- to middle-income country: evaluation of an interactive workshop for clinicians in Kenya.

PubMed

Hill, Jessica A; Lee, Su Yeon; Njambi, Lucy; Corson, Timothy W; Dimaras, Helen

2015-01-01

Clinical genetic testing is becoming an integral part of medical care for inherited disorders. While genetic testing and counseling are readily available in high-income countries, in low- and middle-income countries like Kenya genetic testing is limited and genetic counseling is virtually non-existent. Genetic testing is likely to become widespread in Kenya within the next decade, yet there has not been a concomitant increase in genetic counseling resources. To address this gap, we designed an interactive workshop for clinicians in Kenya focused on the genetics of the childhood eye cancer retinoblastoma. The objectives were to increase retinoblastoma genetics knowledge, build genetic counseling skills and increase confidence in those skills. The workshop was conducted at the 2013 Kenyan National Retinoblastoma Strategy meeting. It included a retinoblastoma genetics presentation, small group discussion of case studies and genetic counseling role-play. Knowledge was assessed by standardized test, and genetic counseling skills and confidence by questionnaire. Knowledge increased significantly post-workshop, driven by increased knowledge of retinoblastoma causative genetics. One-year post-workshop, participant knowledge had returned to baseline, indicating that knowledge retention requires more frequent reinforcement. Participants reported feeling more confident discussing genetics with patients, and had integrated more genetic counseling into patient interactions. A comprehensive retinoblastoma genetics workshop can increase the knowledge and skills necessary for effective retinoblastoma genetic counseling.

Food biotechnology and nutrition in Africa: a case for Kenya.

PubMed

Ngichabe, Christopher K

2002-12-01

Household food consumption surveys indicate that the diet in Kenya is ill balanced and that many families cannot afford nutrient-rich foods such as meat and fruits. In this regard, rural populations-the majority of the Kenyan population-are much worse off than urban populations. Agriculture, the most important sector in the Kenyan economy, contributes 27% of the gross domestic product and generates 65% of the country's export earnings. Food-enhancing biotechnologies thus could increase national food yields and fill nutrition gaps by contributing to household and national food security and poverty reduction in Kenya. To overcome barriers to adopting biotechnology to improve food crops in Kenya and elsewhere in Africa, policy makers must create a receptive environment for, increase public understanding of, and stimulate investment in the new technology.

Assessment of palliative care services in western Kenya.

PubMed

Zubairi, Hijab; Tulshian, Priyanka; Villegas, Sarah; Nelson, Brett D; Ouma, Kennedy; Burke, Thomas F

2017-04-01

The need for palliative care services is rapidly increasing due to the rising number of patients with non-communicable diseases. The objective of this study was to assess the current availability and barriers to palliative care and healthcare worker knowledge and perceptions on palliative pain control in western Kenya. An evidence-based 40-question assessment tool was conducted between October 2015 and February 2016 in Siaya County, western Kenya. All level 4 and 5 facilities (e.g., regional and district hospitals) were assessed, as well as a selection of lower-level facilities chosen via convenience sampling, stratified by facility level (e.g., dispensaries, health centers, and health clinics). A key informant at each of 22 facilities was surveyed and included 1 medical officer (5%), 12 clinical officers (55%), and 9 nurses (41%). Key themes included training and education, awareness of palliative care and hospice, services provided, and pain control. All 22 providers had heard of palliative care and 4 (18%) had received formal training. Fourteen (64%) providers knew that morphine was on the World Health Organization (WHO) essential medication list, 8 (36%) had previously prescribed opioids, and 5 (23%) had prescribed them for palliation. Provider concerns for opioid use included its addictive properties (59%), appropriate dosing (9%), cost (5%), side effects (9%), and availability (5%). Palliative care and hospice services were identified by providers as important components in the management of chronic illnesses in western Kenya. Further provider education as well as increased access to pain medications including opioids is necessary to improve the care of patients in western Kenya.

SAGES: A Suite of Freely-Available Software Tools for Electronic Disease Surveillance in Resource-Limited Settings

PubMed Central

Lewis, Sheri L.; Feighner, Brian H.; Loschen, Wayne A.; Wojcik, Richard A.; Skora, Joseph F.; Coberly, Jacqueline S.; Blazes, David L.

2011-01-01

Public health surveillance is undergoing a revolution driven by advances in the field of information technology. Many countries have experienced vast improvements in the collection, ingestion, analysis, visualization, and dissemination of public health data. Resource-limited countries have lagged behind due to challenges in information technology infrastructure, public health resources, and the costs of proprietary software. The Suite for Automated Global Electronic bioSurveillance (SAGES) is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings. One or more SAGES tools may be used in concert with existing surveillance applications or the SAGES tools may be used en masse for an end-to-end biosurveillance capability. This flexibility allows for the development of an inexpensive, customized, and sustainable disease surveillance system. The ability to rapidly assess anomalous disease activity may lead to more efficient use of limited resources and better compliance with World Health Organization International Health Regulations. PMID:21572957

The seroprevalence and seroincidence of dengue virus infection in western Kenya.

PubMed

Blaylock, Jason M; Maranich, Ashley; Bauer, Kristen; Nyakoe, Nancy; Waitumbi, John; Martinez, Luis J; Lynch, Julia

2011-09-01

Epidemics of dengue fever have been documented throughout the African continent over the past several decades, however little is known about the prevalence or incidence of dengue virus infection in the absence of an outbreak. No studies have analyzed the prevalence of dengue infection in western Kenya to date. This study describes the seroincidence and seroprevalence of dengue infection in western Kenya. Banked sera obtained from 354 healthy, afebrile children ages 12-47 months from Kisumu District, Kenya, were analyzed for antibodies to dengue virus using an IgG indirect ELISA. We found a seroprevalence of 1.1% (4 of 354 samples) and incidence of 8.5 seroconversions per 1000 persons per year in this study population. This appears to be similar to that previously reported in coastal regions of the country outside of known epidemic periods. Since there has never been a reported dengue epidemic in western Kenya, continued investigation and evaluation in a patient population presenting with fever is necessary to further confirm this finding. Published by Elsevier Ltd.

The Situation Analysis Study of the family planning program in Kenya.

PubMed

Miller, R A; Ndhlovu, L; Gachara, M M; Fisher, A A

1991-01-01

A new, relatively "quick and clean" operations research approach called a "situation analysis" was developed for examining the strengths and weaknesses of the family planning program of Kenya. Field research teams visited a stratified random sample of 99 of the Ministry of Health's approximately 775 service delivery points. Observation techniques and interviewing were used to collect information on program components and on the quality of care provided to new family planning clients during the observation day. As late as 1986, the Kenya program was rated "weak" and "poor" in the international literature. The Kenya Situation Analysis Study found a functioning, integrated maternal and child health/family planning program serving large numbers of clients, with an emphasis on oral contraceptives and Depo-Provera (and an underemphasis on permanent methods). Although a number of program problems were revealed by the study, overall, in terms of performance, a rating of "moderate" is suggested as more appropriate for Kenya's national family planning program today. In terms of the quality of care, a "moderate to moderate-high" rating is suggested.

Differences in perceptions of communication, tourism benefits, and management issues in a protected area of rural Kenya.

PubMed

Bruyere, Brett L; Beh, Adam W; Lelengula, Geoffrey

2009-01-01

With record-breaking tourist visits in Kenya in 2005-2006, communities near the country's renowned protected areas must undertake or revisit planning efforts to conserve and enhance the region's natural, social, and economic resources. This article examines the differences between two stakeholder groups in the Samburu region of central Kenya: (1) protected area leadership and staff; and (2) members of the communities adjacent to the protected areas. Based on the results and analysis of 30 in-depth interviews, the authors identify differences between protected area staff and their community members regarding perceptions about communication between the two groups, and the economic benefits of tourism. The different stakeholders agreed, however, about challenges related to equitable distribution of tourism-based employment and revenue. The results indicate a need to reach consensus about what constitutes sufficient communication between national reserves and their community, and to what extent tourism-related revenue and employment should be distributed within the region. A discussion of the potential role of indicators and standards to make such decisions is presented.

A Qualitative Assessment of Beliefs, Attitudes, and Behaviors Related to Diarrhea and Water Filtration in Rural Kenya

PubMed Central

Apondi, Rose; Lugada, Eric; Kahn, James G.; Sandiford-Day, Mary Ann; DasBanerjee, Tania

2011-01-01

Objectives. We qualitatively assessed beliefs, attitudes, and behaviors related to diarrhea and water filtration in rural Kenya. Methods. A public health campaign was conducted in rural western Kenya to give community members a comprehensive prevention package of goods and services, including a personal water filter or a household water filter (or both). Two months after the campaign, we conducted qualitative interviews with 34 campaign attendees to assess their beliefs, attitudes, and behaviors related to diarrhea and use of the filtration devices. Results. Participants held generally correct perceptions of diarrhea causation. Participants provided positive reports of their experiences with using filters and of their success with obtaining clean water, reducing disease, and reducing consumption of resources otherwise needed to produce clean water. Several participants offered technical suggestions for device improvements, and most participants were still using the devices at the time of the assessment. Conclusions. Novel water filtration devices distributed as part of a comprehensive public health campaign rapidly proved acceptable to community members and were consistent with community practices and beliefs. PMID:21680914

Differences in Perceptions of Communication, Tourism Benefits, and Management Issues in a Protected Area of Rural Kenya

NASA Astrophysics Data System (ADS)

Bruyere, Brett L.; Beh, Adam W.; Lelengula, Geoffrey

2009-01-01

With record-breaking tourist visits in Kenya in 2005-2006, communities near the country’s renowned protected areas must undertake or revisit planning efforts to conserve and enhance the region’s natural, social, and economic resources. This article examines the differences between two stakeholder groups in the Samburu region of central Kenya: (1) protected area leadership and staff; and (2) members of the communities adjacent to the protected areas. Based on the results and analysis of 30 in-depth interviews, the authors identify differences between protected area staff and their community members regarding perceptions about communication between the two groups, and the economic benefits of tourism. The different stakeholders agreed, however, about challenges related to equitable distribution of tourism-based employment and revenue. The results indicate a need to reach consensus about what constitutes sufficient communication between national reserves and their community, and to what extent tourism-related revenue and employment should be distributed within the region. A discussion of the potential role of indicators and standards to make such decisions is presented.

Conformity and Change: Community Effects on Female Genital Cutting in Kenya

ERIC Educational Resources Information Center

Hayford, Sarah R.

2005-01-01

In this article, I analyze women's decisions to have their daughters circumcised based on data from 7,873 women in Kenya collected in the 1998 Kenya Demographic and Health Survey. I use multilevel models to assess the degree to which women's decisions are correlated with the decisions of other women in their community, in addition to studying the…

Building and Managing Electronic Resources in Digital Era in India with Special Reference to IUCAA and NIV, Pune: A Comparative Case Study

NASA Astrophysics Data System (ADS)

Sahu, H. K.; Singh, S. N.

2015-04-01

This paper discusses and presents a comparative case study of two libraries in Pune, India, Inter-University Centre for Astronomy and Astrophysics and Information Centre and Library of National Institute of Virology (Indian Council of Medical Research). It compares how both libraries have managed their e-resource collections, including acquisitions, subscriptions, and consortia arrangements, while also developing a collection of their own resources, including pre-prints and publications, video lectures, and other materials in an institutional repository. This study illustrates how difficult it is to manage electronic resources in a developing country like India, even though electronic resources are used more than print resources. Electronic resource management can be daunting, but with a systematic approach, various problems can be solved, and use of the materials will be enhanced.

Satellite-based drought monitoring in Kenya in an operational setting

NASA Astrophysics Data System (ADS)

Klisch, A.; Atzberger, C.; Luminari, L.

2015-04-01

The University of Natural Resources and Life Sciences (BOKU) in Vienna (Austria) in cooperation with the National Drought Management Authority (NDMA) in Nairobi (Kenya) has setup an operational processing chain for mapping drought occurrence and strength for the territory of Kenya using the Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI at 250 m ground resolution from 2000 onwards. The processing chain employs a modified Whittaker smoother providing consistent NDVI "Mondayimages" in near real-time (NRT) at a 7-daily updating interval. The approach constrains temporally extrapolated NDVI values based on reasonable temporal NDVI paths. Contrary to other competing approaches, the processing chain provides a modelled uncertainty range for each pixel and time step. The uncertainties are calculated by a hindcast analysis of the NRT products against an "optimum" filtering. To detect droughts, the vegetation condition index (VCI) is calculated at pixel level and is spatially aggregated to administrative units. Starting from weekly temporal resolution, the indicator is also aggregated for 1- and 3-monthly intervals considering available uncertainty information. Analysts at NDMA use the spatially/temporally aggregated VCI and basic image products for their monthly bulletins. Based on the provided bio-physical indicators as well as a number of socio-economic indicators, contingency funds are released by NDMA to sustain counties in drought conditions. The paper shows the successful application of the products within NDMA by providing a retrospective analysis applied to droughts in 2006, 2009 and 2011. Some comparisons with alternative products (e.g. FEWS NET, the Famine Early Warning Systems Network) highlight main differences.

Climate, Birth Weight, and Agricultural Livelihoods in Kenya and Mali

PubMed Central

Grace, Kathryn; Nawrotzki, Raphael J.

2018-01-01

Objectives. To examine an association between climate variability and birth weight in Mali and Kenya in relation to the local agricultural specialization. Methods. We combined health and sociodemographic data from the Demographic Health Surveys for Kenya (2008 and 2014) and Mali (2006 and 2012) with detailed data on precipitation, temperature, and vegetation. We analyzed the association between climate variability and birth weight by using multilevel regression models for the most common agricultural specializations: food cropping, cash cropping, and pastoralism. Results. There are differences in sensitivity to climate among different agricultural communities. An additional 100 millimeters of rainfall during the 12-month period before birth was associated with a 47-gram (P = .001) and 89-gram (P = .10) increase in birth weight for food croppers in Kenya and Mali, respectively. Every additional hot month in food-cropping communities in Kenya was associated with a 71-gram decrease in birth weight (P = .030), likely because of food croppers’ limited use of modern agricultural techniques. Overall, cash croppers are least sensitive to climate variability in both countries. Conclusions. Effective climate change adaptation strategies are essential for protecting and improving health outcomes and should be tailored to local households’ livelihood strategies. PMID:29072943

Physiologic specialization of Puccinia graminis f. sp. tritici in Kenya in 2011

USDA-ARS?s Scientific Manuscript database

A total of 12 collections of Puccinia graminis f. sp. tritici were obtained from Kenya during 2011. Collections were made around Mount Kenya and in wheat growing areas southwest towards Nakuru in the Rift Valley. Four collections were made from the international stem rust screening nursery in Njoro....

Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya.

PubMed

Puffer, Eve S; Drabkin, Anya S; Stashko, Allison L; Broverman, Sherryl A; Ogwang-Odhiambo, Rose A; Sikkema, Kathleen J

2012-09-01

To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya. Randomly selected adolescents aged 10-18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver-child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk. Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver-youth communication were more strongly associated with lower sex-related self-efficacy for orphans. Orphans are at higher risk for psychosocial problems. These problems may affect orphans' self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans.

Information architecture considerations in designing a comprehensive tuberculosis enterprise system in Western Kenya.

PubMed

Gichoya, Judy; Pearce, Chris; Wickramasinghe, Nilmini

2013-01-01

Kenya ranks among the twenty-two countries that collectively contribute about 80% of the world's Tuberculosis cases; with a 50-200 fold increased risk of tuberculosis in HIV infected persons versus non-HIV hosts. Contemporaneously, there is an increase in mobile penetration and its use to support healthcare throughout Africa. Many are skeptical that such m-health solutions are unsustainable and not scalable. We seek to design a scalable, pervasive m-health solution for Tuberculosis care to become a use case for sustainable and scalable health IT in limited resource settings. We combine agile design principles and user-centered design to develop the architecture needed for this initiative. Furthermore, the architecture runs on multiple devices integrated to deliver functionality critical for successful Health IT implementation in limited resource settings. It is anticipated that once fully implemented, the proposed m-health solution will facilitate superior monitoring and management of Tuberculosis and thereby reduce the alarming statistic regarding this disease in this region.

Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya

PubMed Central

Stuckey, Erin M.; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish Y.; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, Thomas A.; Cox, Jonathan; Chitnis, Nakul

2014-01-01

Introduction Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. Methods Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. Results The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN) use by 80% of the population, 90% of households covered by indoor residual spraying (IRS) with deployment starting in April, and intermittent screen and treat (IST) of school children using Artemether lumefantrine (AL) with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs) over a five year period. Conclusions All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to assist malaria

Modeling the cost effectiveness of malaria control interventions in the highlands of western Kenya.

PubMed

Stuckey, Erin M; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish Y; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, Thomas A; Cox, Jonathan; Chitnis, Nakul

2014-01-01

Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN) use by 80% of the population, 90% of households covered by indoor residual spraying (IRS) with deployment starting in April, and intermittent screen and treat (IST) of school children using Artemether lumefantrine (AL) with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs) over a five year period. All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to assist malaria control program managers in the study area in

Comparison of the Lithospheric Structure Beneath Kenya and Ethiopia From Joint Inversion of Receiver Functions and Rayleigh Wave Dispersion Velocities

NASA Astrophysics Data System (ADS)

Dugda, M. T.; Nyblade, A. A.; Julia, J.

2007-12-01

Shear-wave velocity structure of the crust and upper mantle beneath Kenya has been investigated using joint inversion of receiver functions, and Rayleigh wave group and phase velocities. Most of the data for this study come from the Kenya broadband seismic experiment, conducted between 2001 and 2002. Shear velocity models obtained from the joint inversion show crustal thicknesses of 37 to 42 km beneath the East African Plateau in Kenya and near the edge of the Kenya Rift, and a crustal thickness of about 30 km beneath the Kenya Rift. These crustal parameters are consistent with crustal thicknesses published previously by different authors. A comparison has been made between the lithosphere under Kenya and other parts of the East African Plateau in Tanzania. A comparison between the lithosphere under Kenya and that under Ethiopia has also been made, specifically between the lithosphere under the Ethiopian Plateau and the Kenya Plateau, and between the lithosphere beneath the Main Ethiopian Rift (MER) and the Kenya (Gregory) Rift. The lithospheric mantle beneath the East African Plateau in Kenya has a maximum shear wave velocity of about 4.6 km/s, similar to the value obtained under the East African Plateau in Tanzania. Beneath the Kenya Rift, the lithosphere extends to a depth of at most ~75 km. The average velocity of the mantle lithosphere under the East African Plateau in Kenya appears to be similar to the lithosphere under Tanzania away from the East African Rift System. The lithosphere under the Kenya Plateau is not perturbed as compared to the highly perturbed lithosphere beneath the Ethiopian Plateau. The lithosphere under the Kenya Rift is perturbed as compared to the rest of the region but is not as perturbed as that under the Main Ethiopian Rift or the Afar. Though Kenya and Ethiopia have similar uplift, volcanism and rifting at the surface, they have different lithospheric structures at the bottom. The Afar Flood Basalt Volcanism (AFB) may be the cause of

Old and new ways: family planning in Kenya.

PubMed

Antarsh, L

1989-04-01

Kenya has the highest fertility rate in the world. The average woman has 8 children. Further, urban areas attract people from rural areas leaving fewer people to farm the finite land or raise cattle. Therefore a reduced need for children to partake in agricultural activities exists. Nevertheless many barriers to family planning continue in Kenya. Family planning services are scarce especially in rural areas. Husbands must agree to their wives undergoing voluntary sterilization by going to the clinic to sign a consent form. Children are highly valued. Succession of the generations is important. The higher a woman's fertility the more valuable she is to husband. The continuance of legal polygamy fosters competition among a man's wives to have many sons with the 1 having the most being his most prized wife. In spite of these obstacles, the president of Kenya promotes family planning through his speeches and requires the Ministry of Health (MOH) to provide family planning services at all government hospitals. Moreover, church hospitals also provide family planning services. Additionally, articles that cover teenage pregnancy and family planning programs appear in daily newspapers. The MOH and the National Council on Population and Development are organizing a network of government and nongovernment organizations that provide family planning services to the public. A sample of these organizations include the Family Planning Association of Kenya, an influential women's organization (Mandeleo ya Wanawake), and several church organizations. The Association for Voluntary Surgical Contraception's regional office has promoted minilaparotomies under local anesthesia since 1986. They are now used in maternal and child health programs in government hospitals, mission hospitals, and in several family planning clinics.

Detecting and enumerating soil-transmitted helminth eggs in soil: New method development and results from field testing in Kenya and Bangladesh.

PubMed

Steinbaum, Lauren; Kwong, Laura H; Ercumen, Ayse; Negash, Makeda S; Lovely, Amira J; Njenga, Sammy M; Boehm, Alexandria B; Pickering, Amy J; Nelson, Kara L

2017-04-01

Globally, about 1.5 billion people are infected with at least one species of soil-transmitted helminth (STH). Soil is a critical environmental reservoir of STH, yet there is no standard method for detecting STH eggs in soil. We developed a field method for enumerating STH eggs in soil and tested the method in Bangladesh and Kenya. The US Environmental Protection Agency (EPA) method for enumerating Ascaris eggs in biosolids was modified through a series of recovery efficiency experiments; we seeded soil samples with a known number of Ascaris suum eggs and assessed the effect of protocol modifications on egg recovery. We found the use of 1% 7X as a surfactant compared to 0.1% Tween 80 significantly improved recovery efficiency (two-sided t-test, t = 5.03, p = 0.007) while other protocol modifications-including different agitation and flotation methods-did not have a significant impact. Soil texture affected the egg recovery efficiency; sandy samples resulted in higher recovery compared to loamy samples processed using the same method (two-sided t-test, t = 2.56, p = 0.083). We documented a recovery efficiency of 73% for the final improved method using loamy soil in the lab. To field test the improved method, we processed soil samples from 100 households in Bangladesh and 100 households in Kenya from June to November 2015. The prevalence of any STH (Ascaris, Trichuris or hookworm) egg in soil was 78% in Bangladesh and 37% in Kenya. The median concentration of STH eggs in soil in positive samples was 0.59 eggs/g dry soil in Bangladesh and 0.15 eggs/g dry soil in Kenya. The prevalence of STH eggs in soil was significantly higher in Bangladesh than Kenya (chi-square, χ2 = 34.39, p < 0.001) as was the concentration (Mann-Whitney, z = 7.10, p < 0.001). This new method allows for detecting STH eggs in soil in low-resource settings and could be used for standardizing soil STH detection globally.

Detecting and enumerating soil-transmitted helminth eggs in soil: New method development and results from field testing in Kenya and Bangladesh

PubMed Central

Kwong, Laura H.; Ercumen, Ayse; Negash, Makeda S.; Lovely, Amira J.; Njenga, Sammy M.; Boehm, Alexandria B.; Pickering, Amy J.; Nelson, Kara L.

2017-01-01

Globally, about 1.5 billion people are infected with at least one species of soil-transmitted helminth (STH). Soil is a critical environmental reservoir of STH, yet there is no standard method for detecting STH eggs in soil. We developed a field method for enumerating STH eggs in soil and tested the method in Bangladesh and Kenya. The US Environmental Protection Agency (EPA) method for enumerating Ascaris eggs in biosolids was modified through a series of recovery efficiency experiments; we seeded soil samples with a known number of Ascaris suum eggs and assessed the effect of protocol modifications on egg recovery. We found the use of 1% 7X as a surfactant compared to 0.1% Tween 80 significantly improved recovery efficiency (two-sided t-test, t = 5.03, p = 0.007) while other protocol modifications—including different agitation and flotation methods—did not have a significant impact. Soil texture affected the egg recovery efficiency; sandy samples resulted in higher recovery compared to loamy samples processed using the same method (two-sided t-test, t = 2.56, p = 0.083). We documented a recovery efficiency of 73% for the final improved method using loamy soil in the lab. To field test the improved method, we processed soil samples from 100 households in Bangladesh and 100 households in Kenya from June to November 2015. The prevalence of any STH (Ascaris, Trichuris or hookworm) egg in soil was 78% in Bangladesh and 37% in Kenya. The median concentration of STH eggs in soil in positive samples was 0.59 eggs/g dry soil in Bangladesh and 0.15 eggs/g dry soil in Kenya. The prevalence of STH eggs in soil was significantly higher in Bangladesh than Kenya (chi-square, χ2 = 34.39, p < 0.001) as was the concentration (Mann-Whitney, z = 7.10, p < 0.001). This new method allows for detecting STH eggs in soil in low-resource settings and could be used for standardizing soil STH detection globally. PMID:28379956

Environmental Communication: A Review of Information Sources and Communication Channels for Enhanced Community-Based Natural Resource Management in the Greater Mara Region of Kenya

ERIC Educational Resources Information Center

Ongare, David; Macharia, Ayub; Mwakaje, Agnes; Muchane, Muchai; Warui, Charles; Mugoya, Charles; Masiga, Clet; Nikundiwe, Alfeyo; Muiti, Anastacia; Wakibara, James

2013-01-01

The Mara-Serengeti is an ecosystem of immense importance to both Kenya and Tanzania, contributing significantly to the economies of both countries and forming a rich biodiversity reservoir. This ecosystem is among the most threatened ecosystems on the African continent. Increasing human population density and changing lifestyles have escalated…

Use of Lot Quality Assurance Sampling to Ascertain Levels of Drug Resistant Tuberculosis in Western Kenya

PubMed Central

Cohen, Ted; Zignol, Matteo; Nyakan, Edwin; Hedt-Gauthier, Bethany L.; Gardner, Adrian; Kamle, Lydia; Injera, Wilfred; Carter, E. Jane

2016-01-01

Objective To classify the prevalence of multi-drug resistant tuberculosis (MDR-TB) in two different geographic settings in western Kenya using the Lot Quality Assurance Sampling (LQAS) methodology. Design The prevalence of drug resistance was classified among treatment-naïve smear positive TB patients in two settings, one rural and one urban. These regions were classified as having high or low prevalence of MDR-TB according to a static, two-way LQAS sampling plan selected to classify high resistance regions at greater than 5% resistance and low resistance regions at less than 1% resistance. Results This study classified both the urban and rural settings as having low levels of TB drug resistance. Out of the 105 patients screened in each setting, two patients were diagnosed with MDR-TB in the urban setting and one patient was diagnosed with MDR-TB in the rural setting. An additional 27 patients were diagnosed with a variety of mono- and poly- resistant strains. Conclusion Further drug resistance surveillance using LQAS may help identify the levels and geographical distribution of drug resistance in Kenya and may have applications in other countries in the African Region facing similar resource constraints. PMID:27167381

Use of Lot Quality Assurance Sampling to Ascertain Levels of Drug Resistant Tuberculosis in Western Kenya.

PubMed

Jezmir, Julia; Cohen, Ted; Zignol, Matteo; Nyakan, Edwin; Hedt-Gauthier, Bethany L; Gardner, Adrian; Kamle, Lydia; Injera, Wilfred; Carter, E Jane

2016-01-01

To classify the prevalence of multi-drug resistant tuberculosis (MDR-TB) in two different geographic settings in western Kenya using the Lot Quality Assurance Sampling (LQAS) methodology. The prevalence of drug resistance was classified among treatment-naïve smear positive TB patients in two settings, one rural and one urban. These regions were classified as having high or low prevalence of MDR-TB according to a static, two-way LQAS sampling plan selected to classify high resistance regions at greater than 5% resistance and low resistance regions at less than 1% resistance. This study classified both the urban and rural settings as having low levels of TB drug resistance. Out of the 105 patients screened in each setting, two patients were diagnosed with MDR-TB in the urban setting and one patient was diagnosed with MDR-TB in the rural setting. An additional 27 patients were diagnosed with a variety of mono- and poly- resistant strains. Further drug resistance surveillance using LQAS may help identify the levels and geographical distribution of drug resistance in Kenya and may have applications in other countries in the African Region facing similar resource constraints.

Mitochondrial markers to distinguish two species of Aedes Neomelaniconion (Diptera: Culicidae) from Kenya

USDA-ARS?s Scientific Manuscript database

Aedes mcintoshi and Ae circumluteolus are two common flood water mosquito species collected in Kenya. Both belong to the Aedes subgenus Neomelaniconion, a relatively large subgenus with representative species in the Ethiopian, Oriental, Australian and Palearctic regions. In Kenya, both have been imp...

Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.

PubMed

Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David

2015-05-07

Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national

[Use of internet and electronic resources among Spanish intensivist physicians. First national survey].

PubMed

Gómez-Tello, V; Latour-Pérez, J; Añón Elizalde, J M; Palencia-Herrejón, E; Díaz-Alersi, R; De Lucas-García, N

2006-01-01

Estimate knowledge and use habits of different electronic resources in a sample of Spanish intensivists: Internet, E-mail, distribution lists, and use of portable electronic devices. Self-applied questionnaire. A 50-question questionnaire was distributed among Spanish intensivists through the hospital marketing delegates of a pharmaceutical company and of electronic forums. A total of 682 questionnaires were analyzed (participation: 74%). Ninety six percent of those surveyed used Internet individually: 67% admitted training gap. Internet was the second source of clinical consultations most used (61%), slightly behind consultation to colleagues (65%). The pages consulted most were bibliographic databases (65%) and electronic professional journals (63%), with limited use of Evidence Based Medicine pages (19%). Ninety percent of those surveyed used e-mail regularly in the practice of their profession, although 25% admitted that were not aware of its possibilities. The use of E-mail decreased significantly with increase in age. A total of 62% of the intensivists used distribution lists. Of the rest, 42% were not aware of its existence and 32% admitted they had insufficient training to handle them. Twenty percent of those surveyed had portable electronic devices and 64% considered it useful, basically due to its rapid consultation at bedside. Female gender was a negative predictive factor of its use (OR 0.35; 95% CI 0.2-0.63; p=0.0002). A large majority of the Spanish intensivists use Internet and E-mail. E-mail lists and use of portable devices are still underused resources. There are important gaps in training and infrequent use of essential pages. There are specific groups that require directed educational policies.

Capacity Development of Youth in Geospatial Tools for Addressing Climate Change in Kenya

NASA Astrophysics Data System (ADS)

Mubea, K.; Kasera, K.; Maina, C.

2017-12-01

SERVIR E&SA builds on the institutional partnerships and networks in Eastern and Southern Africa together with the network and partnerships associated with USAID country missions in the region. The RCMRD Space Challenge was meant to equip students from high/secondary schools and primary schools within Kenya and beyond with the necessary skills and awareness in relation to environmental degradation, climate change and its drivers. Furthermore, this contributes to the achievement of Sustainable Development Goals (SDGs), developing the youth in Science, Technology, Engineering and Math (STEM) and ultimately contributing to capacity building of the youth with the objective of promoting sustainable development. RCMRD partnered with GLOBE Program Kenya, 4-H Kenya and Esri Eastern Africa in this endeavor. The challenge involved students from seven schools analyzing data from automatic weather stations and plotting the results against other location of schools. The students were required to use TAHMO Automatic Weather Stations (AWS) normalized atmospheric data provided by GLOBE, TAHMO and RCMRD. The three parameters, humidity, precipitation and temperature were found to be very closely related. The students generated graphs that were obtained from the normalized data for the five climatic zones in Kenya. Nasokol Girls School located at Kishaunet in West Pokot County (Kenya) emerged the winners followed by St. Scholastica Catholic Primary School in Nairobi, and Moi Forces Academy Nairobi. The students were urged to utilize the knowledge acquired to address challenges related to climate change. RCMRD Space Challenge will be held annually in Kenya in collaboration with partners.

