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Full-Text Articles in Social and Behavioral Sciences

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya Jan 2015

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …


Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative Jan 2015

Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative

Reproductive Health

At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …


Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council Jan 2015

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …


Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao Jan 2015

Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …


Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich Jan 2015

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …


Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Kibera, Population Council Jan 2015

Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Kibera, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to increase adolescent girls’ knowledge of reproductive health and sexuality; reinforce and promote attitudes and behaviors that will lead to a better quality of life; and instill skills among adolescents to enable them to overcome the challenges of growing up and becoming responsible adults including communication skills, decision-making, assertiveness, setting goals and resisting peer pressure. The sessions were developed to be delivered without a lot of resources or materials, with limited time available …


Willingness To Pay For Contraceptive Vaginal Rings In Kenya, Wilson Liambila, Deepa Rajamani, Francis Obare, Saumya Ramarao, Harriet Birungi, Heather Clark Jan 2015

Willingness To Pay For Contraceptive Vaginal Rings In Kenya, Wilson Liambila, Deepa Rajamani, Francis Obare, Saumya Ramarao, Harriet Birungi, Heather Clark

Reproductive Health

Despite progress made in reducing fertility and increasing the contraceptive prevalence rate in Kenya, many women still experience high unmet need for contraception. Part of the challenge in addressing current levels of unmet need is the limited use of contraception by women during the first 12 months postpartum. New methods are needed that offer greater ease of use, are women-initiated, and do not require significant medical provider involvement for service delivery. One such method is the Progesterone Vaginal Ring (PVR), a reversible contraceptive that according to clinical trial data is safe and effective for breastfeeding women. New product introduction strategies …


Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative Jan 2015

Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative

Reproductive Health

Policymakers and researchers have long hypothesized the potential benefits of integrating HIV prevention, treatment, and care with sexual and reproductive health (SRH) services in settings with generalized HIV epidemics. In addition to improving health and social outcomes, integration of services holds the promise of increasing efficiency of service delivery and maximizing health care resources. Economic theory suggests several potential efficiency advantages at the service and programmatic levels. However, evidence on the unit cost and efficiency gains associated with integration remains scarce. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings …


Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Kibera, Population Council Jan 2015

Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Kibera, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to prepare adolescent girls for the financial responsibilities of adulthood. The sessions were developed to be delivered without a lot of resources or materials, with limited time available for training. The guide contains step-by-step descriptions of the learning activities as well as background information.


Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Wajir, Population Council Jan 2015

Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to prepare adolescent girls for the financial responsibilities of adulthood. The sessions were developed to be delivered without a lot of resources or materials, with limited time available for training. The guide contains step-by-step descriptions of the learning activities as well as background information.


Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Wajir, Population Council Jan 2015

Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to increase adolescent girls’ knowledge of reproductive health and sexuality; reinforce and promote attitudes and behaviors that will lead to a better quality of life; and instill skills among adolescents to enable them to overcome the challenges of growing up and becoming responsible adults including communication skills, decision-making, assertiveness, setting goals and resisting peer pressure. The sessions were developed to be delivered without a lot of resources or materials, with limited time available …


Adolescent Girls Initiative-Kenya: Baseline Report, Karen Austrian, Eunice N. Muthengi, Taylor Riley, Joyce Mumah, Caroline W. Kabiru, Benta Abuya Jan 2015

Adolescent Girls Initiative-Kenya: Baseline Report, Karen Austrian, Eunice N. Muthengi, Taylor Riley, Joyce Mumah, Caroline W. Kabiru, Benta Abuya

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. The Adolescent Girls Initiative–Kenya (AGI-K) will deliver multisectoral interventions for over 5,000 girls aged 11–14 in two marginalized areas of Kenya: the Kibera slums in Nairobi, and Wajir County in Northeastern Kenya. Implemented by Plan International in Kibera and Save the Children in Wajir, these interventions will be implemented for two years and will comprise a combination of girl-level, household-level, and community-level interventions. A randomized controlled trial will be used to compare the impact of four different packages of interventions to …


Baseline Survey Instruments: Adolescent Girls Initiative–Kenya, Population Council Jan 2015

Baseline Survey Instruments: Adolescent Girls Initiative–Kenya, Population Council

Poverty, Gender, and Youth

This document contains various AGI-K survey instruments, including: Household Characteristics Survey (English), Respondent’s Schooling History (English), Respondent’s Work in Last Year (English), Respondent’s Spending in Last Year (English), Respondent’s Savings in Last Year (Kiswahili), Respondent’s Savings in Last Year (English).


Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi Jan 2015

Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi

Reproductive Health

In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …


Delivering Contraceptive Vaginal Rings—Task Shifting And Task Sharing In The Delivery Of Family Planning Services: Experiences From Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark Jan 2015

Delivering Contraceptive Vaginal Rings—Task Shifting And Task Sharing In The Delivery Of Family Planning Services: Experiences From Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

This report describes the task-shifting and task-sharing policies and experiences relevant to the provision of family planning (FP) services in Kenya and the potential place for contraceptive vaginal rings. The feasibility, effectiveness, and acceptability of mid- and lower-level providers in the provision of FP services is documented. The report highlights how the provision of integrated RH/FP/HIV services could be delivered by various levels in the national health care system through task-sharing. Opportunities for facilitating delivery of the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) within the national health care system in Kenya are also described. Kenya has in place policies …


