Socio-Economic Factors Influencing Farmers’ Participation in Grain Warehouse Receipt System and the Extent of Participation in Nakuru District, Kenya

Post harvest losses in Sub-Saharan Africa (excluding South Africa) are generally high, arising from handling, transportation, storage, processing and packaging and marketing. In Kenya, it is estimated that 21.1% of total annual maize production is lost through poor post harvest handling techniques. As an effort to mitigate post-harvest losses, the Government together with development partners introduced the Grain Warehousing Receipt System (GWRS). Under this system, farmers store their marketable surplus in parastatal storage capacity or private grain handling service providers. The farmers are charged for storage service. As certification of their deposition, farmers are issued with receipts from the warehouses. The receipts can be used to access credit facilities from cooperating financial institutions up to 80% of the prevailing maize market prices. After waiting for prices to rise over the storage season, the farmers market the produce and payment made through respective financial institutions. Methods: The study was carried out in Nakuru District, Kenya. Double Hurdle model was used to estimate factors influencing farmers’ participation in GWRS and the extent of participation. The sample size was 178 farmers using multistage sampling technique where two divisions, Mauche and Gilgil were chosen to represent zones where maize farming is commercialized.  Each of these divisions had 89 farmers randomly selected.The determination of sample size was through the approach based on the precision rate and confidence level. Results: Six explanatory variables were found to significantly influence participation in GWRS.  Gender and distance to warehouse negatively influenced participation in GWRS while gender land size under maize production, off farm income, group membership positively influenced participation in GWRS. On the extent of participation in GWRS, five dependent variables were found to significantly influence participation in GWRS. Gender, household size and distance to warehouse negatively influenced while land size under maize production, group membership positively influenced the extent of participation. From the study the following recommendations are made; Strengthening of farmer owned organizations is highly recommended. This is achievable through capacity building and training on organizational development. Empowering women in agricultural activities is desirable. Offline diversification should be promoted to enhance household income. Grain driers and collection points should be made available at distance which farmers access them with ease to counter quality and transport challenges experienced by farmers. Storage costs charged by warehouses, interest on loan and loan arrangement fees should be brought down through research for farmers to optimize profit. This can be achieved by approving more warehouses, involving more cooperating financial institutions, warehouses diversifying to offer farm inputs and financial services and offer contract farming. Keywords: Socio-economic characteristics, Participation, Marginal effect

A Comparison of the Socio- Economic Characteristics of Dairy-Crop Integrators versus Non Integrators: A Case Study in Elgeyo-Marakwet County, Kenya

The aim of this study was to compare the different inherent socio economic characteristics amongst the dairy-crop integrators and non integrators in Elgeyo-Marakwet County, Kenya. The study carried out a census of 85 integrators and 85 non integrators. The data were collected with the help of a structured questionnaire. Descriptive statistics such as means and percentages were used to present the findings. The study found out that Integrators had a higher household size mean unlike the non integrators. The integrators had a lower mean in years of schooling of as compared to that of non integrators who had a higher mean of years of schooling. On the other hand, Integrators had a larger size of land on average as compared to non integrators. The study therefore recommends policy interventions to enhance access to credit, reduce illiteracy levels among rural entrepreneurs through training and extension services. Key words: Integration, Non-integration, Off-farm income, Househol

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc