Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya

Background Millions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya. Methods We use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below −2 standard deviation were categorized as stunted. We used Cox regression to analyse the data. Results The prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting. Conclusion Our results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to reduce the high rates of child malnutrition in the urban informal settlements

Water Supply and Sanitation Interventions in Developing Countries: The Role of Hygiene Promotion

The World Health Organization's (WHO) Global Water Supply and Sanitation Assessment 2000 Report, states that as of the beginning of the year 2000, 2.4 billion people lacked access to proper sanitation facilities while another 1.1 billion lacked access to improved water supplies (WHO, 2000). Given the negative health impacts associated within adequate water supplies and sanitation, these numbers suggest that there is a great need for interventions designed to increase access to safe and adequate water supply and sanitation. However, the provision of the appropriate technology and infrastructure may be insufficient if people fail to use it or if they lack a basic understanding of the need for hygiene. Based on this assumption this review aims to determine whether properly designed hygiene promotion programs enhance the success of water supply and sanitation interventions. The findings from the review of the literature are inconclusive in term of whether hygiene promotion enhances the success of water supply and sanitation interventions. However, there is some evidence that hygiene promotion alone can result in a reduction of certain disease outcomes and may therefore be a low-cost alternative where the provision of water supply and sanitation infrastructure is not feasible.Master of Public Healt

Gender Equality in the Oil Mining Sector: An Interaction with Socio Demographic Factors in Lokichar, Turkana Kenya

The extraction and processing of minerals presents an opportunity for women’s economic empowerment. The paper capitalizes on the authors recent study “Change in Gender Roles as a Factor in Gender Participation and Empowerment in The Oil Mining Industry: A Case of Lokichar, Kenya” whose main objective was to establish the changes in gender roles and participation as influenced by oil mining in Lokichar in Turkana County. The  paper anchors on interaction with Socio Demographic factors. The null hypothesis; there is no relationship between equal hiring and equal  opportunity for men and women to work in mining activities was tested. The target group was the active labour force (direct and indirect) aged  between 15 to 64 years. The study adopted both qualitative and quantitative approaches to data collection. Cross tabulation was generated on the  responses to show the differences based on the gender and Chi-square used to test the hypotheses and establish whether there were changes in  gender roles and empowerment. Major findings indicate that there is a relationship between equal hiring and gender equality. The socio  demographic indicators findings are discussed in depth. This descriptive study therefore intended to enlighten stakeholders (i.e. government and oil  companies) to craft policies in a bid to respond to challenges in oil mining and adopt gender sensitive policies that can help to enhance  workforce efficiency and enhance gender equality. The paper recommends that issues like compensation, decision making, royalty sharing, power  relations should be well spelt in policies to ensure gender mainstreaming

Improving the documentation of female genital mutilation or cutting (FGM/C) abandonment interventions and their evaluations

Female genital mutilation/cutting (FGM/C) is internationally recognized as a violation of human rights. Consequently, there have been extensive efforts to promote the abandonment of the practice. There is limited evidence on the impact of many of the efforts, in part because many interventions are implemented by small organizations with inadequate resources to document and evaluate their activities. The complex nature of FGM/C interventions, as with other interventions aimed at addressing violence against women and girls, also makes it difficult to adequately document what is done, how, when, and with what results. Nonetheless, it is important that implementing organizations make every effort to document and evaluate their interventions, and share the outcomes and lessons learned to ensure accountability and for others to learn from, adapt, replicate, and scale up successful interventions. In this Guidance Note, we provide guidance to help organizations that are implementing FGM/C abandonment interventions better document and report on their programmatic and evaluation activities

The effect of education on household food security in two informal urban settlements in Kenya: a longitudinal analysis

