Sample records for nakuru district kenya

  1. Influence of Gender and Knowledge on Secondary School Students' Scientific Creativity Skills in Nakuru District, Kenya

    ERIC Educational Resources Information Center

    Okere, Mark I. O.; Ndeke, Grace C. W.

    2012-01-01

    The purpose of this study was to investigate the influence of gender and knowledge on scientific creativity among form three biology students (third year in secondary school cycle) in Nakuru district in Kenya. The cross- sectional survey research was employed. A sample of eight schools with a total of 363 students was selected from the population…

  2. IMPACT OF CLINICAL OFFICER ANAESTHETIST TRAINING PROGRAMME AT THE KENYA MEDICAL TRAINING COLLEGE, NAKURU, ON TRAINEE SATISFACTION, QUALITY OF PRACTICE, AND CADRE SHORTFALL ALLEVIATION.

    PubMed

    Nyamai, K; Ng'ang'a, P; Mutisya, R

    2013-07-01

    To determine the impact of Clinical Officer (C.O) Anaesthetist Training programme at Kenya Medical Training College (KMTC) Nakuru, on Trainee satisfaction, quality of practice and cadre shortfall alleviation. Cross-sectional descriptive study. Kenya Medical Training College, Nakuru. All thirty one Clinical Officer Anaesthetist graduates from KMTC Nakuru, since the training programme started 8 years ago. Twenty nine of the 31 C.O Anaesthetist graduates responded. Twenty six of the 29 respondents (89.7%) passed in the final qualifying examination in the first sitting. Twenty one (72.4%) are working in Public health facilities. All graduates are distributed in 16 out of the 47 counties in Kenya. Twenty six (89.7%) are satisfied with the training. Their average working week is 54 hours, with a median of 45 working hours a week. They recommend an improvement in peripheral nerve blocks and epidural training in the 2005 curriculum. C.O Anaesthetist training in KMTC Nakuru over the last eight years has produced self reported satisfied, adequately trained graduates and has had an impact in alleviating shortage of this cadre in Kenya. Improvement in peripheral nerve blocks and epidural training is needed.

  3. The Nakuru posterior segment eye disease study: methods and prevalence of blindness and visual impairment in Nakuru, Kenya.

    PubMed

    Mathenge, Wanjiku; Bastawrous, Andrew; Foster, Allen; Kuper, Hannah

    2012-10-01

    To estimate the prevalence of blindness and visual impairment (VI) in adults aged ≥50 years in the Nakuru district of Kenya and to identify sociodemographic risk factors for these conditions. We also sought to validate the Rapid Assessment of Avoidable Blindness (RAAB) methodology. There were 5010 subjects enumerated for this study. Of these, 4414 participants underwent examination, for a response rate of 88.1%. Cross-sectional, population-based survey. Cluster random samplings with probability proportionate to size procedures were used to select a representative cross-sectional sample of adults aged ≥50 years. Each participant was interviewed, had distance visual acuity (VA) measured with reduced logarithm of the minimal angle of resolution tumbling-E chart, underwent autorefraction, and thereby had measurements of presenting, uncorrected, and best-corrected VA. All participants, regardless of vision, underwent detailed ophthalmic examinations including slit-lamp assessment and dilated retinal photographs. Visual acuity of <6/12. A representative sample of 4414 adults were enumerated (response rate, 88.1%). The prevalence of blindness (VA < 3/60 in better eye) was 1.6% (95% confidence interval [CI], 1.2-2.1%) and of VI, 0.4% (95% CI, 0.3-0.7%); 8.1% (95% CI, 7.2-9.2%); and 5.1% (95% CI, 4.3-6.1%) were severely (<6/60-3/60), moderately (<6/18-6/60), or mildly (<6/12-6/18) visually impaired, respectively. Being male, having less education, having Kalenjin tribal origin, and being ≥80 years old were associated with increased blindness prevalence. Prevalence estimates were comparable to a RAAB performed in the same area 2 years earlier. This survey provides reliable estimates of blindness and VI prevalence in Nakuru. Older age and tribal origin were identified as predictors of these conditions. This survey validates the use of RAAB as a method of estimating blindness and VI prevalence. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier

  4. Major and trace element geochemistry of Lake Bogoria and Lake Nakuru, Kenya, during extreme draught.

    PubMed

    Jirsa, Franz; Gruber, Martin; Stojanovic, Anja; Omondi, Steve Odour; Mader, Dieter; Körner, Wilfried; Schagerl, Michael

    2013-10-01

    The physico-chemical properties of water samples from the two athalassic endorheic lakes Bogoria and Nakuru in Kenya were analysed. Surface water samples were taken between July 2008 and October 2009 in weekly intervals from each lake. The following parameters were determined: pH, salinity, electric conductivity, dissolved organic carbon (DOC), the major cations (FAAS and ICP-OES) and the major anions (IC), as well as certain trace elements (ICP-OES). Samples of superficial sediments were taken in October 2009 and examined using Instrumental Neutron Activation Analysis (INAA) for their major and trace element content including rare earth elements (REE). Both lakes are highly alkaline with a dominance of Na > K > Si > Ca in cations and HCO 3  > CO 3  > Cl > F > SO 4 in anions. Both lakes also exhibited high concentrations of Mo, As and fluoride. Due to an extreme draught from March to October 2009, the water level of Lake Nakuru dropped significantly. This created drastic evapoconcentration, with the total salinity rising from about 20‰ up to 63‰. Most parameters (DOC, Na, K, Ca, F, Mo and As) increased with falling water levels. A clear change in the quality of DOC was observed, followed by an almost complete depletion of dissolved Fe from the water phase. In Lake Bogoria the evapoconcentration effects were less pronounced (total salinity changed from about 40‰ to 48‰). The distributions of REE in the superficial sediments of Lake Nakuru and Lake Bogoria are presented here for the first time. The results show a high abundance of the REE and a very distinct Eu depletion of Eu/Eu* = 0.33-0.45.

  5. Major and trace element geochemistry of Lake Bogoria and Lake Nakuru, Kenya, during extreme draught

    PubMed Central

    Jirsa, Franz; Gruber, Martin; Stojanovic, Anja; Omondi, Steve Odour; Mader, Dieter; Körner, Wilfried; Schagerl, Michael

    2013-01-01

    The physico-chemical properties of water samples from the two athalassic endorheic lakes Bogoria and Nakuru in Kenya were analysed. Surface water samples were taken between July 2008 and October 2009 in weekly intervals from each lake. The following parameters were determined: pH, salinity, electric conductivity, dissolved organic carbon (DOC), the major cations (FAAS and ICP-OES) and the major anions (IC), as well as certain trace elements (ICP-OES). Samples of superficial sediments were taken in October 2009 and examined using Instrumental Neutron Activation Analysis (INAA) for their major and trace element content including rare earth elements (REE). Both lakes are highly alkaline with a dominance of Na > K > Si > Ca in cations and HCO3 > CO3 > Cl > F > SO4 in anions. Both lakes also exhibited high concentrations of Mo, As and fluoride. Due to an extreme draught from March to October 2009, the water level of Lake Nakuru dropped significantly. This created drastic evapoconcentration, with the total salinity rising from about 20‰ up to 63‰. Most parameters (DOC, Na, K, Ca, F, Mo and As) increased with falling water levels. A clear change in the quality of DOC was observed, followed by an almost complete depletion of dissolved Fe from the water phase. In Lake Bogoria the evapoconcentration effects were less pronounced (total salinity changed from about 40‰ to 48‰). The distributions of REE in the superficial sediments of Lake Nakuru and Lake Bogoria are presented here for the first time. The results show a high abundance of the REE and a very distinct Eu depletion of Eu/Eu* = 0.33–0.45. PMID:25843965

  6. Results of Automated Retinal Image Analysis for Detection of Diabetic Retinopathy from the Nakuru Study, Kenya.

    PubMed

    Hansen, Morten B; Abràmoff, Michael D; Folk, James C; Mathenge, Wanjiku; Bastawrous, Andrew; Peto, Tunde

    2015-01-01

    Digital retinal imaging is an established method of screening for diabetic retinopathy (DR). It has been established that currently about 1% of the world's blind or visually impaired is due to DR. However, the increasing prevalence of diabetes mellitus and DR is creating an increased workload on those with expertise in grading retinal images. Safe and reliable automated analysis of retinal images may support screening services worldwide. This study aimed to compare the Iowa Detection Program (IDP) ability to detect diabetic eye diseases (DED) to human grading carried out at Moorfields Reading Centre on the population of Nakuru Study from Kenya. Retinal images were taken from participants of the Nakuru Eye Disease Study in Kenya in 2007/08 (n = 4,381 participants [NW6 Topcon Digital Retinal Camera]). First, human grading was performed for the presence or absence of DR, and for those with DR this was sub-divided in to referable or non-referable DR. The automated IDP software was deployed to identify those with DR and also to categorize the severity of DR. The primary outcomes were sensitivity, specificity, and positive and negative predictive value of IDP versus the human grader as reference standard. Altogether 3,460 participants were included. 113 had DED, giving a prevalence of 3.3% (95% CI, 2.7-3.9%). Sensitivity of the IDP to detect DED as by the human grading was 91.0% (95% CI, 88.0-93.4%). The IDP ability to detect DED gave an AUC of 0.878 (95% CI 0.850-0.905). It showed a negative predictive value of 98%. The IDP missed no vision threatening retinopathy in any patients and none of the false negative cases met criteria for treatment. In this epidemiological sample, the IDP's grading was comparable to that of human graders'. It therefore might be feasible to consider inclusion into usual epidemiological grading.

  7. A Comparative Study of the Influence of Head Teachers Management Styles on Pupils Performance in KCPE in Public and Private Primary Schools in Nakuru Municipality, Kenya

    ERIC Educational Resources Information Center

    Shibo, Margaret Nekesa

    2016-01-01

    The purpose of this study was to compare the influence of management styles of head teacher's on pupils' performance in private and public primary schools in Nakuru municipality at Kenya Certificate of Primary Education level. The population comprised of teachers and head teachers in public primary schools. The study adopted the ex post facto…

  8. Wildlife Population Dynamics in Human-Dominated Landscapes under Community-Based Conservation: The Example of Nakuru Wildlife Conservancy, Kenya

    PubMed Central

    Ogutu, Joseph O.; Kuloba, Bernard; Piepho, Hans-Peter; Kanga, Erustus

    2017-01-01

    Wildlife conservation is facing numerous and mounting challenges on private and communal lands in Africa, including in Kenya. We analyze the population dynamics of 44 common wildlife species in relation to rainfall variation in the Nakuru Wildlife Conservancy (NWC), located in the Nakuru-Naivasha region of Kenya, based on ground total counts carried out twice each year from March 1996 to May 2015. Rainfall in the region was quasi-periodic with cycle periods dependent on the rainfall component and varying from 2.8 years for the dry season to 10.9 years for the wet season. These oscillations are associated with frequent severe droughts and food scarcity for herbivores. The trends for the 44 wildlife species showed five general patterns during 1996–2015. 1) Steinbuck, bushbuck, hartebeest and greater kudu numbers declined persistently and significantly throughout 1996–2015 and thus merit the greatest conservation attention. 2) Klipspringer, mongoose, oribi, porcupine, cheetah, leopard, ostrich and Sykes monkey numbers also decreased noticeably but not significantly between 1996 and 2015. 3) Dik dik, eland, African hare, Jackal, duiker, hippo and Thomson’s gazelle numbers first increased and then declined between 1996 and 2015 but only significantly for duiker and hippo. 4) Aardvark, serval cat, colobus monkey, bat-eared fox, reedbuck, hyena and baboon numbers first declined and then increased but only the increases in reedbuck and baboon numbers were significant. 5) Grant’s gazelle, Grevy’s zebra, lion, spring hare, Burchell’s zebra, bushpig, white rhino, rock hyrax, topi, oryx, vervet monkey, guinea fowl, giraffe, and wildebeest numbers increased consistently between 1996 and 2015. The increase was significant only for rock hyrax, topi, vervet monkey, guinea fowl, giraffe and wildebeest. 6) Impala, buffalo, warthog, and waterbuck, numbers increased significantly and then seemed to level off between 1996 and 2015. The aggregate biomass of primates and

  9. Wildlife Population Dynamics in Human-Dominated Landscapes under Community-Based Conservation: The Example of Nakuru Wildlife Conservancy, Kenya.

    PubMed

    Ogutu, Joseph O; Kuloba, Bernard; Piepho, Hans-Peter; Kanga, Erustus

    2017-01-01

    Wildlife conservation is facing numerous and mounting challenges on private and communal lands in Africa, including in Kenya. We analyze the population dynamics of 44 common wildlife species in relation to rainfall variation in the Nakuru Wildlife Conservancy (NWC), located in the Nakuru-Naivasha region of Kenya, based on ground total counts carried out twice each year from March 1996 to May 2015. Rainfall in the region was quasi-periodic with cycle periods dependent on the rainfall component and varying from 2.8 years for the dry season to 10.9 years for the wet season. These oscillations are associated with frequent severe droughts and food scarcity for herbivores. The trends for the 44 wildlife species showed five general patterns during 1996-2015. 1) Steinbuck, bushbuck, hartebeest and greater kudu numbers declined persistently and significantly throughout 1996-2015 and thus merit the greatest conservation attention. 2) Klipspringer, mongoose, oribi, porcupine, cheetah, leopard, ostrich and Sykes monkey numbers also decreased noticeably but not significantly between 1996 and 2015. 3) Dik dik, eland, African hare, Jackal, duiker, hippo and Thomson's gazelle numbers first increased and then declined between 1996 and 2015 but only significantly for duiker and hippo. 4) Aardvark, serval cat, colobus monkey, bat-eared fox, reedbuck, hyena and baboon numbers first declined and then increased but only the increases in reedbuck and baboon numbers were significant. 5) Grant's gazelle, Grevy's zebra, lion, spring hare, Burchell's zebra, bushpig, white rhino, rock hyrax, topi, oryx, vervet monkey, guinea fowl, giraffe, and wildebeest numbers increased consistently between 1996 and 2015. The increase was significant only for rock hyrax, topi, vervet monkey, guinea fowl, giraffe and wildebeest. 6) Impala, buffalo, warthog, and waterbuck, numbers increased significantly and then seemed to level off between 1996 and 2015. The aggregate biomass of primates and carnivores

  10. The mental health, quality of life and life satisfaction of internally displaced persons living in Nakuru County, Kenya.

    PubMed

    Getanda, Elijah Mironga; Papadopoulos, Chris; Evans, Hala

    2015-08-06

    Internally displaced persons (IDPs) are among the most vulnerable people in the world today. Previous research highlights that conflict-induced forced displacement can cause problems with mental health and wellbeing. This study aimed to contribute to this body of knowledge by investigating the mental health, quality of life, and life satisfaction among IDPs living in Nakuru, Kenya. A questionnaire that included the General Health Questionnaire-12, Satisfaction with Life Scale, and a modified version of the WHO Quality of Life-BREF tool was used for data collection. The questionnaire also included an open-ended question inviting qualitative responses about their experience as an IDP. The questionnaire was distributed through a three-stage sampling approach across four refugee camps from four regions of the Nakuru County in Kenya. One hundred IDPs participated in this study. All participants scored substantially higher than the applied GHQ-12 threshold for caseness (mean GHQ-12 score = 28.7, SD = 3.6). Quality of life and life satisfaction scores were also very poor (M = 10.24, SD = 1.9; M = 6.82, SD = 1.5 respectively). The qualitative results reflected these findings with statements reflecting suicidal thoughts, unhappiness with the government, lack of support, and fear for themselves and their children. Significantly higher GHQ-12 scores were found among older IDPs (rho = .202, sig = .046), widowers compared to married IDPs (mean difference = -2.41, SE = .885, sig = .027), while lower scores were found among IDPs who reported having friends as a source of support (U = 834, sig = .045), while quality of life scores were higher among IDPs who reported receiving governmental support (U = 248, sig = .018). The findings revealed poor levels of mental health, quality of life and life satisfaction. Older, widowed IDPs and those who did not perceive support from friends or the government were found to be at the highest risk of poor health and wellbeing.

  11. 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....

  12. Prevalence and predictors of refractive error and spectacle coverage in Nakuru, Kenya: a cross-sectional, population-based study.

    PubMed

    Bastawrous, Andrew; Mathenge, Wanjiku; Foster, Allen; Kuper, Hannah

    2013-10-01

    A cross-sectional study was undertaken in Nakuru, Kenya to assess the prevalence of refractive error and the spectacle coverage in a population aged ≥50 years. Of the 5,010 subjects who were eligible, 4,414 underwent examination (response rate 88.1 %). LogMAR visual acuity was assessed in all participants and refractive error was measured in both eyes using a Topcon auto refractor RM8800. Detailed interviews were undertaken and ownership of spectacles was assessed. Refractive error was responsible for 51.7 % of overall visual impairment (VI), 85.3 % (n = 191) of subjects with mild VI, 42.7 % (n = 152) of subjects with moderate VI, 16.7 % (n = 3) of subjects with severe VI and no cases of blindness. Myopia was more common than hyperopia affecting 59.5 % of those with refractive error compared to 27.4 % for hyperopia. High myopia (<-5.0 DS) was also more common than extreme hyperopia (>+5.0 DS). Of those who needed distance spectacles (spectacle coverage), 25.5 % owned spectacles. In conclusion, the oldest, most poor and least educated are most likely to have no spectacles and they should be specifically targeted when refractive services are put in place.

  13. 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

  14. Effects of Advance Organiser Strategy during Instruction on Secondary School Students' Mathematics Achievement in Kenya's Nakuru District

    ERIC Educational Resources Information Center

    Githua, Bernard N.; Nyabwa, Rachel Angela

    2008-01-01

    Students have continued to perform poorly in KCSE examinations in certain mathematics topics taught in secondary schools in Kenya. One such topic is commercial arithmetic. Successful teaching of mathematics depends partly on correct use of teaching methods in classroom settings. This study sought to examine how the use of advance organisers during…

  15. Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study

    PubMed Central

    Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Rono, Hillary; Gichangi, Michael; Weiss, Helen A.; Macleod, David; Foster, Allen; Burton, Matthew J.; Kuper, Hannah

    2016-01-01

    Purpose To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007–2008. Of these, 2170 (50%) were reexamined in 2013–2014. Methods The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. Results Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3–13.8%) and blindness was 1.51% (95%CI: 1.0–2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8–3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ≥50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ≥50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. Conclusions The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population. PMID:27820953

  16. Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study.

    PubMed

    Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Rono, Hillary; Gichangi, Michael; Weiss, Helen A; Macleod, David; Foster, Allen; Burton, Matthew J; Kuper, Hannah

    2016-11-01

    To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007-2008. Of these, 2170 (50%) were reexamined in 2013-2014. The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3-13.8%) and blindness was 1.51% (95%CI: 1.0-2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8-3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ≥50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ≥50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population.

  17. Population structure of giraffes is affected by management in the Great Rift Valley, Kenya

    PubMed Central

    2018-01-01

    Giraffe populations in East Africa have declined in the past thirty years yet there has been limited research on this species. This study had four objectives: i) to provide a baseline population assessment for the two largest populations of Rothschild’s giraffes in Kenya, ii) to assess whether there are differences in population structure between the two enclosed populations, iii) to assess the potential and possible implications of different management practices on enclosed giraffe populations to inform future decision-making, and iv) to add to the availability of information available about giraffes in the wild. I used individual identification to assess the size and structure of the two populations; in Soysambu Conservancy between May 2010 and January 2011, I identified 77 giraffes; in Lake Nakuru National Park between May 2011 and January 2012, I identified 89. Population structure differed significantly between the two sites; Soysambu Conservancy contained a high percentage of juveniles (34%) and subadults (29%) compared to Lake Nakuru NP, which contained fewer juveniles (5%) and subadults (15%). During the time of this study Soysambu Conservancy contained no lions while Lake Nakuru NP contained a high density of lions (30 lions per 100km2). Lions are the main predator of giraffes, and preferential predation on juvenile giraffes has previously been identified in Lake Nakuru NP. My results suggest that high lion density in Lake Nakuru NP may have influenced the structure of the giraffe population by removing juveniles and, consequently, may affect future population growth. I suggest that wildlife managers consider lion densities alongside breeding plans for Endangered species, since the presence of lions appears to influence the population structure of giraffes in enclosed habitats. PMID:29298338

  18. Population structure of giraffes is affected by management in the Great Rift Valley, Kenya.

    PubMed

    Muller, Zoe

    2018-01-01

    Giraffe populations in East Africa have declined in the past thirty years yet there has been limited research on this species. This study had four objectives: i) to provide a baseline population assessment for the two largest populations of Rothschild's giraffes in Kenya, ii) to assess whether there are differences in population structure between the two enclosed populations, iii) to assess the potential and possible implications of different management practices on enclosed giraffe populations to inform future decision-making, and iv) to add to the availability of information available about giraffes in the wild. I used individual identification to assess the size and structure of the two populations; in Soysambu Conservancy between May 2010 and January 2011, I identified 77 giraffes; in Lake Nakuru National Park between May 2011 and January 2012, I identified 89. Population structure differed significantly between the two sites; Soysambu Conservancy contained a high percentage of juveniles (34%) and subadults (29%) compared to Lake Nakuru NP, which contained fewer juveniles (5%) and subadults (15%). During the time of this study Soysambu Conservancy contained no lions while Lake Nakuru NP contained a high density of lions (30 lions per 100km2). Lions are the main predator of giraffes, and preferential predation on juvenile giraffes has previously been identified in Lake Nakuru NP. My results suggest that high lion density in Lake Nakuru NP may have influenced the structure of the giraffe population by removing juveniles and, consequently, may affect future population growth. I suggest that wildlife managers consider lion densities alongside breeding plans for Endangered species, since the presence of lions appears to influence the population structure of giraffes in enclosed habitats.

  19. The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya.

    PubMed

    Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Bastawrous, Madeleine; Rono, Hillary; Weiss, Helen A; Macleod, David; Foster, Allen; Peto, Tunde; Blows, Peter; Burton, Matthew; Kuper, Hannah

    2017-03-23

    The epidemic rise of diabetes carries major negative public health and economic consequences particularly for low and middle-income countries. The highest predicted percentage growth in diabetes is in the sub-Saharan Africa (SSA) region where to date there has been no data on the incidence of diabetic retinopathy from population-based cohort studies and minimal data on incident diabetes. The primary aims of this study were to estimate the cumulative six-year incidence of Diabetes Mellitus (DM) and DR (Diabetic Retinopathy), respectively, among people aged ≥50 years in Kenya. Random cluster sampling with probability proportionate to size were used to select a representative cross-sectional sample of adults aged ≥50 years in 2007-8 in Nakuru District, Kenya. A six-year follow-up was undertaken in 2013-14. On both occasions a comprehensive ophthalmic examination was performed including LogMAR visual acuity, digital retinal photography and independent grading of images. Data were collected on general health and risk factors. The primary outcomes were the incidence of diabetes mellitus and the incidence of diabetic retinopathy, which were calculated by dividing the number of events identified at 6-year follow-up by the number of people at risk at the beginning of follow-up. Age-adjusted risk ratios of the outcomes (DM and DR respectively) were estimated for each covariate using a Poisson regression model with robust error variance to allow for the clustered design and including inverse-probability weighting. At baseline, 4414 participants aged ≥50 years underwent complete examination. Of the 4104 non-diabetic participants, 2059 were followed-up at six-years (50 · 2%). The cumulative incidence of DM was estimated at 61 · 0 per 1000 (95% CI: 50 · 3-73 · 7) in people aged ≥50 years. The cumulative incidence of DR in the sample population was estimated at 15 · 8 per 1000 (95% CI: 9 · 5-26 · 3) among those without DM at baseline

  20. 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.

  1. Paleoclimate change in the Nakuru basin, Kenya, at 119 - 109 ka derived from δ18Odiatom and diatom assemblages and 40Ar/39Ar geochronology

    NASA Astrophysics Data System (ADS)

    Bergner, Andreas; Deino, Alan; Leng, Melanie; Gasse, Francoise

    2016-04-01

    A 4.5m-thick diatomite bed deposited during the cold interval of the penultimate interglacial at ~119 - 109 ka documents a period in which a deep freshwater lake filled the Nakuru basin in the Central Kenya Rift (CKR), East Africa. Palaeohydrological conditions of the basin are reconstructed for the paleolake highstand using δ18Odiatom and characterization of diatom assemblages. The age of the diatomite deposit is established by precise 40Ar/39Ar-dating of intercalated pumice tuffs. The paleolake experienced multiple hydrological fluctuations on sub-orbital (~1,500 to 2,000 years) time scales. The magnitude of the δ18Odiatom change (+/- 3‰) and significant changes in the plankton-littoral ratio of the diatom assemblage (+/- 25%) suggest that the paleolake record can be interpreted in the context of long-term climatic change in East Africa. Using 40Ar/39Ar age control and nominal diatomite-sedimentation rates we establish a simplified age model of paleohydrological vs. climatic change, from which we conclude that more humid conditions prevailed in equatorial East Africa during the late Pleistocene over a relatively long time interval of several thousands years. Then, extreme insolation at eccentricity maximum and weakened zonal air-pressure gradients in the tropics favored intensified ITCZ-like convection over East Africa and deep-freshwater lake conditions.

  2. 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…

  3. Prevalence, knowledge, attitude and practice of speeding in two districts in Kenya: Thika and Naivasha.

    PubMed

    Bachani, Abdulgafoor M; Hung, Yuen Wai; Mogere, Stephen; Akungah, Daniel; Nyamari, Jackim; Stevens, Kent A; Hyder, Adnan A

    2013-12-01

    In Kenya, RTIs had the second highest increase in disability-adjusted life years between 1990 and 2010, compared to other conditions. This study aims to determine the prevalence, knowledge, attitudes and practices for speeding in Thika and Naivasha districts in Kenya. Direct observations of vehicle speed were conducted at various times during the day and different days of the week on six roads selected based on a multi-stage sampling method in two districts to determine the prevalence of speeding. Roadside KAP interviews were administered to drivers, at motorcycle bays, petrol stations, and rest areas. Eight rounds of speed observations and four rounds of KAP interviews were conducted between July 2010 and November 2012. Results from the speeding observational studies show an overall high proportion of vehicles speeding above posted limits in both districts, with an average of 46.8% in Thika and 40.2% in Naivasha. Trend analysis revealed a greater decline in this prevalence in Thika (OR: 0.804, 95% CI: 0.793-0.814) than in Naivasha (OR: 0.932, 95% CI: 0.919-0.945) over the study period. On average, 58.8% of speeding vehicles in Thika and 57.2% of speeding vehicles in Naivasha travelled at 10 km/h or higher above speed limit. While the majority of respondents agreed that speeding is a cause of road traffic crashes in both Thika (70.3%) and Naivasha (68.7%), knowledge of speed limits at the location of the interview was limited. Enforcement levels also remained low, but subsequent rounds of data collection showed improvement, especially in Thika. This study demonstrates an improvement in the prevalence of speeding in two districts of Kenya over 2010-2012. It also highlights the need for further action to be taken to address the problem, and represents new data on speeding in Kenya and Africa. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Physico-chemical Analysis, Microbial Isolation, Sensitivity Test of the Isolates and Solar Disinfection of Water Running in Community Taps and River Kandutura in Nakuru North Sub-county, Kenya

    PubMed Central

    Waithaka, Paul N; Maingi, John Muthini; Nyamache, Anthony Kebira

    2015-01-01

    Nakuru North sub-county is a peri-urban area which has both dry and wet seasons. Its residents rely mostly on untreated water sources for daily water needs due to unreliable water supply from the urban council. However, this water has not been evaluated on its quality despite residents solely depending on it. This study was aimed at determining the physico-chemical and bacteriological quality of water drawn from River Kandutura and water taps in Nakuru North sub-county. In addition, the study was aimed at carrying out sensitivity test of the isolates to antibiotics and determining effectiveness of solar disinfection in water treatment. A total of 510 water samples; river (255) and taps (255) were collected and analyzed between January and December 2013. Antimicrobial sensitivity test was carried out using Kirby Bauer disk diffusion test. Out of five hundred and ten (510) samples examined for microorganisms, 36.86 % (188/510) were positive for E. coli, Shigella and Salmonella. Water used by Nakuru North sub-county residents is highly contaminated thus posing public health risk. Solar disinfection experiment indicated a possibility of effective decontamination of water up on exposure to sun light for 3-5 h. E. coli showed the highest resistance (26.3 %) followed by Salmonella (17.4 %) while Shigella showed the least (17.1 %). However, there was no significant deference (p=0.98) in resistance among total coliforms, Total heterotrophic and Salmonella at 0.05 level of significant. There is a need to enforce laws and policies on proper waste disposal as part of water pollution control. PMID:26464611

  5. Out-of-pocket costs for paediatric admissions in district hospitals in Kenya

    PubMed Central

    Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

    2012-01-01

    Objective To describe out-of-pocket costs of inpatient care for children under 5 years of age in district hospitals in Kenya. Methods A total of 256 caretakers of admitted children were interviewed in 2-week surveys conducted in eight hospitals in four provinces in Kenya. Caretakers were asked to report care seeking behaviour and expenditure related to accessing inpatient care. Family socio-economic status was assessed through reported expenditure in the previous month. Results Seventy eight percent of caretakers were required to pay user charges to access inpatient care for children. User charges (mean, US$ 8.1; 95% CI, 6.4–9.7) were 59% of total out-of-pocket costs, while transport costs (mean, US$ 4.9; 95% CI, 3.9–6.0) and medicine costs (mean, US$ 0.7; 95% CI, 0.5–1.0) were 36% and 5%, respectively. The mean total out-of-pocket cost per paediatric admission was US$ 14.1 (95% CI, 11.9–16.2). Out-of-pocket expenditures on health were catastrophic for 25.4% (95% CI, 18.4–33.3) of caretakers interviewed. Out-of-pocket expenditures were regressive, with a greater burden being experienced by households with lower socio-economic status. Conclusion Despite a policy of user fee exemption for children under 5 years of age in Kenya, our findings show that high unofficial user fees are still charged in district hospitals. Financing mechanisms that will offer financial risk protection to children seeking care need to be developed to remove barriers to child survival. PMID:22716184

  6. 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

  7. 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.

  8. 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

  9. Hunting Apprenticeship as Indigenous Form of Education for Sustainable Conservation of Wildlife in Mau Forest of Kenya

    ERIC Educational Resources Information Center

    Ronoh, T. K.; Makori, G.; Ayub, M.

    2016-01-01

    Mau Forest, the home of the majority of the Ogiek people is located in the Rift Valley Province and straddles Kericho, Nakuru, Narok and Bomet districts. Traditionally, the Ogiek as hunter-gatherers have distinctive histories of interaction with the natural environment. Over the years, the Ogiek have inhabited in the Mau Forest with little impact…

  10. Tectonic and climatic control on evolution of rift lakes in the Central Kenya Rift, East Africa

    NASA Astrophysics Data System (ADS)

    Bergner, A. G. N.; Strecker, M. R.; Trauth, M. H.; Deino, A.; Gasse, F.; Blisniuk, P.; Dühnforth, M.

    2009-12-01

    The long-term histories of the neighboring Nakuru-Elmenteita and Naivasha lake basins in the Central Kenya Rift illustrate the relative importance of tectonic versus climatic effects on rift-lake evolution and the formation of disparate sedimentary environments. Although modern climate conditions in the Central Kenya Rift are very similar for these basins, hydrology and hydrochemistry of present-day lakes Nakuru, Elmenteita and Naivasha contrast dramatically due to tectonically controlled differences in basin geometries, catchment size, and fluvial processes. In this study, we use eighteen 14C and 40Ar/ 39Ar dated fluvio-lacustrine sedimentary sections to unravel the spatiotemporal evolution of the lake basins in response to tectonic and climatic influences. We reconstruct paleoclimatic and ecological trends recorded in these basins based on fossil diatom assemblages and geologic field mapping. Our study shows a tendency towards increasing alkalinity and shrinkage of water bodies in both lake basins during the last million years. Ongoing volcano-tectonic segmentation of the lake basins, as well as reorganization of upstream drainage networks have led to contrasting hydrologic regimes with adjacent alkaline and freshwater conditions. During extreme wet periods in the past, such as during the early Holocene climate optimum, lake levels were high and all basins evolved toward freshwater systems. During drier periods some of these lakes revert back to alkaline conditions, while others maintain freshwater characteristics. Our results have important implications for the use and interpretation of lake sediment as climate archives in tectonically active regions and emphasize the need to deconvolve lacustrine records with respect to tectonics versus climatic forcing mechanisms.

  11. Free Primary Education Policy: Coping Strategies in Public Primary Schools in Kakamega South District, Kakamega County, Kenya

    ERIC Educational Resources Information Center

    Mulinya, Lidoro Charles; Orodho, John Aluko

    2015-01-01

    This study examined the challenges of implementing free primary education and copping strategies in public primary schools in Kakamega South District, Kakamega County, Kenya. The study was premised on the demand and supply theory. A descriptive survey research design was adopted. The sample comprised 23 headteachers, 92 teachers and one Ministry…

  12. Perceptions of the preparedness of medical graduates for internship responsibilities in district hospitals in Kenya: a qualitative study.

    PubMed

    Muthaura, Patricia N; Khamis, Tashmin; Ahmed, Mushtaq; Hussain, Syeda Ra'ana

    2015-10-21

    Aga Khan University is developing its undergraduate medical education curriculum for East Africa. In Kenya, a 1 year internship is mandatory for medical graduates' registration as practitioners. The majority of approved internship training sites are at district hospitals. The purposes of this study were to determine: (1) whether recent Kenyan medical graduates are prepared for their roles as interns in district hospitals upon graduation from medical school; (2) what working and training conditions and social support interns are likely to face in district hospital; and (3) what aspects of the undergraduate curriculum need to be addressed to overcome perceived deficiencies in interns' competencies. Focus group discussions and semi-structured interviews were conducted with current interns and clinical supervisors in seven district hospitals in Kenya. Perceptions of both interns and supervisors regarding interns' responsibilities and skills, working conditions at district hospitals, and improvements required in medical education were obtained. Findings included agreement across informants on deficiencies in interns' practical skills and experience of managing clinical challenges. Supervisors were generally critical regarding interns' competencies, whereas interns were more specific about their weaknesses. Supervisor expectations were higher in relation to surgical procedures than those of interns. There was agreement on the limited learning, clinical facilities and social support available at district hospitals including, according to interns, inadequate supervision. Supervisors felt they provided adequate supervision and that interns lacked the ability to initiate communication with them. Both groups indicated transition challenges from medical school to medical practice attributable to inadequate practical experience. They indicated the need for more direct patient care responsibilities and clinical experience at a district hospital during undergraduate training

  13. Variations in the prevalence of antibody to brucella infection in cattle by farm, area and district in Kenya.

    PubMed Central

    Kadohira, M.; McDermott, J. J.; Shoukri, M. M.; Kyule, M. N.

    1997-01-01

    Variations in the sero-prevalence of antibody to brucella infection by cow, farm and area factors were investigated for three contrasting districts in Kenya: Samburu, an arid and pastoral area: Kiambu, a tropical highland area; and Kilifi, a typical tropical coastal area. Cattle were selected by a two-stage cluster sampling procedure and visited once between August 1991 and 1992. Schall's algorithm, a statistical model suitable for multi-level analysis was used. Using this model, older age, free grazing and large herd size (> or = 31) were associated with higher seroprevalence. Also, significant farm-to-farm, area-to-area and district-to-district variations were estimated. The patterns of high risk districts and areas seen were consistent with known animal husbandry and movement risk factors, but the larger than expected farm-to-farm variation within high risk areas and districts could not be explained. Thus, a multi-level method provided additional information beyond conventional analyses of sero-prevalence data. PMID:9042033

  14. Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

    PubMed Central

    Nzioki, Japheth Mativo; Onyango, Rosebella Ogutu; Ombaka, James Herbert

    2015-01-01

    Introduction Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district. Methods This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis. Results Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs. Conclusion Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed. PMID:26090046

  15. Evaluation of a communication campaign to improve continuation among first-time injectable contraceptive users in Nyando District, Kenya.

