Local council's response to street homelessness in Welkom

Faculty of Arts School of Humanities 0400617v [email protected] Degree of master housingThe aim of the study was to investigate, how Welkom council is responding to street homelessness in Welkom. The democratic government adopted, the Reconstruction and Development Programme, as an integrated socio-economic policy framework, to mobilize national, and human resources, towards a sustainable housing for urban, and rural poor. However, despite, the government’s concerted commitment to providing massive housing for its citizens, the problem of homelessness, remains pervasive. Three themes, which emerged as critical during the study, are discussed in detail, namely, lack of housing policy, addressing specifically street homelessness; lack of financial and legal mandate, by the local council, to house street homelessness; and lack of research department, and human resources for effective conceptualization of the issue. It is argued that the department of research is critical in providing strategic research facilities, in areas of housing policy, and legislation frameworks. Equally critical, is the need for skilled human resources, necessary for strategic and holistic provision of efficient and effective services. The study suggests complete overhaul of the national housing policy making it holistically inclusive. Equally suggested, is capacity building necessary for sustainable, efficient, and effective housing delivery and eradication of homelessness

Effects of Allium Sativum Ethanolic Extract on Trypanosoma brucei brucei Parasites’ Morphometric Parameters and Clinical Outcome in White Albino Laboratory Rats

Background: Trypanosomosis affects humans as well as wild and domestic vertebrates, yet has no successful prophylaxis, chemotherapy nor cure.Objectives: The study was to investigate the effects of Allium sativum extract on Trypanosoma brucei brucei parasites’ morphometric parameters, parasitemia and the clinical outcome in white infected Albino laboratory rats in order to determine its trypanocidal effects.Methodology: The study was conducted at the department of Biological Sciences Laboratory of the Moi University Eldoret. Thirty two (32) mature rats randomly divided into four groups (M, N, P and Q) were kept in four (4) cages in a well ventilated room, with adequate light supply in the day.Sixteen (16) rats were infected with T. b. brucei (1.0 x 104 parasites per rat); eight (8) of which (Group N) were treated with the A. sativum ethanolic  extract on day 5 and day 9 after infection, while the other eight (8)rats (Group Q) received saline treatment on the same days.Sixteen (16) non-infected rats (controls) were also divided into two groups of eight rats each (P and M) and treated as in group N and Q, respectively. The rats were obtained from University of Nairobi, Chiromo Campus.Results: All infected rats became parasitemic two days after infection and reached peak levels on day 4 and 5 post infection. Parasitemia in saline treated infected rats fluctuated between 4025.5 ± 0.05 - 5544.4 ± 0.05 parasites per 200WBC whereas in the extract treated rats parasitemia declinedfrom 6976.6 ± 0.05 - 311.0 ± 0.05 parasites per 200WBC after the first treatment. Uninfected saline treated rats maintained normal Hb level (10.6g/L to 11.8g/L) as compared to the uninfected extract treated rats’ whose Hb levels was at 13.41g/L to 14.36g/L. The haemoglobin level changed to 8.0g/L four days after the infection in the group N rats before rising to 10.2g/L on day 8 post-infection following the extract treatments. Group Qrats’ Hb declined to 6.43g/L by the end of the study. RBC count of the infected saline treated rats declined to 3.38 x 106/μL as compared to 4.93-7.61 x 106/μL in the normal rats by 11 days postinfection. There was however no significant change in WBC, temperature and weight between the saline extract treated rats. The extract produced a shrinking effect on the parasite's body with some of the morphometric parameters appearing  significantly (P<0.05) reduced as observed under a microscope with ocular and stage micrometer scale. The mean nucleus, posterior ends to nucleus centre, the nucleus centre to the anterior end and the body length were reduced from 2.41μm to 1.42μm(P=0.00), 4.42μm to  3.68μm(P=0.017) , 4.65μm to 4.18μm(P=0.001) and 8.58μm to 7.19μm(P=0.001) respectively.Conclusion: In conclusion it was evident that, A. sativum ethanolic extract exhibited Trypanocidal effects that can be exploited to control clinical progression of Trypanosomosis in rats. In addition, the data presented demonstrates the plant extract had the potential to improve the red and white blood cell indices reducing parasitaemia following T. b. brucei infection. These findings suggest that, the garlic extract affected the plasma membrane of the parasites since shrinking was only possible with disrupted membrane biochemistry. Key words:  Trypanosoma brucei brucei, Allium Sativum, Parasitemia, Morphometric parameters

