Change and Continuity in Kin-Based Support Systems for Widows and Orphans among the Luo in Western Kenya

No Abstract Available African Sociological Review 8, (1), 2004, pp. 139-15

Ethical dilemmas of social science research on AIDS and orphanhood in Western Kenya

This paper is based on the experiences drawn from a long-term social science research programme on the impact of the AIDS pandemic on orphanhood in western Kenya. It discusses the ethical dilemma of maintaining a delicate balance between research ethics, the expectations of the study population and negotiating the community's vested interests in a health related research project in a low-income society. I argue that informed consent and the intended benefits of the study to the participants continue to be major challenges facing the justification of social research with people affected by or living with AIDS in low-income societies. The paper underscores the importance of community feedback sessions as a way of enhancing chances of acceptability of research efforts and obtaining informed consent. It further shows how community feedback sessions contribute to local knowledge of the problem being studied, creating opportunities for advocacy. This discussion adds to the existing ethical debate on the wider contexts within which research on vulnerable people affected by AIDS is conducted by arguing that research practice is inseparable from epistemological concerns of knowledge production. I suggest that ethnographers should enhance efforts to innovatively design action research projects to serve the twin purposes of data collection and deal with ethical challenges that are experienced when doing long-term research on vulnerable groups.Kenya Research ethics HIV/AIDS Informed consent Orphanhood Social science research Children Ethnography

“This is Our Home”:Notions of Home and Childhood Vulnerability in Western Kenya

Luo orphaned children derive their conceptualization of home from historical ideologies of patrilineal kinship and the local discourses of belonging situated within properly constituted marriage. Contrary to older literature that presents home as a domestic spatial arrange-ment, orphans understand home as a relational pathway that safeguards growth. We show that orphans use their notion of home to express feel-ings of vulnerability and apply their agency against adult-initiated foster-age practices. The article contributes to an enhanced understanding of Luo sociality and promotes a dynamic anthropology of relationships and child anthropology by unpacking the facets of childhood vulnerability. Our analysis points to analytic themes of contradictions and paradox in Luo kinship values in relation to child support and ambivalence in how children’s agency is exercised in fosterage arrangements.</p

Perception of Cervical Cancer Patients on their Financial Challenges in Western Kenya

Abstract Background The number of cervical cancer cases is reported to increase among women of reproductive age in the recent past with patients facing challenges with care and management of the illness. However, little is known about the financial challenges these patients undergo in contexts such as western Kenya. This study assessed financial challenges and sources of financial assistance for cervical cancer patients in western Kenya. Methods A cross-sectional study involving 334 cervical cancer patients was conducted in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu from September 2014 to February 2015. Structured questionnaire, in-depth interview guide and key informant interview guide were used to collect data. Quantitative data was analyzed using Statistical Package for Social Scientists (SPSS) Version 20 at a statistical significance of P ≤ 0.05, descriptive statistics and crosstabulations were performed. For qualitative data, the responses were transcribed verbatim and the content was then analyzed by searching for emerging themes on the financial challenges faced by cervical cancer patients. Qualitative data was presented in textual form with verbatim reports for illustrations. Results The key financial challenges from the study were costs of medication 291 (87%), cost of travel 281 (84%) and cost of diagnostic tests 250 (75%). Other costs incurred by the patients were cost of cloths and wigs 91 (27%), and cost of home and child care 80 (24%). Most 304 (91%) of the cervical cancer patients admitted and referred to JOOTRH did not have insurance cover and only 30 (9%) had National Hospital Insurance Fund cover which catered for only bed component of inpatient costs. Results showed that no patient received any assistance from well-wishers. Only a few received assistance from charity organizations 43 (13%), friends 91 (27%) and colleagues 31 (9%). Some patients received some assistance from relatives 32 (10%) and church 32 (10%). Conclusion Cervical cancer patients experience several financial challenges yet only few of them had insurance cover which catered for only bed component of inpatient costs. There is a need for the Kenyan health care system to develop mechanisms for provision of financial support for cervical cancer patients

Non-adherence to antiretroviral treatment among migrating fishermen in western Kenya’s islands : a rapid qualitative study

