Gender and poverty: the agriculture sector programme support in Uganda.

At the time of writings, Uganda was the only country in Africa with an established Ministry of Gender. The country has an operational National Gender Policy to facilitate the process of mainstreaming gender concerns in the national development process. The policy outlines the strategies to be followed and the institutional framework. It is concluded that poverty eradication and gender equity can only be achieved through recognition of the fact that the two are complementary

Influence of Literacy on the Smallholder Farmer’s Ability to Adapt to Drought in Pallisa District, Eastern Uganda

Functional literacy if well-applied increases lifelong livelihood opportunities for the smallholder farmers faced with drought episodes. This study examined the influence of literacy on the smallholder farmer’s ability to adapt to drought. The social-economic data was collected and analysed using both multi-stage and cross-sectional sampling methods. A total sample of 153 smallholder farmers was randomly selected from Gogonyo, Kameke, Kamuge and Kasodo sub-counties and administered household questionnaires. The study results revealed that there was a very significant relationship between literacy (reading and writing) and adaptation to drought by the smallholder farmers (p<0.05). This was brought about by remarkable functional literacy players. The farmers recognised non-governmental organisations (65%) and farmer associations (20%) as the major contributors of their functional literacy levels followed by the government (15%) through extension programmes. Specifically, community public gathering including public announcements, farmer field schools with 70% and use of visual aids (posters) –(20%) were the major modes of adaptation content delivery to the smallholder farmers followed by the use of electronic media such as radios, television (6%) and use of public documents like newspapers and magazines with 4%. However, the shortfalls in the acquisition of literacy were largely caused by the farmer’s nonattendance to the schools and training, insufficient knowledge to comprehend, shortage of scholastic writing materials, trekking longer distances to educational centres and inadequate financial resources to meet their school requirements. Above all, the promotion of reading and writing literacy skills amongst the smallholder farmers is more likely to trigger, improve and lead to the introduction of adaptation innovations that are critical in improving the farmer’s resilience and livelihood status. Keywords: Smallholder farmers, drought, literacy, adapt, Pallisa, Ugand

TEACHER COUNSELLORS’ PERCEPTION ON THE EFFECTIVENESS OF PEER COUNSELLING SERVICES IN THE MANAGEMENT OF DISCIPLINE AMONG PUBLIC SECONDARY SCHOOL STUDENTS IN NAKURU EAST SUB-COUNTY, KENYA

Teacher counsellors and other educationists have come up with ways of managing discipline. Some of the ways of dealing with student indiscipline are by preventing it as well as teaching appropriate behaviour and coping skills. Peer counselling has been adopted as one of the methods of behaviour management. The purpose of this study was to establish the perceptions of the teacher counsellors on the effectiveness of peer counselling services in the management of discipline in public secondary schools in Nakuru East sub-county, Kenya. The study was guided by the Social Cognitive Theory (SCT) that posits that learning occurs in a social context within a dynamic and reciprocal interaction of the person, environment and behaviour. The study used a descriptive survey research design. The population under the study comprised 19 teacher counsellors from 19 public secondary schools in Nakuru East Sub-county. The 19 secondary schools were stratified as follows: single-sex (boys and girls) and co-educational schools then simple random sampling was used. The census method was used in selecting the teacher counsellors. Teacher Counsellor Questionnaires (TCQ) were used to collect data. The instruments were pilot-tested in one public secondary school using two teacher counsellors to establish the validity and reliability of the instruments. The scale measuring teacher counsellors’ perception had a Cronbach's alpha of 0.907. The questionnaire items were considered to be reliable after yielding a reliability coefficient of 0.70 and above. The data was analyzed using descriptive statistics that included frequencies and percentages. The Statistical Package for Social Sciences (SPSS) version 22 was used in the analysis. Teacher counsellors gave an aggregate effectiveness rating (mean = 2.56). Based on these findings, the study concludes that peer counselling services have a moderate effect in the management of discipline in public secondary schools in Nakuru East. The study concluded that teacher counsellors and peer mentors in high schools should get professional training in counselling and supervision of peer counsellors. The evaluation of peer counselling is rarely done and this maintains the persistent status quo of inefficiency in peer counselling in high schools. The study recommends that to improve the effectiveness of peer counselling, the relationship between teacher counsellors and peer counsellors should be enhanced and the training of peer counsellors be improved.  Article visualizations