    PubMed

    McClain Burke, Holly; Ambasa-Shisanya, Constance

    2014-06-01

    Communication campaigns might be a viable means of improving contraceptive continuation; however, few such interventions aimed at reducing contraceptive discontinuation have been evaluated. Data were collected from independent samples of new injectable users in Nyando District, Kenya-site of a communication campaign to increase contraceptive continuation-and in a comparison district, nine months before and nine months after intervention implementation. Survival analysis was used to compare the intervention and comparison groups with respect to the distribution of time until first discontinuation of modern method use among women still in need of family planning. Exposure to family planning information was high in both the treatment and the comparison district before (97% and 85%, respectively) and after the intervention (99% and 78%). Postintervention, 5% of women in the comparison district discontinued by 98 days, 8% by 196 days and 23% by 294 days; the proportions in the treatment district were 4%, 6% and 16%, respectively. No significant difference between the districts was found in the ninemonth postintervention contraceptive continuation rates. Having method-related side effects or health concerns was the reason most consistently associated with discontinuation. Other factors associated with discontinuation differed between the districts. Addressing method-related side effects and health concerns will be critical in improving continuation of the injectable.

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

    Milukas, M.V.

    Secondary cities are currently seen as an important focus for promoting a more spatially-equitable pattern of economic infrastructure in developing countries, but their energy needs have not been considered. To test the thesis of this work - that the present pattern of energy demand in secondary cities differs, in important ways, from that of primary cities - a case study was conducted in the East African city of Nakuru, Kenya. Energy supplies used in Nakuru fall into two categories: industrial sources (electricity and petroleum) and traditional sources (wood, charcoal, and agricultural residues). This analysis of Nakuru's use of industrial sourcesmore » is introduced by a historical discussion of nationwide patterns of distribution, use, and pricing of electricity and petroleum products, and is followed by data gathered from Nakuru's suppliers of these energy sources. The portrait of energy use in Nakuru is completed with an analysis of the demand for traditional energy sources. Surveys were conducted to estimate the total quantities of charcoal, wood, and agricultural resides used in Nakuru. The cornerstone of this effort was a residential energy survey stratified according to income. Nakuru is shown to rely on biomass fuels (charcoal) to a much greater degree than Nairobi, thereby proving the thesis.« less

  17. Risk factors associated with occurrence of African swine fever outbreaks in smallholder pig farms in four districts along the Uganda-Kenya border.

    PubMed

    Nantima, Noelina; Ocaido, Michael; Ouma, Emily; Davies, Jocelyn; Dione, Michel; Okoth, Edward; Mugisha, Anthony; Bishop, Richard

    2015-03-01

    A cross-sectional survey was carried out to assess risk factors associated with occurrence of African swine fever (ASF) outbreaks in smallholder pig farms in four districts along Kenya-Uganda border. Information was collected by administering questionnaires to 642 randomly selected pig households in the study area. The study showed that the major risk factors that influenced ASF occurrence were purchase of pigs in the previous year (p < 0.000) and feeding of pigs with swill (p < 0.024). By employing cluster analysis, three clusters of pig production types were identified based on production characteristics that were found to differ significantly between districts. The most vulnerable cluster to ASF was households with the highest reported number of ASF outbreaks and composed of those that practiced free range at least some of the time. The majority of the households in this cluster were from Busia district in Uganda. On the other hand, the least vulnerable cluster to ASF composed of households that had the least number of pig purchases, minimal swill feeding, and less treatment for internal and external parasites. The largest proportion of households in this cluster was from Busia district Kenya. The study recommended the need to sensitize farmers to adopt proper biosecurity practices such as total confinement of pigs, treatment of swill, isolation of newly purchased pigs for at least 2 weeks, and provision of incentives for farmers to report suspected outbreaks to authorities and rapid confirmation of outbreaks.

  18. 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…

  19. The Influence of Enterprise Diversification on Household Food Security among Small-Scale Sugarcane Farmers: A Case Study of Muhoroni Division, Nyando District, Kenya

    ERIC Educational Resources Information Center

    Muthoni Thuo, Caroline

    2011-01-01

    This paper examines the levels of household food security and the influence of enterprise diversification on household food security among small-scale sugarcane farmers in Muhoroni division, Nyando District, Kenya. A cross-sectional research design was used in this study. The population consisted of small-scale sugarcane farmers who grow sugarcane…

  20. Lexico-Semantic Errors of the Learners of English: A Survey of Standard Seven Keiyo-Speaking Primary School Pupils in Keiyo District, Kenya

    ERIC Educational Resources Information Center

    Jeptarus, Kipsamo E.; Ngene, Patrick K.

    2016-01-01

    The purpose of this research was to study the Lexico-semantic errors of the Keiyo-speaking standard seven primary school learners of English as a Second Language (ESL) in Keiyo District, Kenya. This study was guided by two related theories: Error Analysis Theory/Approach by Corder (1971) which approaches L2 learning through a detailed analysis of…

  1. In the Web of Cultural Transition: A Tracer Study of Children in Embu District, Kenya. Early Childhood Development: Practice and Reflections. Following Footsteps.

    ERIC Educational Resources Information Center

    Njenga, Ann; Kabiru, Margaret

    Funding from the Bernard van Leer Foundation was used to conduct this longitudinal study in the Embu District of Kenya to compare the academic performance of children cared for by preschool teachers who had received different levels of training. Participating in the study were children from 18 preschools who were followed into primary school. In…

  2. Fecal contamination of drinking water in Kericho District, Western Kenya: role of source and household water handling and hygiene practices.

    PubMed

    Too, Johana Kiplagat; Kipkemboi Sang, Willy; Ng'ang'a, Zipporah; Ngayo, Musa Otieno

    2016-08-01

    Inadequate protection of water sources, and poor household hygienic and handling practices have exacerbated fecal water contamination in Kenya. This study evaluated the rate and correlates of thermotolerant coliform (TTC) household water contamination in Kericho District, Western Kenya. Culture and multiplex polymerase chain reaction (PCR) techniques were used to characterize TTCs. The disk diffusion method was used for antibiotic susceptibility profiling of pathogenic Escherichia coli. Out of the 103 households surveyed, 48 (46.6%) had TTC contaminated drinking water (TTC levels of >10 cfu/100 mL). Five of these households were contaminated with pathogenic E. coli, including 40% enteroaggregative E. coli, 40% enterotoxigenic E. coli, and 20% enteropathogenic E. coli. All these pathogenic E. coli strains were multidrug resistant to sulfamethoxazole/trimethoprim, ampicillin, tetracycline and ampicillin/sulbactam. Rural household locality, drinking water hand contact, water storage container cleaning practice, hand washing before water withdrawal, water source total coliforms <10 cfu/100 mL, temperature, and free chlorine levels were associated with TTC contamination of household drinking water. Significant proportions of household drinking water in Kericho District are contaminated with TTCs including with pathogenic multidrug-resistant E. coli. Source and household hygiene and practices contribute significantly to drinking water contamination.

  3. Knowledge of neonatal danger signs among mothers attending well baby clinic in Nakuru Central District, Kenya: cross sectional descriptive study.

    PubMed

    Kibaru, Elizabeth Gathoni; Otara, Amos Magembe

    2016-10-25

    Neonatal mortality has remained high in Kenya despite various efforts being applied to reduce this negative trend. Early detection of neonatal illness is an important step towards improving new born survival. Toward this end there is need for the mothers to be able to identify signs in neonates that signifies severe neonatal illnesses. The objective of the study was to determine the level of knowledge of mothers attending well baby clinics on postnatal neonatal danger signs and determine the associated factors. Cross sectional descriptive study. Purposive sampling of Health care facilities that provide antenatal, delivery and postnatal services were identified. In each of the selected health facility structured questionnaires were administered to mothers with children aged six weeks to nine months attending well baby clinics. Frequencies, Chi square and multivariate logistic regression were determined using the SPSS software (version 20). During the period of study 414 mothers attending well baby clinics were interviewed. Information on neonatal dangers was not provided to 237 (57.2%) of the postnatal mothers during their antenatal clinic attendance by the health care providers. Majority of mothers 350 (84.5%) identified less than three neonatal danger signs. Hotness of the body (fever) was the commonly recognized danger sign by 310 (74.9%) postnatal mothers. Out of 414 mothers 193 (46.6%), 166 (40.1%), 146 (35.3%) and 24 (5.8%) identified difficulty in breathing, poor sucking, jaundice and lethargy/unconsciousness as new born danger signs respectively. Only 46 (11.1%) and 40 (9.7%) identified convulsion and hypothermia as new born danger signs respectively. Education Level, PNC accompaniment by Spouse, Danger signs information to Mother, Explanation of MCH booklet by Care provider during ANC and Mother read MCH Booklet were factors positively associated with improved knowledge of neonatal danger sign. In multivariate logistic regression none of the factors tested

  4. A survey of the knowledge, attitude and practice of induced abortion among nurses in Kisii district, Kenya.

    PubMed

    Kidula, N A; Kamau, R K; Ojwang, S B; Mwathe, E G

    1992-01-01

    A cross-sectional study was carried out in Kisii District in the western part of Kenya between April 1 and April 28, 1991, with the objectives of ascertaining the attitude of nurses towards induced abortion, patients, and their involvement in abortion. Data were collected using a structured, self-administered questionnaire. All nurses present at the various institutions were recruited. A total of 218 nurses were recruited into the study. 75-83% were married, female nurses younger than 40, and therefore in the reproductive age group. 134 (61.5%) nurses were Protestant and 51% worked in the government district hospital. The nurses displayed a deficient knowledge of all aspects of induced abortion. Among clinically safe methods only intraamniotic saline instillation and dilation and curettage were mentioned by 4% and 11%, respectively. This deficiency in knowledge may be explained by the fact that most nurses work in the government hospitals, where induced abortion is not a routine procedure. Only 26-28% of the nurses thought it was safe to induce abortion at 1 and 2 months of gestation. 31-43% either did not know or were uncertain. Abortion is illegal in Kenya except when the life of the mother is in danger. Most nurses seemed to favor the law. A previous study in Nairobi revealed that only 38% of the nurses favored abortion on demand under a liberalized abortion law. 24 (11%) of nurses admitted to have induced abortion before. Their knowledge of induced abortion needs to be improved in order to prevent an increase in mortality and morbidity associated with improperly performed abortions.

  5. 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

  6. Quality Education for the Pastoralist in Public Primary Schools in Kajiado County, Kenya: Case Study of Dupoto-E-Maa Education Project in Kajiado Central District

    ERIC Educational Resources Information Center

    Ouda, James Bill; Opiyo, Rose Atieno; Wambiya, Pascal

    2015-01-01

    Conditions of learning are critical in determining quality of education. There have been real concerns raised by stakeholders regarding the quality of education for pastoralists in public primary schools in Kajiado Central District in Kenya. Interventions have been put in place to address the issue of quality education. One such intervention is…

  7. Improving service uptake and quality of care of integrated maternal health services: the Kenya Kwale District improvement collaborative.

    PubMed

    Mwaniki, Michael K; Vaid, Sonali; Chome, Isaac Mwamuye; Amolo, Dorcas; Tawfik, Youssef

    2014-09-21

    Health-related millennium development goals are off track in most of the countries in the sub-Saharan African region. Lack of access to, and low utilization of essential services and high-impact interventions, together with poor quality of health services, may be partially responsible for this lack of progress. We explored whether improvement approaches can be applied to increase utilization of antenatal care (ANC), health facility deliveries, prevention of mother-to-child transmission services and adherence to ANC standards of care in a rural district in Kenya. We targeted improvement of ANC services because ANC is a vital point of entry for most high-impact interventions targeting the pregnant mother. Healthcare workers in 21 public health facilities in Kwale District, Kenya formed improvement teams that met regularly to examine performance gaps in service delivery, identify root causes of such gaps, then develop and implement change ideas to address the gaps. Data were collected and entered into routine government registers by the teams on a daily basis. Data were abstracted from the government registers monthly to evaluate 20 indicators of care quality for improvement activities. For the purposes of this study, aggregate data for the district were collected from the District Health Management Office. The number of pregnant mothers starting ANC within the first trimester and those completing at least four ANC checkups increased significantly (from 41 (8%) to 118 (24%) p=0.002 and from 186 (37%) to 316 (64%) p<0.001, respectively). The proportions of ANC visits in which provision of care adhered to the required standards increased from <40% to 80-100% within three to six months (X2 for trend 4.07, p<0.001). There was also a significant increase in the number of pregnant women delivering in health facilities each month from 164 (33%) to 259 (52%) (p=0.012). Improvement approaches can be applied in rural health care facilities in low-income settings to increase

  8. 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.

  9. 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

  10. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey

    PubMed Central

    2014-01-01

    Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the ‘REsponse to ACcountable priority setting for Trust in health systems’ (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to

  11. Evaluation of existing district health management information systems a case study of the district health systems in Kenya.

    PubMed

    Odhiambo-Otieno, George W

    2005-09-01

    This paper discusses some of the issues and challenges of implementing appropriate and coordinated District Health Management Information System (DHMIS) in environments dependent on external support especially when insufficient attention has been given to the sustainability of systems. It also discusses fundamental issues which affect the usability of DHMIS to support District Health System (DHS), including meeting user needs and user education in the use of information for management; and the need for integration of data from all health-providing and related organizations in the district. This descriptive cross-sectional study was carried out in three DHSs in Kenya. Data was collected through use of questionnaires, focus group discussions and review of relevant literature, reports and operational manuals of the studied DHMISs. Key personnel at the DHS level were not involved in the development and implementation of the established systems. The DHMISs were fragmented to the extent that their information products were bypassing the very levels they were created to serve. None of the DHMISs was computerized. Key resources for DHMIS operation were inadequate. The adequacy of personnel was 47%, working space 40%, storage space 34%, stationery 20%, 73% of DHMIS staff were not trained, management support was 13%. Information produced was 30% accurate, 19% complete, 26% timely, 72% relevant; the level of confidentiality and use of information at the point of collection stood at 32% and 22% respectively and information security at 48%. Basic DHMIS equipment for information processing was not available. This inhibited effective and efficient provision of information services. An effective DHMIS is essential for DHS planning, implementation, monitoring and evaluation activities. Without accurate, timely, relevant and complete information the existing information systems are not capable of facilitating the DHS managers in their day-today operational management. The existing

  12. Enhancing knowledge and awareness of biosecurity practices for control of African swine fever among smallholder pig farmers in four districts along the Kenya-Uganda border.

    PubMed

    Nantima, Noelina; Davies, Jocelyn; Dione, Michel; Ocaido, Michael; Okoth, Edward; Mugisha, Anthony; Bishop, Richard

    2016-04-01

    A study was undertaken along the Kenya-Uganda border in four districts of Tororo and Busia (Uganda) and Busia and Teso (Kenya) to understand smallholder farmers' knowledge, practices and awareness of biosecurity measures. Information was collected by administering questionnaires to 645 randomly selected pig households in the study area. In addition, focus group discussions were carried out in 12 villages involving 248 people using a standardized list of questions. The outcome suggested that there was a very low level of awareness of biosecurity practices amongst smallholder farmers. We conclude that adoption of specific biosecurity practices by smallholder farmers is feasible but requires institutional support. There is a clear requirement for government authorities to sensitize farmers using approaches that allow active participation of farmers in the design, planning and implementation of biosecurity practices to enable enhanced adoption.

  13. 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

  14. 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.

  15. Enumeration of sex workers in the central business district of Nairobi, Kenya.

    PubMed

    Kimani, Joshua; McKinnon, Lyle R; Wachihi, Charles; Kusimba, Judith; Gakii, Gloria; Birir, Sarah; Muthui, Mercy; Kariri, Anthony; Muriuki, Festus K; Muraguri, Nicholas; Musyoki, Helgar; Ball, T Blake; Kaul, Rupert; Gelmon, Lawrence

    2013-01-01

    Accurate program planning for populations most at risk for HIV/STI acquisition requires knowledge of the size and location where these populations can best be reached. To obtain this information for sex workers operating at 137 hotspots in the central business district (CBD) in Nairobi, Kenya, we utilized a combined mapping and capture-recapture enumeration exercise. The majority of identified hotspots in this study were bars. Based on this exercise, we estimate that 6,904 male and female sex workers (95% confidence intervals, 6690 and 7118) were working nightly in the Nairobi CBD in April 2009. Wide ranges of captures per spot were obtained, suggesting that relatively few hot spots (18%) contain a relatively high proportion of the area's sex workers (65%). We provide geographic data including relatively short distances from hotspots to our dedicated sex worker outreach program in the CBD (mean<1 km), and clustering of hotspots within a relatively small area. Given the size covered and areas where sex work is likely taking place in Nairobi, the estimate is several times lower than what would be obtained if the entire metropolitan area was enumerated. These results have important practical and policy implications for enhancing HIV/STI prevention efforts.

  16. Socio-Pedagogical Challenges Facing Orphaned and Vulnerable Children in the Aftermath of the 2007-2008 Election Violence in Nakuru County, Kenya

    ERIC Educational Resources Information Center

    Majanga, Eunice; Mukonyi, Phillip; Vundi, Silvia

    2015-01-01

    The conflict situations that have afflicted parts of Kenya every five years, in the wake of general elections, since 1992 were most prominent after the disputed presidential elections of 2007. The magnitude of the clashes, loss of life, destruction of property and internal displacement of people were hitherto unwitnessed. The situation of Orphans…

  17. NURSES INFECTION PREVENTION PRACTICES IN HANDLING INJECTIONS: A CASE OF RIFT VALLEY PROVINCIAL HOSPITAL IN KENYA.

    PubMed

    Chemoiwa, R K; Mukthar, V K; Maranga, A K; Kulei, S J

    2014-10-01

    To analyse the infection prevention practices in handling of injections by nurses in Rift Valley Provincial Hospital in Kenya. A cross-sectional observational study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. A sample of 386 injection procedures attributed to the nurses in Rift Valley Provincial Hospital was considered for this study. The study established that among all the injections administered in this study, 43.7% (386) adhered to aseptic techniques. Over seventy five percent (76.9%, n = 386) of the observed injections procedures did not involve the hand-washing, 53.4% (n = 206) did not involve swabbing of a vial rubber cap with alcohol swabs and 95.1%(n = 263) involved using of multidose drug in more than one designated patient. Over ninety five percent (95.6%, n = 364) of the observed procedures involved use of sterile the syringe bit of the devices only while the rest used either clean or contaminated syringes. Around forty percent (42.2%, n = 316) of the injections preparation was done elsewhere (not at the patient bedside) before administration. Slightly over thirty five percent (36.6%, n = 386) of the injections were administered immediately upon reconstitution(at the right time). The study also established the use of aseptic techniques to reconstitute and administer was significantly related to the number of nurses to patients ratio per shift (X2(1) = 3.5: p = 0.04). The findings of this study indicate that patient safety in public hospital is still relatively low. The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public health facilities in Kenya.

  18. A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

    PubMed

    Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

    2012-01-01

    To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost

  19. Hazard analysis of Arid and semi-Arid (ASAL) regions of Kenya.

    PubMed

    Tabu, J S; Otwelo, J A; Koskei, P; Makokha, P

    2013-06-01

    This paper describes a situationanalysis on hazards in the Arid and semi-Arid lands of Kenya. The leading hazards affecting the Arid and semi-arid lands are mainly natural and include among others drought, floods, and landslides. Other hazards of importance were found to be war and conflict, HIV/AIDS and fires. Over 80% of these are weather related. The overall objective of this study was to prioritize hazards in the ASAL region. Specifically, the study identified the top ten hazards in the ASAL Districts of Kenya, determined Probability of occurrence; Analyzed the potential impact of the hazard and utilizing multiplier effect prioritized the Hazards using a hypothetical model. This was a descriptive study conducted in over half of the Kenya's ASAL Districts in four regions of Lower and Upper Eastern, North Eastern and part of the Coast region. Six Districts were purposively selected per region with six officers from each District all totaling one hundred and forty four. The sectors where respondents were sourced from were Agriculture, Health, local Government, and Provincial Administration, Environment and NGO. The members through a consensus process analyzed hazards in groups of their respective districts using a tool that had been developed and respondents trained on its use. One hundred and forty four (144) officers from Twenty four Districts in the four regions were recruited. One hundred twenty seven (81%) were male and only 27 (19% ) were female The representation of participants per sector was Governance 25% followed by Civil society organizations 21%, Health 16%, Agriculture and arid lands 15%, Research and scientific institutions 13%. The top Priority Hazards identified using the mean score were Drought and famine (5.4) Epidemics and epizootics (3.8), HIV/AIDS (3.6), War and conflict (2.5), Floods (2.5) CONCLUSIONS: The exercise confirmed the priority hazards in the Arid and semi-arid regions of Kenya and described vulnerability factors that included

  20. 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.

  1. 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.

  2. Using Advance Organizers to Enhance Pupils' Achievement in Learning Poetry in English Language

    ERIC Educational Resources Information Center

    Muiruri, Mary; Wambugu, Patriciah; Wamukuru, Kuria

    2016-01-01

    The study was a quasi-experimental that investigated the effects of Advance Organizers (AO) on achievement in poetry. Target population was class seven pupils of Nakuru North Sub-county primary schools in Kenya. 160 pupils were involved in the study. Four sampled schools were randomly assigned to control and experimental groups in Solomon Four…

  3. 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.

  4. Socio-Economic and Cultural Determinants of Human African Trypanosomiasis at the Kenya – Uganda Transboundary

    PubMed Central

    Rutto, Jane Jemeli; Osano, Odipo; Thuranira, Elias Gitonga; Kurgat, Richard Kiptum; Odenyo, Victor Agab Omondi

    2013-01-01

    Background Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than

  5. Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

    PubMed Central

    2012-01-01

    Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom

  6. Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia.

    PubMed

    Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H; Makundi, Emmanuel; Michelo, Charles; Zulu, Joseph; Byskov, Jens

    2012-11-26

    A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been

  7. Mothers' knowledge, attitudes and practices regarding acute respiratory infections in children in Baringo District, Kenya.

    PubMed

    Simiyu, D E; Wafula, E M; Nduati, R W

    2003-06-01

    Control of acute respiratory infections (ARI) is a major public health problem in developing countries. Implementation of case management protocols requires participation of the community to reduce morbidity and mortality from ARI. Health education programmes can only be effective when designed to take into account the prevailing knowledge, attitudes and practices (KAP) of the community towards ARI in their children. To determine the KAP of mothers regarding ARI in their children aged less than five years. Community based cross-sectional survey. Baringo District, Kenya. Mothers with children aged 0-5 years were recruited following stratified random sampling in three areas of Baringo District to represent low, medium and high potential areas based on agricultural productivity. A mixed structured and unstructured questionnaire was administered to each of the respondent mothers by the investigator; with the help of an interpreter where necessary. A total of 309 mothers were interviewed. Their mean age was 31.5 years (range 16-51) and 34% had no formal education. Only 18% of mothers described pneumonia satisfactorily. 60.2% knew that measles is preventable by immunisation. 87.1% of the mothers said they would seek health centre services for severe ARI. Formal education had a positive influence on the KAP of the mothers. The study reveals that the mothers had good knowledge of mild forms of ARI but not the severe forms. Their attitude to ARI was appropriate but subsequent practices were not. Low utilisation of health services for moderate ARI may result in continued high mortality because of delayed identification of seriously ill children.

  8. Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya.

    PubMed

    Maruti, Phidelis M; Mulianga, Ekesa A; Wambani, Lorna N; Wafula, Melda N; Mambo, Fidelis A; Mutisya, Shadrack M; Wakaria, Eric N; Mbati, Erick M; Amayo, Angela A; Majani, Jonathan M; Nyary, Bryan; Songwe, Kilian A

    2014-01-01

    Bungoma District Hospital Laboratory (BDHL), which supports a 200-bed referral facility, began its Strengthening Laboratory Management Toward Accreditation (SLMTA) journey in 2011 together with eight other laboratories in the second round of SLMTA rollout in Kenya. To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders - including upper management, clinicians, laboratory staff and maintenance staff - to the mission of sustainable quality practices at BDHL. After 16 months in the SLMTA programme, BDHL improved from zero stars (38%) to four stars (89%). Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81%) in an external surveillance audit conducted by Kenya Accreditation Service (KENAS). Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.

  9. Strengthening health system governance using health facility service charters: a mixed methods assessment of community experiences and perceptions in a district in Kenya.

    PubMed

    Atela, Martin; Bakibinga, Pauline; Ettarh, Remare; Kyobutungi, Catherine; Cohn, Simon

    2015-12-04

    Enhancing accountability in health systems is increasingly emphasised as crucial for improving the nature and quality of health service delivery worldwide and particularly in developing countries. Accountability mechanisms include, among others, health facilities committees, suggestion boxes, facility and patient charters. However, there is a dearth of information regarding the nature of and factors that influence the performance of accountability mechanisms, especially in developing countries. We examine community members' experiences of one such accountability mechanism, the health facility charter in Kericho District, Kenya. A household survey was conducted in 2011 among 1,024 respondents (36% male, 64% female) aged 17 years and above stratified by health facility catchment area, situated in a division in Kericho District. In addition, sixteen focus group discussions were conducted with health facility users in the four health facility catchment areas. Quantitative data were analysed through frequency distributions and cross-tabulations. Qualitative data were transcribed and analysed using a thematic approach. The majority (65%) of household survey respondents had seen their local facility service charter, 84% of whom had read the information on the charter. Of these, 83% found the charter to be useful or very useful. According to the respondents, the charters provided useful information about the services offered and their costs, gave users a voice to curb potential overcharging and helped users plan their medical expenses before receiving the service. However, community members cited several challenges with using the charters: non-adherence to charter provisions by health workers; illegibility and language issues; lack of expenditure records; lack of time to read and understand them, often due to pressures around queuing; and socio-cultural limitations. Findings from this study suggest that improving the compliance of health facilities in districts across

  10. 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…

  11. A Multifaceted Intervention to Improve the Quality of Care of Children in District Hospitals in Kenya: A Cost-Effectiveness Analysis

    PubMed Central

    Barasa, Edwine W.; Ayieko, Philip; Cleary, Susan; English, Mike

    2012-01-01

    Background To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Methods and Findings Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26–67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67–47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19–2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A “what-if” analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Conclusion Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital

  12. State Limitations, Self-Help Secondary Schooling, and Development in Kenya.

    ERIC Educational Resources Information Center

    Bradshaw, York W.

    1993-01-01

    Over 60% of Kenya's secondary schools are nongovernment community-run schools. Analysis of district-level data on adult literacy, secondary enrollment, child health and mortality, malaria prevalence, and rural development indicates that government schooling has few effects. Nongovernment schooling is associated with lower child mortality and other…

  13. THE UPTAKE OF MODERN CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE ATTENDING MATERNAL CHILD HEALTH AND FAMILY PLANNING (MCH/FP) CLINICS.

    PubMed

    Mukthar, V K; Maranga, A K; Kulei, S J; Chemoiwa, R K

    2014-12-01

    To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya. A descriptive cross-sectional study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital. The respondents were identified by systematic random sampling Modern contraceptive uptake is over ninety percent (90.4, n = 218). The factors that are significantly associated with uptake of modern contraceptives are perceived convenience to use modern contraceptives (OR 0.39, CI: 0.16 - 0.93, p value- 0.04), experience of unmet needs of contraception (OR 0.08, CI: 0.03 - 0.2, p value- 0.001), history of a modern contraception discontinuation (OR 5.5, CI: 1.7 - 9.2, p value- 0.036) and knowledge of modern contraceptives (OR 19.1, CI: 12.3 - 27.5, p value-0.001). Conclusion: This study concluded that uptake of modern contraceptive is relatively high in Nakuru, Kenya and there is need for programmes to focus more on the client of modern contraceptive and the attributes of the modern contraceptives in up-scaling the uptake of modern contraceptives.

  14. Capacity Building of a District Education System: Insights from Kenya

    ERIC Educational Resources Information Center

    Datta, Dipankar; Phillip, Serene; Verma, Prashant Kumar

    2009-01-01

    Both (a) in-school factors such as over-focus on academic performance, absence of uniform, and corporal punishment, and (b) out-of school factors such as caring for ailing parents, child labor, etc., hinder participation of orphan and vulnerable children (PVC) in Free Primary Education (FOE) system in Nyasa Province, Kenya. In this context Concern…

  15. Time Series Analysis of Sexual Assault Case Characteristics and the 2007–2008 Period of Post-Election Violence in Kenya

    PubMed Central

    Anastario, Michael P.; Adhiambo Onyango, Monica; Nyanyuki, Joan; Naimer, Karen; Muthoga, Rachel; Sirkin, Susannah; Barrick, Kelle; van Hasselt, Martijn; Aruasa, Wilson; Kibet, Cynthia; Omollo, Grace

    2014-01-01

    Background Following the declaration that President Mwai Kibaki was the winner of the Kenyan presidential election held on December 27, 2007, a period of post-election violence (PEV) took place. In this study, we aimed to identify whether the period of PEV in Kenya was associated with systematic changes in sexual assault case characteristics. Methods and Findings Medical records of 1,615 patients diagnosed with sexual assault between 2007 and 2011 at healthcare facilities in Eldoret (n = 569), Naivasha (n = 534), and Nakuru (n = 512) were retrospectively reviewed to examine characteristics of sexual assault cases over time. Time series and linear regression were used to examine temporal variation in case characteristics relative to the period of post-election violence in Kenya. Key informant interviews with healthcare workers at the sites were employed to triangulate findings. The time series of sexual assault case characteristics at these facilities were examined, with a specific focus on the December 2007–February 2008 period of post-election violence. Prais-Winsten estimates indicated that the three-month period of post-election violence was associated with a 22 percentage-point increase in cases where survivors did not know the perpetrator, a 20 percentage-point increase in cases with more than one perpetrator, and a 4 percentage-point increase in cases that had evidence of abdominal injury. The post-election violence period was also associated with an 18 percentage-point increase in survivors waiting >1 month to report to a healthcare facility. Sensitivity analyses confirmed that these characteristics were specific to the post-election violence time period. Conclusion These results demonstrate systematic patterns in sexual assault characteristics during the PEV period in Kenya. PMID:25170917

  16. Assessment of Malaria Reporting and Epidemic Preparedness Systems in Health Facilities in Eldoret West District, Uasin Gishu County, Kenya

    PubMed Central

    Kirinyet, Ruth C.; Juma, Ahmad

    2016-01-01

    The most important factor in reducing the impact of an epidemic is a timely response with implementation of effective control measures at the point of detection. This study sought to assess the malaria reporting and epidemic preparedness systems of health facilities in Eldoret West District, Kenya. A cross-sectional study design was adapted. A census technique was used to select all the forty five health facilities in the district comprising of government, mission and non-governmental facilities. An interviewer administered questionnaire was used for data collection and analysis done using Stata. Categorical variables were summarized as frequencies and corresponding percentages. The overall reporting rate was 91.7% for all the health facilities. Only 15 health facilities (33%) plotted malaria trend lines for number of cases of malaria. Malaria epidemics were reported within 24 hours in 22 health facilities but they lacked the appropriate supplies to respond to confirmed cases or epidemics. The overall malaria reporting completeness rate was above 90% implying that the malaria surveillance system was generally good. Concerted efforts by concerned stakeholders should ensure improvement of malaria epidemic preparedness system in all health facilities and provision of information to health personnel on malaria outbreak response strategies. PMID:28299154

  17. 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.

  18. 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.

  19. Effects of Selected Cultural, Financial, and School-Based Factors on Girl-Child's Educational Access and Socioeconomic Development in Sarkish Flower Farm, Nakuru County, Kenya

    ERIC Educational Resources Information Center

    Ronoh, T. K.; Sang, A. K.; Sisungo, Z. W.; Mumiukha, C. K.; Ayub, M. J.

    2015-01-01

    This paper sought to establish the effects of selected cultural, financial, and school-based factors on the girl-child's access to educational and socioeconomic development in Kenya. It is arguably observed that various local and international conventions, treaties, commissions, and state actors have strived to promote the development of…

  20. 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.

  1. Using remote sensing environmental data to forecast malaria incidence at a rural district hospital in Western Kenya.

    PubMed

    Sewe, Maquins Odhiambo; Tozan, Yesim; Ahlm, Clas; Rocklöv, Joacim

    2017-06-01

    Malaria surveillance data provide opportunity to develop forecasting models. Seasonal variability in environmental factors correlate with malaria transmission, thus the identification of transmission patterns is useful in developing prediction models. However, with changing seasonal transmission patterns, either due to interventions or shifting weather seasons, traditional modelling approaches may not yield adequate predictive skill. Two statistical models,a general additive model (GAM) and GAMBOOST model with boosted regression were contrasted by assessing their predictive accuracy in forecasting malaria admissions at lead times of one to three months. Monthly admission data for children under five years with confirmed malaria at the Siaya district hospital in Western Kenya for the period 2003 to 2013 were used together with satellite derived data on rainfall, average temperature and evapotranspiration(ET). There was a total of 8,476 confirmed malaria admissions. The peak of malaria season changed and malaria admissions reduced overtime. The GAMBOOST model at 1-month lead time had the highest predictive skill during both the training and test periods and thus can be utilized in a malaria early warning system.

  2. Barriers to emergency obstetric care services: accounts of survivors of life threatening obstetric complications in Malindi District, Kenya.

    PubMed

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique; Kombe, Yeri; Nyandieka, Lillian; Byskov, Jens

    2014-01-01

    Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Findings indicate that pregnant women experienced delays in making decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays.

  3. A Multidimensional Assessment of Children in Conflictual Contexts: The Case of Kenya

    ERIC Educational Resources Information Center

    Okech, Jane E. Atieno

    2012-01-01

    Children in Kenya's Kisumu District Primary Schools (N = 430) completed three measures of trauma. Respondents completed the "My Worst Experience Scale" (MWES; Hyman and Snook 2002) and its supplement, the "School Alienation and Trauma Survey" (SATS; Hyman and Snook 2002), sharing their worst experiences overall and specifically…

  4. Determinants of teenage pregnancies: the case of Busia District in Kenya.

    PubMed

    Were, Maureen

    2007-07-01

    Sub-Saharan Africa has one of the highest levels of teenage pregnancies in the world. In spite of that, there is paucity of empirical research on causes of teenage pregnancies in African countries. This paper investigates the determinants of teenage pregnancies based on a case study of Busia District in Kenya. The data are from a household survey conducted in 1998/1999. Empirical results indicate that girls' education level has significant influence on the probability of teenage birth, with non-schooling adolescents and those with primary school level education being more vulnerable. Among the variables used as proxies for access to sex education, availability of church forums that educate adolescents about sex and family life issues reduce probability of teenage pregnancy. Age is positively related to teenage pregnancies, with older adolescents being more predisposed to pregnancies. Though use of contraceptives is found to have a positive effect, only a small proportion of adolescents were using modern contraceptives and, supply side factors such as quality and availability were not accounted for. Other key factors as outlined by the adolescents themselves include peer pressure and social environment-related factors like inappropriate forms of recreation, which act as rendezvous for pre-marital sex, as well as lack of parental guidance and counselling. Overall, lack of access to education opportunities, sex education and information regarding contraceptives, as well the widespread poverty predispose girls to teenage pregnancies. The problem of teenage pregnancies should be viewed within the broader socio-economic and socio-cultural environment in which the adolescents operate. For instance, lack of parental guidance on issues of sexuality and sex education was reinforced by cultural taboos that inhibit such discussions. Adolescents should be equipped with the relevant knowledge to enable them make informed choices regarding sexual relationships. This should be

  5. 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.

  6. Organizational HIV monitoring and evaluation capacity rapid needs assessment: the case of Kenya.

    PubMed

    Mbondo, Mwende; Scherer, Jennifer; Aluoch, Gilbert Onyango; Sundsmo, Aaron; Mwaura, Njeri

    2013-01-01

    Due to the commitment by the Government of Kenya (GoK) and international donors to address HIV/AIDS, Kenya has some of Africa's most developed health infrastructure for tackling the crisis. Despite this commitment, significant gaps exist in the national HIV/AIDS monitoring and evaluation (M&E) system. To identify these gaps and opportunities for improvement, the U.S. Centers for Disease Control and Prevention funded the Strengthening HIV Strategic Information in Kenya project, which conducted an organizational HIV M&E capacity rapid needs assessment (RNA). The project included an in-depth desk review of national documents, policies, tools, and international best practices. National, regional, and district officials from government agencies, development partners, and implementing partners participated in key informant interviews and focus group discussions. Given the large number of regions and districts, purposive sampling was used to select 16 facilities in 8 districts across 2 regions based on the general quality of the reported HIV data and the number of partners supporting the regions. RNA findings revealed tremendous improvements at the national level and in the various subsystems that contribute to the overall HIV strategic information. There also were significant gaps, including in a lack of M&E guidelines, parallel reporting systems, feedback given to subnational levels, and data use and general data management and use capacity at subnational levels. An urgent need exists for the development of national M&E guidelines and a comprehensive training curriculum. To ensure success further, capacity building for subnational levels should be conducted and feedback channels to subnational staff should be established and maintained.

