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Full-Text Articles in Public Health

Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar Jan 1999

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1998

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 Jan 1997

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 Jan 1997

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 Jan 1997

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 Jan 1996

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 Jan 1996

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 Jan 1996

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 Jan 1995

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 Jan 1995

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 Jan 1995

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 Jan 1994

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 …


Hanover Street: Un Experimento De Capacitacion Femenina En Soladadura Y Carpinteria, Peggy Antrobus, Barbara Rogers Jan 1983

Hanover Street: Un Experimento De Capacitacion Femenina En Soladadura Y Carpinteria, Peggy Antrobus, Barbara Rogers

Poverty, Gender, and Youth

El Proyecto de Hanover Street, conocido oficialmente como United Women's Woodworking and Welding Project (Proyecto de Carpintería y Soldadura de la Unión Femenina), es un experimento destinado a capacitar a un grupo de mujeres en oficios que usualmente desempeñan los hombres. Se inició en 1976 y fue el primer proyecto de esta clase de la Oficina de la Mujer Jamaiquina, una dependencia creada por el Gobierno de Jamaica durante el Año Internacional de la Mujer, para garantizar la total participación femenina en el desarrollo del país. A pesar de encontrarse aún en una etapa de desarrollo, el proyecto ha demostrado …


Hanover Street: An Experiment To Train Women In Welding And Carpentry, Peggy Antrobus, Barbara Rogers Jan 1980

Hanover Street: An Experiment To Train Women In Welding And Carpentry, Peggy Antrobus, Barbara Rogers

Poverty, Gender, and Youth

The Hanover Street Project, formally known as the United Women’s Woodworking and Welding Project, is an experiment in training women for jobs usually held only by men. Begun in 1976, this was the first such program of the Jamaica Women's Bureau, established by the government during International Women's Year to ensure that women participate fully in Jamaica’s development. The project demonstrated that low-income women can learn non-traditional skills and can work together to improve their lives. Through trial and error, the project is providing the Women's Bureau with a wealth of information about teaching technical skills, working with other government …


Village Women Organize: The Mraru Bus Service, Jill Kneerim Jan 1980

Village Women Organize: The Mraru Bus Service, Jill Kneerim

Poverty, Gender, and Youth

The Mraru Women's Group in rural Kenya, like many community women's organizations around the world, is an example of a deeply rooted tradition of association and self-help among women. In 1971 the group began to gather its resources to solve a common problem—transportation. They raised money, bought a bus, and began a public transport service that made money; they now face other difficult questions such as reinvesting profits, serving members' broader needs, and maintaining a strong economic base. The Mraru Women's Group has shown unusual creativity and persistence in identifying common needs and organizing to meet them. They have also …


Population Review 1970: Kenya, Norman Miller Dec 1970

Population Review 1970: Kenya, Norman Miller

Dartmouth Scholarship

The Republic of Kenya, located astride the equator on the Indian Ocean, enjoys the distinction of being the first tropical African nation to initiate a serious government program in population analysis and family planning. Ghana, Botswana, and the Reunion Islands off the African coast recently followed suit and have positive programs underway. By contrast, most other African states remain apathetic toward their own population problems, and a few are vigorously pronatal. Perhaps the most extreme example is Kenya's island neighbor, Zanzibar, which reportedly has introduced the death penalty for illegal abortions, and banned the sale of all contraceptives.