Medicine and Health Sciences Commons^™

Validity, Reliability, And Measurement Invariance Of An Adapted Short Version Of The Hiv Stigma Scale Among Perinatally Hiv Infected Adolescents At The Kenyan Coast, Stanley W. Wanjala, Derrick Ssewanyana, Patrick N. Mwangala, Carophine Nasambu, Esther Chongwo, Stanley Luchters, Charles R. J. C. Newton, Amina Abubakar

Population Health, East Africa

Background: There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context. We examined the psychometric properties and measurement invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast.

Methods: A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12-17 years between November 2017 and October 2018. A short version of the Berger HIV stigma scale (HSS-40) containing twelve items (HSS-12) covering the four dimensions of …

Determinants Of Preconception Care Among Pregnant Women In An Urban And A Rural Health Facility In Kenya: A Qualitative Study, Joan Okemo, Dorothy Kamya, Mukaindo Mwaniki, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could con- tribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya.

Methods: A qualitative approach was …

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …

Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.

The Etiology Of Pneumonia In Hiv-Uninfected Children In Kilifi, Kenya: Findings From The Pneumonia Etiology Research For Child Health (Perch) Study, Juliet O. Awori, Alice Kamau, Susan Morpeth, Sidi Kazungu, Micah Silaba, Joyce Sande, Angela Karani, Sammy Nyongesa, Salim Mwarumba, Robert Musyimi

Imaging & Diagnostic Radiology, East Africa

Background: In the 1980s, Streptococcus pneumoniae and Haemophilus influenzae were identified as the principal causes of severe pneumonia in children. We investigated the etiology of severe childhood pneumonia in Kenya after introduction of conjugate vaccines against H. influenzae type b, in 2001, and S. pneumoniae, in 2011.

Methods: We conducted a case–control study between August 2011 and November 2013 among residents of the Kilifi Health and Demographic Surveillance System 28 days to 59 months of age. Cases were hospitalized at Kilifi County Hospital with severe or very severe pneumonia according to the 2005 World Health Organization definition. Controls …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr. Ph.D., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A. Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Application Of The Ultra-Poverty Graduation Model In Understanding Community Health Volunteers’ Preferences For Socio-Economic Empowerment Strategies To Enhance Retention: A Qualitative Study In Kilifi, Kenya, Njeri Nyanja, Nelson Nyamu, Lucy Nyaga, Sophie Chabeda, Adelaide Lusambili, Marleen Temmerman, Michaela Mantel, Anthony Ngugi

Family Medicine, East Africa

Background: A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare cover- age, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary nature of their work; hence, the high attrition rates from community-based health programmes. There is an urgent need to support CHVs become economically self-reliant. We report here on the application of the Ultra-Poverty Graduation (UPG) Model to map CHVs’ preferences for socio-economic empowerment strategies that could enhance their retention in a rural area …

Community Health Volunteers Challenges And Preferred Income Generating Activities For Sustainability: A Qualitative Case Study Of Rural Kilifi, Kenya, Adelaide Lusambili, Njeri Nyanja, Sophie Vusha Chabeda, Marleen Temmerman, Lucy Nyaga, Jerim Obure, Anthony Ngugi

Population Health, East Africa

Background: There is a global emphasis on engaging community health volunteers (CHVs) in low- to middle-income countries (LMICs) to reach to the vast underserved populations that live in rural areas. Retention of CHVs in most countries has however been difficult and turnover in many settings has been reported to be high with profound negative effects on continuity of community health services. In rural Kenya, high attrition among CHVs remains a concern. Understanding challenges faced by CHVs in rural settings and how to reduce attrition rates with sustainable income-generating activities (IGAs) is key to informing the implementation of contextual measures that …

A Qualitative Endline Evaluation Study Of Male Engagement In Promoting Reproductive, Maternal, Newborn, And Child Health Services In Rural Kenya, Adelaide Lusambili, Stefania Wisofschi, Constance Shumba, Peter Muriuki, Jerim Obure, Michaela Mantel, Lindsay Mossman, Rachel Pell, Lucy Nyaga, Anthony Ngugi, James Orwa, Stanley Luchters, Kennedy Mulama, Terrance J. Wade, Marleen Temmerman

Population Health, East Africa

Background: Globally, male involvement in reproductive, maternal, newborn, and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University implemented the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), project funded by the Government of Canada and Aga Khan Foundation Canada (AKFC). A key component of the project was to encourage greater male engagement in RMNCH in rural Kisii and Kilifi, two predominantly patriarchal communities in Kenya, through a wide range of interventions. Toward the end of the project, we conducted a …

Management Of Intimate Partner Violence In Health Care Settings: A Training Manual For Health Care Providers, Division Of Reproductive And Maternal Health

Reproductive Health

Intimate partner violence (IPV) is any behavior by an intimate partner that causes physical, sexual, or psychological harm. In healthcare settings where providers are well trained, caring, and sensitive, most survivors respond positively to being asked about their exposure to violence. Healthcare providers are in a unique position to identify survivors and offer appropriate management and referrals. The World Health organization developed clinical guidelines to provide evidence-based guidance to healthcare providers on the identification and appropriate response to IPV and sexual violence. Based on this guidance, the Ministry of Health developed a comprehensive training manual to empower healthcare providers with …

Systematic Review On Epidemiology, Interventions And Management Of Noncommunicable Diseases In Acute And Emergency Care Settings In Kenya, Christine Ngaruiya, Annrita Kawira, Florence Mali, Faith Kambua, Beatrice Mwangi, Mbatha Wambua, Denise Hersey, Laventa Obare, Rebecca Leff, Benjamin Wachira

Emergency Medicine, East Africa

Introduction: Mortality and morbidity from Non-Communicable Diseases (NCDs) in Africa are expected to worsen if the status quo is maintained. Emergency care settings act as a primary point of entry into the health system for a spectrum of NCD-related illnesses, however, there is a dearth of literature on this population. We conducted a systematic review assessing available evidence on epidemiology, interventions and management of NCDs in acute and emergency care settings in Kenya, the largest economy in East Africa and a medical hub for the continent.

Methods: All searches were run on July 15, 2015 and updated on December 11, …

Digital News Media Coverage On Sexual And Gender-Based Violence In Kenya: Scoping The Impact Of The Covid-19 Pandemic, Clara Broekaert, Ceri-Lune Renneboog, Ferdinand Okwaro, Abdu Mohiddin, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Sexual and gender-based violence (SGBV) in Kenya is frequently covered in digital news media. As a powerful influencer of public opinion, news media coverage can have a significant societal impact. This scoping review identifies the extent, nature, and themes of all available digital news media coverage on SGBV in Kenya from June 2019 to July 2020. It analyzes changes in coverage since the start of the COVID-19 pandemic.

Method: The methodological framework for scoping reviews developed by Arksey and O’Malley (2005) guided the scoping review. The selected articles were analyzed using NVivo.

Results: Analysis of the 340 …