  7. Cost Effectiveness Analysis between Boarding and Day Secondary Students in Kenya

    ERIC Educational Resources Information Center

    Jagero, N.; Ayodo, T. M.; Agak, J. A.

    2011-01-01

    This paper examines the cost effectiveness of educating boarding and day secondary students in Kisumu district in Kenya. The research designs used in this study were descriptive survey and casual comparative designs. The population consisted of five head teachers, 140 form four teachers and 609 form four students. Saturated and systematic random…

  8. Nutritional status and morbidity on an irrigation project in Turkana District, Kenya.

    PubMed

    Brainard, Jean

    1990-01-01

    The research reported on here was undertaken to identify the most important contributors to continuing high mortality on a small-scale irrigation project at Nakwamoru in Turkana District, Kenya. The health status of project settlers had not been assessed prior to the present study, which was undertaken in 1978-79, a decade after the project was started. The purpose of the study was to estimate the nutritional status of project children and the major causes of morbidity in the Nakwamoru area. Nutritional status was derived from cross-sectional anthropometric measurements, including weights, heights, triceps skinfolds, and upper arm circumferences, taken on approximately 60% of project children (n = 236) aged 1-10 years. The major causes of morbidity in project settlers of all ages for the period 1973-78 were estimated from outpatient records from the local primary care facility. Age/sex patterns of clinic use were obtained through interviews. Stunting was found to be prevalent, especially in children aged 1-4, while wasting was only observed in a small proportion of the sample, indicating a seasonal pattern of malnutrition. Derived cross-sectional areas of upper arm muscle and fat were found to be low by comparison with U.S. standards, suggesting both energy and protein deficits in project children. Malaria and acute respiratory infections were found to be the major causes of illness in the local population, and both are likely to have contributed to the generally poor nutritional status of project children. Despite free biomedical care, 15% of the local population in general and 23% of adult females had never used clinic services. Copyright © 1990 Wiley-Liss, Inc., A Wiley Company.

  9. Knowledge, Attitudes and Practices (KAP) on Rift Valley Fever among Pastoralist Communities of Ijara District, North Eastern Kenya

    PubMed Central

    Abdi, Ismail H.; Affognon, Hippolyte D.; Wanjoya, Anthony K.; Onyango-Ouma, Washington; Sang, Rosemary

    2015-01-01

    Outbreaks of Rift Valley fever (RVF), a mosquito-borne viral zoonosis, have previously been associated with unusually heavy rainfall and extensive flooding. The disease is a serious public health problem in Africa and the Middle East, and is a potential global health threat. In Kenya, outbreaks of the disease have disproportionately affected impoverished pastoralist communities. This study sought to assess the knowledge, attitudes and practices (KAP) regarding RVF among the pastoralists of North Eastern Kenya, and to establish the determinants of KAP on RVF. A cross-sectional study involving 392 pastoralists living in Ijara district (Masalani and Ijara wards) was carried out using an interview questionnaire. All respondents interviewed (100%) had heard about RVF disease. They recognized that the disease is dangerous (99%), and had a positive attitude towards vaccination of animals (77%). However, few respondents knew that abortion (11%) and high mortality of young animals (10%) were key signs of RVF in animals. Very few (4%) use any form of protection when handling sick animals to avoid infection. Significant factors associated with knowledge were being in a household with a history of RVF infection (OR = 1.262, 95% CI = 1.099–1.447), having more livestock (OR = 1.285, 95% CI = 1.175–1.404) and the place of residence, Masalani (OR = 0.526, 95% CI = 0.480–0.576). Overall knowledge score on RVF was found to be a significant predictor of good preventive practice of the disease (OR = 1.073, 95% CI = 1.047–1.101). Despite the positive attitude that pastoralist communities have towards the prevention of RVF, there exist gaps in knowledge and good practices on the disease. Therefore there is need for public health education to address these gaps, and to identify and facilitate the removal of barriers to behavioural change related to the prevention of RVF. PMID:26566218

  10. Many Districts Left Behind: An Individual Change Analysis of Inequity in the Kenyan Primary Educational Opportunities (2001-2007)

    ERIC Educational Resources Information Center

    Bagaka's, Joshua Gisemba

    2010-01-01

    The study examined variations in district performance in KCPE national examination in Kenya between 2001 and 2007. The individual change model revealed that district poverty rate was not a significant predictor of either the initial district performance (2001) or the rate of change over the seven-year period. The regional context of North Eastern…

  11. Community and facility-level engagement in planning and budgeting for the government health sector--a district perspective from Kenya.

    PubMed

    O'Meara, Wendy Prudhomme; Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine; McKenzie, F Ellis

    2011-03-01

    Health systems reform processes have increasingly recognized the essential contribution of communities to the success of health programs and development activities in general. Here we examine the experience from Kilifi district in Kenya of implementing annual health sector planning guidelines that included community participation in problem identification, priority setting, and planning. We describe challenges in the implementation of national planning guidelines, how these were met, and how they influenced final plans and budgets. The broad-based community engagement envisaged in the guidelines did not take place due to the delay in roll out of the Ministry of Health-trained community health workers. Instead, community engagement was conducted through facility management committees, though in a minority of facilities, even such committees were not involved. Some overlap was found in the priorities highlighted by facility staff, committee members and national indicators, but there were also many additional issues raised by committee members and not by other groups. The engagement of the community through committees influenced target and priority setting, but the emphasis on national health indicators left many local priorities unaddressed by the final work plans. Moreover, it appears that the final impact on budgets allocated at district and facility level was limited. The experience in Kilifi highlights the feasibility of engaging the community in the health planning process, and the challenges of ensuring that this engagement feeds into consolidated plans and future implementation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa

    PubMed Central

    Gilson, Lucy; Barasa, Edwine; Nxumalo, Nonhlanhla; Cleary, Susan; Goudge, Jane; Molyneux, Sassy; Tsofa, Benjamin; Lehmann, Uta

    2017-01-01

    Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach. The paper presents evidence of the instability and daily disruptions managed at the front lines of the district health system. These include patient complaints, unpredictable staff, compliance demands, organisational instability linked to decentralisation processes and frequently changing, and sometimes unclear, policy imperatives. The paper also identifies managerial responses to these challenges and assesses whether or not they indicate everyday resilience, using two conceptual lenses. From this analysis, we suggest that such resilience seems to arise from the leadership offered by multiple managers, through a combination of strategies that become embedded in relationships and managerial routines, drawing on wider organisational capacities and resources. While stable governance structures and adequate resources do influence everyday resilience, they are not enough to sustain it. Instead, it appears important to nurture the power of leaders across every system to reframe challenges, strengthen their routine practices in ways that encourage mindful staff engagement, and develop social networks within and outside organisations. Further research can build on these insights to deepen understanding. PMID:29081995

  13. Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa.

    PubMed

    Gilson, Lucy; Barasa, Edwine; Nxumalo, Nonhlanhla; Cleary, Susan; Goudge, Jane; Molyneux, Sassy; Tsofa, Benjamin; Lehmann, Uta

    2017-01-01

    Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach. The paper presents evidence of the instability and daily disruptions managed at the front lines of the district health system. These include patient complaints, unpredictable staff, compliance demands, organisational instability linked to decentralisation processes and frequently changing, and sometimes unclear, policy imperatives. The paper also identifies managerial responses to these challenges and assesses whether or not they indicate everyday resilience, using two conceptual lenses. From this analysis, we suggest that such resilience seems to arise from the leadership offered by multiple managers, through a combination of strategies that become embedded in relationships and managerial routines, drawing on wider organisational capacities and resources. While stable governance structures and adequate resources do influence everyday resilience, they are not enough to sustain it. Instead, it appears important to nurture the power of leaders across every system to reframe challenges, strengthen their routine practices in ways that encourage mindful staff engagement, and develop social networks within and outside organisations. Further research can build on these insights to deepen understanding.

  14. 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…

  15. Community Health Worker Performance in the Management of Multiple Childhood Illnesses: Siaya District, Kenya, 1997–2001

    PubMed Central

    Kelly, Jane M.; Osamba, Benta; Garg, Renu M.; Hamel, Mary J.; Lewis, Jennifer J.; Rowe, Samantha Y.; Rowe, Alexander K.; Deming, Michael S.

    2001-01-01

    Objectives. To characterize community health worker (CHW) performance using an algorithm for managing common childhood illnesses in Siaya District, Kenya, we conducted CHW evaluations in 1998, 1999, and 2001. Methods. Randomly selected CHWs were observed managing sick outpatient and inpatient children at a hospital, and their management was compared with that of an expert clinician who used the algorithm. Results. One hundred, 108, and 114 CHWs participated in the evaluations in 1998, 1999, and 2001, respectively. The proportions of children treated “adequately” (with an antibiotic, antimalarial, oral rehydration solution, or referral, depending on the child's disease classifications) were 57.8%, 35.5%, and 38.9%, respectively, for children with a severe classification and 27.7%, 77.3%, and 74.3%, respectively, for children with a moderate (but not severe) classification. CHWs adequately treated 90.5% of malaria cases (the most commonly encountered classification). CHWs often made mistakes assessing symptoms, classifying illnesses, and prescribing correct doses of medications. Conclusions. Deficiencies were found in the management of sick children by CHWs, although care was not consistently poor. Key reasons for the deficiencies appear to be guideline complexity and inadequate clinical supervision; other possible causes are discussed. PMID:11574324

  16. An Analysis on Dropout Levels of Public Secondary Schools in Kericho District in Relation to Selected School Characteristics

    ERIC Educational Resources Information Center

    Sang, Anthony K. A.; Koros, Peter K. A.; Bosire, Joseph N.

    2013-01-01

    The Education Sector in Kenya and other parts of the world has faced many challenges particularly dropouts, which is an indicator of low internal efficiency during the past two decades. This study sought to determine and analyze the dropout levels of Public Secondary Schools in Kericho District of Kenya for the period between 2004 and 2007. The…

  17. Ways Constituency Development Fund Promotes Secondary Education in Laikipia West District, Kenya

    ERIC Educational Resources Information Center

    Mwangi, Peter Murage

    2013-01-01

    Kenya started providing secondary school education as part of her basic education in 2008 through subsidized secondary education in 2008, but was faced by two major challenges; secondary schools are fewer than primary schools, and secondary education is more costly than primary education. This has made many students especially those from poor…

  18. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

    PubMed Central

    2010-01-01

    Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation

  19. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya.

    PubMed

    Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy

    2010-07-02

    The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR

  20. The challenges of achieving high training coverage for IMCI: case studies from Kenya and Tanzania

    PubMed Central

    Mushi, Hildegalda P; Mullei, Kethi; Macha, Janet; Wafula, Frank; Borghi, Josephine; Goodman, Catherine; Gilson, Lucy

    2011-01-01

    Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007–08. Bunda and Malindi achieved higher levels of training coverage (44% and 25%) compared with Tarime and Homa Bay (5% and 13%). Key factors allowing the first two districts to perform better were: strong district leadership and personal commitment to IMCI, which facilitated access to external funding and encouraged local-level policy adaptation; sensitization and training of district health managers; and lower staff turnover. However, IMCI training coverage remained well below target levels across all sites. The main barrier to expanding coverage was the cost of training due to its duration, the number of facilitators and its residential nature. Mechanisms for financing IMCI also restricted district capacity to raise funds. In Tanzania, districts could not spend more than 10% of their budgets on training. In Kenya, limited financial decentralization meant that district managers had to rely on donors for financial support. Critically, the low priority given to IMCI at national and international levels also limited the expansion of training. Levels of domestic and donor support for IMCI have diminished over time in favour of vertical programmes, partly due to the difficulty in monitoring and measuring the impact of an integrated intervention like IMCI. Alternative, lower cost methods of IMCI training need to be promoted, and greater advocacy for IMCI is needed both nationally and internationally. PMID

  1. Effects of Livestock Herd Migration on Child Schooling in Marsabit District, Kenya

    ERIC Educational Resources Information Center

    Mburu, Samuel

    2017-01-01

    To throw light on the challenge of providing education to pastoral households in the context of social and economic change, this study investigates the effects of herd migration on child schooling in Northern Kenya. Specifically, the analysis uses both household panel data and community-level focus-group data to identify the barriers to schooling,…

  2. On-Farm Evaluation of Hermetic Technology Against Maize Storage Pests in Kenya.

    PubMed

    Likhayo, Paddy; Bruce, Anani Y; Mutambuki, Kimondo; Tefera, Tadele; Mueke, Jones

    2016-08-01

    On-farm trial with a total of 32 farmers in eight villages of Naivasha and Nakuru areas of Kenya was conducted between December 2013 and September 2014 to evaluate hermetic grain storage technologies under farmers' management conditions. The storage technologies evaluated were metal silo and SuperGrain IV-R bag alongside the standard woven polypropylene bag with or without Actellic super dust. Moisture content, insect population, grain discoloration, and weight loss were analyzed 90, 180, and 270 d after storage. Grain moisture content remained stable over the storage period. Both metal silo and SuperGrain IV-R bag suppressed insect population, prevented grain loss and cross-infestation of insects from the surrounding environment. On the contrary, polypropylene bags allowed rapid build up of insect population and re-infestation from the surrounding environment. Grain weight losses were 1.5% in the metal silo and 1.8% in the SuperGrain IV-R bags compared to 32% in the polypropylene bags without Actellic Super dust, 270 d after storage. The present study, therefore, demonstrates that storing grains either in metal silo or SuperGrain IV-R bags would benefit farmers in reducing grain losses and improving quality. The study was of great interest to the farmers, grain storage scientists, and food security experts. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Post-caldera faulting of the Late Quaternary Menengai caldera, Central Kenya Rift (0.20°S, 36.07°E)

    NASA Astrophysics Data System (ADS)

    Riedl, Simon; Melnick, Daniel; Mibei, Geoffrey K.; Njue, Lucy; Strecker, Manfred R.

    2015-04-01

    A structural geological analysis of young caldera volcanoes is necessary to characterize their volcanic activity, assess their geothermal potential, and decipher the spatio-temporal relationships of faults on a larger tectonic scale. Menengai caldera is one of several major Quaternary trachytic caldera volcanoes that are aligned along the volcano-tectonic axis of the Kenya Rift, the archetypal active magmatic rift and nascent plate boundary between the Nubia and Somalia plates. The caldera covers an area of approximately 80 km² and is among the youngest and also largest calderas in the East African Rift, situated close to Nakuru - a densely populated urban area. There is an increasing interest in caldera volcanoes in the Kenya Rift, because these are sites of relatively young volcanic and tectonic activity, and they are considered important sites for geothermal exploration and future use for the generation of geothermal power. Previous studies of Menengai showed that the caldera collapsed in a multi-event, multiple-block style, possibly as early as 29 ka. In an attempt to characterize the youngest tectonic activity along the volcano-tectonic axis in the transition between the Central and Northern Kenya rifts we first used a high-resolution digital surface model, which we derived by structure-from-motion from an unmanned aerial vehicle campaign. This enabled us to identify previously unrecognized normal faults, associated dyke intrusions and volcanic eruptive centers, and transfer faults with strike-slip kinematics in the caldera interior and its vicinity. In a second step we verified these structures at outcrop scale, assessed their relationship with known stratigraphic horizons and dated units, and performed detailed fault measurements, which we subsequently used for fault-kinematic analysis. The most important structures that we mapped are a series of north-northeast striking normal faults, which cross-cut both the caldera walls and early Holocene lake

  4. Environment and farm factors associated with exposure to Theileria parva infection in cattle under traditional mixed farming system in Mbeere District, Kenya.

    PubMed

    Gachohi, John M; Kitala, Phillip M; Ngumi, Priscilla N; Skilton, Rob A

    2011-01-01

    The objective of this study was to investigate the relationship between seroprevalence to Theileria parva infection in cattle and potential environmental and farm-level effects in 80 farms under traditional crop-livestock system in Mbeere District, Kenya. A standardized questionnaire was used to collect the effects characteristics as related to T. parva infection epidemiology. Serum samples were collected from 440 cattle of all ages for detection of T. parva antibodies by the enzyme-linked immunosorbent assay technique. The association between the variables was assessed using a generalized estimation equation logistic regression model. The overall T. parva seroprevalence, accounting for correlation of responses, was 19.3% (95% confidence interval (CI) 14%, 25%). Two variables, "administrative division" and "presence of the vector tick on the farm", were significantly associated with the T. parva seroresponse. Respectively, cattle from farms in Gachoka, Evurore, and Mwea divisions were (and their 95% CI) 1.3 (0.36, 4.8), 4.4 (1.2, 15.9), and 15.2 (4.9, 47.1) times more likely to be seropositive relative to those from Siakago Division (P = 0.000). Cattle from farms in which the vector tick was present were 2.9 (1.2, 6.7) times more likely to be seropositive (P = 0.011). Results of this study suggested that both environmental and farm factors may be associated with T. parva infection epidemiology in Mbeere District. Under such circumstances, characterization of environmental suitability for the vector tick and corresponding environment-specific farm management practices in the district is required both for improved understanding of the disease and in planning disease control programs.

  5. Kericho CLinic-based ART Diagnostic Evaluation (CLADE): design, accrual, and baseline characteristics of a randomized controlled trial conducted in predominately rural, district-level, HIV clinics of Kenya.

    PubMed

    Sawe, Fredrick K; Obiero, Eunice; Yegon, Peter; Langat, Rither C; Aoko, Appolonia; Tarus, Jemutai; Kiptoo, Ignatius; Langat, Raphael K; Maswai, Jonah; Bii, Margaret; Khamadi, Samoel; Shikuku, Kibet P; Close, Nicole; Sinei, Samuel; Shaffer, Douglas N

    2015-01-01

    Prospective clinical trial data regarding routine HIV-1 viral load (VL) monitoring of antiretroviral therapy (ART) in non-research clinics of Sub-Saharan Africa are needed for policy makers. CLinic-based ART Diagnostic Evaluation (CLADE) is a randomized, controlled trial (RCT) evaluating feasibility, superiority, and cost-effectiveness of routine VL vs. standard of care (clinical and immunological) monitoring in adults initiating dual nucleoside reverse transcriptase inhibitor (NRTI)+non-NRTI ART. Participants were randomized (1:1) at 7 predominately rural, non-research, district-level clinics of western Kenya. Descriptive statistics present accrual patterns and baseline cohort characteristics. Over 15 months, 820 adults enrolled at 7 sites with 86-152 enrolled per site. Monthly site enrollment ranged from 2-92 participants. Full (100%) informed consent compliance was independently documented. Half (49.9%) had HIV diagnosed through voluntary counseling and testing. Study arms were similar: mostly females (57.6%) aged 37.6 (SD = 9.0) years with low CD4 (166 [SD = 106]) cells/m3). Notable proportions had WHO Stage III or IV disease (28.7%), BMI <18.5 kg/m2 (23.1%), and a history of tuberculosis (5.6%) or were receiving tuberculosis treatment (8.2%) at ART initiation. In the routine VL arm, 407/409 (99.5%) received baseline VL (234,577 SD = 151,055 copies/ml). All participants received lamivudine; 49.8% started zidovudine followed by 38.4% stavudine and 11.8% tenofovir; and, 64.4% received nevirapine as nNRTI (35.6% efavirenz). A RCT can be enrolled successfully in rural, non-research, resource limited, district-level clinics in western Kenya. Many adults presenting for ART have advanced HIV/AIDS, emphasizing the importance of universal HIV testing and linkage-to-care campaigns. ClinicalTrials.gov NCT01791556.

  6. 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.

  7. Changing Concepts of Health and Illness among Children of Primary School Age in Western Kenya

    ERIC Educational Resources Information Center

    Onyango-Ouma, W.; Aagaard-Hansen, J.; Jensen, B. B.

    2004-01-01

    This paper examines changes in children's concepts of health and illness following an action-oriented health education intervention in Bondo district of Western Kenya. The study is a feasibility study exploring a specific educational approach, and it combines elements of health education research and anthropological research. Forty primary…

  8. Information, Affect and Action: Motivating Reduction of Risk Behaviors for HIV/AIDS in Kenya and Tanzania

    ERIC Educational Resources Information Center

    Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica

    2012-01-01

    This study reports assessment of motivational and perceptual components of a youth and community AIDS awareness education program, focusing on effectiveness across program sites. The design of this investigation was quasi-experimental, with two intervention districts and one control each, in Kenya and Tanzania. Methods included questionnaires…

  9. Between Tradition and Modernity: Girls' Talk about Sexual Relationships and Violence in Kenya, Ghana and Mozambique

    ERIC Educational Resources Information Center

    Parkes, Jenny; Heslop, Jo; Januario, Francisco; Oando, Samwel; Sabaa, Susan

    2016-01-01

    This paper interrogates the influence of a tradition-modernity dichotomy on perspectives and practices on sexual violence and sexual relationships involving girls in three districts of Kenya, Ghana and Mozambique. Through deploying an analytical framework of positioning within multiple discursive sites, we argue that although the dichotomy…

  10. The Murang'a landslide, Kenya

    NASA Astrophysics Data System (ADS)

    Davies, T. C.; Nyambok, I. O.

    1993-04-01

    On 15 May 1991, a landslide occurred at Gacharage Village in the Murang'a District of Kenya; it buried a house near the toe of a cliff, killing all eight residents in their sleep. The principal determining factors of the slide were a high, mechanically unstable slope of deeply weathered volcanic soil and a high sorption capacity of the surface soil layer. The slide was triggered by rapid saturation of the soil following a heavy downpour. Based on field investigations and laboratory studies, this paper discusses the physical properties and environmental factors that affected slope stability at Murang'a. It also points out the economic and social impact of landslides in the region and suggests remedial measures.

  11. Brine shrimp toxicity and antimalarial activity of some plants traditionally used in treatment of malaria in Msambweni district of Kenya.

    PubMed

    Nguta, J M; Mbaria, J M

    2013-07-30

    In Kenya, most people especially in rural areas use traditional medicine and medicinal plants to treat many diseases including malaria. Malaria is of national concern in Kenya, in view of development of resistant strains of Plasmodium falciparum to drugs especially chloroquine, which had been effective and affordable. There is need for alternative and affordable therapy. Many antimalarial drugs have been derived from medicinal plants and this is evident from the reported antiplasmodial activity. The present study reports on the in vivo antimalarial activity and brine shrimp lethality of five medicinal plants traditionally used to treat malaria in Msambweni district, Kenya. A total of five aqueous crude extracts from different plant parts used in traditional medicine for the treatment of malaria were evaluated for their in vivo antimalarial activity using Plasmodium berghei infected Swiss mice and for their acute toxicity using Brine shrimp lethality test. The screened crude plant extracts suppressed parasitaemia as follows: Azadirachta indica (L) Burm. (Meliaceae), 3.1%; Dichrostachys cinerea (L) Wight et Arn (Mimosaceae), 6.3%; Tamarindus indica L. (Caesalpiniaceae), 25.1%; Acacia seyal Del. (Mimosaceae) 27.8% and Grewia trichocarpa Hochst ex A.Rich (Tiliaceae) 35.8%. In terms of toxicity, A.indica root bark extract had an LC50 of 285.8 µg/ml and was considered moderately toxic. T.indica stem bark extract and G.trichocarpa root extract had an LC50 of 516.4 and 545.8 µg/ml respectively and were considered to be weakly toxic while A.seyal and D.cinerea root extracts had a LC50>1000 µg/ml and were therefore considered to be non toxic. The results indicate that the aqueous extracts of the tested plants when used alone as monotherapy had antimalarial activity which was significantly different from that of chloroquine (P≤0.05). The results also suggest that the anecdotal efficacy of the above plants reported by the study community is related to synergism of

  12. An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

    PubMed

    Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

    2015-01-01

    In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

  13. Rift Valley Fever Outbreak in Livestock in Kenya, 2006–2007

    PubMed Central

    Munyua, Peninah; Murithi, Rees M.; Wainwright, Sherrilyn; Githinji, Jane; Hightower, Allen; Mutonga, David; Macharia, Joseph; Ithondeka, Peter M.; Musaa, Joseph; Breiman, Robert F.; Bloland, Peter; Njenga, M. Kariuki

    2010-01-01

    We analyzed the extent of livestock involvement in the latest Rift Valley fever (RVF) outbreak in Kenya that started in December 2006 and continued until June 2007. When compared with previous RVF outbreaks in the country, the 2006–07 outbreak was the most extensive in cattle, sheep, goats, and camels affecting thousands of animals in 29 of 69 administrative districts across six of the eight provinces. This contrasted with the distribution of approximately 700 human RVF cases in the country, where over 85% of these cases were located in four districts; Garissa and Ijara districts in Northeastern Province, Baringo district in Rift Valley Province, and Kilifi district in Coast Province. Analysis of livestock and human data suggests that livestock infections occur before virus detection in humans, as supported by clustering of human RVF cases around livestock cases in Baringo district. The highest livestock morbidity and mortality rates were recorded in Garissa and Baringo districts, the same districts that recorded a high number of human cases. The districts that reported RVF in livestock for the first time in 2006/07 included Kitui, Tharaka, Meru South, Meru central, Mwingi, Embu, and Mbeere in Eastern Province, Malindi and Taita taveta in Coast Province, Kirinyaga and Murang'a in Central Province, and Baringo and Samburu in Rift Valley Province, indicating that the disease was occurring in new regions in the country. PMID:20682907

  14. Changing trends in blood transfusion in children and neonates admitted in Kilifi District Hospital, Kenya.

    PubMed

    Pedro, Rosalon; Akech, Samuel; Fegan, Greg; Maitland, Kathryn

    2010-10-30

    Severe anaemia is a common cause for hospitalization in children in sub-Saharan Africa. Malaria plays an important aetiological role, resulting in a substantial burden of paediatric transfusion in hospitals. A decline in malaria and paediatric admissions to the Kilifi District Hospital has been reported recently. This study aimed to investigate whether this trend affected clinical burden, clinical severity of anaemia and requirements for paediatric transfusion. Eight-year retrospective review of paediatric admissions to Kilifi District Hospital, Kenya describing the frequency of moderate and severe anaemia, blood transfusion and case fatality over time. Definitions for severe anaemia were Hb <8 g/dl for newborns and <5 g/dl for other age groups and for moderate anaemia was Hb 8 to <11 g/dl for newborns and 5 to <9.3 g/dl for other age groups. Life threatening anaemia was defined as severe anaemia (Hb <5 g/dl) complicated by either deep breathing or prostration or profound anaemia (Hb <4 g/dl) alone. Of the 35,139 admissions 13,037 (37%) had moderate anaemia and 2,265 (6%) had severe anaemia; respiratory distress complicated 35% of cases with Hb <5 g/dl. Concurrent with the decline in malaria there was a marked decline in the prevalence of severe anaemia between 2002 (8%) and 2009 (< 4%) (chi2 for trend = 134, P < 0.0001). The number and proportion of admissions transfused also declined significantly over this time (chi2 for trend = 152, P < 0.0001). Of the 2,265 children with severe anaemia 191 (8%) died. Case fatality remained unchanged during this period (P < 0.26) and was largely explained by the unchanged proportion with life-threatening anaemia, present in 58-65% of cases throughout the study period. The impact of reduced malaria transmission on child morbidity has positive public benefits on the demand and use of blood for paediatric transfusion. Despite an overall reduction in paediatric transfusion requirement, case fatality of severe anaemia remained

  15. Equity and Access to University Education through Higher Loans in Bungoma District Kenya

    ERIC Educational Resources Information Center

    Wachiye, Herman J.; Nasongo, Joseph W.

    2009-01-01

    University student loans were introduced in Kenya with the aim of easing the burden of public expenditure in higher education. In the initial years the loans were to benefit all students enrolled at University irrespective of their socio-economic backgrounds. The beneficiaries were expected to repay the loan later upon getting into employment.…

  16. Stigmatizing attitudes toward mental illness among primary school children in Kenya.

    PubMed

    Ndetei, David M; Mutiso, Victoria; Maraj, Anika; Anderson, Kelly K; Musyimi, Christine; McKenzie, Kwame

    2016-01-01

    Literature describing stigmatizing attitudes towards people with mental illness by children in the developing world is lacking. Children's mental health issues in the Kenyan context are especially pertinent due to the increased likelihood of exposure to risk factors and the high prevalence of mental disorders. The objective of the current study was to examine socio-demographic factors associated with the endorsement of stigmatizing attitudes towards people with mental illness among Kenyan school children. We analyzed cross-sectional survey data from 4585 primary school-aged children in standards one through seven in the Eastern Province of Kenya. We examined relationships between the endorsement of stigmatizing attitudes and age, gender, district, religion, being in the standard appropriate for one's age, and parental employment status. Stigma scores decreased with increasing age (β = -0.83; 95 % CI = -0.99 to -0.67). Boys had higher stigma scores compared to girls (β = 1.55; 95 % CI = 0.86-2.24). Students from the rural district had higher average stigma scores as compared to those from the peri-urban district (β = 1.14; 95 % CI = 0.44-1.84). Students who were not in the standard appropriate for their age had lower stigma scores than those who were in the standard typical for their age (β = -1.60; 95 % CI = -2.43 to -0.77). Stigmatizing attitudes toward the mentally ill exist among primary school children in Kenya; thus, anti-stigma interventions are needed, and our findings highlight particular subgroups that could be targeted.

  17. Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda.

    PubMed

    Mueller, Dirk H; Abeku, Tarekegn A; Okia, Michael; Rapuoda, Beth; Cox, Jonathan

    2009-01-16

    Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates.

  18. Planning and Implementation of Guidance and Counseling Activities in Secondary Schools: A Case of Kamariny Division of Keiyo District, Kenya

    ERIC Educational Resources Information Center

    Ruttoh, Margaret Jepkoech K.

    2015-01-01

    Guidance and Counseling programme in Kenya has become increasingly important in recent years because the country is faced with new psychological and social challenges that require guidance and counseling (Mutie & Ndambuki, 1999). The Government of Kenya has reinforced guidance and counseling services by encouraging teachers to take specialized…

  19. Willingness to pay for contagious bovine pleuropneumonia vaccination in Narok South District of Kenya.

    PubMed

    Kairu-Wanyoike, Salome W; Kaitibie, Simeon; Heffernan, Claire; Taylor, Nick M; Gitau, George K; Kiara, Henry; McKeever, Declan

    2014-08-01

    Contagious bovine pleuropneumonia (CBPP) is an economically important trans-boundary cattle disease which affects food security and livelihoods. A conjoint analysis-contingent valuation was carried out on 190 households in Narok South District of Kenya to measure willingness to pay (WTP) and demand for CBPP vaccine and vaccination as well as factors affecting WTP. The mean WTP was calculated at Kenya Shillings (KSh) 212.48 (USD 3.03) for vaccination using a vaccine with the characteristics that were preferred by the farmers (preferred vaccine and vaccination) and KSh -71.45 (USD -1.02) for the currently used vaccine and vaccination. The proportion of farmers willing to pay an amount greater than zero was 66.7% and 34.4% for the preferred and current vaccine and vaccination respectively. About one third (33.3%) of farmers would need to be compensated an average amount of KSh 1162.62 (USD 13.68) per animal to allow their cattle to be vaccinated against CBPP using the preferred vaccine and vaccination. About two-thirds (65.6%) of farmers would need to be compensated an average amount of KSh 853.72 (USD 12.20) per animal to allow their cattle to be vaccinated against CBPP using the current vaccine and vaccination. The total amount of compensation would be KSh 61.39 million (USD 0.88 million) for the preferred vaccine and vaccination and KSh 90.15 million (USD 1.29 million) for the current vaccine and vaccination. Demand curves drawn from individual WTP demonstrated that only 59% and 27% of cattle owners with a WTP greater than zero were willing to pay a benchmark cost of KSh 34.60 for the preferred and current vaccine respectively. WTP was negatively influenced by the attitude about household economic situation (p=0.0078), presence of cross breeds in the herd (p<0.0001) and years since CBPP had been experienced in the herd (p=0.0375). It was positively influenced by education (p=0.0251) and the practice of treating against CBPP (p=0.0432). The benefit cost ratio (BCR

  20. Willingness to pay for contagious bovine pleuropneumonia vaccination in Narok South District of Kenya

    PubMed Central

    Kairu-Wanyoike, Salome W.; Kaitibie, Simeon; Heffernan, Claire; Taylor, Nick M.; Gitau, George K.; Kiara, Henry; McKeever, Declan

    2014-01-01

    Contagious bovine pleuropneumonia (CBPP) is an economically important trans-boundary cattle disease which affects food security and livelihoods. A conjoint analysis–contingent valuation was carried out on 190 households in Narok South District of Kenya to measure willingness to pay (WTP) and demand for CBPP vaccine and vaccination as well as factors affecting WTP. The mean WTP was calculated at Kenya Shillings (KSh) 212.48 (USD 3.03) for vaccination using a vaccine with the characteristics that were preferred by the farmers (preferred vaccine and vaccination) and KSh −71.45 (USD −1.02) for the currently used vaccine and vaccination. The proportion of farmers willing to pay an amount greater than zero was 66.7% and 34.4% for the preferred and current vaccine and vaccination respectively. About one third (33.3%) of farmers would need to be compensated an average amount of KSh 1162.62 (USD 13.68) per animal to allow their cattle to be vaccinated against CBPP using the preferred vaccine and vaccination. About two-thirds (65.6%) of farmers would need to be compensated an average amount of KSh 853.72 (USD 12.20) per animal to allow their cattle to be vaccinated against CBPP using the current vaccine and vaccination. The total amount of compensation would be KSh 61.39 million (USD 0.88 million) for the preferred vaccine and vaccination and KSh 90.15 million (USD 1.29 million) for the current vaccine and vaccination. Demand curves drawn from individual WTP demonstrated that only 59% and 27% of cattle owners with a WTP greater than zero were willing to pay a benchmark cost of KSh 34.60 for the preferred and current vaccine respectively. WTP was negatively influenced by the attitude about household economic situation (p = 0.0078), presence of cross breeds in the herd (p < 0.0001) and years since CBPP had been experienced in the herd (p = 0.0375). It was positively influenced by education (p = 0.0251) and the practice of treating against CBPP (p = 0.0432). The

  1. Entomophagy among the Luo of Kenya: a potential mineral source?

    PubMed

    Christensen, Dirk L; Orech, Francis O; Mungai, Michael N; Larsen, Torben; Friis, Henrik; Aagaard-Hansen, Jens

    2006-01-01

    Primary objective To determine the iron, zinc, and calcium content in different insects commonly eaten among the Luo of Kenya. Research design A cross-sectional design was chosen for the study in order to determine the insects eaten and their mineral content during a specific season.Methods and procedures Five different insect species were identified and collected with the help of local informants in the Nyang'oma sublocation of the Bondo district in western Kenya, and were analysed for iron, zinc and calcium contents. Main outcomes and results The iron content ranged from 18 to 1562 mg/100 g dry matter, the zinc content from 8 to 25 mg/100 g, and the calcium content from 33 to 341 mg/100 g in five different insects, onyoso mammon (ant), oyala (termite), ogawo (termite), agaor (termite), onjiri mammon (cricket). Conclusions Insect eating could prove to be a valuable measure to combat, especially, iron and zinc deficiency in developing countries.

  2. Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda

    PubMed Central

    Mueller, Dirk H; Abeku, Tarekegn A; Okia, Michael; Rapuoda, Beth; Cox, Jonathan

    2009-01-01

    Background Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. Methods An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. Results The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. Conclusion Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates. PMID:19149878

  3. Spatial autocorrelation in uptake of antenatal care and relationship to individual, household and village-level factors: results from a community-based survey of pregnant women in six districts in western Kenya.

