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Full-Text Articles in Public Health

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council Jan 2011

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …


Sexual And Reproductive Health Needs Of Adolescents Living With Hiv In Kenya, Harriet Birungi, Francis Obare, Jane Harriet Namwebya, Ibrahim Mohammed, Margaret Gitau, Margaret Makumi Jan 2011

Sexual And Reproductive Health Needs Of Adolescents Living With Hiv In Kenya, Harriet Birungi, Francis Obare, Jane Harriet Namwebya, Ibrahim Mohammed, Margaret Gitau, Margaret Makumi

Reproductive Health

The objective of this study was to assess the sexual and reproductive health needs of adolescents living with HIV in Kenya with a view to identifying and developing interventions that integrate these needs within the existing HIV/AIDS treatment, care, and support programs in the country. The study was a result of collaboration between Population Council, APHIA II Rift Valley and Coast (Family Health International), the National AIDS and STI Control Programme, and APHIA II Nairobi and Central (Pathfinder International). Major findings indicate that many of the adolescents living with HIV are vulnerable, and that programmatic gaps exist in addressing the …


Ten Years Of The Kenya Adolescent Reproductive Health Project: What Has Happened?, Humphres Evelia, Monica Wanjiru, Francis Obare, Harriet Birungi Jan 2011

Ten Years Of The Kenya Adolescent Reproductive Health Project: What Has Happened?, Humphres Evelia, Monica Wanjiru, Francis Obare, Harriet Birungi

Reproductive Health

This evaluation by the Population Council’s APHIA II Operations Research Project sought to find out whether the adolescent sexual and reproductive health (ASRH) and HIV/AIDS activities in Kenya had been sustained over a 10-year period when the project was replicated and scaled up to cover seven provinces in the country. The evaluation had three main objectives: 1) to determine the extent to which activities of the Kenya Adolescent Reproductive Health Program (KARHP) have continued at national, provincial, and district levels; 2) to determine whether desired sexual and reproductive health outcomes (knowledge, behavior, and practices) have been sustained among in- and …


Using Youth-Friendly Communication Approaches To Communicate Hiv/Aids With Young People Is Feasible And Acceptable, Population Council Jan 2011

Using Youth-Friendly Communication Approaches To Communicate Hiv/Aids With Young People Is Feasible And Acceptable, Population Council

Reproductive Health

HIV remains a major concern in Kenya among all segments of the population, including adolescents. New ways of delivering HIV information and services are therefore needed, especially to reach young people and encourage them to take up counselling and testing to know their sero-status. The APHIA II Operations Research Project collaborated with the Ministry of Education, Well Told Story, and the National AIDS and STD Control Programme to implement a project to enhance communication in schools about HIV and create demand for early counseling and testing. The project also sought to create a supportive environment in schools for young people …


Élargir L'Accès Des Adolescentes Aux Espaces Sécurisés, À L'Éducation Financière Et Aux Produits D'Épargne Au Kenya, Karen Austrian Jan 2011

Élargir L'Accès Des Adolescentes Aux Espaces Sécurisés, À L'Éducation Financière Et Aux Produits D'Épargne Au Kenya, Karen Austrian

Poverty, Gender, and Youth

Près d'un milliard de personnes vivent dans des implantations urbaines sauvages et informelles, à savoir des «bidonvilles». Au Kenya, 60% des quelques 3 millions d’habitants de Nairobi vivent dans des taudis caractérisés par des niveaux élevés de pauvreté et de VIH. Kibera est le plus grand de ces bidonvilles. La vie est particulièrement dangereuse pour les adolescentes dans les bidonvilles, car elles font leur transition vers l'âge adulte. Les filles sont davantage susceptibles que les garçons du même âge d'être infectées par le VIH, et l'initiation sexuelle des jeunes filles se produit souvent dans le contexte de violence et de …


Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya Jan 2011

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …


Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Results From The Uganda Pilot Evaluation, Karen Austrian Jan 2011

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Results From The Uganda Pilot Evaluation, Karen Austrian

Poverty, Gender, and Youth

This presentation was given at the Global Youth Economic Opportunities Conference in Washington DC, USA in 2011. It looks at results from a Uganda Pilot Program to provide financial education among girls and increase asset building in the form of Girls Savings Programs. Results from this study saw that savings programs build social, health, and economic assets for girls.


