Water, women and local social organization in the Western Kenya highlands

Safe water is widely recognized as both a fundamental human need and a key input into economic activity. Across the developing world, the typical approach to addressing these needs is to segregate supplies of water for domestic use from water for large-scale agricultural production. In that arrangement, the goal of domestic water supply is to provide small amounts of clean safe water for direct consumption, cleaning, bathing and sanitation, while the goal of agricultural water supply is to provide large amounts of lower quality water for irrigated agriculture. A new third use of water is now being given more attention by researchers: small amounts of water employed in selected household enterprises. This third use may be particularly important for women. There is a potential, therefore, that provision of modest amounts of water to smallholder farmers can enhance household economic production, save labor time for women and girls, and improve family health. This paper adds to the merger literature on the multiple values of improved water supplies – improved health, time savings, and small-scale production for individual farmers and collectives – for the case of a rural community in the western highlands of Kenya. With minimum external support, two groups in this community have managed to install and operate systems of spring protection and piped water to their members’ homesteads. A third group is in the process of replicating this success. The experience of this community also illustrates some of the challenges that must be faced for a community to effectively selforganize the investment and maintenance of a community-based water scheme. There are challenges of finance, gender relations, conflicts over scarce water supplies, group leadership, enforcement of community bi-laws, and policy. Data from a census of springs in the same area show that successful collective action for water management is unusual, but certainly not unique, in this region of Kenya. Although women emerge as the main beneficiaries of improved water management in the community, their substantial contributions are largely hidden behind social norms regarding gender roles and relations. Research methods need to carefully triangulate information sources in order to clarify the very substantial and active roles performed by women.Length: 21p.WomenGenderWater supplyWater rightsHealthCollective actionParticipatory management

Prevalence of Under Nutrition and Its Effects on Response to Malaria Treatments Among Children Under Five Years at Ahero and Homa Bay Hospitals, Western Kenya

Nutritional status of a person with malaria infection is thought to contribute to host treatment outcome. Limited studies have investigated the association despite the widespread concern with nutrition in malaria endemic areas. We evaluated the impact of under nutrition on the treatment outcome by Artemether Lumefantrine and Clindamycin plus Quinine. Sample of 384 children aged below five years diagnosed with uncomplicated Plasmodium falciparum malaria, were randomized to receive Clindamycin plus quinine or Artemether-lumefantrine (AL) for treatment. The children were followed up for 28 days to monitor body weight and height, clinical and parasitological parameters of treatment response.Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 28 days of follow-up. Prevalence of underweight was 6 % (n=23) and stunting was 12% (n=45). Body weight increased over the 28 day follow up period. The initial mean weight was 13.03kg while the mean weight on day 28 was 13.7kg.The proportion of children with stunting was comparable between the female and male children: 40% verse 60%, p=0.06. Generally, the prevalence of underweight was comparable between the treatment arms (p=0.08). Similarly, the prevalence of stunting was not significantly different between the treatment arms (p=0.34). Cure rate was high in the Artemether group (96.5%) compared to the Clindamycin group (44.2%). Children who were underweight were 0.69 times less likely to be cured compared to those who were not underweight, but this difference was not significantly different from that of children were had no underweight (p = 0.429). Treatment outcomes were known for 43 of the 45 (95.6%) children with stunting. Overall, stunted children were 1.15 times more likely to be cured compared with children who were not stunted, but this difference was not statistically significant (p=0.704). No association between under nutrition (underweight and stunting) and treatment outcome was observed.  Further research is suggested on the impact of under nutrition on response to malaria treatment using Artemether Lumefantrine alone on children less than five years. Ministry of health and other policy makers may formulate guidelines to improve management of children with malaria taking into consideration their nutritional status, and to integrate nutrition in malaria programmes

Utilization of PMTCT Services among HIV Positive Mothers Who Delivered At Home: A Case Of Turbo Health Centre, Eldoret North District, Kenya