Mass medical repatriation of injured civilians after terrorist attack in Mombassa, Kenya: medical needs, resources used, and lessons learned.

PubMed

Marmor, Meir; Goldstein, Liav; Levi, Yeheskel; Onn, Erez; Blumenfeld, Amir; Kosashvili, Yona; Levy, Gad; Hirschorn, Gil; Heldenberg, Eitan; Or, Jacob; Setton, Eric; Goldberg, Avishay; Bar-Dayan, Yaron

2005-01-01

On 28 November 2002, three suicide bombers crashed their car into a hotel in Mombassa, Kenya; 12 people were killed, including three Israelis, and 80 were wounded (22 of whom were Israeli). The Israeli Defense Force Airborne Medical Evacuation Flight Teams participated in a repatriation mission to bring the wounded home. The objectives of this study are to outline the distinctive aspects of this mission, as well as to share the experiences and lessons learned. Israeli Army debriefing reports were used to study the composition of the crew, medical equipment taken, injury distribution, mode of operation, and mission schedule. A total of six fixed-wing aircraft were used--two Boeing 707s and four Hercules C-130s--with a total of 54 medical team members on board. A total of 260 Israelis were repatriated, 22 of whom were wounded, and three were dead. Of the casualties, 14 were conveyed sitting, and eight supine. The time from the first landing in Kenya to the evacuation of the last supine patient was 5.5 hours. Nurses, as well as social workers, played a central role in the mission. A forward team, including five doctors, was used for the initial organization and for gathering information on the medical status of the casualties. There was redundancy in the medical crew and medical equipment sent. The need for improved infrastructure on the medical aircraft was stressed. Based on this experience, a new mode for operation for similar missions in the future was formulated.

Incidence of acute mountain sickness in UK Military Personnel on Mount Kenya.

PubMed

Hazlerigg, Antonia; Woods, D R; Mellor, A J

2016-12-01

Acute mountain sickness (AMS) is a common problem of trekkers to high altitude. The UK military train at high altitude through adventurous training (AT) or as exercising troops. The ascent of Point Lenana at 4985 m on Mount Kenya is frequently attempted on AT. This study sought to establish the incidence of AMS within this population, to aid future planning for military activities at altitude. A voluntary questionnaire was distributed to all British Army Training Unit Kenya based expeditions attempting to ascend Mount Kenya during the period from February to April 2014. The questionnaire included twice daily Lake Louise and Borg (perceived exertion scale) self-scoring. All expeditions were planned around a 5-day schedule, which included reserve time for acclimatisation, illness and inclement weather. Data were collected on 47 participants, 70% of whom reached the summit of Point Lenana. 62% (29/47) self-reported AMS (defined as Lake Louise score (LLS) ≥3) on at least one occasion during the ascent, and 34% (10/29) suffered severe AMS (LLS ≥6). Those who attempted the climb within 2 weeks of arrival in Kenya had a higher incidence of AMS (12/15 (80%) vs 17/32 (53%), p=0.077). Participants recording a high Borg score were significantly more likely to develop AMS (16/18 vs 9/21, p=0.003). This represents the first informative dataset for Mount Kenya ascents and altitude. The incidence of AMS during AT on Mount Kenya using this ascent profile is high. Adapting the current ascent profile, planning the ascent after time in country and reducing perceived exertion during the trek may reduce the incidence of AMS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Abolition of Secondary School Fees in Kenya: Responses by the Poor

ERIC Educational Resources Information Center

Ohba, Asayo

2011-01-01

Following the 2007 presidential election, the Government of Kenya abolished secondary school fees in 2008. In the context of this significant change in policy, this study examines the effect of fees on transition to secondary schooling by following 109 primary school leavers in rural Kenya after the fee abolition, starting in 2007. The study draws…

Rationale for Critical Pedagogy of Decolonization: Kenya as a Unit of Analysis

ERIC Educational Resources Information Center

Gatimu, M. Wangeci

2009-01-01

In December 2007, political violence erupted in Kenya after a general election. Both Kenya and the international community were confronted with the question as to why citizens of a hitherto peaceful nation would engage in acts of hooliganism and violence after exercising a democratic right in a national election. This paper examines how new…

Equatorial Paleointensities from Kenya and the Well-behaved Geocentric Axial Dipole

NASA Astrophysics Data System (ADS)

Wang, H.; Kent, D. V.

2017-12-01

A previous study of Plio-Pleistocene lavas from the equatorial Galapagos Islands (latitude 1ºS) that used an adjustment for multidomain (MD) effects [Wang and Kent, 2013 G-cubed] obtained a mean paleointensity of 21.6 ± 11.0 µT (1σ, same in the following) from 27 lava flows [Wang et al., 2015 PNAS]. This is about half of the present-day value. Here, in a pilot study to check this result, we utilized previously thermally demagnetized specimens of Plio-Pleistocene lavas from the Mt. Kenya region (latitude 0º) and fresh specimens from the Loiyangalani region (latitude 3ºN) of Kenya that were previously studied for paleosecular variation [Opdyke et al., 2010 G-cubed] for paleointensity studies. We selected 2-3 specimens from each of 30 lava sites from Mt. Kenya region and 31 lava sites from Loiyangalani region with coherent directions and not exhibiting any indications of having been struck by severe lightning. Rock magnetic data show that the main magnetization carriers are fine-grained pseudo-single-domain magnetite with saturation remanence to saturation magnetization ratios (Mr/Ms) ranging from 0.05 to 0.60 [Opdyke et al., 2010, G-cubed]. Our preliminary MD-adjusted paleointensity results (Loiyangalani specimens with tTRM thermal alteration check [Wang and Kent, 2013 G-cubed]; Mt. Kenya specimens with an alternate thermal alteration check) show that the overall mean values are 15.3 ± 5.7 µT for the Mt. Kenya region (from 7 lava flows) and 16.4 ± 5.2 µT for the Loiyangalani region (from 8 lava flows). Along with paleointensities from Antarctica (latitude 78ºS, 33.4 ± 13.9 µT from 38 lava flows) [Lawrence et al., 2009 G-cubed], Iceland (latitude 64ºN, 37.7 ± 14.2 µT from 10 lava flows) [Cromwell et al., 2015 JGR] and Galapagos [Wang et al., 2015 PNAS], our preliminary Kenya lava results support a geocentric axial dipole (GAD) model of the time-averaged field in both direction (tan[inclination] = 2×tan[latitude]) and paleointensity (equatorial

Impact of Knowledge Resources Linked to an Electronic Health Record on Frequency of Unnecessary Tests and Treatments

ERIC Educational Resources Information Center

Goodman, Kenneth; Grad, Roland; Pluye, Pierre; Nowacki, Amy; Hickner, John

2012-01-01

Introduction: Electronic knowledge resources have the potential to rapidly provide answers to clinicians' questions. We sought to determine clinicians' reasons for searching these resources, the rate of finding relevant information, and the perceived clinical impact of the information they retrieved. Methods: We asked general internists, family…

The relation of female circumcision to sexual behavior in Kenya and Nigeria.

PubMed

Mpofu, Sibonginkosi; Odimegwu, Clifford; De Wet, Nicole; Adedini, Sunday; Akinyemi, Joshua

2017-08-01

One of the reasons for the perpetuation of female circumcision is that it controls female sexuality. In this study, the authors examined the relationship between female circumcision and the sexual behavior of women in Kenya and Nigeria. Data on women who were aware of circumcision and were circumcised were extracted from the Kenya Demographic and Health Survey of 2008-09 as well as the Nigeria Demographic and Health Survey of 2008. The sample size was 7,344 for Kenya and 16,294 for Nigeria. The outcome variables were age at first intercourse and total lifetime number of sexual partners. The study hypothesis was that women who were circumcised were less likely to have initiated sex early and to have only one sex partner. Cox proportional hazards regression and Poisson regression were used to examine the relations of female circumcision and other selected variables to sexual behavior. No association was observed between female circumcision and the outcomes for sexual behavior of women in Kenya and Nigeria. The argument of sexual chastity is insufficient to sustain the perpetuation of female circumcision.

Under-reporting of sputum smear-positive tuberculosis cases in Kenya.

PubMed

Tollefson, D; Ngari, F; Mwakala, M; Gethi, D; Kipruto, H; Cain, K; Bloss, E

2016-10-01

Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ⩾55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported.

What makes or mars the facility-based childbirth experience: thematic analysis of women's childbirth experiences in western Kenya.

PubMed

Afulani, Patience A; Kirumbi, Leah; Lyndon, Audrey

2017-12-29

Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.

The Mentorship of Kenya Ayers

ERIC Educational Resources Information Center

Boerner, Heather

2016-01-01

Being a college president has been Kenya Ayers' goal since she started in higher education in the late 1990s. "I'm really clear," she says. "I want to do this." Ayers is well on her way. She's been a provost, an academic dean and an administrative one, and an associate vice president of academic affairs at colleges in…

A cross-sectional study of disclosure of HIV status to children and adolescents in western Kenya.

PubMed

Vreeman, Rachel C; Scanlon, Michael L; Mwangi, Ann; Turissini, Matthew; Ayaya, Samuel O; Tenge, Constance; Nyandiko, Winstone M

2014-01-01

Disclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya. We conducted a cross-sectional study, randomly sampling HIV-infected children ages 6-14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics. Among 792 caregiver-child dyads, mean age of the children was 9.7 years (SD = 2.6) and 51% were female. Prevalence of disclosure was 26% and varied significantly by age; while 62% of 14-year-olds knew their status, only 42% of 11-year-olds and 21% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95%CI 1.35-1.63), taking antiretroviral drugs (OR 2.27, 95%CI 1.29-3.97), and caregiver-reported depression symptoms (OR 2.63, 95%CI 1.12-6.20) were significantly associated with knowing one's status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95%CI 1.75-6.76). Few HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children.

The Prevalence of Alcohol Abuse among Egerton University Students in Njoro-Kenya

ERIC Educational Resources Information Center

Boitt, Richard Kimuge

2016-01-01

The main objective of higher institutions of learning in Kenya is to provide education and growth experiences for its students but alcohol abuse has continued to be a problem in the university campuses that is slowing down their progress and the Kenya vision 2030 that envisages a healthy population free from the impact of alcohol abuse through the…

Integrating participatory engagement and scientific research to inform causes and solutions to water problems in the River Njoro Watershed Kenya.

NASA Astrophysics Data System (ADS)

Jenkins, M.

2012-12-01

Over the course of 9 years, an international multidisciplinary team of US and Kenyan scientists under the Sustainable Management of Rural Watersheds (SUMAWA) Project, based at Egerton University in Kenya, worked with Kenyan public agencies to apply a variety of participatory methods and outreach activities combined with land use mapping, hydrologic and water system modeling, and other scientific tools and evaluations to investigate and identify solutions to declining water quantity and quality problems affecting communities and environmental and productive sectors in the River Njoro Watershed in Kenya. Traditional participatory rural appraisal techniques were modified to engage low income, informal, and tribal communities in identification of local services, benefits, and groups linked to water and riparian resources and collect their perceptions of water-related problems, priorities, and solution options throughout the watershed. Building on this foundation of insights, information, and engagement on water issues with local communities and other stakeholders, the project designed a research agenda aimed at creating shared scientific understanding of the causes of identified problems and developing and testing promising interventions to address community and stakeholder priority concerns. This presentation will share lessons from the SUMAWA experience of using a problem-driven, solution-oriented, community-based watershed approach to address water resource problems at local scale in a semi-arid African developing country setting.

Epidemiology and Epizootiological Investigations of Hemorrhagic Fever Viruses in Kenya

DTIC Science & Technology

1988-05-30

1 " EPIDEMIOLOGY AND EPIZOOTICLOGICAL INVESTIGATIONS OF HEMORRHAGIC FEVER VIRUSES IN KENYA ANNUAL REPORT 0PETER M. TUKEI In 00 NMAY 30, 1988...Investigations of Hemorrhagic Fever Viruses in Kenya 12. PERSONAL AUTHOR(S) Peter M. Tukei 13a. TYPE OF REPORT 13b. TIME COVERED 14. DATE OF REPORT (Year...etneM’Orwy andidentifY by block jumb. FIELD GROUP j SUB-GROUP j’-1 , Hemorrhagic fever , Epidemiology, Ebola, Filovirus Ub 03 06 13 I I 19. ABSTRACT

Rabies and African wild dogs in Kenya.

PubMed

Kat, P W; Alexander, K A; Smith, J S; Munson, L

1995-11-22

Three packs of African wild dogs (Lycaon pictus) ranging to the north of the Masai Mara National Reserve in southwestern Kenya were monitored from 1988 to 1990. During a six week period (August 2-September 14, 1989), 21 of 23 members of one of these packs died. Histological examination of two brain samples revealed eosinophilic intracytoplasmic inclusions (Negri bodies), supporting a diagnosis of rabies viral encephalitis. An additional brain sample tested positive for rabies with a fluorescent antibody test. Nucleotide sequence of the rabies viral N and G genes from isolates of four African wild dogs (including an individual from Tanzania) indicated that infection was with a viral variant common among domestic dogs in Kenya and Tanzania. A hypothesis linking African wild dog rabies deaths to researcher handling is evaluated and considered implausible.

Ethnobotanical study of medicinal plants used by Sabaots of Mt. Elgon Kenya.

PubMed

Okello, S V; Nyunja, R O; Netondo, G W; Onyango, J C

2009-10-15

Though the majority of people in Kenya and at Kopsiro Division in particular, rely on ethnomedicinal plant species to manage human ailments, the indigenous knowledge largely remains undocumented. Therefore, an ethnobotanical study was conducted on medicinal plant species used to manage human ailments at Kopsiro Division Mt. Elgon District Kenya. The objectives were to identify and document plants traditionally used for medicinal therapy by the Sabaots, to find out the method used for preparing and administering the drugs and to find out the conservation practices for the medicinal plants. Observations and semi-structured interviews were used to gather ethnobotanical data. 107 plants belonging to 56 families were identified and reported to be of medicinal value to the locals. Roots (47.3%) were the most frequently used parts of the plant followed by the bark (23.35%) then leaves (22.75%). The whole plant (1.8%), seed (1.2%), fruit (1.2%), sap (1.2%), flower (0.6%) and wood (0.6%) are least used in that order. The study revealed other hitherto undocumented medicinal plant species that may be new records for treating various ailments. Traditional medicine in Kopsiro division offers cheap, accessible and convenient remedy that suits the traditional lifestyle of the local community in comparison to the conventional medicine. Most medicinal plant species reported in this study were found to be under threat and this calls for urgent conservation measures so as to maximize the sustainable use of these vital resources in the study area.

Rift Valley fever outbreak--Kenya, November 2006-January 2007.

PubMed

2007-02-02

In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Médecins Sans Frontières (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007.

Visceral Leishmaniasis Unresponsive to Pentostam Caused by Leishmania tropica in Kenya

DTIC Science & Technology

1989-01-01

LARRY HENDRICKS , JOHANNES LEEUWENBURG DAVY KOECH, AND CLIFFORD ROBERTS Biomedical Sciences Research Centre, Clinical Research (entre. Kenya Medical...supplemented with 20% heat-inactivated fetal have implicated L. fropica as a causative agent bovine serum plus penicillin (250 U/ml), strep- of visceral...treatment with pentami- search Institute, Nairobi, Kenya. Larry Hendricks and dine. 7rans R Soc Trop .Lied Jlfpl 79:705-714. Clifford Roberts, U.S. Army

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be

A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand.

PubMed

Reynolds, Jaratdao; Wisaijohn, Thunthita; Pudpong, Nareerut; Watthayu, Nantiya; Dalliston, Alex; Suphanchaimat, Rapeepong; Putthasri, Weerasak; Sawaengdee, Krisada

2013-04-12

The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced.

A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand

PubMed Central

2013-01-01

Background The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. Methods A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. Results The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Conclusion Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced. PMID:23587128

Opening a Can of wERMS: Texas A&M University's Experiences in Implementing Two Electronic Resource Management Systems

ERIC Educational Resources Information Center

Hartnett, Eric; Price, Apryl; Smith, Jane; Barrett, Michael

2010-01-01

Over the past few years, Texas A&M University (TAMU) has searched for a way to administer its electronic subscriptions as well as the electronic subscriptions shared among the TAMU System. In this article, we address our attempts to implement an effective electronic resource management system (ERMS), both for subscriptions on the main campus…

Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya.

PubMed

Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine

2018-05-09

In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed

Integrating Genomic Resources with Electronic Health Records using the HL7 Infobutton Standard

PubMed Central

Overby, Casey Lynnette; Del Fiol, Guilherme; Rubinstein, Wendy S.; Maglott, Donna R.; Nelson, Tristan H.; Milosavljevic, Aleksandar; Martin, Christa L.; Goehringer, Scott R.; Freimuth, Robert R.; Williams, Marc S.

2016-01-01

Summary Background The Clinical Genome Resource (ClinGen) Electronic Health Record (EHR) Workgroup aims to integrate ClinGen resources with EHRs. A promising option to enable this integration is through the Health Level Seven (HL7) Infobutton Standard. EHR systems that are certified according to the US Meaningful Use program provide HL7-compliant infobutton capabilities, which can be leveraged to support clinical decision-making in genomics. Objectives To integrate genomic knowledge resources using the HL7 infobutton standard. Two tactics to achieve this objective were: (1) creating an HL7-compliant search interface for ClinGen, and (2) proposing guidance for genomic resources on achieving HL7 Infobutton standard accessibility and compliance. Methods We built a search interface utilizing OpenInfobutton, an open source reference implementation of the HL7 Infobutton standard. ClinGen resources were assessed for readiness towards HL7 compliance. Finally, based upon our experiences we provide recommendations for publishers seeking to achieve HL7 compliance. Results Eight genomic resources and two sub-resources were integrated with the ClinGen search engine via OpenInfobutton and the HL7 infobutton standard. Resources we assessed have varying levels of readiness towards HL7-compliance. Furthermore, we found that adoption of standard terminologies used by EHR systems is the main gap to achieve compliance. Conclusion Genomic resources can be integrated with EHR systems via the HL7 Infobutton standard using OpenInfobutton. Full compliance of genomic resources with the Infobutton standard would further enhance interoperability with EHR systems. PMID:27579472

Q Fever, Scrub Typhus, and Rickettsial Diseases in Children, Kenya, 2011-2012.

PubMed

Maina, Alice N; Farris, Christina M; Odhiambo, Antony; Jiang, Ju; Laktabai, Jeremiah; Armstrong, Janice; Holland, Thomas; Richards, Allen L; O'Meara, Wendy P

2016-05-01

To increase knowledge of undifferentiated fevers in Kenya, we tested paired serum samples from febrile children in western Kenya for antibodies against pathogens increasingly recognized to cause febrile illness in Africa. Of patients assessed, 8.9%, 22.4%, 1.1%, and 3.6% had enhanced seroreactivity to Coxiella burnetii, spotted fever group rickettsiae, typhus group rickettsiae, and scrub typhus group orientiae, respectively.

Influence of Examinations Oriented Approaches on Quality Education in Primary Schools in Kenya

ERIC Educational Resources Information Center

Mackatiani, Caleb Imbova

2017-01-01

This paper provides a critical appraisal of the influence of examinations oriented approaches on quality education in primary schools in Kenya. The purpose of the study was to determine effects of examination oriented teaching approaches on learning achievement among primary school pupils in Kakamega County, Kenya. It explored the assumptions…

Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis.

PubMed

Perumal, Nandita; Cole, Donald C; Ouédraogo, Hermann Z; Sindi, Kirimi; Loechl, Cornelia; Low, Jan; Levin, Carol; Kiria, Christine; Kurji, Jaameeta; Oyunga, Mary

2013-07-11

Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya. Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. χ2 test and Student's t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, <4, ≥4) on knowledge and practice scores, adjusting for maternal socio-demographic confounders, such as age, gestational age, education level and household wealth index. Among the 979 pregnant women in the survey, 59% had attended ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge. Substantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices.

Considering Point-of-Care Electronic Medical Resources in Lieu of Traditional Textbooks for Medical Education.

PubMed

Hale, LaDonna S; Wallace, Michelle M; Adams, Courtney R; Kaufman, Michelle L; Snyder, Courtney L

2015-09-01

Selecting resources to support didactic courses is a critical decision, and the advantages and disadvantages must be carefully considered. During clinical rotations, students not only need to possess strong background knowledge but also are expected to be proficient with the same evidence-based POC resources used by clinicians. Students place high value on “real world” learning and therefore may place more value on POC resources that they know practicing clinicians use as compared with medical textbooks. The condensed nature of PA education requires students to develop background knowledge and information literacy skills over a short period. One way to build that knowledge and those skills simultaneously is to use POC resources in lieu of traditional medical textbooks during didactic training. Electronic POC resources offer several advantages over traditional textbooks and should be considered as viable options in PA education.

Educational Marginalization: Examining Challenges and Possibilities for Improving Educational Outcomes in Northeastern Kenya

ERIC Educational Resources Information Center

Okilwa, Nathern S. A.

2015-01-01

As a developing country in sub-Saharan Africa, Kenya has fared comparatively well in educating its young people. The new constitution of Kenya and various acts of parliament identify education as a fundamental human right and mandates the government to provide basic education for all. Consistent with the government's "Vision 2030," most…

Dating, Sex, and Schooling in Urban Kenya

PubMed Central

Clark, Shelley; Mathur, Rohini

2013-01-01

Completion of secondary school is increasingly viewed as a desirable life goal for young men and women in urban Kenya. Yet achieving this goal often conflicts with other key transitions to adulthood, such as becoming sexually active, marrying, having children, and finding employment. Drawing upon exceptionally rich life-history calendar data from young people in Kisumu, Kenya, we explore how the timing and sequencing of key transitions affects the likelihood of secondary school completion. Conversely, we also examine how school enrollment and performance affect the timing of sexual initiation. Our findings indicate that sexual activity and the transition toward family formation are largely incompatible with young women’s schooling. For men, however, romantic and sexual partnerships have no impact on schooling unless a partner becomes pregnant. Instead, paid employment appears to be least compatible with continued education. PMID:23185860

Usage Data for Electronic Resources: A Comparison between Locally Collected and Vendor-Provided Statistics.

ERIC Educational Resources Information Center

Duy, Joanna; Vaughan, Liwen

2003-01-01

Vendor-provided electronic resource usage statistics are not currently standardized across vendors. This study investigates the feasibility of using locally collected data to check the reliability of vendor-provided data. Vendor-provided data were compared with local data collected from North Carolina State University (NCSU) Libraries' Web…

Expanding Kenya's protected areas under the Convention on Biological Diversity to maximize coverage of plant diversity.

PubMed

Scherer, Laura; Curran, Michael; Alvarez, Miguel

2017-04-01

Biodiversity is highly valuable and critically threatened by anthropogenic degradation of the natural environment. In response, governments have pledged enhanced protected-area coverage, which requires scarce biological data to identify conservation priorities. To assist this effort, we mapped conservation priorities in Kenya based on maximizing alpha (species richness) and beta diversity (species turnover) of plant communities while minimizing economic costs. We used plant-cover percentages from vegetation surveys of over 2000 plots to build separate models for each type of diversity. Opportunity and management costs were based on literature data and interviews with conservation organizations. Species richness was predicted to be highest in a belt from Lake Turkana through Mount Kenya and in a belt parallel to the coast, and species turnover was predicted to be highest in western Kenya and along the coast. Our results suggest the expanding reserve network should focus on the coast and northeastern provinces of Kenya, where new biological surveys would also fill biological data gaps. Meeting the Convention on Biological Diversity target of 17% terrestrial coverage by 2020 would increase representation of Kenya's plant communities by 75%. However, this would require about 50 times more funds than Kenya has received thus far from the Global Environment Facility. © 2016 Society for Conservation Biology.

Resource conservation approached with an appropriate collection and upgrade-remanufacturing for used electronic products.

PubMed

Zlamparet, Gabriel I; Tan, Quanyin; Stevels, A B; Li, Jinhui

2018-03-01

This comparative research represents an example for a better conservation of resources by reducing the amount of waste (kg) and providing it more value under the umbrella of remanufacturing. The three discussed cases will expose three issues already addressed separately in the literature. The generation of waste electrical and electronic equipment (WEEE) interacts with the environmental depletion. In this article, we gave the examples of addressed issues under the concept of remanufacturing. Online collection opportunity eliminating classical collection, a business to business (B2B) implementation for remanufactured servers and medical devices. The material reuse (recycling), component sustainability, reuse (part harvesting), product reuse (after repair/remanufacturing) indicates the recovery potential using remanufacturing tool for a better conservation of resources adding more value to the products. Our findings can provide an overview of new system organization for the general collection, market potential and the technological advantages using remanufacturing instead of recycling of WEEE or used electrical and electronic equipment. Copyright © 2017. Published by Elsevier Ltd.

Challenges in regulation of biomedical research: The case of Kenya.

PubMed

Wekesa, M

2015-12-01

Unregulated biomedical research has previously caused untold suffering to humankind. History is full of examples of abuse of animal and human subjects for research. Several codes and instruments have been formulated to regulate biomedical research. In Kenya, the Science, Technology and Innovation Act, 2014, together with the Constitution of Kenya, 2010, provide a fairly robust legal framework. Possible challenges include capacity building, overlap of functions of institutions, monitoring and evaluation, scientific/technological advances, intellectual property rights, funding for research, and dispute resolution. It is hoped that the new legislation will adequately address these challenges.

Early Primary Literacy Instruction in Kenya

ERIC Educational Resources Information Center

Dubeck, Margaret M.; Jukes, Matthew C. H.; Okello, George

2012-01-01

We report on a study that used observations, conversations, and formal interviews to explore literacy instruction in 24 lower-primary classrooms in coastal Kenya. Specifically, we report the ways literacy instruction is delivered and how that delivery aligns with practices understood to promote reading acquisition. We find (1) prioritization of…

Treatment outcomes of drug-resistant tuberculosis patients in Kenya.

PubMed

Mibei, D J; Kiarie, J W; Wairia, A; Kamene, M; Okumu, M E

2016-11-01

Successful treatment of drug-resistant tuberculosis (DR-TB) is crucial in preventing disease transmission and reducing related morbidity and mortality. A standardised DR-TB treatment regimen is used in Kenya. Although patients on treatment are monitored, no evaluation of factors affecting treatment outcomes has yet been performed. To analyse treatment outcomes of DR-TB patients in Kenya and factors associated with successful outcome. Retrospective analysis of secondary data from Kenya's National Tuberculosis, Leprosy and Lung disease programme. DR-TB data from the national database for January to December 2012 were reviewed. Of 205 DR-TB patients included in the analysis, 169 (82.4%) had a successful treatment outcome, 18 (9%) died and 18 (9%) were lost to follow-up. Only sex (P = 0.006) and human immunodeficiency virus (HIV) status (P = 0.008) were predictors of successful treatment. Females were more likely to attain treatment success (OR 3.86, 95%CI 1.47-10.12), and HIV-negative status increased the likelihood of successful treatment (OR 3.53, 95%CI 1.4-8.9). Treatment success rates were higher than World Health Organization targets. Targeted policies for HIV-positive patients and males will improve treatment outcomes in these groups.

Detection of Rift Valley fever viral activity in Kenya by satellite remote sensing imagery

NASA Technical Reports Server (NTRS)

Linthicum, Kenneth J.; Bailey, Charles L.; Davies, F. Glyn; Tucker, Compton J.

1987-01-01

Data from the advanced very high resolution radiometer on board the National Oceanic and Atmospheric Administration's polar-orbiting meteorological satellites have been used to infer ecological parameters associated with Rift Valley fever (RVF) viral activity in Kenya. An indicator of potential viral activity was produced from satellite data for two different ecological regions in Kenya, where RVF is enzootic. The correlation between the satellite-derived green vegetation index and the ecological parameters associated with RVF virus suggested that satellite data may become a forecasting tool for RVF in Kenya and, perhaps, in other areas of sub-Saharan Africa.

Childhood Disability Risk Factors in Kenya: Impact of Poverty and Other Socio-Demographics

ERIC Educational Resources Information Center

Mugoya, George C. T.; Mutua, Kagendo N.

2015-01-01

The overarching purpose of this study was to ascertain the prevalence of maternal and infant/child health indices that have an established link to childhood disability (CHD) and their association with socio-economic status (SES) in Kenya. Data were drawn from the 2008/2009 Kenya Demographic and Health Survey. Descriptive and weighted Pearson's…

The seismicity related to the southern part of the Kenya Rift

NASA Astrophysics Data System (ADS)

Hollnack, D.; Stangl, R.

1998-04-01

In 1990 the Geology Department of the University of Nairobi started to build up a seismological network for Kenya, which has been operating since 1993. In this paper the actual state of this seismological network is described. Additionally, the first results on the seismic activity in the southern part of Kenya and adjacent areas between October 1993 and August 1996 are presented and are compared with historical data. Out of more than 2000 recorded local earthquakes 435 could be localised within the study area with local magnitudes of up to 5. The distribution of the events shows three areas of prominent seismicity: the Rift Valley between Nakuru and northern Tanzania; the area northeast of Kilimanjaro; and the Nyanza Rift in western Kenya. In a first attempt to assess the seismic hazard for the study area, a seismic energy map for the period of observation is given.

Orphan Status, HIV Risk Behavior, and Mental Health Among Adolescents in Rural Kenya

PubMed Central

Drabkin, Anya S.; Stashko, Allison L.; Broverman, Sherryl A.; Ogwang-Odhiambo, Rose A.; Sikkema, Kathleen J.

2012-01-01

Objective To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya. Methods Randomly selected adolescents aged 10–18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver–child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk. Results Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver–youth communication were more strongly associated with lower sex-related self-efficacy for orphans. Conclusions Orphans are at higher risk for psychosocial problems. These problems may affect orphans’ self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans. PMID:22728899

Kenya’s Cultural Complexity

DTIC Science & Technology

2003-03-05

hyacinth infestation in Lake Victoria; deforestation; soil erosion; desertification; and poaching of wildlife, especially elephant and rhinoceros...with limited prospects for their personal and family improvement. a) To what extent has Kenya succeeded in overcoming the negative impact of...tension among non-African traders from Asia and the Middle East? Has such tension, to the extent that they exist, been overcome? c) What was the impact

The Contextual Impact on School Leadership in Kenya and Need for Trust Formation

ERIC Educational Resources Information Center

Abaya, Joel; Normore, Anthony H.

2014-01-01

This article is based on a qualitative case study carried out along the Nyanza-Rift Valley Provinces border in Southwestern Kenya. The purpose of this paper is to examine the context in which school leader's work and operate in southwestern Kenya. We further postulate how best the influence of these contexts can be minimized through the formation…

A Cross-Sectional Study of Disclosure of HIV Status to Children and Adolescents in Western Kenya

PubMed Central

Vreeman, Rachel C.; Scanlon, Michael L.; Mwangi, Ann; Turissini, Matthew; Ayaya, Samuel O.; Tenge, Constance; Nyandiko, Winstone M.

2014-01-01

Introduction Disclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya. Methods We conducted a cross-sectional study, randomly sampling HIV-infected children ages 6–14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics. Results Among 792 caregiver-child dyads, mean age of the children was 9.7 years (SD = 2.6) and 51% were female. Prevalence of disclosure was 26% and varied significantly by age; while 62% of 14-year-olds knew their status, only 42% of 11-year-olds and 21% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95%CI 1.35–1.63), taking antiretroviral drugs (OR 2.27, 95%CI 1.29–3.97), and caregiver-reported depression symptoms (OR 2.63, 95%CI 1.12–6.20) were significantly associated with knowing one’s status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95%CI 1.75–6.76). Conclusions Few HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children. PMID:24475159

Disassembly factories for electrical and electronic products to recover resources in product and material cycles.