    PubMed

    Prudhomme O'Meara, Wendy; Platt, Alyssa; Naanyu, Violet; Cole, Donald; Ndege, Samson

    2013-12-07

    The majority of maternal deaths, stillbirths, and neonatal deaths are concentrated in a few countries, many of which have weak health systems, poor access to health services, and low coverage of key health interventions. Early and consistent antenatal care (ANC) attendance could significantly reduce maternal and neonatal morbidity and mortality. Despite this, most Kenyan mothers initiate ANC care late in pregnancy and attend fewer than the recommended visits. We used survey data from 6,200 pregnant women across six districts in western Kenya to understand demand-side factors related to use of ANC. Bayesian multi-level models were developed to explore the relative importance of individual, household and village-level factors in relation to ANC use. There is significant spatial autocorrelation of ANC attendance in three of the six districts and considerable heterogeneity in factors related to ANC use between districts. Working outside the home limited ANC attendance. Maternal age, the number of small children in the household, and ownership of livestock were important in some districts, but not all. Village proportions of pregnancy in women of child-bearing age was significantly correlated to ANC use in three of the six districts. Geographic distance to health facilities and the type of nearest facility was not correlated with ANC use. After incorporating individual, household and village-level covariates, no residual spatial autocorrelation remained in the outcome. ANC attendance was consistently low across all the districts, but factors related to poor attendance varied. This heterogeneity is expected for an outcome that is highly influenced by socio-cultural values and local context. Interventions to improve use of ANC must be tailored to local context and should include explicit approaches to reach women who work outside the home.

  4. Completeness of malaria indicator data reporting via the District Health Information Software 2 in Kenya, 2011-2015.

    PubMed

    Githinji, Sophie; Oyando, Robinson; Malinga, Josephine; Ejersa, Waqo; Soti, David; Rono, Josea; Snow, Robert W; Buff, Ann M; Noor, Abdisalan M

    2017-08-17

    Health facility-based data reported through routine health information systems form the primary data source for programmatic monitoring and evaluation in most developing countries. The adoption of District Health Information Software (DHIS2) has contributed to improved availability of routine health facility-based data in many low-income countries. An assessment of malaria indicators data reported by health facilities in Kenya during the first 5 years of implementation of DHIS2, from January 2011 to December 2015, was conducted. Data on 19 malaria indicators reported monthly by health facilities were extracted from the online Kenya DHIS2 database. Completeness of reporting was analysed for each of the 19 malaria indicators and expressed as the percentage of data values actually reported over the expected number; all health facilities were expected to report data for each indicator for all 12 months in a year. Malaria indicators data were analysed for 6235 public and 3143 private health facilities. Between 2011 and 2015, completeness of reporting in the public sector increased significantly for confirmed malaria cases across all age categories (26.5-41.9%, p < 0.0001, in children aged <5 years; 30.6-51.4%, p < 0.0001, in persons aged ≥5 years). Completeness of reporting of new antenatal care (ANC) clients increased from 53.7 to 70.5%, p < 0.0001). Completeness of reporting of intermittent preventive treatment in pregnancy (IPTp) decreased from 64.8 to 53.7%, p < 0.0001 for dose 1 and from 64.6 to 53.4%, p < 0.0001 for dose 2. Data on malaria tests performed and test results were not available in DHIS2 from 2011 to 2014. In 2015, sparse data on microscopy (11.5% for children aged <5 years; 11.8% for persons aged ≥5 years) and malaria rapid diagnostic tests (RDTs) (8.1% for all ages) were reported. In the private sector, completeness of reporting increased significantly for confirmed malaria cases across all age categories (16.7-23.1%, p < 0

  5. Rift Valley Fever Virus Epidemic in Kenya, 2006/2007: The Entomologic Investigations

    PubMed Central

    Sang, Rosemary; Kioko, Elizabeth; Lutomiah, Joel; Warigia, Marion; Ochieng, Caroline; O'Guinn, Monica; Lee, John S.; Koka, Hellen; Godsey, Marvin; Hoel, David; Hanafi, Hanafi; Miller, Barry; Schnabel, David; Breiman, Robert F.; Richardson, Jason

    2010-01-01

    In December 2006, Rift Valley fever (RVF) was diagnosed in humans in Garissa Hospital, Kenya and an outbreak reported affecting 11 districts. Entomologic surveillance was performed in four districts to determine the epidemic/epizootic vectors of RVF virus (RVFV). Approximately 297,000 mosquitoes were collected, 164,626 identified to species, 72,058 sorted into 3,003 pools and tested for RVFV by reverse transcription-polymerase chain reaction. Seventy-seven pools representing 10 species tested positive for RVFV, including Aedes mcintoshi/circumluteolus (26 pools), Aedes ochraceus (23 pools), Mansonia uniformis (15 pools); Culex poicilipes, Culex bitaeniorhynchus (3 pools each); Anopheles squamosus, Mansonia africana (2 pools each); Culex quinquefasciatus, Culex univittatus, Aedes pembaensis (1 pool each). Positive Ae. pembaensis, Cx. univittatus, and Cx. bitaeniorhynchus was a first time observation. Species composition, densities, and infection varied among districts supporting hypothesis that different mosquito species serve as epizootic/epidemic vectors of RVFV in diverse ecologies, creating a complex epidemiologic pattern in East Africa. PMID:20682903

  6. Rift Valley fever virus epidemic in Kenya, 2006/2007: the entomologic investigations.

    PubMed

    Sang, Rosemary; Kioko, Elizabeth; Lutomiah, Joel; Warigia, Marion; Ochieng, Caroline; O'Guinn, Monica; Lee, John S; Koka, Hellen; Godsey, Marvin; Hoel, David; Hanafi, Hanafi; Miller, Barry; Schnabel, David; Breiman, Robert F; Richardson, Jason

    2010-08-01

    In December 2006, Rift Valley fever (RVF) was diagnosed in humans in Garissa Hospital, Kenya and an outbreak reported affecting 11 districts. Entomologic surveillance was performed in four districts to determine the epidemic/epizootic vectors of RVF virus (RVFV). Approximately 297,000 mosquitoes were collected, 164,626 identified to species, 72,058 sorted into 3,003 pools and tested for RVFV by reverse transcription-polymerase chain reaction. Seventy-seven pools representing 10 species tested positive for RVFV, including Aedes mcintoshi/circumluteolus (26 pools), Aedes ochraceus (23 pools), Mansonia uniformis (15 pools); Culex poicilipes, Culex bitaeniorhynchus (3 pools each); Anopheles squamosus, Mansonia africana (2 pools each); Culex quinquefasciatus, Culex univittatus, Aedes pembaensis (1 pool each). Positive Ae. pembaensis, Cx. univittatus, and Cx. bitaeniorhynchus was a first time observation. Species composition, densities, and infection varied among districts supporting hypothesis that different mosquito species serve as epizootic/epidemic vectors of RVFV in diverse ecologies, creating a complex epidemiologic pattern in East Africa.

  7. Quantitative and qualitative verification of data quality in the childbirth registers of two rural district hospitals in Western Kenya.

    PubMed

    Chiba, Yoko; Oguttu, Monica A; Nakayama, Takeo

    2012-06-01

    to verify the data quality of childbirth registers and explore factors that influence quality at two rural district hospitals in Western Kenya. a retrospective comparative case study for data quality of the 2006 childbirth registers by quantitative and qualitative methods. Siaya and Bondo District Hospitals. after confirming the physical condition and availability of childbirth registers, the total number of births; number of complete/incomplete data; and number of complete data that were illegible, incorrectly coded, inappropriate and unrecognised were verified quantitatively to evaluate accuracy and completeness. Data categories and instructions were examined qualitatively to assess the relevance, completeness and accuracy of the data. Semi-structured interviews were conducted with key informants to capture their views and factors that influence data quality. the childbirth registers used by the two hospitals were not developed by the Ministry of Health, and their supply to Bondo was interrupted. Of the 30 data categories in the registers, five for Siaya and 23 for Bondo were more than 20% incomplete. Data for number of antenatal consultations and use of human immunodeficiency virus drugs were at least 50% incomplete for both hospitals. The percentage of illegible, incorrectly coded and inappropriate data was relatively low, and only the place of residence had unrecognised data. Data categories in the registers did not correspond well with those of monthly reports, and inappropriate instructions suggested hidden inaccuracy among apparently valid data. Organisational impediments of the health information system in general, perinatal and intrapartum contexts were identified. data quality of the childbirth registers was unsatisfactory. Influential factors were primarily organisational and technical, which may have had an adverse effect on midwives' record keeping behaviour. data quality of the registers can be improved by re-examining technical challenges and

  8. Determinants of childhood vaccination completion at a peri-urban hospital in Kenya, December 2013 -January 2014: a case control study

    PubMed Central

    Emmanuel, Okunga Wandera; Samuel, Amwayi Anyangu; Helen, Kutima Lydia

    2015-01-01

    Introduction Vaccine preventable diseases account for about 17% of deaths among children below five years in Kenya. Immunization is one the most cost-effective ways of reducing child mortality and morbidity worldwide. In Kenya, national full vaccination coverage today stands at above 80%. However there continue to be pockets of low full vaccination coverage like the catchment area of Alupe Sub-District Hospital which pose a threat to the rest of the country. Methods This was a case-control study at Alupe Sub-District Hospital, Western Kenya. Sixty one (61) cases and 122 controls were sampled from the facility maternal and child health register by systematic random sampling and traced to their households. Cases were defined as children 12-23 months resident in Kenya who received at least one infant vaccine at the facility but were not fully vaccinated at the time of the study, while controls were children 12-23 months who were fully vaccinated by the time of the study. Pretested structured questionnaires were used for data collection. Data entry and analysis was done using Epi-Info 3.5.4 statistical software. Results Independent determinants of infant vaccination completion were the child's age < 18 months (AOR 4.2(1.8-9.6), p < 0.01), maternal age < 25 years (AOR 2.5(1.1-5.0), p = 0.03), maternal tetanus toxoid vaccination status < 2 TT doses (AOR 2.5(1.2-5.4), p < 0.02) and late receipt of BCG [AOR 3.2(1.4-7.3), p = 0.005). Conclusion Strategies to increase full vaccination should target young mothers especially during antenatal period. PMID:26161200

  9. Determinants of childhood vaccination completion at a peri-urban hospital in Kenya, December 2013 -January 2014: a case control study.

    PubMed

    Emmanuel, Okunga Wandera; Samuel, Amwayi Anyangu; Helen, Kutima Lydia

    2015-01-01

    Vaccine preventable diseases account for about 17% of deaths among children below five years in Kenya. Immunization is one the most cost-effective ways of reducing child mortality and morbidity worldwide. In Kenya, national full vaccination coverage today stands at above 80%. However there continue to be pockets of low full vaccination coverage like the catchment area of Alupe Sub-District Hospital which pose a threat to the rest of the country. This was a case-control study at Alupe Sub-District Hospital, Western Kenya. Sixty one (61) cases and 122 controls were sampled from the facility maternal and child health register by systematic random sampling and traced to their households. Cases were defined as children 12-23 months resident in Kenya who received at least one infant vaccine at the facility but were not fully vaccinated at the time of the study, while controls were children 12-23 months who were fully vaccinated by the time of the study. Pretested structured questionnaires were used for data collection. Data entry and analysis was done using Epi-Info 3.5.4 statistical software. Independent determinants of infant vaccination completion were the child's age < 18 months (AOR 4.2(1.8-9.6), p < 0.01), maternal age < 25 years (AOR 2.5(1.1-5.0), p = 0.03), maternal tetanus toxoid vaccination status < 2 TT doses (AOR 2.5(1.2-5.4), p < 0.02) and late receipt of BCG [AOR 3.2(1.4-7.3), p = 0.005). Strategies to increase full vaccination should target young mothers especially during antenatal period.

  10. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey.

    PubMed

    Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy

    2013-10-10

    Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to

  11. 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

  12. Influence of distance to urban markets on smallholder dairy farming systems in Kenya.

    PubMed

    Migose, S A; Bebe, B O; de Boer, I J M; Oosting, S J

    2018-03-28

    We studied influence of distance to urban markets on smallholder dairy farming system development. Farms were chosen from three locations that varied in distance to the urban market of Nakuru Town in the Kenyan highlands: urban location (UL, n = 10) at less than 15 km distance, mid-rural location (MRL, n = 11) in between 20 and 50 km west of Nakuru and extreme rural location (ERL, n = 9) beyond 50 km west and south-west of Nakuru. In-depth interviews with farmers and focus group discussions with eight groups of stakeholders were held to collect narratives and data about market quality, production factors, farm performance and functions of dairy cattle. We applied thematic content analysis to qualitative information by clustering narratives according to predefined themes and used ANOVA to analyse farm data. In UL, markets were functional, with predominantly informal market chains, with a high milk price (US $ 45.1/100 kg). Inputs were available in UL markets, but prices were high for inputs such as concentrates, fodder, replacement stock and hired labour. Moreover, availability of grazing land and the high opportunity costs for family labour were limiting dairy activities. In UL, milk production per cow (6.9 kg/cow/day) and per farm (20.1 kg/farm/day) were relatively low, and we concluded that farm development was constrained by scarcity of inputs and production factors. In rural locations (MRL and ERL), markets were functional with relatively low prices (average US $ 32.8/100 kg) for milk in both formal and informal market chains. Here, concentrates were relatively cheap but also of low quality. Fodder, replacement stock and labour were more available in rural locations than in UL. In rural locations, milk production per cow (average 7.2 kg/cow/day) and per farm (average 18.5 kg/farm/day) were low, and we concluded that farm development was constrained by low quality of concentrates and low price of milk. In all locations, production for

  13. Role-Play Technique as an Antecedent of Performance in English Language: Evidence from Secondary Schools in Wareng District, Uasin Gishu County, Kenya

    ERIC Educational Resources Information Center

    Julius, Kemboi; Osman, Ahmed

    2015-01-01

    In Kenya, there is a national concern over English language dismal performance over the years in Kenya Certificate of Secondary Education (K.C.S.E). Blame has been put on teachers of English language for relying on techniques that favor them at the expense of their students. This article therefore sought to assess the use of role-play technique as…

  14. Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

    PubMed

    Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

    2013-09-30

    Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

  15. The accountability for reasonableness approach to guide priority setting in health systems within limited resources--findings from action research at district level in Kenya, Tanzania, and Zambia.

    PubMed

    Byskov, Jens; Marchal, Bruno; Maluka, Stephen; Zulu, Joseph M; Bukachi, Salome A; Hurtig, Anna-Karin; Blystad, Astrid; Kamuzora, Peter; Michelo, Charles; Nyandieka, Lillian N; Ndawi, Benedict; Bloch, Paul; Olsen, Oystein E

    2014-08-20

    Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This

  16. Hydatid disease in the Turkana District of Kenya, IV. The prevalence of Echinococcus granulosus infections in dogs, and observations on the role of the dog in the lifestyle of the Turkana.

    PubMed

    Macpherson, C N; French, C M; Stevenson, P; Karstad, L; Arundel, J H

    1985-02-01

    The prevalence of Echinococcus granulosus in dogs in the Turkana District of Kenya was 39.4% of 695 examined. Of these, 98 (35.8%) had heavy Echinococcus worm burdens (10(3)-5 X 10(4) ), while 54 (19.7%) and 122 (44.5%) had medium (201-1000) and light (1-200) burdens. The possible sources of these infections are discussed. The prevalence rate differed in various parts of the district, ranging from 63.5% in the northwest, where the highest incidence of human hydatidosis also occurs, to nil along the shores of Lake Turkana. Infection rates of 32.0% and 16.7% were recorded at Lokitaung (north-east) and Lodwar (central), while in the south 48.9% of dogs harboured Echinococcus. This latter figure is surprising as the area has a low incidence of human hydatidosis. The Turkana keep a large number of dogs, and the reasons for this and the social role of the dog in the district is discussed. No difference in susceptibility was found between Turkana-type dogs and those of mixed breeds from Nairobi when they were experimentally infected with hydatid protoscolices from man, camels, cattle, sheep and goats. However, it proved difficult to infect the Turkana-type of dogs with viable protoscolices of cattle origin. The reasons for this and its epidemiological implications remain unclear. It is suggested that droughts, which affect Turkana every six to ten years, may play an important role in the perpetuation of hydatid disease in the area.

  17. 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.

  18. Patterns of Teaching Style and Active Teaching: Do They Differ across Subjects in Low and High Performing Primary Schools in Kenya?

    ERIC Educational Resources Information Center

    Ngware, Moses W.; Mutisya, Maurice; Oketch, Moses

    2012-01-01

    This paper focuses on the patterns of teaching styles and active teaching across subjects and between low and high performing schools in an attempt to examine what accounts for differences in performance between schools which are within the same locality. It uses data collected in 72 primary schools spread across six districts in Kenya. Video…

  19. Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya.

    PubMed

    Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S

    2010-01-01

    Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.

  20. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey

    PubMed Central

    2013-01-01

    Background Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Methods Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Results Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users’ low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Conclusion Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative

  1. 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.

  2. Perspectives on utilization of community based health information systems in Western Kenya.

    PubMed

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

  3. Effects of Climate Change on Indigenous Livelihoods: The Case of Recurrent Droughts among Nomadic Pastoralist of Southeastern Kenya

    NASA Astrophysics Data System (ADS)

    Mwangi, M. N.; Desanker, P. V.

    2006-12-01

    Drought is the most injurious impact of climate change that decimates lives and hinders socioeconomic development in most rangelands of Kenya. Several scientific evidences indicate that global climate change will increase frequency and intensity of droughts. This will have important ramification for ecosystems and social systems in the rangelands of southeastern Kenya, and correctly so. These rangelands are fragile and degraded; and the inhabitants are mostly poverty-stricken. Nomadic pastoralism is the chief source of livelihood in this region; it relies on local natural pastures. Besides, pressures from land use change constitute an additional exposure, of nomadic pastoralism, to vulnerabilities of this climatic hazard. This region is highly prone to droughts; it is currently recovering from a devastating drought that started in early 2005 and terminated at the start this year. Most important, and like most societies in sub-Saharan Africa, inadequate adaptive capacity among nomadic pastoralists of Kenya, exacerbates deleterious impacts of drought. The livelihood of these pastoralists, therefore, stands to be destabilized. This study presents findings from an on-going research in Kajiado District of southeastern Kenya. Impacts of and adaptation strategies to recurrent and prolonged droughts among the nomadic Maasai pastoralist are presented. The study concludes with possible future scenarios of this form of pastoralism from which climate change actors can draw from.

  4. Experiences of Parents with the Reading to Learn Approach: A Randomised Control Trial Initiative to Improve Literacy and Numeracy in Kenya and Uganda

    ERIC Educational Resources Information Center

    Abuya, Benta A.; Oketch, Moses; Ngware, Moses W.; Mutisya, Maurice; Musyoka, Peter K.

    2015-01-01

    Parental involvement in their children's schooling is in recognition that establishing the context in which a child attends school is important. Reading to Learn (RtL)was implemented in two districts of Kwale and Kinango in Kenya and of Amolatar and Dokolo in Uganda. This paper looks at parental involvement and their experiences with RtL. Data are…

  5. Prevalence, awareness and risk factors associated with Hepatitis B infection among pregnant women attending the antenatal clinic at Mbagathi District Hospital in Nairobi, Kenya.

    PubMed

    Ngaira, Jacqueline Asundula Malungu; Kimotho, James; Mirigi, Isaac; Osman, Saida; Ng'ang'a, Zipporah; Lwembe, Raphael; Ochwoto, Missiani

    2016-01-01

    Hepatitis B Viral Infection (HBV) remains one of the leading cause of morbidity and mortality globally accounting for 38-53% of chronic liver diseases and about 686,000 deaths annually. The prevalence of HBV is 9-20% in Sub-Saharan Africa, and in Kenya it is 5-30% among the general population and 9.4% among pregnant women. This study was aimed at identifying the prevalence, awareness and risk factors associated with HBV infections among pregnant women attending Antenatal clinic (ANC) at Mbagathi District hospital, Nairobi. This was a cross-sectional study involving 287 pregnant women enrolled for three months (September to December 2014) from Nairobi and neighbouring counties. A structured questionnaire that captured social, demographic and explanatory variables was administered to the study participants. Blood samples were also drawn from the participants and tested for HBV using Enzyme-Linked Immunosorbent Assay (ELISA) system. The study established that the prevalence of HBV infections among pregnant women attending antenatal clinic at Mbagathi District Hospital was 3.8% with highest infection rate among the 20-24 years age group. Seventy six (60.8 %) of the participants reported sexual encounters in less than a month before the interview of which 5 (7.6%) reported encounters involving other partners apart from their spouses. HBV awareness among the study participants was 12.2%. Before the interview, those with at least tertiary education (Mean =1.33, SD = 1.131), were more informed about HBV infection as compared to those with primary and secondary education (Mean = 0.63, SD = 0.722; (Mean =0.31, SD= 0.664). In regards to assessment of the risk factors; type of family (χ ² =19.753 df2 p<0.01), parity (χ ² =7.128 df2 p<0.01), History of abortions (χ ² =9.094 df1 p<0.01), early age (11-15 years) at first sexual encounter (χ ² =8.185 df1 p<0.01) were significantly associated with HBV positivity. The prevalence of HBV infection among pregnant women

  6. Fear of being tested for HIV at ANC clinics associated with low uptake of intermittent preventive treatment (IPT) of malaria among pregnant women attending Bondo District Hospital, Western Kenya.

    PubMed

    Sande, John Hafu; Kaseje, Dan; Nyapada, Linet; Owino, Victor O

    2010-03-01

    Malaria is a major cause of morbidity and mortality in tropical and subtropical regions, affecting mostly the impoverished sections of the population. Pregnant women living in malaria-endemic areas are at higher risk of malaria infection with higher density of parasitaemia than non-pregnant women. The aim of this study was to assess factors affecting the uptake of IPT among women attending antenatal clinics at Bondo District Hospital, Western Kenya. This study was a hospital-based cross-sectional survey among pregnant women attending clinics. Malaria is endemic in Bondo district. Both women from Bondo town (urban) and greater Bondo District (rural) who had been pregnant for at least 35 weeks or had delivered not more than 6 weeks prior to the survey), and had ANC cards were included in the study. The main outcomes were ANC attendance, IPT doses received and client and provider factors. Results showed that women's knowledge on ANC and IPT was high. The uptake of IPT was low among pregnant women with those from urban areas more likely to make more ANC visits and to get more IPT doses than women from the rural areas. ANC attendance was hampered by the fear of being tested for HIV at the clinic. Perceived side effects associated with IPT-SP hindered IPT uptake and were linked to HIV-related symptoms. Negative attitude among health workers towards pregnant women also adversely impacted IPT uptake. Women suggested that IPT drugs be distributed through community health workers instead of the health facility for improved uptake. Retraining of health workers on the administration of IPT, harmonization of health messages, and assessment of alternative community-based IPT distribution channels ought to be urgently considered. More evidence on the influence of HIV pandemic on perceptions and attitudes toward and uptake of other health interventions is urgently needed.

  7. 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.

  8. Modelling the risk of Taenia solium exposure from pork produced in western Kenya.

    PubMed

    Thomas, Lian F; de Glanville, William A; Cook, Elizabeth A J; Bronsvoort, Barend M De C; Handel, Ian; Wamae, Claire N; Kariuki, Samuel; Fèvre, Eric M

    2017-02-01

    The tapeworm Taenia solium is the parasite responsible for neurocysticercosis, a neglected tropical disease of public health importance, thought to cause approximately 1/3 of epilepsy cases across endemic regions. The consumption of undercooked infected pork perpetuates the parasite's life-cycle through the establishment of adult tapeworm infections in the community. Reducing the risk associated with pork consumption in the developing world is therefore a public health priority. The aim of this study was to estimate the risk of any one pork meal in western Kenya containing a potentially infective T. solium cysticercus at the point of consumption, an aspect of the parasite transmission that has not been estimated before. To estimate this, we used a quantitative food chain risk assessment model built in the @RISK add-on to Microsoft Excel. This model indicates that any one pork meal consumed in western Kenya has a 0.006 (99% Uncertainty Interval (U.I). 0.0002-0.0164) probability of containing at least one viable T. solium cysticercus at the point of consumption and therefore being potentially infectious to humans. This equates to 22,282 (99% U.I. 622-64,134) potentially infective pork meals consumed in the course of one year within Busia District alone. This model indicates a high risk of T. solium infection associated with pork consumption in western Kenya and the work presented here can be built upon to investigate the efficacy of various mitigation strategies for this locality.

  9. Modelling the risk of Taenia solium exposure from pork produced in western Kenya

    PubMed Central

    de Glanville, William A.; Cook, Elizabeth A. J.; Bronsvoort, Barend M. De C.; Handel, Ian; Wamae, Claire N.; Kariuki, Samuel; Fèvre, Eric M.

    2017-01-01

    The tapeworm Taenia solium is the parasite responsible for neurocysticercosis, a neglected tropical disease of public health importance, thought to cause approximately 1/3 of epilepsy cases across endemic regions. The consumption of undercooked infected pork perpetuates the parasite’s life-cycle through the establishment of adult tapeworm infections in the community. Reducing the risk associated with pork consumption in the developing world is therefore a public health priority. The aim of this study was to estimate the risk of any one pork meal in western Kenya containing a potentially infective T. solium cysticercus at the point of consumption, an aspect of the parasite transmission that has not been estimated before. To estimate this, we used a quantitative food chain risk assessment model built in the @RISK add-on to Microsoft Excel. This model indicates that any one pork meal consumed in western Kenya has a 0.006 (99% Uncertainty Interval (U.I). 0.0002–0.0164) probability of containing at least one viable T. solium cysticercus at the point of consumption and therefore being potentially infectious to humans. This equates to 22,282 (99% U.I. 622–64,134) potentially infective pork meals consumed in the course of one year within Busia District alone. This model indicates a high risk of T. solium infection associated with pork consumption in western Kenya and the work presented here can be built upon to investigate the efficacy of various mitigation strategies for this locality. PMID:28212398

  10. Effects of Cooperative Learning Approach on Biology Mean Achievement Scores of Secondary School Students' in Machakos District, Kenya

    ERIC Educational Resources Information Center

    Muraya, Daniel Ngaru; Kimamo, Githui

    2011-01-01

    Performance in Biology at secondary school level in Kenya remains poor and one reason is the teaching approach adopted by teachers with teacher-centered approaches being pre-dominant. This study sought to determine the effect of cooperative learning approach on mean achievement scores in Biology of secondary school students.…

  11. The accountability for reasonableness approach to guide priority setting in health systems within limited resources – findings from action research at district level in Kenya, Tanzania, and Zambia

    PubMed Central

    2014-01-01

    Background Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). Methods This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. Results The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. Conclusions District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to

  12. Gender inequality in food intake and nutritional status of children under 5 years old in rural Eastern Kenya.

    PubMed

    Ndiku, M; Jaceldo-Siegl, K; Singh, P; Sabaté, J

    2011-01-01

    Although gender inequality in nutritional status has been consistently reported in several parts of South Asia, in sub-Sahara Africa there is a paucity of data and conflicting conclusions. We conducted a study to assess if gender inequality in food intake and nutritional status is present in rural Eastern Kenya. This was a descriptive cross sectional study conducted in the Mwingi and Makueni districts of Ukambani region in Eastern Kenya, two rural districts where grains are the main contributor of energy intake. There were 629 children aged <60 months, randomly selected for participation in the study. Boys consistently had higher energy intakes than girls (P = 0.005). More girls were stunted, underweight and wasted 51.7%, (49.9-53.5), 32.1%, (30.4-33.7), 4.6%, (3.9-5.4) than boys 35.9% (34.2-37.7), 14.6% (13.4-15.9) and 1.2% (0.8-1.6), respectively, P < 0.001. Of the total, 24.6% (23.1-26.2) of the girls were severely stunted compared with boys 16.3% (15.0-17.7). Boys had higher Z-score indices (height-for-age (HAZ) = -1.33 ± 1.86, weight-for-age (WAZ) = -0.60 ± 1.53 and weight-for-height (WHZ) = 0.25 ± 1.23) than girls (HAZ = -2.02 ± 1.94, WAZ = -1.37 ± 1.27 and WHZ = -0.10 ± 1.49), all P < 0.001. The prevalence of malnutrition among children in rural Eastern Kenya is sizable. However, girls were more stunted, underweight and wasted than boys at all age categories due to their consistent lower food intake. Further research is needed to expose the social and cultural determinants underlying gender discrimination in intra-household allocation of food.

  13. 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

  14. Using mobile phone text messaging for malaria surveillance in rural Kenya

    PubMed Central

    2014-01-01

    Background Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study “SMS for Life” was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. Methods Health workers from 87 public health facilities used their personal mobile phones to send a weekly structured SMS text message reporting the counts of four basic surveillance data elements to a web-based system accessed by district managers. Longitudinal monitoring of SMS reported data through the web-based system and two rounds of cross-sectional health facility surveys were done to validate accuracy of data. Results Mean response rates were 96% with 87% of facilities reporting on time. Fifty-eight per cent of surveillance data parameters were accurately reported. Overall mean testing rates were 37% with minor weekly variations ranging from 32 to 45%. Overall test positivity rate was 24% (weekly range: 17-37%). Ratio of anti-malarial treatments to test positive cases was 1.7:1 (weekly range: 1.3:1–2.2:1). District specific trends showed fluctuating patterns in testing rates without notable improvement over time but the ratio of anti-malarial treatments to test positive cases improved over short periods of time in three out of five districts. Conclusions The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data. PMID:24642130

  15. Perspectives on utilization of community based health information systems in Western Kenya

    PubMed Central

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Introduction Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Methods Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Results Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. Conclusion The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers. PMID:28904707

  16. Parental awareness of hearing impairment in their school-going children and healthcare seeking behaviour in Kisumu district, Kenya.

    PubMed

    Omondi, Dickens; Ogol, Calistus; Otieno, Syprine; Macharia, Isaac

    2007-03-01

    Hearing-impaired children who are identified early and appropriately managed have improved outcomes in speech, language, cognitive and social development. Enhanced parental awareness of their child's hearing disability, behavioral, developmental and psychosocial limitations is essential to sustaining timely detection and appropriate intervention. Additionally, availability of services for diagnosis, treatment and habilitation would improve the demand for pedaudiological care in this community. To describe level of parental awareness of childhood HI and the pattern of access to and utilization of ambulatory care services. Thirty-three parents of lower primary school-going children who failed audiometric screening from sampled schools in Kisumu district, western Kenya. First person to detect HI, age of child at first suspicion of HI, source of ambulatory health care and use of the health care facilities. The prevalence of HI was 2.48%. Most parents/guardians (69.7%) were aware of their child's hearing impairment. Of these, 63.6% were first to detect HI in the pupils, while 30.3% were detected by screen. Most children (57.2%) were first recognized with (HI) after age 2 years. The mean age at identification was 5.5 years. The median travel distance to the preferred health care facility was 2 km (IQR 1-2.5). Parents seldom sought or lacked help for their hearing-impaired children. Of 27.3% who asked for hearing assessment, 9.1% received some counsel on HI and 12.1% received medication, one (3%) was referred for audiological assessment and none used a hearing aid. Use of health facilities for maternal care was (65.7%) and immunization (62.9%). Despite adequate parental awareness of chronic childhood disability, health facilities were underutilized. This indicates the need to further stimulate and maintain a desirable level of uptake of services for diagnosis, treatment and habilitation of childhood HI, while sustaining delivery of effective and acceptable high quality

  17. 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

  18. The existence of Dracunculus medinensis (Linnaeus, 1758) in Turkana, Kenya.

    PubMed

    Macpherson, C N

    1981-01-01

    Dracontiasis has been previously reported in southern Sudan, northern Uganda and north-west Eritrea but this is the first report of autochthonous cases in Turkana, Kenya. Five Turkana tribesmen, three females from the same family, one young boy and an adult male were being treated for guinea-worm at the dispensary in Lokichogio, northern Turkana District. The three women had recently returned from southern Sudan, where the disease is endemic, but the two male tribesmen had only lived in and around the Lokichogio region. The methods used in obtaining water from water-holes dug in dry river beds provide an ideal situation for Dracunculus transmission amongst the tribesmen; this parasite may therefore become a problem in this remote impoverished area.

  19. 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.

  20. Modeling the Financial and Clinical Implications of Malaria Rapid Diagnostic Tests in the Case-management of Older Children and Adults in Kenya

    PubMed Central

    Zurovac, Dejan; Larson, Bruce A.; Skarbinski, Jacek; Slutsker, Laurence; Snow, Robert W.; Hamel, Mary J.

    2008-01-01

    Using data on clinical practices for outpatients 5 years and older, test accuracy, and malaria prevalence, we model financial and clinical implications of malaria rapid diagnostic tests (RDTs) under the new artemether-lumefantrine (AL) treatment policy in one high and one low malaria prevalence district in Kenya. In the high transmission district, RDTs as actually used would improve malaria treatment (61% less over-treatment but 8% more under-treatment) and lower costs (21% less). Nonetheless, the majority of patients with malaria would not be correctly treated with AL. In the low transmission district, especially because the treatment policy was new and AL was not widely used, RDTs as actually used would yield a minor reduction in under-treatment errors (36% less but the base is small) with 41% higher costs. In both districts, adherence to revised clinical practices with RDTs has the potential to further decrease treatment errors with acceptable costs. PMID:18541764

  1. Utilisation of priority traditional medicinal plants and local people's knowledge on their conservation status in arid lands of Kenya (Mwingi District)

    PubMed Central

    2010-01-01

    Mwingi District lies within the Kenyan Arid and Semiarid lands (ASALs) in Eastern Province. Although some ethnobotanical surveys have been undertaken in some arid and semiarid areas of Kenya, limited studies have documented priority medicinal plants as well as local people's awareness of conservation needs of these plants. This study sought to establish the priority traditional medicinal plants used for human, livestock healthcare, and those used for protecting stored grains against pest infestation in Mwingi district. Further, the status of knowledge among the local people on the threat and conservation status of important medicinal species was documented. This study identified 18 species which were regarded as priority traditional medicinal plants for human health. In terms of priority, 8 were classified as moderate, 6 high, while 4 were ranked highest priority species. These four species are Albizia amara (Roxb.) Boiv. (Mimosacaeae), Aloe secundiflora (Engl. (Aloaceae), Acalypha fruticosa Forssk. (Euphorbiaceae) and Salvadora persica L. (Salvadoraceae). In regard to medicinal plants used for ethnoveterinary purposes, eleven species were identified while seven species were reported as being important for obtaining natural products or concoctions used for stored grain preservation especially against weevils. The data obtained revealed that there were new records of priority medicinal plants which had not been documented as priority species in the past. Results on conservation status of these plants showed that more than 80% of the respondents were unaware that wild medicinal plants were declining, and, consequently, few of them have any domesticated species. Some of the species that have been conserved on farm or deliberately allowed to persist when wild habitats are converted into agricultural lands include: Croton megalocarpus Hutch., Aloe secundiflora, Azadirachta indica A. Juss., Warburgia ugandensis Sprague, Ricinus communis L. and Terminalia brownie Fresen

  2. Modifiable factors associated with active pulmonary tuberculosis in a Kenyan prison.

    PubMed

    Amwayi, A S; Kikuvi, G M; Muchiri, E M

    2010-02-01

    To establish modifiable factors associated with active pulmonary tuberculosis (PTB) among prisoners. Retrospective matched case-control study. Nakuru GK prison in Kenya. A total of 144 subjects (48 cases and 96 controls) were recruited into the study. Cases were adult prisoners who had at least two initial sputum specimens being Acid Fast Bacilli-positive (AFB+) on direct smear microscopy and hence recruited to PTB WHO DOTS Programme. Controls were adults with no chronic cough and not on PTB treatment six months prior to the study. Independent factors significantly associated with active PTB disease were: self reported HIV+ status (OR=11; 95% CI = 2.42-47.77), evidence of BCG vaccination (OR = 0.20; 95% CI = 0.05-0.60), contact with PTB case (OR = 7.0; 95% CI = 1.17-38.23), unemployment (OR = 9.0; 95% CI = 1.84-43.97) and sharing linen (OR = 4.32; 95%CI = 1.08-17.29). Modifiable factors associated with active PTB in Nakuru G.K prison are: HIV status, BCG vaccination, PTB case contact, poverty and poor personal hygiene. We recommend HIV counselling and testing of all PTB patients, screening for TB upon prison entry and TB contact investigation and improving personal hygiene of prisoners.