Financial Capability and Asset Building in Social and Economic Development: Advancing the Sustainable Development Goals

The concern for economic well-being undergirds most of the United Nations Sustainable Development Goals. This Perspective articulates an agenda for advancing those goals in resource-constrained countries by leveraging financial capability and asset-building (FCAB) strategies. It also specifies a role for financial technology (commonly called “FinTech”) in this work. The authors conclude with a call for better integrating FCAB and FinTech into plans for advancing the SDGs

Mobile Health–Supported HIV Self-Testing Strategy Among Urban Refugee and Displaced Youth in Kampala, Uganda: Protocol for a Cluster Randomized Trial (Tushirikiane, Supporting Each Other)

© Carmen Logie, Moses Okumu, Robert Hakiza, Daniel Kibuuka Musoke, Isha Berry, Simon Mwima, Peter Kyambadde, Uwase Mimy Kiera, Miranda Loutet, Stella Neema, Katie Newby, Clara McNamee, Stefan D Baral, Richard Lester, Joshua Musinguzi, Lawrence Mbuagbaw. Originally published in JMIR Research Protocols. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/)Background: HIV is the leading cause of mortality among youth in sub-Saharan Africa. Uganda hosts over 1.43 million refugees, and more than 83,000 live in Kampala, largely in informal settlements. There is limited information about HIV testing uptake and preferences among urban refugee and displaced youth. HIV self-testing is a promising method for increasing testing uptake. Further, mobile health (mHealth) interventions have been effective in increasing HIV testing uptake and could be particularly useful among youth. Objective: This study aims to evaluate the feasibility and effectiveness of two HIV self-testing implementation strategies (HIV self-testing intervention alone and HIV self-testing combined with an mHealth intervention) in comparison with the HIV testing standard of care in terms of HIV testing outcomes among refugee/displaced youth aged 16 to 24 years in Kampala, Uganda. Methods: A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomization will be performed with a 1:1:1 method. Approximately 450 adolescents (150 per cluster) will be enrolled and followed for 12 months. Data will be collected at the following three time points: baseline enrollment, 8 months after enrollment, and 12 months after enrollment. Primary outcomes (HIV testing frequency, HIV status knowledge, linkage to confirmatory testing, and linkage to HIV care) and secondary outcomes (depression, condom use efficacy, consistent condom use, sexual relationship power, HIV stigma, and adolescent sexual and reproductive health stigma) will be evaluated. Results: The study has been conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (June 14, 2019), Mildmay Uganda (November 11, 2019), and the Uganda National Council for Science and Technology (August 3, 2020). The Tushirikiane trial launched in February 2020, recruiting a total of 452 participants. Data collection was paused for 8 months due to COVID-19. Data collection for wave 2 resumed in November 2020, and as of December 10, 2020, a total of 295 participants have been followed-up. The third, and final, wave of data collection will be conducted between February and March 2021. Conclusions: This study will contribute to the knowledge of differentiated HIV testing implementation strategies for urban refugee and displaced youth living in informal settlements. We will share the findings in peer-reviewed manuscripts and conference presentations.Peer reviewe

Accessibility of long-term family planning methods: a comparison study between output based approach (OBA) clients verses non-OBA clients in the voucher supported facilities in Kenya

Background: The study seeks to evaluate the difference in access of long-term family planning (LTFP) methods among the output based approach (OBA) and non-OBA clients within the OBA facility. Methods: The study utilises a quasi experimental design. A two tailed unpaired t-test with unequal variance is used to test for the significance variation in the mean access. The difference in difference (DiD) estimates of program effect on long term family planning methods is done to estimate the causal effect by exploiting the group level difference on two or more dimensions. The study also uses a linear regression model to evaluate the predictors of choice of long-term family planning methods. Data was analysed using SPSS version 17. Results: All the methods (Bilateral tubal ligation-BTL, Vasectomy, intrauterine contraceptive device -IUCD, Implants, and Total or combined long-term family planning methods -LTFP) showed a statistical significant difference in the mean utilization between OBA versus non-OBA clients. The difference in difference estimates reveal that the difference in access between OBA and non OBA clients can significantly be attributed to the implementation of the OBA program for intrauterine contraceptive device (p?=?0.002), Implants (p?=?0.004), and total or combined long-term family planning methods (p?=?0.001). The county of residence is a significant determinant of access to all long-term family planning methods except vasectomy and the year of registration is a significant determinant of access especially for implants and total or combined long-term family planning methods. The management level and facility type does not play a role in determining the type of long-term family planning method preferred; however, non-governmental organisations (NGOs) as management level influences the choice of all methods (Bilateral tubal ligation, intrauterine contraceptive device, Implants, and combined methods) except vasectomy. The adjusted R2 value, representing the percentage of the variance explained by various models, is larger than 18% for implants and total or combined long-term family planning. Conclusion: The study showed that the voucher services in Kenya has been effective in providing long-term family planning services and improving access of care provided to women of reproductive age. Therefore, voucher scheme can be used as a tool for bridging the gap of unmet needs of family planning in Kenya and could potentially be more effective if rolled out to other counties

A facility-based study of women' satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program

Background: This is a facility-based study designed to assess perceived quality of care and satisfaction of reproductive health services under the output-based approach (OBA) services in Kenya from clients’ perspective. Method: An exit interview was conducted on 254 clients in public health facilities, non-governmental organizations, faith-based organizations and private facilities in Kitui, Kilifi, Kiambu, and Kisumu counties as well as in the Korogocho and Viwandani slums in Nairobi, Kenya using a 23-item scale questionnaire on quality of reproductive health services. Descriptive analysis, exploratory factor analysis, reliability test, and subgroup analysis using linear regression were performed. Results: Clients generally had a positive view on staff conduct and healthcare delivery but were neutral on hospital physical facilities, resources, and access to healthcare services. There was a high overall level of satisfaction among the clients with quick service, good handling of complications, and clean hospital stated as some of the reasons that enhanced satisfaction. The County of residence was shown to impact the perception of quality greatly with other social demographic characteristics showing low impact. Conclusion: Majority of the women perceived the quality of OBA services to be high and were happy with the way healthcare providers were handling birth related complications. The conduct and practice of healthcare workers is an important determinant of client’s perception of quality of reproductive and maternal health services. Findings can be used by health care managers as a guide to evaluate different areas of healthcare delivery and to improve resources and physical facilities that are crucial in elevating clients’ level of satisfaction

Moving Towards the Future: Complete Streets Policy in the U.S.

Complete Streets (CS) policy is a commitment to creating streets that safely and conveniently accommodate not only motorists but also bikers, walkers, and those who use public transit. The distribution of this policy over time follows the Diffusion of Innovation theory. This project aims to assess if CS policy adoption reflects a pattern consistent with diffusion of innovation theory; determine if modes of transport to work differ between stateswith CS policy differ and states without CS policy.https://openscholarship.wustl.edu/gis_poster/1152/thumbnail.jp

Alleviating psychological distress and promoting mental wellbeing among adolescents living with HIV in sub-Saharan Africa, during and after COVID-19

COVID-19 social control measures (e.g. physical distancing and lockdowns) can have both immediate (social isolation, loneliness, anxiety, stress) and long-term effects (depression, post-traumatic stress disorder) on individuals’ mental health. This may be particularly true of adolescents living with HIV (ALHIV) and their caregivers – populations already overburdened by intersecting stressors (e.g. psychosocial, biomedical, familial, economic, social, or environmental). Addressing the adverse mental health sequelae of COVID-19 among ALHIV requires a multi-dimensional approach that at once (a) economically empowers ALHIV and their households and (b) trains, mentors, and supervises community members as lay mental health services providers. Mental health literacy programming can also be implemented to increase mental health knowledge, reduce stigma, and improve service use among ALHIV. Schools and HIV care clinics offer ideal environments for increasing mental health literacy and improving access to mental health services

Pilot testing Fostering Open eXpression among Youth (FOXY), an arts-based HIV/STI prevention approach for adolescent women in the Northwest Territories, Canada

Fostering Open eXpression among Youth (FOXY) is an arts-based HIV prevention program developed by Northern Canadians to address sexual health, HIV, sexually transmitted infections (STIs), sexuality, and healthy relationships among Northern and Indigenous youth in Canada. We conducted a pilot study with Indigenous and Northern young women aged 13-17 years from 17 communities in the Northwest Territories to evaluate whether, in comparison to pre-intervention, FOXY participants demonstrated increased knowledge of STIs, increased safer sex self-efficacy, and increased resilience. Wilcoxon test results indicated significant increases in STI knowledge scores and safer sex self-efficacy scores. Findings suggest that FOXY holds promise as an effective method of delivering sexual health information through peer education, and increasing STI knowledge, safe sex self-efficacy, and resilience.The authors received financial support from the Canadian Institutes of Health Research and the Public Health Agency of Canada for the research of this article. CM was also supported by an Ontario Ministry of Research & Innovation Early Researcher Award