PubMed

Basdere, Bahadir; Seliger, Guenther

2003-12-01

Cycle economy as a paradigm for industry in the 21st century depends on the economical and ecological treatment of limited resources. The objective is to achieve more use with fewer resources to increase the use-productivity of these resources. The European Union, aware of the adverse environmental impacts associated with electrical and electronic consumer goods in particular, has passed legislation regulating their appropriate end-of-life treatment. Adaptation processes, including essential disassembly and re-assembly operations, contribute significantly toward the economical fulfillment of these new legal requirements. Typically, the disassembly of used products is characterized by a high rate of manual operations, wide variety of product types, and unknown product properties. To cope with such demands, life cycle units or product accompanying information systems, are being developed and used for acquiring data about a specific product throughout its life cycle to aid in determining the level of product deterioration. Modular disassembly processes and tools have been developed and realized to enable the handling of multiple productvariants. They are being implemented in prototypical hybrid disassembly systemsfor large- and small-size electrical and electronic consumer goods.

Observations on the epidemiology of Rift Valley fever in Kenya.

PubMed

Davies, F G

1975-10-01

The epizootic range of Rift Valley fever in Kenya is defined from the results of virus isolations during epizootics, and form an extensive serological survey of cattle which were exposed during an epizootic. A study of the sera from a wide range of wild bovidae sampled immediately after the epizootic, showed that they did not act as reservoir or amplifying hosts for RVF. Virus isolation attempts from a variety of rodents proved negative. Rift Valley fever did not persist between epizootics by producing symptomless abortions in cattle in areas within its epizootic range. A sentinel herd sampled annually after an epizootic in 1968 revealed not one single seroconversion from 1969 to 1974. Certain forest and forest edge situations were postulated as enzootic for Rift Valley fever, and a small percentage of seroconversions were detected in cattle in these areas, born four years after the last epizootic. This has been the only evidence for the persistence of the virus in Kenya since 1968, and may be a part of the interepizootic maintenance cycle for Rift Valley fever in Kenya, which otherwise remains unknown.

Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings.

PubMed

Rattanaumpawan, Pinyo; Boonyasiri, Adhiratha; Vong, Sirenda; Thamlikitkul, Visanu

2018-02-01

Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings. We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians. A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection. This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Composition of the crust beneath the Kenya rift

USGS Publications Warehouse

Mooney, W.D.; Christensen, N.I.

1994-01-01

We infer the composition of the crust beneath and on the flanks of the Kenya rift based on a comparison of the KRISP-90 crustal velocity structure with laboratory measurements of compressional-wave velocities of rock samples from Kenya. The rock samples studied, which are representative of the major lithologies exposed in Kenya, include volcanic tuffs and flows (primarily basalts and phonolites), and felsic to intermediate composition gneisses. This comparison indicates that the upper crust (5-12 km depth) consists primarily of quartzo-feldspathic gneisses and schists similar to rocks exposed on the flanks of the rift, whereas the middle crust (12-22 km depth) consists of more mafic, hornblende-rich metamorphic rocks, probably intruded by mafic rocks beneath the rift axis. The lower crust on the flanks of the rift may consist of mafic granulite facies rocks. Along the rift axis, the lower crust varies in thickness from 9 km in the southern rift to only 2-3 km in the north, and has a seismic velocity substantially higher than the samples investigated in this study. The lower crust of the rift probably consists of a crust/mantle mix of high-grade metamorphic rocks, mafic intrusives, and an igneous mafic residuum accreted to the base of the crust during differentiation of a melt derived from the upper mantle. ?? 1994.

The Palliative Care Journey in Kenya and Uganda.

PubMed

Kamonyo, Emmanuel S

2018-02-01

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems. This update is aimed at examining palliative care development/achievements and challenges in Kenya and Uganda and the role of various actors in palliative care establishment in the region. It assesses the policy environment, progress in education, access to essential medicines, palliative care implementation efforts, and legal and human rights work. East African nations have huge disease burdens, both communicable and noncommunicable. HIV and cancer are the major causes of mortality in Kenya and Uganda and put huge demands on the health care system and on the country's economies. All these conditions will require palliative care services as the disease burden increases. Unfortunately, for many African countries, accessing palliative care services, including access to pain relief, remains very limited resulting in serious suffering for patients and their families. The interventions in Kenya and Uganda help palliative care organizations engage with their respective governments to ensure that the social and legal barriers impeding access to palliative care services are removed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda

PubMed Central

Bott, Sarah; Neuman, Melissa; Helleringer, Stephane; Desclaux, Alice; Asmar, Khalil El; Obermeyer, Carla Makhlouf

2015-01-01

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients’ rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. This article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. It also explores health workers’ fear of infection within the workplace and their reports on discrimination against HIV clients within health facilities. HIV care providers in Burkina Faso, Kenya and Uganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. They also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. Health workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with HIV, and also from difficult ethical dilemmas related to clients who do not disclose their HIV status to those around them, including partners. These findings suggest that providers of HIV testing and counselling need more resources and support, including better protections against HIV exposure in the workplace. The findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some

Public by Day, Private by Night: Examining the Private Lives of Kenya's Public Universities

ERIC Educational Resources Information Center

Wangenge-Ouma, Gerald

2012-01-01

This article examines the emergence of the public university in Kenya as a key provider of private higher education, characterised mainly by the phenomenon of the "private public university student." It probes the broader socio-economic reforms circumscribing the privatisation of Kenya's public universities and the local and global…

A Survey of the Use of Electronic Resources at Seven Universities in Wuhan, China

ERIC Educational Resources Information Center

Zhang, Liyi; Ye, Pinghao; Liu, Qihua

2011-01-01

Purpose: The purpose of this paper is to report on users' information behaviour in China, a topic which has not been researched extensively. The aim is to help producers and providers collect and develop more electronic resources. Design/methodology/approach: The study investigates users' information behaviour at seven "211 Project"…

Catastrophic health expenditure and its determinants in Kenya slum communities.

PubMed

Buigut, Steven; Ettarh, Remare; Amendah, Djesika D

2015-05-14

In Kenya, where 60 to 80% of the urban residents live in informal settlements (frequently referred to as slums), out-of-pocket (OOP) payments account for more than a third of national health expenditures. However, little is known on the extent to which these OOP payments are associated with personal or household financial catastrophe in the slums. This paper seeks to examine the incidence and determinants of catastrophic health expenditure among urban slum communities in Kenya. We use a unique dataset on informal settlement residents in Kenya and various approaches that relate households OOP payments for healthcare to total expenditures adjusted for subsistence, or income. We classified households whose OOP was in excess of a predefined threshold as facing catastrophic health expenditures (CHE), and identified the determinants of CHE using multivariate logistic regression analysis. The results indicate that the proportion of households facing CHE varies widely between 1.52% and 28.38% depending on the method and the threshold used. A core set of variables were found to be key determinants of CHE. The number of working adults in a household and membership in a social safety net appear to reduce the risk of catastrophic expenditure. Conversely, seeking care in a public or private hospital increases the risk of CHE. This study suggests that a substantial proportion of residents of informal settlements in Kenya face CHE and would likely forgo health care they need but cannot afford. Mechanisms that pool risk and cost (insurance) are needed to protect slum residents from CHE and improve equity in health care access and payment.

Effective Knowledge Development in Secondary Schools Educational Level in Contemporary Information Age: Assessment of Availability of Electronic Information Resources in Nigerian School Libraries

ERIC Educational Resources Information Center

Bello, Stephen Adeyemi; Ojo, Funmilayo Roseline; Ocheje, Charles Bala

2015-01-01

Relevant electronic information resources in contemporary information age are necessity to buttress teaching and learning for effective knowledge development in educational institutions. The purpose of the study is to know the state of availability of electronic information resources in government owned secondary school libraries in Ijumu Local…

Women Education and Economic Development in Kenya: Implications for Curriculum Development and Implementation Processes

ERIC Educational Resources Information Center

Syomwene, Anne; Kindiki, Jonah Nyaga

2015-01-01

This paper is a discussion of the relationship between women education and sustainable economic development in Kenya and its implications for curriculum development and implementation processes. The argument advanced in this paper is that the solution to the development problems in Kenya and other developing nations lies on women education.…

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

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

Determinants of health insurance ownership among women in Kenya: evidence from the 2008–09 Kenya demographic and health survey

PubMed Central

2014-01-01

Background The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya. Methods Data came from the 2008–09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15–49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership. Results Being employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province. Conclusions As the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups. PMID:24678655

Open-source mobile digital platform for clinical trial data collection in low-resource settings.

PubMed

van Dam, Joris; Omondi Onyango, Kevin; Midamba, Brian; Groosman, Nele; Hooper, Norman; Spector, Jonathan; Pillai, Goonaseelan Colin; Ogutu, Bernhards

2017-02-01

Governments, universities and pan-African research networks are building durable infrastructure and capabilities for biomedical research in Africa. This offers the opportunity to adopt from the outset innovative approaches and technologies that would be challenging to retrofit into fully established research infrastructures such as those regularly found in high-income countries. In this context we piloted the use of a novel mobile digital health platform, designed specifically for low-resource environments, to support high-quality data collection in a clinical research study. Our primary aim was to assess the feasibility of a using a mobile digital platform for clinical trial data collection in a low-resource setting. Secondarily, we sought to explore the potential benefits of such an approach. The investigative site was a research institute in Nairobi, Kenya. We integrated an open-source platform for mobile data collection commonly used in the developing world with an open-source, standard platform for electronic data capture in clinical trials. The integration was developed using common data standards (Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model), maximising the potential to extend the approach to other platforms. The system was deployed in a pharmacokinetic study involving healthy human volunteers. The electronic data collection platform successfully supported conduct of the study. Multidisciplinary users reported high levels of satisfaction with the mobile application and highlighted substantial advantages when compared with traditional paper record systems. The new system also demonstrated a potential for expediting data quality review. This pilot study demonstrated the feasibility of using a mobile digital platform for clinical research data collection in low-resource settings. Sustainable scientific capabilities and infrastructure are essential to attract and support clinical research studies. Since many research structures

Tuberculosis and HIV at the national level in Kenya: results from the Second Kenya AIDS Indicator Survey.

PubMed

Mbithi, Agneta; Gichangi, Anthony; Kim, Andrea A; Katana, Abraham; Weyenga, Herman; Williamson, John; Robinson, Katherine; Oluoch, Tom; Maina, William K; Kellogg, Timothy A; De Cock, Kevin M

2014-05-01

Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa. In the second Kenya AIDS Indicator Survey, we collected data on knowledge and experience of HIV and tuberculosis, as well as on access to and coverage of relevant treatment services and antiretroviral therapy (ART) in Kenya. A national, population-based household survey was conducted from October 2012 to February 2013. Information was collected through household questionnaires, and blood samples were taken for HIV, CD4 cell counts, and HIV viral load testing at a central laboratory. Overall, 13,720 persons aged 15-64 years participated; 96.7% [95% confidence interval (CI): 96.3 to 97.1] had heard of tuberculosis, of whom 2.0% (95% CI: 1.7 to 2.2) reported having prior tuberculosis. Among those with laboratory-confirmed HIV infection, 11.6% (95% CI: 8.9 to 14.3) reported prior tuberculosis. The prevalence of laboratory-confirmed HIV infection in persons reporting prior tuberculosis was 33.2% (95% CI: 26.2 to 40.2) compared to 5.1% (95% CI: 4.5 to 5.8) in persons without prior tuberculosis. Among those in care, coverage of ART for treatment-eligible persons was 100% for those with prior tuberculosis and 88.6% (95% CI: 81.6 to 95.7) for those without. Among all HIV-infected persons, ART coverage among treatment-eligible persons was 86.9% (95% CI: 74.2 to 99.5) for persons with prior tuberculosis and 58.3% (95% CI: 47.6 to 69.0) for those without. Morbidity from tuberculosis and HIV remain major health challenges in Kenya. Tuberculosis is an important entry point for HIV diagnosis and treatment. Lack of knowledge of HIV serostatus is an obstacle to access to HIV services and timely ART for prevention of HIV transmission and HIV-associated disease, including tuberculosis.

Which influenza vaccine formulation should be used in Kenya? A comparison of influenza isolates from Kenya to vaccine strains, 2007-2013.

PubMed

Waiboci, Lilian W; Mott, Joshua A; Kikwai, Gilbert; Arunga, Geoffrey; Xu, Xiyan; Mayieka, Lilian; Emukule, Gideon O; Muthoka, Phillip; Njenga, M Kariuki; Fields, Barry S; Katz, Mark A

2016-05-17

Every year the World Health Organization (WHO) recommends which influenza virus strains should be included in a northern hemisphere (NH) and a southern hemisphere (SH) influenza vaccine. To determine the best vaccine formulation for Kenya, we compared influenza viruses collected in Kenya from April 2007 to May 2013 to WHO vaccine strains. We collected nasopharyngeal and oropharyngeal (NP/OP) specimens from patients with respiratory illness, tested them for influenza, isolated influenza viruses from a proportion of positive specimens, tested the isolates for antigenic relatedness to vaccine strains, and determined the percentage match between circulating viruses and SH or NH influenza vaccine composition and schedule. During the six years, 7.336 of the 60,072 (12.2%) NP/OP specimens we collected were positive for influenza: 30,167 specimens were collected during the SH seasons and 3717 (12.3%) were positive for influenza; 2903 (78.1%) influenza A, 902 (24.2%) influenza B, and 88 (2.4%) influenza A and B positive specimens. We collected 30,131 specimens during the NH seasons and 3978 (13.2%) were positive for influenza; 3181 (80.0%) influenza A, 851 (21.4%) influenza B, and 54 (1.4%) influenza A and B positive specimens. Overall, 362/460 (78.7%) isolates from the SH seasons and 316/338 (93.5%) isolates from the NH seasons were matched to the SH and the NH vaccine strains, respectively (p<0.001). Overall, 53.6% and 46.4% SH and NH vaccines, respectively, matched circulating strains in terms of vaccine strains and timing. In six years of surveillance in Kenya, influenza circulated at nearly equal levels during the SH and the NH influenza seasons. Circulating viruses were matched to vaccine strains. The vaccine match decreased when both vaccine strains and timing were taken into consideration. Either vaccine formulation could be suitable for use in Kenya but the optimal timing for influenza vaccination needs to be determined. Copyright © 2016 Elsevier Ltd. All rights

Resource Utilisation and Curriculum Implementation in Community Colleges in Kenya

ERIC Educational Resources Information Center

Kigwilu, Peter Changilwa; Akala, Winston Jumba

2017-01-01

The study investigated how Catholic-sponsored community colleges in Nairobi utilise the existing physical facilities and teaching and learning resources for effective implementation of Artisan and Craft curricula. The study adopted a mixed methods research design. Proportional stratified random sampling was used to sample 172 students and 18…

Biomedical laboratory science education: standardising teaching content in resource-limited countries.

PubMed

Arneson, Wendy; Robinson, Cathy; Nyary, Bryan

2013-01-01

There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates.

Assessing reading fluency in Kenya: Oral or silent assessment?

NASA Astrophysics Data System (ADS)

Piper, Benjamin; Zuilkowski, Stephanie Simmons

2015-04-01

In recent years, the Education for All movement has focused more intensely on the quality of education, rather than simply provision. Many recent and current education quality interventions focus on literacy, which is the core skill required for further academic success. Despite this focus on the quality of literacy instruction in developing countries, little rigorous research has been conducted on critical issues of assessment. This analysis, which uses data from the Primary Math and Reading Initiative (PRIMR) in Kenya, aims to begin filling this gap by addressing a key assessment issue - should literacy assessments in Kenya be administered orally or silently? The authors compared second-grade students' scores on oral and silent reading tasks of the Early Grade Reading Assessment (EGRA) in Kiswahili and English, and found no statistically significant differences in either language. They did, however, find oral reading rates to be more strongly related to reading comprehension scores. Oral assessment has another benefit for programme evaluators - it allows for the collection of data on student errors, and therefore the calculation of words read correctly per minute, as opposed to simply words read per minute. The authors therefore recommend that, in Kenya and in similar contexts, student reading fluency be assessed via oral rather than silent assessment.

Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review

PubMed Central

Zolfo, Maria; Diro, Ermias

2017-01-01

Background Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services. Thus, the adoption of EHRs in regions with a lack of infrastructure, untrained staff, and ill-equipped health care providers is an important task. However, the main barrier to adopting EHR software in low- and middle-income countries is the cost of its purchase and maintenance, which highlights the open-source approach as a good solution for these underserved areas. Objective The aim of this study was to conduct a systematic review of open-source EHR systems based on the requirements and limitations of low-resource settings. Methods First, we reviewed existing literature on the comparison of available open-source solutions. In close collaboration with the University of Gondar Hospital, Ethiopia, we identified common limitations in poor resource environments and also the main requirements that EHRs should support. Then, we extensively evaluated the current open-source EHR solutions, discussing their strengths and weaknesses, and their appropriateness to fulfill a predefined set of features relevant for low-resource settings. Results The evaluation methodology allowed assessment of several key aspects of available solutions that are as follows: (1) integrated applications, (2) configurable reports, (3) custom reports, (4) custom forms, (5) interoperability, (6) coding systems, (7) authentication methods, (8) patient portal, (9) access control model, (10) cryptographic features, (11) flexible data model, (12) offline support, (13) native client, (14) Web client,(15

Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review.

PubMed

Syzdykova, Assel; Malta, André; Zolfo, Maria; Diro, Ermias; Oliveira, José Luis

2017-11-13

Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services. Thus, the adoption of EHRs in regions with a lack of infrastructure, untrained staff, and ill-equipped health care providers is an important task. However, the main barrier to adopting EHR software in low- and middle-income countries is the cost of its purchase and maintenance, which highlights the open-source approach as a good solution for these underserved areas. The aim of this study was to conduct a systematic review of open-source EHR systems based on the requirements and limitations of low-resource settings. First, we reviewed existing literature on the comparison of available open-source solutions. In close collaboration with the University of Gondar Hospital, Ethiopia, we identified common limitations in poor resource environments and also the main requirements that EHRs should support. Then, we extensively evaluated the current open-source EHR solutions, discussing their strengths and weaknesses, and their appropriateness to fulfill a predefined set of features relevant for low-resource settings. The evaluation methodology allowed assessment of several key aspects of available solutions that are as follows: (1) integrated applications, (2) configurable reports, (3) custom reports, (4) custom forms, (5) interoperability, (6) coding systems, (7) authentication methods, (8) patient portal, (9) access control model, (10) cryptographic features, (11) flexible data model, (12) offline support, (13) native client, (14) Web client,(15) other clients, (16) code

The Cascade Model of Teachers' Continuing Professional Development in Kenya: A Time for Change?

ERIC Educational Resources Information Center

Bett, Harry Kipkemoi

2016-01-01

Kenya is one of the countries whose teachers the UNESCO (2015) report cited as lacking curriculum support in the classroom. As is the case in many African countries, a large portion of teachers in Kenya enter the teaching profession when inadequately prepared, while those already in the field receive insufficient support in their professional…

Malaria Prevention and Treatment Using Educational Animations: A Case Study in Kakamega County, Kenya

ERIC Educational Resources Information Center

Bello-Bravo, Julia; Namatsi Lutomia, Anne; Madela, Lawrence Mbhekiseni; Pittendrigh, Barry Robert

2017-01-01

Despite worldwide efforts to prevent malaria, the disease continues to take its strongest toll in sub-Saharan Africa. Kenya is no exception, with millions of cases and thousands of deaths reported annually. This pilot study looks at knowledge on malaria prevention and treatment among peri-urban communities in Western Kenya. Through a study on the…

Islam in Tanzania and Kenya: Ally or Foe in the War on Terror?

DTIC Science & Technology

2009-01-01

US foreign policy in the region. The recent US strategy of intelligence-sharing with Kenya, training and military support to both Kenya and Tanzania...assisted one another in establishing businesses , houses, schools, and so forth.43 Indeed, they were among the first Muslim groups to establish...be debated at that level , although under supervision from the central government. Also, local elections occurred for representatives, even if both

Serosurvey of Coxiella burnetii (Q fever) in Dromedary Camels (Camelus dromedarius) in Laikipia County, Kenya.

PubMed

Browne, A S; Fèvre, E M; Kinnaird, M; Muloi, D M; Wang, C A; Larsen, P S; O'Brien, T; Deem, S L

2017-11-01

Dromedary camels (Camelus dromedarius) are an important protein source for people in semi-arid and arid regions of Africa. In Kenya, camel populations have grown dramatically in the past few decades resulting in the potential for increased disease transmission between humans and camels. An estimated four million Kenyans drink unpasteurized camel milk, which poses a disease risk. We evaluated the seroprevalence of a significant zoonotic pathogen, Coxiella burnetii (Q fever), among 334 camels from nine herds in Laikipia County, Kenya. Serum testing revealed 18.6% positive seroprevalence of Coxiella burnetii (n = 344). Increasing camel age was positively associated with C. burnetii seroprevalence (OR = 5.36). Our study confirmed that camels living in Laikipia County, Kenya, have been exposed to the zoonotic pathogen, C. burnetii. Further research to evaluate the role of camels in disease transmission to other livestock, wildlife and humans in Kenya should be conducted. © 2017 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

Using Electronic Information Resources Centers by Faculty Members at University Education: Competencies, Needs and Challenges

ERIC Educational Resources Information Center

Abouelenein, Yousri

2017-01-01

This study aimed at investigating the factual situation of electronic information resources centers to faculty members at university education. Competencies that faculty members should possess regarding this issue were determined. Also their needs for (scientific research skills and teaching) were assessed. In addition, problems that hinder their…

Spatial modelling and mapping of female genital mutilation in Kenya.

PubMed

Achia, Thomas N O

2014-03-25

Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15-49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural-urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p<0.001). This suggests that the fight against FGM/C in Kenya is not yet over

Seismic structure of the uppermost mantle beneath the Kenya rift

USGS Publications Warehouse

Keller, Gordon R.; Mechie, J.; Braile, L.W.; Mooney, W.D.; Prodehl, C.

1994-01-01

A major goal of the Kenya Rift International Seismic Project (KRISP) 1990 experiment was the determination of deep lithospheric structure. In the refraction/wide-angle reflection part of the KRISP effort, the experiment was designed to obtain arrivals to distances in excess of 400 km. Phases from interfaces within the mantle were recorded from many shotpoints, and by design, the best data were obtained along the axial profile. Reflected arrivals from two thin (< 10 km), high-velocity layers were observed along this profile and a refracted arrival was observed from the upper high-velocity layer. These mantle phases were observed on record sections from four axial profile shotpoints so overlapping and reversed coverage was obtained. Both high-velocity layers are deepest beneath Lake Turkana and become more shallow southward as the apex of the Kenya dome is approached. The first layer has a velocity of 8.05-8.15 km/s, is at a depth of about 45 km beneath Lake Turkana, and is observed at depths of about 40 km to the south before it disappears near the base of the crust. The deeper layer has velocities ranging from 7.7 to 7.8 km/s in the south to about 8.3 km/s in the north, has a similar dip as the upper one, and is found at depths of 60-65 km. Mantle arrivals outside the rift valley appear to correlate with this layer. The large amounts of extrusive volcanics associated with the rift suggest compositional anomalies as an explanation for the observed velocity structure. However, the effects of the large heat anomaly associated with the rift indicate that composition alone cannot explain the high-velocity layers observed. These layers require some anisotropy probably due to the preferred orientation of olivine crystals. The seismic model is consistent with hot mantle material rising beneath the Kenya dome in the southern Kenya rift and north-dipping shearing along the rift axis near the base of the lithosphere beneath the northern Kenya rift. This implies lithosphere

Spatial modelling and mapping of female genital mutilation in Kenya

PubMed Central

2014-01-01

Background Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. Methods The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15–49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. Results The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural–urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p < 0.001). Conclusion This suggests that the

Life cycle cost analysis of a stand-alone PV system in rural Kenya

NASA Astrophysics Data System (ADS)

Daly, Emma

The purpose of this quantitative research study was to determine the economic feasibility of a stand-alone PV system to electrify a rural area in Kenya. The research conducted involved a comprehensive review of all the relevant literature associated with the study. Methodologies were extrapolated from this extensive literature to develop a model for the complete design and economic analysis of a stand-alone PV system. A women's center in rural Kenya was used as a worked example to demonstrate the workings of the model. The results suggest that electrifying the center using a stand-alone PV system is an economically viable option which is encouraging for the surrounding area. This model can be used as a business model to determine the economic feasibility of a stand-alone PV system in alternative sites in Kenya.

Outcomes from the first multidrug-resistant tuberculosis programme in Kenya.

PubMed

Huerga, H; Bastard, M; Kamene, M; Wanjala, S; Arnold, A; Oucho, N; Chikwanha, I; Varaine, F

2017-03-01

In March 2006, the first multidrug-resistant tuberculosis (MDR-TB) treatment programme was implemented in Kenya. To describe patients' treatment outcomes and adverse events. A retrospective case note review of patients started on MDR-TB treatment at two Médecins Sans Frontières-supported sites and the national referral hospital of Kenya was undertaken. Sites operated an ambulatory model of care. Patients were treated for a minimum of 24 months with at least 4-5 drugs for the intensive phase of treatment, including an injectable agent. Of 169 patients, 25.6% were human immunodeficiency virus (HIV) positive and 89.3% were culture-positive at baseline. Adverse events occurred in 67.4% of patients: 45.9% had nausea/vomiting, 43.9% electrolyte disturbance, 41.8% dyspepsia and 31.6% hypothyroidism. The median time to culture conversion was 2 months. Treatment outcomes were as follows: 76.6% success, 14.5% deaths, 8.3% lost to follow-up and 0.7% treatment failure. HIV-positive individuals (adjusted odds ratio [aOR] 3.51, 95% confidence interval [CI] 1.12-11.03) and women (aOR 2.73, 95%CI 1.01-7.39) had a higher risk of unfavourable outcomes, while the risk was lower in those with culture conversion at 6 months (aOR 0.11, 95%CI 0.04-0.32). In Kenya, where an ambulatory model of care is used for MDR-TB treatment, treatment success was high, despite high rates of HIV. Almost half of the patients experienced electrolyte disturbance and one third had hypothyroidism; this supports the view that systematic regular biochemical monitoring is needed in Kenya.

An Exploration of Life Skills Programme on Pre-School Children in Embu West, Kenya

ERIC Educational Resources Information Center

Gatumu, Jane Ciumwari; Kathuri, Wilfred Njeru

2018-01-01

The Life Skills Programme, which is one of the newest programmes in the Kenya Preschool educational system was explored to establish the impact it had on the lives of preschool children in Embu West, Kenya. A primary school that is perceived as having well-disciplined children was purposively selected. The sample consisted of 39 students, 43…

Socio-Demographic Factors Associated with Alcohol Abuse among Egerton University Students in Njoro-Kenya

ERIC Educational Resources Information Center

Boitt, Richard Kimuge; Boitt, Monicah Lydia; Othieno, Caleb; Obondo, Anne

2016-01-01

The main objective of higher institutions of learning in Kenya is to provide education and growth experiences for its students but alcohol abuse has continued to be a problem in the university campuses that is slowing down their progress and the Kenya vision 2030 that envisages a healthy population free from the impact of alcohol abuse through the…

Estimating maize production in Kenya using NDVI: Some statistical considerations

USGS Publications Warehouse

Lewis, J.E.; Rowland, James; Nadeau , A.

1998-01-01

A regression model approach using a normalized difference vegetation index (NDVI) has the potential for estimating crop production in East Africa. However, before production estimation can become a reality, the underlying model assumptions and statistical nature of the sample data (NDVI and crop production) must be examined rigorously. Annual maize production statistics from 1982-90 for 36 agricultural districts within Kenya were used as the dependent variable; median area NDVI (independent variable) values from each agricultural district and year were extracted from the annual maximum NDVI data set. The input data and the statistical association of NDVI with maize production for Kenya were tested systematically for the following items: (1) homogeneity of the data when pooling the sample, (2) gross data errors and influence points, (3) serial (time) correlation, (4) spatial autocorrelation and (5) stability of the regression coefficients. The results of using a simple regression model with NDVI as the only independent variable are encouraging (r 0.75, p 0.05) and illustrate that NDVI can be a responsive indicator of maize production, especially in areas of high NDVI spatial variability, which coincide with areas of production variability in Kenya.

Epidemiology of operative burns at Kijabe Hospital from 2006 to 2010: Pilot study of a web-based tool for creation of the Kenya Burn Repository

PubMed Central

Dale, Elizabeth L.; Mueller, Melissa A.; Wang, Li; Fogerty, Mary D.; Guy, Jeffrey S.; Nthumba, Peter M.

2013-01-01

Introduction In order to implement effective burn prevention strategies, the WHO has called for improved data collection to better characterize burn injuries in low and middle income countries (LMIC). This study was designed to gather information on burn injury in Kenya and to test a model for such data collection. Methods The study was designed as a retrospective case series study utilizing an electronic data collection tool to assess the scope of burn injuries requiring operation at Kijabe Hospital from January 2006 to May 2010. Data were entered into a web-based tool to test its utility as the potential Kenya Burn Repository (KBR). Results 174 patients were included. The median age was 10 years. There was a male predominance (59% vs. 41%). Findings included that timing of presentation was associated with burn etiology (p = 0.009). Length of stay (LOS) was associated with burn etiology (p < 0.001). Etiology differed depending on the age group, with scald being most prominent in children (p = 0.002). Conclusions Burn injuries in Kenya show similarities with other LMIC in etiology and pediatric predominance. Late presentation for care and prolonged LOS are areas for further investigation. The web-based database is an effective tool for data collection and international collaboration. PMID:23040425

Epidemiology of operative burns at Kijabe Hospital from 2006 to 2010: pilot study of a web-based tool for creation of the Kenya Burn Repository.

PubMed

Dale, Elizabeth L; Mueller, Melissa A; Wang, Li; Fogerty, Mary D; Guy, Jeffrey S; Nthumba, Peter M

2013-06-01

In order to implement effective burn prevention strategies, the WHO has called for improved data collection to better characterize burn injuries in low and middle income countries (LMIC). This study was designed to gather information on burn injury in Kenya and to test a model for such data collection. The study was designed as a retrospective case series study utilizing an electronic data collection tool to assess the scope of burn injuries requiring operation at Kijabe Hospital from January 2006 to May 2010. Data were entered into a web-based tool to test its utility as the potential Kenya Burn Repository (KBR). 174 patients were included. The median age was 10 years. There was a male predominance (59% vs. 41%). Findings included that timing of presentation was associated with burn etiology (p=0.009). Length of stay (LOS) was associated with burn etiology (p<0.001). Etiology differed depending on the age group, with scald being most prominent in children (p=0.002). Burn injuries in Kenya show similarities with other LMIC in etiology and pediatric predominance. Late presentation for care and prolonged LOS are areas for further investigation. The web-based database is an effective tool for data collection and international collaboration. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Community perceptions of malaria and vaccines in the South Coast and Busia regions of Kenya.