Poverty and food insecurity continue to feature prominently in the global agenda, with particularly close attention being paid to the determinants of food insecurity. However, the effect of education is mixed and remains understudied in low income countries. Using longitudinal data collected between 2007 and 2012 in Kenya, we investigated the effect of household education attainment on food security among poor urban households. Household food security was constructed from a set of four key items while education was the average years of schooling for individuals aged 18 years and above in a household. To determine the association between education attainment and food security, we fitted a random effects generalised ordered probit model. The prevalence of severe food insecurity ranged from 49% in 2008 to 35% in 2012. The ordered probit results showed a significant effect of education on food security. The probability of being food insecure decreased by 0.019 for a unit increase in the average years of schooling for a given household. The effect of education, remained significant even after controlling for household wealth index, a more proximate determinant of food security in a cash-based economy such as the urban slums. The findings highlight the need to focus on the food security status of the urban poor. Specifically, results suggest the need for programs aimed at reducing food insecurity among the urban poor and enhancing household livelihoods. In addition, investment in the education of the slum households may, in the long term, contribute to reduction in the prevalence of food insecurity

Tracing change in female genital mutilation/cutting: Shifting norms and practices among communities in Narok and Kisii counties, Kenya

In Kenya, there has been a steady and marked decline in the prevalence of female genital mutilation/cutting (FGM/C) but there is great variance in the prevalence of FGM/C across the country, with prevalence remaining high among certain ethnic groups such as Somali, Samburu, Kisii, and the Maasai. The objectives of this study were: 1) to explore whether and how unprogrammed factors or programmed FGM/C interventions (alternative rites of passage, legal and policy measures, religious-oriented approaches, promotion of girls’ education, intergenerational dialogues, use of rescue centers, and other undocumented approaches) influence community values deliberation in Narok and Kisii counties; 2) to assess what changes in FGM/C norms and practices have occurred in Narok and Kisii counties, and identify factors motivating these changes; and 3) to identify barriers to FGM/C abandonment in these key “hot spots,” and assess how, in light of empirical findings and theoretical models of behavior, intervention efforts might be optimized and coordinated to accelerate abandonment. The study clearly shows that norms and practices of FGM/C are not static even in these study areas. While there might not be widespread abandonment yet, people are reassessing norms and traditions in light of the current social 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

Using Demographic and Health Surveys in the campaign to end FGM/C: A Kenyan example

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 in 1998, 2003, 2008, and 2014. The brief presents lessons learned and suggestions for the way forward

Shifts in female genital mutilation/cutting in Kenya: Perspectives of families and health care providers

Despite compelling reasons and efforts to eradicate female genital mutilation/cutting (FGM/C) in Kenya, the practice has persisted, albeit with some changes. This study sought to understand the shifts in FGM/C among families and healthcare providers from selected Kenyan communities that practice FGM/C. Our findings highlight similarities and differences across three distinct Kenyan communities. FGM/C appears to persist through two models: first, shifts (changes) in the practice, notably cutting at a younger age, lesser cutting; and second, through stability and consistency with minimal change. The two diverse models appear to rely on and sustain social norms that support FGM/C in these communities. The study findings highlight several possible avenues for leveraging positive change, outlined in this report, which also includes future research needs

Exploring the nature and extent of normative change in FGM/C in Somaliland

More than 200 million girls and women alive today have undergone FGM/C across 30 countries in Africa, Asia, and the Middle East. While most affected countries have adopted legal frameworks prohibiting FGM/C, these have been varyingly effective in preventing the practice or significantly accelerating its abandonment. The success of programmatic interventions to address FGM/C has also been variable. One possible reason for the limited success of these initiatives is the neglect of the collectively held social norms underpinning the practice’s continuation. This study, conducted in 30 villages in Somaliland, aimed to investigate: 1) if the norms associated with FGM/C are consistent with a social coordination norm; 2) which norms—if any—are associated with different stages of readiness to change; 3) how, to what extent, and by whom the norms and practices are being contested or altered; and 4) if the stages of readiness to change are associated with gender, location (rural/urban), and generational differences

Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.

Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods