Assessment of farmer preferences for cattle traits in smallholder cattle production systems of Kenya and Ethiopia

The urgent need to improve livestock productivity in sub.Saharan Africa in order to keep pace with expected increases in demand for meat and milk is very topical. Breed improvement provides key entry points for increasing productivity in cattle populations. However, there are tendencies for genetic improvement programs to focus on single, market driven traits such as milk or meat production in isolation of environmental constraints and broader livestock system functions which cattle perform in developing countries. This potentially leads to genotypes that are not well adapted to the environment and not capable of performing the multiple roles that cattle assume in smallholder systems. In developing countries, many important functions of livestock are embedded in non-tradeable traits that are neither captured in economic analysis nor considered in livestock improvement programs. This study employs Participatory Rural Appraisal (PRA) ranking techniques and conjoint analysis to evaluate preferences of cattle keepers in pastoral and agro-pastoral systems of selected sites in Kenya and Ethiopia for various cattle traits. These systems are characterized by low input management and prevalence of various cattle diseases. Trypanosomosis is a serious disease constraint in Ghibe valley of Ethiopia and some of the pastoral areas in Kenya. The results indicate that farmer preferences for cattle traits are influenced by various factors including production system characteristics, infrastructural constraints and environmental conditions, especially in relation to disease prevalence and availability of cattle feeds. In the crop-livestock systems of Ghibe valley in Ethiopia, preferred cattle traits include trypanotolerance, reproductive potential and fitness to traction. Milk production is a less important trait. On the other hand, in the pastoral and agropastoral systems of Kenya, important traits include trypanotolerance, reproductive potential, coat colour and watering needs

Leveraging Rural Institutions for Collective Action to Improve Markets for the Poor: Lessons and Policy Options

Market transactions in rural areas of sub-Saharan Africa (SSA) are usually small, because the markets are thin and point-to-point transportation of commodities is difficult. The prices offered are not competitive and volumes traded are usually season dependent. Where market infrastructure is weak and under-developed, liberalization and structural adjustment policies have not been able to improve market access; and the private sector has failed to make the investments needed for proper and effective market coordination

Resource use efficiency of smallholder crop production in the central highlands of Ethiopia

Resource use efficiency in agricultural production has been a major concern in Ethiopia. In this article data from 700 households in the central highland districts were used to assess farm-level resource use efficiency and to determine factors that influence inefficiencies in the production of teff (Eragrostis tef), wheat and chickpea, the major important crops in the country. The study established that smallholder farmers are resource use inefficient. Moreover, a two-limit Tobit regression model results reveal that inefficiency in resource use is positively and significantly affected by family size, farming experience and membership to associations. It is also found that those households whose decision makers have roles in their community activities show improved resource use efficiency. Moreover, the findings show that eliminating resource use inefficiency could contribute about 31.28% of the minimum annual income required for the sustenance of an average farm household. The study established that resource use efficiency and productivity gains are likely to be significantly improved through expansion of nonfarm sectors, reform of farmer related associations and integrating community leadership in various community activities and programs. Moreover, market infrastructure development would likely increase efficiency and agricultural productivity

Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya

<p>Abtsract</p> <p>Background</p> <p>Alternatives to the traditional 'supply-side' approach to financing service delivery are being explored. These strategies are termed results-based finance, demand-side health financing or output-based aid which includes a range of interventions that channel government or donor subsidies to the user rather than the provider. Initial pilot assessments of reproductive health voucher programs suggest that, they can increase access and use, reducing inequities and enhancing program efficiency and service quality. However, there is a paucity of evidence describing how the programs function in different settings, for various reproductive health services. Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the 'voucher and accreditation' approaches to improving the reproductive health of low income women in Kenya.</p> <p>Methods/Design</p> <p>A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level; and assessing the effect of vouchers on increasing access to, and quality of, and reducing inequities in the use of selected reproductive health services. The study comprises of four populations: facilities, providers, women of reproductive health age using facilities and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in samples of health facilities - public, private and faith-based in: three districts; Kisumu, Kiambu, Kitui and two informal settlements in Nairobi which are accredited to provide maternal and newborn health and family planning services to women holding vouchers for the services; and compared with a matched sample of non-accredited facilities. Health facility assessments (HFA) will be conducted at two stages to track temporal changes in quality of care and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be carried out in areas where vouchers are distributed and similar locations where vouchers are not distributed.</p

