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Articles 241 - 270 of 274
Full-Text Articles in Medicine and Health Sciences
Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health
Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health
Reproductive Health
La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …
The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar
The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar
Poverty, Gender, and Youth
This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …
Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health
Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health
Reproductive Health
The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …
Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health
Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health
Reproductive Health
The Kenya Adolescent Reproductive Health Project (KARHP) was launched in October 1999 in Busia and Vihiga districts as a three-year operations research study to determine the feasibility, cost, and effectiveness of implementing systematic interventions that address the reproductive health (RH) needs of adolescents aged 10–19 years. This USAID-funded project is part of the Population Council’s Frontiers in Reproductive Health Program’s global operations research. PATH (Program for Appropriate Technology in Health) is implementing the project, in collaboration with the Ministries of Health, Education, and Home Affairs, Heritage, and Sports. The objective of the study is to establish the effectiveness of interventions …
Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard
Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard
Reproductive Health
This study’s objective was to improve understanding of Kenyan men’s actual and potential roles as supportive partners in various phases of reproductive health (RH), to help in the design of strategies to encourage men’s greater participation in a variety of RH initiatives in Kenya. The results of the study clearly show that, to a larger extent than anticipated, men in Kenya already participate in women-centered RH services. Overall the institutional barriers seemed to be more overwhelming than the cultural barriers, given that one of the reasons frequently given for nonparticipation was fear of non-acceptance by the health providers. Based on …
Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu
Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu
Reproductive Health
Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …
Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg
Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg
Reproductive Health
To increase men’s participation in family planning (FP) and reproductive health (RH) both for their own well-being and as gatekeepers to women’s health, the African Population Policy Research Center and the Population Council’s OR/TA Project II launched a study designed to explore best practices for delivering services to men. The study examined men’s knowledge, perceptions, and concerns about RH issues, including FP, and the social context of their knowledge. In sub-Saharan Africa, FP and reproductive health-care research and interventions place a disproportionate emphasis on women and largely ignore the role of men. As a result, male participation in FP and …
Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha
Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha
Reproductive Health
In an effort to address the global crisis of HIV/AIDS and to reduce the spread of other sexually transmitted infections (STIs), maternal and child health/family planning (MCH/FP) programs have attempted to integrate the management of STIs into their services. This integration was endorsed at the 1994 International Conference on Population and Development in Cairo. However, as noted in this report, programs have encountered a number of difficulties as they try to effectively manage STIs in an MCH/FP setting. In particular, the effective detection and treatment of STIs has proven difficult among MCH/FP populations. This current study was developed to help …
The Cost Of Health Services At The Facilities Level Of The Nakuru Municipal Council, Nakuru, Kenya, Andrew Thompson, Barbara Janowitz, Julie Solo
The Cost Of Health Services At The Facilities Level Of The Nakuru Municipal Council, Nakuru, Kenya, Andrew Thompson, Barbara Janowitz, Julie Solo
Reproductive Health
The Nakuru Municipal Council (NMC), in Kenya, is concerned with the financial sustainability of its services and is considering increasing prices. The Council is currently charging for services but these fees are not based on the cost of providing services. Before changing its prices, the NMC wanted information on its costs because another strategy to improve financial sustainability is to decrease the costs of producing various services. Information on current costs of services can also help the NMC to determine ways to reduce these costs. The NMC, in collaboration with the Africa OR/TA II project and Family Health International, conducted …
Integrating Sti And Mch/Fp Services, Population Council
Integrating Sti And Mch/Fp Services, Population Council
Reproductive Health
The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …
Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar
Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar
Poverty, Gender, and Youth
Although an overall decline has occurred in adolescent fertility in Kenya, the proportion of births to teenagers that takes place prior to marriage is rising. At the same time that premarital sex and childbearing have increased, educational participation has expanded considerably, especially for girls. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 33 primary schools that the adolescents attended, this paper explores whether certain aspects of the school environment affect the likelihood of early and unprotected sex among adolescent girls and boys in three districts of Kenya. Because of the concern with “schoolgirl pregnancy” …
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Reproductive Health
Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Reproductive Health