PubMed

Ojakaa, David I; Ofware, Peter; Machira, Yvonne W; Yamo, Emmanuel; Collymore, Yvette; Ba-Nguz, Antoinette; Vansadia, Preeti; Bingham, Allison

2011-05-30

Malaria is a leading cause of morbidity and mortality in children younger than 5 years in Kenya. Within the context of planning for a vaccine to be used alongside existing malaria control methods, this study explores sociocultural and health communications issues among individuals who are responsible for or influence decisions on childhood vaccination at the community level. This qualitative study was conducted in two malaria-endemic regions of Kenya--South Coast and Busia. Participant selection was purposive and criterion based. A total of 20 focus group discussions, 22 in-depth interviews, and 18 exit interviews were conducted. Participants understand that malaria is a serious problem that no single tool can defeat. Communities would welcome a malaria vaccine, although they would have questions and concerns about the intervention. While support for local child immunization programs exists, limited understanding about vaccines and what they do is evident among younger and older people, particularly men. Even as health care providers are frustrated when parents do not have their children vaccinated, some parents have concerns about access to and the quality of vaccination services. Some women, including older mothers and those less economically privileged, see themselves as the focus of health workers' negative comments associated with either their parenting choices or their children's appearance. In general, parents and caregivers weigh several factors--such as personal opportunity costs, resource constraints, and perceived benefits--when deciding whether or not to have their children vaccinated, and the decision often is influenced by a network of people, including community leaders and health workers. The study raises issues that should inform a communications strategy and guide policy decisions within Kenya on eventual malaria vaccine introduction. Unlike the current practice, where health education on child welfare and immunization focuses on women, the

Evaluation of three electronic report processing systems for preparing hydrologic reports of the U.S Geological Survey, Water Resources Division

USGS Publications Warehouse

Stiltner, G.J.

1990-01-01

In 1987, the Water Resources Division of the U.S. Geological Survey undertook three pilot projects to evaluate electronic report processing systems as a means to improve the quality and timeliness of reports pertaining to water resources investigations. The three projects selected for study included the use of the following configuration of software and hardware: Ventura Publisher software on an IBM model AT personal computer, PageMaker software on a Macintosh computer, and FrameMaker software on a Sun Microsystems workstation. The following assessment criteria were to be addressed in the pilot studies: The combined use of text, tables, and graphics; analysis of time; ease of learning; compatibility with the existing minicomputer system; and technical limitations. It was considered essential that the camera-ready copy produced be in a format suitable for publication. Visual improvement alone was not a consideration. This report consolidates and summarizes the findings of the electronic report processing pilot projects. Text and table files originating on the existing minicomputer system were successfully transformed to the electronic report processing systems in American Standard Code for Information Interchange (ASCII) format. Graphics prepared using a proprietary graphics software package were transferred to all the electronic report processing software through the use of Computer Graphic Metafiles. Graphics from other sources were entered into the systems by scanning paper images. Comparative analysis of time needed to process text and tables by the electronic report processing systems and by conventional methods indicated that, although more time is invested in creating the original page composition for an electronically processed report , substantial time is saved in producing subsequent reports because the format can be stored and re-used by electronic means as a template. Because of the more compact page layouts, costs of printing the reports were 15% to 25

A new species of dwarf gecko in the genus Lygodactylus (squamata: Gekkonidae) from central Kenya.

PubMed

Malonza, Patrick K; Granthon, Carolina; Williams, Dean A

2016-01-08

A new species of Lygodactylus gecko (L. wojnowskii sp. nov.) is described from the vicinity of Chogoria Town on the eastern lower slopes of Mt. Kenya in central Kenya. A phylogeny based on mitochondrial and nuclear DNA shows that the proposed new taxon is distinct within the Lygodactylus picturatus group and is the sister lineage to L. mombasicus and L. kimhowelli. It is morphologically very similar to both L. mombasicus and L. keniensis but its dorsal coloration and pattern is different. Its dorsum is grey with dark stripes while its head has black and white stripes that form a Y-shaped mark. While the male throat pattern is similar to that of L. mombasicus, that of the female is like that of females and some males of Lygodactylus keniensis. Lygodactylus wojnowskii sp. nov. has a higher number of post-postmental scales (6) than do its close relatives (5). The new species is distributed on the lower slopes of mid-altitude areas on eastern Mt. Kenya, but it may occur in other areas at similar elevations in central Kenya. It is associated with short, scattered trees within agricultural areas. It has not yet been recorded within the protected Chogoria forest block of Mt. Kenya forest. It is likely present in Mwea National Reserve as it occurs in nearby areas.

Thyroid Surgery in a Resource-Limited Setting.

PubMed

Jafari, Aria; Campbell, David; Campbell, Bruce H; Ngoitsi, Henry Nono; Sisenda, Titus M; Denge, Makaya; James, Benjamin C; Cordes, Susan R

2017-03-01

Objective The present study reviews a series of patients who underwent thyroid surgery in Eldoret, Kenya, to demonstrate the feasibility of conducting long-term (>1 year) outcomes research in a resource-limited setting, impact on the quality of life of the recipient population, and inform future humanitarian collaborations. Study Design Case series with chart review. Setting Tertiary public referral hospital in Eldoret, Kenya. Subjects and Methods Twenty-one patients were enrolled during the study period. A retrospective chart review was performed for all adult patients who underwent thyroid surgery during humanitarian trips (2010-2015). Patients were contacted by mobile telephone. Medical history and physical examination, including laryngoscopy, were performed, and the SF-36 was administered (a quality-of-life questionnaire). Laboratory measurements of thyroid function and neck ultrasound were obtained. Results The mean follow-up was 33.6 ± 20.2 months after surgery: 37.5% of subtotal thyroidectomy patients and 15.4% of lobectomy patients were hypothyroid postoperatively according to serologic studies. There were no cases of goiter recurrence or malignancy. All patients reported postoperative symptomatic improvement and collectively showed positive pre- and postoperative score differences on the SF-36. Conclusion Although limited by a small sample size and the retrospective nature, our study demonstrates the feasibility of long-term surgical and quality-of-life outcomes research in a resource-limited setting. The low complication rates suggest minimal adverse effects of performing surgery in this context. Despite a considerable rate of postoperative hypothyroidism, it is in accordance with prior studies and emphasizes the need for individualized, longitudinal, and multidisciplinary care. Quality-of-life score improvements suggest benefit to the recipient population.

East African Rift Valley, Kenya

NASA Technical Reports Server (NTRS)

1990-01-01

This rare, cloud free view of the East African Rift Valley, Kenya (1.5N, 35.5E) shows a clear view of the Turkwell River Valley, an offshoot of the African REift System. The East African Rift is part of a vast plate fracture which extends from southern Turkey, through the Red Sea, East Africa and into Mozambique. Dark green patches of forests are seen along the rift margin and tea plantations occupy the cooler higher ground.

The Role of Education in Agricultural Projects for Food Security and Poverty Reduction in Kenya

NASA Astrophysics Data System (ADS)

Walingo, Mary Khakoni

2006-05-01

Agricultural development projects have been promoted in many places as a feature of poverty-reduction strategies. Such projects have often been implemented without a strong in-built education component, and hence have had little success. Agricultural projects seek to improve food security by diversifying a household's resource base and facilitating the social and economic empowerment of women. The present study presents a survey designed to assess the relationship between education level and ability to benefit from dairy-development projects in Kenya. Results reveal higher occupation and employment levels among beneficiary than non-beneficiary households. On the other hand, beneficiaries of poverty-reduction schemes require specialized training. Apart from project-specific training, the level of general education alone cannot predict the attainment of project objectives.

Organizational Cultural Factors Hindering Women Ascending to Top Management Positions in Public Universities in Kenya: A Case of Moi University

ERIC Educational Resources Information Center

Makori, Rebecca S.; Onyango, Maria; Attyang, Judith Miguda; Bantu, Edward; Onderi, Peter Omae

2016-01-01

It is observed that the major setback to economic development in Kenya is stagnation in industrial development. To overcome these, Kenya plans to be a middle level income nation by the year 2030. These plans are to be realized through "Vision 2030." To achieve these goals, Kenya requires gender mainstreamed team of highly skilled workers…

A preliminary categorization of end-of-life electrical and electronic equipment as secondary metal resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oguchi, Masahiro, E-mail: oguchi.masahiro@nies.go.jp; Murakami, Shinsuke; Sakanakura, Hirofumi

2011-09-15

Highlights: > End-of-life electrical and electronic equipment (EEE) as secondary metal resources. > The content and the total amount of metals in specific equipment are both important. > We categorized 21 EEE types from contents and total amounts of various metals. > Important equipment types as secondary resources were listed for each metal kind. > Collectability and possible collection systems of various EEE types were discussed. - Abstract: End-of-life electrical and electronic equipment (EEE) has recently received attention as a secondary source of metals. This study examined characteristics of end-of-life EEE as secondary metal resources to consider efficient collection andmore » metal recovery systems according to the specific metals and types of EEE. We constructed an analogy between natural resource development and metal recovery from end-of-life EEE and found that metal content and total annual amount of metal contained in each type of end-of-life EEE should be considered in secondary resource development, as well as the collectability of the end-of-life products. We then categorized 21 EEE types into five groups and discussed their potential as secondary metal resources. Refrigerators, washing machines, air conditioners, and CRT TVs were evaluated as the most important sources of common metals, and personal computers, mobile phones, and video games were evaluated as the most important sources of precious metals. Several types of small digital equipment were also identified as important sources of precious metals; however, mid-size information and communication technology (ICT) equipment (e.g., printers and fax machines) and audio/video equipment were shown to be more important as a source of a variety of less common metals. The physical collectability of each type of EEE was roughly characterized by unit size and number of end-of-life products generated annually. Current collection systems in Japan were examined and potentially appropriate collection

Rate of Financial Return to University Schooling among Lecturers in Two Public Universities in Kenya

ERIC Educational Resources Information Center

Rugar, T. O.; Ayodo, T. M. O.; Agak, J. O.

2010-01-01

Influence of education on earnings among workers is well documented. However, the level of relationship that exists between earnings and schooling among lecturers in public universities in Kenya remain undetermined. The purpose of this study was to establish the financial profitability of university schooling in Kenya. The study was based on the…

The Pedagogical Readiness of Instructors towards Achieving Integration of ICT's in TVET Institutions in Kenya

ERIC Educational Resources Information Center

Maina, Tirus Muya; Ogalo, James; Mwai, Naomi

2016-01-01

This paper points to the necessity to conduct research on the pedagogical readiness of instructors towards achieving integration of ICT's in Technical and Vocational Education and Training (TVET) institutions in Kenya. Research on the integration of ICTs in teaching and learning in TVET institution in Kenya have been done to improve the learning…

Seasonal dynamics of snail populations in coastal Kenya: Model calibration and snail control

NASA Astrophysics Data System (ADS)

Gurarie, D.; King, C. H.; Yoon, N.; Wang, X.; Alsallaq, R.

2017-10-01

A proper snail population model is important for accurately predicting Schistosoma transmission. Field data shows that the overall snail population and that of shedding snails have a strong pattern of seasonal variation. Because human hosts are infected by the cercariae released from shedding snails, the abundance of the snail population sets ultimate limits on human infection. For developing a predictive dynamic model of schistosome infection and control strategies we need realistic snail population dynamics. Here we propose two such models based on underlying environmental factors and snail population biology. The models consist of two-stage (young-adult) populations with resource-dependent reproduction, survival, maturation. The key input in the system is seasonal rainfall which creates snail habitats and resources (small vegetation). The models were tested, calibrated and validated using dataset collected in Msambweni (coastal Kenya). Seasonal rainfall in Msambweni is highly variable with intermittent wet - dry seasons. Typical snail patterns follow precipitation peaks with 2-4-month time-lag. Our models are able to reproduce such seasonal variability over extended period of time (3-year study). We applied them to explore the optimal seasonal timing for implementing snail control.

Diagnosis and Chemotherapy of Human Trypanosomiasis and Vector Ecology of Rift Valley and Congo-Crimean Hemorrhagic Fever in Kenya.

DTIC Science & Technology

1994-01-27

VALLEY AND CONGO-CRIMEAN HEMORRHAGIC FEVER IN KENYA PRINCIPAL INVESTIGATOR: J. K. Omuse CONTRACTING ORGANIZATION : Kenya Trypanosomiasis Research...J. K. Omuse 7. PERFORMING ORGANIZATION NAME(S) AND ADORESS(ES) 8. PERFORMING ORGANIZATION Kenya Trypanosomiasis Research Institute REPORT NUMBER P.O...these flagellated protozoan parasites "homes" to the microvasculature of the brain and skeletal muscles, and the frequent paucity of organisms in the

Relationship Transitions among Youth in Urban Kenya

ERIC Educational Resources Information Center

Clark, Shelley; Kabiru, Caroline; Mathur, Rohini

2010-01-01

The process of courtship and marriage in sub-Saharan Africa has changed remarkably. These changes, however, have received scant attention because recent research has focused on adolescent relationships' links to HIV/AIDS rather than to marriage. Drawing on detailed reports of 1,365 romantic and sexual partnerships from youths in Kisumu, Kenya, we…

Sharing Special Education Strategies in Rural Kenya

ERIC Educational Resources Information Center

Shamberger, Cynthia T.

2014-01-01

As a former special education teacher at the elementary, middle and high school levels, many unique and complex learning situations were encountered. The author, who was a junior faculty member on her initial trip to Kenya, experienced a very challenging, yet rewarding, learning opportunity with teachers gathered in a community located in rural…

Village victories: new motivational techniques in Kenya and Zimbabwe.

PubMed

Miller, N N

1983-01-01

The Institute of Cultural Affairs (ICA) in Kenya and the Zimbabwe Project in Zimbabwe are organizations working to promote local level development in their respective countries and a major challenge to these organizations has been how to change the attitudes and perceptions of the poor in ways that help them help themselves. ICA efforts are carried out in Kenya by several hundred volunteer staff, including 30 expatriates. Most are assigned to 1 of the 21 projects spread across southern Kenya. Since 1975 the ICA has launched projects in over 200 villages. Village clean up, public health, school construction, water development, and agricultural improvement are some of the project categories. Tangible results include starting demonstration farms, field terracing projects, building pit latrines and compost pits, constructing new pathways, roads, and schoolrooms. Many of ICA's efforts are funded by local companies and through Kenyan offices of development organizations. In the field of health, ICA provides training courses at the village level that emphasize preventive care, sanitation, hygiene, nutrition, family planning, first aid, and treatment of common illnesses. ICA's mobilization techniques are based on motivating villagers to help themselves, to "catalyze and energize" the resources at hand. The process begins with a "consult" in which 12 or more ICA staff conduct a 3- or 4-day meeting with villagers to reorient local thinking. A special effort is made to break old attitudes that have held traditional villagers back. The consult is also designed to confront traditional assumptions about what the longterm reality might be. For urban slum villages the focus is on the transient nature of community that serves as low cost housing for thousands of newly arrived migrants. Today the Zimbabwe Project (ZP) is working with former soldiers, although when established in 1978 in Britain its purpose was to assist refugees from the Rhodesian struggle who had fled to Botswana

Using standard and institutional mentorship models to implement SLMTA in Kenya

PubMed Central

Mwalili, Samuel; Basiye, Frank L.; Zeh, Clement; Emonyi, Wilfred I.; Langat, Raphael; Luman, Elizabeth T.; Mwangi, Jane

2014-01-01

Background Kenya is home to several high-performing internationally-accredited research laboratories, whilst most public sector laboratories have historically lacked functioning quality management systems. In 2010, Kenya enrolled an initial eight regional and four national laboratories into the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. To address the challenge of a lack of mentors for the regional laboratories, three were paired, or ‘twinned’, with nearby accredited research laboratories to provide institutional mentorship, whilst the other five received standard mentorship. Objectives This study examines results from the eight regional laboratories in the initial SLMTA group, with a focus on mentorship models. Methods Three SLMTA workshops were interspersed with three-month periods of improvement project implementation and mentorship. Progress was evaluated at baseline, mid-term, and exit using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit checklist and scores were converted into a zero- to five-star scale. Results At baseline, the mean score for the eight laboratories was 32%; all laboratories were below the one-star level. At mid-term, all laboratories had measured improvements. However, the three twinned laboratories had increased an average of 32 percentage points and reached one to three stars; whilst the five non-twinned laboratories increased an average of 10 percentage points and remained at zero stars. At exit, twinned laboratories had increased an average 12 additional percentage points (44 total), reaching two to four stars; non-twinned laboratories increased an average of 28 additional percentage points (38 total), reaching one to three stars. Conclusion The partnership used by the twinning model holds promise for future collaborations between ministries of health and state-of-the-art research laboratories in their regions for laboratory quality improvement. Where they

COMPLETE GENOMIC SEQUENCE OF VIRULENT PIGEON PARAMYXOVIRUS IN LAUGHING DOVES (STREPTOPELIA SENEGALENSIS) IN KENYA.

PubMed

Obanda, Vincent; Michuki, George; Jowers, Michael J; Rumberia, Cecilia; Mutinda, Mathew; Lwande, Olivia Wesula; Wangoru, Kihara; Kasiiti-Orengo, Jacquiline; Yongo, Moses; Angelone-Alasaad, Samer

2016-07-01

Following mass deaths of Laughing Doves (Streptopelia senegalensis) in different localities throughout Kenya, internal organs obtained during necropsy of two moribund birds were sampled and analyzed by next generation sequencing. We isolated the virulent strain of pigeon paramyxovirus type-1 (PPMV-1), PPMV1/Laughing Dove/Kenya/Isiolo/B2/2012, which had a characteristic fusion gene motif (110)GGRRQKRF(117). We obtained a partial full genome of 15,114 nucleotides. The phylogenetic relationship based on the fusion gene and genomic sequence grouped our isolate as class II genotype VI, a group of viruses commonly isolated from wild birds but potentially lethal to Chickens ( Gallus gallus domesticus ). The fusion gene isolate clustered with PPMV-I strains from pigeons (Columbidae) in Nigeria. The complete genome showed a basal and highly divergent lineage to American, European, and Asian strains, indicating a divergent evolutionary pathway. The isolated strain is highly virulent and apparently species-specific to Laughing Doves in Kenya. Risk of transmission of such a strain to poultry is potentially high whereas the cyclic epizootic in doves is a threat to conservation of wild Columbidae in Kenya.

Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya

PubMed Central

Cleary, Susan; Molyneux, Sassy; English, Mike

2017-01-01

Abstract This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities

Cholera outbreak in Homa Bay County, Kenya, 2015.

PubMed

Githuku, Jane Njoki; Boru, Waqo Gufu; Hall, Casey Daniel; Gura, Zeinab; Oyugi, Elvis; Kishimba, Rogath Saika; Semali, Innocent; Farhat, Ghada Nadim; Mattie Park, Meeyoung

2017-01-01

Cholera is among the re-emerging diseases in Kenya. Beginning in December 2014, a persistent outbreak occurred involving 29 out of the 47 countries. Homa Bay County in Western Kenya was among the first counties to report cholera cases from January to April 2015. This case study is based on an outbreak investigation conducted by FELTP residents in Homa Bay County in February 2015. It simulates an outbreak investigation including laboratory confirmation, active case finding, descriptive epidemiology and implementation of control measures. This case study is designed for the training of basic level field epidemiology trainees or any other health care workers working in public health-related fields. It can be administered in 2-3 hours. Used as adjunct training material, the case study provides the trainees with competencies in investigating an outbreak in preparation for the actual real-life experience of such outbreaks.

Improving medical education in Kenya: an international collaboration.

PubMed

Mayo, Alexa

2014-04-01

This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya.

Evaluating a scalable model for implementing electronic health records in resource-limited settings.

PubMed

Were, Martin C; Emenyonu, Nneka; Achieng, Marion; Shen, Changyu; Ssali, John; Masaba, John P M; Tierney, William M

2010-01-01

Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.

What's up in Kenya? (Besides population).

PubMed

Yinger, N; Carty, W

1987-11-01

There are some indications that things are changing in Kenya, a nation with 1 of the world's fastest growing populations. Kenya's population will increase from the present 22.4 million to 44.8 million in the next 18 years if the 3.9% annual population growth rate remains constant. The government has renewed its campaign to increase awareness of the relationship between population growth and economic progress. There is not much progress to report as yet. Contraceptive prevalence is increasing slowly and now stands at 20% of eligible women. The government family planning program has been only minimally effective in recruiting or keeping family planning clients, but some smaller scale, private family planning programs demonstrate that Kenyans are receptive to family planning if they have access to appropriate and well-operated services. The key to the successful community-based program at Chogoria Hospital has been the use of the tradition of self-help. The original targets of the Family Planning Private Sector Project (FPPS), funded by the US Agency for International Development (USAID), have been met, and the new goals are for a total of 50 subprojects and 50,000 acceptors. The strategy of FPPS is to convince a company, plantation, para-state organization, private clinic, or school that its social and economic interests would be served by adopting a strong family planning program. The project then trains health clinic staff, and programs are designed to carry out the individual projects. Workers are educated about the economic and health benefits of smaller families and provided with appropriate information, contraceptives, and followup services. After 2 years of support, FPPS leaves the projects to the companies to operate and finance on a permanent basis. This approach works because Kenya has 1 of the largest and most socially responsible nongovernmental sectors in Africa. Project such as Chogoria and FPPS show that many Kenyans recognize the health and economic

Serotype and genetic diversity of human rhinovirus strains that circulated in Kenya in 2008.

PubMed

Milanoi, Sylvia; Ongus, Juliette R; Gachara, George; Coldren, Rodney; Bulimo, Wallace

2016-05-01

Human rhinoviruses (HRVs) are a well-established cause of the common cold and recent studies indicated that they may be associated with severe acute respiratory illnesses (SARIs) like pneumonia, asthma, and bronchiolitis. Despite global studies on the genetic diversity of the virus, the serotype diversity of these viruses across diverse geographic regions in Kenya has not been characterized. This study sought to characterize the serotype diversity of HRV strains that circulated in Kenya in 2008. A total of 517 archived nasopharyngeal samples collected in a previous respiratory virus surveillance program across Kenya in 2008 were selected. Participants enrolled were outpatients who presented with influenza-like (ILI) symptoms. Real-time RT-PCR was employed for preliminary HRV detection. HRV-positive samples were amplified using RT-PCR and thereafter the nucleotide sequences of the amplicons were determined followed by phylogenetic analysis. Twenty-five percent of the samples tested positive for HRV. Phylogenetic analysis revealed that the Kenyan HRVs clustered into three main species comprising HRV-A (54%), HRV-B (12%), and HRV-C (35%). Overall, 20 different serotypes were identified. Intrastrain sequence homology among the Kenyan strains ranged from 58% to 100% at the nucleotide level and 55% to 100% at the amino acid level. These results show that a wide range of HRV serotypes with different levels of nucleotide variation were present in Kenya. Furthermore, our data show that HRVs contributed substantially to influenza-like illness in Kenya in 2008. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Occurrence, diversity and pattern of damage of Oplostomus species (Coleoptera: Scarabaeidae), honey bee pests in Kenya

USDA-ARS?s Scientific Manuscript database

Several arthropod pests including the hive beetles Aethina tumida and Oplostomus haroldi and the ectoparasite Varroa destructor have recently been identified as associated with honey bee colonies in Kenya. Here, we report the first documentation of O. fuligineus in Kenya, a related scarab of O. haro...

Perceptions of malaria and vaccines in Kenya.

PubMed

Ojakaa, David; Yamo, Emmanuel; Collymore, Yvette; Ba-Nguz, Antoinette; Bingham, Allison

2011-10-01

Malaria is a leading cause of morbidity and mortality in Kenya. To confront malaria, the Government of Kenya has been implementing and coordinating three approaches - vector control by distributing insecticide-treated bed nets and indoor residual spraying, case management, and the management of malaria during pregnancy. Immunization is recognized as one of the most cost-effective public health interventions. Efforts are underway to develop a malaria vaccine. The most advanced (RTS,S), is currently going through phase 3 trials. Although recent studies show the overwhelming support in the community for the introduction of a malaria vaccine, two issues - culture and the delivery of child immunization services - need to be considered. Alongside the modern methods of malaria control described above, traditional methods coexist and act as barriers to attainment of universal immunization. The gender dimension of the immunization programme (where women are the main child caretakers) will also need to be addressed. There is an age dimension to child immunization programmes. Two age cohorts of parents, caregivers, or family members deserve particular attention. These are the youth who are about to initiate childbearing, and the elderly (particularly mother-in-laws who often play a role in child-rearing). Mothers who are less privileged and socially disadvantaged need particular attention when it comes to child immunization. Access to immunization services is often characterized in some Kenyan rural communities in terms of living near the main road, or in the remote inaccessible areas. Should a malaria vaccine become available in the future, a strategy to integrate it into the immunization programme in Kenya should take into account at least two issues. First, it must address the fact that alongside the formal approach in malaria control, there exist the informal traditional practices among communities. Secondly, it must address particular issues in the delivery of

Medical student appraisal: electronic resources for inpatient pre-rounding.

PubMed

Sampognaro, P J; Mitchell, S L; Weeks, S R; Khalifian, S; Markman, T M; Uebel, L W; Dattilo, J R

2013-01-01

Pre-rounding is essential to preparing for morning rounds. Despite its importance, pre-rounding is rarely formally taught within the medical school curriculum and more often informally learned by modeling residents. The evolution of mobile applications provides opportunities to optimize this process. To evaluate three options available to medical students while pre-rounding and promote adoption of mobile resources in clinical care. Six medical students formed the evaluation cohort. Students were surveyed to assess pre-rounding practices. Participants utilized paper-based pre-rounding templates for two weeks followed by two weeks of the electronic note-taking service Evernote. A review of mobile applications on the iTunes and Google Play stores was performed, with each application informally reviewed by a single student. The application Scutsheet was selected for formal review by all students. Data was collected from narrative responses supplied by students throughout the evaluation periods and aggregated to assess strengths and limitations of each application. Pre-study responses demonstrated two consistent processes: verbal sign-out of overnight events and template use to organize patient information. The paper-based template was praised for its organization and familiarity amongst residents, but perceived as limited by the requirement of re-copying data into the hospital's electronic medical record (EMR). Evernote excelled due to compatibility across multiple operating systems, including accessibility from clinical workstations and ability to copy notes into the hospital's EMR. Scutsheet allowed for retention of data across multiple hospital days, but was limited by inability to export data or modify the electronic template. Aggregated user feedback identified the abilities to customize templates and copy information into the EMR as two prevailing characteristics that enhanced the efficiency of pre-rounding. Mobile devices offer the potential to enhance pre

Child Labor and School Attendance in Kenya

ERIC Educational Resources Information Center

Moyi, Peter

2011-01-01

Sub-Saharan Africa has the highest incidence of child labor in the world and estimates show that it continues to grow. This paper examines the causes and magnitude of child labor in Kenya. Unlike previous studies that examined child labor as only an economic activity, this paper includes household chores. Including household chores is important…

Biomedical laboratory science education: standardising teaching content in resource-limited countries

PubMed Central

Robinson, Cathy; Nyary, Bryan

2013-01-01

Background There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Objectives Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Method Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. Results The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. Conclusions These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates. PMID:29043162

Sexual behavior of female sex workers and access to condoms in Kenya and Uganda on the Trans-Africa highway.

PubMed

Morris, Chester N; Morris, Sheldon R; Ferguson, Alan G

2009-10-01

Female sex workers and their clients remain a high risk core group for HIV in Africa. We measured sexual behavior of a snowball sample of female sex workers (FSW) along the Trans Africa highway from Mombasa, Kenya to Kampala, Uganda and surveyed the availability of male condoms at 1,007 bars and lodgings in Kenya along the highway trucking stops where transactional sex occurs. There were 578 FSW one month sex diaries analyzed, 403 from Kenya and 175 from Uganda. Kenyan FSW had a median of 45 sexual acts per 28 days compared to 39 sex acts per 28 days by Ugandan FSW (P < 0.05). Condom use by FSW for all sexual liaisons was 79% in Kenya compared to 74% in Uganda. In multivariate analysis, adjusting for repeated measures, Kenyan FSW were more likely to use a condom by an adjusted odds ratio of 2.54 (95% confidence interval 1.89-3.41) compared to Ugandan FSW. Condom use with regular clients was 50.8% in Uganda compared with 68.7% in Kenya (P < 0.01). The number of sex workers reporting 100% condom use was 26.8% in Kenya and 18.9% in Uganda (P < 0.01). Bars and lodges in Kenya compared to Uganda were more likely to: have condom dispensers, 25% versus 1%, respectively (P < 0.01); distribute or sell condoms, 73.9% versus 47.6% (P < 0.01); and have more weekly condom distribution, 4.92 versus 1.27 condoms per seating capacity (P < 0.01). Our data indicate that in both countries condom use for FSW is suboptimal, particularly with regular partners, and greater condom use by Trans African highway FSW in Kenya compared to Uganda may be related to availability. Targeted interventions are warranted for FSW and truck drivers to prevent transmission in this important core group.

The effect of facility-based antiretroviral therapy programs on outpatient services in Kenya and Uganda.

PubMed

Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C

2017-08-16

Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations

School Enrolment and Attendance for Children with Disabilities in Kenya: An Examination of Household Survey Data

ERIC Educational Resources Information Center

Moyi, Peter

2017-01-01

While evidence confirms that children with disabilities face significant obstacles to schooling, especially in low-income countries like Kenya, there is limited empirical research on which to develop policy. The government of Kenya has long neglected the plight of people with disabilities. Despite numerous policy recommendations from the various…

Getting "Entangled": A Focus on the Hotel and Hospitality Curriculum Implementation in Public Universities in Kenya

ERIC Educational Resources Information Center

Mukolwe, Eunice; Cheloti, Isabela Mapelu

2016-01-01

Universities play a critical role in achieving Kenya Vision 2030 and the sustainable development goals. The demand for university education in Kenya has significantly increased and continues to swell. Many secondary school graduates and the working class look for opportunities to pursue university education, yet the process of curriculum…

Use of Electronic Information Resources among Research Scholars in the Islamia University of Bahawalpur, Pakistan

ERIC Educational Resources Information Center

Amjad, Anam; Ahmed, Shamshad; Bin Naeem, Salman

2013-01-01

This study examined the use of electronic resources among academic scholars of The Islamia University of Bahawalpur (IUB), Punjab, Pakistan. A quantitative survey was found most convenient and useful for this study. The total population of the study was 169 research students in IUB. The response rate was 79% and 133 utilizable responses were coded…

Molecular characterization of human coronaviruses and their circulation dynamics in Kenya, 2009-2012.

PubMed

Sipulwa, Lenata A; Ongus, Juliette R; Coldren, Rodney L; Bulimo, Wallace D

2016-02-01

Human Coronaviruses (HCoV) are a common cause of respiratory illnesses and are responsible for considerable morbidity and hospitalization across all age groups especially in individuals with compromised immunity. There are six known species of HCoV: HCoV-229E, HCoV-NL63, HCoV-HKU1, HCoV-OC43, MERS-CoV and SARS-HCoV. Although studies have shown evidence of global distribution of HCoVs, there is limited information on their presence and distribution in Kenya. HCoV strains that circulated in Kenya were retrospectively diagnosed and molecularly characterized. A total of 417 nasopharyngeal specimens obtained between January 2009 and December 2012 from around Kenya were analyzed by a real time RT-PCR using HCoV-specific primers. HCoV-positive specimens were subsequently inoculated onto monolayers of LL-CMK2 cells. The isolated viruses were characterized by RT-PCR amplification and sequencing of the partial polymerase (pol) gene. The prevalence of HCoV infection was as follows: out of the 417 specimens, 35 (8.4 %) were positive for HCoV, comprising 10 (2.4 %) HCoV-NL63, 12 (2.9 %) HCoV-OC43, 9 (2.1 %) HCoV-HKU1, and 4 (1 %) HCoV-229E. The Kenyan HCoV strains displayed high sequence homology to the prototypes and contemporaneous strains. Evolution analysis showed that the Kenyan HCoV-OC43 and HCoV-NL63 isolates were under purifying selection. Phylogenetic evolutionary analyses confirmed the identities of three HCoV-HKU1, five HCoV-NL63, eight HCoV-OC43 and three HCoV-229E. There were yearly variations in the prevalence and circulation patterns of individual HCoVs in Kenya. This paper reports on the first molecular characterization of human Coronaviruses in Kenya, which play an important role in causing acute respiratory infections among children.

