The politics of ideology and personality rivalry in Murang'a district, Kenya: a study of electoral competition

Kenya got independence in 1963 amidst a cloud of confusion about the ideological and development path she would follow. Such confusion led to an intensive political debate which tended to categorize the contestants into leftists and pro-western rightist. In Muranga District Kaggiah and Kiano represented the two camps respectively, though the latter was more interested in boosting his personal political hegemonies than in ideological victory. Since independence, therefore, elections in the District tended to revolve around Kiano's political personality. His ouster in 1979 seems to have led to a new type of political development where the very wealthy commercial group of people has taken over political leadership in the District, thus finally replacing the entire 1960's political leadership in the area. Political negligence and arrogance, as well as inadequate attention to the people's socio-economic needs and demands have been identified as the main factors behind the ouster of several MPs in Muranga and in Kangema particularly. The dominance of elite interests in an election has great influence on both the attitude and behaviour of the electorate towards the incumbent and his challengers, the party and the government, and the efficacy of elections in influencing governmental policy

Self-Regulation of Facebook Usage and Academic Performance of Students in Kenyan Universities

The increasing connectivity of places to the internet platform has led to widespread use of the social media platforms in homes, workplaces and schools wherein it is preffered by mostly the young people christened as dot.com generation. The use of social media platforms has a potential effect on the productivity of the users either in their places of work, schools and society in general. The purpose of this study was to investigate the influence of self-regulation of Facebook usage on academic performance among university students in Kenya. To achieve this objective, the study employed the ex post facto research design. Purposive and stratified random sampling methods  were used to select partcipating campuses (n=4) from (N=12) and students (n=348) from (N=2698) third year regular students. Data was collected using a self administered questionnaire. The null hypothesis was tested at .01 level of significance using Kendall's tau_b correlation coefficient. The findings revealed that there was a moderate level of self regualtion on facebook usage by university students thus depicting ambivalence in attitude towards controlling the urge to use facebook when in site. Further, it was found that there was a significant relationship between the level of facebook self regulation and academic performance (p<.01). The implication of this finding was that the more one self regulates, the higher the likelihood of improving in academic performance. From the findings, it is recommended that universities incorporate time management skills in the curriculum in order to help the students achieve balance between leisure activites and academics. KEYWORDS: Facebook, Facebook usage, self-regulation, academic performance

School Meals Case Study: Kenya

This school meals case study forms part of a collection led by the Research Consortium for School Health and Nutrition’s "Good Examples" Community of Practice. The School Meals Case Study of Kenya serves to document how the national school meals programme is organized, funded, and monitored throughout the country. The objectives of this case study include presenting an introduction to the country profile, outlining the design and implementation of school feeding programmes, describing their monitoring and evaluation processes, and highlighting lessons learned, best practices, and challenges. This case study is written as a working paper, and can be updated to reflect evolving circumstances. The ‘Good Examples’ Community of Practice supports the evidence generation of the Research Consortium for School Health and Nutrition, the evidence-generating arm of the School Meals Coalition. The Research Consortium’s objective is to carry out independent research across diverse sectors and generate solid, compelling, and actionable evidence regarding the benefits of school food programs to inform evidence-based decision-making on school health and nutrition policies and practices

Nephropathy in patients with recently diagnosed type 2 diabetes mellitus black Africans

Background: Albuminuria is long recognised as a sign of renal disease in diabetes. In type 1 diabetes, renal disease occurs after a longer duration of diabetic state. In type 2 diabetes, it is more variable. Objective: To determine the prevalence and any risk factors of albuminuria in short­ term (≤2 yrs) type 2 diabetes. Design: Cross sectional, descriptive study. Microalbuminuria was assessed using micro II strips. Setting: Outpatient diabetic clinic at Kenyatta National Hospital, Nairobi. Subjects: Patients who were newly diagnosed or had had type 2 diabetes for two years or less. Main outcome measures: Microalbuminuria, lipids, glycated haemoglobin, fasting blood glucose and blood pressure. Results: One hundred and thirty nine patients who had type 2 diabetes mellitus for ≤2 yrs were seen, but only 100 patients were included in the study over a six month period. Their mean (SD) age was 53.7 (9.3) years. Mean (SD) duration of diabetes was 10.3 (7.5) months. Fifty per cent of the study patients were hypertensive. Only 48% had HbAic \u3c8% while 36% had HbAic \u3e9%. The lipid profile of total, LDL - HDL­ cholesterol and triglycerides were predominantly within normal limits. Twenty six per cent were established to have albuminuria of which one patient had macroalbuminuria. Blood pressure, glycated haemoglobin and lipid parameters were not significantly different from patients without albuminuria Conclusion: Albuminuria occurred in a significant proportion of patients with short term type 2 diabetes. Comparable to studies done elsewhere on short-term type 2 diabetes, albuminuria is both a sign of nephropathy and a cardiovascular risk factor. It should be looked for in all patients with type 2 diabetes attending this clinic, even at diagnosis

Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya

Background: Despite numerous interventions promoting optimal breastfeeding practices in Kenya, pockets of suboptimal breastfeeding practices are documented in Kenya’s urban slums. This paper describes cultural and social beliefs and practices that influence breastfeeding in two urban slums in Nairobi, Kenya. Methods: Qualitative data were collected in Korogocho and Viwandani slums through 10 focus group discussions and 19 in-depth interviews with pregnant, breastfeeding women and community health volunteers and 11 key-informant interviews with community leaders. Interviews were audiotaped, transcribed verbatim, coded in NVIVO and analyzed thematically. Results: Social and cultural beliefs and practices that result to suboptimal breastfeeding practices were highlighted including; considering colostrum as ‘dirty’ or ‘curdled milk’, a curse ‘bad omen’ associated with breastfeeding while engaging in extra marital affairs, a fear of the ‘evil eye’ (malevolent glare which is believed to be a curse associated with witchcraft) when breastfeeding in public and breastfeeding being associated with sagging breasts. Positive social and cultural beliefs were also identified including the association of breast milk with intellectual development and good child health. The beliefs and practices were learnt mainly from spouses, close relatives and peers. Conclusion: Interventions promoting behavior change with regards to breastfeeding should focus on dispelling the beliefs and practices that result to suboptimal breastfeeding practices and to build on the positive ones, while involving spouses and other family members as they are important sources of information on breastfeeding

Social value of a nutritional counselling and support program for breastfeeding in urban poor settings, Nairobi

Background: In Kenya, poor maternal nutrition, suboptimal infant and young child feeding practices and high levels of malnutrition have been shown among the urban poor. An intervention aimed at promoting optimal maternal infant and young child nutrition (MIYCN) practices in urban poor settings in Nairobi, Kenya was implemented. The intervention involved home-based counselling of pregnant and breastfeeding women and mothers of young children by community health volunteers (CHVs) on optimal MIYCN practices. This study assesses the social impact of the intervention using a Social Return on Investment (SROI) approach. Methods: Data collection was based on SROI methods and used a mixed methods approach (focus group discussions, key informant interviews, in-depth interviews, quantitative stakeholder surveys, and revealed preference approach for outcomes using value games). Results: The SROI analysis revealed that the MIYCN intervention was assessed to be highly effective and created social value, particularly for mothers and their children. Positive changes that participants experienced included mothers being more confident in child care and children and mothers being healthier. Overall, the intervention had a negative social impact on daycare centers and on health care providers, by putting too much pressure on them to provide care without providing extra support. The study calculated that, after accounting for discounting factors, the input ($USD 419,716) generated$USD 8 million of social value at the end of the project. The net present value created by the project was estimated at $USD 29.5 million.$USD 1 invested in the project was estimated to bring USD$71 (sensitivity analysis: USD$ 34-136) of social value for the stakeholders. Conclusion: The MIYCN intervention showed an important social impact in which mothers and children benefited the most. The intervention resulted in better perceived health of mothers and children and increased confidence of mothers to provide care for their children, while it resulted in negative impacts for day care center owners and health care providers

Characterised existing sweetpotato seed system actors, identified efficient seed distribution channels and market preferred varieties in Bukombe and Butiama districts, Tanzania

