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

Forage Monitoring and Prediction Model for Early Warning Application over the East of Africa Region

Rangelands dominate arid and semi-arid lands of the Greater Horn ofAfrica (GHA) region, whereby pastoralism being the primary source oflivelihood. The pastoral livelihood is affected by the seasonal variabilityof pasture and water resources. This research sought to design a grid-basedforage monitoring and prediction model for the cross-border areas of theGHA region. A technique known as Geographically Weighted Regressionwas used in developing the model with monthly rainfall, temperature,soil moisture, and the Normalized Difference Vegetation Index (NDVI).Rainfall and soil moisture had a high correlation with NDVI, and thusformed the model development parameters. The model performed wellin predicting the available forage biomass at each grid-cell with March-May and October-December seasons depicting a similar pattern but witha different magnitude in ton/ha. The output is critical for actionable earlywarning over the GHA region’s rangeland areas. It is expected that thismode can be used operationally for forage monitoring and prediction overthe eastern Africa region and further guide the regional, national, sub-national actors and policymakers on issuing advisories before the season

Prevalence of antimicrobial resistance and association with patient outcomes in a rural Kenyan hospital

Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study. Cohort A consisted of adult and pediatric patients who had blood, urine, or cerebrospinal fluid cultures obtained from 2016 to 2020. A total of 3,013 isolates were used to create the Kijabe Hospital’s first antibiogram. Gram-negative organisms were found to be less than 50% susceptible to third- and fourth-generation cephalosporins, 67% susceptible to piperacillin–tazobactam, 87% susceptible to amikacin, and 93% susceptible to meropenem. We then evaluated the association between AMR and clinical characteristics, management, and outcomes among ICU patients (Cohort B). Demographics, vital signs, laboratory results, management data, and outcomes were obtained. Antimicrobial resistance was defined as resistance to one or more antimicrobials. Seventy-six patients were admitted to the ICU with bacteremia during this time. Forty complete paper charts were found for review. Median age was 34 years (interquartile range, 9–51), 26 patients were male (65%), and 28 patients were older than 18 years (70%). Septic shock was the most common diagnosis (n = 22, 55%). Six patients had AMR bacteremia; Escherichia coli was most common (n = 3, 50%). There was not a difference in mortality between patients with AMR versus non-AMR infections (P = 0.54). This study found a prevalence of AMR. There was no association between AMR and outcomes among ICU patients. More studies are needed to understand the impact of AMR in resource-variable settings

AN ASSESSMENT OF FACTORS INFLUENCING THE MANAGEMENT OF COVID-19 PANDEMIC AMONG COUNTY GOVERNMENTS IN KENYA

The global pandemic of Covid-19 created dramatic challenges for governments worldwide. It led to skyrocketing numbers of deaths and outbreaks, challenged the public and private health systems of many countries and brought many national economies to a halt. Kenya was not an exception and like other countries used a number of strategies to combat the epidemic but equally suffered the same fate. There is little empirical evidence to determine whether the strategies, especially by the county governments were effective in handling the Covid-19 pandemic. Thereby lies the knowledge gap that this study seeks to answer. It is against this background that this study sought to assess the extent to which medical equipment and supplies, personnel and funding influenced the management of the Covid-19 pandemic by county governments in Kenya. The general objective guiding the study was, to assess the factors influencing the management of the Covid-19 pandemic among county governments in Kenya. The specific objectives of the study were: To determine the extent to which medical equipment and supplies influenced the management of the Covid-19 pandemic in the county governments, to determine the extent to which the use of personnel resources influenced the management of the Covid-19 pandemic in the county governments and to determine the extent to which funding influenced the management of Covid-19 pandemic in the county governments. Fink's crisis management model guided the study, which reviewed the empirical literature on medical equipment and supplies, personnel resources and funding in the management of the Covid-19 pandemic. This study adopted a descriptive survey research design with a target population of 70,500 employees from the health sector. The research used simple random sampling as a sampling technique and a sample size of 100 respondents was selected using the Yamane formula. Data was collected using questionnaires. The data were subjected to descriptive statistics and analyzed using SPSS. Based on the findings, 79.6% of the respondents agreed that medical equipment and supplies greatly influenced the management of the Covid-19 pandemic in the county governments, 85% of the respondents indicated that personnel resources played a critical role in the management of Covid-19 pandemic among the counties and 74.2% of the respondents agreed that funding greatly influenced management of Covid-19 pandemic in county governments. Based on the findings, the study recommended that a staff audit and workload analysis should be undertaken and a recruitment process initiated to improve staffing levels; an audit of bed capacity of all medical facilities be initiated and a procurement plan for the acquisition of additional beds based on needs undertaken; an audit and analysis of staff training be undertaken to identify training gaps and necessary action initiated; negotiate with SRC on additional medical staff allowances and lastly fast-track legislation on the expenditure of emergency funds. JEL: H10; H51; H76; I10; I18  Article visualizations

