Timing and Determinants of Tuberculosis Treatment Interruption in Nairobi County, Kenya

Tuberculosis (TB) treatment is a key pillar in the management and control of TB. Service delivery within the treatment facilities plays an important role in ensuring treatment adherence by TB patients. A prospective cohort study involving 25 health facilities, 25 facility in-charge officers and 291 patients diagnosed as new sputum smear positive (SM+) between December 2014 and July 2015 was undertaken. The aim of the study was to estimate the median time to treatment interruption, associated factors and overall predictors of non-adherence to TB treatment. A total of 19 (6.5%) treatment interruptions were observed. The median time to default was 56 [95% CI, 36-105] days. Treatment in a non-public facility [AOR=0.210, 95% CI (0.046-0.952)] and facilities perceived to have adequate number of health care workers to offer Directly Observed Therapy (DOT) [AOR=0.195, 95% CI (0.068-0.56)] showed a lower odds of treatment interruption whereas attainment of secondary level education [AOR=5.28, 95% CI (1.18-23.59)] indicated a higher odds of treatment interruption. Non-clinical aspects of health care service delivery influence patient adherence to TB treatment. Health seeking behavior of groups considered to be high risk for treatment interruption should be incorporated into the design and delivery of TB treatment

Impact of Enclosures on Range Productivity in Chepareria West Pokot County Kenya

In the semi-arid areas of West Pokot particularly Chepareria, majority of the people live semi sedentary lives while others are nomadic pastoralists. In the last three decades, there have been concerted efforts to restore and improve rangeland in this area. Use of enclosures, which is one of the key interventions, by the Vi Agro- forestry a Non-Governmental Organisation, enhancing with many ecological processes such as disturbance, is a method of rehabilitating degraded rangeland, which in turn affects vegetation dynamics. Adoption of these strategies by farmers has been gradual and some areas are still open and degraded. The aim of this study was to evaluate the effects of enclosures on range productivity in the semi-arid rangeland in West Pokot. Plant productivity, diversity and density were assessed in enclosures of different ages and in adjacent open land used for communal grazing. Questionnaires were also used to assess local community perception of the range restoration and improvement. Modified Whittaker plot was used for sampling in the selected enclosures and open areas. Herbaceous biomass and plant cover were greater in enclosures than in open areas. The average herbaceous cover in the enclosed area was 76% while that in the open it was 55% which was significantly different, P \u3c 0.001. The average herbaceous biomass in the enclosure was 137.2kg/ha while in the open it was 37.8kg/ha respectively. Enclosed areas are more productive than open areas and should be adopted in other dry areas as a method of rehabilitating degraded grazing lands

Cost and benefit analysis for climate-smart soil practices in Western Kenya.

Most of the countries in sub-Saharan Africa (SSA), including Kenya, depend heavily on agriculture for income and food security. Any effort aiming to sustain and improve the productivity in agriculture is, therefore, an important step towards improving the livelihoods of many households. Soils are integral to the function of food and fibre production. In addition, they have a large potential for sequestering carbon and mitigating greenhouse gases. The adoption of climate-smart soil practices can improve the soil-nitrogen cycle, enhance yield, soil fertility, crop productivity, improve soil biodiversity, and reduce soil erosion and water pollution. This could, in turn, help to boost food production, income and household ability to adapt. However, a review of published literature indicates a lack of in-depth empirical analysis on the costs and benefits associated with implementing these climate-smart soil (CSS) practices. Therefore, there is a gap about the cost effectiveness of adopting these practices – a key ingredient to the development of appropriate policies. The results presented in this paper attempt to bridge this knowledge gap, using an ex-ante cost and benefit analysis (CBA) to assess the cost-effectiveness of a few selected CSS practices in three counties in Western Kenya. The study’s main goal is to assess costs and benefits of selected CSS practices as a step toward understanding whether it is beneficial or not – both from private and social points of view – for farmers who have implemented them

Comparative description of land use and characteristics of belowground biodiversity benchmark sites in Kenya = Descripción comparativa de usos del suelo y características de la diversidad del subsuelo en sitios empleados como referencia en Kenia

In Kenya, the below-ground biodiversity (BGBD) project selected two benchmark sites for the inventory of soil biota; these included the Irangi and Ngangao forest sites in the Mount Kenya region of Embu District and the Taita Hills area of Taita Taveta District. The areas selected by the project were located in biodiversity hotspots that are supporting rare and endemic plant and animal species. For more in-depth studies and analysis, the broader Embu and Taita benchmark areas were further sub-sampled into smaller areas that we refer to as study areas, designated by the symbols E1 and E2 for Embu and T1 and T2 for Taita benchmark. Within the study areas, we plotted and sampled 200x200 square grids for collecting soil as well as socio-economic data. Site characterization was carried out using the method provided by FAO-UNESCO for characterizing and classifying soils. Further to this, attempts were made to establish land use intensity (LUI) and land productivity (PI) indices that provided land condition indicators. The indicators offered insights into the quantitative relationship between the environmental conditions and land use. Parameters used in the computation of the land use intensity were; total quantity of inputs per ha, the frequency of input application, cropping intensity and cultivation frequency. The soils in Taita Taveta benchmark site were classified as Plinthic Lixisols, Plinthic Acrisols, Dystric Cambisols and Chromic Luvisols, while those from Embu ones were Rhodic Nitisols, Humic Nitisols, Humic Acrisols, Haplic Acrisols and Umbric Andosols. The highest level of soil organic carbon recorded was 7.6% in the forest and the lowest value of 1.6% in intensely cultivated maize-based and horticultural systems. Low land use intensity gradients were observed in the forests (LUI40%). The productivity index (PI) followed a similar trend, being highest in the natural forest and grassland (40-50%) and lowest in horticultural and maize-based systems (15-20%) It was concluded that the decline in soil quality and productivity was linked to increased land use intensification and lack of knowledge of the appropriate management practices for sustainable ecosystem functions and services

