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Evaluation Of Community-Based Interventions Addressing Social Attitudes And Behavioural Intentions Related To Female Genital Mutilation In Somaliland, Francis Obare, Dennis Matanda, Stephen Kizito, Chi-Chi Undie

Sexual and Reproductive Health, Rights, and Choices

This study aimed to assess changes in social attitudes/beliefs and behavioural intentions related to FGM and gender as a result of community-directed interventions to accelerate positive changes in social attitudes towards ending the practice. The study was conducted in the context of The Girl Generation support to – Africa-Led Movement (TGG-ALM) programme implementation in Somaliland using public opinion poll and vignettes. Key intervention activities implemented by TGG-ALM included conducting community intergenerational dialogues and small grants for community-based organizations to implement interventions at the community level.

Endline Evaluation Of Community-Based Interventions Addressing Social Attitudes And Behavioural Intentions Related To Female Genital Mutilation In Isiolo And Narok Counties, Kenya, Dennis Matanda, Francis Obare, Robert Omondi, Stephen Kizito, Stella Muthuri, Chi-Chi Undie

Sexual and Reproductive Health, Rights, and Choices

The Girl Generation: Support to the Africa-Led Movement (TGG-ALM) programme works to end Female Genital Mutilation (FGM) by shifting social attitudes/beliefs and behavioral intentions related to FGM and the gender ideologies that sustain its continued practice through interventions implemented at the community level. This study aimed to assess such shifts in the context of TGG-ALM intervention sites in Kenya, while also tracking the diffusion of the intervention beyond intervention sites. Key intervention activities implemented by TGG-ALM included conducting community intergenerational dialogues in both Isiolo and Narok counties, women-only reflect circles in Isiolo and couples-only/homestead dialogues in Narok.

What Do Young Feminists In Kenya Need To Thrive?, Chantalle Okondo, John Malkia, Ivy Kutswa, Ruth Juliet, Sar Kagendo, Stacie Akinyi, Gladys Jerop, Juma Damaris, Terry Owino, Jerry Okal

Adolescents and Young People

The Nawiri Project used a core Participatory Action Research Evaluation (PARe) approach to explore the landscape of young feminist organizing/organizations (YFOs) in Kenya and Mexico. The project aimed to synthesize evidence on YFOs’ context, impact, and strengths. In Kenya, the core PARe team included nine young feminists and seven Feminist Advisory Panel (FAP) members, who collaborated with Population Council, Kenya from the project’s inception to dissemination. To define and measure impact, the team conducted five case studies with YFO leadership, nine focus group discussions with YFO beneficiaries, 31 key informant interviews with current and previous partners, and cost and benefit …

Sustainability And Funding Of Young Feminist Organizing/Organization In Kenya, Chantalle Okondo, John Malkia, Ivy Kutswa, Ruth Juliet, Sar Kagendo, Stacie Akinyi, Gladys Jerop, Juma Damaris, Terry Owino, Jerry Okal

Adolescents and Young People

The Nawiri Project used a core Participatory Action Research Evaluation (PARe) approach to explore the landscape of young feminist organizing/organizations (YFOs) in Kenya and Mexico. The project aimed to synthesize evidence on YFOs’ context, impact, and strengths. In Kenya, the core PARe team included nine young feminists and seven Feminist Advisory Panel (FAP) members, who collaborated with Population Council, Kenya from the project’s inception to dissemination. To define and measure impact, the team conducted five case studies with YFO leadership, nine focus group discussions with YFO beneficiaries, 31 key informant interviews with current and previous partners, and cost and benefit …

Understanding Impact Among Young Feminist Organizing/Organizations In Kenya, Chantalle Okondo, John Malkia, Ivy Kutswa, Ruth Juliet, Sar Kagendo, Stacie Akinyi, Terry Owino, Jerry Okal

Adolescents and Young People

The Nawiri Project used a core Participatory Action Research Evaluation (PARe) approach to explore the landscape of young feminist organizing/organizations (YFOs) in Kenya and Mexico. The project aimed to synthesize evidence on YFOs’ context, impact, and strengths. In Kenya, the core PARe team included nine young feminists and seven Feminist Advisory Panel (FAP) members, who collaborated with Population Council–Kenya from the project’s inception to dissemination. To define and measure impact, the team conducted five case studies with YFO leadership, nine focus group discussions with YFO beneficiaries, 31 key informant interviews with current and previous partners, and cost and benefit analysis …

Adolescent Girls Initiative–Kenya: Testing For Scale—Recommendations Report, Karen Austrian, Eva Ireri Muluve, Ruth Nanjekho, John A. Maluccio, Erica Soler-Hampejsek