The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …
Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett
Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett
Poverty, Gender, and Youth
Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Poverty, Gender, and Youth
The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …
El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Poverty, Gender, and Youth
Esta es la primera de varias ediciones de Quality/Calidad/Qualité que describen métodos concebidos para ayudar tanto a los directores como al personal de los programas de planificación familiar a efectuar una evaluación propia de la calidad de los servicios que prestan. Estas herramientas dan a los patrocinadores de los programas la oportunidad de identificar las deficiencias en su entorno de servicio y proponer soluciones. El informe examina la experiencia de la Asociación Nacional de Planificación Familiar de Kenia, proporciona algunas lecciones aprendidas y demuestra que estos ejercicios de autoevaluación están, de hecho, dando como resultado una mejora de la calidad …
Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew
Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew
Reproductive Health
The presence of certain STIs increases the risk of the sexual transmission of HIV. Thus, controlling STIs can reduce the incidence of HIV. Almost all women in the East and Southern African regions attend MCH/FP clinics regularly, and recent surveys have shown that the prevalence levels of many STIs, including HIV, can be high for women seeking FP and antenatal services, even though they are frequently asymptomatic. MCH/FP services are provided by medically trained staff with many of the same skills needed for managing STIs. Consequently, several MCH/FP programs have started looking for ways to integrate STI management strategies, such …
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Reproductive Health
How are effective population policies articulated and implemented? Have international agencies played a strong role in prompting developing-country governments to adopt and implement strong population policies? How has the international debate influenced deliberations on population issues in developing countries? The impetus for the four country studies presented in this book was provided by a desire to better understand some of these issues within specific contexts. Egypt, India, Kenya, and Mexico were selected because of their demographic weight, a long history of population policies and programs, and evidence of fertility decline. The four country studies examine the influence of many forces …
The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark
The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark
Poverty, Gender, and Youth
In Kenya, adolescent girls fare poorly relative to boys in an educational system characterized by enormous growth, deteriorating quality, and rising costs. Girls are more likely than boys to drop out of school prematurely and are less likely to do well on the primary school leaving exams that come at the end of grade eight. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 36 primary schools in which those adolescents reside, this paper investigates the effect of school quality on the likelihood of dropping out from primary school in three districts of Kenya. In …
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Poverty, Gender, and Youth
This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …
Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings
Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings
Reproductive Health
In Kenya, as throughout the world, the health consequences of unsafe abortion for women of reproductive age are significant. Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35 percent of pregnancy-related mortality and at least 50 percent of hospitals’ gynecological admissions. The concept of postabortion care (emergency treatment, postabortion family planning counseling and services, links between emergency abortion treatment services and comprehensive reproductive health care) has gained wide acceptance as one model of providing comprehensive care to women suffering from abortion complications. Integration of these three components is rarely found in public health …
Youth Centres In Kenya: Evaluation Of The Family Planning Association Of Kenya Programme, Annabel Erulkar, Barbara Mensch
Youth Centres In Kenya: Evaluation Of The Family Planning Association Of Kenya Programme, Annabel Erulkar, Barbara Mensch
Reproductive Health
Since 1987, the Family Planning Association of Kenya (FPAK) has operated two youth centers, one in Nairobi and the other in Mombasa. The centers target unmarried youth aged 10–24 and their primary objective is reduction in incidence of sexual and reproductive-health-related problems. These centers offer recreational and sports facilities, counseling services, including reproductive health (RH) information, limited RH services, and referrals. In 1996, FPAK undertook a systematic evaluation of its youth-center program including a situation analysis of the centers, a survey in their catchment areas, and an analysis of program costs. The main strength of the program was found to …
Gender Differences In The Schooling Experiences Of Adolescents In Low-Income Countries: The Case Of Kenya, Barbara Mensch, Cynthia B. Lloyd
Gender Differences In The Schooling Experiences Of Adolescents In Low-Income Countries: The Case Of Kenya, Barbara Mensch, Cynthia B. Lloyd
Poverty, Gender, and Youth
Little research on education in developing countries has focused on adolescent issues at the same time, despite the fact that a growing proportion of young people are spending some time in school during the phase of their lives between puberty and marriage, there is little research on schooling as a key dimension of the adolescent experience. This paper examines the school environment in Kenya and the potential ways it can help or hinder adolescents. We focus on gender differences with a view toward illuminating some of the factors that may present particular obstacles or opportunities for girls. The paper begins …
Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew
Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew
Reproductive Health
Most national MCH-FP programs in sub-Saharan Africa are shifting their programmatic strategies toward a broader reproductive health service approach that includes integrating STI and HIV/AIDS services into existing MCH-FP programs. This is based on the belief that integration will lead to more cost-effective and better-quality service, and maximize use of existing resources. There is an assumption that the basic infrastructure for the MCH-FP programs can absorb the extra demands of the STI/HIV/AIDS services with minimal additional inputs and that staff providing MCH-FP services require only minimal training to be able to provide STI/HIV/AIDS services. There is a further assumption that …
Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard
Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard
Reproductive Health
One of the most topical areas in reproductive health today is the consequences of induced and often unsafe abortion. Safe motherhood initiatives continue to highlight the contribution of unsafe abortion to the persistent high rates of maternal mortality and morbidity in sub-Saharan Africa. In some countries, unsafe abortion is responsible for up to half of all maternal mortality and morbidity, with adolescents constituting a significant proportion of those procuring unsafe abortions. In Kenya, concern about the problem of incomplete and septic abortion has increased, particularly on the part of service providers who must treat women suffering from the complications of …
Components Of Kenya's Future Population Growth And Population Policy Implications, John Kekovole
Components Of Kenya's Future Population Growth And Population Policy Implications, John Kekovole
Poverty, Gender, and Youth
The world’s population has grown rapidly from about 2.5 billion in 1950 to a current size of 5.8 billion. As noted in this report, most of the increase has been recorded in the developing countries of Africa, Asia, and Latin America due to continued high fertility in the face of reductions in levels of mortality. Kenya provides a unique opportunity to study the impact of various policy options on future population growth. The primary objective of this study is to measure the impact of different causes of continued population growth on Kenya’s future size and to formulate appropriate policy measures …
Quality Of Care In Family Planning Service Delivery In Kenya: Clients' And Providers' Perspectives, Lewis Ndhlovu
Quality Of Care In Family Planning Service Delivery In Kenya: Clients' And Providers' Perspectives, Lewis Ndhlovu
Reproductive Health
In recent years, the increasing number of organizations that have studied quality of care in international family planning (FP) programs demonstrates the importance the topic has acquired. To define quality of care in FP, the Bruce–Jain framework of six elements of care (choice of methods, information given to clients, technical competence, interpersonal relations, continuity and follow up, and appropriate constellation of services) have been used as the standard. However, what has been overlooked in this approach is the clients' perspectives of service quality. This study sought to narrow the gap in knowledge about the comparability and consistency in views between …
Community-Based Aids Prevention And Care In Africa—Dissemination Of Phase I Findings: Report Of Five National Workshops, Population Council
Community-Based Aids Prevention And Care In Africa—Dissemination Of Phase I Findings: Report Of Five National Workshops, Population Council
HIV and AIDS
Given the constraints faced by the health care infrastructure in responding to the AIDS crisis in sub-Saharan Africa, and the limitations of traditional educational approaches in motivating people to modify their sexual behavior within the African context, community-based efforts at AIDS prevention, and care of those affected, are the first lines of defense against the disease. Thus, they deserve greater scrutiny, to learn from the experiences and to continue and expand their efforts. The “Community-Based AIDS Prevention and Care in Africa: Building on Local Initiatives” project is being carried out by the Population Council with support from Glaxo Wellcome. The …
Current Experiences With Community-Based Distribution Of Family Planning In Kenya: A Review Prepared For Usaid/Kenya, Population Council
Current Experiences With Community-Based Distribution Of Family Planning In Kenya: A Review Prepared For Usaid/Kenya, Population Council
Reproductive Health
Kenya has been one of the leading countries worldwide in developing and implementing community-based distribution (CBD) programs as part of the national family planning (FP) program. CBD activities in Kenya are coordinated by the National Council for Population and Development, with support from USAID and other donor agencies. Kenya’s CBD program has been widely publicized because of its success in improving access to FP information and services, and its diversity of organizational structures. USAID would like to review the current situation and possible future directions before designing its CBD strategy for the next five-year bilateral project. The Africa OR/TA II …
Community-Based Aids Prevention And Care In Africa: Case Studies From Five African Countries, Ann Leonard
Community-Based Aids Prevention And Care In Africa: Case Studies From Five African Countries, Ann Leonard
HIV and AIDS
The Population Council carried out a three-year project entitled “Community-Based AIDS Prevention and Care in Africa: Building on Local Initiatives.” Given the constraints faced by the health care infrastructure in responding to the AIDS crisis and the limitations of traditional educational approaches in motivating people to modify their sexual behavior, in the African context community-based AIDS prevention and care of those affected are the first line of defense against the infection. This project was developed to explore efforts by organizations in Africa dealing directly with the consequences of AIDS, to understand the essential components of effective community-based efforts for AIDS …