This article was written as a product of 2022 September Summer School at the University of Pretoria and as part of a Wellcome Trust funded project Reimagining Reproduction: Making babies, making kin and citizens in Africa.Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. The association of migration with HIV and AIDS in sub-Saharan Africa is well documented. Frequent mobility, high consumption of alcohol, multiple sexual partners, transactional and commercial sex, poor health infrastructure and limited access to health services are reported among the main factors shaping the HIV epidemic in fishing communities. Moreover, studies have been conducted in sub-Saharan Africa on adherence to antiretroviral treatment (ART) among fishers; however, non-adherence to ART remains poorly understood among migrating fishermen in the western Kenya islands. This qualitative study investigated factors contributing to non-adherence among fishermen in the western Kenya islands. This study utilised 51 in-depth interviews and six focus group discussions to highlight factors contributing to non-adherence to ART by mobile fishermen. Data were analysed using a contextualised thematic analysis. Results show that migration, alcohol consumption and ART sharing contributed to non-adherence. Adherence to ART is a powerful predictor of survival for individuals living with HIV and AIDS. The Kenyan government can use lessons from this study to target fishermen to achieve the UNAIDS 2025 recommendations on people-centred and context-specific service responses to AIDS as this would move Kenya closer to the 90% reduction in annual infections by 2030. This article contributes to a deeper understanding of how and why fishermen from the islands in western Kenya struggle to adhere to treatment even though they can access ARTs through the public health care system. Longitudinal studies should be conducted to explore how the factors associated with non-adherence correlate with other key health outcomes such as drug resistance.http://www.www.tandfonline.com/toc/raar202024-11-28hj2024Centre for the Advancement of ScholarshipSDG-03:Good heatlh and well-beingSDG-11:Sustainable cities and communitie

Children in refugee camps and their role in refugee-host community integration

The UN Convention on the Rights of the Child significantly strengthened the legal basis for recognising children as actors with agency and a voice. In contrast to this, children in displacement contexts are still commonly portrayed as victims without agency. Children are dependent on adults, but that does not mean that they have no right to participate in decisions that affect their lives. This policy brief sheds light on the active role that children in displacement situations can take in their daily lives to shape refugee-host interactions and local integration in camp settings. It discusses how the role of children in the social integration of refugees can be strengthened and supported, indicating potential areas for intervention. With 40 per cent of the displaced population worldwide being below the age of 18, children form a significant part of this group (United Nations High Commissioner for Refugees [UNHCR], 2023). However, there continues to be limited information on the perspectives and experiences of children in displacement situations, particularly those living in the Global South. Although there is some knowledge regarding interventions to support the integration of refugee children, not much has been said about their own initiatives with respect to social integration and mediating the circumstances that displacement and encampment entail. Children change the world around them and invariably impact the adult-dominated processes of migration and integration when they participate. Independently from adults, children negotiate and construct relations during their interactions in public and private spaces, such as in (pre-)schools, organised sporting events and in private meeting points. They develop friendships and share learning materials, food and language. Through their agency, children build relations that are critical for the process of integration. This can transcend adult-dominated notions about the safety and securitisation of displacement contexts, thus transforming the conflict rhetoric associated with refugee-host community relations. The role of children has become even more salient in view of efforts to facilitate integration through the Comprehensive Refugee Response Framework (CRRF), a key framework guiding refugee policy in many refugee-hosting countries in the Global South. At the same time, children's unique growth and developmental needs have to be adequately understood and incorporated into integration policies and programmes. In this policy brief, we call for a change in policy and programming to recognise and support children's critical role in social integration. We make the following recommendations to host governments, international agencies and local partners active in refugee camp settings to: - Support more data collection and analysis of children's actions in building relations that can foster integration in different displacement contexts. - Ensure that children are included as a special category in policy frameworks. Their interests and needs should be taken into account by listening to their voices and providing platforms for exchanges with adults, policy-makers and practitioners. - Create more opportunities for refugee and host community children to interact inside and outside of school environments. - Support sensitisation programmes that bring together parents of refugee and host community children to understand the role of children in the integration process and to ensure that the views of adults as parents and guardians are also listened to and addressed. - Address negative stereotypes and open conflicts between refugee and host community children that restrict free and positive interactions. This can include fostering dialogue and peaceful means to resolve conflicts as well as facilitating cooperation