  3. Kenya.

    PubMed

    Obura, D O

    2001-12-01

    The Kenya coast is bathed by the northward-flowing warm waters of the East Africa Coastal Current, located between latitudes 1 and 5 degrees S. With a narrow continental shelf, the coastal marine environments are dominated by coral reefs, seagrass beds and mangroves, with large expanses of sandy substrates where river inputs from Kenya's two largest rivers, the Tana and Athi rivers, prevent the growth of coral reefs. The northern part of the coast is seasonally influenced by upwelling waters of the Somali Current, resulting in lower water temperatures for part of the year. The coast is made up of raised Pleistocene reefs on coastal plains and hills of sedimentary origin, which support native habitats dominated by scrub bush and remnant pockets of the forests that used to cover East Africa and the Congo basin. The marine environment is characterized by warm tropical conditions varying at the surface between 25 degrees C and 31 degrees C during the year, stable salinity regimes, and moderately high nutrient levels from terrestrial runoff and groundwater. The semi-diurnal tidal regime varies from 1.5 to 4 m amplitude from neap to spring tides, creating extensive intertidal platform and rocky-shore communities exposed twice-daily during low tides. Fringing reef crests dominate the whole southern coast and parts of the northern coast towards Somalia, forming a natural barrier to the wave energy from the ocean. Coral reefs form the dominant ecosystem along the majority of the Kenya coast, creating habitats for seagrasses and mangroves in the lagoons and creeks protected by the reef crests. Kenya's marine environment faces a number of threats from the growing coastal human population estimated at just under three million in 2000. Extraction of fish and other resources from the narrow continental shelf, coral reef and mangrove ecosystems increases each year with inadequate monitoring and management structures to protect the resource bases. Coastal development in urban and

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

    Nelson, Y.M.; DiSante, C.J.; Lion, L.W.

    Toxic trace metals have been implicated as a potential cause of recent flamingo kills at Lake Nakuru, Kenya. Chromium (Cr), copper (Cu), lead (Pb), and zinc (Zn) have accumulated in the lake sediments as a result of unregulated discharges and because this alkaline lake has no natural outlet. Lesser flamingos (Phoeniconaias minor) at Lake Nakuru feed predominantly on the cyanobacterium Spirulina platensis, and because of their filter-feeding mechanism, they are susceptible to exposure to particle-bound metals. Trace metal adsorption isotherms to lake sediments and S. platensis were obtained under simulated lake conditions, and a mathematical model was developed to predictmore » metal exposure via filter feeding based on predicted trace metal phase distribution. Metal adsorption to suspended solids followed the trend Pb {much_gt} Zn > Cr > Cu, and isotherms were linear up to 60 {micro}g/L. Adsorption to S. platensis cells followed the trend Pb {much_gt} Zn > Cu > Cr and fit Langmuir isotherms for Cr, Cu and Zn and a linear isotherm for Pb. Predicted phase distributions indicated that Cr and Pb in Lake Nakuru are predominantly associated with suspended solids, whereas Cu and Zn are distributed more evenly between the dissolved phase and particulate phases of both S. platensis and suspended solids. Based on established flamingo feeding rates and particle size selection, predicted Cr and Pb exposure occurs predominantly through ingestion of suspended solids, whereas Cu and Zn exposure occurs through ingestion of both suspended solids and S. platensis. For the lake conditions at the time of sampling, predicted ingestion rates based on measured metal concentrations in lake suspended solids were 0.71, 6.2, 0.81, and 13 mg/kg-d for Cr, Cu, Pb, and Zn, respectively.« less

  5. Headteachers' Perceptions of the Relationship between Parental Support and Learners' Retention in Public Secondary Schools in Bureti District, Kenya

    ERIC Educational Resources Information Center

    Kirui, Philip K.; Changeiywo, Johnson M.; Sang, Anthony K.

    2015-01-01

    Parental support has been central to realizing quality education. Parental support in areas of fees, teaching materials, uniforms and labour has been vital for the expansion of education in Kenya. However, a low retention level which is an indicator of internal efficiency has remained a challenge in most public secondary schools. Consequently, the…

  6. Clinical Validation of a Smartphone-Based Adapter for Optic Disc Imaging in Kenya.

    PubMed

    Bastawrous, Andrew; Giardini, Mario Ettore; Bolster, Nigel M; Peto, Tunde; Shah, Nisha; Livingstone, Iain A T; Weiss, Helen A; Hu, Sen; Rono, Hillary; Kuper, Hannah; Burton, Matthew

    2016-02-01

    Visualization and interpretation of the optic nerve and retina are essential parts of most physical examinations. To design and validate a smartphone-based retinal adapter enabling image capture and remote grading of the retina. This validation study compared the grading of optic nerves from smartphone images with those of a digital retinal camera. Both image sets were independently graded at Moorfields Eye Hospital Reading Centre. Nested within the 6-year follow-up (January 7, 2013, to March 12, 2014) of the Nakuru Eye Disease Cohort in Kenya, 1460 adults (2920 eyes) 55 years and older were recruited consecutively from the study. A subset of 100 optic disc images from both methods were further used to validate a grading app for the optic nerves. Data analysis was performed April 7 to April 12, 2015. Vertical cup-disc ratio for each test was compared in terms of agreement (Bland-Altman and weighted κ) and test-retest variability. A total of 2152 optic nerve images were available from both methods (also 371 from the reference camera but not the smartphone, 170 from the smartphone but not the reference camera, and 227 from neither the reference camera nor the smartphone). Bland-Altman analysis revealed a mean difference of 0.02 (95% CI, -0.21 to 0.17) and a weighted κ coefficient of 0.69 (excellent agreement). The grades of an experienced retinal photographer were compared with those of a lay photographer (no health care experience before the study), and no observable difference in image acquisition quality was found. Nonclinical photographers using the low-cost smartphone adapter were able to acquire optic nerve images at a standard that enabled independent remote grading of the images comparable to those acquired using a desktop retinal camera operated by an ophthalmic assistant. The potential for task shifting and the detection of avoidable causes of blindness in the most at-risk communities makes this an attractive public health intervention.

  7. Medical pluralism on Mfangano Island: use of medicinal plants among persons living with HIV/AIDS in Suba District, Kenya.

    PubMed

    Nagata, Jason M; Jew, Alan R; Kimeu, John M; Salmen, Charles R; Bukusi, Elizabeth A; Cohen, Craig R

    2011-05-17

    Given the increasing coverage of antiretroviral therapy (ART) for HIV/AIDS treatment as well as the high utilization of herbal medicine, many persons living with HIV/AIDS in sub-Saharan Africa are thought to practice medical pluralism, or the adoption of more than one medical system for their care and treatment. Using a cross-sectional study we sought to document and identify the herbal medicines used by persons living with HIV/AIDS on Mfangano Island, Suba District, Nyanza Province, Kenya. We interviewed herbalists and knowledgeable mothers to obtain information regarding medicinal plants, particularly for HIV/AIDS-related symptoms, HIV/AIDS, and chira (an illness concept with similarities to HIV/AIDS regarding sexual transmission and wasting symptoms). Using systematic sampling, 67 persons living with HIV/AIDS (49 of whom were receiving ART) were selected from an Mfangano Island health clinic and participated in semi-structured interviews. Interviews with herbalists and mothers identified 40 plant species in 37 genera and 29 families that a person with HIV/AIDS or chira could use for herbal remedies. Overall, 70.1% of persons living with HIV/AIDS had used medicinal plants after HIV diagnosis, most commonly to treat symptoms related to HIV/AIDS. In addition to common vegetables and fruits that can serve medicinal purposes, Azadirachta indica A. Juss. (Meliaceae), Carissa edulis (Forssk.) Vahl (Apocynaceae), and Ximenia americana L. (Olacaceae) were the most frequently cited medicinal plants used by persons living with HIV/AIDS. Collaboration and communication between biomedical clinicians and herbalists should be encouraged given high rates of concomitant ART-herb usage. Pharmacological, toxicological, and ART-herb interaction studies based on the plants identified in this study and their constituent ingredients should be considered. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Medical pluralism on Mfangano Island: Use of medicinal plants among persons living with HIV/AIDS in Suba District, Kenya

    PubMed Central

    Nagata, Jason M.; Jew, Alan R.; Kimeu, John M.; Salmen, Charles R.; Bukusi, Elizabeth A.; Cohen, Craig R.

    2011-01-01

    Ethnopharmacological relevance Given the increasing coverage of antiretroviral therapy (ART) for HIV/AIDS treatment as well as the high utilization of herbal medicine, many persons living with HIV/AIDS in sub-Saharan Africa are thought to practice medical pluralism, or the adoption of more than one medical system for their care and treatment. Using a cross-sectional study we sought to document and identify the herbal medicines used by persons living with HIV/AIDS on Mfangano Island, Suba District, Nyanza Province, Kenya. Materials and Methods We interviewed herbalists and knowledgeable mothers to obtain information regarding medicinal plants, particularly for HIV/AIDS-related symptoms, HIV/AIDS, and chira (an illness concept with similarities to HIV/AIDS regarding sexual transmission and wasting symptoms). Using systematic sampling, 67 persons living with HIV/AIDS (49 of whom were receiving ART) were selected from an Mfangano Island health clinic and participated in semi-structured interviews. Results Interviews with herbalists and mothers identified 40 plant species in 37 genera and 29 families that a person with HIV/AIDS or chira could use for herbal remedies. Overall, 70.1% of persons living with HIV/AIDS had used medicinal plants after HIV diagnosis, most commonly to treat symptoms related to HIV/AIDS. In addition to common vegetables and fruits that can serve medicinal purposes, Azadirachta indica A.Juss. (Meliaceae), Carissa edulis (Forssk.) Vahl (Apocynaceae), and Ximenia americana L. (Olacaceae) were the most frequently cited medicinal plants used by persons living with HIV/AIDS. Conclusions Collaboration and communication between biomedical clinicians and herbalists should be encouraged given high rates of concomitant ART-herb usage. Pharmacological, toxicological, and ART-herb interaction studies based on the plants identified in this study and their constituent ingredients should be considered. PMID:21458556

  9. Bed net ownership in Kenya: the impact of 3.4 million free bed nets.

    PubMed

    Hightower, Allen; Kiptui, Rebecca; Manya, Ayub; Wolkon, Adam; Vanden Eng, Jodi Leigh; Hamel, Mary; Noor, Abdisalan; Sharif, Shahnaz K; Buluma, Robert; Vulule, John; Laserson, Kayla; Slutsker, Laurence; Akhwale, Willis

    2010-06-24

    In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%). The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.

  10. Cross-Sectional Serological Survey for Leptospira spp. in Beef and Dairy Cattle in Two Districts in Uganda.

    PubMed

    Dreyfus, Anou; Odoch, Terence; Alinaitwe, Lordrick; Rodriguez-Campos, Sabrina; Tsegay, Amanuel; Jaquier, Valentine; Kankya, Clovice

    2017-11-21

    Seroprevalence of Leptospira spp. in cattle is unknown in Uganda. The aim of this study was to estimate the seroprevalence of L. interrogans Icterohaemorrhagiae, Pomona, L. kirschneri Butembo, Grippotyphosa, L. borgpetersenii Nigeria, Hardjo, Wolfii, and Kenya and an overall seroprevalence in cattle from Kole and Mbale districts. Two hundred-seventy five bovine sera from 130 small holder farms from Kole ( n = 159) and Mbale ( n = 116), collected between January and July 2015, were tested for antibodies against eight Leptospira strains by Microscopic Agglutination Test. A titer of ≥100 was considered seropositive, indicating past exposure. Overall, the seroprevalence was 19.27% (95% CI 14.9-24.5%). Pomona seroprevalence was highest with 9.45% (6.4-13.7%), followed by Kenya 5.09% (2.9-8.6%), Nigeria 4.00% (2.1-7.2%), Wolfii 3.27% (1.6-6.3%), Butembo 1.86% (0.7-4.4%), Hardjo 1.45% (0.5-3.9%), and Icterohaemorragiae and Grippotyphosa with less than 1% positive. Seroprevalence did not differ between districts and gender ( p ≥ 0.05). Seven animals had titers ≥400. Cross-reactions or exposure to ≥1 serovar was measured in 43% of serum samples. Seroprevalence of 19% implies exposure of cattle to leptospires.

  11. 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

  12. A comparative study of the quality of care and glycemic control among ambulatory type 2 diabetes mellitus clients, at a Tertiary Referral Hospital and a Regional Hospital in Central Kenya.

    PubMed

    Mwavua, Shillah Mwaniga; Ndungu, Edward Kiogora; Mutai, Kenneth K; Joshi, Mark David

    2016-01-05

    Peripheral public health facilities remain the most frequented by the majority of the population in Kenya; yet remain sub-optimally equipped and not optimized for non-communicable diseases care. We undertook a descriptive, cross sectional study among ambulatory type 2 diabetes mellitus clients, attending Kenyatta National Referral Hospital (KNH), and Thika District Hospital (TDH) in Central Kenya. Systematic random sampling was used. HbA1c was assessed for glycemic control and the following, as markers of quality of care: direct client costs, clinic appointment interval and frequency of self monitoring test, affordability and satisfaction with care. We enrolled 200 clients, (Kenyatta National Hospital 120; Thika District Hospital 80); Majority of the patients 66.5% were females, the mean age was 57.8 years; and 58% of the patients had basic primary education. 67.5% had diabetes for less than 10 years and 40% were on insulin therapy. The proportion (95% CI) with good glycemic was 17% (12.0-22.5 respectively) in the two facilities [Kenyatta National Hospital 18.3% (11.5-25.6); Thika District Hospital 15% (CI 7.4-23.7); P = 0.539]. However, in Thika District Hospital clients were more likely to have a clinic driven routine urinalysis and weight, they were also accorded shorter clinic appointment intervals; incurred half to three quarter lower direct costs, and reported greater affordability and satisfactions with care. In conclusion, we demonstrate that in Thika district hospital, glycemic control and diabetic care is suboptimal; but comparable to that of Kenyatta National Referral hospital. Opportunities for improvement of care abound at peripheral health facilities.

  13. 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.

  14. 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.

  15. Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

    PubMed Central

    Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

    2017-01-01

    Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

  16. Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

    PubMed Central

    Smith, Jennifer L.; Sturrock, Hugh J. W.; Assefa, Liya; Nikolay, Birgit; Njenga, Sammy M.; Kihara, Jimmy; Mwandawiro, Charles S.; Brooker, Simon J.

    2015-01-01

    Transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as a platform to assess the impact of mass drug administration (MDA) on soil-transmitted helminths (STHs). This study used computer simulation and field data from pre- and post-MDA settings across Kenya to evaluate the performance and cost-effectiveness of the TAS design for STH assessment compared with alternative survey designs. Variations in the TAS design and different sample sizes and diagnostic methods were also evaluated. The district-level TAS design correctly classified more districts compared with standard STH designs in pre-MDA settings. Aggregating districts into larger evaluation units in a TAS design decreased performance, whereas age group sampled and sample size had minimal impact. The low diagnostic sensitivity of Kato-Katz and mini-FLOTAC methods was found to increase misclassification. We recommend using a district-level TAS among children 8–10 years of age to assess STH but suggest that key consideration is given to evaluation unit size. PMID:25487730

  17. 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

  18. Implementing Maternal Death Surveillance and Response in Kenya: Incremental Progress and Lessons Learned

    PubMed Central

    Smith, Helen; Ameh, Charles; Godia, Pamela; Maua, Judith; Bartilol, Kigen; Amoth, Patrick; Mathai, Matthews; van den Broek, Nynke

    2017-01-01

    ABSTRACT Maternal death surveillance and response (MDSR) constitutes a quality improvement approach to identify how many maternal deaths occur, what the underlying causes of death and associated factors are, and how to implement actions to reduce the number of preventable stillbirths and maternal and neonatal deaths. This requires a coordinated approach, ensuring both national- and district-level stakeholders are enabled and supported and can implement MDSR in a “no name, no blame” environment. This field action report from Kenya provides an example of how MDSR can be implemented in a “real-life” setting by summarizing the experiences and challenges faced thus far by maternal death assessors and Ministry of Health representatives in implementing MDSR. Strong national leadership via a coordinating secretariat has worked well in Kenya. However, several challenges were encountered including underreporting of data, difficulties with reviewing the data, and suboptimal aggregation of data on cause of death. To ensure progress toward a full national enquiry of all maternal deaths, we recommend improving the notification of maternal deaths, ensuring regular audits and feedback at referral hospitals lead to continuous quality improvement, and strengthening community linkages with health facilities to expedite maternal death reporting. Ultimately, both a top-down and bottom-up approach is needed to ensure success of an MDSR system. Perinatal death surveillance and response is planned as a next phase of MDSR implementation in Kenya. To ensure the process continues to evolve into a full national enquiry of all maternal deaths, we recommend securing longer-term budget allocation and financial commitment from the ministry, securing a national legal framework for MDSR, and improving processes at the subnational level. PMID:28963171

  19. 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…

  20. Breast-feeding and human immunodeficiency virus infection: assessment of knowledge among clinicians in Kenya.

    PubMed

    Murila, Florence; Obimbo, Moses M; Musoke, Rachel; Tsikhutsu, Isaac; Migiro, Santau; Ogeng'o, Julius

    2015-02-01

    In Kenya, human immunodeficiency virus (HIV) prevalence ranks among the highest in the world. Approximately 60 000 infections yearly are attributed to vertical transmission including the process of labour and breast-feeding. The vast of the population affected is in the developing world. Clinical officers and nurses play an important role in provision of primary health care to antenatal and postnatal mothers. There are a few studies that have explored the clinicians' knowledge on breast-feeding in the face of HIV and in relation to vertical transmission this being a vital component in prevention of maternal-to-child transmission. The aim of this study was to evaluate clinicians' knowledge on HIV in relation to breast-feeding in Kenya. A cross-sectional survey was conducted to assess knowledge of 161 clinical officers and nurses serving in the maternity and children' wards in various hospitals in Kenya. The participants were derived from all district and provincial referral facilities in Kenya. A preformatted questionnaire containing a series of questions on HIV and breast-feeding was administered to clinicians who were then scored and analyzed. All the 161 participants responded. Majority of clinicians (92%) were knowledgeable regarding prevention of mother-to-child transmission. Regarding HIV and breast-feeding, 49.7% thought expressed breast milk from HIV-positive mothers should be heated before being given. Majority (78.3%) thought breast milk should be given regardless of availability of alternatives. According to 74.5% of the participants, exclusive breast-feeding increased chances of HIV transmission. Two-thirds (66.5%) would recommend breast-feeding for mothers who do not know their HIV status (66.5%). This study observes that a majority of the clinicians have inadequate knowledge on breast-feeding in the face of HIV. There is need to promote training programmes on breast-feeding and transmission of HIV from mother to child. This can be done as in

  1. The oral health knowledge and oral hygiene practices among primary school children age 5-17 years in a rural area of Uasin Gishu district, Kenya.

    PubMed

    Okemwa, K A; Gatongi, P M; Rotich, J K

    2010-06-01

    To determine the oral health knowledge and oral hygiene practices among school children in the study region This was a descriptive cross-sectional study carried out among primary school going children in Kapsaret Educational division, Uasin-Gishu District, Kenya. A researcher administered questionnaire was used to determine the oral health knowledge and practices in a random sample of 401 students in the period March to June 2002. 92% of the students claimed they brushed their teeth. About 48% brushed at least twice daily. More students (59.1%) reported using the chewing stick compared to those using commercial toothbrushes (p = 0.000).Female students brushed more frequently than their male counterparts (p = 0.000, chi2 = 24.65). 39.9% of the students knew the cause of tooth decay, 48.2% could state at least one method of prevention, while 16.5% knew the importance of teeth. Use of toothpaste was reported by 38.9% of the students. Less than half of the students knew the causes of tooth decay and how to prevent it. Only about half of the students brushed their teeth twice daily with the chewing stick being more frequently used. There is need to increase the oral health knowledge through well Planned school based oral health education programmes in the primary schools. This would hopefully lead to improvement on the oral hygiene practices.

  2. Bed net ownership in Kenya: the impact of 3.4 million free bed nets

    PubMed Central

    2010-01-01

    Background In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. Methods A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. Results In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%). Conclusions The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels. PMID:20576145

  3. 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

  4. The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa.

    PubMed

    Edwards, Nancy; Kaseje, Dan; Kahwa, Eulalia; Klopper, Hester C; Mill, Judy; Webber, June; Roelofs, Susan; Harrowing, Jean

    2016-08-03

    The enormous impact of HIV on communities and health services in Sub-Saharan Africa and the Caribbean has especially affected nurses, who comprise the largest proportion of the health workforce in low- and middle-income countries (LMICs). Strengthening action-based leadership for and by nurses is a means to improve the uptake of evidence-informed practices for HIV care. A prospective quasi-experimental study in Jamaica, Kenya, Uganda and South Africa examined the impact of establishing multi-stakeholder leadership hubs on evidence-informed HIV care practices. Hub members were engaged through a participatory action research (PAR) approach. Three intervention districts were purposefully selected in each country, and three control districts were chosen in Jamaica, Kenya and Uganda. WHO level 3, 4 and 5 health care institutions and their employed nurses were randomly sampled. Self-administered, validated instruments measured clinical practices (reports of self and peers), quality assurance, work place policies and stigma at baseline and follow-up. Standardised average scores ranging from 0 to 1 were computed for clinical practices, quality assurance and work place policies. Stigma scores were summarised as 0 (no reports) versus 1 (one or more reports). Pre-post differences in outcomes between intervention and control groups were compared using the Mantel Haenszel chi-square for dichotomised stigma scores, and independent t tests for other measures. For South Africa, which had no control group, pre-post differences were compared using a Pearson chi-square and independent t test. Multivariate analysis was completed for Jamaica and Kenya. Hub members in all countries self-assessed changes in their capacity at follow-up; these were examined using a paired t test. Response rates among health care institutions were 90.2 and 80.4 % at baseline and follow-up, respectively. Results were mixed. There were small but statistically significant pre-post, intervention versus control

  5. Acceptability, Usability, and Views on Deployment of Peek, a Mobile Phone mHealth Intervention for Eye Care in Kenya: Qualitative Study.

    PubMed

    Lodhia, Vaishali; Karanja, Sarah; Lees, Shelley; Bastawrous, Andrew

    2016-05-09

    The Portable Eye Examination Kit (Peek) is a mobile phone-based ophthalmic testing system that has been developed to perform comprehensive eye examinations. Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools. This qualitative study evaluated the acceptability and usability of Peek in addition to perceptions regarding its adoption and nationwide deployment. Semistructured interviews were conducted with patients and analyzed using a framework approach. This included analysis of interviews from 20 patients, 8 health care providers (HCPs), and 4 key decision makers in ophthalmic health care provision in Kenya. The participants were purposefully sampled. The coding structure involved predefined themes for assessing the following: (1) the context, that is, environment, user, task, and technology; (2) patient acceptability, that is, patients' perceived benefits, patient preference, and patient satisfaction; (3) usability, that is, efficiency, effectiveness, learnability, and flexibility and operability of Peek; and (4) the benefits of Peek in strengthening eye care provision, that is, capabilities enhancer, opportunity creator, social enabler, and knowledge generator. Emerging themes relating to the objectives were explored from the data using thematic analysis. Patients found Peek to be acceptable because of its benefits in overcoming the barriers to accessing ophthalmic services. Most thought it to be fast, convenient, and able to reach a large population. All patients expressed being satisfied with Peek. The HCPs perceived it to satisfy the criteria for usability and found Peek to be acceptable based on the technology acceptance model. Peek was

  6. Comparative point-spread function calculations for the MOMS-1, Thematic Mapper and SPOT-HRV instruments

    NASA Technical Reports Server (NTRS)

    Salomonson, V. V.; Nickeson, J. E.; Bodechtel, J.; Zilger, J.

    1988-01-01

    Point-spread functions (PSF) comparisons were made between the Modular Optoelectronic Multispectral Scanner (MOMS-01), the LANDSAT Thematic Mapper (TM) and the SPOT-HRV instruments, principally near Lake Nakuru, Kenya. The results, expressed in terms of the width of the point spread functions at the 50 percent power points as determined from the in-scene analysis show that the TM has a PSF equal to or narrower than the MOMS-01 instrument (50 to 55 for the TM versus 50 to 68 for the MOMS). The SPOT estimates of the PSF range from 36 to 40. When the MOMS results are adjusted for differences in edge scanning as compared to the TM and SPOT, they are nearer 40 in the 575 to 625 nm band.

  7. Control of contagious bovine pleuropneumonia: knowledge, attitudes, perceptions and practices in Narok district of Kenya.

    PubMed

    Kairu-Wanyoike, S W; Kiara, H; Heffernan, C; Kaitibie, S; Gitau, G K; McKeever, D; Taylor, N M

    2014-08-01

    CBPP is an important transboundary disease in sub-Saharan Africa whose control is urgent. Participatory data collection involving 52 focus group discussions in 37 village clusters and key informant interviews, a cross-sectional study involving 232 households and a post-vaccination follow up involving 203 households was carried out in 2006-2007 in Narok South district of Kenya. This was to investigate knowledge, attitudes, perceptions and practices (KAPP) associated with control of CBPP as well as the adverse post-vaccination reactions in animals in order to advice the control policy. The community perceived trans-boundary CBPP threat to their cattle. They had traditional disease coping mechanisms and were conversant with CBPP prevention and control with 49.8% (95%CI: 42.8-56.7%) giving priority to CBPP control. However, 12.9% (95%CI: 9.0-18.1%) of pastoralists had no knowledge of any prevention method and 10.0% (95%CI: 6.5-14.7%) would not know what to do or would do nothing in the event of an outbreak. Although 43.5% (95%CI: 37.1-50.2%) of pastoralists were treating CBPP cases with antimicrobials, 62.5% (95%CI: 52.1-71.7%) of them doubted the effectiveness of the treatments. Pastoralists perceived vaccination to be the solution to CBPP but vaccination was irregular due to unavailability of the vaccine. Vaccination was mainly to control outbreaks rather than preventive and exhibited adverse post-vaccination reactions among 70.4% (95%CI: 63.6-76.5%) of herds and 3.8% (95%CI: 3.5-4.2%) of animals. Consequently, nearly 25.2% (95%CI: 18.5-33.2%) of pastoralists may resist subsequent vaccinations against CBPP. Pastoralists preferred CBPP vaccination at certain times of the year and that it is combined with other vaccinations. In conclusion, pastoralists were not fully aware of the preventive measures and interventions and post-vaccination reactions may discourage subsequent CBPP vaccinations. Consequently there is need for monitoring and management of post vaccination

  8. Control of contagious bovine pleuropneumonia: Knowledge, attitudes, perceptions and practices in Narok district of Kenya

    PubMed Central

    Kairu-Wanyoike, S.W.; Kiara, H.; Heffernan, C.; Kaitibie, S.; Gitau, G.K.; McKeever, D.; Taylor, N.M.

    2014-01-01

    CBPP is an important transboundary disease in sub-Saharan Africa whose control is urgent. Participatory data collection involving 52 focus group discussions in 37 village clusters and key informant interviews, a cross-sectional study involving 232 households and a post-vaccination follow up involving 203 households was carried out in 2006–2007 in Narok South district of Kenya. This was to investigate knowledge, attitudes, perceptions and practices (KAPP) associated with control of CBPP as well as the adverse post-vaccination reactions in animals in order to advice the control policy. The community perceived trans-boundary CBPP threat to their cattle. They had traditional disease coping mechanisms and were conversant with CBPP prevention and control with 49.8% (95%CI: 42.8–56.7%) giving priority to CBPP control. However, 12.9% (95%CI: 9.0–18.1%) of pastoralists had no knowledge of any prevention method and 10.0% (95%CI: 6.5–14.7%) would not know what to do or would do nothing in the event of an outbreak. Although 43.5% (95%CI: 37.1–50.2%) of pastoralists were treating CBPP cases with antimicrobials, 62.5% (95%CI: 52.1–71.7%) of them doubted the effectiveness of the treatments. Pastoralists perceived vaccination to be the solution to CBPP but vaccination was irregular due to unavailability of the vaccine. Vaccination was mainly to control outbreaks rather than preventive and exhibited adverse post-vaccination reactions among 70.4% (95%CI: 63.6–76.5%) of herds and 3.8% (95%CI: 3.5–4.2%) of animals. Consequently, nearly 25.2% (95%CI: 18.5–33.2%) of pastoralists may resist subsequent vaccinations against CBPP. Pastoralists preferred CBPP vaccination at certain times of the year and that it is combined with other vaccinations. In conclusion, pastoralists were not fully aware of the preventive measures and interventions and post-vaccination reactions may discourage subsequent CBPP vaccinations. Consequently there is need for monitoring and management of

  9. Standardizing operational vector sampling techniques for measuring malaria transmission intensity: evaluation of six mosquito collection methods in western Kenya.

    PubMed

    Wong, Jacklyn; Bayoh, Nabie; Olang, George; Killeen, Gerry F; Hamel, Mary J; Vulule, John M; Gimnig, John E

    2013-04-30

    Operational vector sampling methods lack standardization, making quantitative comparisons of malaria transmission across different settings difficult. Human landing catch (HLC) is considered the research gold standard for measuring human-mosquito contact, but is unsuitable for large-scale sampling. This study assessed mosquito catch rates of CDC light trap (CDC-LT), Ifakara tent trap (ITT), window exit trap (WET), pot resting trap (PRT), and box resting trap (BRT) relative to HLC in western Kenya to 1) identify appropriate methods for operational sampling in this region, and 2) contribute to a larger, overarching project comparing standardized evaluations of vector trapping methods across multiple countries. Mosquitoes were collected from June to July 2009 in four districts: Rarieda, Kisumu West, Nyando, and Rachuonyo. In each district, all trapping methods were rotated 10 times through three houses in a 3 × 3 Latin Square design. Anophelines were identified by morphology and females classified as fed or non-fed. Anopheles gambiae s.l. were further identified as Anopheles gambiae s.s. or Anopheles arabiensis by PCR. Relative catch rates were estimated by negative binomial regression. When data were pooled across all four districts, catch rates (relative to HLC indoor) for An. gambiae s.l (95.6% An. arabiensis, 4.4% An. gambiae s.s) were high for HLC outdoor (RR = 1.01), CDC-LT (RR = 1.18), and ITT (RR = 1.39); moderate for WET (RR = 0.52) and PRT outdoor (RR = 0.32); and low for all remaining types of resting traps (PRT indoor, BRT indoor, and BRT outdoor; RR < 0.08 for all). For Anopheles funestus, relative catch rates were high for ITT (RR = 1.21); moderate for HLC outdoor (RR = 0.47), CDC-LT (RR = 0.69), and WET (RR = 0.49); and low for all resting traps (RR < 0.02 for all). At finer geographic scales, however, efficacy of each trap type varied from district to district. ITT, CDC-LT, and WET appear to be effective methods for large-scale vector sampling in

  10. Basing care reforms on evidence: The Kenya health sector costing model

    PubMed Central

    2011-01-01

    Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health

  11. Basing care reforms on evidence: the Kenya health sector costing model.

    PubMed

    Flessa, Steffen; Moeller, Michael; Ensor, Tim; Hornetz, Klaus

    2011-05-27

    The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead

  12. Gender differences in the schooling experiences of adolescents in low-income countries: the case of Kenya.

    PubMed

    Mensch, B S; Lloyd, C B

    1998-06-01

    Although a growing proportion of young people is spending some time in school between puberty and marriage, little research on education in developing countries has been focused on adolescent issues. This article examines the school environment in Kenya and the ways it can help or hinder adolescents. Gender differences are considered with a view toward illuminating some factors that may present particular obstacles or opportunities for girls. Using both qualitative and quantitative data, 36 primary schools in rural areas in three districts of Kenya are studied. These schools are chosen to reflect the spectrum of school quality in the country. The focus in this study is on primary schools because the majority of adolescents in school attend primary school. In these schools, where considerable variation in performance and parental educational status is found, disorganization coexists with strict punishment, minimal comforts are lacking, learning materials are scare, learning is by rote, and sex education is not provided. In the primary-school-leaving exam, girls' performance is poorer than that of boys. Teachers' attitudes and behavior reveal lower expectations for adolescent girls, traditional assumptions about gender roles, and a double standard about sexual activity.

  13. 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

  14. 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…

  15. Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework.

    PubMed

    Bukachi, Salome A; Onyango-Ouma, Washington; Siso, Jared Maaka; Nyamongo, Isaac K; Mutai, Joseph K; Hurtig, Anna Karin; Olsen, Oystein Evjen; Byskov, Jens

    2014-01-01

    In resource-poor settings, the accountability for reasonableness (A4R) has been identified as an important advance in priority setting that helps to operationalize fair priority setting in specific contexts. The four conditions of A4R are backed by theory, not evidence, that conformance with them improves the priority setting decisions. This paper describes the healthcare priority setting processes in Malindi district, Kenya, prior to the implementation of A4R in 2008 and evaluates the process for its conformance with the conditions for A4R. In-depth interviews and focus group discussions with key players in the Malindi district health system and a review of key policy documents and national guidelines show that the priority setting process in the district relies heavily on guidelines from the national level, making it more of a vertical, top-down orientation. Multilateral and donor agencies, national government, budgetary requirements, traditions and local culture influence the process. The four conditions of A4R are present within the priority setting process, albeit to varying degrees and referred to by different terms. There exists an opportunity for A4R to provide a guiding approach within which its four conditions can be strengthened and assessed to establish whether conformance helps improve on the priority setting process. Copyright © 2013 John Wiley & Sons, Ltd.

  16. A study of the medicinal plants used by the Marakwet Community in Kenya

    PubMed Central

    2014-01-01

    Background The medicinal plants used by herbalists in Kenya have not been well documented, despite their widespread use. The threat of complete disappearance of the knowledge on herbal medicine from factors such as deforestation, lack of proper regulation, overexploitation and sociocultural issues warrants an urgent need to document the information. The purpose of the study was to document information on medicinal plants used by herbalists in Marakwet District towards the utilization of indigenous ethnobotanical knowledge for the advancement of biomedical research and development. Methods Semi- structured oral interviews were conducted with 112 practicing herbalists. The types of plants used were identified and the conditions treated recorded. Results Herbal practice is still common in the district, and 111 plants were identified to have medicinal or related uses. Different herbal preparations including fruits and healing vegetables are employed in the treatment of various medical conditions. Veterinary uses and pesticides were also recorded. Conclusion The study provides comprehensive ethnobotanical information about herbal medicine and healing methods among the Marakwet community. The identification of the active ingredients of the plants used by the herbalists may provide some useful leads for the development of new drugs. PMID:24555424

  17. 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

  18. Economic evaluation of delivering Haemophilus influenzae type b vaccine in routine immunization services in Kenya.

    PubMed

    Akumu, Angela Oloo; English, Mike; Scott, J Anthony G; Griffiths, Ulla K

    2007-07-01

    Haemophilus influenzae type b (Hib) vaccine was introduced into routine immunization services in Kenya in 2001. We aimed to estimate the cost-effectiveness of Hib vaccine delivery. A model was developed to follow the Kenyan 2004 birth cohort until death, with and without Hib vaccine. Incidence of invasive Hib disease was estimated at Kilifi District Hospital and in the surrounding demographic surveillance system in coastal Kenya. National Hib disease incidence was estimated by adjusting incidence observed by passive hospital surveillance using assumptions about access to care. Case fatality rates were also assumed dependent on access to care. A price of US$ 3.65 per dose of pentavalent diphtheria-tetanus-pertussis-hep B-Hib vaccine was used. Multivariate Monte Carlo simulations were performed in order to assess the impact on the cost-effectiveness ratios of uncertainty in parameter values. The introduction of Hib vaccine reduced the estimated incidence of Hib meningitis per 100,000 children aged < 5 years from 71 to 8; of Hib non-meningitic invasive disease from 61 to 7; and of non-bacteraemic Hib pneumonia from 296 to 34. The costs per discounted disability adjusted life year (DALY) and per discounted death averted were US$ 38 (95% confidence interval, CI: 26-63) and US$ 1197 (95% CI: 814-2021) respectively. Most of the uncertainty in the results was due to uncertain access to care parameters. The break-even pentavalent vaccine price--where incremental Hib vaccination costs equal treatment costs averted from Hib disease--was US$ 1.82 per dose. Hib vaccine is a highly cost-effective intervention in Kenya. It would be cost-saving if the vaccine price was below half of its present level.

  19. 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…

  20. 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...

  1. 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

  2. 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.

