Peacebuilding in the Context of Displacement: Women’s Groups in Internally Displaced Persons (IDPs) Settlements in Kenya

Abstract Following the 2007-2008 post-election violence in Kenya, 650,000 people, comprising men, women, youth, and children, fled their communities, and found refuge in internally displaced persons (IDPs) camps. Although the Kenyan Government resettled some of the IDPs later in eco-villages and inner city settlements, seven years later there were still 309,200 in IDPs camps across the country. The objective of this qualitative multi-sited single case study is to explore the role of women’s groups in peacebuilding efforts following the post-election conflict. The study focuses on four grassroots-level local women’s groups in the Bankala and Mambira eco-villages and an inner-city settlement in the Rift-Valley, Kenya. The study uses the human security approach to peacebuilding to examine the activities and initiatives of the women’s groups. It also adopts the African feminisms theoretical framework that focuses on the African context of the settlements, female autonomy and cooperation, the importance of kinship, and the inclusion of all members of the community. The methodology involves the analysis of 28 individual interviews, five focus group discussions with 32 participants, participant observations, and published and unpublished documents. The findings indicate that the economic, social, and cultural initiatives of the women’s groups contributed to meeting dimensions of human security in the displaced persons’ settlements. Additionally, the findings signify that a community-based approach to peacebuilding that involved women, men, youth, and children allowed for sustainable structures of peace. Finally, I recommend the involvement of external organizations and the Kenyan government in collaborative partnerships and interventions with the women’s groups in order to sustain their peacebuilding initiatives beyond the grassroots levels. Keywords: Peacebuilding, women’s groups, Internally Displaced Persons, eco-villages, human security, grassroots level, community involvement, post-election conflict

Perceived Barriers to Accessing and Adhering to Antiretroviral Therapy by People Living with HIV/AIDS (PLWHAs) in Akwa Ibom State, Nigeria

There have been various studies on barriers to accessing and adhering to Anti Retroviral Therapy by People with HIV/AIDS. This paper presents empirical data using questionnaire and interview on barriers to accessing ART by PLWHAs.  The study was carried out in Akwa Ibom state Nigeria using a cross sectional survey design with questionnaire and in-depth interview. Five hundred and forty (540) respondents were drawn from twenty (20) support groups in the state. They were selected only on the basis of their willingness to participate in the study. Ten respondents who were not administered questionnaire to were interviewed. Findings suggest that side effects of the drugs appear to be a major barrier as 67.2 percent of the respondents attested to that. Also it was found that due to fear of stigmatization, some of the PLWHAs visit ART centres far from their place of residence  and so distance and waiting period before one is attended to by health personnel became a barrier for them but not for others. We suggest the need for more enlightenment of the public to reduce stigmatization. Also health personnel should educate the PLWHAs more on how to manage the side effects. There is also need to sustain the progress made so far in reducing some of the barriers to accessing ART and one way of sustaining is by educating and organising on the job training for health personnel periodically. Keywords: Barriers, Access, ART, Side effects, PLWHAs, Nigeria

Post-Traumatic Stress Disorder among Children Survivors of 2007/2008 Post-Election Violence in Nakuru County, Kenya

Recent advances in psychological research indicate that traumatic events can have effects on the victims, perpetrators and those who witness such events.  This is on the premise that no one who experiences a disaster is untouched by it. In the 2007/2008 post-election violence in Kenya, children were exposed to and witnessed various traumatic events.  Some may have developed behavioral and anxiety disorders. The study sought to assess levels Posttraumatic Stress Disorder severity among the children. The study was guided by Cognitive Behavioral Theory. The study target population was 77,768 children. A sample size of 460 respondents was derived from 10 divisions in Nakuru county which were hard hit by post-election violence.  The sample comprised of 400 children who included primary and secondary survivors of the violence and 20 deputy head teachers in the schools sampled and 40 parents who took part in focused group discussions. Expost facto comparative research design was utilized and multi-stage sampling approach was used to derive the sample. Data for the study was obtained using questionnaires, interview schedules and focused group discussions. A pilot study was conducted in Subukia division involving 80 children, four deputy head teachers and two focused group discussions. The hypotheses were tested at significance level of 0.05. The study found high PTSD levels children survivors of post- election violence. This study recommended psychological debriefing and trauma counseling as interventions needed for the survivors. Keywords: Post-Traumatic Stress disorder traumatic experiences, post-election violence, secondary survivors, primary survivor

Relationship between Traumatic Experiences of Primary and Secondary Survivors and PTSD Severity in areas affected by Post- Election Violence of 2007/2008 in Nakuru County, Kenya.

The 2007/2008 post-election violence in Kenya no doubt exposed children were to a myriad of traumatic events that left scars of shattered assumptions of safety and personal vulnerability.  Some of them may have developed anxiety disorders. The purpose of the study was to establish the relationship between traumatic experiences and posttraumatic stress disorder (PTSD) of primary and secondary survivors during the post-election violence of 2007/2008 in Nakuru county. A sample size of 460 respondents was derived from 10 divisions in Nakuru county that was among counties in Kenya that experienced the post-election violence.  The sample comprised of 400 children who included primary and secondary survivors of the violence and 20 deputy head teachers in the schools sampled as well as 40 parents. A multi-stage sampling approach was used to get the sample.  Data was obtained through questionnaires, interview schedules and Focused Group Discussions. The split-half method was used to determine the reliability of the research instruments. Data from questionnaires was analyzed using descriptive and inferential statistics namely correlation computed using Pearson product moment formula. Keywords: children survivors, Post Traumatic Stress Disorder, Post-Election Violence of 2007/2008, Traumatic Experiences.

