Participation and the focus of nutrition education in a rural child growth monitoring program in Kenya

Nutrition education is one of the strategies that addresses high levels of malnutrition in the world. Since independence in 1963. Kenya has instituted socio-economic, food security, nutrition and health policies to improve the nutrition and quality of life of it\u27s people. In spite of these policies, one third of the Kenyan population is undernourished. This study was planned to establish how nutrition education is conducted in the Ministry of Health Thika District through a rural child growth monitoring program and to generate and reflect on women\u27s participation in decision making in the program. Open-ended interviews were conducted with 21 women from the program, 4 community health workers and 16 nutrition stuff from Thika District. Focus groups, in-depth interviews and eight observations of the child growth monitoring sessions over nine months of fieldwork, provide data for this study. Participants were engaged actively in the entire research process. A participatory process was introduced by asking participants to contribute to the research agenda and make suggestions on what they wanted the program to address and how to do so. The process was developed through continuous dialogue and decision making. Reliability of data was ensured by conducting the research in the natural environment of the program and for an extended period of time. Triangulation of data and data collection methods and providing feedback to participants as a way to crosscheck the findings, validated data. Descriptive statistics analysed the data from the open-ended interviews whereas qualitative data were coded and analysed according to emerging themes and issues and synthesised to address the research questions. Results are presented by use of narrative to exemplify the concepts. The findings of this study show that nutrition education is important but what makes it work are the economic and food security concerns of the people. Findings reveal that although government nutrition staff and participants of the program identify a wide spectrum of causes and solutions to nutrition problems, implementation of nutrition education narrowly focuses on provision of nutrition information. This narrow focus is emphasised by government nutrition staff who focus more on curative than preventive nutrition. Nutrition staff have minimal training in primary health care and none in participatory approaches although they are expected to promote community participation. On the other hand, volunteer community health workers once trained, are left to plan and implement the program with minimal supervision, motivation or visible recognition. Findings show that there are no written nutrition education plans and that once nutrition programs are set in place, the programs are left to go on without reflection on their achievements. This study revealed that grassroot personnel have not accessed government policies on nutrition and community participation that they are supposed to implement and that there are limited resources set aside for nutrition within the Ministry of Health. Participation was promoted in the growth monitoring program by planning the research together with and progressing according to the expressed needs of participants. Women\u27s participation in the program identified the realities of food accessibility and lack of money that influence nutrition. Empowerment was evidenced by diversifying the program to include an income activity and development of a curriculum based on the knowledge women wanted. Selection of a separate committee for the income activity, evidence of interdependent decision making and criticism of dependency are some of the outcomes of participation. Findings show that participation demands commitment and time from all actors. Participants are willing to make that commitment when they perceive individual benefits for them as a result of their participation. This research reveals that motivation and supervision are considered important for the community health workers. These findings show that there is potential for a nutrition program to respond to the realities of people such as appropriate nutrition knowledge, food accessibility and incomes by negotiating program priorities between the participants and nutrition facilitators through participation. A model of participation that I recommend in this study is one that has clear reasons for participation and incorporates an outsider’s perspectives to catalyse the process. This enables local participants to see possibilities which they have not seen due to familiarity with their circumstances. Participation strategy should be able to link with research in order to contribute to publicity and advocacy. Linkage with policy ensures that the process may be addressed practically by current government policies. Participants should engage in a continuous process of assessing the program goals, design, action and analysis. This research recommends nutrition education strategies that explore training in participatory approaches for facilitators. Training should extend to work with community health workers in the community to design and clarify monitoring and evaluation at the community level. Participants in the program should have a voice to decide how the program functions. For effectiveness, an analysis of the resources required to implement participatory approaches is essential. Research that focuses on non-participating mothers, that analyses measures and cost effectiveness of participation und studies that compare the process in different contexts in order to make positive decisions that can influence policy are recommended. The ultimate outcome of this research is that although government policies that promote nutrition and participation in health are in existence in Kenya, grassroot nutrition staff do not access these policies. Promotion of nutrition is worsened by the weak link between the growth monitoring program, the health sector and collaborating non-governmental organisations at the grassroot level on the one hand and between nutrition staff at different government levels. This research recommends that what is required to address the broad nature of nutrition problems are not only policies on nutrition and participation but ensuring the practice of these policies that will bring about a more realistic manner of solving complex nutrition problems. This thesis explains how policy on food security and nutrition at the government level is useless unless those at all relevant levels espccially grassroot government personnel and the community are actively engaged in planning and implementing such policies

A Flash Flood Control System Based on the Global Earth Observation System of Systems

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Determinants of the Effectiveness of Antimicrobial Prophylaxis among Neurotrauma Patients at a Referral Hospital in Kenya: Findings and Implications

Background: Surgical site infections can occur adding to morbidity, mortality and costs, and can be particularly problematic in low and middle income countries. This includes infections in neurosurgical patients following surgery despite antimicrobial prophylaxis. The study aimed at measuring the incidence of surgical site infections (SSIs) and identifying factors that influence the effectiveness of antimicrobial prophylaxis in a leading hospital in Kenya. Methods: Prospective cohort study from April to July 2015 in the Neurosurgical ward of a leading referral hospital in Kenya. Adult head injury patients were recruited by universal sampling. Data was collected on prophylactic antibiotics and the occurrence of SSIs. Risk factors for infection were identified by logistic regression. Results: Eighty four patients were recruited, with 69 patients eventually analysed. Incidence of SSIs was 37.7% (n=26). The most common antibiotic used for prophylaxis was ceftriaxone. Patients on prophylaxis were less likely to be infected than those who did not receive prophylaxis; however, this was not statistically significant (RR 0.87, 95% CI 0.40-1.893). The presence of epidural haematoma was a risk factor for the development of SSIs (Crude RR 2.456, 95% CI 1.474-4.090). Overall, antimicrobial prophylaxis was effective only in patients who underwent evacuation of hematoma by craniotomy (risk reduction, 62.5% (CI, 29.0% -96.0%). Conclusion: Evacuation of haematomas through craniotomy increased the effectiveness of prophylaxis, and should be considered in the future. The rationale will be explored further to see if antibiotic prophylaxis can reduce SSIs in other patients with neuro trauma

Effect of Corporate Governance on Performance of Savings and Credit Co-operative Societies in Kakamega County

The study on the effect of corporate governance on performance of SACCOs was based on the revelations that some cooperatives are ailing, while others are very vibrant and sustainable. Good corporate governance is now accepted as vital to achieving the Millennium Development Goals and as a pre-condition for sustainable economic growth. The purpose of this study was to examine the effect of corporate governance on performance of SACCOs. Corporate governance was operationalized by transparency and accountability, shareholder involvement, policies and guidelines, and rewards and incentives while performance of SACCOs was characterized by growth in share capital/deposits, growth in membership, growth in turnover, and customer satisfaction. The significance of the study was to demonstrate the need for good corporate governance in the co-operative movement. Extensive literature was reviewed to establish the importance of the study, highlighted knowledge gaps and provided benchmark for comparison of the findings. The target population was 33 Savings and Credit Co-operative Societies in Kakamega County. Stratified sampling was applied to get the number of respondents in the study. The respondents were the executive board members, ordinary members, and Chief Executive Officers from the sampled SACCOs. Descriptive and correlational survey designs were both used. Data collection was conducted by use of a questionnaire and document review. Cronbach’s alpha coefficient (KR 20), a test of reliability was computed to define the correlation of items contained in the instruments. Piloting of the instruments was through pre-testing of the instruments by carrying out a pilot study in two co-operatives that is Weko and Wesacco. Data was analyzed using descriptive and inferential statistics. The study found that corporate governance had a significant positive effect on performance of SACCOs. Recommendations from this study included the need for all SACCOs to embrace corporate governance since it enhances performance. Measures should also be put in place for SACCOs to embrace right culture, learning, and right organizational structures as they implement their plans. However, the study has recommended further researches on the effect of corporate governance in other types of co-operatives like housing, marketing, and co-operative unions and research that will cover a wider area. Key words: Corporate Governance, Performance, Savings and Credit Co-operatives, Keny

Formulation of Furosemide Dispersible Tablets for Use in Paediatrics

Furosemide (4 mg) dispersible tablets tailored for paediatric patients were formulated by direct compression using granulated lactose as the filler. Combinations of superdisintergrants namely sodium starch glycolate-crospovidone, sodium starch glycolate-croscarmellose and croscarmellose-crospovidone were incorporated to form three tablet batches; with a total superdisintegrant concentration of 4% w/w per tablet. The quality of the resultant tablets was evaluated using pharmacopoeial physicochemical tests. Tablets prepared with sodium starch glycolate-crospovidone and croscarmellose-crospovidone as superdisintegrants were found to comply with all specifications for tablet quality, while those formulated with sodium starch glycolate-croscarmellose, failed both the uniformity of weight and friability tests. This study showed that low dose furosemide dispersible tablets for pediatric use can be formulated using 4% w/w combinations of sodium starch glycolate-crospovidone and croscarmellosecrospovidone as superdisintegrants.Keywords: Furosemide, dispersible tablet, pediatric, formulation, superdisintegrant

Diversity and Taxonomic Identity of Rumen Bacterial Community in Cattle Fed Different Diets

In this study, the identity of rumen bacterial community and their taxonomic classification in Zebu heifers (n=24) fed 4 different diets (range grasses, Bracharia MulatoII, Azolla and Cassava leaf meal) was surveyed using metagenomics sequencing of the 16SrRNA gene. Rumen liquor samples were collected from the heifers from which a total of 192 DNA samples were amplified and the resulting 16S rRNA sequences compared to the existing sequences at the National Centre for Biotechnology Information (NCBI) BLAST database through the MetagenAssist . Bioinformatics analyses indicated that 17 operational taxonomic units (OTUs) were present at the phylum level. Of these, 43.3% were affiliated to the phylum Firmicutes, 27.2% Bacteroidetes, 22.8% Proteobacteria and 1.7% Euryarchaeota. The remaining were Cyanobacteria (1.4%), Chloroflexi (1%) while Actinobacteria, Verrucomicrobia, Spirochaetes, Tenericutes, Planctomycetes, Elusimicrobia, Lentisphaerae, Armatimonadetes, Fibrobacteres, Synergistetes and Arthropoda were all below 1%. Both Time and Diet had significant effect on the abundance of microbes but did not affect their diversity. Different diets therefore can affect the abundance of rumen microbiome and eventually the performance of animals

Combating Desertification through Enhancement of Woody Floral Diversity in the Drylands of Kenya: Analysis, Milestones, and Strategies

Desertification remains one of the most challenging phenomena in the drylands of Kenya, where it affects about 80% of the country. This is because of persistent degradation of these areas by climatic variations, human activities, and overgrazing by livestock and wildlife. In these areas, inhabitants suffer from widespread acute poverty and other adverse effects of drought. In order to effectively and efficiently combat desertification and reduce the impacts of further degradation, the Government of Kenya and partners are committed to developing and implementing methods, approaches, strategies, and mechanisms that would slow down or reverse this phenomenon. This chapter covers an in-depth review of advances made so far in the area of woody resources restoration and sustainable management in the drylands of Kenya through biodiversity assessments, conservation, rehabilitation, afforestation, and reafforestation initiatives and research. Achievements, challenges, and opportunities encountered are highlighted for sustainable development and wise utilization of dryland woody and allied resources