Determining smallholder farmers’ preferences for Push-Pull technology dissemination pathways in western Kenya

The push-pull technology (PPT) has widely been disseminated to control stemborer (Chilo partellus and Busseola fusca) and Striga weeds (Striga hermonthica and Striga asiatica) in maize fields in Kenya. This study examined farmers’ preferences for various dissemination pathways in order to proffer better targeting of resources in an optimal dissemination strategy. The pathways considered were public meetings (barazas), radio, farmer field schools (FFS), field days (FD), farmer teachers (FT), the fellow farmers (FF) and print materials. Using a weighted score index and ordered probit regression, the different pathways were sequentially ranked as FD, FT, FFS, FF, print materials, Radio, and barazas. Marginal effects from ordered probit showed that farmers had the least preferences for baraza and radio pathways. The farmer categories with the highest preference for particular pathways were: less educated farmers for FD, farmers with small land sizes for FT, farmers belonging to groups for FFS, and young educated farmers for the print materials. This information is extremely important for targeting the different segments of farmers.Push-pull technology, Stemborer, Striga, Dissemination pathways, preference, Research and Development/Tech Change/Emerging Technologies,

Climate-adapted companion cropping increases agricultural productivity in East Africa

AbstractProduction of cereals, the main staple and cash crops for millions of farmers in sub-Saharan Africa (SSA) is severely constrained by parasitic striga weed Striga hermonthica, stemborers and poor soil fertility. A companion cropping system known as ‘push–pull’ overcomes these constraints while providing additional soil fertility and forage grass benefits to smallholder farmers. To ensure the technology's long-term sustainability in view of the current and further potential aridification as a consequence of climate change, drought-tolerant crops, Brachiaria cv mulato (border crop) and greenleaf desmodium (intercrop), have been identified and incorporated into a ‘climate-adapted push–pull’. The aims of the current study were to evaluate effectiveness of the new system (i) in integrated control of striga and stemborer pests and (ii) in improving maize grain yields, and to evaluate farmers’ perceptions of the technology to assess potential for further adoption. 395 farmers who had adopted the technology in drier areas of Kenya, Uganda and Tanzania were randomly selected for the study. Each farmer had a set of two plots, a climate-adapted push–pull and a maize monocrop. Seasonal data were collected in each plot on the number of emerged striga plants, percentage of maize plants damaged by stemborers, plant height and grain yields. Similarly, farmers’ perceptions of the benefits of the technology were assessed using a semi-structured questionnaire. There were highly significant reductions in striga and stemborer damage to maize plants in the climate-adapted push–pull compared to the maize monocrop plots: striga levels were 18 times lower and stemborer levels were 6 times lower. Similarly, maize plant height and grain yields were significantly higher. Mean yields were 2.5 times higher in companion planting plots. Farmers rated the climate-adapted push–pull significantly superior in reducing striga infestation and stemborer damage rates, and in improving soil fertility and maize grain yields. These results demonstrate that the technology is effective in controlling both weeds and pests with concomitant yield increases under farmers’ conditions. It thus provides an opportunity to improve food security, stimulate economic growth, and alleviate poverty in the region while making agriculture more resilient to climate change

Achieving food security for one million Sub-Saharan African poor through push-pull innovation by 2020

Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, ‘push–pull’, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers’ income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push–pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development

Reconceptualizing successful pandemic preparedness and response: a feminist perspective

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic – its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what ‘successful’ pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators

Women\u2019s participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana

Background: Low-quality monotonous diet is a major problem confronting resource-constrained settings across the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between women\u2019s decision-making autonomy and women\u2019s achievement of higher dietary diversity (DD) and determine the socio-demographic factors that can independently predict women\u2019s attainment of higher DD. Methods: The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised of 2262 women aged 15\u201349 years and who have complete dietary data. The DD score was derived from a 24-h recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD 644) and higher (DD 655). Logistic regression was used to assess the association between women decision-making autonomy (final say on how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for covariates at the individual and household levels. Results: The analysis showed that women participation in decision-making regarding household purchases was significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of achieving higher DD were higher among women who had a say in deciding household purchases, compared to women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20). Compared to women who lived in polygamous households, those who lived in monogamous households had higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93). Conclusions: Net other covariates, women who have a say in making household purchases are more likely to achieve higher DD compare to those who do not have a say. This may indicate autonomy to buy nutritious foods, suggesting that improving women decision-making autonomy could have a positive impact on women dietary intake

Nutritional status and HIV in rural South African children.

BACKGROUND: Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status. METHODS: The study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritional status. RESULTS: Prevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97). HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence. CONCLUSIONS: This study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Empowering HIV-infected women in lowresource settings: A pilot study evaluating a patient-centered HIV prevention strategy for reproduction in Kisumu, Kenya