Gender Difference in Traumatic Experiences and Level of Post Trumatic Stress Disorder among Children Survivors in Areas Affected by the Post-Election of 2007/2008 in Nakuru County, Kenya

Gender differences have been observed in children experience of traumatic events as well in development of PTSD. Males have commonly been found to experience more traumas except for sexual assault while the female are more likely to develop PTSD after a traumatic event. In the 2007/2008 post-election violence in Kenya, both female and children were exposed to and witnessed various traumatic events.  Some may have developed anxiety disorders. The purpose of this study was to investigate the traumatic experiences of children during post-election violence and possibility of development of post-traumatic stress disorder among children survivors of 2007/2008 post-election violence in Nakuru county.  The study sought to determine gender difference in traumatic experiences and PTSD. The study utilized expost facto and correlational research designs. The study was guided by Cognitive Behavioral Theory. A sample size of 400 respondents was derived from areas affected by post-election violence in Nakuru county. A multi-stage sampling approach was used to derive the sample. Data for the study was obtained using questionnaires. Data was analyzed using descriptive and inferential statistics. Independent t-test was used to test the hypotheses. The hypotheses were tested at significance level of 0.05. Significant gender difference was established in traumatic experiences and level of PTSD severity. Keywords: Post-traumatic stress disorder, post-election violence of 2007/2008, gender, traumatic experiences.

Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya

BACKGROUND: In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. METHODS: A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. RESULTS: 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. CONCLUSION: The proposed spatial modelling framework presents a rationale for equitable allocation of routine LLINs and could be used for quantification of other maternal and child health commodities applicable in different settings. Western Kenya region received adequate LLINs for routine distribution in line with government of Kenya targets, however, the model shows important inefficiencies in the allocation of the LLINs at clinic level

The survey of Lake Victoria's fishers

The findings are presented of a survey conducted regarding the fishers of Lake Victoria, which examined the relationships affecting supply flows of raw material on to the market, and also the characteristics of fishing activities and their effects on fish quality and distribution. Fish marketing plays a vital role in the lives of much of the lake basin's population, both in terms of employment and nutrition. The results of the survey comprise, in part, a base-line data set which will facilitate further research, analysis and management decision-making in relation to stakeholders of the lake's resources. Data collection, methods and research difficulties encountered are described and details given of a profile of a boat owner/renter and aslo of a profile of a crew member. The survey shows that Lake Victoria's fishery is one of very limited diversity. The fishers recount that they consistently target one or more of the 3 most common species within the lake (Nile perch, tilapia and dagaa) and very rarely consider any other species type. The largest proportion of fishers on the lake are Nile perch fishers; there is considerable demand for this species, and hence fishers have little incentive to either target alternative fish species, not to try and establish firm marketing outlets through the creation of arrangements with their principal buyers. In Kenyan waters, however, the number of Nile perch fishers is equaled by the number of dagaa fishers; this fish now commands a considerable portion of the market for fish from Lake Victoria through its availability as well as its relatively low prices. The tilapia fishery is in decline, and all 3 riparian states would not appear to be attracting investment almost certainly as a result of declining catches. For many of those working in Lake Victoria's fishery, the problems faced appear most often to be associated with the vagaries of an unstable market which may rise or fall depending on the state of the international market or the state of access roads to fish landings. (PDF contains 42 pages

Impact of elemental composition of particulate matter in the airshed of a University Farm on the local air quality.

The impact of particulate matter on the ambient air quality of Landmark University Farm was assessed using deposition fluxes of Trace elements (TEs) in the airshed of the farm. Deposition gauges were employed to collect both dry and wet deposition samples of particulate matter between 2018 and 2019. Elemental compositions of particulates collected during the sampling period were analyzed using Energy Dispersive X-ray Fluorescence Spectroscopy (ED-XRF). The deposition fluxes of crustal and anthropogenic trace elements were also determined using standard methods. Results showed that in dry season, iron has the highest mean concentration (3283.61 mg/kg), while chromium has the lowest (0.023 mg/kg). On the other hand, in wet season, silicon and nickel have the highest and lowest mean concentrations of 159.34 mg/kg and 0.01 mg/kg respectively. Although the concentrations of these metals were higher in the dry season than wet season, there was no statistical significant difference between the mean concentrations of the elements measured in each season of the year (p > 0.05). The compositions of some of the elements in the particulate matters were found to be far above the recommended exposure limits prescribed by OSHA. The study concluded that the elemental composition of particulate matter in the airshed of the University Farm adversely impacts the ambient air quality of the Communit

The prevalence, clinical features, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Kenya

Objectives: To determine the prevalence, clinical features, risk factors and outcomes associated with cryptococcal meningitis (CM) in human immunodeficiency virus (HIV) positive patients at two referral hospitals in Nairobi, Kenya.Design: Prospective, observational study.Setting: Kenyatta National Hospital (KNH) and Mbagathi District Hospital (MDH), Nairobi, KenyaSubjects: Three hundred and forty HIV patients presenting with suspected CM.Results: Of three hundred and forty suspected CM patients, 111 (33%) were diagnosed with CM by CrAg. Among CM patients, in-hospital mortality was 36% (38/106), median age was 35 years (range, 19-60 years) and median CD4 count was 41 cells/μL (n=89, range 2-720 cells/μL). Common clinical manifestations among CM patients included headache 103 (93%), neck stiffness 76 (69%) and weight loss 53 (48%). Factors independently associated with CM were male sex, headache, blurred vision and previous antifungal drug use. Night sweats and current use of anti-retroviral therapy were associated with reduced risk for CM.Conclusions: There is a high prevalence of CM and CM-associated mortality in HIV patients at KNH and MDH despite treatment with antifungal and anti-retroviral drugs. This study demonstrates the need to address the existing inadequacies of CM patient outcomes in Kenya