Perceptions and Experiences of School Teachers During the Implementation of a School-Based Deworming Activity in Kenya

Background: Primary school teachers are key stakeholders in the success of school-based deworming activity as they are responsible for drug administration and provision of health education to the School-Age Children (SAC). In Kenya, the National School-Based Deworming Programme (NSBDP) for control of soil-transmitted helminths and schistosomiasis was initiated in the year 2012 in prioritised areas. By the year 2013, over 6 million SAC had been treated. The present study sought to assess the teachers’ perceptions and experiences of the school-based deworming activity in an effort to improve programme effectiveness.   Methods: Qualitative data were collected, using in-depth interviews, in 4 subcounties of the coastal region of Kenya. Using purposive selection, 1 primary school teacher from each of the 38 schools also purposively selected participated in the study. The data were audio-recorded, transcribed, coded and analysed manually by study themes which included: reason for being selected for training to administer drugs; perceptions of training content and duration; experiences during drug acquisition, administration and record-keeping and motivation to continue participating in the deworming of school-age children.   Results: Half of the teachers indicated that they were selected to administer drugs to children as they were responsible for school health matters. The duration and content of the training were considered sufficient, and no challenges were faced during drug acquisition. Challenges faced during drug administration included non-compliance and experience of side effects of the drugs. No major problems were experienced in record-keeping, although the teachers felt that the forms needed to be simplified. Improvement of the children’s health and class performance was reported as a source of motivation to the teachers to continue administering the drugs. Fellow teachers were reported to have given moral support while over half of the respondents indicated that parents did not provide much support.   Conclusion: Generally, teachers have positive experiences and perceptions of the deworming activity. There is, however, a need to involve all stakeholders especially the parents through the school board of management to help counter non-compliance and possibly support in providing meals to the children to help minimise side effects after drug consumption. Inadequate moral support and incentives are negative factors on the teachers’ motivation

Knowledge, practices and perceptions of trachoma and its control among communities of Narok County, Kenya

© 2016 The Author(s). Background: Trachoma is the leading infectious cause of blindness in the world. It is commonly found in cultural groups with poor hygiene. Trachoma control includes Surgery, Antibiotics, Facial cleanliness and Environmental Improvement (SAFE). Potentially blinding and active trachoma are monitored using trachomatous trichiasis (TT) in adults and trachoma inflammation-follicular (TF) in children aged 1-9 years respectively. A cross-sectional study to assess the knowledge, practices and perceptions of trachoma and its control was conducted in the endemic communities in Narok County. Methods: Qualitative methods were used for data collection. Using purposive sampling, 12 focus group discussions (FGDs) with single sex adult and young men and women groups of homogenous characteristics, 12 key informant interviews with opinion leaders and 5 in-depth interviews (IDIs) with trichiasis patients and 6 with persons who have undergone trichiasis surgery were conducted. Data was audio recorded, transcribed, coded and analyzed manually by study themes; knowledge, practices and perceptions of trachoma transmission, infection signs, prevention and control. Results: Majority of the community members had knowledge of trachoma and its transmission. The practices that contributed to transmission of infection included: failure to wash faces and bathe regularly, sharing of water basins and towels for face washing, traditional methods of trachoma treatment and dirty household environment. Due to socio-cultural perceptions, toilets were unacceptable and use of bushes for human waste disposal was common. Poor perceptions on disease susceptibility, flies on children's faces, latrine ownership and usage and separation of human and animal dwellings also played a role in the transmission of trachoma. Fear of loss of sight during surgery was a deterrent to its uptake and a desire to be able to see and take care of domestic animals promoted surgery uptake. Majority of the community members were appreciative of Mass Drug Administration (MDA) though side effect such as vomiting and diarrhoea were reported. Conclusion: Poor practices and related socio-cultural perceptions are important risk factors in sustaining trachoma infection and transmission. Community members require health education for behavior change and awareness creation about surgery, MDA and its potential side effects for elimination of trachoma in Narok County, Kenya. Trial registration: KEMRI SSC 2785. Registered 2 September 2014