Background: Female positive/male negative HIV-serodiscordant couples express a desire for children and may engage in condomless sex to become pregnant. Current guidelines recommend antiretroviral treatment in HIV-serodiscordant couples, yet HIV RNA viral suppression may not be routinely assessed or guaranteed and pre-exposure prophylaxis may not be readily available. Therefore, options for becoming pregnant while limiting HIV transmission should be offered and accessible to HIV-affected couples desiring children. Methods: A prospective pilot study of female positive/male negative HIV-serodiscordant couples desiring children was conducted to evaluate the acceptability, feasibility, and effectiveness of timed vaginal insemination. Eligible women were 18-34 years with regular menses. Prior to timed vaginal insemination, couples were observed for two months, and tested and treated for sexually transmitted infections. Timed vaginal insemination was performed for up to six menstrual cycles. A fertility evaluation and HIV RNA viral load assessment was offered to couples who did not become pregnant. Findings: Forty female positive/male negative HIV-serodiscordant couples were enrolled; 17 (42.5%) exited prior to timed vaginal insemination. Twenty-three couples (57.5%) were introduced to timed vaginal insemination; eight (34.8%) achieved pregnancy, and six live births resulted without a case of HIV transmission. Seven couples completed a fertility evaluation. Four women had no demonstrable tubal patency bilaterally; one male partner had decreased sperm motility. Five women had unilateral/bilateral tubal patency; and seven women had an HIV RNA viral load (≥ 400 copies/mL). Conclusion: Timed vaginal insemination is an acceptable, feasible, and effective method for attempting pregnancy. Given the desire for children and inadequate viral suppression, interventions to support safely becoming pregnant should be integrated into HIV prevention programs

Impacts of climate-resilient push–pull technology on farmers’ income in selected counties in Kenya and Tanzania: propensity score matching approach

Background: Agricultural research and technology adoption play a key role in improving productivity and therefore generate impact on household livelihoods. The push–pull technology developed by the International Centre of Insect Physiology and Ecology and collaborators/partners has been recognized for its multiple roles in productivity improvement and income generation. However, the subsequent impacts after its adaptation to drier agro-ecologies have not been ascertained. An ex-post study was conducted to evaluate the impact of the climate-resilient push–pull technology on farmers’ income. Methodology: This study was conducted in eight counties in Kenya and Mara region in Tanzania, involving 486 farmers; half were climate-resilient push–pull technology adopters. The study adopted the propensity score matching (PSM) technique in order to correct the self-selection bias in adoption. Results: From the results, education of the farmer, household size, Tropical Livestock Unit and group membership positively and significantly influenced adoption. The average treatment effect on the treated was positive for all the matching methods; USD 455.8 for Nearest Neighbor Matching, USD 474.2 for the Kernel Matching and USD 439.1 for the Radius/Caliper Matching. The balancing test for self-selection bias showed that none of the observed covariates was significant after matching. The results demonstrate that adopting climate-resilient push–pull technology has a positive impact on the adopter farmers’ income. Adopter farmers were able to earn much more in terms of gross margin. Conclusion: The positive change in income for adopters was attributable to the technology. With increased incomes, farmers were able to access alternative foodstuff, hence had more food security and diversity than those without. Efforts to expand dissemination and adoption of climate-resilient push–pull technology will have positive impacts on adopting families and hence to the economy

Factors affecting actualization of the WHO breastfeeding recommendations in urban poor settings in Kenya

Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings.This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbear- ing age, community health workers, village elders and community leaders and other knowledgeable people in the community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies. The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours often dictated to them by their circumstances. Macro-level policies and interventions that consider the ecological setting are needed

Effectiveness of home-based nutritional counselling and support on exclusive breastfeeding in urban poor settings in Nairobi: a cluster randomized controlled trial

Background: Exclusive breastfeeding (EBF) improves infant health and survival. We tested the effectiveness of a homebased intervention using Community Health Workers (CHWs) on EBF for six months in urban poor settings in Kenya. Methods: We conducted a cluster-randomized controlled trial in Korogocho and Viwandani slums in Nairobi. We recruited pregnant women and followed them until the infant’s first birthday. Fourteen community clusters were randomized to intervention or control arm. The intervention arm received home-based nutritional counselling during scheduled visits by CHWs trained to provide specific maternal infant and young child nutrition (MIYCN) messages and standard care. The control arm was visited by CHWs who were not trained in MIYCN and they provided standard care (which included aspects of ante-natal and post-natal care, family planning, water, sanitation and hygiene, delivery with skilled attendance, immunization and community nutrition). CHWs in both groups distributed similar information materials on MIYCN. Differences in EBF by intervention status were tested using chi square and logistic regression, employing intention-to-treat analysis. Results: A total of 1110 mother-child pairs were involved, about half in each arm. At baseline, demographic and socioeconomic factors were similar between the two arms. The rates of EBF for 6 months increased from 2% pre-intervention to 55.2% (95% CI 50.4–59.9) in the intervention group and 54.6% (95% CI 50.0–59.1) in the control group. The adjusted odds of EBF (after adjusting for baseline characteristics) were slightly higher in the intervention arm compared to the control arm but not significantly different: for 0–2 months (OR 1.27, 95% CI 0.55 to 2.96; p = 0.550); 0–4 months (OR 1.15; 95% CI 0.54 to 2.42; p = 0.696), and 0–6 months (OR 1.11, 95% CI 0.61 to 2.02; p = 0.718). Conclusions: EBF for six months significantly increased in both arms indicating potential effectiveness of using CHWs to provide home-based counselling to mothers. The lack of any difference in EBF rates in the two groups suggests potential contamination of the control arm by information reserved for the intervention arm. Nevertheless, this study indicates a great potential for use of CHWs when they are incentivized and monitored as an effective model of promotion of EBF, particularly in urban poor settings. Given the equivalence of the results in both arms, the study suggests that the basic nutritional training given to CHWs in the basic primary health care training, and/or provision of information materials may be adequate in improving EBF rates in communities. However, further investigations on this may be needed. One contribution of these findings to implementation science is the difficulty in finding an appropriate counterfactual for community-based educational interventions. Trial registration: ISRCTN ISRCTN83692672. Registered 11 November 2012. Retrospectively registered