An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization's Assessment Instrument for Mental Health Systems.

PubMed

Bitta, Mary A; Kariuki, Symon M; Chengo, Eddie; Newton, Charles R J C

2017-01-01

Little is known about the state of mental health systems in Kenya. In 2010, Kenya promulgated a new constitution, which devolved national government and the national health system to 47 counties including Kilifi County. There is need to provide evidence from mental health systems research to identify priority areas in Kilifi's mental health system for informing county health sector decision making. We conducted an initial assessment of state of mental health systems in Kilifi County and documented resources, policy and legislation and spectrum of mental, neurological and substance use disorders. This was a pilot study that used the brief version of the World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 to collect data. Data collection was based on the year 2014. Kilifi county has two public psychiatric outpatient units that are part of general hospitals. There is no standalone mental hospital in Kilifi. There are no inpatients or community based facilities for people with mental health problems. Although the psychiatric facilities in Kilifi have an essential drugs list, supply of drugs is erratic with frequent shortages. There is no psychiatrist or psychologist in Kilifi with only two psychiatric nurses for a population of approximately 1.2 million people. Schizophrenia was the commonest reason for visiting outpatient facilities (47.1%) while suicidal ideation was the least common (0.4%). Kenya's mental health policy, which is being used by Kilifi County, is outdated and does not cater for the current mental health needs of Kilifi. There is no specific legislation to protect the rights of people with mental health problems. No budget exists specifically for mental health care. There have been no efforts to integrate mental health care into primary care in Kilifi, and there is no empirical research work to evaluate its feasibility. There is an urgent need to increase resources allocated for mental health in particular

Multi-temporal Soil Erosion Modelling over the Mt Kenya Region with Multi-Sensor Earth Observation Data

NASA Astrophysics Data System (ADS)

Symeonakis, Elias; Higginbottom, Thomas

2015-04-01

Accelerated soil erosion is the principal cause of soil degradation across the world. In Africa, it is seen as a serious problem creating negative impacts on agricultural production, infrastructure and water quality. Regarding the Mt Kenya region, specifically, soil erosion is a serious threat mainly due to unplanned and unsustainable practices linked to tourism, agriculture and rapid population growth. The soil types roughly correspond with different altitudinal zones and are generally very fertile due to their volcanic origin. Some of them have been created by eroding glaciers while others are due to millions of years of fluvial erosion. The soils on the mountain are easily eroded once exposed: when vegetation is removed, the soil quickly erodes down to bedrock by either animals or humans, as tourists erode paths and local people clear large swaths of forested land for agriculture, mostly illegally. It is imperative, therefore, that a soil erosion monitoring system for the Mt Kenya region is in place in order to understand the magnitude of, and be able to respond to, the increasing number of demands on this renewable resource. In this paper, we employ a simple regional-scale soil erosion modelling framework based on the Thornes model and suggest an operational methodology for quantifying and monitoring water runoff and soil erosion using multi-sensor and multi-temporal remote sensing data in a GIS framework. We compare the estimates of this study with general data on the severity of soil erosion over Kenya and with measured rates of soil loss at different locations over the area of study. The results show that the measured and estimated rates of erosion are generally similar and within the same order of magnitude. They also show that, over the last years, erosion rates are increasing in large parts of the region at an alarming rate, and that mitigation measures are needed to reverse the negative effects of uncontrolled socio-economic practices.

Multilingual Education in Kenya: Debunking the Myths

ERIC Educational Resources Information Center

Orwenjo, Daniel Ochieng

2012-01-01

Arguments that have been advanced against multilingual education in Kenya and Africa in general are not new. Most post-colonial African governments have stuck to the pre-colonial education policies which have no relevance to the present day Africa and were, at best, guided by the interests of the colonial power. Unfortunately, most of the claims…

A school-based supplementary food programme in rural Kenya did not reduce children's intake at home.

PubMed

Gewa, Constance A; Murphy, Suzanne P; Weiss, Robert E; Neumann, Charlotte G

2013-04-01

To examine changes in energy intake along with markers of dietary quality (animal-source energy and protein intakes) among household members in the presence of supplementary school feeding in rural Kenya. A 2-year, longitudinal, randomized controlled feeding intervention study. Kyeni South Division, Embu District, Kenya. A total of 182 schoolchildren and selected household members. There was no evidence that schoolchildren who received supplementary snacks at school experienced reduced intakes at home or that intakes by other family members were increased at the expense of the schoolchild's intake. This analysis highlights a number of factors useful in planning for supplementary feeding interventions in rural Kenya and similar communities.

The development of the East African Rift system in north-central Kenya

NASA Astrophysics Data System (ADS)

Hackman, B. D.; Charsley, T. J.; Key, R. M.; Wilkinson, A. F.

1990-11-01

Between 1980 and 1986 geological surveying to produce maps on a scale of 1:250,000 was completed over an area of over 100,000 km 2 in north-central Kenya, bounded by the Equator, the Ethiopian border and longitudes 36° and 38 °E. The Gregory Rift, much of which has the structure of an asymmetric half-graben, is the most prominent component of the Cenozoic multiple rift system which extends up to 200 km to the east and for about 100 km to the west, forming the Kenya dome. On the eastern shoulder and fringes two en echelon arrays of late Tertiary to Quaternary multicentre shields can be recognized: to the south is the Aberdares-Mount Kenya-Nyambeni Range chain and, to the north the clusters of Mount Kulal, Asie, Huri Hills and Marsabit, with plateau lavas and fissure vents south of Marsabit in the Laisamis area. The Gregory Rift terminates at the southern end of Lake Turkana. Further north the rift system splays: the arcuate Kinu Sogo fault zone forms an offset link with the central Ethiopian Rift system. In the rifts of north-central Kenya volcanism, sedimentation and extensional tectonics commenced and have been continuous since the late Oligocene. Throughout this period the Elgeyo Fault acted as a major bounding fault. A comparative study of the northern and eastern fringes of the Kenya dome with the axial graben reinforces the impression of regional E-W asymmetry. Deviations from the essential N-trend of the Gregory Rift reflect structural weaknesses in the underlying Proterozoic basement, the Mozambique Orogenic Belt: thus south of Lake Baringo the swing to the southeast parallels the axes of the ca. 620 Ma phase folds. Secondary faults associated with this flexure have created a "shark tooth" array, an expression of en echelon offsets of the eastern margin of the Gregory Rift in a transtensional stress regime: hinge zones where major faults intersect on the eastern shoulder feature intense box faulting and ramp structures which have counterparts in the rift

Plant use of the Maasai of Sekenani Valley, Maasai Mara, Kenya

PubMed Central

Bussmann, Rainer W; Gilbreath, Genevieve G; Solio, John; Lutura, Manja; Lutuluo, Rumpac; Kunguru, Kimaren; Wood, Nick; Mathenge, Simon G

2006-01-01

Traditional plant use is of tremendous importance in many societies, including most rural African communities. This knowledge is however, rapidly dwindling due to changes towards a more Western lifestyle, and the influence of modern tourism. In case of the Sekenani Maasai, the recent change from a nomadic to a more sedentary lifestyle has not, thus far lead to a dramatic loss of traditional plant knowledge, when compared to other Maasai communities. However, in Sekenani, plants are used much less frequently for manufacturing tools, and for veterinary purposes, than in more remote areas. While the knowledge is still present, overgrazing and over-exploitation of plant resources have already led to a decline of the plant material available. This paper examines the plant use of the Maasai in the Sekenani Valley, North of the Masaai Mara National Reserve. The Maasai pastoralists of Kenya and Tanzania use a large part of the plants in their environment for many uses in daily life. The plant use and knowledge of the Sekenani Maasai is of particular interest, as their clan, the "Il-Purko", was moved from Central Kenya to this region by the British Colonial Administration in 1904. The results of this study indicate that despite their relocation 100 years ago, the local population has an extensive knowledge of the plants in their surroundings, and they ascribe uses to a large percentage of the plants found. One-hundred-fifty-five plant species were collected, identified and their Maa names and traditional uses recorded. Although fifty-one species were reported as of "no use", only eighteen of these had no Maasai name. Thirty-three were recognized by a distinctive Maa name. Thirty-nine species had a medicinal use, and 30 species served as fodder for livestock. Six species could not be identified. Of these plants five were addressed by the Maasai with distinct names. This exemplifies the Sekenani Maasai's in-depth knowledge of the plant resources. Traditionally, the Maasai

Diagnosis and Chemotherapy of Human Trypanosomiasis and Vector Ecology of Rift Valley Fever and Congo-Crimean Hemorrhagic Fever in Kenya

DTIC Science & Technology

1991-11-06

CONGO-CRIMEAN HEMORRHAGIC FEVER IN KENYA PRINCIPAL INVESTIGATOR: J. K. Omuse, Ph.D. CONTRACTING ORGANIZATION : Kenya Trypanosomiasis Research Institute P.O...Distribution unlimited 4. PERFORMING ORGANIZATION REPORT NUMBER(S) S. MONITORING ORGANIZATION REPORT NUMBER(S) Go. NAME OF PERFORMING ORGANIZATION 6b...OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION Kenya Trypanosomiasis (I akabe) Research Institute I 6r. ADDRESS (Cit,, State, and ZIP Cod#) 7b

Controlling user access to electronic resources without password

DOEpatents

Smith, Fred Hewitt

2015-06-16

Described herein are devices and techniques for remotely controlling user access to a restricted computer resource. The process includes pre-determining an association of the restricted computer resource and computer-resource-proximal environmental information. Indicia of user-proximal environmental information are received from a user requesting access to the restricted computer resource. Received indicia of user-proximal environmental information are compared to associated computer-resource-proximal environmental information. User access to the restricted computer resource is selectively granted responsive to a favorable comparison in which the user-proximal environmental information is sufficiently similar to the computer-resource proximal environmental information. In at least some embodiments, the process further includes comparing user-supplied biometric measure and comparing it with a predetermined association of at least one biometric measure of an authorized user. Access to the restricted computer resource is granted in response to a favorable comparison.

[Female migration and social change in Africa. The case of Kenya].

PubMed

Vorlaufer, K

1985-06-01

Causes of the recent increase in female rural-urban migration in Kenya are investigated. "Reasons for this additional migration-wave are to be found in a general weakening of traditional values and authorities, the increasing land shortage and the resulting population pressure in the rural areas, which are factors that do in fact force women to migrate to towns." Comparisons are made with male migration flows. Regional differences in migration patterns are also noted. The author concludes that the increase in female migration is not a result of greater emancipation of women but rather a symptom of increasing poverty among Kenya's female population. (SUMMARY IN ENG) excerpt

In Search of Remedy to Secondary School Dropout Pandemic in Kenya: Role of the Principal

ERIC Educational Resources Information Center

Achoka, J. S. K.

2007-01-01

As a nation, Kenya hopes to achieve Education for All (EFA) by the year 2015. This is an uphill task given the various challenges in the education sector. The year 2015 is also significant globally because it is the target year for the fulfillment of the eight-millennium goals. Kenya looks forward to have her people achieve the millennium goals…

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda.

PubMed

Bott, Sarah; Neuman, Melissa; Helleringer, Stephane; Desclaux, Alice; Asmar, Khalil El; Obermeyer, Carla Makhlouf

2015-10-01

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients' rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. This article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. It also explores health workers' fear of infection within the workplace and their reports on discrimination against HIV clients within health facilities. HIV care providers in Burkina Faso, Kenya and Uganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. They also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. Health workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with HIV, and also from difficult ethical dilemmas related to clients who do not disclose their HIV status to those around them, including partners. These findings suggest that providers of HIV testing and counselling need more resources and support, including better protections against HIV exposure in the workplace. The findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some

Roosting, social organization and the annual cycle in a Kenya population of the bat Pipistrellus nanus

USGS Publications Warehouse

O'Shea, Thomas J.

1980-01-01

The tiny (3.1–3.8 g) vespcrtilionid bat Pipistrellus nanus was studied in Kenya palm-thatched roofs from May 1973 to July 1974. Roosting social organization and related activities and behavior are described. ♂♂ held diurnal roosting territories where ♀♀ gathered in small and compositionally labile groups, attracted to the most vocal ♂♂. Annual variation in population-wide aspects of social organization follows predictable seasonal changes in climate and predator abundance. Variability between individuals follows a common mammalian pattern: high male competition for ♀, variance in presumed male reproductive success, and a mating system resembling one based on resource defense polygyny. Social organization in this population contrasts with that known from studies of other P. nanus populations.

Orphans and vulnerable children in Kenya: results from a nationally representative population-based survey.

PubMed

Lee, Veronica C; Muriithi, Patrick; Gilbert-Nandra, Ulrike; Kim, Andrea A; Schmitz, Mary E; Odek, James; Mokaya, Rose; Galbraith, Jennifer S

2014-05-01

In Kenya, it is estimated that there are approximately 3.6 million children aged <18 years who have been orphaned or who are vulnerable. We examined the data from the second Kenya AIDS Indicator Survey (KAIS 2012) to determine the number and profile of orphans and vulnerable children (OVC) in Kenya who were aged <18 years. KAIS 2012 was a nationally representative, population-based household survey. We analyzed the data for all the children from birth to age 17 years who resided in an eligible household so as to determine whether their parents were alive or had been very ill to define their OVC status. We estimated that there were 2.6 million OVC in Kenya in 2012, of whom 1.8 million were orphans and 750,000 were vulnerable. Among orphans, 15% were double orphans. Over one-third of all the OVC were aged between 10 and 14 years. Households with ≥1 OVC (12% of all households) were usually in the lowest 2 wealth quintiles, and 22% of OVC households had experienced moderate or severe hunger. Receipt of OVC support services was low for medical (3.7%), psychological (4.1%), social (1.3%), and material support (6.2%); educational support was slightly more common (11.5%). Orphanhood among children aged <15 years increased from 1993 to 2003 (P < 0.01) but declined from 2003 to 2012 (P < 0.01). The 2.6 million OVC constitute a significant proportion of Kenya's population aged <18 years. Special attention should be paid to OVC to prevent further vulnerability and ensure their well-being and development as they transition into adulthood.

Digitized Ethnic Hate Speech: Understanding Effects of Digital Media Hate Speech on Citizen Journalism in Kenya

ERIC Educational Resources Information Center

Kimotho, Stephen Gichuhi; Nyaga, Rahab Njeri

2016-01-01

Ethnicity in Kenya permeates all spheres of life. However, it is in politics that ethnicity is most visible. Election time in Kenya often leads to ethnic competition and hatred, often expressed through various media. Ethnic hate speech characterized the 2007 general elections in party rallies and through text messages, emails, posters and…

Gender Factor in Decision Making: Challenges Facing Women Leadership Development in Primary Schools' Management in Kenya

ERIC Educational Resources Information Center

Choge, Jepkemboi Ruth

2015-01-01

The degree of attention given to women leadership in Education in Kenya has increased considerably in the recent years especially after the government introduced the affirmative action for both girls and women in education and employment in support of Millennium Development Goals, World Conventions, the Kenya Vision 2030 blue print for economic…

Comparative efficacy of existing surveillance tools for Aedes aegypti in Western Kenya.

PubMed

Yalwala, Sancto; Clark, Jeffrey; Oullo, David; Ngonga, Daniel; Abuom, David; Wanja, Elizabeth; Bast, Joshua

2015-12-01

All traditional surveillance techniques for Aedes aegypti have been developed for the cosmopolitan domestic subspecies Ae. aegypti aegypti, and not the sylvatic subspecies, Ae. aegypti formosus. The predominant form in Western Kenya is Ae. aegypti formosus that is rarely associated with human habitations but is linked to transmission of sylvatic dengue virus strains. We compared five surveillance methods for their effectiveness in sampling Ae. aegypti formosus with the goal of determining a sustainable surveillance strategy in Kenya. The methods included larval and pupal surveys, oviposition trapping, BG-Sentinel trapping, resting boxes, and backpack aspirations. Larval and pupal surveys collected the highest number of Ae. aegypti formosus (51.3%), followed by oviposition traps (45.7%), BG-Sentinel traps (3.0%), and zero collected with either backpack aspiration or resting box collections. No Ae. aegypti formosus larvae or pupae were found indoors. The results indicate that oviposition traps and outdoor larval and pupal surveys were better surveillance methods for Ae. aegypti formosus in Western Kenya. © 2015 The Society for Vector Ecology.

Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya.

PubMed

Shretta, Rima; Johnson, Brittany; Smith, Lisa; Doumbia, Seydou; de Savigny, Don; Anupindi, Ravi; Yadav, Prashant

2015-02-05

Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated. In Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain

What has driven the decline of infant mortality in Kenya in the 2000s?

PubMed

Demombynes, Gabriel; Trommlerová, Sofia Karina

2016-05-01

Substantial declines in early childhood mortality have taken place in many countries in Sub-Saharan Africa. Kenya's infant mortality rate fell by 7.6 percent per year between 2003 and 2008, the fastest rate of decline among the 20 countries in the region for which recent Demographic and Health Survey (DHS) data are available. The average rate of decline across all 20 countries was 3.6 percent per year. Among the possible causes of the observed decline in Kenya is a large-scale campaign to distribute insecticide-treated bednets (ITN) which started in 2004. A Oaxaca-Blinder decomposition using DHS data shows that the increased ownership of bednets in endemic malaria zones explains 79 percent of the decline in infant mortality. Although the Oaxaca-Blinder method cannot identify causal effects, given the wide evidence basis showing that ITN usage can reduce malaria prevalence and the huge surge in ITN ownership in Kenya, it is likely that the decomposition results reflect at least in part a causal effect. The widespread ownership of ITNs in areas of Kenya where malaria is rare suggests that better targeting of ITN provision could improve the cost-effectiveness of such programs. Copyright © 2016. Published by Elsevier B.V.

Electronic theses and dissertations: a review of this valuable resource for nurse scholars worldwide.

PubMed

Goodfellow, L M

2009-06-01

A worldwide repository of electronic theses and dissertations (ETDs) could provide worldwide access to the most up-to-date research generated by masters and doctoral students. Until that international repository is established, it is possible to access some of these valuable knowledge resources. ETDs provide a technologically advanced medium with endless multimedia capabilities that far exceed the print and bound copies of theses and dissertations housed traditionally in individual university libraries. CURRENT USE: A growing trend exists for universities worldwide to require graduate students to submit theses or dissertations as electronic documents. However, nurse scholars underutilize ETDs, as evidenced by perusing bibliographic citation lists in many of the research journals. ETDs can be searched for and retrieved through several digital resources such as the Networked Digital Library of Theses and Dissertations (http://www.ndltd.org), ProQuest Dissertations and Theses (http://www.umi.com), the Australasian Digital Theses Program (http://adt.caul.edu.au/) and through individual university web sites and online catalogues. An international repository of ETDs benefits the community of nurse scholars in many ways. The ability to access recent graduate students' research electronically from anywhere in the world is advantageous. For scholars residing in developing countries, access to these ETDs may prove to be even more valuable. In some cases, ETDs are not available for worldwide access and can only be accessed through the university library from which the student graduated. Public access to university library ETD collections is not always permitted. Nurse scholars from both developing and developed countries could benefit from ETDs.

Ethnopharmacological survey of Samburu district, Kenya

PubMed Central

Nanyingi, Mark O; Mbaria, James M; Lanyasunya, Adamson L; Wagate, Cyrus G; Koros, Kipsengeret B; Kaburia, Humphrey F; Munenge, Rahab W; Ogara, William O

2008-01-01

Background Ethnobotanical pharmacopoeia is confidently used in disease intervention and there is need for documentation and preservation of traditional medical knowledge to bolster the discovery of novel drugs. The objective of the present study was to document the indigenous medicinal plant utilization, management and their extinction threats in Samburu District, Kenya. Methods Field research was conducted in six divisions of Samburu District in Kenya. We randomly sampled 100 consented interviewees stratified by age, gender, occupation and level of education. We collected plant use data through semi-structured questionnaires; transect walks, oral interviews and focus groups discussions. Voucher specimens of all cited botanic species were collected and deposited at University of Nairobi's botany herbarium. Results Data on plant use from the informants yielded 990 citations on 56 medicinal plant species, which are used to treat 54 different animal and human diseases including; malaria, digestive disorders, respiratory syndromes and ectoparasites. Conclusion The ethnomedicinal use of plant species was documented in the study area for treatment of both human and veterinary diseases. The local population has high ethnobotanical knowledge and has adopted sound management conservation practices. The major threatening factors reported were anthropogenic and natural. Ethnomedical documentation and sustainable plant utilization can support drug discovery efforts in developing countries. PMID:18498665

Girls' Attitudes Towards Science in Kenya

NASA Astrophysics Data System (ADS)

Chetcuti, Deborah A.; Kioko, Beriter

2012-07-01

This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences in attitudes in SS and Co-Ed schools and in schools in rural and urban areas. The methodology included the use of both questionnaires and focus group interviews. The main aim was to gain insight into the extent and depth of students' attitudes towards science. The findings of the study showed that the majority of Kenyan girls who participated in the study have a favourable attitude towards science. Girls in SS schools were found to have a more favourable attitude than those in Co-Ed schools, while girls in rural area schools were found to find science more relevant than those in urban schools. It emerged from this study that the attitudes of Kenyan girls are influenced by their perceptions of the relevance of science, enjoyment of studying science, perceptions of the suitability of science for a career, and their perceptions of subject difficulty.

Conservation of living resources in a changing world

NASA Astrophysics Data System (ADS)

Teer, James G.

1996-11-01

Conservation of living resources is no longer parochial in scope; it is a global challenge. Ecological, social, political, and business interests operate in a network that reaches across seas, continents, and nations. Industries, including the electric utility industry, are diversifying in products and expanding into international markets. They soon discover that, while all nations have common goals for their peoples, conservation and environmental issues in less-developed nations have different dimensions and norms than are encountered in Western, affluent societies. In developing countries, survival is more of an issue than quality of life, and burgeoning human numbers have put tremendous pressures on resources including wildlife and its habitats. Human population, urbanization of society, changes in single-species to ecosystem and landscape levels of management, and protectionists and animal rights philosophies are influences with which conservation of resources and the environment must contend. The human condition and conservation efforts are inextricably linked. Examples to demonstrate this fact are given for Project Tiger in India, the jaguar in Latin America, and the Serengeti ecosystem in Kenya and Tanzania.

Principles, practices and knowledge of clinicians when assessing febrile children: a qualitative study in Kenya.

PubMed

Hooft, Anneka M; Ripp, Kelsey; Ndenga, Bryson; Mutuku, Francis; Vu, David; Baltzell, Kimberly; Masese, Linnet N; Vulule, John; Mukoko, Dunstan; LaBeaud, A Desiree

2017-09-20

Clinicians in low resource settings in malaria endemic regions face many challenges in diagnosing and treating febrile illnesses in children. Given the change in WHO guidelines in 2010 that recommend malaria testing prior to treatment, clinicians are now required to expand the differential when malaria testing is negative. Prior studies have indicated that resource availability, need for additional training in differentiating non-malarial illnesses, and lack of understanding within the community of when to seek care play a role in effective diagnosis and treatment. The objective of this study was to examine the various factors that influence clinician behavior in diagnosing and managing children presenting with fever to health centres in Kenya. A total of 20 clinicians (2 paediatricians, 1 medical officer, 2 nurses, and 15 clinical officers) were interviewed, working at 5 different government-sponsored public clinic sites in two areas of Kenya where malaria is prevalent. Clinicians were interviewed one-on-one using a structured interview technique. Interviews were then analysed qualitatively for themes. The following five themes were identified: (1) Strong familiarity with diagnosis of malaria and testing for malaria; (2) Clinician concerns about community understanding of febrile illness, use of traditional medicine, delay in seeking care, and compliance; (3) Reliance on clinical guidelines, history, and physical examination to diagnose febrile illness and recognize danger signs; (4) Clinician discomfort with diagnosis of primary viral illness leading to increased use of empiric antibiotics; and (5) Lack of resources including diagnostic testing, necessary medications, and training modalities contributes to the difficulty clinicians face in assessing and treating febrile illness in children. These themes persisted across all sites, despite variation in levels of medical care. Within these themes, clinicians consistently expressed a need for reliable basic testing

Sustainable water use and management options in a water-stressed river basin in Kenya

NASA Astrophysics Data System (ADS)

Hirpa, Feyera; Dadson, Simon; Dyer, Ellen; Barbour, Emily; Charles, Katrina; Hope, Robert

2017-04-01

Sustainable water resource is critical for maintaining healthy ecosystems and supporting socio-economic sectors. Hydro-climatic change and variability, population growth as well as new infrastructure developments create water security risks. Therefore, evidence-based management decisions are necessary to improve water security and meet the future water demands of multiple competing sectors. In this work we perform water resource modelling in order to investigate the impact of increasing water demand (expanding agriculture, booming industry, growing population) on the sustainable water use in Turkwel river basin, located in arid north-western Kenya. We test different management options to determine those that meet the water demands of the concerned sectors whilst minimising environmental impact. We perform scenario analysis using Water Evaluation And Planning (WEAP) model to explore different ranges of climate conditions, population growth rates, irrigation scale, reservoir operations, and economic development. The results can be used as a scientific guideline for the policy makers who decide the alternative management options that ensure the sustainable water use in the basin. The work is part of the REACH - improving water security for the poor program (http://reachwater.org.uk/), aiming to support a pathway to sustainable growth and poverty reduction

Ethnobotany of the Samburu of Mt. Nyiru, South Turkana, Kenya

PubMed Central

Bussmann, Rainer W

2006-01-01

Traditional plant use is of extremely high importance in many societies, and prevalent in African communities. This knowledge is however dwindling rapidly due to changes towards a more Western lifestyle. The influence of modern tourism cannot be neglected in this context. This paper examines the plant use of the Samburu of the Mt. Nyiru area in Northern Kenya. The Samburu pastoralists of Kenya are still amongst the most traditional communities of the country and have retained most of their knowledge about the use of a large part of the plants in their environment for a wide variety of purposes. The results indicate that the local population has a very high knowledge of the plants in their surroundings, and attributes a purpose to a large percentage of the plants found. 448 plant species were collected, identified and their Samburu names and traditional uses recorded. 199 species were reported as of "no use". The high proportion of 249 plant species however had some traditional use: The highest number (180 species) was used as fodder, followed by 80 species that had medicinal use. Firewood (59 species), construction (42 species), tools (31 species), food (29 species) and ceremonial use (19 species) ranked far behind. Traditionally the Samburu attribute most illnesses to the effect of pollutants that block or inhibit digestion. This can include "polluted" food, contagion through sick people as well as witchcraft. In most cases the treatment of illness involves herbal purgatives to cleanse the patient. There are however frequent indications of plant use for common problems like wounds, parasites, body aches and burns. The change from a nomadic to a more sedentary lifestyle, often observed in other areas of the country, has affected the Samburu of remote Mt. Nyiru to a much lesser extent and did so far not lead to a major loss of traditional plant knowledge. However, overgrazing and over-exploitation of plant resources have already led to a decline of the plant

Extreme Wildlife Declines and Concurrent Increase in Livestock Numbers in Kenya: What Are the Causes?

PubMed

Ogutu, Joseph O; Piepho, Hans-Peter; Said, Mohamed Y; Ojwang, Gordon O; Njino, Lucy W; Kifugo, Shem C; Wargute, Patrick W

There is growing evidence of escalating wildlife losses worldwide. Extreme wildlife losses have recently been documented for large parts of Africa, including western, Central and Eastern Africa. Here, we report extreme declines in wildlife and contemporaneous increase in livestock numbers in Kenya rangelands between 1977 and 2016. Our analysis uses systematic aerial monitoring survey data collected in rangelands that collectively cover 88% of Kenya's land surface. Our results show that wildlife numbers declined on average by 68% between 1977 and 2016. The magnitude of decline varied among species but was most extreme (72-88%) and now severely threatens the population viability and persistence of warthog, lesser kudu, Thomson's gazelle, eland, oryx, topi, hartebeest, impala, Grevy's zebra and waterbuck in Kenya's rangelands. The declines were widespread and occurred in most of the 21 rangeland counties. Likewise to wildlife, cattle numbers decreased (25.2%) but numbers of sheep and goats (76.3%), camels (13.1%) and donkeys (6.7%) evidently increased in the same period. As a result, livestock biomass was 8.1 times greater than that of wildlife in 2011-2013 compared to 3.5 times in 1977-1980. Most of Kenya's wildlife (ca. 30%) occurred in Narok County alone. The proportion of the total "national" wildlife population found in each county increased between 1977 and 2016 substantially only in Taita Taveta and Laikipia but marginally in Garissa and Wajir counties, largely reflecting greater wildlife losses elsewhere. The declines raise very grave concerns about the future of wildlife, the effectiveness of wildlife conservation policies, strategies and practices in Kenya. Causes of the wildlife declines include exponential human population growth, increasing livestock numbers, declining rainfall and a striking rise in temperatures but the fundamental cause seems to be policy, institutional and market failures. Accordingly, we thoroughly evaluate wildlife conservation

Factors Affecting Subsidized Free Day Secondary Education in Enhancing Learners Retention in Secondary Schools in Kenya

ERIC Educational Resources Information Center

James, Asena Muganda; Simiyu, Aggrey Mukasa; Riechi, Andrew

2016-01-01

Learners are the key stakeholders of a school for it to be registered by the Department of Education. However the retention of these learners in Kenya's Secondary Level Education is a great challenge in Kenya. Every secondary school dropout signifies unfulfilled objective, goal and aim for the individual as well as the community at large. The…

Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia.

PubMed

Chopra, Mickey; Doherty, Tanya; Mehatru, Saba; Tomlinson, Mark

2009-12-01

The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints. Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers. A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007. Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources. In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT

Modern contraceptive use among migrant and non-migrant women in Kenya.

PubMed

Ochako, Rhoune; Askew, Ian; Okal, Jerry; Oucho, John; Temmerman, Marleen

2016-06-01

Manifest socio-economic differences are a trigger for internal migration in many sub-Saharan settings including Kenya. An interplay of the social, political and economic factors often lead to internal migration. Internal migration potentially has significant consequences on an individual's economic growth and on access to health services, however, there has been little research on these dynamics. In Kenya, where regional differentials in population growth and poverty reduction continue to be priorities in the post MDG development agenda, understanding the relationships between contraceptive use and internal migration is highly relevant. Using data from the 2008-09 Kenya Demographic and Health Survey (DHS), we analyze data from 5,905 women aged 15-49 years who reported being sexually active in the last 12 months prior to the survey. Bivariate and multivariate logistic regressions are fitted to predict correlates of contraceptive use in the presence of migration streams among other explanatory variables. Modern contraceptive use was significantly higher among women in all migration streams (non-migrant urban (OR = 2.8, p < 0.001), urban-urban (OR = 2.0, p < 0.001), urban-rural (OR = 2.0, p < 0.001), rural-urban (OR = 2.6, p < 0.001), rural-rural (OR = 1.7, p < 0.001), than non-migrant rural women. Women who internally migrate within Kenya, whether from rural to urban or between urban centres, were more likely to use modern contraception than non-migrant rural women. This phenomenon appears to be due to selection, adaption and disruption effects which are likely to promote use of modern contraceptives. Programmatically, the differentials in modern contraceptive use by the different migration streams should be considered when designing family planning programmes among migrant and non-migrant women.