Expanding Access To Secondary School Education For Teenage Mothers In Kenya: A Baseline Study Report, Chi-Chi Undie, Harriet Birungi, George Odwe, Francis Obare Jan 2015

Expanding Access To Secondary School Education For Teenage Mothers In Kenya: A Baseline Study Report, Chi-Chi Undie, Harriet Birungi, George Odwe, Francis Obare

Reproductive Health

Carried out in Homa Bay County, Kenya, this study provides a baseline assessment involving the following data collection components: a household survey with out-of-school teenage girls (regardless of whether they had ever been pregnant or not), teenage mothers, and their household heads; and a school survey with secondary school principals and students. The objectives of the study were to: 1) foster an understanding of the current situation and context in regard to out-of-school teenage mothers and their potential support systems for school re-entry at the household and school levels; 2) clarify possible solutions for promoting school re-entry on the part …


A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman Jan 2015

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …


Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi Jan 2015

Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi

Reproductive Health

The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of …


Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council Jan 2015

Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …


Promoting Respectful Maternity Care Resource Package—Implementing Respectful Maternity Care In Kenya, Population Council Jan 2015

Promoting Respectful Maternity Care Resource Package—Implementing Respectful Maternity Care In Kenya, Population Council

Reproductive Health

The Respectful Maternity Care (RMC) Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project. The resource package is designed to be used by program managers, supervisors, trainers, technical advisors, and others who organize or facilitate RMC training workshops on sexual and reproductive health as well as skills training in emergency obstetric and newborn care. The resource package provides experienced facilitators with background information, materials, instructions, and tips for promoting respectful care in reproductive, maternal, and newborn health services in both facilities and communities. The resource package also includes tools for …


Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend Jan 2015

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …


Male Utilization In Integrated Srh And Hiv Services, Integra Initiative Jan 2015

Male Utilization In Integrated Srh And Hiv Services, Integra Initiative

Reproductive Health

Worldwide, men are less likely to seek sexual and reproductive health (SRH) and HIV services than women. This is due to the way in which SRH and HIV services are organized and promoted as well as rigid gender norms and harmful perceptions of what it means to be a man, with far reaching consequences on health and well-being. The “Steps to Integration” series provides a guide on how to integrate SRH and HIV services based on findings from the Integra Initiative, managed by International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the …


Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark Jan 2015

Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time, yet this is the most neglected period for the coverage and provision of quality care. The building blocks of the WHO health systems model were applied in describing the status and health system structures that support the provision of postpartum and postnatal care (PNC) services in Kenya. Many opportunities exist for facilitating the delivery of the Population Council’s Progesterone Contraceptive Vaginal Rings (PCVR) within PNC services in Kenya, such as integration with other primary health care …


Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council Jan 2015

Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council

Reproductive Health

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of …


Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council Jan 2015

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …


Education Sector Response To Early And Unintended Pregnancy: A Review Of Country Experiences In Sub-Saharan Africa, Harriet Birungi, Chi-Chi Undie, Ian Mackenzie, Anne Katahoire, Francis Obare, Patricia Machawira Jan 2015

Education Sector Response To Early And Unintended Pregnancy: A Review Of Country Experiences In Sub-Saharan Africa, Harriet Birungi, Chi-Chi Undie, Ian Mackenzie, Anne Katahoire, Francis Obare, Patricia Machawira

Reproductive Health

In Sub-Saharan Africa (SSA), early and unintended pregnancy leads to a colossal loss of educational opportunities for girls. Existing studies that show associations between early/unintended pregnancy and school dropout lead to critical questions about how the education sector is responding to the issue in SSA. Conducted from August 2014 to April 2015, this review was devoted to an examination of such responses across six countries: Botswana, Kenya, Malawi, Tanzania, Uganda, and Zambia. The review focused on several key issues, including: education-sector policies for pregnant students and adolescent mothers; integration of pregnancy prevention into sexuality education curricula; the school environment as …


Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango Jan 2015

Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango

Reproductive Health

The literature on fertility transitions in the sub-Saharan Africa region suggests that an early transition was observed across nearly all age groups, socioeconomic groups, and countries. This workshop report analyzes fertility transitions in Ghana and Kenya which are influenced by a multiplicity of factors, with marked similarities and differences between each country. Paradoxically, these analyses and critiques of policy and programming experiences suggest that, if enabling women and couples to achieve their wanted fertility rates within a rights-based approach that reduces inequities as well as reducing TFR toward replacement level are the goals of a national family planning program, then …


Creating Conditions For Scale Up: Technical Assistance As An Implementation Research Uptake Strategy, Ian Askew Jan 2015

Creating Conditions For Scale Up: Technical Assistance As An Implementation Research Uptake Strategy, Ian Askew

Reproductive Health

No abstract provided.


Adolescent Girls Initiative-Kenya: Program Overview, Population Council Jan 2015

Adolescent Girls Initiative-Kenya: Program Overview, Population Council

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education, health, and general well-being—including early marriage; teenage pregnancy; early, unprotected, and/or unwanted sexual activity; violence; social isolation; and HIV/STIs. For the most part, very young adolescent girls who live in risk-prone environments have not yet experienced these negative outcomes. It is critical, therefore, to intervene early and increase girls’ capacity to overcome these risks before the challenges result in outcomes that may be irreversible. Research has shown that single-sector interventions are not adequate to obtain the range of outcomes needed to help girls enter into adulthood …