  3. 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

  4. 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…

  5. Task shifting for cataract surgery in eastern Africa: productivity and attrition of non-physician cataract surgeons in Kenya, Malawi and Tanzania.

    PubMed

    Eliah, Edson; Lewallen, Susan; Kalua, Khumbo; Courtright, Paul; Gichangi, Michael; Bassett, Ken

    2014-01-01

    This project examined the surgical productivity and attrition of non-physician cataract surgeons (NPCSs) in Tanzania, Malawi, and Kenya. Baseline (2008-9) data on training, support, and productivity (annual cataract surgery rate) were collected from officially trained NPCSs using mailed questionnaires followed by telephone interviews. Telephone interviews were used to collect follow-up data annually on productivity and semi-annually on attrition. A detailed telephone interview was conducted if a surgeon left his/her post. Data were entered into and analysed using STATA. Among the 135 NPCSs, 129 were enrolled in the study (Kenya 88, Tanzania 38, and Malawi 3) mean age 42 years; average time since completing training 6.6 years. Employment was in District 44%, Regional 24% or mission/ private 32% hospitals. Small incision cataract surgery was practiced by 38% of the NPCSs. The mean cataract surgery rate was 188/year, median 76 (range 0-1700). For 39 (31%) NPCSs their surgical rate was more than 200/year. Approximately 22% in Kenya and 25% in Tanzania had years where the cataract surgical rate was zero. About 11% of the surgeons had no support staff. High quality training is necessary but not sufficient to result in cataract surgical activity that meets population needs and maintains surgical skill. Needed are supporting institutions and staff, functioning equipment and programs to recruit and transport patients.

  6. 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

  7. 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

  8. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study.

    PubMed

    Ochako, Rhoune; Mbondo, Mwende; Aloo, Stephen; Kaimenyi, Susan; Thompson, Rachel; Temmerman, Marleen; Kays, Megan

    2015-02-10

    Young women in Kenya experience a higher risk of mistimed and unwanted pregnancy compared to older women. However, contraceptive use among youth remains low. Known barriers to uptake include side effects, access to commodities and partner approval. To inform a youth focussed behaviour change communication campaign, Population Services Kenya developed a qualitative study to better understand these barriers among young women. The study was carried out in Nyanza, Coast, and Central regions. Within these regions, urban or peri-urban districts were purposively selected based on having contraceptive prevalence rate close to the regional average and having a population with low socioeconomic profiles. In depth interviews were conducted with a sample of sexually active women aged 15-24, both users and non-users, that were drawn from randomly selected households. All the respondents in the study were familiar with modern methods of contraception and most could describe their general mechanisms of action. Condoms were not considered as contraception by many users. Contraception was also associated with promiscuity and straying. Fear of side effects and adverse reactions were a major barrier to use. The biggest fear was that a particular method would cause infertility. Many fears were based on myths and misconceptions. Young women learn about both true side effects and myths from their social networks. Findings from this research confirm that awareness and knowledge of contraception do not necessarily translate to use. The main barriers to modern contraceptive uptake among young women are myths and misconceptions. The findings stress the influence of social network approval on the use of family planning, beyond the individual's beliefs. In such settings, family planning programming should engage with the wider community through mass and peer campaign strategies. As an outcome from this study, Population Services Kenya developed a mass media campaign to address key myths and

  9. 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…

  10. 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

  11. Developing a Nursing Database System in Kenya

    PubMed Central

    Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

    2007-01-01

    Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

  12. 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.

  13. Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya

    PubMed Central

    Noor, A. M.; Zurovac, D.; Hay, S. I.; Ochola, S. A.; Snow, R. W.

    2010-01-01

    Summary Distance is a crucial feature of health service use and yet its application and utility to health care planning have not been well explored, particularly in the light of large-scale international and national efforts such as Roll Back Malaria. We have developed a high-resolution map of population-to-service access in four districts of Kenya. Theoretical physical access, based upon national targets, developed as part of the Kenyan health sector reform agenda, was compared with actual health service usage data among 1668 paediatric patients attending 81 sampled government health facilities. Actual and theoretical use were highly correlated. Patients in the larger districts of Kwale and Makueni, where access to government health facilities was relatively poor, travelled greater mean distances than those in Greater Kisii and Bondo. More than 60% of the patients in the four districts attended health facilities within a 5-km range. Interpolated physical access surfaces across districts highlighted areas of poor access and large differences between urban and rural settings. Users from rural communities travelled greater distances to health facilities than those in urban communities. The implications of planning and monitoring equitable delivery of clinical services at national and international levels are discussed. PMID:14516303

  14. Basic Education from Early Childhood: Impacts of Free Primary Education and Subsidized Secondary Education on Public ECDE Centers in Nyahururu District, Kenya

    ERIC Educational Resources Information Center

    Mwangi, Peter Murage; Serem, T. D. K.

    2013-01-01

    Kenya must invest more in education to realize her vision 2030. The government commitment to Education for All's goal has been expressed through provision of basic education in pre-primary, primary and secondary school levels. To this end, the government introduced two kitties; Free Primary Education in 2003 and Subsidized Secondary Education in…

  15. Spatial and socio-demographic predictors of time-to-immunization in a rural area in Kenya: Is equity attainable?

    PubMed

    Moïsi, Jennifer C; Kabuka, Jonathan; Mitingi, Dorah; Levine, Orin S; Scott, J Anthony G

    2010-08-09

    We conducted a vaccine coverage survey in Kilifi District, Kenya in order to identify predictors of childhood immunization. We calculated travel time to vaccine clinics and examined its relationship to immunization coverage and timeliness among the 2169 enrolled children (median age: 12.5 months). 86% had vaccine cards available, >95% had received three doses of DTP-HepB-Hib and polio vaccines and 88% of measles. Travel time did not affect vaccination coverage or timeliness. The Kenyan EPI reaches nearly all children in Kilifi and delays in vaccination are few, suggesting that vaccines will have maximal impact on child morbidity and mortality. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. Malaria control in Bungoma District, Kenya: a survey of home treatment of children with fever, bednet use and attendance at antenatal clinics.

    PubMed Central

    Hamel, M. J.; Odhacha, A.; Roberts, J. M.; Deming, M. S.

    2001-01-01

    OBJECTIVE: To lay the basis for planning an improved malaria control programme in Bungoma District, Kenya. METHODS: By means of a cluster sample household survey an investigation was conducted into the home management of febrile children, the use of bednets, and attendance at antenatal clinics. FINDINGS: Female carers provided information on 314 recently febrile children under 5 years of age, of whom 43% received care at a health facility, 47% received an antimalarial drug at home, and 25% received neither. Of the antimalarial treatments given at home, 91% were started by the second day of fever and 92% were with chloroquine, the nationally recommended antimalarial at the time. The recommended dosage of chloroquine to be administered over three days was 25 mg/kg but the median chloroquine tablet or syrup dosage given over the first three days of treatment was 15 mg/kg. The total dosages ranged from 2.5 mg/kg to 82 mg/kg, administered over one to five days. The dosages were lower when syrup was administered than when tablets were used. Only 5% of children under 5 years of age slept under a bednet. No bednets had been treated with insecticide since purchase. At least two antenatal visits were made by 91% of pregnant women. CONCLUSIONS: Carers are major and prompt providers of antimalarial treatment. Home treatment practices should be strengthened and endorsed when prompt treatment at a health facility is impossible. The administration of incorrect dosages, which proved common with chloroquine, may occur less frequently with sulfadoxine-pyrimethamine, as its dosage regimen is simpler. High levels of utilization of antenatal clinics afford the opportunity to achieve good coverage with presumptive intermittent malaria treatments during pregnancy, and to reach the goal of widespread bednet use by pregnant women and children by distributing nets during antenatal clinic visits. PMID:11731808

  17. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy

    PubMed Central

    2011-01-01

    Background Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. Methods A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. Results The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. Conclusions In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities. PMID:21917166

  18. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy.

    PubMed

    Njenga, Sammy M; Mwandawiro, Charles S; Muniu, Erastus; Mwanje, Mariam T; Haji, Fatma M; Bockarie, Moses J

    2011-09-14

    Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities.

  19. 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)

  20. 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…

  1. 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.

  2. Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya.

    PubMed

    Mannah, Margaret Titty; Warren, Charlotte; Kuria, Shiphrah; Adegoke, Adetoro A

    2014-08-15

    Availability of skilled care at birth remains a major problem in most developing countries. In an effort to increase access to skilled birth attendance, the Kenyan government implemented the community midwifery programme in 2005. The aim of this programme was to increase women's access to skilled care during pregnancy, childbirth and post-partum within their communities. Qualitative research involving in-depth interviews with 20 community midwives and six key informants. The key informants were funder, managers, coordinators and supervisors of the programme. Interviews were conducted between June to July, 2011 in two districts in Western and Central provinces of Kenya. Findings showed major challenges and opportunities in implementing the community midwifery programme. Challenges of the programme were: socio-economic issues, unavailability of logistics, problems of transportation for referrals and insecurity. Participants also identified the advantages of having midwives in the community which were provision of individualised care; living in the same community with clients which made community midwives easily accessible; and flexible payment options. Although the community midwifery model is a culturally acceptable method to increase skilled birth attendance in Kenya, the use of skilled birth attendance however remains disproportionately lower among poor mothers. Despite several governmental efforts to increase access and coverage of delivery services to the poor, it is clear that the poor may still not access skilled care even with skilled birth attendants residing in the community due to several socio-economic barriers.

  3. Adapting agriculture to climate change in Kenya: household strategies and determinants.

    PubMed

    Bryan, Elizabeth; Ringler, Claudia; Okoba, Barrack; Roncoli, Carla; Silvestri, Silvia; Herrero, Mario

    2013-01-15

    Countries in Sub-Saharan Africa are particularly vulnerable to climate change, given dependence on agricultural production and limited adaptive capacity. Based on farm household and Participatory Rural Appraisal data collected from districts in various agroecological zones in Kenya, this paper examines farmers' perceptions of climate change, ongoing adaptation measures, and factors influencing farmers' decisions to adapt. The results show that households face considerable challenges in adapting to climate change. While many households have made small adjustments to their farming practices in response to climate change (in particular, changing planting decisions), few households are able to make more costly investments, for example in agroforestry or irrigation, although there is a desire to invest in such measures. This emphasizes the need for greater investments in rural and agricultural development to support the ability of households to make strategic, long-term decisions that affect their future well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. 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.

  5. Effectiveness of Haemophilus influenzae type b conjugate vaccine introduction into routine childhood immunization in Kenya

    PubMed Central

    Cowgill, Karen D.; Ndiritu, Moses; Nyiro, Joyce; Slack, Mary P. E.; Chiphatsi, Salome; Ismail, Amina; Kamau, Tatu; Mwangi, Isaiah; English, Mike; Newton, Charles R. J. C.; Feikin, Daniel R.; Scott, J. Anthony G.

    2006-01-01

    Context Haemophilus influenzae type b (Hib) conjugate vaccine is not perceived as a public health priority in Africa because data on Hib disease burden and vaccine effectiveness are scarce. Hib immunization was introduced in Kenyan infants in 2001. Objective to define invasive Hib disease incidence and Hib vaccine program effectiveness. Design, Setting, Patients culture-based surveillance for invasive Hib disease at Kilifi District Hospital from 2000 to 2005 was linked to demographic surveillance of 38,000 children aged <5 years in Kilifi District, Kenya. HIV infection and Hib vaccination status were determined for children with Hib disease admitted 2002–2005. Interventions Conjugate Hib vaccine within the routine childhood immunization program at ages 6, 10 and 14 weeks from November 2001 Main outcome measures Incidence of culture-proven Hib invasive disease before and after vaccine introduction and vaccine program effectiveness (1-incidence rate ratio) Results Prior to vaccine introduction the median age of Hib cases was 8 months; case fatality was 23%. Among children aged <5 years the annual incidence of invasive Hib disease 1 year before and 1 and 3 years after vaccine introduction was 66, 47 and 7.6 per 100,000, respectively. For children <2 years, incidence was 119, 82 and 16, respectively. In 2004–2005 vaccine effectiveness was 88% (95% CI 73–96%) among children <5 years and 87% (95% CI 66–96%) among children <2 years. Of 53 Hib cases admitted during 2002–2005, 29 (55%) were age-ineligible to have received vaccine, 12 (23%) had not been vaccinated despite being eligible, and 12 (23%) had received ≥2 doses of vaccine (2 were HIV-positive). Conclusions In Kenya, introduction of Hib vaccine into the routine childhood immunization program reduced Hib disease incidence among children aged <5 years to 12% of its baseline level. This impact was not observed until the third year after vaccine introduction. PMID:16896110

  6. 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.

  7. 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

  8. Fossil wood from the upper Miocene Mpesida Beds at Cheparain (Baringo District, Kenya): Botanical affinities and palaeoenvironmental implications

    NASA Astrophysics Data System (ADS)

    De Franceschi, Dario; Bamford, Marion; Pickford, Martin; Senut, Brigitte

    2016-03-01

    Seven wood samples from a petrified forest, in situ in ash flow deposits at Cheparain in the Tugen Hills (Kenya) in the Mpesida Beds, were discovered and studied. The age of the Mpesida Formation is estimated to be about 6.3 Ma on the basis of radio-isotope age determinations on the volcanic deposits, which overlie and underlie the sedimentary levels. The wood samples are mineralized with obvious sectors of differential mineralization, and different degrees of silica impregnation. All samples show heteroxylous structures corresponding to angiosperm dicotyledon trees. One sample consists in a half cylinder showing a well preserved mineralized structure of heteroxylous wood and probably corresponds to a fragment of root. This wood, with solitary (or in radial group) vessels, heterocellular multiseriate rays, paratracheal parenchyma in wide bands, and partly storied fusiform cells, clearly shows affinities with the genus Erythrina (Fabaceae). A slightly compressed branch, partly disturbed by injuries and highly mineralized shows solitary (or in short radial group) vessels, the rays uni-(bi) seriate are heterocellular, and the apotracheal parenchyma is in thin tangential bands. The closest affinities are with the genus Spirostachys (Euphorbiaceae). The other structures are poorly preserved (highly mineralized) and precise botanical affinities cannot be accessed. But the growth rings are distinct or diversely marked and the samples show semi-ring porous structures. They exhibit two different patterns. The growth rings reveal the presence of seasonal climate, and numerous injuries, a disturbance of the vegetation by animals and/or strong climatic events. Erythrina and Spirostachys are present in the extant vegetation of the Tana River Valley, in Kenya, which could represent a modern analogue for the vegetation of the Mpesida Beds prior to the major uplift of the Tugen Hills at the end of the Miocene.

  9. 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

  10. Factors Affecting the Management of Women Groups' Micro and Small Enterprises in Kakamega District, Kenya

    ERIC Educational Resources Information Center

    Wawire, Nelson H. W.; Nafukho, Fredrick M.

    2010-01-01

    Purpose: The purpose of this study is to highlight the main factors that affect the management of the WGs' Micro and Small Enterprises (MSEs) in Kakamega District and Africa in general. Design/methodology/approach: The study adopted a descriptive research design. This is because the study was concerned about a univariate question in which the…

  11. 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...

  12. 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...

  13. 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...

  14. A field survey for the seroprevalence of Theileria equi and Babesia caballi in donkeys from Nuu Division, Kenya.

    PubMed

    Oduori, David O; Onyango, Solomon C; Kimari, Joseph N; MacLeod, Ewan T

    2015-07-01

    Equine piroplasmosis is one of the most significant tick-borne disease of equids. The prevalence of this disease in donkeys of semi-arid Kenya remains largely unexplored. The primary objective of this study was to demonstrate the extent to which donkeys in Nuu division, Kenya have been exposed to the haemoprotozoans Babesia caballi and Theileria equi, the causative agents of equine piroplasmosis. The study also assessed the effect of age and sex on seroprevalence. A stratified sampling approach was used and three hundred and fourteen donkeys were sampled across nine sub-locations in Nuu division, Mwingi district. Serodiagnosis was via competitive inhibition enzyme linked immunosorbent assays (cELISA). The seroprevalence of T. equi was 81.2% (95% CI: 76.4-85.4). There was no significant difference in sub-location seropositivity, gender seropositivity or age related seropositivity. Antibodies against B. caballi were not detected (95% CI: 0-1.2). Findings from this study suggest that T. equi infection is endemic in Nuu division, Mwingi where it exists in a state of endemic stability. Existence of the infection should be communicated to animal health practitioners and donkey owning communities in the area. Copyright © 2015 Elsevier GmbH. All rights reserved.

  15. 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…

  16. 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

  17. 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)

  18. 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.

  19. Care seeking and attitudes towards treatment compliance by newly enrolled tuberculosis patients in the district treatment programme in rural western Kenya: a qualitative study

    PubMed Central

    2011-01-01

    Background The two issues mostly affecting the success of tuberculosis (TB) control programmes are delay in presentation and non-adherence to treatment. It is important to understand the factors that contribute to these issues, particularly in resource limited settings, where rates of tuberculosis are high. The objective of this study is to assess health-seeking behaviour and health care experiences among persons with pulmonary tuberculosis, and identify the reasons patients might not complete their treatment. Methods We performed qualitative one-on-one in-depth interviews with pulmonary tuberculosis patients in nine health facilities in rural western Kenya. Thirty-one patients, 18 women and 13 men, participated in the study. All reside in an area of western Kenya with a Health and Demographic Surveillance System (HDSS). They had attended treatment for up to 4 weeks on scheduled TB clinic days in September and October 2005. The nine sites all provide diagnostic and treatment services. Eight of the facilities were public (3 hospitals and 5 health centres) and one was a mission health centre. Results Most patients initially self-treated with herbal remedies or drugs purchased from kiosks or pharmacies before seeking professional care. The reported time from initial symptoms to TB diagnosis ranged from 3 weeks to 9 years. Misinterpretation of early symptoms and financial constraints were the most common reasons reported for the delay. We also explored potential reasons that patients might discontinue their treatment before completing it. Reasons included being unaware of the duration of TB treatment, stopping treatment once symptoms subsided, and lack of family support. Conclusions This qualitative study highlighted important challenges to TB control in rural western Kenya, and provided useful information that was further validated in a quantitative study in the same area. PMID:21714895

  20. Helmet wearing in Kenya: prevalence, knowledge, attitude, practice and implications.

    PubMed

    Bachani, A M; Hung, Y W; Mogere, S; Akunga, D; Nyamari, J; Hyder, A A

    2017-03-01

    In light of the increasing prevalence of motorcycles on Kenyan roads, there is a need to address the safety of individuals using this mode of transport. Helmet use has been proven to be effective in preventing head injuries and fatalities in the event of a crash. This study aims to understand the prevalence of helmet use as well as knowledge, attitudes, and practices in two districts in Kenya over a 5-year period (2010-2014). Observational studies on helmet use at randomly selected locations throughout each district were done every quarter to estimate the prevalence of helmet use. Roadside knowledge, attitude, and practice (KAP) surveys were done two times a year in each district. Helmet use among motorcycle drivers and passengers in Thika and Naivasha was assessed through systematic observations at randomly selected locations in the two districts between August 2010 and December 2014. Roadside KAP surveys were administered in both sites to motorcyclists in areas where they stopped, including motorcycle bays, petrol stations and rest areas near the helmet observation sites. Secondary analysis of trauma registries was also used. Negative binomial regressions were used to assess trends of helmet wearing among motorcyclists over time, and logistic regressions were used to analyze associated risk factors as well as association with health outcomes among those admitted to the four hospitals. A total of 256,851 motorcycles were observed in the two target districts during the study period. Overall, prevalence of helmet use among motorcycle drivers in Thika and Naivasha across all periods was 35.12% (95% confidence interval [CI]: 34.87%-35.38%) and 37.42% (95% CI: 37.15%-37.69%) respectively. Prevalence of helmet wearing remained similar after the passage of a traffic amendment bill. These results were not statistically significant in either Thika or in Naivasha. Data from the KAP survey showed that respondents recognized the life-saving effect of wearing a helmet, but

  1. 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,…

  2. 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,…

  3. 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.

  4. 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

  5. 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,…

  6. The Right to Education for Children in Domestic Labour: Empirical Evidence from Kenya

    NASA Astrophysics Data System (ADS)

    Munene, Ishmael I.; Ruto, Sara J.

    2010-02-01

    Since 1948, various UN conventions have recognised basic education as a human right. Yet this right continues to be denied to many child labourers across the world. This articles draws on the results of a study examining how children in domestic labour in Kenya access and participate in education. Three issues were explored: (1) the correlates of child domestic labourers; (2) their working conditions and contexts; and (3) the right to education. Interviews and group discussions held in one city and two rural districts elicited data from 91 child domestic labourers and 84 adults. The results indicated that child labour was both poverty-induced and adult-initiated, and that children worked in hazardous environments characterised by economic exploitation. Most did not attend school; those who did had to contend with a rigid school structure and an authoritarian class environment. Children in domestic labour often skipped school, and their participation in classes was low.

  7. Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya.

    PubMed

    Rusk, Andria; Smith, Nathan; Menya, Diana; Obala, Andrew; Simiyu, Chrispinus; Khwa-Otsyula, Barasa; O'Meara, Wendy

    2012-08-06

    Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of febrile individuals first seek treatment for febrile illness over the counter from medicine retailers. Understanding medicine retailer knowledge and behaviour in treating suspected malaria and dispensing anti-malarials is crucial. To investigate medicine retailer knowledge about anti-malarials and their dispensing practices, a survey was conducted of all retail drug outlets that sell anti-malarial medications and serve residents of the Webuye Health and Demographic Surveillance Site in the Bungoma East District of western Kenya. Most of the medicine retailers surveyed (65%) were able to identify artemether-lumefantrine (AL) as the Kenyan Ministry of Health recommended first-line anti-malarial therapy for uncomplicated malaria. Retailers who correctly identified this treatment were also more likely to recommend AL to adult and paediatric customers. However, the proportion of medicine retailers who recommend the correct treatment is disappointingly low. Only 48% would recommend AL to adults, and 37% would recommend it to children. It was discovered that customer demand has an influence on retailer behaviour. Retailer training and education were found to be correlated with anti-malarial drug knowledge, which in turn is correlated with dispensing practices. Medicine retailer behaviour, including patient referral practice and dispensing practices, are also correlated with knowledge of the first-line anti-malarial medication. The Kenya Ministry of Health guidelines were found to influence retailer drug stocking and dispensing behaviours. Most medicine retailers could identify the recommended first-line treatment for uncomplicated malaria, but the percentage that could not is still too high. Furthermore, knowing the MOH recommended

  8. Impact of Enrollment on the Quality of Learning in Primary Schools in Imenti Central District, Kenya

    ERIC Educational Resources Information Center

    Mwirigi, Silas Francis; Muthaa, George M.

    2015-01-01

    To promote participation and access to education, the government introduced free primary education. The introduction of FSE has resulted into increased enrolment at all levels which has been blamed for the poor performance of pupils in public primary school of Imenti Central District. The current study sought to determine the impact of enrollment…

  9. Use of cellular phone contacts to increase return rates for immunization services in Kenya.

    PubMed

    Mokaya, Evans; Mugoya, Isaac; Raburu, Jane; Shimp, Lora

    2017-01-01

    In Kenya, failure to complete immunization schedules by children who previously accessed immunization services is an obstacle to ensuring that children are fully immunized. Home visit approaches used to track defaulting children have not been successful in reducing the drop-out rate. This study tested the use of phone contacts as an approach for tracking immunization defaulters in twelve purposively-selected facilities in three districts of western Kenya. For nine months, children accessing immunization services in the facilities were tracked and caregivers were asked their reasons for defaulting. In all of the facilities, caregiver phone ownership was above 80%. In 11 of the 12 facilities, defaulter rates between pentavalent1 and pentavalent3 vaccination doses reduced significantly to within the acceptable level of < 10%. Caregivers provided reliable contact information and health workers positively perceived phone-based defaulter communications. Tracking a defaulter required on average 2 minutes by voice and Ksh 6 ($ 0.07). Competing tasks and concerns about vaccinating sick children and side-effects were the most cited reasons for caregivers defaulting. Notably, a significant number of children categorised as defaulters had been vaccinated in a different facility (and were therefore "false defaulters"). Use of phone contacts for follow-up is a feasible and cost-effective method for tracking defaulters. This approach should complement traditional home visits, especially for caregivers without phones. Given communication-related reasons for defaulting, it is important that immunization programs scale-up community education activities. A system for health facilities to share details of defaulting children should be established to reduce "false defaulters".

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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.

  16. [Pediatric case series in an ophthalmic camp in Turkana (Kenya)].

    PubMed

    Noval, S; Cabrejas, L; Jarrín, E; Ruiz-Guerrero, M; Ciancas, E

    2013-12-01

    Turkana is the largest district in Kenya, situated in the Northwest of the country. It features a semi-nomadic population of 850,000. Around 60% of population lives below the poverty threshold. The ratio of doctors is 1:75,000 inhabitants. Five ophthalmologists took part in the last deployment in November. Local staff had previously selected the patients from the rural areas, as well as in Lodwar, the capital of the district. Of the 371 patients who attended the clinic, 128 required surgery. To describe the pediatric population attended to in the last «Turkana Eye Project» Camp. Description of the ophthalmic pathologies of the children seen in the clinic in this surgical camp, and the diagnostic and therapeutic options according to the limitations of the environment. Of the 371 patients, 54 were younger than 15 years old (14.5%). Four children had surgery (3.25% of the 128 patients). In 2 more cases surgery was the indicated but not performed. Therefore, of the total of 54 cases, 6 could be considered as surgical (11.1%), and 17 suffered ophthalmic problems other than refraction defects, or mild ocular surface pathologies: traumatic cataracts, neuropathies, impetigo, exophthalmos, retinal dystrophies, dermoid cysts, or nyctalopia. The etiology was traumatic in four of the 17 children (23.5%). Surgical camps are increasing in the developing countries. They are usually focused on particular pathologies, such as cataracts or trachoma. Our case series shows the importance of pediatric teams and the need to be prepared to face complex pediatric pathologies. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  17. 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…

  18. Kenya's Maternal Child Health Family Planning Program (Family Health).

    PubMed

    Kiereini, E M

    1982-01-01

    In an attempt to improve accessibility to health care for the majority of its population, the government of Kenya has, since 1970, undertaken an integration of its dispersed health care system. In 1972 the Ministry of Health carried out a study to identify the problems associated with health care in rural areas. A task force consisting of government and other officials carried out a situation analysis with a view to making specific recommendations for improving community health status. The 4 main health problems identified had to do with family health problems, communicable diseases, diseases related to poor environmental sanitation, and health problems related to poor nutrition. The analysis also revealed the importance of maternal and child health for overall health of the community. A Maternal Child Health Family Planning (MCH/FP) program was then designed to improve services to women aged 15-49 years and children below 5 years, the groups proven to be at greatest risk for ill health. Also integrated into this approach were family planning services. Health workers ranging from enrolled community nurses (equipped with knowledge and skills for diagnosing and treating common conditions) to traditional birth attendants, serve both rural and urban areas. In addition, registered public health nurses, supervising MCH/FP services in district facilities, also operate in urban areas. Rural populations also have the services of a clinical officer who is answerable to the district medical officer, and who has charge of the health center. The Family Health Field Educators Training Program, which was started in 1975 has not yet been evaluated, but it is evident that the efforts of the government to train and equip health workers has greatly improved the quality and availability of health care service to Kenyans.

  19. 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.

  20. 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

  1. Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014.

    PubMed

    Haji, Adam; Lowther, S; Ngan'ga, Z; Gura, Z; Tabu, C; Sandhu, H; Arvelo, Wences

    2016-02-16

    Globally, vaccine preventable diseases are responsible for nearly 20% of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program. The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥ 2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose. We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31-99 days), and 574 (51%) were male. There were 136 (12%) dropouts. Thirteen (4%) children dropped out among those who received text messages, 60 (16%) among who received sticker reminders, and 63 (17%) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95% Confidence Interval (CI) 1.1-3.2], and residing >5 km from health facility (OR 1.6, CI 1.0-2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04-0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5-1.6). Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of

  2. 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.

  3. Factors Associated with Acquisition of Human Infective and Animal Infective Trypanosome Infections in Domestic Livestock in Western Kenya

    PubMed Central

    von Wissmann, Beatrix; Machila, Noreen; Picozzi, Kim; Fèvre, Eric M.; deC. Bronsvoort, Barend M.; Handel, Ian G.; Welburn, Susan C.

    2011-01-01

    Background Trypanosomiasis is regarded as a constraint on livestock production in Western Kenya where the responsibility for tsetse and trypanosomiasis control has increasingly shifted from the state to the individual livestock owner. To assess the sustainability of these localised control efforts, this study investigates biological and management risk factors associated with trypanosome infections detected by polymerase chain reaction (PCR), in a range of domestic livestock at the local scale in Busia, Kenya. Busia District also remains endemic for human sleeping sickness with sporadic cases of sleeping sickness reported. Results In total, trypanosome infections were detected in 11.9% (329) out of the 2773 livestock sampled in Busia District. Multivariable logistic regression revealed that host species and cattle age affected overall trypanosome infection, with significantly increased odds of infection for cattle older than 18 months, and significantly lower odds of infection in pigs and small ruminants. Different grazing and watering management practices did not affect the odds of trypanosome infection, adjusted by host species. Neither anaemia nor condition score significantly affected the odds of trypanosome infection in cattle. Human infective Trypanosoma brucei rhodesiense were detected in 21.5% of animals infected with T. brucei s.l. (29/135) amounting to 1% (29/2773) of all sampled livestock, with significantly higher odds of T. brucei rhodesiense infections in T. brucei s.l. infected pigs (OR = 4.3, 95%CI 1.5-12.0) than in T. brucei s.l. infected cattle or small ruminants. Conclusions Although cattle are the dominant reservoir of trypanosome infection it is unlikely that targeted treatment of only visibly diseased cattle will achieve sustainable interruption of transmission for either animal infective or zoonotic human infective trypanosomiasis, since most infections were detected in cattle that did not exhibit classical clinical signs of

  4. 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.

  5. 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

  6. The Effect of Indoor Residual Spraying on the Prevalence of Malaria Parasite Infection, Clinical Malaria and Anemia in an Area of Perennial Transmission and Moderate Coverage of Insecticide Treated Nets in Western Kenya

    PubMed Central

    Gimnig, John E.; Otieno, Peter; Were, Vincent; Marwanga, Doris; Abong’o, Daisy; Wiegand, Ryan; Williamson, John; Wolkon, Adam; Zhou, Ying; Bayoh, M. Nabie; Lobo, Neil F.; Laserson, Kayla; Kariuki, Simon; Hamel, Mary J.

    2016-01-01

    Background Insecticide treated nets (ITNs) and indoor residual spraying (IRS) have been scaled up for malaria prevention in sub-Saharan Africa. However, there are few studies on the benefit of implementing IRS in areas with moderate to high coverage of ITNs. We evaluated the impact of an IRS program on malaria related outcomes in western Kenya, an area of intense perennial malaria transmission and moderate ITN coverage (55–65% use of any net the previous night). Methods The Kenya Division of Malaria Control, with support from the US President’s Malaria Initiative, conducted IRS in one lowland endemic district with moderate coverage of ITNs. Surveys were conducted in the IRS district and a neighboring district before IRS, after one round of IRS in July-Sept 2008 and after a second round of IRS in April-May 2009. IRS was conducted with pyrethroid insecticides. At each survey, 30 clusters were selected for sampling and within each cluster, 12 compounds were randomly selected. The primary outcomes measured in all residents of selected compounds included malaria parasitemia, clinical malaria (P. falciparum infection plus history of fever) and anemia (Hb<8) of all residents in randomly selected compounds. At each survey round, individuals from the IRS district were matched to those from the non-IRS district using propensity scores and multivariate logistic regression models were constructed based on the matched dataset. Results At baseline and after one round of IRS, there were no differences between the two districts in the prevalence of malaria parasitemia, clinical malaria or anemia. After two rounds of IRS, the prevalence of malaria parasitemia was 6.4% in the IRS district compared to 16.7% in the comparison district (OR = 0.36, 95% CI = 0.22–0.59, p<0.001). The prevalence of clinical malaria was also lower in the IRS district (1.8% vs. 4.9%, OR = 0.37, 95% CI = 0.20–0.68, p = 0.001). The prevalence of anemia was lower in the IRS district but only in children

  7. 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.

  8. 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)

  9. 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.

  10. 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.

  11. 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…

  12. Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

    PubMed Central

    Flannery, Brendan; Onyango, Bernard; Larson, Charles; Alaii, Jane; Zhang, Xingyou; Hamel, Mary J.; Breiman, Robert F.; Feikin, Daniel R.

    2011-01-01

    Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associa-ted with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient. PMID:21528791

  13. A cross sectional comparison of postnatal care quality in facilities participating in a maternal health voucher program versus non-voucher facilities in Kenya.

    PubMed

    Warren, Charlotte E; Abuya, Timothy; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Temmerman, Marleen; Bellows, Ben

    2015-07-24

    Health service fees constitute substantial barriers for women seeking childbirth and postnatal care. In an effort to reduce health inequities, the government of Kenya in 2006 introduced the output-based approach (OBA), or voucher programme, to increase poor women's access to quality Safe Motherhood services including postnatal care. To help improve service quality, OBA programmes purchase services on behalf of the poor and marginalised, with provider reimbursements for verified services. Kenya's programme accredited health facilities in three districts as well as in two informal Nairobi settlements. Postnatal care quality in voucher health facilities (n = 21) accredited in 2006 and in similar non-voucher health facilities (n = 20) are compared with cross sectional data collected in 2010. Summary scores for quality were calculated as additive sums of specific aspects of each attribute (structure, process, outcome). Measures of effect were assessed in a linear regression model accounting for clustering at facility level. Data were analysed using Stata 11.0. The overall quality of postnatal care is poor in voucher and non-voucher facilities, but many facilities demonstrated 'readiness' for postnatal care (structural attributes: infrastructure, equipment, supplies, staffing, training) indicated by high scores (83/111), with public voucher facilities scoring higher than public non-voucher facilities. The two groups of facilities evinced no significant differences in postnatal care mean process scores: 14.2/55 in voucher facilities versus 16.4/55 in non-voucher facilities; coefficient: -1.70 (-4.9, 1.5), p = 0.294. Significantly more newborns were seen within 48 hours (83.5% versus 72.1%: p = 0.001) and received Bacillus Calmette-Guerin (BCG) (82.5% versus 76.5%: p < 0.001) at voucher facilities than at non-voucher facilities. Four years after facility accreditation in Kenya, scores for postnatal care quality are low in all facilities, even those with Safe Motherhood

  14. 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.

  15. 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…

  16. 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…

  17. Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations.

    PubMed

    Kiima, David; Jenkins, Rachel

    2010-06-28

    Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines to accompany the general health policy, tobacco

  18. Investigation of Practices to Support the Complex Communication Needs of Children with Hearing Impairment and Cerebral Palsy in a Rural District of Kenya: A Case Series

    ERIC Educational Resources Information Center

    Bunning, Karen; Gona, Joseph K.; Buell, Susan; Newton, Charles R.; Hartley, Sally

    2013-01-01

    Background: Rehabilitation services are scarce in low-income countries, where under-representation of some specialist professions has led to the role extension of others. An example of this can be found in Kilifi in Kenya where the role of speech and language therapy has been taken on by occupational therapists and teachers. Aims: To investigate…

  19. 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.

  20. Respiratory syncytial virus epidemiology in a birth cohort from Kilifi district, Kenya: infection during the first year of life.

    PubMed

    Nokes, D James; Okiro, Emelda A; Ngama, Mwanajuma; White, Lisa J; Ochola, Rachel; Scott, Paul D; Cane, Patricia A; Medley, Graham F

    2004-11-15

    We report estimates of incidence of respiratory syncytial virus (RSV) infection during the first year of life for a birth cohort from rural, coastal Kenya. A total of 338 recruits born between 21 January 2002 and 30 May 2002 were monitored for symptoms of respiratory infection by home visits and hospital referrals. Nasal washings were screened by use of immunofluorescence. From 311 child-years of observation (cyo), 133 RSV infections were found, of which 48 were lower respiratory tract infections (LRTIs) and 31 were severe LRTIs, resulting in 4 hospital admissions. There were 121 primary RSV infections (248 cyo), of which 45 were LRTIs and 30 were severe LRTIs, resulting in 4 hospital admissions; there was no association with age. RSV contributed significantly to total LRTI disease in this vaccine-target group.

