Commentary: Using law more effectively towards abandonment of FGM/C in Kenya

Female genital mutilation/cutting (FGM/C) is considered a harmful cultural practice and a form of violence against women. Kenya has an FGM/C prevalence rate of 21 percent, but levels vary by ethnic group. Kenya has adopted a robust legal framework for the prohibition of FGM/C, including passage of the Prohibition of FGM Act in 2011, a detailed law that criminalizes carrying out FGM/C and associated offenses. Kenya relies on the human rights–based approach and criminalization in its legal framework for the prohibition of this practice. Despite extensive legal provisions, Kenya has prosecuted fewer than 100 cases, raising concerns with the law’s enforcement. This commentary reflects consultations with key actors regarding results of the Evidence to End FGM/C Research Program’s study assessing the role of law in reducing the practice in Kenya. Expert opinions on the implementation of Kenya’s anti-FGM/C law and potential areas for strengthening this approach have been collated to outline recommendations on how the legal framework for the prohibition of FGM/C in Kenya can be strengthened to better contribute toward abandonment of the practice

Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa : protocol for a systematic review and meta-analysis

Background Uncontrolled hypertension is the most important risk factor and leading cause of cardiovascular diseases. It is predicted that the number of people with hypertension will increase, and a large proportion of this increase will occur in developing countries. The highest prevalence of uncontrolled hypertension is reported in sub-Saharan Africa, and treatment for hypertension is unacceptably low. Hypertension commonly co-exists with comorbidities and this is associated with poorer health outcomes for patients. This review aims to estimate the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa. Methods and analysis All published and unpublished studies on the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa will be included. MEDLINE via OVID, Embase, and Web of Science will be searched to identify all relevant articles published from January 2000 to June 2019. Experts in the field will be contacted for unpublished literature, and Open SIGLE will be reviewed for relevant information. No language restriction will be imposed. Two reviewers will select, screen, extract data, and assess the risk of bias while a third reviewer will arbitrate the disagreements. A meta-analysis will be performed on variables that are similar across the included studies. Proportions will be stabilized before estimates are pooled using a random effects model. The presence of publication bias will be assessed using Egger’s test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported in accordance with the PRISMA-P protocol guidelines. Results will be stratified by country, comorbidity, and geographic region

Assessing the role of law in reducing the practise of FGM/C in Kenya

Criminalization is an important aspect of anti-FGM/C policies and programs. In countries where FGM/C is practiced, the enactment of a law prohibiting the practice is an important indicator of progress toward abandonment. Criminalization is often seen as playing an important role in the declining prevalence of FGM/C. However, there is not much research on the link between the enactment of laws that prohibit and criminalize FGM/C and declining prevalence of the practice. The objectives of this study, therefore, were to assess the extent to which people obey the law on FGM/C; to investigate the reasons and causes that motivate people born into a tradition of FGM/C to obey or not to obey a law prohibiting FGM/C; and to establish the legal, policy, and program responses, across varying contexts, that would most effectively reduce the practice of FGM/C. The study was conducted in Kenya, where FGM/C is criminalized under the 2001 Children’s Act and the 2011 Prohibition of FGM Act

Food safety and public health implications of growing urban food markets

Currently, Africa suffers from the highest per capita rate of foodborne illnesses in the world. The riskiest foods from a health perspective are animal-source foods, fruits, and fresh vegetables. Consumption of all these is growing rapidly in African cities. Food products sold in formal markets and retail outlets are not necessarily safer than those sold in informal markets. Improvements in urban food safety will require intentioned investments in domestic market infrastructure and improved awareness of the shared responsibility to provide safe food by regulators and value chain actors