Emerging Lessons from Medium Sized Public Private Partnerships (PPPs) in the Kenyan Water Sector

In Kenya as many other countries of the world, Government tax revenues are constrained due to population pressures, expanded mandate of governments including social welfare and environmental protection that have resulted in fiscal constraints. The Kenya Water Master plan 2030 estimates that investments of KES 1.7 trillion are needed for rehabilitation and development of new Water Supply infrastructure to realise Vision 2030 goals of 100 percent water coverage and 80 percent sanitation coverage against a budget of KES 561.5 billion leaving a deficit of KES 1.2 trillion for the water sector that needs to be financed through other innovative financing mechanism. The Fiscal constraints experienced in Kenya have resulted in the adoption of Private Partnerships (PPPs) as an innovative approach to the provision and financing of public infrastructure and services such as water and sanitation, electricity and transport to supplement the traditional tax financing of services. This paper explores the genesis of Public-Private partnership (PPPs) projects in the water sector and the processes of project development to share on experiences and lessons learnt from implementing water PPPs in Kenya. Public-Private partnership was adopted by the Government of Kenya to mobilize private sector financing, innovation and management expertise in all sector of the economy including water service provision. The Kenyan Water sector PPPs initiative commenced in May 2013 when the Ministry of Water and Irrigation (MWI) sent out a “call for PPP project proposals” to all Water Service Providers (WSPs). Fifteen WSPs across the country submitted twenty five (25) projects in response to the “call for proposals” which were reviewed and a final six projects from six county Governments’ identified as viable for further development as PPP projects. Keywords: Private sector, public private partnership (PPP), infrastructure, financing, water service

Impact of macroeconomic variables on stock market volatility : a case study of the Nairobi Stock Exchange.

A Research project submitted in partial fulfillment of the requirements for the degree of Bachelor of Business Science in Actuarial Science at Strathmore UniversityStock market plays a very important role in economic growth and development. It is a center of network transactions where buyers and sellers of securities meet at a specified price. Movement of stock markets is an important indicator of the growth of the economy. A well-organized stock market mobilizes the savings and activates the investment projects, which lead to the economic activities in a country hence growth of the industry and commerce of the country as a consequence of liberalized ad globalized policies adopted by most emerging and developed country. The key function of a stock market is to act as a mediator between savers and borrowers. It further mobilizes funds from a large pool of savers and directs it into worthy investments that are sure going to generate sufficient profits. It also provides liquidity from domestic expansion and credit growth. The stock market performance can be measured by changes in its index which is inclined by many factors macroeconomic, social and political factors. A stock market is also a subsidiary market which assigns policy for investors to easily buy and sell the stocks. Stock prices depict predictions of the upcoming representation of corporate firms whether they are performing poorly or the vice vers

Sweet potato value chain in Kenya

Study on the sweet potato value chain in Kenya that revealed key strategies to reduce postharvest losses to improve food and nutrition security

Keeping food on the table: Urban food environments in Nairobi under COVID-19

The COVID-19 pandemic has spread rapidly around the world since late 2019. Measures taken to curb infection rates—curfews, border closures, closure of markets, and movement restrictions—have disrupted food systems and affected food environments. There is limited evidence of the effects of the pandemic on food environments, especially in the informal neighborhoods/slums of urban towns or cities. This study characterizes the food environment (formal and informal outlets) in low- and middle-income urban neighborhoods of Nairobi, Kenya during the current COVID-19 pandemic. It also analyses the social economic effects of government measures, taken to curb the pandemic, on different types of food outlets in these communities

How women’s empowerment affects farm production and dietary quality in East Africa

Malnutrition remains a key global challenge constraining social and economic development in most developing countries. Although women can play an important role in improving household diet quality, their participation is constrained by limited access to productive resources. Women’s empowerment in agriculture is a viable strategy for improving dietary quality, but investigations on the important type(s) of empowerment are inconclusive. Using crosssectional data collected from Uganda and Kenya, and analyzed using three-stage least squares, this paper investigates women’s empowerment and its effect on dietary diversity. Women’s empowerment is measured using the Women’s Empowerment in Agriculture Index (WEAI). We find that control over use of income, autonomy in production and inadequate leisure time, are the major WEAI indicators contributing to women’s disempowerment. Regression analysis shows that farm production diversity positively influences dietary diversity, but only the production autonomy indicator has a positive and significant effect on farm production diversity, implying that women’s empowerment has an indirect positive effect on dietary diversity – through the farm production diversity pathway. Study implications are also explained

Impact of COVID-19 on diets of poor consumers in Africa: Evidence from the slums of Nairobi, Kenya.

The COVID-19 pandemic has disrupted food systems worldwide, and this is likely to have negative implications for food and nutrition security. The vulnerable poor, especially those in the urban areas, are likely to feel a bigger impact. More than half of Africa’s urban population lives in slums. Little is known about the impact of the current pandemic on their consumption behavior and diets. This study analyzes effects of the COVID-19 pandemic on consumption of nutritious foods (including fresh fruits and vegetables and animal source foods) and diets of poor slumdwellers and middle-income non-slum dwellers in Nairobi, Kenya, using primary data collected from 2,465 households between April and May 2020. Food (in)security assessment and consumption behavior questions are asked to capture before and during pandemic using recall. In addition, household dietary diversity scores are calculated based on 7-day food consumption recalls. Both descriptive and econometric regression analyses are conducted. Households in the slums are affected more than the non-slum middle-income households. More than 40% of slum households do not have jobs, their average monthly household income is very low, at USD78. About 90% of households in the slums reported dire food insecurity situations. They were not able to eat the kind of foods they preferred, they ate a limited variety of foods, a smaller meal than they felt they needed and fewer number of meals in a day. Slum households have a lower dietary diversity score (4 out of 9) compared to the non-slum (5 out of 9). In addition, slum dwellers show larger negative effects on consumption of nutritious foods especially fresh fruit and vegetables and animal source foods. Several factors associated with quality food consumption during the pandemic period are highlighted. Mitigation measures should pay close attention to slums as they are deeply impacted by the pandemic. In addition, policy design and implementation should be inclusive of the vulnerable poor consumers in the slums

Comparison of artesunate–mefloquine and artemether–lumefantrine fixed-dose combinations for treatment of uncomplicated Plasmodium falciparum malaria in children younger than 5 years in sub-Saharan Africa: a randomised, multicentre, phase 4 trial

SummaryBackgroundWHO recommends combinations of an artemisinin derivative plus an antimalarial drug of longer half-life as treatment options for uncomplicated Plasmodium falciparum infection. In Africa, artemether–lumefantrine is the most widely used artemisinin-based combination therapy, whereas artesunate–mefloquine is used infrequently because of a perceived poor tolerance to mefloquine. WHO recommends reconsideration of the use of artesunate–mefloquine in Africa. We compared the efficacy and safety of fixed-dose artesunate–mefloquine with that of artemether–lumefantrine for treatment of children younger than 5 years with uncomplicated P falciparum malaria.MethodsWe did this multicentre, phase 4, open-label, non-inferiority trial in Burkina Faso, Kenya, and Tanzania. Children aged 6–59 months with uncomplicated malaria were randomly assigned (1:1), via a computer-generated randomisation list, to receive 3 days' treatment with either one or two artesunate–mefloquine tablets (25 mg artesunate and 55 mg mefloquine) once a day or one or two artemether–lumefantrine tablets (20 mg artemether and 120 mg lumefantrine) twice a day. Parasitological assessments were done independently by two microscopists who were blinded to treatment allocation. The primary outcome was the PCR-corrected rate of adequate clinical and parasitological response (ACPR) at day 63 in the per-protocol population. Non-inferiority was shown if the lower limit of the 95% CI for the difference between groups was greater than −5%. Early vomiting was monitored and neuropsychiatric status assessed regularly during follow-up. This study is registered with ISRCTN, number ISRCTN17472707, and the Pan African Clinical Trials Registry, number PACTR201202000278282.Findings945 children were enrolled and randomised, 473 to artesunate–mefloquine and 472 to artemether–lumefantrine. The per-protocol population consisted of 407 children in each group. The PCR-corrected ACPR rate at day 63 was 90·9% (370 patients) in the artesunate–mefloquine group and 89·7% (365 patients) in the artemether–lumefantrine group (treatment difference 1·23%, 95% CI −2·84% to 5·29%). At 72 h after the start of treatment, no child had detectable parasitaemia and less than 6% had fever, with a similar number in each group (21 in the artesunate–mefloquine group vs 24 in the artemether–lumefantrine group). The safety profiles of artesunate–mefloquine and artemether–lumefantrine were similar, with low rates of early vomiting (71 [15·3%] of 463 patients in the artesunate–mefloquine group vs 79 [16·8%] of 471 patients in the artemether–lumefantrine group in any of the three dosing days), few neurological adverse events (ten [2·1%] of 468 vs five [1·1%] of 465), and no detectable psychiatric adverse events.InterpretationArtesunate–mefloquine is effective and safe, and an important treatment option, for children younger than 5 years with uncomplicated P falciparum malaria in Africa.FundingAgence Française de Développement, France; Department for International Development, UK; Dutch Ministry of Foreign Affairs, Netherlands; European and Developing Countries Clinical Trials Partnership; Fondation Arpe, Switzerland; Médecins Sans Frontières; Swiss Agency for Development and Cooperation, Switzerland

Yellow Fever Outbreak, Imatong, Southern Sudan

In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus–reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak

Mortality Surveillance Methods to Identify and Characterize Deaths in Child Health and Mortality Prevention Surveillance Network Sites

Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through comprehensive mortality surveillance, utilizing minimally invasive tissue sampling (MITS), postmortem laboratory and pathology testing, verbal autopsy, and clinical and demographic data. CHAMPS sites have established facility- and community-based mortality notification systems, which aim to report potentially eligible deaths, defined as under-5 deaths and stillbirths within a defined catchment area, within 24-36 hours so that MITS can be conducted quickly after death. Where MITS has been conducted, a final cause of death is determined by an expert review panel. Data on cause of death will be provided to local, national, and global stakeholders to inform strategies to reduce perinatal and childhood mortality in sub-Saharan Africa and South Asia