Examining levels, distribution and correlates of health insurance coverage in Kenya.

PubMed

Kazungu, Jacob S; Barasa, Edwine W

2017-09-01

To examine the levels, inequalities and factors associated with health insurance coverage in Kenya. We analysed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorise households into five socio-economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high-low ratio (Q5/Q1 ratio), concentration curve and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage. Overall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX = 0.61, 95% CI 0.52-0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX = 0.49, 95% CI 0.45-0.52). Individuals that were older, employed in the formal sector; married, exposed to media; and male, belonged to a small household, had a chronic disease and belonged to rich households, had increased odds of health insurance coverage. Health insurance coverage in Kenya remains low and is characterised by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax-funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered. © 2017 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Influenza-Associated Disease Burden in Kenya: A Systematic Review of Literature

PubMed Central

Emukule, Gideon O.; Paget, John; van der Velden, Koos; Mott, Joshua A.

2015-01-01

Background In Kenya data on the burden of influenza disease are needed to inform influenza control policies. Methods We conducted a systematic review of published data describing the influenza disease burden in Kenya using surveillance data collected until December 2013. We included studies with laboratory confirmation of influenza, well-defined catchment populations, case definitions used to sample patients for testing and a description of the laboratory methods used for influenza testing. Studies with or without any adjustments on the incidence rates were included. Results Ten studies reporting the incidence of medically-attended and non-medically attended influenza were reviewed. For all age groups, the influenza positive proportion ranged from 5–10% among hospitalized patients, and 5–27% among all medically-attended patients (a combination of in- and outpatients). The adjusted incidence rate of hospitalizations with influenza among children <5 years ranged from 2.7–4.7 per 1,000 [5.7 per 1,000 in children <6 months old], and were 7–10 times higher compared to persons aged ≥5 years. The adjusted incidence of all medically-attended influenza among children aged <5 years ranged from 13.0–58.0 per 1,000 compared to 4.3–26.0 per 1,000 among persons aged ≥5 years. Conclusions Our review shows an expanding set of literature on disease burden associated with influenza in Kenya, with a substantial burden in children under five years of age. Hospitalizations with influenza in these children were 2–3 times higher than reported in the United States. These findings highlight the possible value of an influenza vaccination program in Kenya, with children <5 years and pregnant women being potentially important targets. PMID:26398196

Connective power: Solar electrification and social change in Kenya

NASA Astrophysics Data System (ADS)

Jacobson, Arne Edward

Household solar photovoltaic systems have emerged as a key alternative to grid-based rural electrification in many developing countries. This may seem a victory for appropriate technology advocates, but my research indicates that the social significance of solar electrification in Kenya, which is among the largest developing country solar markets per capita, is far removed from the classic "small is beautiful" neo-populist vision of building small-scale alternatives to global capitalism. Instead, solar electrification is more closely connected to neo-liberal goals of market-based service provision and economic integration. In this study I combine quantitative and qualitative methods, including surveys, intra-household energy allocation studies, and historical analysis, to analyze the social significance of solar electrification in Kenya. I find that "connective" applications, including television, radio, and cellphones, are centrally important. Television is especially notable; the expansion of TV broadcasting to rural areas was a key condition for solar market development. Solar electricity is also used for lighting. In Kenya, income and work related uses of solar lighting are modest, while education uses are more significant. However, in many households, especially those with small systems, intra-household dynamics constrain key social uses (e.g. children's studying), as the energy is allocated to other uses. Social use patterns combine with access dynamics in Kenya's unsubsidized market to shape the social significance of solar electrification. Solar ownership is dominated by the rural upper and middle classes. Thus, productivity and education uses make small contributions to differentiation and middle class formation. Additionally, solar electrification's role in supporting rural television and radio use improves business advertisers' ability to expand consumer goods markets. These findings link solar electrification to important processes of rural development

Rural culture and the conservation of Mackinders eagle owls (Bubo capensis mackinderi) in Kenya.

PubMed

Ogada, Darcy L

2008-06-01

The author describes her fieldwork studying a population of Mackinders eagle owls that live adjacent to small-scale farms in rural Kenya. Her study investigated the effects of farming practices on the diet and breeding ecology of the owls. She documented local people's attitudes toward owls since owls are taboo throughout Africa. She describes a typical day in the field, the community aspect of her project, her unique experiences studying owls in Kenya, and promotion of owl tourism.

Improving medical education in Kenya: an international collaboration*†

PubMed Central

Mayo, Alexa

2014-01-01

This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya. PMID:24860265

Barriers to prompt and effective malaria treatment among the poorest population in Kenya.

PubMed

Chuma, Jane; Okungu, Vincent; Molyneux, Catherine

2010-05-27

Prompt access to effective malaria treatment is central to the success of malaria control worldwide, but few fevers are treated with effective anti-malarials within 24 hours of symptoms onset. The last two decades saw an upsurge of initiatives to improve access to effective malaria treatment in many parts of sub-Saharan Africa. Evidence suggests that the poorest populations remain least likely to seek prompt and effective treatment, but the factors that prevent them from accessing interventions are not well understood. With plans under way to subsidize ACT heavily in Kenya and other parts of Africa, there is urgent need to identify policy actions to promote access among the poor. This paper explores access barriers to effective malaria treatment among the poorest population in four malaria endemic districts in Kenya. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: a cross-sectional survey (n=708 households); 24 focus group discussions; semi-structured interviews with health workers (n=34); and patient exit interviews (n=359). Multiple factors related to affordability, acceptability and availability interact to influence access to prompt and effective treatment. Regarding affordability, about 40 percent of individuals who self-treated using shop-bought drugs and 42 percent who visited a formal health facility reported not having enough money to pay for treatment, and having to adopt coping strategies including borrowing money and getting treatment on credit in order to access care. Other factors influencing affordability were seasonality of illness and income sources, transport costs, and unofficial payments. Regarding acceptability, the major interrelated factors identified were provider patient relationship, patient expectations, beliefs on illness causation, perceived effectiveness of treatment, distrust in the quality of care and poor adherence to treatment regimes

School Participation for Children with Disabilities in Kenya

ERIC Educational Resources Information Center

Moyi, Peter

2017-01-01

In Kenya, policies to increase access to quality education have largely focused on reducing rural/urban, gender, and income inequality. Yet, many children do not attend or fully participate in school because they have physical and mental disabilities. The goal of this paper is to examine school enrollment, attendance, and primary school completion…

The electronic encapsulation of knowledge in hydraulics, hydrology and water resources

NASA Astrophysics Data System (ADS)

Abbott, Michael B.

The rapidly developing practice of encapsulating knowledge in electronic media is shown to lead necessarily to the restructuring of the knowledge itself. The consequences of this for hydraulics, hydrology and more general water-resources management are investigated in particular relation to current process-simulation, real-time control and advice-serving systems. The generic properties of the electronic knowledge encapsulator are described, and attention is drawn to the manner in which knowledge 'goes into hiding' through encapsulation. This property is traced in the simple situations of pure mathesis and in the more complex situations of taxinomia using one example each from hydraulics and hydrology. The consequences for systems architectures are explained, pointing to the need for multi-agent architectures for ecological modelling and for more general hydroinformatics systems also. The relevance of these developments is indicated by reference to ongoing projects in which they are currently being realised. In conclusion, some more general epistemological aspects are considered within the same context. As this contribution is so much concerned with the processes of signification and communication, it has been partly shaped by the theory of semiotics, as popularised by Eco ( A Theory of Semiotics, Indiana University, Bloomington, 1977).

Treatment outcomes of a Stage 1 cognitive-behavioral trial to reduce alcohol use among HIV-infected outpatients in western Kenya

PubMed Central

Papas, Rebecca K.; Sidle, John E.; Gakinya, Benson N.; Baliddawa, Joyce B.; Martino, Steve; Mwaniki, Michael M.; Songole, Rogers; Omolo, Otieno E.; Kamanda, Allan M.; Ayuku, David O.; Ojwang, Claris; Owino-Ong’or, Willis D.; Harrington, Magdalena; Bryant, Kendall J.; Carroll, Kathleen M.; Justice, Amy C.; Hogan, Joseph W.; Maisto, Stephen A.

2011-01-01

Aims Dual epidemics of HIV and alcohol use disorders, and a dearth of professional resources for behavioral treatment in sub-Saharan Africa, suggest the need for development of culturally relevant and feasible interventions. The purpose of this study was to test the preliminary efficacy of a culturally adapted 6-session gender-stratified group cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Design Randomized clinical trial comparing CBT against a usual care assessment only control Setting A large HIV outpatient clinic in Eldoret, Kenya, part of the Academic Model for Providing Access to Healthcare collaboration Participants 75 HIV-infected outpatients who were antiretroviral (ARV)-initiated or ARV-eligible and who reported hazardous or binge drinking Measurements Percent drinking days (PDD) and mean drinks per drinking days (DDD) measured continuously using the Timeline Followback Findings There were 299 ineligible and 102 eligible outpatients with 12 refusals. Effect sizes of the change in alcohol use since baseline between the two conditions at the 30-day follow-up were large (d=.95, p=.0002, mean difference=24.93 (95% CI: 12.43, 37.43) PDD; d=.76, p=.002, mean difference=2.88 (95% CI: 1.05, 4.70) DDD). Randomized participants attended 93% of the 6 CBT sessions offered. Reported alcohol abstinence at the 90-day follow-up was 69.4% (CBT) and 37.5% (usual care). Paraprofessional counselors achieved independent ratings of adherence and competence equivalent to college-educated therapists in the U.S. Treatment effect sizes were comparable to alcohol intervention studies conducted in the U.S. Conclusions Cognitive-behavioral therapy can be successfully adapted to group paraprofessional delivery in Kenya and may be effective in reducing alcohol use among HIV-infected Kenyan outpatients. PMID:21631622

Integration of Palliative Care Into Comprehensive Cancer Treatment at Moi Teaching and Referral Hospital in Western Kenya

PubMed Central

Kipsang, Susan; Gramelspacher, Gregory; Choi, Eunyoung; Brown, Colleen; Hill, Adam B.; Loehrer, Patrick J.; Busakhala, Naftali; Chite Asirwa, F.

2015-01-01

Purpose The prognosis for the majority of patients with cancer in Kenya is poor, with most patients presenting with advanced disease. In addition, many patients are unable to afford the optimal therapies required. Therefore, palliative care is an essential part of comprehensive cancer care. This study reviews the implementation of a palliative care service based at the Moi Teaching and Referral Hospital in Eldoret, Kenya, and describes the current scope and challenges of providing palliative care services in an East African tertiary public referral hospital. Methods This is a review of the palliative care clinical services at the only tertiary public referral hospital in western Kenya from January 2012 through September 2014. Palliative care team members documented each patient's encounter on standardized palliative care assessment forms; data were then entered into the Academic Model Providing Access to Health Care (AMPATH)-Oncology database. Interviews were also conducted to identify current challenges and opportunities for program improvement. Results This study documents the implementation of a palliative care service line in Eldoret, Kenya. Barriers to providing optimal palliative cancer care include distance to pharmacies that stock opioids, limited selection of opioid preparations, education of health care workers in palliative care, access to palliative chemoradiation, and limited availability of outpatient and inpatient hospice services. Conclusion Palliative care services in Eldoret, Kenya, have become a key component of its comprehensive cancer treatment program. PMID:28804768

Integration of Palliative Care Into Comprehensive Cancer Treatment at Moi Teaching and Referral Hospital in Western Kenya.

PubMed

Cornetta, Kenneth; Kipsang, Susan; Gramelspacher, Gregory; Choi, Eunyoung; Brown, Colleen; Hill, Adam B; Loehrer, Patrick J; Busakhala, Naftali; Chite Asirwa, F

2015-10-01

The prognosis for the majority of patients with cancer in Kenya is poor, with most patients presenting with advanced disease. In addition, many patients are unable to afford the optimal therapies required. Therefore, palliative care is an essential part of comprehensive cancer care. This study reviews the implementation of a palliative care service based at the Moi Teaching and Referral Hospital in Eldoret, Kenya, and describes the current scope and challenges of providing palliative care services in an East African tertiary public referral hospital. This is a review of the palliative care clinical services at the only tertiary public referral hospital in western Kenya from January 2012 through September 2014. Palliative care team members documented each patient's encounter on standardized palliative care assessment forms; data were then entered into the Academic Model Providing Access to Health Care (AMPATH)-Oncology database. Interviews were also conducted to identify current challenges and opportunities for program improvement. This study documents the implementation of a palliative care service line in Eldoret, Kenya. Barriers to providing optimal palliative cancer care include distance to pharmacies that stock opioids, limited selection of opioid preparations, education of health care workers in palliative care, access to palliative chemoradiation, and limited availability of outpatient and inpatient hospice services. Palliative care services in Eldoret, Kenya, have become a key component of its comprehensive cancer treatment program.

Integration of mental health into primary care in Kenya

PubMed Central

JENKINS, RACHEL; KIIMA, DAVID; NJENGA, FRANK; OKONJI, MARX; KINGORA, JAMES; KATHUKU, DAMMAS; LOCK, SARAH

2010-01-01

Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

How Confounder Strength Can Affect Allocation of Resources in Electronic Health Records.

PubMed

Lynch, Kristine E; Whitcomb, Brian W; DuVall, Scott L

2018-01-01

When electronic health record (EHR) data are used, multiple approaches may be available for measuring the same variable, introducing potentially confounding factors. While additional information may be gleaned and residual confounding reduced through resource-intensive assessment methods such as natural language processing (NLP), whether the added benefits offset the added cost of the additional resources is not straightforward. We evaluated the implications of misclassification of a confounder when using EHRs. Using a combination of simulations and real data surrounding hospital readmission, we considered smoking as a potential confounder. We compared ICD-9 diagnostic code assignment, which is an easily available measure but has the possibility of substantial misclassification of smoking status, with NLP, a method of determining smoking status that more expensive and time-consuming than ICD-9 code assignment but has less potential for misclassification. Classification of smoking status with NLP consistently produced less residual confounding than the use of ICD-9 codes; however, when minimal confounding was present, differences between the approaches were small. When considerable confounding is present, investing in a superior measurement tool becomes advantageous.

Community perceptions of malaria and vaccines in the South Coast and Busia regions of Kenya

PubMed Central

2011-01-01

Background Malaria is a leading cause of morbidity and mortality in children younger than 5 years in Kenya. Within the context of planning for a vaccine to be used alongside existing malaria control methods, this study explores sociocultural and health communications issues among individuals who are responsible for or influence decisions on childhood vaccination at the community level. Methods This qualitative study was conducted in two malaria-endemic regions of Kenya--South Coast and Busia. Participant selection was purposive and criterion based. A total of 20 focus group discussions, 22 in-depth interviews, and 18 exit interviews were conducted. Results Participants understand that malaria is a serious problem that no single tool can defeat. Communities would welcome a malaria vaccine, although they would have questions and concerns about the intervention. While support for local child immunization programs exists, limited understanding about vaccines and what they do is evident among younger and older people, particularly men. Even as health care providers are frustrated when parents do not have their children vaccinated, some parents have concerns about access to and the quality of vaccination services. Some women, including older mothers and those less economically privileged, see themselves as the focus of health workers' negative comments associated with either their parenting choices or their children's appearance. In general, parents and caregivers weigh several factors--such as personal opportunity costs, resource constraints, and perceived benefits--when deciding whether or not to have their children vaccinated, and the decision often is influenced by a network of people, including community leaders and health workers. Conclusions The study raises issues that should inform a communications strategy and guide policy decisions within Kenya on eventual malaria vaccine introduction. Unlike the current practice, where health education on child welfare and

Knowledge of Mange among Masai Pastoralists in Kenya

PubMed Central

Gakuya, Francis; Ombui, Jackson; Heukelbach, Jorg; Maingi, Ndichu; Muchemi, Gerald; Ogara, William; Mijele, Domnic; Alasaad, Samer

2012-01-01

Background Pastoralists in low-income countries usually live in close proximity to their animals and thus represent an important repository of information about livestock disease. Since wild and domestic animals often mix freely whilst grazing, pastoralists are also able to observe first-hand the diseases that are present in wildlife and as such are key informants in disease outbreaks in sylvatic animals. We report here the findings of the first study of the knowledge and role of Masai pastoralists in mange in wildlife and livestock in Masai Mara, Kenya. Methodology/Principal Findings In this paper we describe the knowledge of mange accrued by 56 Masai pastoralists in Kenya and how they respond to it in both wildlife and livestock. In total, 52 (93%) pastoralists had a clear idea of the clinical appearance of mange, 13 (23%) understood its aetiology and 37 (66%) knew that mites were the causal agent. Thirty-nine (69%) believed that mange cross-infection between domestic and wild animals occurs, while 48 (85%) had observed mange in domestic animals including sheep (77%), goats (57%), dogs (24%) and cattle (14%). The pastoralists had also observed wild animals infected with mange, above all lions (19%), gazelles (14%), cheetahs (12%) and wildebeests (2%). In 68% of cases Masai pastoralists treat mange infection or apply control measures, most commonly via the topical use of acaricides (29%) and/or the reporting of the outbreak to the veterinary authorities (21%). In the period 2007–2011, Kenya Wildlife Service received 24 warnings of 59 wild animals with mange-like lesions from the Masai Mara pastoralist community. The reported species were cheetah, lion, wild dog, Thomson’s gazelle and wildebeest. Conclusion Masai pastoralists have good knowledge of mange epidemiology and treatment. Their observations and the treatments they apply are valuable in the control of this disease in both wild and domestic animals. PMID:22912858

The Free Education Policy in Kenya: A Critique

ERIC Educational Resources Information Center

Limukii, Kaberia E.; Mualuko, Ndiku J.

2012-01-01

Educational reforms are crucial in a country if the reforms benefit the intended target group. One of the educational reforms in Kenya was the introduction of Free Primary Education. This was informed by the need to improve access and equity in provision of education. Informed by the need to eradicate ignorance, poverty and disease, the…

Universalising Primary Education in Kenya: The Elusive Goal

ERIC Educational Resources Information Center

Somerset, Anthony

2009-01-01

Since Independence in 1963, Kenya has launched three Free Primary Education programmes: the first in 1974, the second in 1979 and the most recent in 2003. Using historical data, this paper first outlines each initiative in turn, and discusses why, in the case of the earlier initiatives, impressive initial gains in improved access proved difficult…

The occurrence and geochemistry of fluoride in some natural waters of Kenya

NASA Astrophysics Data System (ADS)

Gaciri, S. J.; Davies, T. C.

1993-03-01

In recent years the acquisition of considerable additional data on the hydrogeochemical behaviour of fluoride in natural waters of Kenya has been made possible by extensive surface-water and groundwater sampling campaigns as well as by improvements in analytical techniques. Ultimately, the principal source of fluoride relates to emissions from volcanic activity associated with the East African Rift System. Through various intermediate steps, but also directly, fluoride passes into the natural water system and components of the food chain. Ingestion by man is mainly through drinking water and other beverages. River waters in Kenya generally have a fluoride concentration lower than the recommended level (1.3 ppm) for potable water, thus promoting susceptibility to dental caries. Groundwaters and lake waters show considerably higher fluoride contents, resulting in the widespread incidence of fluorosis in areas where groundwater is the major source of drinking water, and lake fish is a regular component of the diet. This paper presents a synthesis of the data so far obtained on the sources and distribution of fluoride in the hydrological system of Kenya, examines the extent of fluorine toxicity and puts forward recommendations to combat or minimise the problem.

Tracking the Flow of Resources in Electronic Waste - The Case of End-of-Life Computer Hard Disk Drives.

PubMed

Habib, Komal; Parajuly, Keshav; Wenzel, Henrik

2015-10-20

Recovery of resources, in particular, metals, from waste flows is widely seen as a prioritized option to reduce their potential supply constraints in the future. The current waste electrical and electronic equipment (WEEE) treatment system is more focused on bulk metals, where the recycling rate of specialty metals, such as rare earths, is negligible compared to their increasing use in modern products, such as electronics. This study investigates the challenges in recovering these resources in the existing WEEE treatment system. It is illustrated by following the material flows of resources in a conventional WEEE treatment plant in Denmark. Computer hard disk drives (HDDs) containing neodymium-iron-boron (NdFeB) magnets were selected as the case product for this experiment. The resulting output fractions were tracked until their final treatment in order to estimate the recovery potential of rare earth elements (REEs) and other resources contained in HDDs. The results further show that out of the 244 kg of HDDs treated, 212 kg comprising mainly of aluminum and steel can be finally recovered from the metallurgic process. The results further demonstrate the complete loss of REEs in the existing shredding-based WEEE treatment processes. Dismantling and separate processing of NdFeB magnets from their end-use products can be a more preferred option over shredding. However, it remains a technological and logistic challenge for the existing system.

HIV Type 1 Transmission Networks Among Men Having Sex with Men and Heterosexuals in Kenya

PubMed Central

Faria, Nuno Rodrigues; Hassan, Amin; Hamers, Raph L.; Mutua, Gaudensia; Anzala, Omu; Mandaliya, Kishor; Cane, Patricia; Berkley, James A.; Rinke de Wit, Tobias F.; Wallis, Carole; Graham, Susan M.; Price, Matthew A.; Coutinho, Roel A.; Sanders, Eduard J.

2014-01-01

Abstract We performed a molecular phylogenetic study on HIV-1 polymerase sequences of men who have sex with men (MSM) and heterosexual patient samples in Kenya to characterize any observed HIV-1 transmission networks. HIV-1 polymerase sequences were obtained from samples in Nairobi and coastal Kenya from 84 MSM, 226 other men, and 364 women from 2005 to 2010. Using Bayesian phylogenetics, we tested whether sequences clustered by sexual orientation and geographic location. In addition, we used trait diffusion analyses to identify significant epidemiological links and to quantify the number of transmissions between risk groups. Finally, we compared 84 MSM sequences with all HIV-1 sequences available online at GenBank. Significant clustering of sequences from MSM at both coastal Kenya and Nairobi was found, with evidence of HIV-1 transmission between both locations. Although a transmission pair between a coastal MSM and woman was confirmed, no significant HIV-1 transmission was evident between MSM and the comparison population for the predominant subtype A (60%). However, a weak but significant link was evident when studying all subtypes together. GenBank comparison did not reveal other important transmission links. Our data suggest infrequent intermingling of MSM and heterosexual HIV-1 epidemics in Kenya. PMID:23947948

Is There an Enabling Environment for Nutrition-Sensitive Agriculture in East Africa? Stakeholder Perspectives From Ethiopia, Kenya, and Uganda.

PubMed

Hodge, Judith; Herforth, Anna; Gillespie, Stuart; Beyero, Mesfin; Wagah, Margaret; Semakula, Richard

2015-12-01

There is growing recognition that "nutrition-sensitive" development is necessary to ensure nutrition security and reduce malnutrition. While agriculture has the potential to be a strong driver of malnutrition reduction and serves as the main source of livelihood for approximately two-thirds of East Africa's population, its potential to reduce malnutrition is currently not being realized. Leveraging Agriculture for Nutrition in East Africa is a research study based in Ethiopia, Kenya, and Uganda that seeks to understand the enabling environment necessary for optimizing the contribution of the food and agriculture sector to nutrition outcomes. Its objectives were to explore stakeholder perceptions of nutrition-agriculture linkages, of political and institutional challenges and opportunities, of evidence that is available and influential for policy making, and of key issues with regard to capacity. Open-ended and semistructured interviews were conducted with 53 stakeholders from government, civil society, donors, United Nations organizations, private sector, and research/academic institutions in Ethiopia, Kenya, and Uganda in 2014. Although policy opportunities and contexts are different between the 3 countries, stakeholders identified similar barriers to greater action, including a narrow focus on solely market-oriented and staple crop production, a lack of clarity and incentives within the agriculture sector about improving nutrition and how to translate policy into action, and lack of capacity in human and financial resources. Many actions to improve the nutrition sensitivity of agriculture were mentioned, including crop diversification, value chain activities and improved market access, nutrition education, and reduction in time and labor costs to women. Many opportunities exist to strengthen the impact of agriculture on nutrition in East Africa, but stronger formulation and implementation of policies will require adequate human resources, funds, timely data on

Knowledge, Attitudes, and Substance Use Practices Among Street Children in Western Kenya

PubMed Central

Embleton, Lonnie; Ayuku, David; Atwoli, Lukoye; Vreeman, Rachel; Braitstein, Paula

2013-01-01

The study describes the knowledge of and attitudes toward substance use among street-involved youth in Kenya, and how they relate to their substance use practices. In 2011, 146 children and youth ages 10–19 years, classified as either children on the street or children of the street were recruited to participate in a cross-sectional survey in Eldoret, Kenya. Bivariate analysis using χ2 or Fisher’s Exact Test was used to test the associations between variables, and multiple logistic regression analysis was used to identify independent covariates associated with lifetime and current drug use. The study’s limitations and source of funding are noted. PMID:22780841

In-vivo efficacy of amodiaquine-artesunate in children with uncomplicated Plasmodium falciparum malaria in western Kenya

PubMed Central

Thwing, J. I.; Odero, C. O.; Odhiambo, F. O.; Otieno, K. O.; Kariuki, S.; Ord, R.; Roper, C.; McMorrow, M.; Vulule, J.; Slutsker, L.; Newman, R. D.; Hamel, M. J.; Desai, M.

2018-01-01

Summary OBJECTIVES To assess the efficacy of amodiaquine-artesunate in an area with high chloroquine resistance in western Kenya. METHODS Twenty-eight day in-vivo efficacy trial of amodiaquine-artesunate in 103 children aged 6–59 months in western Kenya with smear-confirmed uncomplicated Plasmodium falciparum malaria. RESULTS The 28-day uncorrected adequate clinical and parasitological response (ACPR) was 69.0%, with 15.5% Late Clinical Failure and 15.5% Late Parasitologic Failure rates. The PCR-corrected 28-day ACPR was 90.2%. Clinical risk factors for recurrent infection (recrudescences and reinfections) were lower axillary temperature at enrolment and low weight-for-age Z-score. The presence of single nucleotide polymorphisms pfcrt 76T and pfmdr1 86Y at baseline was associated with increased risk of recurrent infections, both reinfections and recrudescences. CONCLUSION Although artemether-lumefantrine (Coartem®) is the first line ACT in Kenya, amodiaquine-artesunate is registered as an option for treatment of uncomplicated P. falciparum and remains an effective alternative to Coartem® in western Kenya. Continued amodiaquine monotherapy in the private sector may jeopardise the future use of amodiaquine-artesunate as an alternative artemisinin-based combination therapy. PMID:19187521

A Study on the Sources of Resources and Capacity Building in Resource Mobilization: Case of Private Chartered Universities in Nakuru Town, Kenya

ERIC Educational Resources Information Center

Kipchumba, Simon Kibet; Zhimin, Liu; Chelagat, Robert

2013-01-01

The purpose of this study was to review and analyze the resources needs and sources of resources and level of training and capacity building in resource mobilization in Kenyan private chartered universities. The study employed a descriptive survey research design. Purposeful sampling technique was used to select 63 respondents (staff) from three…

Spectrum of Rift Valley Fever Virus Transmission in Kenya: Insights from three Distinct Regions

PubMed Central

Labeaud, A. Desiree; Ochiai, Yoshitsugu; Peters, C.J.; Muchiri, Eric M.; King, Charles H.

2008-01-01

Rift Valley fever virus (RVFV) is an emerging pathogen that maintains high biodefense priority based on its threat to livestock, its ability to cause human hemorrhagic fever, and its potential for aerosol spread. To define the range of human transmission during inter-epidemic and epidemic periods in Kenya, we tested archived sera from defined populations (N = 1,263) for anti-RVFV IgG by ELISA and plaque reduction neutralization testing. RVFV seroprevalence was 10.8% overall and varied significantly by location, sex, and age. In NW Kenya, high seroprevalence among those born before 1980 indicates that an undetected epidemic may have occurred then. Seroconversion documented in highland areas suggests previously unsuspected inter-epidemic transmission. RVFV seroprevalence is strikingly high in certain Kenyan areas, suggesting endemic transmission patterns that may preclude accurate estimation of regional acute outbreak incidence. The extent of both epidemic and inter-epidemic RVFV transmission in Kenya is greater than previously documented. PMID:17488893

HIV, disease plague, demoralization and "burnout": resident experience of the medical profession in Nairobi, Kenya.

PubMed

Raviola, Giuseppe; Machoki, M'Imunya; Mwaikambo, Esther; Good, Mary Jo DelVecchio

2002-03-01

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves--their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self--are significantly affected. Also affected are the patients they work to treat.

Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.

PubMed

Bucher, Sherri; Konana, Olive; Liechty, Edward; Garces, Ana; Gisore, Peter; Marete, Irene; Tenge, Constance; Shipala, Evelyn; Wright, Linda; Esamai, Fabian

2016-08-12

The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care. A structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed. Inappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs. Potentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.

African Journal: Schooling and Politics in Rural Kenya

ERIC Educational Resources Information Center

Axelrod, Paul

2008-01-01

In 2003, York University awarded an honorary doctorate to Phoebe Asiyo, a former Kenyan member of Parliament, in recognition of her impressive human rights work. The author learned at the time that Ms. Asiyo's family provided major support to Wikondiek School (located near their home in western Kenya), many of whose students were AIDS orphans.…

Multilingualism, Language Policy and Creative Writing in Kenya

ERIC Educational Resources Information Center

Mbithi, Esther K

2014-01-01

Language use and creative writing go hand in hand. In the process of exploring language, we also engage in the study of literature. An engagement with literature is, indeed, a continuing process of improving our capacity to use language and refining our sensibility to good language use. In Kenya, there are clearly discernible patterns of creative…

School Leadership Challenges along Kenya's Borabu-Sotik Border

ERIC Educational Resources Information Center

Abaya, Joel

2016-01-01

This article is based on a qualitative multi-case study carried out in southwestern Kenya along the border areas of Nyanza and Rift Valley province. The purpose of the research was to examine the challenges public secondary school principals faced in their leadership roles and suggest efforts they might adopt to minimize the effects of these…

Relative-Change Theory: Examining the Impact of Patriarchy, Paternalism, and Poverty on the Education of Women in Kenya

ERIC Educational Resources Information Center

Omwami, Edith Mukudi

2011-01-01

Forty-five years have passed since Kenya gained independence and almost 30 years since the feminist revolution ushered in a global gender and development agenda. While Kenya's development agenda had a functionalist orientation aimed at modernisation, the outcome of efforts to promote education development cannot be understood without an…

A Biosecurity Survey in Kenya, November 2014 to February 2015.

PubMed

Ndhine, Edwardina Otieno; Slotved, Hans-Christian; Osoro, Eric Mogaka; Olsen, Katja N; Rugutt, Moses; Wanjohi, Cathryn W; Mwanda, Walter; Kinyagia, Benson Mburu; Steenhard, Nina R; Hansen, John-Erik Stig

2016-01-01

A biosecurity survey was performed to gather information on the biosecurity level and laboratory capacity in Kenya for the purpose of providing information outlining relevant components for biosecurity legislation, biosecurity implementation, and enforcement of biosecurity measures in Kenya. This survey is, to the authors' knowledge, the first to be published from an African country. A total of 86 facilities with laboratories covering relevant categories, such as training laboratories, human diagnostic laboratories, veterinary diagnostic laboratories, and research laboratories, were selected to participate in the survey. Each facility was visited by a survey team and staff were asked to answer 29 groups of questions from a questionnaire. The survey showed that Kenyan laboratory facilities contain biological agents of biosecurity concern. The restrictions for these agents were found to be limited for several of the facilities, in that many laboratory facilities and storage units were open for access by either students or staff who had no need of access to the laboratory. The survey showed a great deal of confusion in the terms biosecurity and biosafety and a generally limited biosecurity awareness among laboratory personnel. The survey showed that the security of biological agents of biosecurity concern in many facilities does not meet the international requirements. The authors recommend developing a legal framework in Kenya for effective controls, including national biosecurity regulations, guidelines, and procedures, thereby reducing the risk that a Kenyan laboratory would be the source of a future biological attack.

