International Public Health Commons^™

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 …

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

Reproductive Health

No abstract provided.

Interaction Between Climatic, Environmental, And Demographic Factors On Cholera Outbreaks In Kenya, James D. Stoltzfus, Jane Y. Carter, Muge Akpinar-Elci, Martin Matu, Victoria Kimotho, Mark J. Giganti, Daniel Langat, Omur C. Elsi

Community & Environmental Health Faculty Publications

Background:

Cholera remains an important public health concern in developing countries including Kenya where 11,769 cases and 274 deaths were reported in 2009 according to the World Health Organization (WHO). This ecological study investigates the impact of various climatic, environmental, and demographic variables on the spatial distribution of cholera cases in Kenya.

Methods:

District-level data was gathered from Kenya’s Division of Disease Surveillance and Response, the Meteorological Department, and the National Bureau of Statistics. The data included the entire population of Kenya from 1999 to 2009.

Results:

Multivariate analyses showed that districts had an increased risk of cholera outbreaks when …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green

HIV and AIDS

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and …

Provider Alerts And Reminders To Improve Tuberculosis Care Among People Living With Hiv In Kenya: Tb Tech Formative Report, Caricia Catalani, Eric P. Green, Lameck Diero, Jane Carter, Martin Were, Dennis Israelski, Adrian Gardner, Charity Ndwiga, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) have a 20-fold higher risk of dying from tuberculosis (TB) than the general population. Reducing TB morbidity and mortality among PLHIV requires identifying those with active TB and treating them, as well as preventing new TB infections among those not infected. WHO recommends screening all HIV-infected patients for symptoms of active TB infection, testing those who show symptoms, treating those with positive TB tests, and providing isoniazid preventive therapy (IPT) for those who are either asymptomatic or whose TB test results are negative. WHO classifies Kenya among the “high burden” countries for TB and notes …

Confronting Disrespect And Abuse During Childbirth In Kenya: The Heshima Project, Population Council

Reproductive Health

No woman should be hit, yelled at, or abused in any way during childbirth. However, laboring women in Kenya and elsewhere may experience inhumane treatment in hospitals and clinics. This abuse is a key yet overlooked reason why only four in ten pregnant women in Kenya deliver at health facilities. To increase the number of women delivering in health facilities and thereby reduce maternal deaths, governments, health systems, and practitioners need sound evidence documenting the disrespect and abuse that women experience. Through the Heshima Project, the Population Council is changing how health systems and women think about quality maternity care …

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Kenya, Charlotte E. Warren, James Kelly Kimani, Jackline Kivunaga, Brian Mdawida, Charity Ndwiga, Katharine Mccarthy, Ann K. Blanc

Reproductive Health

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Facility-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Facility-Based Workshops” is to orient service providers on the RMC concept along with a set of evidence-based interventions to promote RMC. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to RMC and the RMC Resource Package. Demonstrate knowledge and use of Values Clarification and Attitude Transformation (VCAT) theory and practice. Discuss selected evidence-based strategies that reduce disrespect and abuse. Discuss participants’ …

Kenya Country Profile: A Status Check On Unintended Pregnancy In Kenya, Joyce Mumah, Jessica Brinton, Caroline W. Kabiru, Carol Mukiira, Chimaraoke O. Izugbara

Reproductive Health

Kenya’s mothers are dying at an alarming rate: a woman giving birth in Kenya has a 1 in 38 chance of dying due to inadequate reproductive health services. In response, in 2014 Kenya’s First Lady Margaret Kenyatta launched the Beyond Zero campaign to create awareness and raise funds to tackle maternal mortality and morbidity and improve child health. This brief offers six policy and programmatic recommendations to address significant sexual and reproductive health challenges highlighted throughout the report. These recommendations take into account the policy context in Kenya, which is evolving at a rapid rate in part because of the …

Improving Family Planning Services In Public Health Facilities To Reach More Women, Caroline W. Kabiru, Jessica Brinton, Joyce Mumah, Carol Mukiira, Chimaraoke O. Izugbara

Reproductive Health

Although Kenya has made significant progress in ensuring its citizens’ right to reproductive health, many Kenyans still lack access to or fail to use contraceptives, in part because of the lack of quality family planning (FP) services. Through the STEP UP research program, the African Population and Health Research Center developed a comprehensive country profile report that outlines the status, causes, and consequences of unintended pregnancy in Kenya. One of the most prominent findings was how important public health facilities are to reducing unmet need for FP. In order to solidify gains achieved and make further progress, concerted commitment from …

Population And Health Dynamics In Nairobi's Informal Settlements: Report Of The Nairobi Cross-Sectional Slums Survey (Ncss 2012), African Population And Health Research Center (Aphrc)

Reproductive Health

This report documents the living conditions and health risks of slum-dwellers across Nairobi’s informal settlements a decade after the Nairobi Cross-sectional Slums Survey (NCSS) of 2000. It aims to not only highlight the needs of slum-dwellers but also inform policymakers on the changes that have occurred in the living conditions of Nairobi’s urban poor since 2000, considering development interventions by the Government of Kenya and its development partners. The NCSS 2012 results highlight marked improvements in environmental, health, and educational indicators among slum dwellers. However, these improvements were not uniform, with subgroups of younger women and women without formal education …

Coping With Unintended Pregnancies: Narratives From Adolescents In Nairobi's Slums, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara, Carol Mukiira

Reproductive Health

This qualitative study examined the challenges faced by adolescents in Kenya with regard to unintended pregnancies and how adolescents in urban slum settlements manage and cope with unintended pregnancies. The study’s findings suggest that high levels of unintended pregnancy among young people in Kenya’s urban slums are linked to myths and misconceptions about contraception. Other findings underscore the fact that many young people lack access to contraception and reproductive health services; indicate that unintended pregnancies are linked to sexual violence; and highlight the need for government to manage the high levels of school dropout as a result of an unintended …

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …

Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. The Community Facilitator’s Guide, designed to be used by facilitators to promote respectful maternity care at the community level, can be adapted to educate a variety of stakeholders in community settings (i.e., Community Health Extension …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Community-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Community-Based Workshops” is to orient community-health workers on the RMC concept. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal health in relation to RMC. Discuss rights-based approaches related to RMC. Discuss selected strategies that reduce disrespect and abuse (D&A). Discuss the role of the community in promoting RMC. Demonstrate knowledge and use of the Alternative Dispute Resolution mechanism. Develop action plans to support the implementation of RMC interventions at the community level. Summary: D&A deters facility-based childbirth and Skilled …

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.

Awareness, Treatment And Control Of Hypertension In Kenya, Jacob Kariuki, Eileen M. Stuart-Shor, Samuel Kimani, James Muchira, Jessica Demita, Heather Milton, Mercy Kamau, Vincent Mutuma, Darren Golden, Peris Kariuki

Office of Community Partnerships Posters

The emerging epidemic of hypertension (HTN) in sub-Saharan Africa is predicted to worsen. Uncontrolled HTN is associated with CVD, high morbidity and premature mortality; hence early detection, treatment and control of HTN is critical to reduction of the associated sequelae. The study was guided by the Social Ecological Model and principles of Community Based Participatory Research.

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi

Poverty, Gender, and Youth

The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …

Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …

Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew

Reproductive Health

This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …

Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows

Reproductive Health

This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …

International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …

Slides: Nokero: Power To The Powerless, Stephen Katsaros

2012 Energy Justice Conference and Technology Exposition (September 17-18)

Presenter: Stephen Katsaros, Inventor, Founder, and CEO, Nokero

13 slides

The Prevalence Of Essential Hypertension In Kasigau, Kenya, Lindsay Williams

Mahurin Honors College Capstone Experience/Thesis Projects

Hypertension is the leading cause of cardiovascular disease worldwide. Cardiovascular disease (CVD) is a widespread chronic non-communicable disease (NCD) which is on the rise in developing countries. Evidence based on extensive research studies on risk factors for NCDs suggests that they could be easily significantly decreased by simply controlling their risk factors. Although high blood pressure has been recognized as a leading risk factor for CVD, little research has been done to document the prevalence and incidence of essential hypertension (EH) in lower socioeconomic developing countries. One such country is Kenya. It was found in our research study that Kasigau …

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …

The Cost Of Reaching The Most Disadvantaged Girls: Programmatic Evidence From Egypt, Ethiopia, Guatemala, Kenya, South Africa, And Uganda, Jessica Sewall-Menon, Judith Bruce, Karen Austrian, Raven Brown, Jennifer Catino, Alejandra Colom, Angel Del Valle, Habtamu Demele, Annabel Erulkar, Kelly Hallman, Eva Roca, Nadia Zibani

Poverty, Gender, and Youth

The most disadvantaged adolescent girls are the poorest girls from the poorest communities. They suffer from human rights abuses, lack education and economic opportunity, are affected by HIV/AIDS, and have poor reproductive and maternal health outcomes. To effectively reach these girls so that they can receive critical services such as gathering spaces, life skills, financial literacy, savings accounts, and reproductive health knowledge, they must be targeted as a distinct segment. It is important to invest in building the capacities of local partners and governments to deliver and scale-up low-cost, well-targeted programs. This technical report is intended to assist programmatic officers, …

The Africa Regional Sexual And Gender-Based Violence Network Annual Partners Meeting: June 26-27 2012, Mombasa, Kenya—Meeting Report, Population Council

Reproductive Health

The Population Council convened an annual partners meeting of its Africa Regional Sexual and Gender-Based Violence (SGBV) Network. Over 30 participants attended the meeting whose objectives were: 1) to facilitate South-South technical exchange and information-sharing on the changing landscape of violence among partners, donors, and other experts; and 2) to reflect on the ways in which research is translating into policy and practice. This report highlights the myriad ways in which activities conducted under this Network have influenced policy, practice, and funding considerations in the region, while detailing the progress of Network partners on their projects, built around several key …