Tanzania is a major sweetpotato producer in sub-Saharan Africa. The area under sweetpotato has been rising steadily relative to main food staples. However, the yields have stagnated at around 4 t/ha compared with the potential yield of above 20 t/ha, partly due to limited access to quality seeds. Most farmers in SSA recycle seed from the previous crop or source from neighbours. This increases the probability of accumulating viruses, which may reduce the sweetpotato yield by over 50%. Studies have shown that farmers are willing to pay a premium for quality seeds. Therefore, an efficient seed distribution channel that ensures seeds move from the breeding stage to the multiplication stage without any disconnections between the nodes can provide farmers with better access to quality seed at an affordable price. However, there are disconnections in the current seed distribution channels, particularly between the public and private sectors. In addition, most farmers do not often replenish planting materials once they buy quality planting materials. There are hardly any exclusive seed multipliers in the seed value chain due to a lack of understanding about potential business opportunities. Identifying a sustainable and profitable business model for seed multipliers is important in ensuring that farmers are constantly supplied with quality planting materials when they need them. This needs greater efforts to demonstrate the benefits of using quality planting materials, establish delivery seed distribution channels to reach a large number of end-users, and strengthen farmer seed management capacities and farmer seed networks. A study was conducted in Mara and Geita regions to identify market preferred and the main sources of the sweetpotato roots. The survey on the root producers were carried to understand the acquisition and provision of the market-preferred varieties and the connections between the nodes in the existing seed distribution channels. The study also conducted key informant interviews with other key stakeholders such as the public sector (i.e., Tanzania Agricultural Research Institute-TARI). The team will propose a sustainable business model that can link formal and informal seed sectors for consistent supply of quality and market preferred planting materials to root producers. The study utilized “the structure, conduct, and performance (SCP)” tool to establish relationships in the sweetpotato seed market. The SCP paradigm postulates a causal relationship where the structure influences the conduct, and in turn, the conduct influences the performance. The structure refers to the type of market, pricing strategy, the degree of concentration of buyers and sellers, the level of product differentiation, and condition of entry in the market. The conduct is the behavior of buyers and sellers and how they react to each other strategy. The performance of the seed market considers indicators such as profit of the seed and root producers and seed security indicators. The study also mapped the linkages of the existing nodes of sweetpotato seed channels by looking at the seed acquisition and provision transactions. A total of 45 traders participated in the survey in Bukombe, Butiama, Ilemela and Nyamagana districts. Most of the traders were male, and the average age was between 37- 44 years in the four districts. Most traders are members of trader’s associations, some traders were in cooperatives, and a few were in digital platforms. The traders benefited from the association through access to credit, access to market information, facilitating joint marketing, and saving cash. The markets were mainly rural (Bukombe and Butiama) and urban markets (Ilemela and Nyamagana). The type of traders in these markets were either wholesalers or middlemen (aggregators), with most markets operating the whole day, where the contract between sellers and buyers is largely oral. The high season when the supply of sweetpotato roots is high in the market ran from February to June, while the low season runs from July to November. Overall, Polista (62%), Mage (40%), and Ukimwi (28%) were the three most traded in the market, but there were district differentials in the traded varieties. For instance, Ukerewe (56%) was the most traded variety in Butiama. The common attributes liked about these varieties include high dry matter, big root size, good taste for Polista, high dry matter, good color and high market demand for Ukimwi, long shelf life, high market demand, and good color of the flesh for Mage. The three most disliked attributes in Polista were late maturing, short storage life, and susceptibility to pests and diseases. In Ukimwi susceptible to pests and diseases, limited supply of planting material, and small size of the root. Low dry matter, late maturing, and high-water content were the three most disliked attributes of Mage variety. In the root and seed producers survey, a total of 110 households from the Bukombe and Butiama district participated in the rapid seed system assessment survey after being identified as a major source to sweetpotato markets in the region. The proportion of root producers who also produced seeds was higher in Bukombe (72%) than Butiama (42%), where the majority of the seed producers were not trained. Most producers produce seeds for their own use. However, the neighbor farmers play a dominant role in both seed acquisition and seed provision. The existing root buyers include wholesalers, commission agents/aggregators, retailers, and NGOs. Most farmers sell the roots to wholesale traders, followed by commission agents and retailers. The median size for sweetpotato root plots was 0.8 hectares in both districts, while the average size for sweetpotato seed plots was 0.2 hectares in Bukombe and 0.32 hectares in Butiama. The average root yield was 2,461 kg/acre in Bukombe and 2060kg/acre in Butiama. The average seed yield was 5,695kg/acre in Bukombe and 3,140 kg/acre in Butiama. Overall, the three most preferred varieties are Polista, Ukimwi, and Mage, but varied with the district. Polista variety was liked because of its high dry matter content, better taste, and high market demand. The traits that farmers disliked include matures late, has low yield and is not resistant to SPW. Ukimwi was preferred because it matures early, has high market demand, high dry matter. The traits producers disliked were less resistant to SPVD, not stress-tolerant, short shelf life, and limited access to planting material. The preferred attributes in Mage include high market demand, good flesh color, early maturing, and high root yield. However, the variety is late maturing, has low dry matter content, has a shorter shelf life, and less resistant to stress (drought and poor soils). About 90% of producers sell/share sweetpotato roots. The roots are mostly sold to wholesale traders, followed by commission agents, retailers, and NGOs. The average quantity sold by the respondents in the last year was about 8924 kg in Bukombe and 4850kg in Butiama. Only 26% and 53% of respondents sold seeds in Butiama and Bukombe, respectively. The most common varieties provided were Ukimwi (33%), Pisi tatu (27%), Uso wa mchina (20%) in Bukombe. Polista (57%) and Ukerewe (29%) were the most common varieties in Butiama. Farmers predominantly sold to sweetpotato producers in both Butiama (86%) and Bukombe (97%). Other seed buyers were international organizations, and local NGOs. Respondents sold to producers mainly because they were friends and relatives without expectations but sold to local NGOs, international organizations because they give higher prices. About 47% in Bukombe and 28% Butiama acquired seed from elsewhere. Ukimwi was the most dominant variety in Bukombe, while most respondents in Butiama received Polista and Ukerewe. At least half of the respondents chose these varieties because they were market preferred. The seeds were mainly sourced from sweetpotato producers because of close relationships (relatives and friends). TARI produced Kabode, Kakamega, NASPOT 12, and Mataya varieties through rapid multiplication in screen houses and conventional methods in open field plots. The three most preferred varieties were Kabode, NASPOT 12, and Mataya. All of them are early maturing, high yielding, with better nutritional benefits. Kabode and NASPOT 12 are also tolerant to SPVD and SPW. TARI has regular contact with about 20 decentralized vine multipliers and 30 farmers. In the last one year, TARI provided 5 types of varieties The five types of varieties that TARI provided were Kabode, Kakamega, NASPOT 12, Mataya, and Ejumula, where the seed class was basic. TARI provided a total of 1257 bundles to local NGOs in February at TSH 2500 for each bundle of 100 cuttings of 30cm size