Adolescents and Young People

The Adolescent Girls Initiative-Kenya, a randomized trial implemented between 2015 and 2021, was designed to test the short- and longer-term effects of two-year multisectoral and multilevel “cash plus” programs for adolescent girls aged 11–14 years. It was implemented in two marginalized areas of Kenya: Kibera, an urban informal settlement in Nairobi, and Wajir, a pastoralist rural county. Results showed that a multisectoral approach was an effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes. The program had long-term sustainable effects. Throughout the testing for scale phase, PC-Kenya …

Gendered Effects Of Covid-19 School Closures: Kenya Case Study, Faith Mbushi, Natalie Wyss, Emily Eunyoung Cho, Karen Austrian, Eva Ireri Muluve, Laura Muthoni, Beth Kangwana

Poverty, Gender, and Youth

This brief summarizes a case study that assessed the gendered impact of COVID-19 school closures in Kenya. COVID-19 school closures escalated education inequalities especially for girls and young people in rural areas. These closures exacerbated adolescent mental health issues, food and economic insecurity, and experiences of violence. COVID-19 response programs implemented by both the Government of Kenya and non-state actors were not able to fully mitigate the impacts of school closures for adolescents, teachers, or schools. Continued efforts to understand the implications of school closures and to support vulnerable students are needed.

Getting It Right! Improving Kenya’S Human Capital By Reducing Stunting—A Household Account, Timothy Abuya, Wangari Ng'ang'a

Reproductive Health

In the last two decades, Kenya has attained middle-income status and established a diverse and private-sector-driven economy. On several socio-economic indicators, such as education, gender equality, and democracy, Kenya scores much higher than its peers. More than two-thirds of Kenyans are under 35 years of age, thus the country’s development hinges on the quality of its youth—their levels of education and skills, their values and attitudes, and the quality of their health and productivity. While Kenya’s investments in the development of its human capital positions the country well to sustain accelerated growth, the trajectory is threatened by high rates of …

Getting Girls Back To School In Kenya: The 4ts ('Trace, Track, Talk And Return') Initiative Implementation Report, George Odwe, Chi-Chi Undie, Ann Gachoya, Truphena Kirongo, Fredrick Kiiru, Jane Njogu

Poverty, Gender, and Youth

The Covid-19 pandemic led to devastating economic and social disruptions globally including in the education sector. The pandemic disrupted access to both sexual and reproductive health services and safe spaces. As a result, many girls faced vulnerabilities that inhibited access to basic education, including risks of child marriage, early pregnancy, gender-based violence, female genital mutilation/cutting, sexual exploitation, and child labor. The negative impact of Covid-19 on girls' education underscores the need for interventions addressing the effect on school re-entry and retention. Kenya has a favorable policy environment for supporting retention within, and re-entry into, schools for vulnerable girls. Notable core …

Endline Results Brief: What Works To Improve Outcomes For Kenya's Adolescent Girls?, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya is a study that evaluates the long-term impact of a multisectoral intervention targeted at adolescent girls aged 11 to 15 years from Kibera and rural Wajir. The intervention consists of four components: a community-based violence-prevention program, an education conditional cash transfer (CCT), health-focused girls-empowerment clubs, and wealth creation for girls via financial education and savings. A random selection of 6,000 girls were exposed to different components of the intervention. Key results, noted in this brief, are: conditional cash transfers are a key driver of improvement in education outcomes, and of delaying sexual debut and pregnancy in …

The Adolescent Girls Initiative-Kenya—Executive Summary: Two-Year Follow Up Results, Population Council

Poverty, Gender, and Youth

In Kenya, early pregnancy is a challenge for girls that often has immediate effects on their educational opportunities, future implications for their social, health, and economic outcomes, and immediate and ongoing negative impacts on their children. Early pregnancy is an outcome shaped by a myriad of issues affecting an adolescent girl’s life—including community norms on gender roles, violence, and the social value of girls; barriers to formal education; household poverty; lack of economic independence; experience of violence; and social isolation. For girls to achieve well-being in early and late adolescence, no single-sector intervention—whether it be education, health, wealth creation, or …

Psychological Distress Prevalence And Associated Stressors And Supports Among Urban-Displaced Congolese Adults In Kenya, Julie A. Tippens, Holly Hatton-Bowers, Ryan Honomichl, Lorey Wheeler, Helen M. Miamidian, Kirstie L. Bash, Michelle C Howell Smith, Dulo Nyaoro, J. Joshua Byrd, Samuel E. Packard, Nicolette I. Teufel-Shone

Department of Child, Youth, and Family Studies: Faculty Publications

Background: There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries.

Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18–80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress.

