A shift from cattle to camel and goat farming can sustain milk production with lower inputs and emissions in north sub-Saharan Africa’s drylands

Climate change is increasingly putting milk production from cattle-based dairy systems in north sub-Saharan Africa (NSSA) under stress, threatening livelihoods and food security. Here we combine livestock heat stress frequency, dry matter feed production and water accessibility data to understand where environmental changes in NSSA’s drylands are jeopardizing cattle milk production. We show that environmental conditions worsened for ∼17% of the study area. Increasing goat and camel populations by ∼14% (∼7.7 million) and ∼10% (∼1.2 million), respectively, while reducing the dairy cattle population by ∼24% (∼5.9 million), could result in ∼0.14 Mt (+5.7%) higher milk production, lower water (−1,683.6 million m3, −15.3%) and feed resource (−404.3 Mt, −11.2%) demand—and lower dairy emissions by ∼1,224.6 MtCO2e (−7.9%). Shifting herd composition from cattle towards the inclusion of, or replacement with, goats and camels can secure milk production and support NSSA’s dairy production resilience against climate change

Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya.

INTRODUCTION:Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. METHODS:This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PAC patient that reduces pregnancy rate by over 99%. RESULTS:Generally, contraceptive counseling was high among all PAC patients (90%). However, only 54% of them received a modern family planning method-45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient's previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PAC patients. DISCUSSION AND CONCLUSION:For better adoption of highly effective FP, counseling of PAC patients requires an understanding of the patient's past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients

Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis

BACKGROUND Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya. METHODS We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form. RESULTS Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %). CONCLUSIONS Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion care service providers must ensure that young clients receive contraceptive counseling and effective pregnancy prevention methods before discharge from the health care facility to prevent unintended pregnancies that may result in subsequent induced abortions.The research presented in this manuscript was funded by the Consortium for Research on Unsafe Abortion in Africa and its principal donor, the UK Department for International Development, as well as the Government of the Netherlands. Analysis and writing time was supported through funding from the Bill and Melinda Gates Foundation (Global Health Grant Number: OPP1021893); UK aid from the UK government for the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium (Grant Number SR1109D-6); a Safe Abortion Action Fund grant for the Understanding and Improving Adolescent Women’s Access to Quality Abortion Care in Kenya Project (2014–2016); and through general support grants to the African Population and Health Research Center from the Swedish International Development Cooperation Agency (Grant Number 2011–001578) and the William and Flora Hewlett Foundation (Grant Number 2012–7612). MMM’s writing time was also funded by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and is funded by the Wellcome Trust (UK) [Grant no. 087547/Z/08/Z], the Department for International Development (DfID) under the Development Partnerships in Higher Education (DelPHE), the Carnegie Corporation of New York [Grant no. B 8606], the Ford Foundation [Grant no. 1100–0399], Google.Org [Grant no. 191994], Sida [grant number 54100029] and John D. and Catherine T. MacArthur Foundation [Grant no. 10-95915-000-INP]

Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data

Abstract Background Complications of unsafe abortion are a leading cause of maternal mortality in sub-Saharan Africa. Adolescents and young women are disproportionately represented among those at risk of these complications. Currently, we know little about the factors associated with young women’s timing of abortion. This study examined the timing of abortion as well as factors influencing it among adolescents and young women aged 12–24 years who sought post-abortion care (PAC) in health facilities in Kenya. Methods We draw on data from a cross-sectional study on the magnitude and incidence of induced abortion in Kenya conducted in 2012. The study surveyed women presenting with a diagnosis of incomplete, inevitable, missed, complete, or septic abortion over a one-month data collection period in 328 health facilities (levels 2–6). Survey data, specifically, from adolescents and young women were analyzed to examine their characteristics, the timing of abortion, and the factors associated with the timing of abortion. Results One thousand one hundred forty-five adolescents and young women presented for PAC during the data collection period. Eight percent of the women reported a previous induced abortion and 78% were not using a modern method of contraception about the time of conception. Thirty-nine percent of the index abortions occurred after 12 weeks of gestation. A greater proportion of women presenting with late abortions (more than 12 weeks gestational age) (46%) than those presenting with early abortions (33%) presented with severe complications. Controlling for socio-demographic and reproductive history, timing of abortion was significantly associated with place of residence (marginal), education, parity, clinical stage of abortion and level of severity. Conclusions Late-term abortions were substantial, and may have contributed substantially to the high proportion of women with post-abortion complications. Efforts to reduce the severity of abortion-related morbidities and mortality must target young women, particularly those living in rural and other remote areas. Interventions to reduce unintended pregnancies in this population are also urgently needed to improve early pregnancy detection and timely care seeking

MOESM1 of Consumer demand heterogeneity and valuation of value-added pulse products: a case of precooked beans in Uganda

Additional file 1. List of blocked choice sets used in the choice experiment