Factors affecting actualization of the WHO breastfeeding recommendations in urban poor settings in Kenya

Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings.This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbear- ing age, community health workers, village elders and community leaders and other knowledgeable people in the community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies. The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours often dictated to them by their circumstances. Macro-level policies and interventions that consider the ecological setting are needed

Effectiveness of home-based nutritional counselling and support on exclusive breastfeeding in urban poor settings in Nairobi: a cluster randomized controlled trial

Background: Exclusive breastfeeding (EBF) improves infant health and survival. We tested the effectiveness of a homebased intervention using Community Health Workers (CHWs) on EBF for six months in urban poor settings in Kenya. Methods: We conducted a cluster-randomized controlled trial in Korogocho and Viwandani slums in Nairobi. We recruited pregnant women and followed them until the infant’s first birthday. Fourteen community clusters were randomized to intervention or control arm. The intervention arm received home-based nutritional counselling during scheduled visits by CHWs trained to provide specific maternal infant and young child nutrition (MIYCN) messages and standard care. The control arm was visited by CHWs who were not trained in MIYCN and they provided standard care (which included aspects of ante-natal and post-natal care, family planning, water, sanitation and hygiene, delivery with skilled attendance, immunization and community nutrition). CHWs in both groups distributed similar information materials on MIYCN. Differences in EBF by intervention status were tested using chi square and logistic regression, employing intention-to-treat analysis. Results: A total of 1110 mother-child pairs were involved, about half in each arm. At baseline, demographic and socioeconomic factors were similar between the two arms. The rates of EBF for 6 months increased from 2% pre-intervention to 55.2% (95% CI 50.4–59.9) in the intervention group and 54.6% (95% CI 50.0–59.1) in the control group. The adjusted odds of EBF (after adjusting for baseline characteristics) were slightly higher in the intervention arm compared to the control arm but not significantly different: for 0–2 months (OR 1.27, 95% CI 0.55 to 2.96; p = 0.550); 0–4 months (OR 1.15; 95% CI 0.54 to 2.42; p = 0.696), and 0–6 months (OR 1.11, 95% CI 0.61 to 2.02; p = 0.718). Conclusions: EBF for six months significantly increased in both arms indicating potential effectiveness of using CHWs to provide home-based counselling to mothers. The lack of any difference in EBF rates in the two groups suggests potential contamination of the control arm by information reserved for the intervention arm. Nevertheless, this study indicates a great potential for use of CHWs when they are incentivized and monitored as an effective model of promotion of EBF, particularly in urban poor settings. Given the equivalence of the results in both arms, the study suggests that the basic nutritional training given to CHWs in the basic primary health care training, and/or provision of information materials may be adequate in improving EBF rates in communities. However, further investigations on this may be needed. One contribution of these findings to implementation science is the difficulty in finding an appropriate counterfactual for community-based educational interventions. Trial registration: ISRCTN ISRCTN83692672. Registered 11 November 2012. Retrospectively registered