Family, Life Course, and Society Commons^™

The Nia Project: Baseline Survey Instruments, Karen Austrian

Poverty, Gender, and Youth

This document includes all of the Nia Project baseline survey instruments used to collect data in Kenya, providing a multidimensional description of a sample of the participating girls and the schools they attend. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The study collected data from 3,489 girls from 140 schools in three rural Kilifi subcounties: Magarini, Kaloleni, and Ganze.

The Nia Project—Brief, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

This brief provides highlights from the Nia Project conducted in Kenya. The study found that while gaps exist in girls’ capabilities, particularly knowledge and attitudes related to menstruation and reproductive health, the Nia Project has the potential to bridge those gaps. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The findings of this study will make a critical contribution to filling an evidence gap in the field of menstrual health and hygiene management, and …

The Nia Project: Baseline Report, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

The onset of puberty and menarche is a particularly vulnerable time for girls, when external pressures are exacerbated by their lack of knowledge of their bodies, their rights, and the implications of their decisions, and by their inability to manage puberty and adolescence safely and comfortably with appropriate menstrual health and hygiene management (MHM) products. Although several programs have previously been developed to address girls’ MHM needs globally, few have been evaluated, and where evidence does exist the results have been mixed. In collaboration with ZanaAfrica, the Population Council is evaluating the Nia Project, a set of interventions for adolescent …

Female Genital Mutilation/Cutting In Kenya: Is Change Taking Place? Descriptive Statistics From Four Waves Of Demographic And Health Surveys, Bettina Shell-Duncan, David Gathara, Zhuzhi Moore

Reproductive Health

Nationally representative survey data on female genital mutilation/cutting (FGM/C) in Kenya are available from four waves of Demographic and Health Surveys. These survey data provide a rich and detailed picture of when, where, and how FGM/C has been carried out, and trends in changes in the practice. National prevalence data from successive waves of surveys show a steady decrease in the prevalence of FGM/C among women aged 15–49. While the data reported here are descriptive, they provide useful insights on the progress of FGM/C abandonment at national and subnational levels. These findings are useful for policymakers in steering discussions on …

Adolescent Girls Initiative-Kenya: Financial Education Audio Training Script, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative project-Kenya (AGI-K) helps young, vulnerable adolescent girls build their social, health, and economic assets. AGI-K tests combinations of interventions in health, violence prevention, wealth creation, and education to determine which package of interventions delivers the most impact and at what cost. The project was led by the Population Council and implemented in two marginalized areas, Kibera in Nairobi and Wajir county in Northeastern Kenya, by Plan International and Save the Children, respectively. This scripted guide was designed to support the delivery of the financial education sessions in Wajir in response to challenges with mentor capacity in …

Improving Uptake Of Hiv Testing Services And Linkage To Care After Diagnosis In Kenya, Project Soar

HIV and AIDS

Project SOAR is conducting two complementary research activities in Kenya, to 1) understand the barriers to and facilitators of HIV testing among men seeking HIV testing services, and 2) to develop and pilot test an HIV post-test assessment tool to promote linkage to HIV care and treatment among newly diagnosed HIV-positive clients. This study will provide needed information to help Kenya and other countries that are scaling up test and start programs to develop effective strategies to increase uptake of HIV testing services among men and linkage to care and treatment among all newly diagnosed HIV-positive clients.

Adolescent Girls Initiative-Kenya: Health And Life Skills Audio Training Script, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative project-Kenya (AGI-K) helps young, vulnerable adolescent girls build their social, health, and economic assets. AGI-K tests combinations of interventions in health, violence prevention, wealth creation, and education to determine which package of interventions delivers the most impact and at what cost. The project was led by Population Council and implemented in two marginalized areas 1) Kiberain Nairobi and 2) Wajir County in Northeastern Kenya by Plan International and Save the Children, respectively. This scripted guide was designed to support the delivery of the health, life skills, and nutrition sessions in Wajir in response to challenges with …

Back To Africa In The 21st Century: The Cultural Reconnection Experiences Of African American Women, Marcia Tate Arunga

Antioch University Full-Text Dissertations & Theses

The purpose of this study is to examine the lived experiences of 18 African American women who went to Kenya, East Africa as part of a Cultural Reconnection delegation. A qualitative narrative inquiry method was used for data collection. This was an optimal approach to honoring the authentic voices of African American women. Eighteen African American women shared their stories, revelations, feelings and thoughts on reconnecting in their ancestral homeland of Africa. The literature discussed includes diasporic returns as a subject of study, barriers to the return including the causes of historic trauma, and how Black women as culture bearers …

Pharmacy Workers In Kenya Need Training And Support On Medical Abortion Information And Referrals To Prevent Unsafe Service Provision, Jesse Njunguru, A. Finnie, Katharine Footman, Wilson Liambila, Kate Reiss

Reproductive Health

Despite the centrality of pharmacists in the provision of abortion services in Kenya, little is known about their medical abortion (MA) knowledge, attitudes, or practices. This policy brief reports on a study that set out to bridge this gap in the evidence. The report concludes that comprehensive training for pharmacy workers could improve the quality of MA provision and referrals, and help pharmacy workers identify opportunities to simultaneously provide clients with information on contraception and STI prevention. Such efforts would be in line with current Kenyan government policies to reduce the public health burden caused by the prevalence of unsafe …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Kenya (Brief #4), Population Council

Reproductive Health

In an attempt to improve the reporting of child sexual abuse (CSA) and children’s access to services, the Gender-Based Violence Recovery Center (GBVRC) of Kenyatta National Hospital (KNH) in Nairobi, Kenya, is exploring the feasibility of routine screening for CSA in healthcare and school settings. Based on the findings, and in collaboration with the Population Council, the GBVRC is developing a response to CSA that takes into account the contextual realities. The intervention will involve dialogues with parents and children in primary schools. The aim is to get people talking about abuse in their community, the consequences of such abuse, …

Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Kenya, Population Council

Reproductive Health

This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Kenya to implement activities in the year ahead.

East African Perspectives Of Family And Community, And How They Can Inform Western Ecclesiology, Ben Strait

M.A. in Family Ministry

East African families and communities function day-to-day as a single living organism. As one participant said, “Life is common.”[1] What he meant by that was that life is shared among the members of a community, whether biologically related relatives or those who live in close proximity with others. Throughout this research, close interaction with several native East Africans took place, and insights were made into how this view of communal living works itself out in daily life.

[1]. Yusufo, interview by author, Grand Rapids, March 31, 2014.

Urban Congolese Refugees In Kenya: The Contingencies Of Coping And Resilience In A Context Marked By Structural Vulnerability, Julie A. Tippens

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

The global increase in refugee migration to urban areas creates challenges pertaining to the promotion of refugee health, broadly conceived. Despite considerable attention to trauma and forced migration, there is relatively little focus on how refugees cope with stressful situations, and on the determinants that facilitate and undermine resilience. This article examines how urban Congolese refugees in Kenya promote psychosocial well-being in the context of structural vulnerability. This article is based on interviews (N = 55) and ethnographic participant observation with Congolese refugees over a period of 8 months in Nairobi in 2014. Primary stressors related to scarcity of material …

Adolescent Girls Initiative-Kenya: Qualitative Report, Eunice N. Muthengi, Karen Austrian, Amanda Landrian, Benta Abuya, Joyce Mumah, Caroline W. Kabiru

Poverty, Gender, and Youth

The Adolescent Girls Initiative-Kenya (AGI-K) is currently delivering multisectoral interventions, targeting violence prevention, education, health, and wealth creation, to adolescent girls aged 11–14 in two marginalized areas of Kenya. This report provides a brief overview of the research design and intervention components being delivered in AGI-K, and presents findings from the first round of qualitative data collection intended to highlight the strengths and weaknesses of the implementation processes thus far. The findings provide important information about the perceived effects of the program from a diverse set of respondents. Overall, beneficiaries, their parents/guardians, and other key stakeholders value the program and …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Kenya (Brief #2), Population Council

Reproductive Health

Data from 130 public health facilities supported by LVCT Health—a Kenyan organization with a goal of reducing HIV infections to zero—indicate that over 60 percent of rape survivors attended to from 2011 to 2014 were children below the age of 18. The Africa Regional Sexual and Gender Based Violence (SGBV) Network, set up in 2006, is addressing violence against children (VAC) in four countries. This Learning Brief is one in a series of five that share critical, initial understandings of VAC that will help us respond more effectively to the problem. Initial findings highlight a post-rape care system in Kenya …

Kenya: Helping Adolescent Mothers Remain In School Through Strengthened Implementation Of School Re-Entry Policies, Esther Lwanga Walgwe, Nancy Termini Lachance, Harriet Birungi, Chi-Chi Undie

Reproductive Health

By applying robust evidence, securing the support of decisionmakers, and engaging stakeholders, STEP UP enabled national and local decisionmakers to better understand the consequences of unintended pregnancy for adolescent girls’ schooling in Homa Bay County, Kenya. STEP UP is playing an important role in informing the implementation of policies within the Kenyan educational sector that will improve educational opportunities for school-age mothers. Through early stakeholder engagement, strong partnerships, the support of implementers and policymakers, effective communication and dissemination strategies, decisionmaker capacity, and the dedication of the adolescent mothers themselves, evidence generated by STEP UP was successfully utilized by key stakeholders. …