Addressing Sexual Violence And Hiv Risk Among Married Adolescent Girls In Rural Nyanza, Kenya, Chi-Chi Undie Jan 2011

Addressing Sexual Violence And Hiv Risk Among Married Adolescent Girls In Rural Nyanza, Kenya, Chi-Chi Undie

Poverty, Gender, and Youth

Married adolescent girls form a large segment of Kenyan youth, yet they are largely overlooked by researchers and program managers concerned with the lives of adolescents. In settings such as Nyanza Province, Kenya, rates of HIV infection are extremely high, and evidence is increasing in some settings that girls who are married are much more likely to be infected, compared with their unmarried sexually active counterparts. Research indicates that the risk of HIV infection following forced sex is likely higher than following consensual sex. Finding ways to tackle sexual violence and HIV infection simultaneously has therefore become a major public …


Strengthening The Delivery Of Comprehensive Reproductive Health Services At The Community Level In Kenya, Population Council Jan 2011

Strengthening The Delivery Of Comprehensive Reproductive Health Services At The Community Level In Kenya, Population Council

Reproductive Health

The Population Council APHIA II Operations Research Project collaborated with the Ministry of Public Health and Sanitation to improve the quality of services offered by community-based midwives in two districts in Western Kenya, to prepare them to offer more comprehensive maternal services through antenatal, obstetric, postpartum, and newborn care. The study found that community midwives can tremendously increase clients’ access to essential maternal health services and other reproductive health services. Therefore Ministry of Health and its partners should scale up community midwives’ activities to enable more women access these services. Furthermore, information campaigns are needed to promote the range of …


Using Community Health Workers Can Lead To Positive Sexual Behavior Outcomes Among People Living With Hiv, Population Council Jan 2011

Using Community Health Workers Can Lead To Positive Sexual Behavior Outcomes Among People Living With Hiv, Population Council

Reproductive Health

This operations research summary reports on the use of community health workers (CHWs) in Kenya to influence sexual behavior outcomes of people living with HIV/AIDS. Results of the Population Council’s APHIA II project indicate that using community-based health workers to provide information and counsel people living with HIV as well as make referrals for antiretroviral therapy can lead to increased uptake of ART among those eligible but not on treatment, and to positive sexual behavior outcomes. HIV prevention and care programs should therefore work with CHWs to increase the reach and impact of their activities.


Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola Jan 2011

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …


Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru Jan 2011

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …


Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council Jan 2011

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …


"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch Jan 2011

"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch

HIV and AIDS

Report of a study exploring the feasibility and acceptability of free HIV home self-testing among health workers in Kenya, within the range of other HIV testing options available.


Expanding Safe Spaces, Financial Education, And Savings For Adolescent Girls In Kenya, Karen Austrian Jan 2011

Expanding Safe Spaces, Financial Education, And Savings For Adolescent Girls In Kenya, Karen Austrian

Poverty, Gender, and Youth

Almost 1 billion people around the globe live in urban informal settlements, or “slums.” In Kenya, 60 percent of Nairobi’s nearly 3 million inhabitants live in slum areas characterized by high levels of poverty and HIV. Kibera is the largest of these slums. Life is particularly perilous for adolescent girls in slums, as they make their transition to adulthood. Girls are several times more likely than their male age-mates to become infected with HIV, and sexual initiation for girls often occurs in the context of violence and coercion. Poverty is a driving force behind these and other vulnerabilities. As described …


Concurrent Sexual And Substance-Use Risk Behaviours Among Female Sex Workers In Kenya's Coast Province: Findings From A Behavioural Monitoring Survey, Simon Pierre Tegang, S. Abdallah, G. Emukule, Stanley Luchters, Nzioka Kingola, M. Barasa, Stephen Mucheke, P. Mwarogo Dec 2010