  1. 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…

  2. 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

  3. 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…

  4. Use of cellular phone contacts to increase return rates for immunization services in Kenya

    PubMed Central

    Mokaya, Evans; Mugoya, Isaac; Raburu, Jane; Shimp, Lora

    2017-01-01

    Introduction In Kenya, failure to complete immunization schedules by children who previously accessed immunization services is an obstacle to ensuring that children are fully immunized. Home visit approaches used to track defaulting children have not been successful in reducing the drop-out rate. Methods This study tested the use of phone contacts as an approach for tracking immunization defaulters in twelve purposively-selected facilities in three districts of western Kenya. For nine months, children accessing immunization services in the facilities were tracked and caregivers were asked their reasons for defaulting. Results In all of the facilities, caregiver phone ownership was above 80%. In 11 of the 12 facilities, defaulter rates between pentavalent1 and pentavalent3 vaccination doses reduced significantly to within the acceptable level of < 10%. Caregivers provided reliable contact information and health workers positively perceived phone-based defaulter communications. Tracking a defaulter required on average 2 minutes by voice and Ksh 6 ($ 0.07). Competing tasks and concerns about vaccinating sick children and side-effects were the most cited reasons for caregivers defaulting. Notably, a significant number of children categorised as defaulters had been vaccinated in a different facility (and were therefore “false defaulters”). Conclusion Use of phone contacts for follow-up is a feasible and cost-effective method for tracking defaulters. This approach should complement traditional home visits, especially for caregivers without phones. Given communication-related reasons for defaulting, it is important that immunization programs scale-up community education activities. A system for health facilities to share details of defaulting children should be established to reduce “false defaulters”. PMID:29138660

  5. 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.

  6. 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.

  7. 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…

  8. 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.

  9. HIV prevention costs and their predictors: evidence from the ORPHEA Project in Kenya

    PubMed Central

    Galárraga, Omar; Wamai, Richard G; Sosa-Rubí, Sandra G; Mugo, Mercy G; Contreras-Loya, David; Bautista-Arredondo, Sergio; Nyakundi, Helen; Wang’ombe, Joseph K

    2017-01-01

    Abstract We estimate costs and their predictors for three HIV prevention interventions in Kenya: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT) and voluntary medical male circumcision (VMMC). As part of the ‘Optimizing the Response of Prevention: HIV Efficiency in Africa’ (ORPHEA) project, we collected retrospective data from government and non-governmental health facilities for 2011–12. We used multi-stage sampling to determine a sample of health facilities by type, ownership, size and interventions offered totalling 144 sites in 78 health facilities in 33 districts across Kenya. Data sources included key informants, registers and time-motion observation methods. Total costs of production were computed using both quantity and unit price of each input. Average cost was estimated by dividing total cost per intervention by number of clients accessing the intervention. Multivariate regression methods were used to analyse predictors of log-transformed average costs. Average costs were $7 and $79 per HTC and PMTCT client tested, respectively; and $66 per VMMC procedure. Results show evidence of economies of scale for PMTCT and VMMC: increasing the number of clients per year by 100% was associated with cost reductions of 50% for PMTCT, and 45% for VMMC. Task shifting was associated with reduced costs for both PMTCT (59%) and VMMC (54%). Costs in hospitals were higher for PMTCT (56%) in comparison to non-hospitals. Facilities that performed testing based on risk factors as opposed to universal screening had higher HTC average costs (79%). Lower VMMC costs were associated with availability of male reproductive health services (59%) and presence of community advisory board (52%). Aside from increasing production scale, HIV prevention costs may be contained by using task shifting, non-hospital sites, service integration and community supervision. PMID:29029086

  10. On-site comprehensive curriculum to teach reproductive health to female adolescents in Kenya.

    PubMed

    Gaughran, Margaret; Asgary, Ramin

    2014-04-01

    Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (p<0.001); general knowledge of teen pregnancy and STIs (57% ± 19% to 82% ± 13%) (p<0.001); and overall scores of knowledge, attitude, and self-efficacy (81% ± 6.6% to 90% ± 5%) (p<0.001). Focus group discussions, however, revealed persistent misconceptions and knowledge gaps with themes regarding HIV transmission risk factors, perceived difficulty negotiating condom use, masturbation and its perceived consequences, and issues surrounding female circumcision. Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.

  11. 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…

  12. Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya

    PubMed Central

    2012-01-01

    Background Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of febrile individuals first seek treatment for febrile illness over the counter from medicine retailers. Understanding medicine retailer knowledge and behaviour in treating suspected malaria and dispensing anti-malarials is crucial. Methods To investigate medicine retailer knowledge about anti-malarials and their dispensing practices, a survey was conducted of all retail drug outlets that sell anti-malarial medications and serve residents of the Webuye Health and Demographic Surveillance Site in the Bungoma East District of western Kenya. Results Most of the medicine retailers surveyed (65%) were able to identify artemether-lumefantrine (AL) as the Kenyan Ministry of Health recommended first-line anti-malarial therapy for uncomplicated malaria. Retailers who correctly identified this treatment were also more likely to recommend AL to adult and paediatric customers. However, the proportion of medicine retailers who recommend the correct treatment is disappointingly low. Only 48% would recommend AL to adults, and 37% would recommend it to children. It was discovered that customer demand has an influence on retailer behaviour. Retailer training and education were found to be correlated with anti-malarial drug knowledge, which in turn is correlated with dispensing practices. Medicine retailer behaviour, including patient referral practice and dispensing practices, are also correlated with knowledge of the first-line anti-malarial medication. The Kenya Ministry of Health guidelines were found to influence retailer drug stocking and dispensing behaviours. Conclusion Most medicine retailers could identify the recommended first-line treatment for uncomplicated malaria, but the percentage that could not is still too high

  13. 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

  14. Reducing Stock-Outs of Life Saving Malaria Commodities Using Mobile Phone Text-Messaging: SMS for Life Study in Kenya

    PubMed Central

    Githinji, Sophie; Kigen, Samwel; Memusi, Dorothy; Nyandigisi, Andrew; Mbithi, Agneta M.; Wamari, Andrew; Muturi, Alex N.; Jagoe, George; Barrington, Jim; Snow, Robert W.; Zurovac, Dejan

    2013-01-01

    Background Health facility stock-outs of life saving malaria medicines are common across Africa. Innovative ways of addressing this problem are urgently required. We evaluated whether SMS based reporting of stocks of artemether-lumefantrine (AL) and rapid diagnostic tests (RDT) can result in reduction of stock-outs at peripheral facilities in Kenya. Methods/Findings All 87 public health facilities in five Kenyan districts were included in a 26 week project. Weekly facility stock counts of four AL packs and RDTs were sent via structured incentivized SMS communication process from health workers’ personal mobile phones to a web-based system accessed by district managers. The mean health facility response rate was 97% with a mean formatting error rate of 3%. Accuracy of stock count reports was 79% while accuracy of stock-out reports was 93%. District managers accessed the system 1,037 times at an average of eight times per week. The system was accessed in 82% of the study weeks. Comparing weeks 1 and 26, stock-out of one or more AL packs declined by 38 percentage-points. Total AL stock-out declined by 5 percentage-points and was eliminated by the end of the project. Stock-out declines of individual AL packs ranged from 14 to 32 percentage-points while decline in RDT stock-outs was 24 percentage-points. District managers responded to 44% of AL and 73% of RDT stock-out signals by redistributing commodities between facilities. In comparison with national trends, stock-out declines in study areas were greater, sharper and more sustained. Conclusions Use of simple SMS technology ensured high reporting rates of reasonably accurate, real-time facility stock data that were used by district managers to undertake corrective actions to reduce stock-outs. Future work on stock monitoring via SMS should focus on assessing response rates without use of incentives and demonstrating effectiveness of such interventions on a larger scale. PMID:23349786

  15. 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

  16. 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.

  17. School District Mergers: What One District Learned

    ERIC Educational Resources Information Center

    Kingston, Kathleen

    2009-01-01

    Throughout the planning process for a school district merger in a northwestern Pennsylvania school district, effective communication proved to be a challenge. Formed in 1932, this school district of approximately 1400 students was part of a utopian community; one established by a transportation system's corporation that was a major industrial…

  18. Population pressure and human carrying capacity in selected locations of Machakos and Kitui districts.

    PubMed

    Bernard, F E; Thom, D J

    1981-04-01

    The nature and magnitude of population pressure in Machakos and Kitui Districts of Kenya were investigated. Specific study objectives were: 1) to examine the roots and evolution of the problem; 2) to compute carrying capacity for a sample of locations and ecozones in the 2 districts; and 3) to consider agricultural and demographic implications of the findings. Carrying capacity is defined as the number of people and the level of their activities which a region is able to sustain in perpetuity at an acceptable quality of life and without land deterioration. A methodology for calculating human carrying capacity utilizing crude soil, ecological, crop yield, and land use data for 41 locations in Machakos and Kitui Districts is demonstrated. Analysis and a comparison of population carrying capacities within the study area reveals that Machakos has reached a critical level of population pressure. To the north in Mbere and eastward in Kitui there are areas that are not currently experiencing population pressure, but it is likely that as the pressure in western Machakos becomes more acute, movement into these adjacent lands of relatively sparse settlement will increase. Signs of environmental stress resulting from overpopulation are evident throughout Machakos. The methodology used for estimating population pressure provided reasonably accurate carrying capacity estimates, but the methodology could be refined. Vigorous efforts to rejuvenate the land through soil and water conservation have been undertaken, but these have been insufficient and must be increased. Such efforts will fail unless the basic problem of population pressure in the marginal lands is resolved.

  19. 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...

  20. 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

  1. Birthweight in Offspring of Mothers with High Prevalence of Helminth and Malaria Infection in Coastal Kenya

    PubMed Central

    Fairley, Jessica K.; Bisanzio, Donal; King, Charles H.; Kitron, Uriel; Mungai, Peter; Muchiri, Eric; King, Christopher L.; Malhotra, Indu

    2013-01-01

    Results of studies on the associations of maternal helminth infection and malaria-helminth co-infection on birth outcomes have been mixed. A group of 696 pregnant women from the Kwale district in Kenya were recruited and tested for malaria and helminth infection at delivery. Birthweight was documented for 664 infants. A total of 42.7% of the mothers were infected with Plasmodium falciparum, 30.6% with Schistosoma haematobium, 36.2% with filariasis, 31.5% with hookworm, and 5.9% with Trichuris trichiura; co-infection was present in 46.7%. Low birthweight (LBW) (weight < 2,500 grams) was present in 15.4% of the offspring, and 8.3% had a weight z-score ≤ 2 SD below the World Health Organization mean. Only gravida, age, and locale had a significant association with LBW. The high prevalence of maternal infection coupled with a higher than expected percentage of LBW highlight a need for further investigation of the association of maternal co-infection with LBW. PMID:23166193

  2. 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.

  3. Traffic Impacts on PM2.5 Air Quality in Nairobi, Kenya

    PubMed Central

    Kinney, Patrick L.; Gichuru, Michael Gatari; Volavka-Close, Nicole; Ngo, Nicole; Ndiba, Peter K.; Law, Anna; Gachanja, Anthony; Gaita, Samuel Mwaniki; Chillrud, Steven N.; Sclar, Elliott

    2011-01-01

    Motor vehicle traffic is an important source of particulate pollution in cities of the developing world, where rapid growth, coupled with a lack of effective transport and land use planning, may result in harmful levels of fine particles (PM2.5) in the air. However, a lack of air monitoring data hinders health impact assessments and the development of transportation and land use policies that could reduce health burdens due to outdoor air pollution. To address this important need, a study of traffic-related PM2.5 was carried out in the city of Nairobi, Kenya, a model city for sub-Saharan Africa, in July 2009. Sampling was carried out using portable filter-based air samplers carried in backpacks by technicians on weekdays over two weeks at several sites in and around Nairobi ranging from high-traffic roadways to rural background. Mean daytime concentrations of PM2.5 ranged from 10.7 at the rural background site to 98.1 μg/m3 on a sidewalk in the central business district. Horizontal dispersion measurements demonstrated a decrease in PM2.5 concentration from 128.7 to 18.7 μg/m3 over 100 meters downwind of a major intersection in Nairobi. A vertical dispersion experiment revealed a decrease from 119.5 μg/m3 at street level to 42.8 μg/m3 on a third-floor rooftop in the central business district. Though not directly comparable to air quality guidelines, which are based on 24-hour or annual averages, the urban concentrations we observed raise concern with regard to public health and related policy. Taken together with survey data on commuting patterns within Nairobi, these results suggest that many Nairobi residents are exposed on a regular basis to elevated concentrations of fine particle air pollution, with potentially serious long-term implications for health. PMID:21779151

  4. 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/.

  5. 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…

  6. 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…

  7. 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

  8. Effectiveness of Teacher Advisory Centre Tutors in Curriculum Implementation in Public Secondary Schools: Case of Chepalungu District, Kenya

    ERIC Educational Resources Information Center

    Kosgey, Milgo Joyce Chelangat

    2011-01-01

    The purpose of this study was to investigate the effectiveness of Teacher Advisory Center (TAC) tutors in curriculum implementation of secondary schools in Chepalungu District. The study aimed at determining ways in which TAC tutors, participate in implementation of secondary school curriculum and to establish whether teachers in secondary schools…

  9. 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.

  10. Habitat stability and occurrences of malaria vector larvae in western Kenya highlands.

    PubMed

    Himeidan, Yousif E; Zhou, Guofa; Yakob, Laith; Afrane, Yaw; Munga, Stephen; Atieli, Harrysone; El-Rayah, El-Amin; Githeko, Andrew K; Yan, Guiyun

    2009-10-21

    Although the occurrence of malaria vector larvae in the valleys of western Kenya highlands is well documented, knowledge of larval habitats in the uphill sites is lacking. Given that most inhabitants of the highlands actually dwell in the uphill regions, it is important to develop understanding of mosquito breeding habitat stability in these sites in order to determine their potential for larval control. A total of 128 potential larval habitats were identified in hilltops and along the seasonal streams in the Sigalagala area of Kakamega district, western Kenya. Water availability in the habitats was followed up daily from August 3, 2006 to February 23, 2007. A habitat is defined as stable when it remains aquatic continuously for at least 12 d. Mosquito larvae were observed weekly. Frequencies of aquatic, stable and larvae positive habitats were compared between the hilltop and seasonal stream area using chi2-test. Factors affecting the presence/absence of Anopheles gambiae larvae in the highlands were determined using multiple logistic regression analysis. Topography significantly affected habitat availability and stability. The occurrence of aquatic habitats in the hilltop was more sporadic than in the stream area. The percentage of habitat occurrences that were classified as stable during the rainy season is 48.76% and 80.79% respectively for the hilltop and stream area. Corresponding frequencies of larvae positive habitats were 0% in the hilltop and 5.91% in the stream area. After the rainy season, only 23.42% of habitat occurrences were stable and 0.01% larvae positive habitats were found in the hilltops, whereas 89.75% of occurrences remained stable in the stream area resulting in a frequency of 12.21% larvae positive habitats. The logistic regression analysis confirmed the association between habitat stability and larval occurrence and indicated that habitat surface area was negatively affecting the occurrence of An. gambiae larvae. While An. gambiae and An

  11. 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.

  12. 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.

  13. 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…

  14. Implementation of repeat HIV testing during pregnancy in southwestern Kenya: progress and missed opportunities.

    PubMed

    Rogers, Anna J; Akama, Eliud; Weke, Elly; Blackburn, Justin; Owino, George; Bukusi, Elizabeth A; Oyaro, Patrick; Kwena, Zachary A; Cohen, Craig R; Turan, Janet M

    2017-12-01

    Repeat HIV testing during the late antenatal period is crucial to identify and initiate treatment for pregnant women with incident HIV infection to prevent perinatal HIV transmission and keep mothers alive. In 2012, the Kenya Ministry of Health adopted international guidelines suggesting that pregnant women be offered retesting three months after an initial negative HIV test. Our objectives were to determine the current rate of antenatal repeat HIV testing; identify successes, missed opportunities and factors associated with retesting; and estimate the incidence of HIV during pregnancy. Retrospective analysis of longitudinal data was conducted for a cohort of 2145 women attending antenatal care clinic at a large district hospital in southwestern Kenya. Data were abstracted from registers for all women who attended the clinic from the years 2011 to 2014. Although 90.2% of women first came to clinic prior to their third trimester and 27.5% had at least four clinic visits, 58.0% of all women went to delivery without a retest. Missed opportunities for retesting included not returning to clinic at all, not returning when eligible, or late gestational age (>28 weeks) at first clinic visit making them ineligible for retesting (accounting for 14.2%, 26.8% and 9.6% of all clinic attendees respectively); and failure to be retested even when eligible at one or more visits (accounting for 73.2% of eligible returnees). Being unmarried and aged 20 or younger was associated with an increase in mean gestational age of first visit by 2.52 weeks (95% CI: 1.56, 3.48) and a 2.59 increased odds (95% CI: 1.90, 3.54) of failing to return to clinic, compared to those who were married and over 20 years of age. On retest, two women tested HIV positive, suggesting an incidence rate of 4.4 per 100 person-years. After adjusting for potential confounders, only later year of last menstrual period (2013 vs. 2012 and 2011) was associated with retesting. Adoption of retesting guidelines in 2012

  15. 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…

  16. 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

  17. 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.

  18. 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

  19. Development of a comprehensive and sustainable gynecologic oncology training program in western Kenya, a low resource setting.

    PubMed

    Rosen, Barry; Itsura, Peter; Tonui, Philip; Covens, Alan; van Lonkhuijzen, Luc; Orang'o, Elkanah Omenge

    2017-08-01

    To provide information on the development of a gynecologic oncology training program in a low-resource setting in Kenya. This is a review of a collaboration between Kenyan and North American physicians who worked together to develop a gynecologic oncology training in Kenya. We review the published data on the increase of cancer incidence in sub-Saharan Africa and outline the steps that were taken to develop this program. The incidence of cervical cancer in Kenya is very high and is the leading cause of cancer mortality in Kenya. WHO identifies cancer as a new epidemic affecting countries in sub-Saharan Africa. In Kenya, a country of 45 million, there is limited resources to diagnose and treat cancer. In 2009 in western Kenya, at Moi University there was no strategy to manage oncology in the Reproductive Health department. There was only 1 gynecologic oncologists in Kenya in 2009. A collaboration between Canadian and Kenya physicians resulted in development of a gynecologic oncology clinical program and initiation of fellowship training in Kenya. In the past 4 years, five fellows have graduated from a 2 year fellowship training program. Integration of data collection on all the patients as part of this program provided opportunities to do clinical research and to acquire peer reviewed grants. This is the first recognized fellowship training program in sub-Saharan Africa outside of South Africa. It is an example of a collaborative effort to improve women's health in a low-resource country. This is a Kenyan managed program through Moi University. These subspecialty trained doctors will also provide advice that will shape health care policy and provide sustainable expertise for women diagnosed with a gynecologic cancer.

  20. 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

  1. Job preferences among clinical officers in public sector facilities in rural Kenya: a discrete choice experiment.

    PubMed

    Takemura, Toshio; Kielmann, Karina; Blaauw, Duane

    2016-01-08

    Clinical officers (COs), a mid-level cadre of health worker, are the backbone of healthcare provision in rural Kenya. However, the vacancy rate for COs in rural primary healthcare facilities is high. Little is known about factors motivating COs' preferences for rural postings. A discrete choice experiment (DCE) questionnaire was used with 57 COs at public health facilities in nine districts of Nyanza Province, Kenya. The questionnaire was developed on the basis of formative qualitative interviews with COs (n = 5) and examined how five selected job attributes influenced COs' preferences for working in rural areas. Conditional logit models were employed to examine the relative importance of different job attributes. Analysis of the qualitative data revealed five important job attributes influencing COs' preferences: quality of the facility, educational opportunities, housing, monthly salary and promotion. Analysis of the DCE indicated that a 1-year guaranteed study leave after 3 years of service would have the greatest impact on retention, followed by good quality health facility infrastructure and equipment and a 30% salary increase. Sub-group analysis shows that younger COs demonstrated a significantly stronger preference for study leave than older COs. Female COs placed significantly higher value on promotion than male COs. Although both financial incentives and non-financial incentives were effective in motivating COs to stay in post, the study leave intervention was shown to have the strongest impact on COs' retention in our study. Further research is required to examine appropriate interventions at each career stage that might boost COs' professional identity and status but without leading to larger deficits in the availability of generalist COs.

  2. Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya.

    PubMed

    Chuma, Jane; Okungu, Vincent; Ntwiga, Janet; Molyneux, Catherine

    2010-03-16

    Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs) in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households), 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Significant resources have been directed towards addressing affordability

  3. Increased fairness in priority setting processes within the health sector: the case of Kapiri-Mposhi District, Zambia

    PubMed Central

    2014-01-01

    Background The challenge of priority setting (PS) in health care within contexts of severe resource limitations has continued to receive attention. Accountability for Reasonableness (AFR) has emerged as a useful framework to guide the implementation of PS processes. In 2006, the AFR approach to enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled ‘Response to Accountable priority setting for Trust in health systems’ (REACT). The project aimed to strengthen fairness and accountability in the PS processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district level in Kapiri-Mposhi District in Zambia. Methods Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district administration, in non-governmental organizations (NGO) and in health facilities. Results During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing in the study district, which was partly attributed to the AFR based intervention. Conclusions The study findings suggest that increased attention was given to fairness in PS processes at

  4. Increased fairness in priority setting processes within the health sector: the case of Kapiri-Mposhi District, Zambia.

    PubMed

    Zulu, Joseph M; Michelo, Charles; Msoni, Carol; Hurtig, Anna-Karin; Byskov, Jens; Blystad, Astrid

    2014-02-18

    The challenge of priority setting (PS) in health care within contexts of severe resource limitations has continued to receive attention. Accountability for Reasonableness (AFR) has emerged as a useful framework to guide the implementation of PS processes. In 2006, the AFR approach to enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled 'Response to Accountable priority setting for Trust in health systems' (REACT). The project aimed to strengthen fairness and accountability in the PS processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district level in Kapiri-Mposhi District in Zambia. Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district administration, in non-governmental organizations (NGO) and in health facilities. During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing in the study district, which was partly attributed to the AFR based intervention. The study findings suggest that increased attention was given to fairness in PS processes at district level. The changes were linked to a

  5. 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.

  6. 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…

  7. 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.

  8. An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

    PubMed Central

    2010-01-01

    Background Most of the global neonatal deaths occur in developing nations, mostly in rural homes. Many of the newborns who receive formal medical care are treated in rural district hospitals and other peripheral health centres. However there are no published studies demonstrating trends in neonatal admissions and outcome in rural health care facilities in resource poor regions. Such information is critical in planning public health interventions. In this study we therefore aimed at describing the pattern of neonatal admissions to a Kenyan rural district hospital and their outcome over a 19 year period, examining clinical indicators of inpatient neonatal mortality and also trends in utilization of a rural hospital for deliveries. Methods Prospectively collected data on neonates is compared to non-neonatal paediatric (≤ 5 years old) admissions and deliveries' in the maternity unit at Kilifi District Hospital from January 1st 1990 up to December 31st 2008, to document the pattern of neonatal admissions, deliveries and changes in inpatient deaths. Trends were examined using time series models with likelihood ratios utilised to identify indicators of inpatient neonatal death. Results The proportion of neonatal admissions of the total paediatric ≤ 5 years admissions significantly increased from 11% in 1990 to 20% by 2008 (trend 0.83 (95% confidence interval 0.45 -1.21). Most of the increase in burden was from neonates born in hospital and very young neonates aged < 7days. Hospital deliveries also increased significantly. Clinical diagnoses of neonatal sepsis, prematurity, neonatal jaundice, neonatal encephalopathy, tetanus and neonatal meningitis accounted for over 75% of the inpatient neonatal admissions. Inpatient case fatality for all ≤ 5 years declined significantly over the 19 years. However, neonatal deaths comprised 33% of all inpatient death among children aged ≤ 5 years in 1990, this increased to 55% by 2008. Tetanus 256/390 (67%), prematurity 554

  9. Monitoring and evaluating the impact of national school-based deworming in Kenya: study design and baseline results.

    PubMed

    Mwandawiro, Charles S; Nikolay, Birgit; Kihara, Jimmy H; Ozier, Owen; Mukoko, Dunstan A; Mwanje, Mariam T; Hakobyan, Anna; Pullan, Rachel L; Brooker, Simon J; Njenga, Sammy M

    2013-07-05

    An increasing number of countries in Africa and elsewhere are developing national plans for the control of neglected tropical diseases. A key component of such plans is school-based deworming (SBD) for the control of soil-transmitted helminths (STHs) and schistosomiasis. Monitoring and evaluation (M&E) of national programmes is essential to ensure they are achieving their stated aims and to evaluate when to reduce the frequency of treatment or when to halt it altogether. The article describes the M&E design of the Kenya national SBD programme and presents results from the baseline survey conducted in early 2012. The M&E design involves a stratified series of pre- and post-intervention, repeat cross-sectional surveys in a representative sample of 200 schools (over 20,000 children) across Kenya. Schools were sampled based on previous knowledge of STH endemicity and were proportional to population size. Stool (and where relevant urine) samples were obtained for microscopic examination and in a subset of schools; finger-prick blood samples were collected to estimate haemoglobin concentration. Descriptive and spatial analyses were conducted. The evaluation measured both prevalence and intensity of infection. Overall, 32.4% of children were infected with at least one STH species, with Ascaris lumbricoides as the most common species detected. The overall prevalence of Schistosoma mansoni was 2.1%, while in the Coast Province the prevalence of S. haematobium was 14.8%. There was marked geographical variation in the prevalence of species infection at school, district and province levels. The prevalence of hookworm infection was highest in Western Province (25.1%), while A. lumbricoides and T. trichiura prevalence was highest in the Rift Valley (27.1% and 11.9%). The lowest prevalence was observed in the Rift Valley for hookworm (3.5%), in the Coast for A. lumbricoides (1.0%), and in Nyanza for T. trichiura (3.6%). The prevalence of S. mansoni was most common in Western

  10. 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…

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Boundaries: The Community Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING STANDARDS...

  17. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Boundaries: The Community Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING STANDARDS...

  18. 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…

  19. 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.

  20. 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.

  1. 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…

  2. 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.

  3. 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

  4. Contextual influences on health worker motivation in district hospitals in Kenya

    PubMed Central

    Mbindyo, Patrick; Gilson, Lucy; Blaauw, Duane; English, Mike

    2009-01-01

    Background Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a factor that may modify the effect of an intervention aimed at changing clinical practices in Kenyan hospitals. Methods Franco LM, et al's (Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002, 54: 1255–66) model of motivational influences was used to frame the study Qualitative methods including individual in-depth interviews, small-group interviews and focus group discussions were used to gather data from 185 health workers during one-week visits to each of eight district hospitals. Data were collected prior to a planned intervention aiming to implement new practice guidelines and improve quality of care. Additionally, on-site observations of routine health worker behaviour in the study sites were used to inform analyses. Results Study settings are likely to have important influences on worker motivation. Effective management at hospital level may create an enabling working environment modifying the impact of resource shortfalls. Supportive leadership may foster good working relationships between cadres, improve motivation through provision of local incentives and appropriately handle workers' expectations in terms of promotions, performance appraisal processes, and good communication. Such organisational attributes may counteract de-motivating factors at a national level, such as poor schemes of service, and enhance personally motivating factors such as the desire to maintain professional standards. Conclusion Motivation is likely to influence powerfully any attempts to change or improve health worker and hospital practices. Some factors influencing motivation may themselves be influenced by

  5. 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…

  6. 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.

  7. 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.

  8. 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.

  9. 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…

  10. 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.

  11. 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

  12. Kenya's health workforce information system: a model of impact on strategic human resources policy, planning and management.

    PubMed

    Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L

    2013-09-01

    Countries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. Sources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. Interviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning

  13. 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.…

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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…

  1. 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…

  2. 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

  3. Cost analysis of immunisation against east coast fever on smallholder dairy farms in Kenya.

    PubMed

    Muraguri, G R; Mbogo, S K; McHardy, N; Kariuki, D P

    1998-03-27

    A spreadsheet model was developed and used to estimate the total cost of immunising cattle against East Coast fever (ECF) based on the infection-and-treatment method. Using data from an immunisation trial carried out on 102 calves and yearlings on 64 farms in the Githunguri division, Kiambu district, Kenya, a reference base scenario of a mean herd of five animals, a 10% rate of reaction to immunisation and a 2-day interval monitoring regimen (a total of 10 farm visits) was simulated. Under these conditions, the mean cost of immunisation per animal was US$16.48 (Ksh 955.78); this was equivalent to US$82.39 (Ksh 4778.90) per five-animal farm. A commonly reported reactor rate of 3% would decrease the cost of US$14.63 (Ksh 848.29) per animal. Reducing the number of farm monitoring visits from 10 to 7 would reduce the total cost by 10%, justified if farmers are trained to undertake some of the monitoring work. The fixed costs were 53% of the total cost of immunisation per farm. The cost of immunisation decreased with increasing number of animals per farm, showing economies of scale.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. Ethnoknowledge of Bukusu community on livestock tick prevention and control in Bungoma district, western Kenya.

    PubMed

    Wanzala, Wycliffe; Takken, Willem; Mukabana, Wolfgang R; Pala, Achola O; Hassanali, Ahmed

    2012-03-27

    To date, nomadic communities in Africa have been the primary focus of ethnoveterinary research. The Bukusu of western Kenya have an interesting history, with nomadic lifestyle in the past before settling down to either arable or mixed arable/pastoral farming systems. Their collective and accumulative ethnoveterinary knowledge is likely to be just as rich and worth documenting. The aim of the present study was to document indigenous knowledge of the Bukusu on the effect of livestock ticks and ethnopractices associated with their management. It was envisaged that this would provide a basis for further research on the efficacy of these practices that could also lead to the discovery of useful tick-control agents. Non-alienating, dialogic, participatory action research (PAR) and participatory rural appraisal (PRA) approaches involving 272 women and men aged between 18 and 118 years from the Bukusu community were used. Ticks are traditionally classified and identified by colour, size, host range, on-host feeding sites, and habitat preference. Tick-associated problems recognised include kamabumba (local reference to East Coast fever, Anaplasmosis or Heartwater diseases transmitted by different species of livestock ticks) and general poor performance of livestock. Traditional methods of controlling ticks include handpicking, on-host use of ethnobotanical suspensions (prepared from one or more of over 150 documented plants) to kill the ticks and prevent re-infestation, fumigation of infested cattle with smoke derived from burning ethnobotanical products, burning pastures, rotational grazing ethnopractices, and livestock quarantine. The study confirms that the Bukusu have preserved rich ethnoveterinary knowledge and practices. It provides some groundwork for elucidating the efficacy of some of these ethnopractices in protecting livestock from tick disease vectors, particularly those involving the use of ethnobotanicals, which may lead to the discovery of useful ant

  10. 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.

  11. 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…

  12. 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…

  13. Constraints to cattle production in a semiarid pastoral system in Kenya.

    PubMed

    Onono, Joshua Orungo; Wieland, Barbara; Rushton, Jonathan

    2013-08-01

    Livestock keeping is the mainstay for the pastoral community while also providing social and cultural value. This study ranked main production constraints and cattle diseases that impacted livelihood and estimated herd prevalence, incidence rate, and impact of diseases on production parameters in a semiarid pastoral district of Narok in Kenya. Data collection employed participatory techniques including listing, pairwise ranking, disease incidence scoring, proportional piling, and disease impact matrix scoring and this was disaggregated by gender. Production constraints with high scores for impact on livelihood included scarcity of water (19%), lack of extension services (15%), presence of diseases (12%), lack of market for cattle and their products (10%), and recurrent cycle of drought (9%). Diseases with high scores for impact on livelihood were East Coast fever (ECF) (22%) and foot and mouth disease (FMD) (21%). High estimated incidence rates were reported for FMD (67%), trypanosomosis (28%), and ECF (15%), while contagious bovine pleuropneumonia (CBPP) had an incidence rate <1%. Milk yield was affected by FMD, ECF, and trypanosomosis, while ECF was the cause of increased mortality. FMD, ECF, CBPP, and brucellosis caused increased abortion, while effect of gender and location of study was not significant. Despite CBPP being regarded as an important disease affecting cattle production in sub-Sahara Africa, its estimated incidence rate in herds was low. This study indicates what issues should be prioritized by livestock policy for pastoral areas.

  14. Why do community health workers volunteer? A qualitative study in Kenya.

    PubMed

    Takasugi, T; Lee, A C K

    2012-10-01

    Globally, there is a dire shortage of healthcare workers, but the situation is particularly bad in low- and middle-income countries. To address this, task shifting of clinical work to lower-level staff, including volunteer health workers, has been used. Whilst there are examples worldwide of such an approach working, the sustainability of programmes based on a volunteer workforce is less certain. In addition, little is known about the factors that motivate such volunteers. This study sought to ascertain these motivational drivers. Qualitative study using focus group discussions. Qualitative study of volunteer community health workers (CHWs) in a rural district of Western Kenya. Twenty-three CHWs were sampled purposively, and took part in six focus group discussions. Thematic analysis was performed on the transcribed discussions. A variety of factors were identified as important drivers of motivation. These included financial as well as non-financial drivers, such as personal recognition, personal development and working conditions. There are serious unanswered questions regarding the viability of healthcare programmes founded on a workforce reliant on volunteer CHWs. This study revealed the importance of some form of reward, be it financial or otherwise, in order to retain and maintain the engagement and motivation of volunteer CHWs in these settings. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. 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.

  16. Spatial Modelling of Soil-Transmitted Helminth Infections in Kenya: A Disease Control Planning Tool

    PubMed Central

    Pullan, Rachel L.; Gething, Peter W.; Smith, Jennifer L.; Mwandawiro, Charles S.; Sturrock, Hugh J. W.; Gitonga, Caroline W.; Hay, Simon I.; Brooker, Simon

    2011-01-01

    Background Implementation of control of parasitic diseases requires accurate, contemporary maps that provide intervention recommendations at policy-relevant spatial scales. To guide control of soil transmitted helminths (STHs), maps are required of the combined prevalence of infection, indicating where this prevalence exceeds an intervention threshold of 20%. Here we present a new approach for mapping the observed prevalence of STHs, using the example of Kenya in 2009. Methods and Findings Observed prevalence data for hookworm, Ascaris lumbricoides and Trichuris trichiura were assembled for 106,370 individuals from 945 cross-sectional surveys undertaken between 1974 and 2009. Ecological and climatic covariates were extracted from high-resolution satellite data and matched to survey locations. Bayesian space-time geostatistical models were developed for each species, and were used to interpolate the probability that infection prevalence exceeded the 20% threshold across the country for both 1989 and 2009. Maps for each species were integrated to estimate combined STH prevalence using the law of total probability and incorporating a correction factor to adjust for associations between species. Population census data were combined with risk models and projected to estimate the population at risk and requiring treatment in 2009. In most areas for 2009, there was high certainty that endemicity was below the 20% threshold, with areas of endemicity ≥20% located around the shores of Lake Victoria and on the coast. Comparison of the predicted distributions for 1989 and 2009 show how observed STH prevalence has gradually decreased over time. The model estimated that a total of 2.8 million school-age children live in districts which warrant mass treatment. Conclusions Bayesian space-time geostatistical models can be used to reliably estimate the combined observed prevalence of STH and suggest that a quarter of Kenya's school-aged children live in areas of high prevalence

  17. The KRISP 90 seismic experiment-a technical review

    USGS Publications Warehouse

    Prodehl, C.; Mechie, J.; Achauer, U.; Keller, Gordon R.; Khan, M.A.; Mooney, W.D.; Gaciri, S.J.; Obel, J.D.