Factors influencing the experience of sexual and reproductive healthcare for female adolescents with perinatally-acquired HIV: a qualitative case study

Background: Young people living with perinatally-acquired HIV require age-appropriate support regarding sex and relationships as they progress towards adulthood. HIV affects both genders but evidence suggests that young women are particularly vulnerable to sexual abuse and more prone to engaging in sexual behaviours to meet their daily survival needs. This can result in poor sexual and reproductive health (SRH) outcomes. HIV services in Malawi provide support for young women’s HIV-related clinical needs, but it is unclear whether there is sufficient provision for their SRH needs as they become adults. This paper explores the sex and relationship experiences of young women growing up with perinatally-acquired HIV in order to understand how to improve SRH care and associated outcomes. Methods: A qualitative case study approach was adopted in which each ‘case’ comprised a young woman (15–19 years) with perinatally acquired HIV, a nominated caregiver and service provider. Participants were purposively selected from three multidisciplinary centres providing specialised paediatric/adolescent HIV care in Malawi. Data was collected for 14 cases through in-depth interviews (i.e. a total of 42 participants) and analysed using within-case and cross-case approaches. The interviews with adolescents were based on an innovative visual method known as ‘my story book’ which encouraged open discussion on sensitive topics. Results: Young women reported becoming sexually active at an early age for different reasons. Some sought a sense of intimacy, love, acceptance and belonging in these relationships, noting that they lacked this at home and/or within their peer groups. For others, their sexual activity was more functional – related to meeting survival needs. Young women reported having little control over negotiating safer sex or contraception. Their priority was preventing unwanted pregnancies yet several of the sample already had babies, and transfer to antenatal services created major disruptions in their HIV care. In contrast, caregivers and nurses regarded sexual activity from a clinical perspective, fearing onward transmission of HIV and advocating abstinence or condoms where possible. In addition, a cultural silence rooted in dominant religious and traditional norms closed down possibilities for discussion about sexual matters and prevented young women from accessing contraception. Conclusion: The study has shown how young women, caregivers and service providers have contrasting perspectives and priorities around SRH care. Illumination of these differences highlights a need for service improvement. It is suggested that young women themselves are involved in future service improvement initiatives to encourage the development of culturally and socially acceptable pathways of care

Implications of the HIV testing protocol for refusal bias in seroprevalence surveys

BACKGROUND: HIV serosurveys have become important sources of HIV prevalence estimates, but these estimates may be biased because of refusals and other forms of non-response. We investigate the effect of the post-test counseling study protocol on bias due to the refusal to be tested. METHODS: Data come from a nine-month prospective study of hospital admissions in Addis Ababa during which patients were approached for an HIV test. Patients had the choice between three consent levels: testing and post-test counseling (including the return of HIV test results), testing without post-test counseling, and total refusal. For all patients, information was collected on basic sociodemographic background characteristics as well as admission diagnosis. The three consent levels are used to mimic refusal bias in serosurveys with different post-test counseling study protocols. We first investigate the covariates of consent for testing. Second, we quantify refusal bias in HIV prevalence estimates using Heckman regression models that account for sample selection. RESULTS: Refusal to be tested positively correlates with admission diagnosis (and thus HIV status), but the magnitude of refusal bias in HIV prevalence surveys depends on the study protocol. Bias is larger when post-test counseling and the return of HIV test results is a prerequisite of study participation (compared to a protocol where test results are not returned to study participants, or, where there is an explicit provision for respondents to forego post-test counseling). We also find that consent for testing increased following the introduction of antiretroviral therapy in Ethiopia. Other covariates of refusal are age (non-linear effect), gender (higher refusal rates in men), marital status (lowest refusal rates in singles), educational status (refusal rate increases with educational attainment), and counselor. CONCLUSION: The protocol for post-test counseling and the return of HIV test results to study participants is an important consideration in HIV prevalence surveys that wish to minimize refusal bias. The availability of ART is likely to reduce refusal rates

Action to protect the independence and integrity of global health research

Storeng KT, Abimbola S, Balabanova D, et al. Action to protect the independence and integrity of global health research. BMJ GLOBAL HEALTH. 2019;4(3): e001746