Concurrent Sexual And Substance-Use Risk Behaviours Among Female Sex Workers In Kenya's Coast Province: Findings From A Behavioural Monitoring Survey, Simon Pierre Tegang, S. Abdallah, G. Emukule, Stanley Luchters, Nzioka Kingola, M. Barasa, Stephen Mucheke, P. Mwarogo

Population Health, East Africa

While many studies confirm the association between HIV, alcohol and injecting drug use by female sex workers (FSWs), little is known about their use of marijuana, khat and other substances and the association of these substances with HIV, risky sexual behaviour, and sexual violence. To better understand this association, data were analysed from a cross-sectional, behavioural survey of 297 FSWs in Mombasa, a well-known tourist destination and the second largest port in Africa and capital city of the Coast Province in Kenya. Among the FSWs, lifetime use of different substances was reported by 91% for alcohol, 71% for khat, 34% …


Characteristics And Etiology Of Moderate-To-Severe Diarrhea Of Acute, Prolonged Acute, And Persistent Duration Among Children Less Than 5 Years Old In Rural Western Kenya, 2008-2010, Katharine A. Schilling Nov 2010

Characteristics And Etiology Of Moderate-To-Severe Diarrhea Of Acute, Prolonged Acute, And Persistent Duration Among Children Less Than 5 Years Old In Rural Western Kenya, 2008-2010, Katharine A. Schilling

Public Health Theses

Worldwide, diarrheal disease is the second leading cause of death in children under 5 years old. Data on diarrhea of extended duration is limited. We described the characteristics associated with acute, prolonged acute and persistent diarrhea in Kenyan children less than 5 years of age participating in the Global Enterics Multicenter Study. Children presenting at a clinic were enrolled if they met the case definition for acute moderate-to-severe diarrhea defined as >3 loose stools in the last 24 hrs, within 7 days of illness onset, with >1 of the following: sunken eyes, skin tenting, dysentery, IV rehydration, or hospitalization. To …


Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed Jan 2010

Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed

Reproductive Health

This report evaluated a project in ten Kenyan health facilities. It examined the feasibility, acceptability and effect of introducing reproductive tract infection and sexually transmitted infection (RTI/STI) guidelines on the quality of care provided, and the incremental costs of integrating these services into existing reproductive health (RH) services; it also disseminated the results and lessons learnt within Kenya. Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into RH services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients.


Life-Skills Education Leads To Improved Effect On Adolescents' Sexual Behavior, Population Council Jan 2010

Life-Skills Education Leads To Improved Effect On Adolescents' Sexual Behavior, Population Council

Reproductive Health

The Kenya Adolescent Reproductive Health Project (KARHP) was a three-pronged program implemented in schools, communities, and health facilities, to provide information and services to adolescents in order to improve their reproductive health outcomes. This operations research summary from the Population Council sought to discover whether the activities started under the project and desired reproductive health outcomes had been sustained in the 10-year period since inception, and to identify challenges experienced in sustaining the model. Although the survey suggests that the efforts to sustain KARHP/ASRH activities may be having desirable behavioral outcomes among adolescents, there is a need to strengthen these …


The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Kenya 2008–09, Population Council Jan 2010

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Kenya 2008–09, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Kenya 2008–09” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …


Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina Jan 2010

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …


Comprehensive Responses To Gender-Based Violence In Low-Resource Settings: Lessons Learned From Implementation, Jill Keesbury, Ian Askew Jan 2010

Comprehensive Responses To Gender-Based Violence In Low-Resource Settings: Lessons Learned From Implementation, Jill Keesbury, Ian Askew

Reproductive Health

The Population Council undertook a program of technical assistance and research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa. This project created an active network of implementers and researchers across sub-Saharan Africa, all of whom were charged with developing, implementing, and evaluating core elements of a comprehensive, multisectoral model for strengthening responses for survivors of SGBV, especially survivors of sexual violence. Based on the experiences of these partners, this document reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa. The findings are intended to …


Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao Jan 2010

Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao

Reproductive Health

Maternal health complications, including those arising from unsafe abortion and miscarriage, are a leading cause of morbidity among women in Kenya. These realities necessitate interventions to prevent unintended or unwanted pregnancies and to ensure access to quality care for women with postabortion complications. In response to this need, the RESPOND Project designed an intervention package aimed at increasing awareness and use of postabortion care (PAC) services and improving family planning, reproductive health, and maternal health outcomes. As part of the intervention, RESPOND works with districts and communities to: strengthen service delivery points to provide PAC services; conduct community mobilization to …


Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council Jan 2010

Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council

Reproductive Health

An operations research intervention by the Population Council in Kenya aimed to design a referral framework for linking HIV‐positive family planning (FP) clients to treatment and care in selected health facilities. The project also assessed the acceptability and effectiveness in increasing the number of eligible HIV‐positive FP clients receiving HIV care and treatment services. This summary details the effort to improve the linkage between FP services and comprehensive care centers that led to a dramatic increase in the proportions of HIV-positive clients in FP clinics who go on to receive HIV/AIDS treatment and care services at the same facility. Recommendations …


Encouraging Abandonment Of Fgm/C Among The Somali Community In Wajir, Kenya, Population Council Jan 2010

Encouraging Abandonment Of Fgm/C Among The Somali Community In Wajir, Kenya, Population Council

Reproductive Health

This report summarizes key achievements of a two-year project to foster community‐wide abandonment of FGM/C by developing and testing the feasibility of working closely with communities highly resistant to external influences. The diagnostic study aimed to identify culturally appropriate empowerment strategies for women and youth in the Somali community.


Looking Back, Moving Forward: Reducing Hiv-Related Stigma, Horizons Studies 2000 To 2007, Julie Pulerwitz, Annie P. Michaelis, Ellen Weiss, Lisanne Brown, Vaishali Sharma Mahendra Jan 2010

Looking Back, Moving Forward: Reducing Hiv-Related Stigma, Horizons Studies 2000 To 2007, Julie Pulerwitz, Annie P. Michaelis, Ellen Weiss, Lisanne Brown, Vaishali Sharma Mahendra

HIV and AIDS

In 1997, the Population Council initiated the Horizons Program—a decade-long USAID-funded collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, PATH, Tulane University, Family Health International, and Johns Hopkins University—designing, implementing, evaluating, and expanding innovative strategies for HIV prevention and care. Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and …


Looking Back, Moving Forward: Understanding The Hiv Risk And Sexual Health Needs Of Men Who Have Sex With Men, Horizons Studies 2001 To 2008, Scott Geibel, Waimar Tun, Placide Tapsoba, Scott E. Kellerman Jan 2010

Looking Back, Moving Forward: Understanding The Hiv Risk And Sexual Health Needs Of Men Who Have Sex With Men, Horizons Studies 2001 To 2008, Scott Geibel, Waimar Tun, Placide Tapsoba, Scott E. Kellerman

HIV and AIDS

In 1997, the Population Council initiated the Horizons Program—a decade-long USAID-funded collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, PATH, Tulane University, Family Health International, and Johns Hopkins University—designing, implementing, evaluating, and expanding innovative strategies for HIV prevention and care. Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and …


Training Service Providers Increases Tb Screening In Postnatal Care, Population Council Jan 2010

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …


Psychosocial Correlates Of Adherence To Antiretroviral Therapy (Art) In People Living With Hiv In Kenya, Thomas M. Kamau Jan 2010

Psychosocial Correlates Of Adherence To Antiretroviral Therapy (Art) In People Living With Hiv In Kenya, Thomas M. Kamau

Seton Hall University Dissertations and Theses (ETDs)

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Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel Jan 2010

Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel

HIV and AIDS

In the past, HIV prevention efforts have focused primarily on developing risk-reduction interventions for those presumed to be HIV-negative and therefore at risk of becoming infected with HIV. In recognition of the need for prevention among people living with HIV (PLHIV), programs have been initiated in Africa, but primarily in clinical settings for those who are on antiretroviral therapy (ART). There is little knowledge about how to reach those PLHIV not on ART, and therefore not in regular contact with the health system or with effective prevention messages. This diagnostic study aimed to address the gap in information on how …