Health Implications of Sexual Violence Among Survivors in Selected Health Facilities in Kenya: Are There Gender Disparities?

Sexual based violence (SBV) is a serious public health problem with profound impact on physical, social and mental health, both immediately and many years after the assault. The global statistics on sexual assault against women indicates that, at least one in every three (34%) has been beaten and/or coerced into sex. A World Health Organisation (WHO) multi-country study reports that between 16% and 59% women from Africa had ever experienced sexual violence. In Kenya, about 24% of women have been raped at least once. Nairobi women Hospital alone receives an average of 230 survivors per month, with approximately 45% being children, 49% women and 6% men respectively. The main aim of this study was to investigate the gender disparities in health implications of SBV among survivors in three health facilities in Kenya. This was a cross-sectional study involving 236(84.3%) female and 44(15.7%) male survivors were enrolled in the study. The study established that sexual based violence resulted into health consequences (76.8%) including psychological trauma 143(51%), physical injuries 75(27%), STIs 38(14%), gynaecological disorders 35(12%), Human Immunodeficiency Virus (HIV) 32(11%), gastrointestinal disorders 21(7%) and unwanted pregnancies 17(6%). The results showed that females and males who developed health complications were not significantly different (χ2=0.223; df=1; p= 0.637). Males were more likely to suffer from psychological trauma, physical injuries and gastrointestinal injuries compared to females (OR= 1.2, CI= 0.6- 2.2; OR= 0.2, CI= 0.1- 5.0; and OR= 0.7, CI= 0.4- 1.5). On the hand, the study established that females were more likely to suffer from Sexually Transmitted Infection (STIs) (OR= 1.4, CI= 0.3- 6.0), gynaecological disorders (OR= 1.5, CI=0.5- 4.5), HIV (OR= 1.9, CI= 0.6- 6.6), and unwanted pregnancies (OR= 2.3, CI= 0.7- 8.1) compared to males. There is an urgent need to deal with the problems of SBV by preventing and stopping it. There should be a collaborative approach between all the stakeholders including the community, ministries of Medical Services and Public Health & Sanitation, private and non-governmental organization in dealing with sexual based violence and health implications resulting from it. Keywords: Sexual based violence, health implications, survivors, males DOI: 10.7176/JHMN/66-03 Publication date:September 30th 201

Leveraging Farmer Field Days to Provide Family Planning and Other Health Services in Rural Kenya

Background: Access to family planning (FP) and other reproductive health (RH) services is difficult in much of rural Africa. Distance to health facilities, staff shortages, stock-outs, and other barriers impede the uptake and continued use of contraception. One way to improve FP access in rural areas is to deliver FP services at non-health events. FHI and Land O’Lakes collaborated to assess a model for providing health services through existing farmer-education events.  This study examined the introduction of Family Planning/Reproductive Health services through Land O’Lakes-supported dairy cooperatives. Methods: The study was conducted at seven events in Central and Rift Valley provinces between August and December 2010. Typical field days draw attendees from across the dairy sector: farmers, processors, development partners and officials from the Ministry of Livestock Development and the Kenya Dairy Board. At each study site, local Land O Lakes and dairy cooperative staff helped to incorporate a “family health camp” where attendees could consult with clinicians. The package included FP services, child immunizations, antenatal care, sexually transmitted infection screening and treatment, and HIV counseling and testing. All women, 18 to 49 years old, who received services from an on-site provider, were invited to participate in a survey about the health camp and the offered services. A total of 319 women were interviewed. Key findings: Use of health services at the seven field days was high; more than 80% of the 2,344 attendees received consultations. The services provided most frequently during the field-days were non-reproductive health exams (66%), FP counseling (18%), and HIV counseling and testing (13%). Of the women interviewed, 40% were affiliated with a dairy cooperative. One-quarter of current FP users acquired additional supplies of contraceptives at the event.  Knowledge contributions: This study contributes to the scant data regarding the provision of health services in the non-health sector. . This model provides a convenient way for rural people to access health services. Key Words: FP services, non-health sector, rural area, farmer