    1994-01-01

    On the basis of a preliminary experiment in 1985 (KRISP 85), a seismic refraction/wide-angle reflection survey and a teleseismic tomography experiment were jointly undertaken to study the lithospheric structure of the Kenya rift down to depths of greater than 200 km. This report serves as an introduction to a series of subsequent papers and will focus on the technical description of the seismic surveys of the main KRISP 90 effort. The seismic refraction/wide-angle reflection survey was carried out in a 4-week period in January and February 1990. It consisted of three profiles: one extending along the rift valley from Lake Turkana to Lake Magadi, one crossing the rift at Lake Baringo, and one located on the eastern flank of the rift proper. A total of 206 mobile vertical-component seismographs, with an average station interval of about 2 km, recorded the energy of underwater and borehole explosions to distances of up to about 550 km. During the teleseismic survey an array of 65 seismographs was deployed to record teleseismic, regional and local events for a period of about 7 months from October 1989 to April 1990. The elliptical array spanned the central portion of the rift, with Nakuru at its center, and covered an area about 300 ?? 200 km, with an average station spacing of 10-30 km. Major scientific goals of the project were to reveal the detailed crustal and upper-mantle structure under the Kenya rift, to study the relationship between deep crustal and mantle structure and the development of sedimentary basins and volcanic features within the rift, to understand the role of the Kenya rift within the Afro-Arabian rift system, and to answer fundamental questions such as the mode and mechanism of continental rifting. ?? 1994.

  18. 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.

  19. 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.

  20. 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…

  1. 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…

  2. 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…

  3. 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

  4. 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…

  5. 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…

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Spatial-temporal analysis of the of the risk of Rift Valley Fever in Kenya

    NASA Astrophysics Data System (ADS)

    Bett, B.; Omolo, A.; Hansen, F.; Notenbaert, A.; Kemp, S.

    2012-04-01

    Historical data on Rift Valley Fever (RVF) outbreaks in Kenya covering the period 1951 - 2010 were analyzed using a logistic regression model to identify factors associated with RVF occurrence. The analysis used a division, an administrative unit below a district, as the unit of analysis. The infection status of each division was defined on a monthly time scale and used as a dependent variable. Predictors investigated include: monthly precipitation (minimum, maximum and total), normalized difference vegetation index, altitude, agro-ecological zone, presence of game, livestock and human population densities, the number of times a division has had an outbreak before and time interval in months between successive outbreaks (used as a proxy for immunity). Both univariable and multivariable analyses were conducted. The models used incorporated an auto-regressive correlation matrix to account for clustering of observations in time, while dummy variables were fitted in the multivariable model to account for spatial relatedness/topology between divisions. This last procedure was followed because it is expected that the risk of RVF occurring in a given division increases when its immediate neighbor gets infected. Functional relationships between the continuous and the outcome variables were assessed to ensure that the linearity assumption was met. Deviance and leverage residuals were also generated from the final model and used for evaluating the goodness of fit of the model. Descriptive analyzes indicate that a total of 91 divisions in 42 districts (of the original 69 districts in place by 1999) reported RVF outbreaks at least once over the period. The mean interval between outbreaks was determined to be about 43 months. Factors that were positively associated with RVF occurrence include increased precipitation, high outbreak interval and the number of times a division has been infected or reported an outbreak. The model will be validated and used for developing an RVF

  11. 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

  12. Use of Rapid Diagnostic Tests in Malaria School Surveys in Kenya: Does their Under-performance Matter for Planning Malaria Control?

    PubMed Central

    Gitonga, Caroline W.; Kihara, Jimmy H.; Njenga, Sammy M.; Awuondo, Ken; Noor, Abdisalan M.; Snow, Robert W.; Brooker, Simon J.

    2012-01-01

    Malaria rapid diagnostic tests (RDTs) are known to yield false-positive results, and their use in epidemiologic surveys will overestimate infection prevalence and potentially hinder efficient targeting of interventions. To examine the consequences of using RDTs in school surveys, we compared three RDT brands used during a nationwide school survey in Kenya with expert microscopy and investigated the cost implications of using alternative diagnostic approaches in identifying localities with differing levels of infection. Overall, RDT sensitivity was 96.1% and specificity was 70.8%. In terms of classifying districts and schools according to prevalence categories, RDTs were most reliable for the < 1% and > 40% categories and least reliable in the 1–4.9% category. In low-prevalence settings, microscopy was the most expensive approach, and RDT results corrected by either microscopy or polymerase chain reaction were the cheapest. Use of polymerase chain reaction–corrected RDT results is recommended in school malaria surveys, especially in settings with low-to-moderate malaria transmission. PMID:23091194

  13. 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.

  14. 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...

  15. 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.

  16. Factors influencing uptake of contraceptive implants in the immediate postpartum period among HIV infected and uninfected women at two Kenyan District Hospitals.

    PubMed

    Shabiby, Mufida M; Karanja, Joseph G; Odawa, Francis; Kosgei, Rose; Kibore, Minnie W; Kiarie, James N; Kinuthia, John

    2015-08-19

    Family planning is a cost effective strategy for prevention of mother to child transmission of HIV and reduction of maternal/infant morbidity and mortality. Contraceptive implants are a safe, effective, long term and reversible family planning method whose use remains low in Kenya. We therefore set out to determine and compare the uptake, and factors influencing uptake of immediate postpartum contraceptive implants among HIV infected and uninfected women at two hospitals in Kenya. This cross sectional study targeted postpartum mothers at two Kenyan district hospitals (one urban and one rural). All participants received general family planning and method specific (Implant) counseling followed by immediate insertion of contraceptive implants to those who consented. The data was analyzed by descriptive analysis, T-test, Chi square tests and logistic regression. One hundred eighty-five participants were enrolled (91 HIV positive and 94 HIV negative) with a mean age of 26 years. HIV positive mothers were significantly older (27.5 years) than their HIV negative counterparts (24.5 years), P = 0.001. The two groups were comparable in education, employment, marital status and religious affiliation. Overall, the uptake of contraceptive implants in the immediate postpartum period was 50.3% and higher among HIV negative than HIV positive participants (57% vs. 43%, P = 0.046). Multivariate analysis revealed that a negative HIV status (P = 0.017) and prior knowledge of contraceptive implants (P = 0.001) were independently associated with increased uptake of contraceptive implants. There was a high uptake of immediate postpartum contraceptive implants among both HIV infected and un-infected women; efforts therefore need to be made in promoting this method of family planning in Kenya and providing this method to women in the immediate postpartum period so as to utilize this critical opportunity to increase uptake and reduce the high unmet need for family planning.

  17. 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

  18. 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…

  19. 77 FR 63326 - Huron Wetland Management District, Madison Wetland Management District, and Sand Lake Wetland...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ... FXRS1265066CCP0] Huron Wetland Management District, Madison Wetland Management District, and Sand Lake Wetland... assessment (EA) involving Huron, Madison, and Sand Lake Wetland Management Districts (Districts). In this..., Madison Wetland Management District, Sand Lake Wetland Management District final CCP'' in the subject line...

  20. 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.

  1. 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

    This study aims to assess inequity in expenditure on sexual and reproductive health (SRH) services in India and Kenya. In addition, this analysis aims to measure the extent to which payments are catastrophic and to explore coping mechanisms used to finance health spending. Data for this study were collected as a part of the situational analysis for the "Diagonal Interventions to Fast Forward Enhanced Reproductive Health" (DIFFER) project, a multi-country project with fieldwork sites in three African sites; Mombasa (Kenya), Durban (South Africa) and Tete (Mozambique), and Mysore in India. Information on access to SRH services, the direct costs of seeking care and a range of socio-economic variables were obtained through structured exit interviews with female SRH service users in Mysore (India) and Mombasa (Kenya) (n = 250). The costs of seeking care were analysed by household income quintile (as a measure of socio-economic status). The Kakwani index and quintile ratios are used as measures of inequitable spending. Catastrophic spending on SRH services was calculated using the threshold of 10% of total household income. The results showed that spending on SRH services was highly regressive in both sites, with lower income households spending a higher percentage of their income on seeking care, compared to households with a higher income. Spending on SRH as a percentage of household income ranged from 0.02 to 6.2% and 0.03-7.5% in India and Kenya, respectively. There was a statistically significant difference in the proportion of spending on SRH services across income quintiles in both settings. In India, the poorest households spent two times, and in Kenya ten times, more on seeking care than the least poor households. The most common coping mechanisms in India and Kenya were "receiving [money] from partner or household members" (69%) and "using own savings or regular income" (44%), respectively. Highly regressive spending on SRH services highlights the heavier

  2. 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

  3. 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…

  4. 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…

  5. 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.

  6. Data-Driven Districts.

    ERIC Educational Resources Information Center

    LaFee, Scott

    2002-01-01

    Describes the use of data-driven decision-making in four school districts: Plainfield Public Schools, Plainfield, New Jersey; Palo Alto Unified School District, Palo Alto, California; Francis Howell School District in eastern Missouri, northwest of St. Louis; and Rio Rancho Public Schools, near Albuquerque, New Mexico. Includes interviews with the…

  7. 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…

  8. 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

  9. 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

  10. [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

  11. 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…

  12. Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study.

    PubMed

    Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

    2016-01-01

    In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake.

  13. Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study

    PubMed Central

    Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

    2016-01-01

    Introduction In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. Methods This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. Results The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Results Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake. PMID:27279952

  14. 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.

  15. 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…

  16. 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…

  17. 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.

  18. Power brokering, empowering, and educating: the role of home-based care professionals in the reduction of HIV-related stigma in Kenya.

    PubMed

    Waterman, Heather; Griffiths, Jane; Gellard, Len; O'Keefe, Catherine; Olang, Grace; Ayuyo, James; Obwanda, Elly; Ogwethe, Vitalis; Ondiege, Joshua

    2007-10-01

    In this article the authors report on how home-based care (HBC) professionals reduce stigmatizing behavior in Kenya. This study was part of an action research project that evaluated the introduction of HBC. HBC professionals coordinate the delivery of HIV/AIDS services at a district level and educate community-based health workers in HBC. Understanding how HBC professionals reduce stigma is crucial to reduce, prevent, and treat HIV/AIDS. Fifty HBC professionals participated in 27 focus group interviews over 18 months. Stigma featured strongly when they discussed barriers to the introduction of HBC. Using sociological theory, the authors organized the data into five themes: Power broking and mobilization, Stigma as a social construction, Community and structural interventions, Educating and training people, and Historical context. The HBC professionals appear to operate at mostly individual and community levels in their efforts to challenge stigma, and in spite of the difficulties they appear to be having some impact.

  19. 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.

  20. 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.

  1. Iron and zinc content of selected foods in the diet of schoolchildren in Kumi district, east of Uganda: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Iron and zinc are essential micronutrients for humans and deficiency of the two elements is widespread in the world with the highest prevalence in less developed countries. There are few data on dietary intake of iron and zinc in Uganda, and no food composition table is available. There is hardly any widely published literature that clearly documents the quality of Ugandan children's diet. Thus information of both food intake and the concentration of these trace elements in local food ingredients are needed in order to assess daily intake. Methods The present study focused on the iron and zinc content in selected foods and intake of the micronutrients iron and zinc among schoolchildren in Kumi District, Uganda. Over a period of 4 weeks single 24-hour dietary recall interviews were carried out on a convenience sample of 178 schoolchildren (9-15 years old). Data from the dietary recalls was used when selecting foods for chemical analysis. Results Results from this study showed that the iron concentrations varied, and were high in some cereals and vegetables. The zinc concentrations in foods generally corresponded with results from other African countries (Mali and Kenya). Data from the 24-hour dietary recall showed that the daily Recommended Nutrient Intake (RNI) was met for iron but not for zinc. Conclusions The schoolchildren of Kumi district had a predominantly vegetable based diet. Foods of animal origin were consumed occasionally. The iron content in the selected foods was high and variable, and higher than in similar ingredients from Kenya and Mali, while the zinc concentrations were generally in accordance with reported values. The total daily zinc (mg) intake does not meet the daily RNI. The iron intake is adequate according to RNI, but due to iron contamination and reduced bioavailability, RNI may not be met in a vegetable based diet. More studies are needed to investigate possible sources of contamination. PMID:21827701

  2. Clients of female sex workers in Nyanza province, Kenya: a core group in STD/HIV transmission.

    PubMed

    Voeten, Helene A C M; Egesah, Omar B; Ondiege, Mark Y; Varkevisser, Corlien M; Habbema, J Dik F

    2002-08-01

    Commercial sex plays an important role in the spread of HIV and AIDS in Africa, especially in beginning epidemics. The goal was to study the sociodemographic characteristics and sexual risk behavior of clients of female sex workers (FSWs) in Nyanza province, Kenya. In the town of Kisumu and the rural districts Siaya and Bondo, male clients of FSWs were identified in bars, nightclubs, and lodges. An informal conversation was held with 64 clients. The majority of clients were between 25 and 36 years old, were married, and had extramarital partners in addition to FSWs. Most clients had visited several (3-5) different FSWs in the previous year, of whom at least 2 were in long-term, steady client-FSW relationships. Clients visited FSWs an average of once or twice a week. Most clients were not consistently using condoms with FSWs; the main reason given was that they "trusted" their steady FSWs. Commercial sex in Nyanza frequently involves multiple steady relationships instead of rapidly changing one-time contacts. Information, education, and communication (IEC) campaigns aimed at risk reduction in commercial sex should promote condom use in steady FSW-client relationships.

  3. 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

  4. Incidence of Fusarium spp. and Levels of Fumonisin B1 in Maize in Western Kenya

    PubMed Central

    Kedera, C. J.; Plattner, R. D.; Desjardins, A. E.

    1999-01-01

    Maize kernel samples were collected in 1996 from smallholder farm storages in the districts of Bomet, Bungoma, Kakamega, Kericho, Kisii, Nandi, Siaya, Trans Nzoia, and Vihiga in the tropical highlands of western Kenya. Two-thirds of the samples were good-quality maize, and one-third were poor-quality maize with a high incidence of visibly diseased kernels. One hundred fifty-three maize samples were assessed for Fusarium infection by culturing kernels on a selective medium. The isolates obtained were identified to the species level based on morphology and on formation of the sexual stage in Gibberella fujikuroi mating population tests. Fusarium moniliforme (G. fujikuroi mating population A) was isolated most frequently, but F. subglutinans (G. fujikuroi mating population E), F. graminearum, F. oxysporum, F. solani, and other Fusarium species were also isolated. The high incidence of kernel infection with the fumonisin-producing species F. moniliforme indicated a potential for fumonisin contamination of Kenyan maize. However, analysis of 197 maize kernel samples by high-performance liquid chromatography found little fumonisin B1 in most of the samples. Forty-seven percent of the samples contained fumonisin B1 at levels above the detection limit (100 ng/g), but only 5% were above 1,000 ng/g, a proposed level of concern for human consumption. The four most-contaminated samples, with fumonisin B1 levels ranging from 3,600 to 11,600 ng/g, were from poor-quality maize collected in the Kisii district. Many samples with a high incidence of visibly diseased kernels contained little or no fumonisin B1, despite the presence of F. moniliforme. This result may be attributable to the inability of F. moniliforme isolates present in Kenyan maize to produce fumonisins, to the presence of other ear rot fungi, and/or to environmental conditions unfavorable for fumonisin production. PMID:9872757

  5. 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…

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. Vocal local versus pharmacological treatments for pain management in tubal ligation procedures in rural Kenya: a non-inferiority trial.

    PubMed

    Keogh, Sarah C; Fry, Kenzo; Mbugua, Edwin; Ayallo, Mark; Quinn, Heidi; Otieno, George; Ngo, Thoai D

    2014-02-04

    Vocal local (VL) is a non-pharmacological pain management technique for gynecological procedures. In Africa, it is usually used in combination with pharmacological analgesics. However, analgesics are associated with side-effects, and can be costly and subject to frequent stock-outs, particularly in remote rural settings. We compared the effectiveness of VL + local anesthesia + analgesics (the standard approach), versus VL + local anesthesia without analgesics, on pain and satisfaction levels for women undergoing tubal ligations in rural Kenya. We conducted a site-randomised non-inferiority trial of 884 women receiving TLs from 40 Marie Stopes mobile outreach sites in Kisii and Machakos Districts. Twenty sites provided VL + local anesthesia + analgesics (control), while 20 offered VL + local anesthesia without additional analgesics (intervention). Pain was measured using a validated 11-point Numeric Rating Scale; satisfaction was measured using 11-point scales. A total of 461 women underwent tubal ligations with VL + local anesthesia, while 423 received tubal ligations with VL + local anesthesia + analgesics. The majority were aged ≥30 years (78%), and had >3 children (99%). In a multivariate analysis, pain during the procedure was not significantly different between the two groups. The pain score after the procedure was significantly lower in the intervention group versus the control group (by 0.40 points; p = 0.041). Satisfaction scores were equally high in both groups; 96% would recommend the procedure to a friend. VL + local anesthesia is as effective as VL + local anesthesia + analgesics for pain management during tubal ligation in rural Kenya. Avoiding analgesics is associated with numerous benefits including cost savings and fewer issues related to the maintenance, procurement and monitoring of restricted opioid drugs, particularly in remote low-resource settings where these systems are weak. Pan-African Clinical Trials Registry PACTR201304000495942.

  12. State and district policy influences on district-wide elementary and middle school physical education practices.

    PubMed

    Chriqui, Jamie F; Eyler, Amy; Carnoske, Cheryl; Slater, Sandy

    2013-01-01

    To examine the influence of state laws and district policies on district-wide elementary school and middle school practices related to physical education (PE) time and the percentage of moderate-to-vigorous physical activity (MVPA) time during PE. Multivariate, cross-sectional analysis of state laws, district wellness and PE policies, and district PE practices for school year 2010-2011 controlling for district-level urbanicity, region, size, race/ethnicity of students, and socioeconomic status and clustered on state. One hundred ninety-five public school districts located in 42 states. District-level PE coordinators for the included districts who responded to an online survey. Minutes and days of PE per week and percent time spent in MVPA during PE time. District PE coordinators reported significantly less PE time than national standards-82.9 and 189.6 minutes at the elementary school and middle school levels, respectively. Physical education was provided an average of 2.5 and 3.7 days per week, respectively; and the percentage of MVPA time in PE was 64.4% and 65.7%, respectively. At the elementary school level, districts in either states with laws governing PE time or in a state and district with a law/policy reported significantly more days of PE (0.63 and 0.67 additional days, respectively), and districts in states with PE time laws reported 18 more minutes of PE per week. At the middle school level, state laws were associated with 0.73 more days of PE per week. Neither state laws nor district policies were positively associated with percent MVPA time in PE. State laws and district policies can influence district-level PE practices-particularly those governing the frequency and duration of PE-although opportunities exist to strengthen PE-related laws, policies, and practices.

  13. 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

  14. 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…

  15. 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

  16. 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

  17. 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.

  18. 46 CFR 50.10-5 - Coast Guard District Commander or District Commander.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Coast Guard District Commander or District Commander. 50.10-5 Section 50.10-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-5 Coast Guard District...

  19. Measles trends and vaccine effectiveness in Nairobi, Kenya.

    PubMed

    Borus, P K; Cumberland, P; Sonoiya, S; Kombich, J; Tukei, P M; Cutts, F T

    2003-07-01

    To determine morbidity and mortality from measles and to estimate measles vaccine effectiveness among children hospitalised with measles in two hospitals in Nairobi. A review of hospital records (index cards). Kenyatta National Hospital and Mbagathi District Hospitals covering the years 1996-2000. A review of index cards for measles morbility and mortality was undertaken in the two hospitals. Measles data at the Kenya Expanded Programme on Immunisation covering both hospitals was analysed for vaccine effectiveness. The incidence of measles was unusually high in 1998 between July and November (monthly range 130-305), reflecting on the occurrence of an outbreak at that time. There was no definite monthly incidence trend of measles in 1996,1997, 1999 and 2000. The median age of cases was 13 months (range 0-420 months) for Kenyatta hospital and 18 months (range 1-336 months) for Mbagathi Hospital. Significantly, 29.8% of all cases were aged below nine months when routine immunisation for measles had not begun. The median number of days spent in hospital were five days (range 0-87 days) for Kenyatta and four days (range 1-13 days) for Mbagathi. The overall case fatality rate was 5.6% and was similar for both males and females. The overall measles vaccine effectiveness among measles cases admitted to Kenyatta and Mbagathi Hospitals was 84.1%. The case admissions in Kenyatta and Mbagathi Hospitals suggest measles was prevalent in Nairobi over the latter half decade of the 1990's. Apart from 1998 when there was an outbreak, the seasonality of measles was dampened. The 1998 outbreak suggests a build up of susceptible children the majority of whom were born in the last quarter of 1996. The high mortality may have had to do with the majority of cases presenting late when symptoms were already complicated and severe.

  20. 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

  1. 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…

  2. 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…

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. Children caring for their "caregivers": exploring the caring arrangements in households affected by AIDS in Western Kenya.

    PubMed

    Skovdal, Morten

    2010-01-01

    Reflecting dominant understandings of childhood, many researchers describe orphans as an emotional and financial cost to the households in which they live. This has created a representation of orphans as a burden, not only to their fostering household, but also to society. This article seeks to challenge this representation by exploring children's contributions to their fostering households. Drawing on research from Bondo District in Kenya, this article brings together the views of 36 guardians and 69 orphaned children between the ages of 11 and 17, who articulated their circumstances through photography and drawing. Nearly 300 photos and drawings were selected by the children and subsequently described in writing. An additional 44 in-depth interviews and three focus group discussions were conducted to explore findings further. The data suggest that many fostering households benefit tremendously from absorbing orphaned children. All orphans were found to contribute to their fostering household's income and provide valuable care or support to ageing, ailing or young members of their households. The article concludes that caution should be exercised in using the term "caregiver" to describe foster parents due to the reciprocity, and indeed at times a reversal, of caring responsibilities.

  9. 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.…

  10. 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…

  11. 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…

  12. 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…

  13. 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.

  14. 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

  15. Reference values for body composition and associations with blood pressure in Kenyan adults aged ≥50 years old.

    PubMed

    Bastawrous, Madeleine C; Piernas, Carmen; Bastawrous, Andrew; Oke, Jason; Lasserson, Daniel; Mathenge, Wanjiku; Burton, Matthew J; Jebb, Susan A; Kuper, Hannah

    2018-05-15

    To develop age- and sex-specific centile reference curves for fat-free mass (FFM) and fat mass (FM) adjusted for height in an adult Kenyan population and to investigate the association between FM, FFM and blood pressure (BP). Measures of body composition from bioimpedance analyses and BP were collected in 1995 participants aged ≥50 years in Nakuru County, Kenya. Reference curves were produced using the LMS method. Multivariable linear regression models were used to test the cross-sectional association between body composition indexes and BP. The age- and sex-specific reference curves for body composition (FMI and FFMI) confirmed that FFMI is lower in both men and women with increasing age. FMI declines with age in women while among men the decline starts after 70 years. FFM was higher in men (47.4 ± 7.2 kg) than in women (38.8 ± 5.5 kg), while FM was lower in men (17.3 ± 8.1 kg) than in women (24.4 ± 10.2 kg). FMI, FFMI and BMI were all positively associated with systolic and diastolic BP, and after adjusting for body weight, FFMI remained positively associated with systolic BP and the FMI remained positively associated with diastolic BP. There was no evidence to suggest that FMI and FFMI were superior to measurement of BMI alone. These body composition reference curves provide normative data on body composition for older adults in Kenya. Further research should consider the prospective associations with health, including frailty-related outcomes.

  16. 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…

  17. 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.

  18. 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

  19. 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

  20. 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

  1. Immunization of cattle against East Coast fever using Theileria parva (Marikebuni) and relaxation of tick control in North Rift, Kenya.

    PubMed

    Wanjohi, J M; Ngeranwa, J N; Rumberia, R M; Muraguri, G R; Mbogo, S K

    2001-09-01

    A total of 90 animals was immunized against East Coast fever (ECF) using Theileria parva (Marikebuni) stock on three large-scale farms in Kiminini Division, Trans-Nzoia District, North Rift, Kenya. Another 90 cattle served as non-immunized controls. Following immunization the number of cattle with significant indirect fluorescent antibody (IFA) titres increased from 43.9% to 84.4% and 6.7% of the cattle developed clinical ECF reactions. Two months after immunization, the immunized and non-immunized cattle were divided into two groups one of which was dipped every 3 weeks and the other dipped when total full body tick counts reached 100. All the animals were monitored for 51 weeks for incidences of ECF and other tick-borne diseases. Twenty-four cases of ECF were diagnosed among the non-immunized cattle compared to four cases among the immunized cattle; a difference that was significant (P > 0.05). There was no significant difference in the incidences of babesiosis and anaplasmosis between the immunized and non-immunized cattle.

  2. 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…

  3. 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…

  4. 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

  5. California's Districts of Choice

    ERIC Educational Resources Information Center

    Kronholz, June

    2014-01-01

    This article describes the results of a California state law established in 2010 that created "Districts of Choice." The District of Choice law was meant to encourage districts to compete for students by offering innovative programs and this-school-fits-my-child options that parents wanted. This designation meant that children from any…

  6. 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.

  7. Zero Energy Districts

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

    Polly, Benjamin J

    This presentation shows how NREL is approaching Zero Energy Districts, including key opportunities, design strategies, and master planning concepts. The presentation also covers URBANopt, an advanced analytical platform for district that is being developed by NREL.

  8. 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

  9. Innovations in communication technologies for measles supplemental immunization activities: lessons from Kenya measles vaccination campaign, November 2012

    PubMed Central

    Mbabazi, William B; Tabu, Collins W; Chemirmir, Caleb; Kisia, James; Ali, Nasra; Corkum, Melissa G; Bartley, Gene L

    2015-01-01

    Background To achieve a measles free world, effective communication must be part of all elimination plans. The choice of communication approaches must be evidence based, locally appropriate, interactive and community owned. In this article, we document the innovative approach of using house visits supported by a web-enabled mobile phone application to create a real-time platform for adaptive management of supplemental measles immunization days in Kenya. Methods One thousand nine hundred and fifty-two Red Cross volunteers were recruited, trained and deployed to conduct house-to-house canvassing in 11 urban districts of Kenya. Three days before the campaigns, volunteers conducted house visits with a uniform approach and package of messages. All house visits were documented using a web-enabled mobile phone application (episurveyor®) that in real-time relayed information collected to all campaign management levels. During the campaigns, volunteers reported daily immunizations to their co-ordinators. Post-campaign house visits were also conducted within 4 days, to verify immunization of eligible children, assess information sources and detect adverse events following immunization. Results Fifty-six per cent of the 164 643 households visited said that they had heard about the planned 2012 measles vaccination campaign 1–3 days before start dates. Twenty-five per cent of households were likely to miss the measles supplemental dose if they had not been reassured by the house visit. Pre- and post-campaign reasons for refusal showed that targeted communication reduced misconceptions, fear of injections and trust in herbal remedies. Daily reporting of immunizations using mobile phones informed changes in service delivery plans for better immunization coverage. House visits were more remembered (70%) as sources of information compared with traditional mass awareness channels like megaphones (41%) and radio (37%). Conclusions In high-density settlements, house-to-house visits

  10. Factors influencing implementation of the Ministry of Health-led private medicine retailer programmes on malaria in Kenya

    PubMed Central

    2010-01-01

    Background Kenya has experienced a number of retail sector initiatives aimed at improving access to antimalarial medicines. This study explored stakeholders' perceptions of the role of private medicine retailers (PMRs), the value and feasibility of programme goals, perceived programme impact, factors influencing implementation and recommendations in three districts of Kenya. Methods This study was part of a larger evaluation of PMR programmes, including quantitative and qualitative components. The qualitative research was conducted to assess implementation processes and actors' experiences in the programmes, through focus group discussions with trained PMRs and mothers of children under five years, and in-depth interviews with programme managers, trainers and co-trainers. Results PMRs were perceived to provide rapid cheap treatment for non-serious conditions and used as a deliberate and continuously evaluated choice between different treatment sources. All stakeholders supported programme goals and most PMRs described increased customer satisfaction, more rational purchasing of medicine stock and increased medicine sales after participation. Factors undermining programme implementation included a lack of MoH resources to train and monitor large numbers of PMRs, the relative instability of outlets, medicines stocked and retail personnel, the large number of proprietary brands and financial challenges to retailers in stocking antimalarial medicines, and their customers in buying them. Unambiguous national support and a broad range of strategies are important to strengthen the feasibility of change in OTC antimalarial use. Conclusions Understanding the context and implementation processes of PMR programmes and the perspectives of key actors are critical to identifying measures to support their effective implementation. Financial barriers underlie many described challenges, with important implications for policies on subsidies in this sector. In spite of barriers to

  11. Factors influencing implementation of the Ministry of Health-led private medicine retailer programmes on malaria in Kenya.

    PubMed

    Rowa, Yvonne; Abuya, Timothy O; Mutemi, Wilfred K; Ochola, Sam; Molyneux, Sassy; Marsh, Vicki

    2010-02-24

    Kenya has experienced a number of retail sector initiatives aimed at improving access to antimalarial medicines. This study explored stakeholders' perceptions of the role of private medicine retailers (PMRs), the value and feasibility of programme goals, perceived programme impact, factors influencing implementation and recommendations in three districts of Kenya. This study was part of a larger evaluation of PMR programmes, including quantitative and qualitative components. The qualitative research was conducted to assess implementation processes and actors' experiences in the programmes, through focus group discussions with trained PMRs and mothers of children under five years, and in-depth interviews with programme managers, trainers and co-trainers. PMRs were perceived to provide rapid cheap treatment for non-serious conditions and used as a deliberate and continuously evaluated choice between different treatment sources. All stakeholders supported programme goals and most PMRs described increased customer satisfaction, more rational purchasing of medicine stock and increased medicine sales after participation. Factors undermining programme implementation included a lack of MoH resources to train and monitor large numbers of PMRs, the relative instability of outlets, medicines stocked and retail personnel, the large number of proprietary brands and financial challenges to retailers in stocking antimalarial medicines, and their customers in buying them. Unambiguous national support and a broad range of strategies are important to strengthen the feasibility of change in OTC antimalarial use. Understanding the context and implementation processes of PMR programmes and the perspectives of key actors are critical to identifying measures to support their effective implementation. Financial barriers underlie many described challenges, with important implications for policies on subsidies in this sector. In spite of barriers to implementation, increased exposure to

  12. 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.

  13. Exploration of Geothermal Natural Resources from Menengai Caldera at Naruku, Kenya

    NASA Astrophysics Data System (ADS)

    Patlan, E.; Wamalwa, A.; Thompson, L. E.; Kaip, G.; Velasco, A. A.

    2011-12-01

    The Menengai Caldera, a large, dormant volcano, lies near the city of Naruku, Kenya (0.20°S, 36.07°E) and presents a significant natural geothermal energy resource that will benefit local communities. Kenya continues to explore and exploit its only major energy resource: geothermal energy. The Geothermal Development Company (GDC) of Kenya and University of Texas at El Paso (UTEP) have initially deployed seven seismic stations to address the volcanic hazards and associated processes that occurs through the analysis of data collection from seismic sensors that record ground motion. Seven more sensors are planned to be deployed in Aug. 2011. In general, the internal state and activity of the caldera is an important component to the understanding of porosity of the fault system, which is derived from the magma movement of the hot spot, and for the exploitation of geothermal energy. We analyze data from March to May 2011 to investigate the role of earthquakes and faults in controlling the caldera processes, and we find 15 events occurred within the caldera. We will utilize the double difference earthquake location algorithm (HypoDD) to analyze the local events in order to find active faulting of the caldera and the possible location of the magma chamber. For future work, we will combine the exiting data with the new seismic station to image the location of the caldera magma chamber.

  14. 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.

  15. 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…

  16. Respiratory Syncytial Virus Infection and Disease in Infants and Young Children Studied from Birth in Kilifi District, Kenya

    PubMed Central

    Nokes, D James; Okiro, Emelda A; Ngama, Mwanajuma; Ochola, Rachel; White, Lisa J; Scott, Paul D; English, Michael; Cane, Patricia A; Medley, Graham F

    2008-01-01

    Background Within the developing country setting data are few that characterise the disease burden due to RSV and which clearly define the age group to target vaccine intervention. Methods Children numbering 635, recruited 2002-03, were intensively monitored until each experienced three RSV epidemics. RSV was diagnosed by use of immunofluorescence on nasal washings collected on occurence of acute respiratory infection. Incidence estimates were adjusted for seasonality in RSV exposure. Results From 1187 child years of observation (cyo) a total of 409 RSV episodes were identifed; 365 primary and 82 repeat. Adjusted incidence estimates (per 1000cyo) of lower respiratory tract infection (LRTI), severe LRTI and hospital admission were 90, 43, and 10, respectively, and corresponding estimates in infants were 104, 66 and 13. The proportion of all-cause LRTI, severe-LRTI and hospitalizations in the cohort due to RSV was 13%, 19% and 5%, respectively. 55-65% of RSV LRTI and severe-LRTI occured in children over 6 months old. The risk of RSV disease following primary symptomatic infection remained significant beyond the first year of life and a quarter of all re-infections were associated with LRTI. Conclusions RSV accounts for a substantial proportion of the total respiratory disease in this rural population: we estimate 85,000 infant cases of severe LRTI annually in Kenya. The majority of this morbidity occurs in late infancy and early childhood; ages at which the risk of disease following infection remains significant. Disease from re-infection is common. Our results inform the debate on vaccine target age group and effectiveness. PMID:18171213

  17. 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).…

  18. 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…

  19. 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

  20. District Support of School Improvement: Highlights from Three Districts. Newsletter

    ERIC Educational Resources Information Center

    Center for Comprehensive School Reform and Improvement, 2009

    2009-01-01

    This newsletter addresses various supports that districts are utilizing to help keep students in school and on the path to graduation. Described herein are three districts that have been particularly successful in raising student achievement--even though they differ in their specific strategies, fund allocation, and demographic composition. A…

  1. 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…

  2. 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…

  3. 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.

  4. 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.

  5. 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

  6. Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya.

    PubMed

    Brooker, Simon; Clarke, Siân; Njagi, Joseph Kiambo; Polack, Sarah; Mugo, Benbolt; Estambale, Benson; Muchiri, Eric; Magnussen, Pascal; Cox, Jonathan

    2004-07-01

    The epidemiology of malaria over small areas remains poorly understood, and this is particularly true for malaria during epidemics in highland areas of Africa, where transmission intensity is low and characterized by acute within and between year variations. We report an analysis of the spatial distribution of clinical malaria during an epidemic and investigate putative risk factors. Active case surveillance was undertaken in three schools in Nandi District, Western Kenya for 10 weeks during a malaria outbreak in May-July 2002. Household surveys of cases and age-matched controls were conducted to collect information on household construction, exposure factors and socio-economic status. Household geographical location and altitude were determined using a hand-held geographical positioning system and landcover types were determined using high spatial resolution satellite sensor data. Among 129 cases identified during the surveillance, which were matched to 155 controls, we identified significant spatial clusters of malaria cases as determined using the spatial scan statistic. Conditional multiple logistic regression analysis showed that the risk of malaria was higher in children who were underweight, who lived at lower altitudes, and who lived in households where drugs were not kept at home. Copyright 2004 Blackwell Publishing Ltd

  7. 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.

  8. Early age at time of primary Epstein-Barr virus infection results in poorly controlled viral infection in infants from Western Kenya: clues to the etiology of endemic Burkitt lymphoma.

    PubMed

    Piriou, Erwan; Asito, Amolo S; Sumba, Peter O; Fiore, Nancy; Middeldorp, Jaap M; Moormann, Ann M; Ploutz-Snyder, Robert; Rochford, Rosemary

    2012-03-15

    Infection with Epstein-Barr virus (EBV) early in life and repeated malaria exposure have been proposed as risk factors for endemic Burkitt lymphoma (eBL). Infants were enrolled from 2 rural sites in Kenya: the Kisumu District, where malaria transmission is holoendemic and risk for eBL is high, and the Nandi District, where malaria transmission is limited and the risk for eBL is low. Blood samples were taken from infants through 2 years of age to measure EBV viral load, EBV antibodies, and malaria parasitemia. We observed a significantly younger age at time of primary EBV infection in children from Kisumu compared with children from Nandi (mean age, 7.28 months [±0.33 SEM] in Kisumu vs 8.39 months [±0.26 SEM] in Nandi), with 35.3% of children in Kisumu infected before 6 months of age. To analyze how different predictors affected EBV viral load over time, we performed multilevel mixed modeling. This modeling revealed that residence in Kisumu and younger age at first EBV infection were significant predictors for having a higher EBV viral load throughout the period of observation. Children from a region at high risk for eBL were infected very early in life with EBV, resulting in higher viral loads throughout infancy.

  9. 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.

  10. 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…

  11. 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…

  12. 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…

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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