Determinants of Successful Implementation of Early Childhood Development Education by County Governments in Kenya; Implementing Partners Perspective

The purpose of this study was to assess the determinants of successful implementation of Early Childhood Development Education (ECDE) by County Governments in Kenya from the implementing partners‟ perspective. This study was guided by the following specific objectives: to determine the influence of the capacities of the County Government staff on the implementation of early childhood development education by County Governments in Kenya, to determine the how management of early childhood development education affects its implementation by County Governments in Kenya, to assess how availability of physical facilities affect the implementation of early childhood development education by County Governments in Kenya and to examine how policies affect the implementation of early childhood development education by County Governments in Kenya. Decentralization theory and organization learning theory were used to explain the relationship between the study variables. Descriptive research design was used in the study. The population for the study was implementing partners working with County Governments in Kenya to support ECDE. Purposive sampling technique was used to select the respondents to participate in the study. A total of 100 respondents were targeted from the 10 organizations studied out of which 70 participated giving a response rate of 70%. Questionnaire was used as instrument for data collection. Both qualitative and quantitative data analysis techniques were used to analyze the data. The study found that the implementation of ECDE by County governments in Kenya was generally successful from the implementing partners‟ perspective and indicated by 56.8%. It is also worth noting that beside the general success, there were myriads of challenges facing the implementation of the program by county governments. Findings from regression analysis showed that the coefficient of determination indicated that 63.5% of the variations on the implementation of ECDE by county governments can be explained by staff capacity, management of ECDE, availability of physical facilities and ECDE policies. The remaining 36.5% can be explained by other variables not included in the study. R square and adjusted R is above average an implication that an above average variation can be explained by the model. The study recommended that county governments should allocate more funds for the renovation and construction of more ECDE centres, allocate adequate funds for the implementation of ECDE and that they should organize consistent in-service training for ECDE teachers and at the same time employ more ECDE staff to cater for the large number of children in ECDE centres.

Aggregate cost implications of selected Cost-Drivers \ud in the Tanzanian Health Sector\ud

\ud Health is an important aspect of life of which one of its determinants is healthcare which is consumed in order to restore back deteriorated health to optimal pre-illness levels. The consumption of healthcare however has cost implications and accounts for a large share of resources directed towards the health sector. In health sector financing, it is vital to identify major cost components and create awareness about the costs of decisions. It is thus vital to identify factors that can cause changes in the cost of identified activities. A number of costly programs have been initiated and some others are on the horizon. In order to create awareness about the financial consequences of these decisions and to draw attention to the financing needs of the health sector, it is considered necessary to analyze the major health sector programs and initiatives with regard to the changes in costs brought about by new strategies, guidelines and interventions (including the adoption of new technologies), and aggregate these costs. The main objective of this study was to identify cost-driving decisions in the health sector. The study methodology comprised of three independent but complementary methodologies and activities: (a) Desk review of literature and documents; (b) Interviews with officials from MOHSW, programs and agencies involved in setting and promoting standards at international level; (c) collection of primary data/information and subsequent analysis of the same. The study reviewed 11 plans, including summary plans like the Health Sector Strategic Plan III and the Primary Health Services Development Program 2007 -2017 and national disease control programme plans/strategies. However, not all of cost-driving decisions in these plans could be integrated into the analysis because the plans are undergoing reprogramming, as the previous cost estimates are regarded not to be realistic relative to achieving plan objectives. In addition the costs of some decisions in some plans/strategies HRH, infrastructure, health care financing strategy, mhealth, etc. are not established or are in the process of being costed or reviewed. It should also be noted that the consultants did not assess all plans/strategies and their associated costs as to their plausibility. This was neither task of the consultants, nor would the time allocated to the study have allowed such an in-depth review. The study reviewed a total of 11 multi-year plans/strategies and found four plans to be affected by costs of decisions. Such decisions are: the adaption of WHO recommendations on Anti-retroviral Treatment eligibility criteria; re-treatment of conventional nets; indoor residual spraying; sustaining availability of long lasting insecticide treated nets (LLINs); provision of delivery kits to pregnant women in public health facilities, and the potential future introduction of a malaria vaccine, human papilloma virus and pneumococcal vaccines, which affect the Health Sector HIV and AIDS Strategic Plan II (HSHSP II) 2008 – 2012, the Malaria Mid-Term Strategic Plan 2008 – 2013 (NMCP), the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008 – 2015 (the Road Map), and the Expanded Program on Immunization 2010 - 2015 Comprehensive Multi Year Plan (EPI), respectively. The study found that these decisions have a significant cost implication to a tune of US$706,688,405 over a five year period 2011- 2015. The initially estimated costs of programs that are currently being updated (HSHSP II, EPI, NMCP and the Road Map) is US$ 2,297,009,378 exclusive of the identified cost drivers. The estimated cost of decisions is about 8 % of the total costs for health sector in Tanzania (HSSP III estimate) and about 3.3% of the 2009 GDP and added nominal per capita health spending/cost of US$17.3 (2009 population estimate) for five year period (annual per capita cost of US$ 3.46). This expenditure will definitely boost per capita health spending (US$13.45 in 2008/9). However, concerted revenue effort is needed if we are to hit HSSP III target of US$ 26.6 in 2014/15. The National Strategy for Non-communicable Diseases 2009 – 2015 did not include estimates, while most parts of the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008 – 2015 are undergoing reprogramming, as the previous cost estimates are regarded not to be realistic relative to achieving plan objectives. The rest of the programs are not significantly affected by cost of decisions. However, the estimated cost is likely to be higher owing to the fact that costs of some decisions in MMAM components such as HRH, infrastructure, health care financing strategy, mhealth, etc. are not established or are in the process of being costed or reviewed. Prevention and treatment of illness are the major strategies used to maintain or improve the health status of a population. Allocation of health resources are usually skewed towards treatment probably because addressing existing illnesses seem a present and clear danger than addressing potential illnesses which is what prevention is all about. Prevention and health promotion however lead to greater benefits than treatment in the long run in the sense that it reduces future demand for treatment than treatment alone does and has stronger merit good characteristics than treatment of illness. Health planning should thus intensify focus on prevention through promoting lifestyle and behaviour changes as well as intensifying prevention and health promotion at community level. Most health sector multi-year plans are characterized by heavy resource dependence on development partners. Such levels of dependence tend to compromise control over some decisions especially those supported by financiers. That is, recipients may be tempted to accept a full funded activity even if there is an ongoing similar activity which ends up creating parallel rather than complementary activities with cost implications. Thus, the financiers and recipients should undertake thorough analysis of potential decisions based on their cost implications (direct and indirect) as well as the time parameters, while avoiding decisions that spin off similar activities rather than complementing the existing ones. This can be facilitated by coordinated analysis from the MOHSW by keeping and monitoring comprehensive cost driver table enriched by inputs from all health sector programs and plans. Continuous reviews of the plans enhance the capacity of programs to adequately identify cost drivers and therefore enhance the planning process. However, reviews are not always undertaken on time and as regular as possible due to lack of resources or transfer of resources set aside for review process to implement other pressing components of the plan. MOHSW should make costing part of the plan a compulsory exercise for approval by the management and should not endorse plans which have not been adequately costed. MOHSW should also consider making reviews of multi-year plans a prerequisite for release of fund for subsequent implementation. Moreover, the reviews should integrate all stakeholders and involve technical people who are knowledgeable in costing and planning. The fact that most of the multi-year plans had indicative budgets, while others are not costed at all, warrants the conclusion that the basic knowledge in costing such as collaboration, parameter assumptions, time, manpower, and resources is lacking. Emphasis should thus be placed on developing and improving costing capacity in the programs as well as the MOHSW in terms of acquiring costing tools and exposure. The MOHSW should ensure that the priority activities of the strategies/plans are funded. This could be done through lobbying the government and other stakeholders for more resources. Protocols such as Abuja Declaration 2001, in which African governments committed themselves to scale up health budget to 15% of the annual budget, could be useful in this end. Also the government and local authorities through laws/bylaws could establish and commit specific sources of resources for the health sector. This should be pursued by keeping a close eye on the ratio of available resources to required resources which can indicate opportunities which development partners can be of help as well as providing an indication of the realism of planning. A review of the plans found the ratio of available resources to required resources to be 76 and 84 percent, respectively, for the Health Sector Strategic Plan III and the Expanded Program on Immunization 2010 – 2015 Comprehensive Multi Year Plan. The Malaria Medium Term Strategic Plan 2008-2013 on the other hand had the lowest ratio of available resources to required resources of 35 percent.\u

Strategies to Promote Market-Oriented Smallholder Agriculture in Developing Countries: A Case of Kenya

Smallholder Agriculture is key to livelihoods of many rural households in developing and transition economies. In Kenya, small farms account for over 75% of total agricultural production and nearly 50% of the marketed output. Despite favourable trends in global development drivers such as rising population, per capita incomes and emerging urban dietary preferences, most smallholder farmers remain poor. This study sought to characterize agricultural commercialization trends, identify and prioritize constraints to participation in markets, analyse determinants of percentage of output sold, and explore strategies to promote market-oriented production. A participatory Rapid Rural Appraisal approach, household survey and a Truncated Regression model were used. A sample of 224 farmers: 76 of them growing maize, 77 involved in horticulture (kales and tomatoes) and 71 practising dairy, were interviewed in one peri-urban and one rural district (Kiambu and Kisii, respectively). Results show that in rural areas, lower levels of output are sold and fewer farmers participate in markets compared to the peri-urban areas. Opportunities for profitable commercial agriculture are observed in growing demand, emerging food preferences and intensive farming. At village-level, market participation is hampered by poor quality and high cost of inputs, high transportation costs, high market charges and unreliable market information. At the household-level, the determinants of percentage of output sold are producer prices, market information arrangement, output, distance to the market, share of non-farm income and gender. Strategies are suggested to improve rural input supply, institutional and regulatory framework, enhance value addition and strengthen market information provision.Smallholder Agriculture, Market Participation, Commercialization, Kenya, Agricultural and Food Policy, Community/Rural/Urban Development, Demand and Price Analysis, Farm Management, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, International Relations/Trade, Land Economics/Use, Marketing, Productivity Analysis, Research and Development/Tech Change/Emerging Technologies,

Analysis of Factors Affecting Use of Pre-Emergence Wheat Herbicides in Kenya

Agrochemicals are used principally to control weeds and pests in agriculture. Wheat production in Kenya has not been sufficient despite concerted efforts by agrochemical companies to market agrochemicals to farmers. The study aimed at establishing the determinants of use of pre-emergence wheat herbicides among the wheat farmers in Kenya. The study was conducted in Uasin Gishu County. Stratified random sampling was used to sample 164 wheat farmers. Data collection was done using a well structured questionnaire administered to the wheat farmers. Logit regression technique was used to determine the association between determinants of use of pre-emergence wheat herbicides among the wheat farmers. The results show that education level, land tenure, average income, extension services, market information and credit access variables were statistically significant. The study recommended improvement of extension services to wheat farmers and increased accessibility of credit facilities by financial institutions at affordable prices. It is also necessary to have further research on how extension services can enhance wheat production. Keywords: Herbicides, Pesticides, Pre-emergence DOI: 10.7176/JESD/10-6-12 Publication date:March 31st 201

Adoption of Cloud Computing by Firms in Kenya: The Role of Institutional Pressures

While there is substantial literature on the adoption of IT innovations based on utility computing, there is a dearth of studies on cloud computing adoption by business organizations. Given that cloud computing adoption has been steadily increasing in Kenya, this study aim to investigate the determinants of cloud computing adoption from an institutional perspective. The relationship between institutional pressures and cloud computing adoption was evaluated and tested using structural equation modelling (PLS SEM). A firm level cross sectional survey was conducted on a sample of 93 firms in the financial, manufacturing, and ICT sectors. The results indicate that coercive and normative pressures have a significant positive relationship with cloud computing adoption. The hypothesis that mimetic pressures have a relationship with cloud computing adoption was not supported. A major implication of this study is that professional and standards bodies do influence technology adoption through normative pressures

Mathematical model for pneumonia dynamics among children

The 2012 Southern Africa mathematical sciences association Conference (SAMSA 2012)26th -29th Nov 2012There are major advances which have been made to understand the epidemiology of infectious diseases. However, more than 2 million children in the developing countries still die from pneumonia each year. The eorts to promptly detect, eectively treat and control the spread of pneumonia is possible if its dynamics is understood. In this paper,we develop a mathematical model for pneumonia among children underve years of age. The model is analyzed using the theory of ordinary dierential equations and dynamical systems. We derive the basic reproduction number, R0, analyze the stability of equilibrium points and bifurcation analysis. The results of the analysis shows that there exist a locally stable disease free equilibrium point, Ef when R0 1.The analysis also shows that there is a possibility of a forward bifurcation

Perceived Barriers to Peritoneal Dialysis Among Kenyan Nephrologists: A Cross-Sectional Descriptive Study

Background: Peritoneal dialysis (PD) is a well-recognized technique of renal replacement therapy (RRT), with similar efficacy as well as survival outcomes as hemodialysis (HD). Despite its advantages including prolonged preservation of residual renal function, potentially lower cost and advances with automated techniques, and commercialization of more biocompatible solutions, the overall prevalence of patients treated with PD is still very low in developed countries and even more so in Africa and low-middle income countries like Kenya. According to our knowledge, no local studies have been done on prevalence of peritoneal dialysis or on potential barriers to utilization of PD as an RRT modality. Objective: To explore perceptive barriers of nephrologists to PD utilization. Methodology: A computer-base, 22-question questionnaire was formulated using the Delphi technique and sent out to all the nephrologists via emails. There were 30 nephrologists, in clinical practice in Kenya, at the time when the study was conducted. This is according to the registry maintained by the Kenya Renal Association (KRA). Their contacts were obtained from the registry. Design: A cross-sectional descriptive study. Setting: A computer based 22-question questionnaire was administered to 23 nephrologists in Kenya. Results: Among the total number of 23 nephrologists, 39% reported to be looking after patients maintained on PD despite 59% of them reporting that they think patients should be maintained on PD. Only 21% of respondents felt limited training in PD limited their use of PD and only 23% felt poor personal experience contributed to limited use. Other barriers that came up with a relative majority of the respondents included lack of nursing expertise, concerns with PD catheter placement, concerns about long-term viability of continuous peritoneal dialysis, concerns about technique failure and peritonitis, lack of facility support for PD, and lack of dialysis education programs. Conclusion: A significant proportion of nephrologists in this survey felt PD, as a modality of RRT, was underutilized and reported systemic and technical factors as being potential barriers