Assessment of Service Delivery in Guidance and Counselling Units in Selected Secondary Schools in Eldoret Municipality, Kenya

ERIC Educational Resources Information Center

Owino, Elizabeth Akinyi

2015-01-01

This paper assesses the type of services delivered by the existing Guidance and Counselling units in secondary schools in Kenya based on a survey conducted in Eldoret Municipality in Uasin Gishu County, Kenya. The study adopted an ex-post facto research design the target population being all secondary schools in the Municipality where a sample was…

Malaria healthcare policy change in Kenya: implications on sales and marketing of antimalarials.

PubMed

Ngure, Peter K; Nyaoke, Lorraine; Minja, David

2012-03-01

Malaria healthcare policy change in Kenya aimed at improving the control of malaria but faced a number of challenges in implementation related to marketing of the drugs. This research investigated the effect of the change of the national malaria policy on drug sales and strategic marketing responses of antimalarial pharmaceutical companies in Kenya. A descriptive cross-sectional design was employed to describe the existing state of antimalarials market in Kenya after the change of the malaria healthcare policy. Policy change did result in an increase in the sales of Coartem®. Novartis Pharma recorded a 97% growth in sales of Coartem® between 2003 and 2004. However, this increase was not experienced by all the companies. Further, SPs (which had been replaced as first-line therapy for malaria) registered good sales. In most cases, these sales were higher than the sales of Coartem®. Generally, the sales contribution of SPs and generic antimalarial medicines exceeded that of Coartem® for most distributors. The most common change made to marketing strategies by distributors (62.5%) was to increase imports of antimalarials. A total of 40% of the manufacturers preferred to increase their budgetary allocation for marketing activities. In view of the fact that continued sale of SP drugs and limited availability of AL poses the risk of increasing the incidence of malaria in Kenya, it is therefore, recommended that pharmacy surveillance systems be strengthened to ensure drugs that have been rendered non-viable or that prescription-only medicines are not sold contrary to the national guidelines.

Dry spell trend analysis in Kenya and the Murray Darling Basin using daily rainfall

NASA Astrophysics Data System (ADS)

Muita, R. R.; van Ogtrop, F. F.; Vervoort, R. W.

2012-04-01

Important agricultural areas in Kenya and the Murray Darling Basin (MDB) in Australia are largely semi-arid to arid. Persistent dry periods and timing of dry spells directly impact the availability of soil moisture and hence crop production in these regions. Most studies focus on the analysis of dry spell lengths at an annual scale. However, timing and length of dry spells at finer temporal scales is more beneficial for cropping when considering a trade-off between the time scale and the ability to analyse dry spell length. The aim of this study was to analyse the interannual and intra annual variations in dry spell lengths in the regions to inform crop management. This study analysed monthly dry spells based on daily rainfall for 1961-2010 on a limited dataset of 13 locations in Kenya and 17 locations in the MDB. This dataset was the most consistent across both regions and future analysis will incorporate more stations and longer time periods where available. Dry spell lengths were analysed by month and year and trends in monthly and annual dry spell lengths were analysed using Generalised Linear Models (GLM) and the Mann Kendall test (MK). Overall, monthly dryspell lengths are right skewed with higher frequency of shorter dryspells (3-25 days). In Kenya, significant increases in mean dry spell lengths (p≤0.02) are observed in inland arid-to semi humid locations but this temporal trend appears to decrease in highland and the coastal regions. Analysis of the MDB stations suggests changes in seasonality. For example, spatial trends suggest a North-South increase in dry spell length in summer (December - February), but a shortening after February. Generally, the GLM and MK results are similar in the two regions but the MK test tends to give higher values of positive slope coefficients and lower values for negative coefficients compared to GLM. This may limit the ability of finding the best estimates for model coefficients. Previous studies in Australia and Kenya

Social Exchange and Sexual Behavior in Young Women’s Premarital Relationships in Kenya

PubMed Central

Luke, Nancy; Goldberg, Rachel E.; Mberu, Blessing U.; Zulu, Eliya M.

2011-01-01

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the linkages between a variety of young women’s resources—including employment and material transfers from male partners—and sexual behaviors. Data on the first month of premarital relationships (N=551 relationships) were collected from a random sample of young adult women ages 18–24 in Kisumu, Kenya, using a retrospective life history calendar. Consistent with the hypotheses, results showed that young women’s income increases the likelihood of safer sexual activities, including delaying sex and using condoms consistently. Material transfers from the male partner displayed the opposite effect, supporting the view that resources obtained from within the relationship decrease young women’s negotiating power. PMID:22180665

Young mothers, first time parenthood and exclusive breastfeeding in Kenya.

PubMed

Naanyu, Violet

2008-12-01

Breastfeeding behaviour is explored in Kenya using data collected in the town of Eldoret, Kenya. This paper specifically examines duration of exclusive breastfeeding among young mothers below 20 years of age as compared to older cohorts. Additionally, focus is laid on the effect of first time motherhood and breastfeeding difficulties on exclusive breastfeeding. Results show that Eldoret mothers are aware of benefits of breastfeeding; nevertheless, the mean duration for exclusive breastfeeding in this sample is 2.4 months. Higher durations of exclusive breastfeeding are associated with increasing age and first time motherhood. Predictably, breastfeeding difficulties bear a negative association with exclusive breastfeeding. While HIV is transmissible through breastfeeding, breast milk remains a vital source of nourishment for infants in Sub-Saharan Africa. More research on mothering should examine the changing socio-economic milieu and its influence on women's infant feeding decisions

The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

PubMed Central

2013-01-01

Background Malaria causes significant mortality and morbidity in sub-Saharan Africa (SSA), especially among children less than five years of age (U5 children). Although the economic burden of malaria in this region has been assessed previously, the extent and variation of this burden remains unclear. This study aimed to estimate the economic costs of malaria in U5 children in three countries (Ghana, Tanzania and Kenya). Methods Health system and household costs previously estimated were integrated with costs associated with co-morbidities, complications and productivity losses due to death. Several models were developed to estimate the expected treatment cost per episode per child, across different age groups, by level of severity and with or without controlling for treatment-seeking behaviour. Total annual costs (2009) were calculated by multiplying the treatment cost per episode according to severity by the number of episodes. Annual health system prevention costs were added to this estimate. Results Household and health system costs per malaria episode ranged from approximately US$ 5 for non-complicated malaria in Tanzania to US$ 288 for cerebral malaria with neurological sequelae in Kenya. On average, up to 55% of these costs in Ghana and Tanzania and 70% in Kenya were assumed by the household, and of these costs 46% in Ghana and 85% in Tanzania and Kenya were indirect costs. Expected values of potential future earnings (in thousands) lost due to premature death of children aged 0–1 and 1–4 years were US$ 11.8 and US$ 13.8 in Ghana, US$ 6.9 and US$ 8.1 in Tanzania, and US$ 7.6 and US$ 8.9 in Kenya, respectively. The expected treatment costs per episode per child ranged from a minimum of US$ 1.29 for children aged 2–11 months in Tanzania to a maximum of US$ 22.9 for children aged 0–24 months in Kenya. The total annual costs (in millions) were estimated at US$ 37.8, US$ 131.9 and US$ 109.0 nationwide in Ghana, Tanzania and Kenya and included average

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

PubMed

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All

Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.

PubMed

Barasa, Edwine W; Cleary, Susan; Molyneux, Sassy; English, Mike

2017-04-01

This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities

High-Resolution Spatial Distribution and Estimation of Access to Improved Sanitation in Kenya.

PubMed

Jia, Peng; Anderson, John D; Leitner, Michael; Rheingans, Richard

2016-01-01

Access to sanitation facilities is imperative in reducing the risk of multiple adverse health outcomes. A distinct disparity in sanitation exists among different wealth levels in many low-income countries, which may hinder the progress across each of the Millennium Development Goals. The surveyed households in 397 clusters from 2008-2009 Kenya Demographic and Health Surveys were divided into five wealth quintiles based on their national asset scores. A series of spatial analysis methods including excess risk, local spatial autocorrelation, and spatial interpolation were applied to observe disparities in coverage of improved sanitation among different wealth categories. The total number of the population with improved sanitation was estimated by interpolating, time-adjusting, and multiplying the surveyed coverage rates by high-resolution population grids. A comparison was then made with the annual estimates from United Nations Population Division and World Health Organization /United Nations Children's Fund Joint Monitoring Program for Water Supply and Sanitation. The Empirical Bayesian Kriging interpolation produced minimal root mean squared error for all clusters and five quintiles while predicting the raw and spatial coverage rates of improved sanitation. The coverage in southern regions was generally higher than in the north and east, and the coverage in the south decreased from Nairobi in all directions, while Nyanza and North Eastern Province had relatively poor coverage. The general clustering trend of high and low sanitation improvement among surveyed clusters was confirmed after spatial smoothing. There exists an apparent disparity in sanitation among different wealth categories across Kenya and spatially smoothed coverage rates resulted in a closer estimation of the available statistics than raw coverage rates. Future intervention activities need to be tailored for both different wealth categories and nationally where there are areas of greater needs when

The Relationship between Teacher-Related Factors and Students' Attitudes towards Secondary School Chemistry Subject in Bureti District, Kenya

ERIC Educational Resources Information Center

Chepkorir, Salome; Cheptonui, Edna Marusoi; Chemutai, Agnes

2014-01-01

This paper examines the relationship between teacher-related factors and student's attitudes towards Chemistry subject in secondary schools in Kenya. The paper is based on a study conducted in Bureti District in Kericho County, Kenya. This paper highlights issues on the teaching methods used by chemistry teachers, the teachers' availability to…

University Education in Kenya: Current Developments and Future Outlook.

ERIC Educational Resources Information Center

Mutula, Stephen M.

2002-01-01

Discusses university education in Kenya, with an emphasis on patterns of financing and how this has affected overall operations of the universities. Assesses reforms to reduce government grants and make public universities self-sustaining, compares private and public universities, and discusses problems facing public universities and how they are…

Cultural Interface Theory in the Kenya Context and Beyond

ERIC Educational Resources Information Center

Maakrun, Julie; Maher, Marguerite

2016-01-01

Yunkaporta's (2009) pedagogical "eight ways" conceptual framework, inspired by Nakata's (2007) cultural interface theory, provided the platform for interpretation of the data in the current study. Here we considered the transferability of the framework to a current initiative in Kenya and its usefulness in preparation for an expansion of…

Academic Achievement of Girls in Rural Schools in Kenya

ERIC Educational Resources Information Center

Mungai, A. M.

2012-01-01

This study examined the effect of two family factors (financial, social capital) and school factors on students' achievement. One hundred eighty two, seventh-grade female students from nine schools in Muranga district, Kenya, were studied. The statistical procedures included logit regression, cross-tabulations, frequency counting and chi-square…

Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya.

PubMed

Magadi, Monica A

2017-09-01

The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Multilevel logistic regression models are applied to nationally-representative samples of 13 094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Electronic Library: A TERI Experiment.

ERIC Educational Resources Information Center

Kar, Debal C.; Deb, Subrata; Kumar, Satish

2003-01-01

Discusses the development of Electronic Library at TERI (The Energy and Resources Institute, New Delhi). Highlights include: hardware and software used; the digital library/Virtual Electronic Library; directory of Internet journals; virtual reference resources; electronic collection/Physical Electronic Library; downloaded online full-length…

The capacity of diagnostic laboratories in Kenya for detecting infectious diseases.

PubMed

Slotved, H-C; Yatich, Kennedy K; Sam, Shem Otoi; Ndhine, Edwardina Otieno

2017-01-01

The aim of this study is to present data of the diagnostic capacity of Kenyan laboratories to diagnose a number of human pathogens. The study is based on the data obtained from a biosecurity survey conducted in Kenya in 2014/2015 and data from the Statistical Abstract of Kenya for 2015. The biosecurity survey has previously been published; however, the survey also included information on laboratory capacity to handle a number of pathogens, which have not been published. Data were retrieved from the survey on 86 laboratory facilities. The data include information from relevant categories such as training laboratories, human diagnostic laboratories, veterinary diagnostic laboratories, and research laboratories. The disease incidence in Kenya ranges widely from malaria and diarrhea with an incidence rate of around 10.000 per year to diseases such as cholera and yellow fever with an incidence rate of 1 per year or less for all age groups. The data showed that diseases with the highest number of diagnostic facilities were mainly malaria-, HIV-, tuberculosis-, and diarrhea-related infectious diseases. The study generally shows that the laboratory facilities have the capacity of detecting the infectious diseases with the highest incidence rates. Furthermore, it seems that the number of facilities able to detect a particular disease is related to the incidence rate of the disease.

A national cholera epidemic with high case fatality rates--Kenya 2009.

PubMed

Loharikar, Anagha; Briere, Elizabeth; Ope, Maurice; Langat, Daniel; Njeru, Ian; Gathigi, Lucy; Makayotto, Lyndah; Ismail, Abdirizak M; Thuranira, Martin; Abade, Ahmed; Amwayi, Samuel; Omolo, Jared; Oundo, Joe; De Cock, Kevin M; Breiman, Robert F; Ayers, Tracy; Mintz, Eric; O'Reilly, Ciara E

2013-11-01

Cholera remains endemic in sub-Saharan Africa. We characterized the 2009 cholera outbreaks in Kenya and evaluated the response. We analyzed surveillance data and estimated case fatality rates (CFRs). Households in 2 districts, East Pokot (224 cases; CFR = 11.7%) and Turkana South (1493 cases; CFR = 1.0%), were surveyed. We randomly selected 15 villages and 8 households per village in each district. Healthcare workers at 27 health facilities (HFs) were surveyed in both districts. In 2009, cholera outbreaks caused a reported 11 425 cases and 264 deaths in Kenya. Data were available from 44 districts for 6893 (60%) cases. District CFRs ranged from 0% to 14.3%. Surveyed household respondents (n = 240) were aware of cholera (97.5%) and oral rehydration solution (ORS) (87.9%). Cholera deaths were reported more frequently from East Pokot (n = 120) than Turkana South (n = 120) households (20.7% vs. 12.3%). The average travel time to a HF was 31 hours in East Pokot compared with 2 hours in Turkana South. Fewer respondents in East Pokot (9.8%) than in Turkana South (33.9%) stated that ORS was available in their village. ORS or intravenous fluid shortages occurred in 20 (76.9%) surveyed HFs. High CFRs in Kenya are related to healthcare access disparities, including availability of rehydration supplies.

The protective role of religious coping in adolescents’ responses to poverty and sexual decision-making in rural Kenya

PubMed Central

Watt, Melissa H.; Sikkema, Kathleen J.; Ogwang-Odhiambo, Rose A.; Broverman, Sherryl A.

2011-01-01

In this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. Adolescents reported praying for God to partner with them to engage in positive behaviors, praying for strength to resist unwanted behaviors, and passive strategies characterized by waiting for God to provide resources or protection from HIV. Adolescents in Sub-Saharan Africa may benefit from HIV prevention interventions that integrate and build upon their use of religious coping. PMID:22505794

Quality Regulation in Expansion of Educational Systems: A Case of Privately Sponsored Students' Programme in Kenya's Public Universities

ERIC Educational Resources Information Center

Yego, Helen J. C.

2016-01-01

This paper examines the expansion and management of quality of parallel programmes in Kenya's public universities. The study is based on Privately Sponsored Students Programmes (PSSP) at Moi University and its satellite campuses in Kenya. The study was descriptive in nature and adopted an ex-post facto research design. The study sample consisted…

Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care

PubMed Central

McCollum, Rosalind; Theobald, Sally; Otiso, Lilian; Martineau, Tim; Karuga, Robinson; Barasa, Edwine; Molyneux, Sassy; Taegtmeyer, Miriam

2018-01-01

Abstract Devolution changes the locus of power within a country from central to sub-national levels. In 2013, Kenya devolved health and other services from central government to 47 new sub-national governments (known as counties). This transition seeks to strengthen democracy and accountability, increase community participation, improve efficiency and reduce inequities. With changing responsibilities and power following devolution reforms, comes the need for priority-setting at the new county level. Priority-setting arises as a consequence of the needs and demand for healthcare resources exceeding the resources available, resulting in the need for some means of choosing between competing demands. We sought to explore the impact of devolution on priority-setting for health equity and community health services. We conducted key informant and in-depth interviews with health policymakers, health providers and politicians from 10 counties (n = 269 individuals) and 14 focus group discussions with community members based in 2 counties (n = 146 individuals). Qualitative data were analysed using the framework approach. We found Kenya’s devolution reforms were driven by the need to demonstrate responsiveness to county contexts, with positive ramifications for health equity in previously neglected counties. The rapidity of the process, however, combined with limited technical capacity and guidance has meant that decision-making and prioritization have been captured and distorted for political and power interests. Less visible community health services that focus on health promotion, disease prevention and referral have been neglected within the prioritization process in favour of more tangible curative health services. The rapid transition in power carries a degree of risk of not meeting stated objectives. As Kenya moves forward, decision-makers need to address the community health gap and lay down institutional structures, processes and norms which promote health

Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

PubMed

Odhiambo, J; Kizito, W; Njoroge, A; Wambua, N; Nganga, L; Mburu, M; Mansoer, J; Marum, L; Phillips, E; Chakaya, J; De Cock, K M

2008-03-01

Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

Status of E-Learning in Public Universities in Kenya

ERIC Educational Resources Information Center

Makokha, George L.; Mutisya, Dorothy N.

2016-01-01

The purpose of this study was to assess the status of e-learning in public universities in Kenya. Data were collected using questionnaires administered to both students and lecturers randomly sampled from seven public universities. Questionnaire responses were triangulated with interviews from key informants and focus group discussions (FGDs).…

The "Invisible" Drama/Theatre in Education Curriculum in Kenya

ERIC Educational Resources Information Center

Joseph, Christopher Odhiambo

2016-01-01

This vignette presents the state of theatre in Education Kenya. The paper argues that though there are several theatre in education like practices, these have not been entrenched in the school curriculum. Theatre in Education finds expression and manifestations outside the mainstream school curriculum for instance in schools and colleges drama…

Q fever is an old and neglected zoonotic disease in Kenya: a systematic review.

PubMed

Njeru, J; Henning, K; Pletz, M W; Heller, R; Neubauer, H

2016-04-05

Q fever is a neglected zoonosis caused by the bacterium Coxiella burnetii. The knowledge of the epidemiology of Q fever in Kenya is limited with no attention to control and prevention programs. The purpose of this review is to understand the situation of Q fever in human and animal populations in Kenya in the past 60 years, and help identify future research priorities for the country. Databases were searched for national and international scientific studies or reports on Q fever. We included studies and reports published between 1950 and 2015 if they reported on Q fever prevalence, incidence, and infection control programs in Kenya. Data were extracted with respect to studies on prevalence of Coxiella infections, study design, study region, the study populations involved, and sorted according to the year of the study. We identified 15 studies and reports which qualified for data extraction. Human seroprevalence studies revealed evidence of C. burnetii infections ranging from 3 to 35.8% in all regions in which surveys were made and two Q fever outbreak episodes. Coxiella burnetii infections found in cattle 7.4-51.1%, sheep 6.7-20%, camels 20-46%, and goats 20-46% revealed variation based on ecoregions and the year of study. Farming and lack of protective clothing were associated with increased seropositivity among humans. However, high quality data is lacking on Q fever awareness, underlying cultural-economic factors influencing C. burnetii infection, and how the pathogen cycles may be embedded in livestock production and management systems in the economically and ecologically different Kenyan regions. We found no studies on national disease incidence estimates or disease surveillance and control efforts. Coxiella burnetii infections are common in human and in a wide range of animal populations but are still unrecognized and underestimated thus presenting a significant human and animal health threat in Kenya. The factors influencing pathogen transmission

Project Based Learning on Students' Performance in the Concept of Classification of Organisms among Secondary Schools in Kenya

ERIC Educational Resources Information Center

Wekesa, Noah Wafula; Ongunya, Raphael Odhiambo

2016-01-01

The concept of classification of organisms in Biology seems to pose a problem to Secondary School students in Kenya. Though, the topic is important for understanding of the basic elements of the subject. The Examinations Council in Kenya has identified teacher centred pedagogical techniques as one of the main causes for this. Project based…

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya.

PubMed

Henry, Jade Vu; Winters, Niall; Lakati, Alice; Oliver, Martin; Geniets, Anne; Mbae, Simon M; Wanjiru, Hannah

2016-06-20

An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya

PubMed Central

Henry, Jade Vu; Winters, Niall; Lakati, Alice; Oliver, Martin; Geniets, Anne; Mbae, Simon M; Wanjiru, Hannah

2016-01-01

ABSTRACT An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms

Comrades' Power: Student Representation and Activism in Universities in Kenya

ERIC Educational Resources Information Center

Macharia, Mwangi J.

2015-01-01

In the last decade, student politics and governance of universities in Kenya and in other African countries have undergone a tremendous transformation. The unprecedented expansion and massification of public universities, the introduction of "Module 2" programmes, the admission of private, "parallel" and…

Using health-facility data to assess subnational coverage of maternal and child health indicators, Kenya.

PubMed

Maina, Isabella; Wanjala, Pepela; Soti, David; Kipruto, Hillary; Droti, Benson; Boerma, Ties

2017-10-01

To develop a systematic approach to obtain the best possible national and subnational statistics for maternal and child health coverage indicators from routine health-facility data. Our approach aimed to obtain improved numerators and denominators for calculating coverage at the subnational level from health-facility data. This involved assessing data quality and determining adjustment factors for incomplete reporting by facilities, then estimating local target populations based on interventions with near-universal coverage (first antenatal visit and first dose of pentavalent vaccine). We applied the method to Kenya at the county level, where routine electronic reporting by facilities is in place via the district health information software system. Reporting completeness for facility data were well above 80% in all 47 counties and the consistency of data over time was good. Coverage of the first dose of pentavalent vaccine, adjusted for facility reporting completeness, was used to obtain estimates of the county target populations for maternal and child health indicators. The country and national statistics for the four-year period 2012/13 to 2015/16 showed good consistency with results of the 2014 Kenya demographic and health survey. Our results indicated a stagnation of immunization coverage in almost all counties, a rapid increase of facility-based deliveries and caesarean sections and limited progress in antenatal care coverage. While surveys will continue to be necessary to provide population-based data, web-based information systems for health facility reporting provide an opportunity for more frequent, local monitoring of progress, in maternal and child health.

Breeding goals for the Kenya dual purpose goat. I. Model development and application to smallholder production systems.

PubMed

Bett, R C; Kosgey, I S; Bebe, B O; Kahi, A K

2007-10-01

A deterministic model was developed and applied to evaluate biological and economic variables that characterize smallholder production systems utilizing the Kenya Dual Purpose goat (KDPG) in Kenya. The systems were defined as: smallholder low-potential (SLP), smallholder medium-potential (SMP) and smallholder high-potential (SHP). The model was able to predict revenues and costs to the system. Revenues were from sale of milk, surplus yearlings and cull-forage animals, while costs included those incurred for feeds, husbandry, marketing and fixed asset (fixed costs). Of the total outputs, revenue from meat and milk accounted for about 55% and 45%, respectively, in SMP and 39% and 61% in SHP. Total costs comprised mainly variable costs (98%), with husbandry costs being the highest in both SMP and SLP. The total profit per doe per year was KSh 315.48 in SMP, KSh -1352.75 in SLP and KSh -80.22 in SHP. Results suggest that the utilization of the KDPG goat in Kenya is more profitable in the smallholder medium-potential production system. The implication for the application of the model to smallholder production systems in Kenya is discussed.

A new species of Letheobia (Serpentes: Typhlopidae) from central Kenya.

PubMed

Malonza, Patrick K; Bauer, Aaron M; Ngwava, Jacob M

2016-03-20

A new species of blind snake in the genus Letheobia (L. mbeerensis sp. nov.) is described from the Mbeere area on the extreme lower slopes of southeastern Mt. Kenya. It is an attenuate blind snake, superficially similar to Letheobia lumbriciformis but with 20 midbody scale rows and 670 middorsal scales. It has a total length of 280 mm with the proportionally longest tail in the genus (2.9% of total length), a broad rostral, eyes barely visible and in life it is pink in color. The new species is known from only a single specimen collected at Siakago, in Mbeere-Embu, which lies at an elevation of about 1200m. It is a burrowing species and like many other blind snakes it is likely to be nocturnal and rarely encountered on the soil surface. The new species is incorporated into a key to the scolecophidian snakes of Kenya.

Electronic neural network for dynamic resource allocation

NASA Technical Reports Server (NTRS)

Thakoor, A. P.; Eberhardt, S. P.; Daud, T.

1991-01-01

A VLSI implementable neural network architecture for dynamic assignment is presented. The resource allocation problems involve assigning members of one set (e.g. resources) to those of another (e.g. consumers) such that the global 'cost' of the associations is minimized. The network consists of a matrix of sigmoidal processing elements (neurons), where the rows of the matrix represent resources and columns represent consumers. Unlike previous neural implementations, however, association costs are applied directly to the neurons, reducing connectivity of the network to VLSI-compatible 0 (number of neurons). Each row (and column) has an additional neuron associated with it to independently oversee activations of all the neurons in each row (and each column), providing a programmable 'k-winner-take-all' function. This function simultaneously enforces blocking (excitatory/inhibitory) constraints during convergence to control the number of active elements in each row and column within desired boundary conditions. Simulations show that the network, when implemented in fully parallel VLSI hardware, offers optimal (or near-optimal) solutions within only a fraction of a millisecond, for problems up to 128 resources and 128 consumers, orders of magnitude faster than conventional computing or heuristic search methods.

Interaction of deep and shallow processes in the evolution of the Kenya rift

NASA Astrophysics Data System (ADS)

Morley, C. K.

1994-09-01

The start of volcanism before rifting in the northern Kenya rift suggests that an asthenospheric thermal anomaly was responsible, not decompression melting due to lithosphere stretching. This volcanism may be partly related to the Ethiopian rift, or even the Anza graben, not the Kenya rift. In the northern Kenya rift the first stage of deformation was the formation of isolated sediment-filled half-graben basins during the Late Oligocene-Early Miocene, perhaps superimposed on lower Tertiary basins. During the Miocene, the location of basins shifted eastwards. This shift is interpreted as being due to strain hardening of the lithosphere during extension caused by a relatively slow strain rate. Relocation of the zone of extension progressively eastwards was possibly caused by migration of the asthenospheric thermal anomaly to the east (which lowered the strength of the crust above the thermal anomaly). The simple McKenzie model of uniform lithosphere stretching does not apparently fit the Kenya rift. Uniform extension may have affected the entire lithosphere but uniform stretching can only be demonstrated for the continental crust. The shape of the geophysically defined base lithosphere under the rift shows much more thinning of the mantle lithosphere than the crust. Consequently, thermal thinning of the mantle lithosphere has to be invoked to explain the discrepancy. Where the asthenosphere lies almost at the base of the crust the surface rift above displays swarms of minor faults and a linear array of Pliocene recent volcanoes. Thus the deep thermal history and the shallow brittle structures of the Kenya rift appear to be closely linked and each has influenced the evolution of the other. Extension estimates for the upper crust and the lower crust are similar, indicating that addition of magma to the crust has not caused an underestimate of lower crust extension. This suggests that either the ratios of magma emplaced within the crust to surface volcanism are much

Assessing Future Hydrological Changes in the Tana River Basin, Kenya

NASA Astrophysics Data System (ADS)

Jenkins, Rhosanna

2017-04-01

Changes in precipitation will be one of the most significant factors in determining the overall impact of global climate change but are also one of the most uncertain and difficult to project. The reliability of global climate models (GCMs) for predicting changes in rainfall is particularly concerning for East Africa. This research focuses on Kenya's Tana River Basin and aims to project the impacts of climate change upon the hydrology in order to inform national climate change adaptation plans. The Tana basin has been identified as crucial for Kenya's development, with increased irrigated agriculture and additional dams planned. The area is also important for biodiversity and contains already-threatened ecosystems and endemic species. Kenya is already a water-scarce country and demand for water is expected to increase in the future as the country develops. Therefore, examining changes to precipitation with climate change is vital. The WaterWorld Policy Support System (http://www.policysupport.org/waterworld), a physically-based hydrological model, has been used to determine annual and monthly changes in hydrology. WaterWorld utilises the WorldClim (Hijmans et al., 2005) climate projections for the latest generation of climate models from the Coupled Model Intercomparison Project, phase 5 (CMIP5) to characterise the temperature and precipitation changes. In order to better understand the high uncertainties in projections of climate change, the full range of latest emissions scenarios (the representative concentration pathways or RCPs) were used to force the WaterWorld model. The WorldClim baseline values were evaluated by comparing them to observations and were found to correctly represent the annual cycle of precipitation. In addition, the CRU TS3.22 data (Harris et al., 2014) have also been examined and provide a valuable comparison to the WorldClim dataset. These simulations encompass a broad range of climate projections, but show a general trend towards

Rural-Urban Differences in Trends in the Wealth Index in Kenya: 1993-2009.

PubMed

Egede, Leonard E; Voronca, Delia; Walker, Rebekah J; Thomas, Craig

The aim of this study was to construct a wealth index that could be compared over time in order to understand the trends in wealth in Kenya and determine predictors of change in wealth index. Data were from the Demographic and Health Survey program collected in Kenya between 1993 and 2009. Variable categories were collapsed to match and factor analysis was performed on the 4-year pooled data to generate a harmonized wealth index. Possible predictors of wealth were selected from household variables available for all 4 years. Household sampling weights and stratification by rural/urban was used. Overall, wealth increased in Kenya between 1993 and 2008; however, when stratified, no significant increase existed in urban areas and a significant increase was identified in rural areas specifically between 2003 and 2008. The strongest predictor was education, with more than a standard deviation difference for secondary or higher levels of education over those with no education. The association of gender of the head of household and whether the head of household had a partner differed between rural and urban areas, with household heads who were women and those who had a partner having more wealth in urban areas but less wealth in rural areas. Wealth in Kenya increased over time, specifically in rural regions. Differences were identified in predictors of wealth by urban/rural residence, educational level, and gender of the head of household and should be taken into account when planning interventions to target those in disproportionately low wealth brackets. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Bamboo mapping of Ethiopia, Kenya and Uganda for the year 2016 using multi-temporal Landsat imagery

NASA Astrophysics Data System (ADS)

Zhao, Yuanyuan; Feng, Duole; Jayaraman, Durai; Belay, Daniel; Sebrala, Heiru; Ngugi, John; Maina, Eunice; Akombo, Rose; Otuoma, John; Mutyaba, Joseph; Kissa, Sam; Qi, Shuhua; Assefa, Fiker; Oduor, Nellie Mugure; Ndawula, Andrew Kalema; Li, Yanxia; Gong, Peng

2018-04-01

Mapping the spatial distribution of bamboo in East Africa is necessary for biodiversity conservation, resource management and policy making for rural poverty reduction. In this study, we produced a contemporary bamboo cover map of Ethiopia, Kenya and Uganda for the year 2016 using multi-temporal Landsat imagery series at 30 m spatial resolution. This is the first bamboo map generated using remotely sensed data for these three East African countries that possess most of the African bamboo resource. The producer's and user's accuracies of bamboos are 79.2% and 84.0%, respectively. The hotspots with large amounts of bamboo were identified and the area of bamboo coverage for each region was estimated according to the map. The seasonal growth status of two typical bamboo zones (one highland bamboo and one lowland bamboo) were analyzed and the multi-temporal imagery proved to be useful in differentiating bamboo from other vegetation classes. The images acquired in September to February are less contaminated by clouds and shadows, and the image series cover the dying back process of lowland bamboo, which were helpful for bamboo identification in East Africa.

