The Impact of an Electrical Mini-grid on the Development of a Rural Community in Kenya

Electrical mini-grids can provide electrification to rural communities far from the national network. However the benefits of such schemes are disputed. We observed changes in two matched trading-centres in Makueni County, Kenya, neither of which were initially electrified. During the study a solar photovoltaic mini-grid scheme (13.5 kWp) was constructed in one of the trading-centres. After electrification there were relative increases in the number of businesses and business income. Comparing the households in the areas around the trading centres, perceived wealth increased more around the electrified trading centre. Qualitative interviews indicated improvements in service provision by the local school and health centre. The cooperative set up to run the mini-grid was free to set its own kWh tariff and chose to reduce it to a level that covers operating costs and would recover 70% of the initial investment interest-free. However, the tariff finally agreed is higher than the national grid tariff, which would be difficult to achieve if the mini-grid was not owned by and run for the benefit of the local community. Overall, we found that the mini-grid had a positive effect over background development, recovered some of its cost and charged a higher tariff than the national rate

Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?

Background: Despite various international efforts initiated to improve maternal health, morethan half a million women worldwide die each year as a result of complications arising frompregnancy and childbirth. This research was guided by the following questions: 1) How doeswomen's autonomy influence the choice of place of delivery in resource-poor urban settings? 2)Does its effect vary by household wealth? and 3) To what extent does women's autonomy mediatethe relationship between women's education and use of health facility for delivery?Methods: The data used is from a maternal health study carried out in the slums of Nairobi, Kenya.A total of 1,927 women (out of 2,482) who had a pregnancy outcome in 2004–2005 were selectedand interviewed. Seventeen variable items on autonomy were used to construct women's decisionmaking,freedom of movement, and overall autonomy. Further, all health facilities serving the studypopulation were assessed with regard to the number, training and competency of obstetric staff;services offered; physical infrastructure; and availability, adequacy and functional status of suppliesand other essential equipment for safe delivery, among others. A total of 25 facilities weresurveyed.Results: While household wealth, education and demographic and health covariates had strongrelationships with place of delivery, the effects of women's overall autonomy, decision-making andfreedom of movement were rather weak. Among middle to least poor households, all threemeasures of women's autonomy were associated with place of delivery, and in the expecteddirection; whereas among the poorest women, they were strong and counter-intuitive. Finally, thestudy showed that autonomy may not be a major mediator of the link between education and useof health services for delivery.Conclusion: The paper argues in favor of broad actions to increase women's autonomy both asan end and as a means to facilitate improved reproductive health outcomes. It also supports thecall for more appropriate data that could further support this line of action. It highlights the needfor efforts to improve households' livelihoods and increase girls' schooling to alter perceptions ofthe value of skilled maternal health care

Perceptions of development by residents of a rural community in Kenya: a capability issue

Despite the acknowledgment that participatory approaches in development have potential in understanding and designing development programmes and policies, perceptions of development continue to be dominated by outsiders including professionals and other development agents, most of whom do not experience the conditions. Using qualitative data collected from residents of Makueni County of Eastern Kenya, this paper attempts to involve Makueni community members in the conceptualization of development in their context and outlining possible strategies to address the identified development issues. The study finds a community keen on participating in development and who are able to rank their development needs and priorities, emphasizing the importance of water in driving development, as well as the perceived hierarchical nature of development. The study recommends the use of both macro and micro approaches to development where development recipients are involved in development plans and decisions

Barriers to health care by women infected with Tuberculosis in Kibera slums in Nairobi, Kenya

Although more men than women die from TB, the disease causes more deaths among women than all causes of maternal mortality combined. Despite TB testing and treatment being free of charge in all government health facilities in Kenya, fewer women than men access this care. This descriptive study explores the TB awareness level among Kibera residents and the barriers faced by women infected with the disease in accessing TB health care. The data used are from 100 household interviews, 5 case studies with female TB patients and 5 key informant interviews with health workers. While an awareness level of TB is above average, there are still some gaps in the knowledge regarding TB treatment, leading to poor compliance with treatment. There is also high stigma associated with TB and HIV/AIDS and poverty. Efforts to improve care seeking among female TB patients in Kibera have to target all these barriers.Bien que plus d'hommes que de femmes meurent de la tuberculose, la maladie est la cause de plus de décès chez les femmes que toutes les causes de mortalité maternelle combinées. Malgré la gratuité du dépistage et du traitement de la tuberculose dans tous les établissements sanitaires publics au Kenya, moins de femmes que d'hommes ont accès à ces soins. Cette étude descriptive examine le niveau de sensibilisation sur la tuberculose parmi les habitants de Kibera et les obstacles rencontrés par les femmes infectées par la maladie pour avoir accès aux soins de santé. Les données utilisées comprennent 100 interviews auprès des ménages, 5 études de cas avec des femmes atteintes de tuberculose et 5 entretiens avec des travailleurs de la santé. Alors que le niveau de sensibilisation sur la tuberculose est supérieure à la moyenne, il ya encore quelques lacunes dans les connaissances concernant le traitement de la tuberculose, menant ainsi à une faible observance du traitement. Il ya aussi une forte stigmatisation liée à la tuberculose, le VIH / SIDA et la pauvreté. Les efforts pour améliorer le recours aux soins chez les femmes atteintes de tuberculose à Kibera doivent cibler tous ces obstacles

Barriers to health care by women infected with Tuberculosis in Kibera slums in Nairobi, Kenya

Although more men than women die from TB, the disease causes more deaths among women than all causes of maternal mortality combined. Despite TB testing and treatment being free of charge in all government health facilities in Kenya, fewer women than men access this care. This descriptive study explores the TB awareness level among Kibera residents and the barriers faced by women infected with the disease in accessing TB health care. The data used are from 100 household interviews, 5 case studies with female TB patients and 5 key informant interviews with health workers. While an awareness level of TB is above average, there are still some gaps in the knowledge regarding TB treatment, leading to poor compliance with treatment. There is also a high stigma associated with TB and HIV/AIDS and poverty. Efforts to improve care seeking among female TB patients in Kibera have to target all these barriersBien que plus d'hommes que de femmes meurent de la tuberculose, la maladie est la cause de plus de décès chez les femmes que toutes les causes de mortalité maternelle combinées. Malgré la gratuité du dépistage et du traitement de la tuberculose dans tous les établissements sanitaires publics au Kenya, moins de femmes que d'hommes ont accès à ces soins. Cette étude descriptive examine le niveau de sensibilisation sur la tuberculose parmi les habitants de Kibera et les obstacles rencontrés par les femmes infectées par la maladie pour avoir accès aux soins de santé. Les données utilisées comprennent 100 interviews auprès des ménages, 5 études de cas avec des femmes atteintes de tuberculose et 5 entretiens avec des travailleurs de la santé. Alors que le niveau de sensibilisation sur la tuberculose est supérieure à la moyenne, il ya encore quelques lacunes dans les connaissances concernant le traitement de la tuberculose, menant ainsi à une faible observance du traitement. Il ya aussi une forte stigmatisation liée à la tuberculose, le VIH / SIDA et la pauvreté. Les efforts pour améliorer le recours aux soins chez les femmes atteintes de tuberculose à Kibera doivent cibler tous ces obstacles.<br/

Fotso, “Barriers to formal emergency obstetric care services’ utilization,” Journal of Urban Health

ABSTRACT Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and healt