Results: More than half of the …

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

Commentary: Using Law More Effectively Towards Abandonment Of Fgm/C In Kenya, Agnes K. Meroka-Mutua

Reproductive Health

Female genital mutilation/cutting (FGM/C) is considered a harmful cultural practice and a form of violence against women. Kenya has an FGM/C prevalence rate of 21 percent, but levels vary by ethnic group. Kenya has adopted a robust legal framework for the prohibition of FGM/C, including passage of the Prohibition of FGM Act in 2011, a detailed law that criminalizes carrying out FGM/C and associated offenses. Kenya relies on the human rights–based approach and criminalization in its legal framework for the prohibition of this practice. Despite extensive legal provisions, Kenya has prosecuted fewer than 100 cases, raising concerns with the law’s …

Female Genital Mutilation/Cutting: A Review Of Laws And Policies In Kenya And Nigeria, Samuel Kimani, Otibho Obianwu

Reproductive Health

Female genital mutilation/cutting (FGM/C) is a cultural practice that has health and human rights impacts on girls and women. The health sector has responsibility for prevention and response to provision of care services to women/girls with FGM/C-related complications. The mandate for the health sector response to FGM/C is anchored in nationwide or sector-specific legal/policy instruments. Kenya and Nigeria have ratified global legal/policy instruments and adopted WHO guidelines/tools for the prevention and management of FGM/C. The extent to which existing legal/policy documents in these two countries address prevention and response to management of FGM/C has been unclear. A desk review was …

Appendices—Female Genital Mutilation/Cutting: A Review Of Laws And Policies In Kenya And Nigeria, Samuel Kimani, Otibho Obianwu

Reproductive Health

This document contains Appendices to “Female Genital Mutilation/Cutting: A Review of Laws and Policies in Kenya and Nigeria.” Appendix 1 contains two tables: “Components of Kenyan Laws Related to FGM/C Prevention and Management,” and “Components of Nigerian Laws Related to FGM/C Prevention and Management.” Appendix 2 contains seven tables: “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in Kenyan Policies,” “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in Nigerian Policies,” “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in the Kenyan Plans of Action,” “Components Relevant to …

Implementation Process Brief: Integrated Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Charlotte E. Warren, Aparna Jain, Melsa Lutomia, Jane Loech, Elizabeth Washika

Reproductive Health

Enabling women living with HIV to use contraception effectively can decrease unintended pregnancies and in turn reduce maternal mortality and vertical transmission of HIV. This brief describes the implementation process and intervention tested under the Evidence Project for delivering integrated FP and HIV services at the community level in Kenya. It outlines the implementation steps, best practices, and lessons learned of an intervention that was tested within the existing community health structure. Community health volunteers were trained to offer FP as part of their routine services to women living with HIV, and community health units were prepared to sustain those …

A Diagnostic Assessment Of The Health System's Response To Female Genital Mutilation/Cutting Management And Prevention In Kenya: A Case Study Of West Pokot County, Samuel Kimani

Reproductive Health

Female genital mutilation/cutting (FGM/C), a pervasive cultural practice in some contexts, is associated with negative impacts on women’s and girls’ health and rights. The health sector is well positioned to respond to the prevention of FGM/C and the management of its complications because of its primary role in disease prevention, health promotion, and curative services. In Kenya, the health sector’s role is anchored in national and county legal and policy instruments and guidelines that are adopted or customized from global or regional frameworks as well as skills support tools approved by the World Health Organization. This brief highlights findings from …

Understanding Local Variation In How Female Genital Mutilation/Cutting Declines, Changes, Or Persists: Analysis Of Household Survey Data For Kenya, Nigeria, And Senegal, Population Reference Bureau

Reproductive Health

Efforts to eliminate female genital mutilation/cutting (FGM/C) intensified in many parts of Africa following a 2012 United Nations General Assembly Resolution, but change has been uneven. Important evidence gaps remain in our understanding of why the practice declines, changes, or persists in specific locations. Policymakers and program planners need such information to better tailor interventions to address local patterns and focus resources on abandonment efforts in areas with the greatest needs. To fill these gaps, researchers with the Evidence to End FGM/C consortium analyzed nationally representative household survey data for Kenya, Nigeria, and Senegal. The results of their research identify …

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council

Reproductive Health

This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Kenya, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara

Reproductive Health

Studies investigating the association between male circumcision and HIV have demonstrated the protective effect of male circumcision. In some settings, FGM/C and male circumcision are considered “equivalent” procedures. This working paper presents findings of a study that investigates the effect of FGM/C on the likelihood of HIV infection for women in practicing communities in Ethiopia, Gambia, Kenya, and Sierra Leone.