Sexual and physical violence against female sex workers in Kenya: a qualitative enquiry.

PubMed

Okal, Jerry; Chersich, Matthew F; Tsui, Sharon; Sutherland, Elizabeth; Temmerman, Marleen; Luchters, Stanley

2011-05-01

Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSW) to sexual and physical violence, and how this impacts on their HIV risk. This qualitative study documents FSW's experiences of violence in Mombasa and Naivasha, Kenya. Eighty-one FSW who obtained clients from the streets, transportation depots, taverns, discos and residential areas were recruited through local sex workers trained as peer counsellors to participate in eight focus-group discussions. Analysis showed the pervasiveness of sexual and physical violence among FSW, commonly triggered by negotiation around condoms and payment. Pressing financial needs of FSW, gender-power differentials, illegality of trading in sex and cultural subscriptions to men's entitlement for sex sans money underscore much of this violence. Sex workers with more experience had developed skills to avoid threats of violence by identifying potentially violent clients, finding safer working areas and minimising conflict with the police. Addressing violence and concomitant HIV risks and vulnerabilities faced by FSW should be included in Kenya's national HIV/AIDS strategic plan. This study indicates the need for multilevel interventions, including legal reforms so that laws governing sex work promote the health and human rights of sex workers in Kenya.

Didactic Competencies among Teaching Staff of Universities in Kenya

ERIC Educational Resources Information Center

Karimi, Florah Katanu

2014-01-01

The aim of this study was to establish the levels and types of didactic competencies that exist among teaching staff in universities in Kenya, giving recognition to curriculum development, pedagogical attributes and quality assurance competencies. The study was carried out in two phases among two samples of the teaching staff population. The first…

E-Learning Readiness in Public Secondary Schools in Kenya

ERIC Educational Resources Information Center

Ouma, Gordon O.; Awuor, Fredrick M.; Kyambo, Benjamin

2013-01-01

As e-learning becomes useful to learning institutions worldwide, an assessment of e-learning readiness is essential for the successful implementation of e-learning as a platform for learning. Success in e-learning can be achieved by understanding the level of readiness of e-learning environments. To facilitate schools in Kenya to implement…

Financing Higher Education in Kenya: Student Perceptions and Experiences

ERIC Educational Resources Information Center

Ngolovoi, Mary S.

2008-01-01

In response to declining governmental funding, cost-sharing in higher education and dual-track tuition policies were introduced in the 1990s in Kenya. The decline of government funding in higher education was a result of slow economic growth, competing public needs (such as health, elementary education, and infrastructure), and pressure to reduce…

Prevalence of metabolic syndrome among an urban population in Kenya.

PubMed

Kaduka, Lydia U; Kombe, Yeri; Kenya, Eucharia; Kuria, Elizabeth; Bore, John K; Bukania, Zipporah N; Mwangi, Moses

2012-04-01

Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya. This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure. The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education. Metabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

The Value of Satellite Early Warning Systems in Kenya and Guatemala: Results and Lessons Learned from Contingent Valuation and Loss Avoidance Approaches

NASA Astrophysics Data System (ADS)

Morrison, I.; Berenter, J. S.

2017-12-01

SERVIR, the joint USAID and NASA initiative, conducted two studies to assess the value of two distinctly different Early Warning Systems (EWS) in Guatemala and Kenya. Each study applied a unique method to asses EWS value. The evaluation team conducted a Contingent Valuation (CV) choice experiment to measure the value of a near-real time VIIRS and MODIS-based hot-spot mapping tool for forest management professionals targeting seasonal forest fires in Northern Guatemala. The team also conducted a survey-based Damage and Loss Avoidance (DaLA) exercise to calculate the monetary benefits of a MODIS-derived frost forecasting system for farmers in the tea-growing highlands of Kenya. This presentation compares and contrasts the use and utility of these two valuation approaches to assess EWS value. Although interest in these methods is growing, few empirical studies have applied them to benefit and value assessment for EWS. Furthermore, the application of CV and DaLA methods is much less common outside of the developed world. Empirical findings from these two studies indicated significant value for two substantially different beneficiary groups: natural resource management specialists and smallholder tea farmers. Additionally, the valuation processes generated secondary information that can help improve the format and delivery of both types of EWS outputs for user and beneficiary communities in Kenya and Guatemala. Based on lessons learned from the two studies, this presentation will also compare and contrast the methodological and logistical advantages, challenges, and limitations in applying the CV and DaLA methods in developing countries. By reviewing these two valuation methods alongside each other, the authors will outline conditions where they can be applied - individually or jointly - to other early warning systems and delivery contexts.

Impact of a decision-support tool on decision making at the district level in Kenya

PubMed Central

2013-01-01

Background In many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions. Methods Thirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts. Results Findings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement. Conclusions This paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation

Climate-disease connections: Rift Valley Fever in Kenya

NASA Technical Reports Server (NTRS)

Anyamba, A.; Linthicum, K. J.; Tucker, C. J.

2001-01-01

All known Rift Valley fever(RVF) outbreaks in Kenya from 1950 to 1998 followed periods of abnormally high rainfall. On an interannual scale, periods of above normal rainfall in East Africa are associated with the warm phase of the El Nino/Southern Oscillation (ENSO) phenomenon. Anomalous rainfall floods mosquito-breeding habitats called dambos, which contain transovarially infected mosquito eggs. The eggs hatch Aedes mosquitoes that transmit the RVF virus preferentially to livestock and to humans as well. Analysis of historical data on RVF outbreaks and indicators of ENSO (including Pacific and Indian Ocean sea surface temperatures and the Southern Oscillation Index) indicates that more than three quarters of the RVF outbreaks have occurred during warm ENSO event periods. Mapping of ecological conditions using satellite normalized difference vegetation index (NDVI) data show that areas where outbreaks have occurred during the satellite recording period (1981-1998) show anomalous positive departures in vegetation greenness, an indicator of above-normal precipitation. This is particularly observed in arid areas of East Africa, which are predominantly impacted by this disease. These results indicate a close association between interannual climate variability and RVF outbreaks in Kenya.

Climate-disease connections: Rift Valley Fever in Kenya.

PubMed

Anyamba, A; Linthicum, K J; Tucker, C J

2001-01-01

All known Rift Valley fever(RVF) outbreaks in Kenya from 1950 to 1998 followed periods of abnormally high rainfall. On an interannual scale, periods of above normal rainfall in East Africa are associated with the warm phase of the El Niño/Southern Oscillation (ENSO) phenomenon. Anomalous rainfall floods mosquito-breeding habitats called dambos, which contain transovarially infected mosquito eggs. The eggs hatch Aedes mosquitoes that transmit the RVF virus preferentially to livestock and to humans as well. Analysis of historical data on RVF outbreaks and indicators of ENSO (including Pacific and Indian Ocean sea surface temperatures and the Southern Oscillation Index) indicates that more than three quarters of the RVF outbreaks have occurred during warm ENSO event periods. Mapping of ecological conditions using satellite normalized difference vegetation index (NDVI) data show that areas where outbreaks have occurred during the satellite recording period (1981-1998) show anomalous positive departures in vegetation greenness, an indicator of above-normal precipitation. This is particularly observed in arid areas of East Africa, which are predominantly impacted by this disease. These results indicate a close association between interannual climate variability and RVF outbreaks in Kenya.

Antiretroviral treatment scale-up among persons living with HIV in Kenya: results from a nationally representative survey.

PubMed

Odhiambo, Jacob O; Kellogg, Timothy A; Kim, Andrea A; Ng'ang'a, Lucy; Mukui, Irene; Umuro, Mamo; Mohammed, Ibrahim; De Cock, Kevin M; Kimanga, Davies O; Schwarcz, Sandra

2014-05-01

In 2007, 29% of HIV-infected Kenyans in need of antiretroviral therapy (ART), based on an immunologic criterion of CD4 ≤350 cells per microliter, were receiving ART. Since then, substantial treatment scale-up has occurred in the country. We analyzed data from the second Kenya AIDS Indicator Survey (KAIS 2012) to assess progress of treatment scale-up in Kenya. KAIS 2012 was a nationally representative survey of persons aged 18 months to 64 years that collected information on HIV status, care, and treatment. ART eligibility was defined based on 2 standards: (1) 2011 Kenya eligibility criteria for ART initiation: CD4 ≤350 cells per microliter or co-infection with active tuberculosis and (2) 2013 World Health Organization (WHO) eligibility criteria for ART initiation: CD4 ≤500 cells per microliter, co-infection with active tuberculosis, currently pregnant or breastfeeding, and infected partners in serodiscordant relationships. Blood specimens were tested for HIV antibodies and HIV-positive specimens tested for CD4 cell counts. Among 13,720 adults and adolescents aged 15-64 years, 11,626 provided a blood sample, and 648 were HIV infected. Overall, 58.8% [95% confidence interval (CI): 52.0 to 65.5) were eligible for treatment using the 2011 Kenya eligibility criteria and 77.4% (95% CI: 72.4 to 82.4) using the 2013 WHO eligibility criteria. Coverage of ART was 60.5% (95% CI: 50.8 to 70.2) using the 2011 Kenya eligibility criteria and 45.9% (95% CI: 37.7 to 54.2) using the 2013 WHO eligibility criteria. ART coverage has increased from 29% in 2007 to 61% in 2012. If Kenya adopts the 2013 WHO guidelines for ART initiation, need for ART increases by an additional 19 percentage points and current coverage decreases by an additional 15 percentage points, representing an additional 214,000 persons who will need to be reached.

Genetic variability and population structure of Plasmodium falciparum parasite populations from different malaria ecological regions of Kenya.

PubMed

Ingasia, Luicer A; Cheruiyot, Jelagat; Okoth, Sheila Akinyi; Andagalu, Ben; Kamau, Edwin

2016-04-01

Transmission intensity, movement of human and vector hosts, biogeographical features, and malaria control measures are some of the important factors that determine Plasmodium falciparum parasite genetic variability and population structure. Kenya has different malaria ecologies which might require different disease intervention methods. Refined parasite population genetic studies are critical for informing malaria control and elimination strategies. This study describes the genetic diversity and population structure of P. falciparum parasites from the different malaria ecological zones in Kenya. Twelve multi-locus microsatellite (MS) loci previously described were genotyped in 225 P. falciparum isolates collected between 2012 and 2013 from five sites; three in lowland endemic regions (Kisumu, Kombewa, and Malindi) and two in highland, epidemic regions (Kisii and Kericho). Parasites from the lowland endemic and highland epidemic regions of western Kenya had high genetic diversity compared to coastal lowland endemic region of Kenya [Malindi]. The Kenyan parasites had a mean genetic differentiation index (FST) of 0.072 (p=0.011). The multi-locus genetic analysis of the 12 MS revealed all the parasites had unique haplotypes. Significant linkage disequilibrium (LD) was observed in all the five parasite populations. Kisumu had the most significant index of association values (0.16; p<0.0001) whereas Kisii had the least significant index of association values (0.03; p<0.0001). Our data suggest high genetic diversity in Kenyan parasite population with the exception of parasite from Malindi where malaria has been on the decline. The presence of significant LD suggests that there is occurrence of inbreeding in the parasite population. Parasite populations from Kisii showed the strongest evidence for epidemic population structure whereas the rest of the regions showed panmixia. Defining the genetic diversity of the parasites in different ecological regions of Kenya after

Using mobile electronic devices to deliver educational resources in developing countries.

PubMed

Mazal, Jonathan Robert; Ludwig, Rebecca

2015-01-01

Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for

Rural-Urban Differences in Trends in the Wealth Index in Kenya: 1993–2009

PubMed Central

Egede, Leonard E.; Voronca, Delia; Walker, Rebekah J.; Thomas, Craig

2017-01-01

Background The aim of this study was to construct a wealth index that could be compared over time in order to understand the trends in wealth in Kenya, and determine predictors of change in wealth index. Methods Data was from the Demographic and Health Survey (DHS) program collected in Kenya between 1993 and 2009. Variable categories were collapsed to match and factor analysis was performed on the four year pooled data to generate a harmonized wealth index. Possible predictors of wealth were selected from household variables available for all four years. Household sampling weights and stratification by rural/urban was used. Results Overall, wealth increased in Kenya between 1993 and 2008; however, when stratified no significant increase existed in urban areas, and a significant increase in rural areas specifically between 2003 and 2008. The strongest predictor was education, with more than a standard deviation difference for secondary or higher levels of education over those with no education. The association of gender of the head of household, and whether the head of household had a partner differed between rural and urban areas, with household heads who were women and those that had a partner having more wealth in urban areas, but less wealth in rural areas. Conclusion Wealth in Kenya increased overtime, specifically in rural regions. Differences were seen in predictors of wealth by urban/rural residence, educational level, and gender of the head-of-household, and should be taken into account when planning interventions to target those in disproportionately low wealth brackets. PMID:28619399

Mapping Prosopis spp. within the Tarach water basin, Turkana, Kenya using Sentinel-2 imagery

NASA Astrophysics Data System (ADS)

Ng, Wai-Tim; Immitzer, Markus; Floriansitz, Matthias; Vuolo, Francesco; Luminari, Luigi; Adede, Chrisgone; Wahome, Raphael; Atzberger, Clement

2016-10-01

Prosopis spp. are a fast growing invasive tree originating from the American dry zones, introduced to Kenya in the 1970s for the restoration of degraded pastoral lands after prolonged droughts and overgrazing. Its deep rooting system is capable of tapping into the ground water table reducing its dependency on rain water and increasing its drought tolerance. It is believed that the Prosopis invasion was eased by a hybridization process, described as the Prosopis Juliflora - Prosopis Pallida complex, suggesting that introduced Prosopis spp. evolved into a hybrid, specifically adapted to the environmental conditions, rendering it a superior and aggressive competitor to endemic species. In many dry lands in Kenya Prosopis has expanded rapidly and has become challenging to control. On the other hand, in some cases, an economic use seems possible. In both cases, detailed and accurate maps are necessary to support stakeholders and design management strategies. The aim of this study is to map the distribution of Prosopis spp. in a selected area in north-west Turkana (Kenya), covering a section of the Tarach water basin. The study is funded by the European Union through the National Drought Management Authority (NDMA) in Kenya, and the main purpose is to assess the potential production of Prosopis pods, which can be used to manufacture emergency livestock feeds to support animals during drought events. The classification was performed using novel Sentinel-2 data through a non-parametric Random Forest classifier. A selection of reference sites was visited in the field and used to train the classifier. Very high classification accuracies were obtained.

Success criteria for electronic medical record implementations in low-resource settings: a systematic review.

PubMed

Fritz, Fleur; Tilahun, Binyam; Dugas, Martin

2015-03-01

Electronic medical record (EMR) systems have the potential of supporting clinical work by providing the right information at the right time to the right people and thus make efficient use of resources. This is especially important in low-resource settings where reliable data are also needed to support public health and local supporting organizations. In this systematic literature review, our objectives are to identify and collect literature about success criteria of EMR implementations in low-resource settings and to summarize them into recommendations. Our search strategy relied on PubMed queries and manual bibliography reviews. Studies were included if EMR implementations in low-resource settings were described. The extracted success criteria and measurements were summarized into 7 categories: ethical, financial, functionality, organizational, political, technical, and training. We collected 381 success criteria with 229 measurements from 47 articles out of 223 articles. Most papers were evaluations or lessons learned from African countries, published from 1999 to 2013. Almost half of the EMR systems served a specific disease area like human immunodeficiency virus (HIV). The majority of criteria that were reported dealt with the functionality, followed by organizational issues, and technical infrastructures. Sufficient training and skilled personnel were mentioned in roughly 10%. Political, ethical, and financial considerations did not play a predominant role. More evaluations based on reliable frameworks are needed. Highly reliable data handling methods, human resources and effective project management, as well as technical architecture and infrastructure are all key factors for successful EMR implementation. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparison of African swine fever virus prevalence and risk in two contrasting pig-farming systems in South-west and Central Kenya.

PubMed

Okoth, E; Gallardo, C; Macharia, J M; Omore, A; Pelayo, V; Bulimo, D W; Arias, M; Kitala, P; Baboon, K; Lekolol, I; Mijele, D; Bishop, R P

2013-06-01

We describe a horizontal survey of African swine fever virus (ASFV) prevalence and risk factors associated with virus infection in domestic pigs in two contrasting production systems in Kenya. A free range/tethering, low input production system in Ndhiwa District of South-western Kenya is compared with a medium input stall fed production system in Kiambu District of Central Kenya. Analysis of variance (ANOVA) of data derived from cluster analysis showed that number of animals, number of breeding sows and number of weaner pigs were a significant factor in classifying farms in Nhiwa and Kiambu. Analysis of blood and serum samples using a PCR assay demonstrated an average animal level positivity to ASFV of 28% in two independent samplings in South-western Kenya and 0% PCR positivity in Central Kenya. No animals were sero-positive in either study site using the OIE indirect-ELISA and none of the animals sampled exhibited clinical symptoms of ASF. The farms that contained ASFV positive pigs in Ndhiwa District were located in divisions bordering the Ruma National Park from which bushpig (Potamochoerus larvatus) incursions into farms had been reported. ASFV prevalence (P<0.05) was significantly higher at distances between 6 and 16km from the National Park than at distances closer or further away. One of the 8 bushpigs sampled from the park, from which tissues were obtained was PCR positive for ASFV. The data therefore indicated a potential role for the bushpig in virus transmission in South-western Kenya, but there was no evidence of a direct sylvatic virus transmission cycle in Central Kenya. ASF control strategies implemented in these areas will need to take these epidemiological findings into consideration. Copyright © 2012 Elsevier B.V. All rights reserved.

An ethnographic exploration of drug markets in Kisumu, Kenya

PubMed Central

Syvertsen, Jennifer L.; Ohaga, Spala; Agot, Kawango; Dimova, Margarita; Guise, Andy; Rhodes, Tim; Wagner, Karla D.

2016-01-01

Background Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly in developing nations where new markets and local patterns of use traditionally have not been well understood. This paper explores the emergent drug market in Kisumu, western Kenya, where our research team recently documented evidence of injection drug use. Methods Our exploratory study of injection drug use was conducted in Kisumu from 2013-2014. We draw on 151 surveys, 29 in-depth interviews, and 8 months of ethnographic fieldwork to describe the drug market from the perspective of injectors, focusing on their perceptions of the market and reports of drug use therein. Results Injectors described a dynamic market in which the availability of drugs and proliferation of injection drug use have taken on growing importance in Kisumu. In addition to reports of white and brown forms of heroin and concerns about drug adulteration in the market, we unexpectedly documented widespread perceptions of cocaine availability and injection in Kisumu. Examining price data and socio-pharmacological experiences of cocaine injection left us with unconfirmed evidence of its existence, but opened further possibilities about how the chaos of new drug markets and diffusion of injection-related beliefs and practices may lend insight into the sociopolitical context of western Kenya. Conclusions We suggest a need for expanded drug surveillance, education and programming responsive to local conditions, and further ethnographic inquiry into the social meanings of emergent drug markets in Kenya and across sub-Saharan Africa. PMID:26838470

Understanding road safety in Kenya: views of matatu drivers.

PubMed

Raynor, Nicolas J; Mirzoev, Tolib

2014-09-01

Road traffic accidents (RTAs) are estimated to cause 1.3 million deaths and 20-50 million injuries worldwide. Road safety is a challenge in Kenya with causes being multi-factorial. Matatus (minibuses) are involved in a large proportion of accidents. A literature review was completed to identify key issues and refine the scope of the study. The fieldwork included 20 semi-structured interviews with matatu drivers. All participants were male, with driving experience of 1-20 years. Thematic framework was used for analysis. Some unstructured observations on different road users and their behaviours were also recorded. Literature showed that the causes of RTAs in Kenya are multi-factorial, but that human factors play a large part. There is also an evidence gap concerning matatu drivers, who are key stakeholders in road safety. Fieldwork showed that the matatu industry creates financial pressures on drivers and an excessive level of competition, leading to dangerous driving. Corruption of traffic police appears to be a major barrier to improving road safety, as road safety legislation is not enforced, and bribery has become the cultural norm. The general public, including passengers and private vehicles owners, also cause problems by failing to understand their role in road safety and placing the blame on others. The key policy implication for improving road safety in Kenya is seeking measures to ensure responsibility by all road users through awareness raising in the short-term and reforming the matatu industry and addressing the root causes of corruption in the longer term. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Biogeography of the Shimba Hills ecosystem herpetofauna in Kenya

PubMed Central

Malonza, Patrick K.; Mulwa, David M.; Nyamache, Joash O.; Jones, Georgina

2018-01-01

The Shimba Hills ecosystem along the south coast of Kenya is a key East African biodiversity hotspot. Historically, it is biogeographically assignable to the East African coastal biome. We examined the current Shimba Hills herpetofauna and their zoogeographical affinities to the coastal forests and nearby Eastern Arc Mountains biodiversity hotspots. The key studied sites included the Shimba Hills National Reserve, forest reserves, Kaya forests, and adjacent private land. Data on herpetofaunal richness were obtained from recent field surveys, literature, and specimens held at the National Museums of Kenya, Herpetology Section Collection, Nairobi. The Makadara, Mwele, and Longo-Mwagandi forests within the Shimba Hills National Reserve hosted the highest number of unique and rare species. Generally, the forest reserves and Kaya forests were important refuges for forest-associated species. On private land, Mukurumudzi Dam riparian areas were the best amphibian habitat and were host to three IUCN (Red List) Endangered-EN amphibian species, namely, Boulengerula changamwensis, Hyperolius rubrovermiculatus, and Afrixalus sylvaticus, as well as one snake species Elapsoidea nigra. Using herpetofauna as zoogeographic indicators, the Shimba Hills were determined to be at a crossroads between the coastal forests (13 endemic species) and the Eastern Arc Mountains (seven endemic species). Most of the Eastern Arc Mountains endemic species were from recent records, and thus more are likely to be found in the future. This ‘hybrid’ species richness pattern is attributable to the hilly topography of the Shimba Hills and their proximity to the Indian Ocean. This has contributed to the Shimba Hills being the richest herpetofauna area in Kenya, with a total of 89 and 38 reptile and amphibian species, respectively. Because of its unique zoogeography, the Shimba Hills ecosystem is undoubtedly a key biodiversity area for conservation investment. PMID:29515091

Biogeography of the Shimba Hills ecosystem herpetofauna in Kenya.

PubMed

Malonza, Patrick K; Mulwa, David M; Nyamache, Joash O; Jones, Georgina

2018-03-18

The Shimba Hills ecosystem along the south coast of Kenya is a key East African biodiversity hotspot. Historically, it is biogeographically assignable to the East African coastal biome. We examined the current Shimba Hills herpetofauna and their zoogeographical affinities to the coastal forests and nearby Eastern Arc Mountains biodiversity hotspots. The key studied sites included the Shimba Hills National Reserve, forest reserves, Kaya forests, and adjacent private land. Data on herpetofaunal richness were obtained from recent field surveys, literature, and specimens held at the National Museums of Kenya, Herpetology Section Collection, Nairobi. The Makadara, Mwele, and Longo-Mwagandi forests within the Shimba Hills National Reserve hosted the highest number of unique and rare species. Generally, the forest reserves and Kaya forests were important refuges for forest-associated species. On private land, Mukurumudzi Dam riparian areas were the best amphibian habitat and were host to three IUCN (Red List) Endangered-EN amphibian species, namely, Boulengerula changamwensis, Hyperolius rubrovermiculatus, and Afrixalus sylvaticus, as well as one snake species Elapsoidea nigra. Using herpetofauna as zoogeographic indicators, the Shimba Hills were determined to be at a crossroads between the coastal forests (13 endemic species) and the Eastern Arc Mountains (seven endemic species). Most of the Eastern Arc Mountains endemic species were from recent records, and thus more are likely to be found in the future. This 'hybrid' species richness pattern is attributable to the hilly topography of the Shimba Hills and their proximity to the Indian Ocean. This has contributed to the Shimba Hills being the richest herpetofauna area in Kenya, with a total of 89 and 36 reptile and amphibian species, respectively. Because of its unique zoogeography, the Shimba Hills ecosystem is undoubtedly a key biodiversity area for conservation investment.

An ethnographic exploration of drug markets in Kisumu, Kenya.

PubMed

Syvertsen, Jennifer L; Ohaga, Spala; Agot, Kawango; Dimova, Margarita; Guise, Andy; Rhodes, Tim; Wagner, Karla D

2016-04-01

Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly in developing nations where new markets and local patterns of use traditionally have not been well understood. This paper explores the emergent drug market in Kisumu, western Kenya, where our research team recently documented evidence of injection drug use. Our exploratory study of injection drug use was conducted in Kisumu from 2013 to 2014. We draw on 151 surveys, 29 in-depth interviews, and 8 months of ethnographic fieldwork to describe the drug market from the perspective of injectors, focusing on their perceptions of the market and reports of drug use therein. Injectors described a dynamic market in which the availability of drugs and proliferation of injection drug use have taken on growing importance in Kisumu. In addition to reports of white and brown forms of heroin and concerns about drug adulteration in the market, we unexpectedly documented widespread perceptions of cocaine availability and injection in Kisumu. Examining price data and socio-pharmacological experiences of cocaine injection left us with unconfirmed evidence of its existence, but opened further possibilities about how the chaos of new drug markets and diffusion of injection-related beliefs and practices may lend insight into the sociopolitical context of western Kenya. We suggest a need for expanded drug surveillance, education and programming responsive to local conditions, and further ethnographic inquiry into the social meanings of emergent drug markets in Kenya and across sub-Saharan Africa. Copyright © 2016 Elsevier B.V. All rights reserved.

Technical Secondary Students in Kenya: Origins, Achievement and Destinations.

ERIC Educational Resources Information Center

Lauglo, Jon

1989-01-01

Reports a study in which 1,000 high school seniors at 8 Kenyan schools participated. Data were gathered regarding their social and geographical regions, and the results on the Kenya Certificate of Education (KCE) examination were used. Findings show there is no rule that school-based vocational training is inferior to academic secondary education.…

Echinococcus spp. in central Kenya: a different story.

PubMed

Mbaya, H; Magambo, J; Njenga, S; Zeyhle, E; Mbae, C; Mulinge, E; Wassermann, M; Kern, P; Romig, T

2014-10-01

Research on cystic echinococcosis (CE) has a long history in Kenya, but has mainly concentrated on two discrete areas, Turkana and Maasailand, which are known to be foci of human CE in Africa. Here, we report on a survey for CE in livestock from central to northeastern Kenya, from where no previous data are available. A total of 7,831 livestock carcasses were surveyed. CE prevalence was 1.92% in cattle (n = 4,595), 6.94% in camels (n = 216), 0.37% in goats (n = 2,955) and 4.62% in sheep (n = 65). Identification of the parasite was done using an RFLP-PCR of the mitochondrial nad1 gene, which had been validated before against the various Echinococcus taxa currently recognized as distinct species. From a total of 284 recovered cysts, 258 could be identified as Echinococcus granulosus sensu stricto (n = 160), E. ortleppi (n = 51) and E. canadensis (n = 47) by RFLP-PCR of nad1. In cattle, fertile cysts occurred mostly in the lungs and belonged to E. ortleppi (31 of 54), while the vast majority were sterile or calcified cysts of E. granulosus s.s.. Most fertile cysts in camels belonged to E. canadensis (33 of 37); sterile or calcified cysts were rare. Goats harboured fertile cysts of E. ortleppi (n = 3)--which is the first record in that host species--and E. canadensis (n = 1), while all cysts of E. granulosus were sterile. Only sterile cysts were found in the three examined sheep. Typically, all cysts in animals with multiple infections belonged to the same species, while mixed infections were rare. Our data indicate that the epidemiological situation in central to northeastern Kenya is clearly different from the well-studied pastoral regions of Turkana and Maasailand, and the apparently low number of human CE cases correlates with the infrequent occurrence of E. granulosus s.s.

The impact of HIV / AIDS on Kenya's commercial sector.

PubMed

Forsythe, S; Roberts, M

1995-02-01

AIDSCAP is undertaking a project designed to encourage Kenya's private sector to participate in HIV/AIDS prevention efforts. Part of that project involves estimating the impact of HIV/AIDS on Kenya's commercial sector. AIDSCAP and Kenyan researcher estimates are based upon financial data from a sugar estate, a transportation company, a wood processing plant, a textile factory, and a light manufacturing company, a small sample representing the diversity of industries in the country. Most are medium-sized companies with 1200-2200 employees. Preliminary results suggest that absenteeism, training costs, and HIV-related health care will cause the greatest losses to Kenyan businesses. Projections show that the HIV/AIDS epidemic could increase labor costs for some Kenyan businesses by 17% by the year 2005. Despite increasing labor costs, however, the epidemic may not cause a significant drop in profits for larger, capital-intensive Kenyan businesses. Some companies could still find their profits cut by 15-25% within the next 10 years. Study findings and implications for workplace prevention programs are discussed.

Invasive Group A Streptococcus Infection among Children, Rural Kenya.

PubMed

Seale, Anna C; Davies, Mark R; Anampiu, Kirimi; Morpeth, Susan C; Nyongesa, Sammy; Mwarumba, Salim; Smeesters, Pierre R; Efstratiou, Androulla; Karugutu, Rosylene; Mturi, Neema; Williams, Thomas N; Scott, J Anthony G; Kariuki, Samuel; Dougan, Gordon; Berkley, James A

2016-02-01

To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998-2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type-specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence.

The Prevalence of Disclosure of HIV Status to HIV-Infected Children in Western Kenya.

PubMed

Turissini, Matthew L; Nyandiko, Winstone M; Ayaya, Samuel O; Marete, Irene; Mwangi, Ann; Chemboi, Victor; Warui, Lucy; Vreeman, Rachel C

2013-06-01

As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)-infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resource-limited settings. We conducted a prospective assessment of a random sample of HIV-infected children ages 6-14 years enrolled in HIV care at a large referral clinic in Eldoret, Kenya. Clinicians administered questionnaires to children and caregivers independently at routine clinic visits to assess disclosure status, ART adherence, stigma, and depression. Children's demographic and clinical characteristics were extracted from chart review. We calculated descriptive statistics and performed logistic regression to assess the association between disclosure and other characteristics. Two hundred seventy children-caregiver dyads completed questionnaires. The mean child age was 9.3 years (standard deviation 2.6); 49% were male, and 42% were orphans. 11.1% of children had been informed of their HIV status (N = 30). Of those under 10 years, 3.3% knew their status, whereas 9.2% of 10- to 12-year-olds and 39.5% of 13- to 14-year-olds knew they had HIV. Only age was significantly associated with disclosure status in both bivariate analyses (P < .0001) and multiple logistic regression (odds ratio 1.67, 95% confidence interval 1.36-2.05) when considering social demographics, disease stage variables, adherence, stigma measures, and depression. Rates of informing children in western Kenya of their HIV status are low, even among older children. Guiding families through developmentally appropriate disclosure processes should be a key facet of long-term pediatric HIV management. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

76 FR 68057 - Importation of French Beans and Runner Beans From the Republic of Kenya Into the United States

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