Adolescent Sexual And Reproductive Health Situation: Insights From The 2014 Kenya Demographic And Health Survey, Francis Obare, George Odwe, Harriet Birungi

Reproductive Health

The 2015 Kenya National Adolescent Sexual and Reproductive Health Policy recognized the importance of addressing adolescent sexual and reproductive health (SRH) needs for achieving the country’s development goals. Although estimates from the 2014 Kenya Demographic and Health Survey (DHS) show the country registered improvements in key reproductive, maternal, and child health outcomes, adolescent outcomes likely remain poor given the challenges associated with adequately addressing their sexual and reproductive health needs. This report presents findings of further analysis of the 2014 Kenya DHS on key SRH outcomes among adolescent girls and boys 15 to 19 years old in Kenya. Understanding the …

Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala

HIV and AIDS

The overarching goal of this study was to pilot an approach to HIV testing services (HTS) that addresses intimate partner violence (IPV) and sexual relationship power (SRP) inequalities, and explores the intervention’s potential for improving uptake and retention of antiretroviral therapy and prevention of mother-to-child transmission services. The project was implemented in Kenyatta National Hospital’s (KNH) antenatal care (ANC) clinic, and examined intermediate indicators of effect, as well as operational issues around incorporating attention to IPV in hospital procedures, especially in high-volume, high-need settings like KNH’s. The findings from this study suggest that providing some minimal IPV/SRP counseling to all …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative

Reproductive Health

At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Kibera, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to increase adolescent girls’ knowledge of reproductive health and sexuality; reinforce and promote attitudes and behaviors that will lead to a better quality of life; and instill skills among adolescents to enable them to overcome the challenges of growing up and becoming responsible adults including communication skills, decision-making, assertiveness, setting goals and resisting peer pressure. The sessions were developed to be delivered without a lot of resources or materials, with limited time available …

Willingness To Pay For Contraceptive Vaginal Rings In Kenya, Wilson Liambila, Deepa Rajamani, Francis Obare, Saumya Ramarao, Harriet Birungi, Heather Clark

Reproductive Health

Despite progress made in reducing fertility and increasing the contraceptive prevalence rate in Kenya, many women still experience high unmet need for contraception. Part of the challenge in addressing current levels of unmet need is the limited use of contraception by women during the first 12 months postpartum. New methods are needed that offer greater ease of use, are women-initiated, and do not require significant medical provider involvement for service delivery. One such method is the Progesterone Vaginal Ring (PVR), a reversible contraceptive that according to clinical trial data is safe and effective for breastfeeding women. New product introduction strategies …

Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative

Reproductive Health

Policymakers and researchers have long hypothesized the potential benefits of integrating HIV prevention, treatment, and care with sexual and reproductive health (SRH) services in settings with generalized HIV epidemics. In addition to improving health and social outcomes, integration of services holds the promise of increasing efficiency of service delivery and maximizing health care resources. Economic theory suggests several potential efficiency advantages at the service and programmatic levels. However, evidence on the unit cost and efficiency gains associated with integration remains scarce. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings …

Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Kibera, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to prepare adolescent girls for the financial responsibilities of adulthood. The sessions were developed to be delivered without a lot of resources or materials, with limited time available for training. The guide contains step-by-step descriptions of the learning activities as well as background information.

Adolescent Girls Initiative-Kenya: Financial Education Curriculum, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to prepare adolescent girls for the financial responsibilities of adulthood. The sessions were developed to be delivered without a lot of resources or materials, with limited time available for training. The guide contains step-by-step descriptions of the learning activities as well as background information.

Adolescent Girls Initiative-Kenya: Health And Life Skills Curriculum, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative–Kenya builds the social, health, and economic assets of adolescent girls in urban slums and Northeastern Kenya. This collection of learning sessions was designed to increase adolescent girls’ knowledge of reproductive health and sexuality; reinforce and promote attitudes and behaviors that will lead to a better quality of life; and instill skills among adolescents to enable them to overcome the challenges of growing up and becoming responsible adults including communication skills, decision-making, assertiveness, setting goals and resisting peer pressure. The sessions were developed to be delivered without a lot of resources or materials, with limited time available …

Adolescent Girls Initiative-Kenya: Baseline Report, Karen Austrian, Eunice N. Muthengi, Taylor Riley, Joyce Mumah, Caroline W. Kabiru, Benta Abuya

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. The Adolescent Girls Initiative–Kenya (AGI-K) will deliver multisectoral interventions for over 5,000 girls aged 11–14 in two marginalized areas of Kenya: the Kibera slums in Nairobi, and Wajir County in Northeastern Kenya. Implemented by Plan International in Kibera and Save the Children in Wajir, these interventions will be implemented for two years and will comprise a combination of girl-level, household-level, and community-level interventions. A randomized controlled trial will be used to compare the impact of four different packages of interventions to …