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya—Brief, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

This policy brief summarizes key findings from a study that examined whether there are shifts in norms and practices related to FGM/C among communities in Narok (predominantly inhabited by Maasai) and Kisii (predominantly inhabited by Abagusii) counties in Kenya. Although Kisii and Narok are FGM/C hotspots, practicing communities in these counties are reassessing norms and traditions in light of the current social and legal climate. These changes may provide a useful starting point for intervention programs that seek to create dialogue and critical reflection on the practice of FGM/C in an effort to accelerate its abandonment. Programmatic recommendations include: engaging …

Using Demographic And Health Surveys In The Campaign To End Fgm/C: A Kenyan Example, Dennis Matanda, Caroline W. Kabiru

Reproductive Health

In order to design effective interventions to end female genital mutilation/cutting (FGM/C), we need to map where FGM/C is practiced and what factors influence it. Data from the Demographic and Health Surveys (DHS), nationally representative surveys conducted in low- and middle-income countries every five years, give us the opportunity to explore how FGM/C is influenced by both individual and community-level factors. Where FGM/C prevalence is not uniform, various research and analysis techniques can be used to improve estimates and draw further information from DHS data. This brief shares insights from two studies carried out in Kenya using DHS data collected …

Urban Congolese Refugees’ Social Capital And Community Resilience During A Period Of Political Violence In Kenya: A Qualitative Study, Julie A. Tippens

Department of Child, Youth, and Family Studies: Faculty Publications

Community resilience has been used as a conceptual framework to promote urban refugee protection, integration, and well-being. In the context of this focus on “refugee communities,” it is critical to gain a deeper understanding of the ways urban refugee “communities” function. This study explored urban Congolese refugees’ use of social capital to promote resilience during a period of political violence in Nairobi, Kenya. Findings illustrate how refugees used social capital across different contexts to access and distribute resilience-promoting resources. Women primarily relied on informal bonding forms of capital while men exhibited greater degrees of access to formal bridging and linking …

What Do We Know About The Hiv Risk Characteristics Of Adolescent Girls And Young Women In Kenya? Findings From Dreams Implementation Science Research, Population Council

HIV and AIDS

The Population Council is conducting implementation science research in Kenya to build needed evidence to inform community-based, girl-centered interventions. DREAMS programs in Kenya are implementing a core package of interventions in the highest HIV-burden areas to address HIV risk among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. This brief summarizes key findings from a survey of 1,778 AGYW, more than half of whom are enrolled in DREAMS programming.

Nisitu (Nisikilize Tujengane): Listen To Me, Let’S Grow Together, Population Council

Poverty, Gender, and Youth

Evidence from several studies, including in Kenya, supports the idea that empowerment and asset-building interventions targeting multiple levels of the socio-ecological environment can improve education, health, economic and social capital, gender-equitable attitudes, and violence outcomes for girls. This brief describes efforts by researchers to test the effects of engaging boys and men alongside girl-centered programming to improve the lives of adolescent girls. In 2017, the Population Council and partners undertook formative research to understand from girls: 1) what are the most influential types of males in their lives; 2) how and what they influence; and 3) what behavior changes among …

What Works To Improve Outcomes For Kenya's Adolescent Girls?, Population Council

Poverty, Gender, and Youth

This fact sheet outlines results from the Adolescent Girls Initiative–Kenya, a study that evaluates the long-term impact of a multi-sectoral intervention targeted at adolescent girls aged 11 to 15 years from Kibera and rural Wajir. The intervention consists of four different components: a community-based violence-prevention program, an education conditional cash transfer (CCT), health-focused girls' empowerment clubs, and wealth creation for girls via financial education and savings. Results indicate that the approach was a cost-effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes.

Addressing Barriers To Quality Of Underutilized Commodities And Services For Prevention And Management Of Pre-Eclampsia And Eclampsia In Kenya, Charity Ndwiga, Pooja Sripad, Charlotte E. Warren

Reproductive Health

The Ending Eclampsia Project seeks to increase access to quality, underutilized interventions and commodities for the prevention, detection, and management of pre-eclampsia and eclampsia (PE/E), including promoting correct use of antihypertensive drugs and magnesium sulphate (MgSO4). This final report details the findings of a qualitative study that explored health system bottlenecks that prevent access to quality maternal and newborn health care in two Kenyan counties, Kakamega and Kitui, with a specific focus on PE/E. The study explored policy implementation gaps in Kenya’s newly devolved county government structure, to:1) assess the policy and health system environment for PE/E diagnosis, referral, and …

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance

Reproductive Health

The goal of family planning and reproductive health operations research is to generate evidence that helps policies and programs maximize access to and quality of services for women and their families. Yet the crucial step of ensuring the utilization of that evidence often receives inconsistent or inadequate attention. The goal of this case study is to document an activity of Marie Stopes International (MSI) in Kenya, part of the STEP UP research program consortium, which resulted in successful evidence utilization. STEP UP research on quality of care for medical abortion, particularly on pharmacy provision of medical abortion, has provided the …