The Dripping Sunlight : The Case of MIKI Rofu\u27s Poems

筆者は、同じ表題で、すでに二つの論文を公にしているが、「ある詩語の水脈」「北原白秋の場合」という副題をそれぞれに付して、区別してある。三編目の今回は、「三木露風の場合」である。室生犀星の「したたり止まぬ日のひかり/うつうつまはる水ぐるま」(「寂しき春」) という表現に集約的に完成されるところの、水をではなく光りを、したたるものとして捉えるという、特異な発想の出没の跡を追跡する試みの一部である

Tuberculosis patients' reasons for, and suggestions to address non-uptake of HIV testing: a cross-sectional study in the Free State Province, South Africa

<p>Abstract</p> <p>Background</p> <p>South Africa endorses the global policy shift from primarily client-initiated voluntary counselling and testing (VCT) to routine/provider-initiated testing and counselling (PITC). The reason for this policy shift has been to facilitate uptake of HIV testing amongst at-risk populations in high-prevalence settings. Despite ostensible implementation of routine/PITC, uptake amongst tuberculosis (TB) patients in this country remains a challenge. This study presents the reasons that non-tested TB patients offered for their refusal of HIV testing and reflects on all TB patients' suggestions as to how this situation may be alleviated.</p> <p>Methods</p> <p>In February-March 2008, a cross-sectional survey was conducted amongst 600 TB patients across 61 primary health care facilities in four sub-districts in the Free State. Patient selection was done proportionally to the numbers registered at each facility in 2007. Data were subjected to bivariate tests and content analysis of open-ended questions.</p> <p>Results</p> <p>Almost one-third (32.5%) of the respondents reported that they had not undertaken HIV testing, with the most often offered explanation being that they were '<it>undecided</it>' (37.0%). Other self-reported reasons for non-uptake included: fear (e.g. of testing HIV-positive, 19.0%); perception of being at low risk of HIV infection (13.4%); desire first to deal with TB 'on its own' (12.5%); and because HIV testing had not been offered to them (12.0%). Many patients expressed the need for support and motivation not only from health care workers (33.3%), but also from their significant others (56.6%). Patients further expressed a need for (increased) dissemination of TB-HIV information by health care workers (46.1%).</p> <p>Conclusions</p> <p>Patients did not undergo HIV testing for various patient-/individual-related reasons. Non-uptake of HIV testing was also due to health system limitations such as the non-offer of HIV testing. Other measures may be necessary to supplement routine/provider-initiation of HIV testing. From the TB patient's perspective, there is a need for (improved) dissemination of information on the TB-HIV link. Patients also require (repeated) motivation and support to undergo HIV testing, the onus for which rests not only on the public health authority and health care workers, but also on other people in the patients' social support networks.</p

Comprehensive transcriptome of the maize stalk borer, Busseola fusca, from multiple tissue types, developmental stages, and parasitoid wasp exposures

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Solar Energy Potential in the Yangtze River Delta Region—A GIS-Based Assessment

Decarbonization of electrical power generation is an essential necessity in the reduction of carbon emissions, mitigating climate change and attaining sustainable development. Solar energy as a substitution for fossil fuel-based energy sources has the potential to aid in realizing this sustainable future. This research performs a geographic information systems (GIS)-based assessment of the solar energy potential in the Yangtze River Delta region (YRDR) of China using high-resolution solar radiation data combined with geographical, social, environmental and cultural constraints data. The solar energy potential is evaluated from the geographical and technical perspective, and the results reveal that the YRDR is endowed with rich solar energy resources, with the geographical potential in the suitable areas ranging from 1446 kWh/m2 to 1658 kWh/m2. It is also estimated that the maximum solar capacity potential could be up to 4140.5 GW, illustrating the high potential available for future capacity development in this region. Realizing this significant potential as an alternative for fossil fuel-based electricity generation would result in a substantial mitigation of CO2 emissions in this region, where air pollution is severe. Potential evaluations found that Jiangsu and Anhui provinces provide the most optimal areas for the development of solar photovoltaics (PV) installations, as they have the highest geographical and technological solar energy potential. Further, findings of the case study undertaken at a solar PV plant show disparities between actual generated power and technical solar potential, highlighting the significance of utilizing solar radiation data from local ground-based meteorological stations. This study provides policy makers and potential investors with information on solar energy potential in the Yangtze River Delta region that would contribute to solar power generation development

Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya

Abstract Background The Community Directed Intervention (CDI) strategy has been used to conduct various health interventions in Africa, including control of Neglected Tropical Diseases (NTDs). Although the CDI approach has shown good results in the control of onchocerciasis and lymphatic filariasis with respect to treatment coverage using community drug distributors, its utility in the control of schistosomiasis among urban poor is yet to be established. Using a longitudinal qualitative study, we explored the experiences, opportunities, challenges as well as recommendations of Community Health Workers (CHWs) after participation in annual mass drug administration (MDA) activities for schistosomiasis using the CDI approach in an urban setting. Methods Unstructured open-ended group discussions were conducted with CHWs after completion of annual MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussions, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.ti. software, and themes explored using the principle of interpretative phenomenological analysis (IPA). Results From the perspective of the CHWs, opportunities for implementing CDI in urban settings, included the presence of CHWs, their supervisory structures and their knowledge of intervention areas, and opportunity to integrate MDA with other health interventions. Several challenges were mentioned with regards to implementing MDA using the CDI strategy among them lack of incentives, fear of side effects, misconceptions regarding treatment and mistrust, difficulties working in unsanitary environmental conditions, insecurity, and insufficient time. A key recommendation in promoting more effective MDA using the CDI approach was allocation of more time to the exercise. Conclusion Findings from this study support the feasibility of using CDI for implementing MDA for schistosomiasis in informal settlements of urban areas. Extensive community sensitization and provision of incentives may help address the aforementioned challenges associated with implementing MDA using the CDI strategy. Opportunities highlighted in this study may be of value to other programmes that may be considering the adoption of the CDI strategy for rolling out interventions in the urban setting

Additional file 1: of Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya

Unstructured open-ended Group discussion Guide for discussion with Community Health Workers. Community Directed Intervention for Schistosomiasis and Soil-transmitted helminth (STH) infections in an urban setting, western Kenya. Unstructured open-ended Group discussion Guide for discussion with Community Health Workers. The file contains unstructured open-ended key questions that were used to guide discussion with community health workers that participated in MDA exercise during feedback sessions. (DOCX 13 kb

Pathways from climate change to emotional wellbeing: A qualitative study of Kenyan smallholder farmers living with HIV.

Climate change is associated with adverse mental and emotional health outcomes. Social and economic factors are well-known drivers of mental health, yet comparatively few studies examine the social and economic pathways through which climate change affects mental health. There is additionally a lack of research on climate change and mental health in sub-Saharan Africa. This qualitative study aimed to identify potential social and economic pathways through which climate change impacts mental and emotional wellbeing, focusing on a vulnerable population of Kenyan smallholder farmers living with HIV. We conducted in-depth, semi-structured interviews with forty participants to explore their experience of climate change. We used a thematic analytical approach. We find that among our study population of Kenyan smallholder farmers living with HIV, climate change is significantly affecting mental and emotional wellbeing. Respondents universally report some level of climate impact on emotional health including high degrees of stress; fear and concern about the future; and sadness, worry, and anxiety from losing ones home, farm, occupation, or ability to support their family. Climate-related economic insecurity is a main driver of emotional distress. Widespread economic insecurity disrupts systems of communal and family support, which is an additional driver of worsening mental and emotional health. Our study finds that individual adaptive strategies used by farmers in the face of economic and social volatility can deepen economic insecurity and are likely insufficient to protect mental health. Finally, we find that agricultural policies can worsen economic insecurity and other mental health risk factors. Our proposed conceptual model of economic and social pathways relevant for mental health can inform future studies of vulnerable populations and inform health system and policy responses to protect health in a changing climate