Cost and benefit analysis for climate-smart agricultural (csa) practices in the coastal savannah agro-ecological zone (aez) of Ghana

Most countries in sub-Saharan Africa (SSA), including Ghana, rely on agriculture for their income and food security. Any initiative that might help to sustain and improve productivity in agriculture would be a crucial step in improving people’s livelihoods. The adoption of climate-smart practices is a key step in reducing the threat to the sustainability of agricultural production in Ghana. Yet, despite the concern about the threat caused by climate variability and change, little empirical analysis has been carried out to date on how best to tackle it. However, recently many of the development and government programs are being designed in such a way that if adopted, can tackle the problems associated with climate variability and change. The majority of rural farmers have now adopted these practices. However, the cost effectiveness of adopting these practices – a key ingredient to the policy-making processes – is challenging. The results presented in this report attempt to bridge the knowledge gap between the cost and effectiveness, using ex-ante cost-benefit analysis to assess the cost effectiveness of some of the proposed climate-smart agricultural practices. This study examines the private and social benefits and the costs of selected climate-smart agricultural practices as a step towards understanding their private and potential social benefits and costs and their implication in terms of deterring their adoption from the farmers’ viewpoint and any potential social benefits, if adopted

Adoption of soil carbon enhancing practices and their impact on farm output in Western Kenya

Adoption of soil carbon practices has the capability of increasing yield, thus improving income and food availability. This paper assessed the adoption of agricultural practices that enhance soil carbon. Data from 334 households were collected in the rural areas of Western Kenya using a multistage sampling technique. The multivariate probit model and propensity score matching method were used to analyze the determinants of adoption of soil carbon practices and the impact on output, respectively. Results show that agroforestry, intercropping, terracing, and the use of inorganic fertilizer are the dominant soil carbon practices, which are discretely and diversely affected by socioeconomic, farm-level, institutional, and biophysical characteristics. However, the adoption of maize-bean intercropping alone has a great impact on maize production and increases output by approximately 240 kilograms. The findings from this study suggest that the adoption capacity of farming households can be accelerated by independently making interventions targeting individual practices rather than compounding the practices. Consequently, emphasis should target interventions that encourage the adoption of intercropping since its economic impact has been evidently underlined

An evaluation of the impact of soil carbon enhancing practices on farm output in Western Kenya

Sustainable agricultural practices that enhance soil carbon simultaneously improve farm yields and income. Despite the expansive literature on adoption of soil carbon practices in Kenya, there is limited information on the impact of the elemental practices on farm output. This study attempts to fill this literature gap by evaluating the impact of soil carbon practices on farm output in Western Kenya. Results show that agroforestry, maize-legume intercropping, terracing and use of inorganic fertilizer are dominant soil carbon practices. Howbeit, the propensity score matching results reveal that maize-legume intercropping solely has observable impact on farm output. On average, farmers involved in the practice have an increase of 27% on maize output as opposed to those who don’t, and as such adoption could improve their welfare. The findings suggests that interventions targeted on facilitating the uptake of maize-legume intercropping among resource-poor rural smallholder farmers should be pursued

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Innovative biomass cooking approaches for sub-Saharan Africa.

Eradicating poverty and achieving food and nutrition security in a sustainable environment is difficult to achieve without adequate access to affordable cooking fuel. It is therefore important to understand the common sources of cooking energy used by people in rural areas and the challenges faced in making fuel sources economically viable, socially acceptable and ecologically sustainable. In the sub-Saharan Africa (SSA) region, more than 90% of the population relies on firewood and charcoal (wood fuel, collectively) as a primary source of domestic energy. Wood fuel sustainability is challenged by unsustainable harvesting and inefficient methods of converting wood into energy. The use of inefficient cook stoves contributes to wood wastage and smoke exposure associated with severe illnesses. Households often abandon traditional nutritious diets that take a long time to cook, reduce the number of meals, and spend income on fuel at the expense of food costs. Innovations exist that have the potential to provide affordable and cleaner tree-based cooking fuel. Pruning trees on the farm as a fuel source brings firewood closer to women, lightens their workload, saves time and reduces income spent on cooking fuel. Using briquettes or gas cook stoves can reduce health risks associated with food preparation and reduce income spent on cooking fuel due to increased fuel efficiency. The development of these innovations indicates the need for a multi-disciplinary approach to increase awareness of the benefits of cooking fuel innovations, encourage further research on product quality enhancement and standardization, to understand cultural and behavioral issues influencing adoption, and integrate innovations into bioenergy policy frameworks