Background: The transmission of the Human Immune Deficiency Virus (HIV) from mother to child during pregnancy, birth and breastfeeding period is the most common way of HIV infection in children. Prevention of Mother to Child Transmission (PMTCT) of HIV program is aimed at reducing the Mother to Child Transmission of HIV. The study aimed at exploring and describing factors which affect compliance to the utilization of PMTCT service package among HIV positive mothers who delivered outside a health facility. Methods: The study adopted a descriptive qualitative study design and entailed in-depth interviews with the HIV positive postnatal mothers attending the maternal child health and family planning clinic (MCH/FP) at Turbo Health Centre as key informants.  The interviews were taped with a voice recorder, transcribed and analysed using NVivo computer software for qualitative research to document emerging themes. Results: Four themes emerged from the results as follows 1) Knowledge of PMTCT services 2) Utilization of PMTCT services 3) Patient Factors that hinder compliance to PMTCT program and 4) Health centre related factors that hinder compliance to PMTCT program. Mothers did not take up the option to deliver at the health due to abrupt onset of labour, lack of transport and fees to pay for the delivery services at the health centre. Also, health related factors such as lack of incentives, staff attitude and lack of consistent information contributed to the mothers delivering at home. Conclusion: It was apparent that the HIV + mothers were recruited in the PMTCT program, and appropriate follow-up made to ensure that they remain on course and comply fully with the PMTCT program. Home delivery was the missing link towards full compliance to PMTCT program

Evaluation of a measles vaccine campaign by oral-fluid surveys in a rural Kenyan district: interpretation of antibody prevalence data using mixture models

We evaluated the effectiveness of a measles vaccine campaign in rural Kenya, based on oral-fluid surveys and mixture-modelling analysis. Specimens were collected from 886 children aged 9 months to 14 years pre-campaign and from a comparison sample of 598 children aged 6 months post-campaign. Quantitative measles-specific antibody data were obtained by commercial kit. The estimated proportions of measles-specific antibody negative in children aged 0–4, 5–9 and 10–14 years were 51%, 42% and 27%, respectively, pre- campaign and 18%, 14% and 6%, respectively, post-campaign. We estimate a reduction in the proportion susceptible of 65–78%, with ~85% of the population recorded to have received vaccine. The proportion of ‘weak’ positive individuals rose from 35% pre-campaign to 54% post-campaign. Our results confirm the effectiveness of the campaign in reducing susceptibility to measles and demonstrate the potential of oral-fluid studies to monitor the impact of measles vaccination campaigns

Stakeholders perception of HIV sero-discordant couples in western Kenya

Objective: To describe the perceptions of key stakeholders regarding the counselling needs of HI V sero-discordant couples as part of preparation for a clinical trial involving HIV sero-discordant couples. Design: Qualitative study using key informant and couple interviews. Setting: Moi Teaching and Referral Hospital (MTRH). Subjects: A purposive sample of nine key informants and 31 couple interviews totaling 71 participants. The couple interviews consisted of HI V untested, HI V concordant (positive and negative) and discordant couples. Results: Seventy one individuals participated in nine key informant and 31 couple interviews. The responses identified the following as key issues in counselling HIV discordant couples: The need for education on the meaning of HI V sero-discordancy including potential sources of infection; assistance in disclosing HIV test results to one\'s partner; discussion of the stigma surrounding formula feeding. Overall, the participants supported safer sexual practices in discordant partnerships. Conclusions: Psychosocial support of HI V sero-discordant couples should include messages about the meaning, mechanisms and implications of sero-discordancy. Culturally appropriate HI Vdisclosure and safer sex messages are also needed to support these partnerships. East African Medical Journal Vol. 85 (7) 2008: pp. 326-33

Determinants In HIV Counselling And Testing In Couples In North Rift Kenya

Background: Voluntary HIV counselling and testing (VCT) has been shown to be an acceptable and effective tool in the fight against HIV/AIDS. Couple HIV Counselling and Testing (CHCT) however, is a relatively new concept whose acceptance and efficacy is yet to be determined.Objective: To describe factors that motivate couples to attend VCT as a couple. Design: A cross sectional qualitative study.Setting: Moi Teaching and Referral Hospital and Moi University, School of Medicine, Eldoret, KenyaSubjects: Seventy one individuals were interviewed during KII (9) and dyad interviews (31 couples). Ten FGDs involving a total of 109 individuals were held. Results: Cultural practices, lack of CHCT awareness, stigma and fear of results deter CHCT utilisation. Location of centre where it is unlikely to be associated with HIV testing, qualified professional staff and minimal waiting times would enhance CHCT utilisation.Conclusions: CHCT as a tool in the fight against HIV/AIDS in this region of Kenya is feasible as the factors that would deter couples are not insurmountable

Diversity of Sorghum (Sorghum bicolor L. Moench) Germplasm from Tanzania

Sorghum (Sorghum bicolor L. Moench) is an important cereal crop cultivated in varied agro-ecological zones of Tanzania ranging from the southern highlands to coastal lowlands. Different cultivars and varieties of sorghum are needed for cultivation in such varied zones. Phenotypic properties of Tanzanian sorghums are not well-studied. Objective of this study was to phenotype some sorghum germplasm from Tanzania using morphological markers to establish their diversity for future use in breeding programs. Ninety-eight sorghum genotypes were evaluated at Bumala and Amagoro in Western Kenya during 2009 and 2010 seasons in a randomized complete block design. The International Plant Genetic Resource Centre descriptors of 1993 were used for data collection. Accession MCSR T29 was the earliest which took only 64 days while MCSR T80 was the latest taking 86 days to attain 50% flowering compared to the overall mean of 71 days. The MCSR T71 was the best yielder (114.6 g/ panicle) and MCSR T10 was the lowest (10.3 g/panicle) compared to overall mean of 92.4g/panicle. About 60% of the sorghums had brown and only 2.2% had black grains. MCSR T90 had bold grains with 1000 seed weight of 55.2g. Leaves per plant ranged from 7 in MCSR T69 to 17 in MCSR T25. Plant height ranged from 72.8 cm in MCSR T53 to 434.6 cm in MCSR T80. This study showed that, Tanzanian sorghums are diverse therefore could be used in future breeding programs for developing multipurpose and adapted cultivars. Keywords: Cultivars, Diversity, Phenotype, Varieties, SorghumSorghum (Sorghum bicolor L. Moench) is an important cereal crop cultivated in varied agro-ecological zones of Tanzania ranging from the southern highlands to coastal lowlands. Different cultivars and varieties of sorghum are needed for cultivation in such varied zones. Phenotypic properties of Tanzanian sorghums are not well-studied. Objective of this study was to phenotype some sorghum germplasm from Tanzania using morphological markers to establish their diversity for future use in breeding programs. Ninety-eight sorghum genotypes were evaluated at Bumala and Amagoro in Western Kenya during 2009 and 2010 seasons in a randomized complete block design. The International Plant Genetic Resource Centre descriptors of 1993 were used for data collection. Accession MCSR T29 was the earliest which took only 64 days while MCSR T80 was the latest taking 86 days to attain 50% flowering compared to the overall mean of 71 days. The MCSR T71 was the best yielder (114.6 g/ panicle) and MCSR T10 was the lowest (10.3 g/panicle) compared to overall mean of 92.4g/panicle. About 60% of the sorghums had brown and only 2.2% had black grains. MCSR T90 had bold grains with 1000 seed weight of 55.2g. Leaves per plant ranged from 7 in MCSR T69 to 17 in MCSR T25. Plant height ranged from 72.8 cm in MCSR T53 to 434.6 cm in MCSR T80. This study showed that, Tanzanian sorghums are diverse therefore could be used in future breeding programs for developing multipurpose and adapted cultivars. Keywords: Cultivars, Diversity, Phenotype, Varieties, Sorghu

A Needs Assessment to Build International Research Ethics Capacity at Moi University

International Research Ethics Partnership. This online version is the post-print version (final, peer-reviewed and accepted for publication version) of the published article. For the published version, refer to the article citation within the item record.International collaborators in biomedical sciences face ethical challenges in the design,review, and conduct of research. Challenges include differences in research ethics capacity, cultural differences in interpretation and application of ethical principles, and cooperation between ethics review boards at collaborating institutions. Indiana University School of Medicine (Indianapolis, USA) and Moi University Faculty of Health Sciences (Eldoret, Kenya)developed a Memorandum of Understanding (MOU) to establish greater cooperation between their ethics review boards, followed by a joint needs assessment to assess barriers to implementing the MOU. Focus groups and interviews at each institution revealed that while each side verbalized understanding and respect for the other's culture, there were misunderstandings deeply rooted in each culture that could potentially derail the collaboration. Although the participants at each university agreed on the major principles and issues in research ethics and on the importance attributed to them, a more in-depth evaluation of the responses revealed important differences. Methods to address these misunderstandings are outlined in the recommended Best Practices.Fogarty International Center at the NIH, Indiana University Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indiana University International Development Fund, Indiana Genomics Initiative, Lilly Endowment, Inc

Localization in Strongly Chaotic Systems

We show that, in the semiclassical limit and whenever the elements of the Hamiltonian matrix are random enough, the eigenvectors of strongly chaotic time-independent systems in ordered bases can on average be exponentially localized across the energy shell and decay faster than exponentially outside the energy shell. Typically however, matrix elements are strongly correlated leading to deviations from such behavior.Comment: RevTeX, 5 pages + 3 postscript figures, submitted to Phys. Rev. Let