Social Seed Networks and Climate Change Adaptation in Central Tanzania: Results from a study to better understand farmers’ primary sources of seed information in Dodoma and Singida Districts, Tanzania

Tanzanian smallholder farmers are vulnerable to the effects of climate change, especially the resultant rainfall variability. One strategy for adapting to the changing climate is to utilise genetic seed sources to resist abiotic and biotic stressors. Another strategy is to access and exchange genetic resources, seed, and the information needed to use those resources effectively. In Tanzania, ‘farmer managed’ seed networks are believed to supply about 80-90 percent of seeds to farmers (Below et al., 2015). Farmer seed networks are an important element of seed access because they are resilient and work to maintain and conserve crop genetic diversity. Research in East Africa has suggested that community-generated information sharing might support more effective farmer response to the changing seasonal and weather patterns associated with climate change (Balama et al., 2013)

Enhancing access to genetic resources for climate change adaptation in Kenya, Uganda and Tanzania: Seed catalogues of best perfoming varieties of sorghum in Dodoma and Singida Tanzania

Climate change poses an increasing threat to food and nutrition security of resource-poor farmers globally. In Tanzania, homogenization of agriculture to single crops or varieties coupled with the associated loss of biodiversity has further decreased the resilience of resource-poor farmers. The loss of genetic diversity in farmers’ custody has greatly narrowed the gene pool from which they depend on. In order to help them adapt to climate change, the project “Promoting Open Source Seed Systems for Beans, Millet and Sorghum for Climate Change Adaptation” funded by the Benefit-sharing Fund (BSF) of the International Treaty on Plant Genetic Resources for Food and Agriculture (ITPGRFA) was implemented in Kenya, Uganda and Tanzania. Through this project, farmers in Dodoma and Singida in Tanzania tested and evaluated the performance of 24 varieties of sorghum for drought tolerance, yield, early maturity, pest and diseases and taste and selected 10 best performing. This catalogue presents these top selected varieties including their agronomic attributes and nutritional benefits

The role of gender and institutional dynamics in adapting seed systems to climate change: case studies from Kenya, Tanzania and Uganda

We explore how seed systems enhance access to seeds, and information for climate-change adaptation in farming communities in Kenya, Tanzania and Uganda, as well as how gender-driven roles and institutional dynamics influence the process. Men and women farmers equally experience climate-change related effects, including drought, short rainy seasons and increased pest and disease incidence. Our study relies on exploratory data analysis of 1001 households surveyed in four sites in 2016. Farmers surveyed preferred early-maturing, heat-tolerant, high-yielding, and pest- and disease-resistant varieties, all important climate-adaptive traits. Seed systems of the focus crops studied are largely informal—overall, 68% women and 62% men use their own seed, indicating women’s higher reliance on ‘informal’ seed and information sources. Only 21% of respondents reported interacting with seed experts who are affiliated with formal organizations. Both formal and informal organizations play a key role in providing access to climate-adapted seed/information, with access for men and women varying across the countries studied. There is a need to support further development of those connections, building on existing social networks. We conclude that inclusive and gender-responsive context- and country-specific seed interventions will ensure equitable outcomes, increase women’s empowerment and strengthen both formal and informal seed systems for more effective climate-change adaptation

Evaluation of Kenya’s readiness to transition from sentinel surveillance to routine HIV testing for antenatal clinic-based HIV surveillance

BACKGROUND: Sentinel surveillance for HIV among women attending antenatal clinics using unlinked anonymous testing is a cornerstone of HIV surveillance in sub-Saharan Africa. Increased use of routine antenatal HIV testing allows consideration of using these programmatic data rather than sentinel surveillance data for HIV surveillance. METHODS: To gauge Kenya’s readiness to discontinue sentinel surveillance, we evaluated whether recommended World Health Organization standards were fulfilled by conducting data and administrative reviews of antenatal clinics that offered both routine testing and sentinel surveillance in 2010. RESULTS: The proportion of tests that were HIV-positive among women aged 15–49 years was 6.2 % (95 % confidence interval [CI] 4.6–7.7 %] in sentinel surveillance and 6.5 % (95 % CI 5.1–8.0 %) in routine testing. The agreement of HIV test results between sentinel surveillance and routine testing was 98.0 %, but 24.1 % of specimens that tested positive in sentinel surveillance were recorded as negative in routine testing. Data completeness was moderate, with HIV test results recorded for 87.8 % of women who received routine testing. CONCLUSIONS: Additional preparation is required before routine antenatal HIV testing data can supplant sentinel surveillance in Kenya. As the quality of program data has markedly improved since 2010 a repeat evaluation of the use of routine antenatal HIV testing data in lieu of ANC sentinel surveillance is recommended

Crop diversity, climate change adaptation and resilience: good practice cases from Africa

As part of the Integrated Seed Sector Development in Africa (ISSD Africa) program’s activities for 2020, the Agrobiodiversity, seeds and climate change action learning group (Theme 3) documented and analyzed a series of good crop diversification practice cases from Africa, which were published in an ISSD Africa working paper [https:// hdl.handle.net/10568/115012]. This brief presents a synthesis of the working paper

Mobilizing crop diversity for climate change adaptation and resilience: Field experiences from Africa

In recent years, a number of international initiatives have piloted various forms of support for novel configurations of actors to work together to conserve and use agrobiodiversity in sustainable agricultural production systems and to equitably share benefits derived from those activities. These configurations operate at farm, community, national and international levels. Among these initiatives, Bioversity International (now the Alliance of Bioversity International and CIAT) and partners have researched the effectiveness of using agrobiodiversity, in particular in the form of crop and crop variety diversity, as an adaptive practice. The hypothesis informing this research is that crop diversification can result in positive livelihood outcomes, such as food and nutritional security, income generation and good health. These outcomes, in turn, could lead to (increased) resilience of rural households and communities to environmental, socio- economic and climatic shocks. In this working paper, we present a number of case studies that to a certain extent have “delivered” on this impact pathway. The case studies were compiled during the year 2020, the year that COVID-19 spread across the globe with devastating consequences for countries, communities and households everywhere

CropPol: a dynamic, open and global database on crop pollination

Seventy five percent of the world's food crops benefit from insect pollination. Hence, there has been increased interest in how global change drivers impact this critical ecosystem service. Because standardized data on crop pollination are rarely available, we are limited in our capacity to understand the variation in pollination benefits to crop yield, as well as to anticipate changes in this service, develop predictions, and inform management actions. Here, we present CropPol, a dynamic, open and global database on crop pollination. It contains measurements recorded from 202 crop studies, covering 3,394 field observations, 2,552 yield measurements (i.e. berry weight, number of fruits and kg per hectare, among others), and 47,752 insect records from 48 commercial crops distributed around the globe. CropPol comprises 32 of the 87 leading global crops and commodities that are pollinator dependent. Malus domestica is the most represented crop (32 studies), followed by Brassica napus (22 studies), Vaccinium corymbosum (13 studies), and Citrullus lanatus (12 studies). The most abundant pollinator guilds recorded are honey bees (34.22% counts), bumblebees (19.19%), flies other than Syrphidae and Bombyliidae (13.18%), other wild bees (13.13%), beetles (10.97%), Syrphidae (4.87%), and Bombyliidae (0.05%). Locations comprise 34 countries distributed among Europe (76 studies), Northern America (60), Latin America and the Caribbean (29), Asia (20), Oceania (10), and Africa (7). Sampling spans three decades and is concentrated on 2001-05 (21 studies), 2006-10 (40), 2011-15 (88), and 2016-20 (50). This is the most comprehensive open global data set on measurements of crop flower visitors, crop pollinators and pollination to date, and we encourage researchers to add more datasets to this database in the future. This data set is released for non-commercial use only. Credits should be given to this paper (i.e., proper citation), and the products generated with this database should be shared under the same license terms (CC BY-NC-SA). This article is protected by copyright. All rights reserved