Teacher Motivational Strategies on Students’ Academic Performance in Day Secondary Schools in Saboti Sub-County,

Teachers motivation has become an important issue given their responsibility to impart knowledge and skills to learners. Consequently, the purpose of this study was to investigate the influence of teacher motivation strategies on the students’ performance in day secondary schools of Saboti Sub-County, Trans Nzoia County, Kenya. Specifically, the study sought to establish how staff development, recognition, advancement and incentives influence students’ academic performance in day secondary schools.  This study was conducted in 20 day secondary schools. The study was limited to the information the respondents gave. Simple stratified sampling technique was used for sampling with each stratum being represented by a sample size using the Kreijcie and Morgan table of sample determination.The data collection instrument was the questionnaire which was tested for validity and reliability before being used in the study. Structured questionnaires were administered to the teachers and head teachers of the day secondary schools in Saboti Sub-County. Data was analyzed using Statistical Package for Social Science (SPSS).The findings of the study were that most teachers lacked motivation in their work and this accounts for the low performance in these schools. Motivation strategies such as recognition, training and development, incentives and career advancement were minimal in the schools. The study recommends that a variety of motivational strategies be consistently employed by the Teachers Services Commission to enhance teachers’ morale and subsequently students’ academic performance. Keywords: Teacher, Motivational Strategy, Students, Academic Performance DOI: 10.7176/JEP/14-12-01 Publication date: April 30th 202

Examining user fee reductions in public primary healthcare facilities in Kenya, 1997-2012: effects on the use and content of antenatal care.

BACKGROUND: In 2004, The Kenyan government removed user fees in public dispensaries and health centers and replaced them with registration charges of 10 and 20 Kenyan shillings (2004 $US 0.13 and$0.25), respectively. This was termed the 10/20 policy. We examined the effect of this policy on the coverage, timing, source, and content of antenatal care (ANC), and the equity in these outcomes. METHODS: Data from the 2003, 2008/9 and 2014 Kenya Demographic and Health Surveys were pooled to investigate women's ANC care-seeking. We conducted an interrupted time series analysis to assess the impact of the 10/20 policy on the levels of and trends in coverage for 4+ ANC contacts among all women; early ANC initiation and use of public facility-based care among 1+ ANC users; and use of public primary care facilities and receipt of good content, or quality, of ANC among users of public facilities. All analyses were conducted at the population level and separately for women with higher and lower household wealth. RESULTS: The policy had positive effects on use of 4+ ANC among both better-off and worse-off women. Among users of 1+ ANC, the 10/20 policy had positive effects on early ANC initiation at the population-level and among better-off women, but not among the worse-off. The policy was associated with reduced use of public facility-based ANC among better-off women. Among worse-off users of public facility-based ANC, the 10/20 policy was associated with reduced use of primary care facilities and increased content of ANC. CONCLUSIONS: This study highlights mixed findings on the impact of the 10/20 policy on ANC service-seeking and content of care. Given the reduced use of public facilities among the better-off and of primary care facilities among the worse-off, this research also brings into question the mechanisms through which the policy achieved any benefits and whether reducing user fees is sufficient for equitably increasing healthcare access

"Sometimes it is difficult for us to stand up and change this": an analysis of power within priority-setting for health following devolution in Kenya

Background Practices of power lie at the heart of policy processes. In both devolution and priority-setting, actors seek to exert power through influence and control over material, human, intellectual and financial resources. Priority-setting arises as a consequence of the needs and demand exceeding the resources available, requiring some means of choosing between competing demands. This paper examines the use of power within priority-setting processes for healthcare resources at sub-national level, following devolution in Kenya. Methods We interviewed 14 national level key informants and 255 purposively selected respondents from across the health system in ten counties. These qualitative data were supplemented by 14 focus group discussions (FGD) involving 146 community members in two counties. We conducted a power analysis using Gaventa’s power cube and Veneklasen’s expressions of power to interpret our findings. Results We found Kenya’s transition towards devolution is transforming the former centralised balance of power, leading to greater ability for influence at the county level, reduced power at national and sub-county (district) levels, and limited change at community level. Within these changing power structures, politicians are felt to play a greater role in priority-setting for health. The interfaces and tensions between politicians, health service providers and the community has at times been felt to undermine health related technical priorities. Underlying social structures and discriminatory practices generally continue unchanged, leading to the continued exclusion of the most vulnerable from priority-setting processes. Conclusions Power analysis of priority-setting at county level after devolution in Kenya highlights the need for stronger institutional structures, processes and norms to reduce the power imbalances between decision-making actors and to enable community participation

Healing Spaces: A Design Framework for Care Centres for Human Trafficking Survivors

"The primary goal of this project is to establish a framework for a new human-centred, evidence-based and user-led approach to the design of facilities – including shelters and care centres – aimed at specifically supporting survivors of human trafficking as part of their psychological rehabilitation. The project will draw on the memory and direct testimony of survivors in Uganda, and of those currently resident in a recovery facility, to investigate and establish how the physical environment can promote their healing. Data collected through creative workshops and the use of observational, participatory and digital media methods will outline key architectural and landscaping design aspects of facilities that positively impact the survivors’ psychological health. The findings of this research will be disseminated as a design framework setting out evidence-based approaches for purpose-built, human-centred facilities aimed at supporting survivors." Extract from Final Publication by BuildXStudi

Health financing in response to COVID-19: An agenda for research

The global spread of COVID-19 has affected both the health and economic condition of countries, with major health system impacts. There has been an immediate need to invest in clinical services to treat patients and mount an effective public health response, requiring substantial increases in health spending. But the impact of the pandemic on the global economy also raises challenges for future health spending, with potential impacts on commitments to universal health coverage. In this working paper we outline a broad research agenda that would help countries deal with the health financing challenges they are facing, and emerge from the COVID-19 crisis with stronger health financing systems. While recognising that research priorities must be tailored to the needs of specific countries, we argue there is much to be gained by starting from a common agenda, which could enable a coordinated approach and maximise the potential for cross-country comparative work. Such a body of research will enable lessons to be drawn for (i) managing the current crisis; (ii) ensuring resilience of health systems to future shocks; and (iii) enhancing medium-term progress towards UHC

Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper.

INTRODUCTION: The World Health Organization recommends TT surveys to be conducted in adults aged 15+ years (TT 15 survey) and certifies elimination of TT as a public health problem when there is less than 1 unknown case per 1,000 people of all ages. There is no standard survey method to accurately confirm this elimination prevalence threshold of 0.1% because rare conditions require large and expensive prevalence survey samples. The aim of this study was to develop an accurate operational research method to measure the total backlog of TT in people of all ages and detect when the elimination threshold is achieved. METHODS: Between July to October 2016, an innovative Community-based, Mapping, Mop-up and Follow-up (CMMF) approach to elimination of TT as a public health problem was developed and tested in Esoit, Siana, Megwara and Naikara sub-locations in Narok County in Kenya. The County had ongoing community-based TT surgical camps and case finders. TT case finders were recruited from existing pool of Community health volunteers (CHV) in the Community Health Strategy Initiative Programme of the Ministry of Health. They were trained, validated and supervised by experienced TT surgeons. A case finder was allocated a population unit with 2 to 3 villages to conduct a de jure pre-survey census, examine all people in the unit and register those with TT (TT all survey). Identified cases were confirmed by TT surgeons prior to surgery. Operated patients were reviewed at 1 day, 2 weeks and 3-6 months. The case finders will also be used to identify and refer new and recurrent cases. People with other eye and medical conditions were treated and referred accordingly. Standardised data collection and computer based data capture tools were used. Case finders kept registers with details of all persons with TT, those operated and those who refused to be operated (refusals). These details informed decision and actions on follow-up and counselling. Progress towards achievement of elimination threshold was assessed by dividing the number of TT cases diagnosed by total population in the population unit multiplied by 1,000. RESULTS: Narok County Government adopted both the CMMF approach and TT all survey method. All persons in 4,784 households in the four sub-locations were enumerated and examined. The total population projection was 29,548 and pre-survey census 22,912 people. Fifty-three cases of TT were diagnosed. The prevalence was 0.23% and this is equivalent to 2.3 cases per thousand population of all ages. Prior to this study, the project required to operate on at least 30 cases (excess cases) to achieve the elimination threshold of 1 case per 1000 population. CONCLUSION: The total backlog of TT was confirmed and the project is now justified to lay claim of having eliminated TT as a public health problem in the study area. TT all method may not be appropriate in settings with high burden of TT. Nomadic migrations affect estimation of population size. Non-trachomatous TT could not be ruled-out