Solar Driven Photocatalytic Activity of Porphyrin Sensitized TiO2: Experimental and Computational Studies

The absence of a secure long-term sustainable energy supply is recognized as a major worldwide technological challenge. The generation of H2 through photocatalysis is an environmentally friendly alternative that can help solve the energy problem. Thus, the development of semiconductor materials that can absorb solar light is an attractive approach. TiO2 has a wide bandgap that suffers from no activity in the visible spectrum, limiting its use of solar radiation. In this research, the semiconductor absorption profile was extended into the visible region of the solar spectrum by preparing porphyrin-TiO2 (P-TiO2) composites of meso-tetra(4-bromophenyl)porphyrin (PP1) and meso-tetra(5-bromo-2-thienyl)porphyrin (PP2) and their In(III), Zn(II) and Ga(III) metal complexes. Density functional theory (DFT) and time-dependent density functional theory (TD-DFT) calculations were performed on the porphyrins to gain insight into their electron injection capability. The results demonstrate that P-TiO2 systems merit further in-depth study for applications that require efficient photocatalytic H2 generation

Unrelenting catastrophic droughts and successive failed rainy seasons in the Greater Horn of Africa

▪ The Greater Horn of Africa (GHoA) is one of the world's most negatively impacted regions by climatic extremes and changes affecting millions, including farmers and livestock keepers. ▪ Addressing the impacts of devastating extreme weather events, climate variabilities, and changes in GHoA require, among other things, strengthening Climate Information Services (CIS), including in terms of Anticipatory Action, Early Warning Systems (EWS), and preparedness and early action for climate-resilient development. ▪ Part of the recommendations and policy-related solutions to the devastating extreme weather events and climate crisis calls for countries to shift from delayed silos and reactive emergency management to proactive responses through effective joint investment, adoption, and implementation of multi-hazard early warning for all initiatives and programs aimed at enhanced regional preparedness and early action by the GHoA countries and the international development partners. ▪ These include: (i) Strengthening disaster risk knowledge and management, (ii) Enhancing infrastructure, human and technical capacity for observing, monitoring, analysing, and forecasting extreme weather and climate variability-related hazards, (iii) Improving communication and dissemination for better access, uptake, and use of a multi-hazard early warning, and (iv) Enhancing preparedness and coordinated early action by building regional, national, and community-level response capabilities of the GHoA countries. ▪ There is a clear and urgent need to protect the lives of millions of people, including smallholder farmers and livestock keepers, from extreme weather and the climate crisis in the GHoA region. ▪ National governments, regional climate centers, and international development partners should support the enhancement and sustainability of infrastructure, as well as human and technical expertise in the region to take advantage of the advances in science and technology (i.e., use of digital decision support tools, ICTs, and broadcast systems) to ensure the availability and accuracy of CIS and EWS for enhanced service delivery for all, preparedness and early action at the national and sub-national levels

Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries.

BACKGROUND: Plasmodium falciparum prevalence (PfPR) is a widely used metric for assessing malaria transmission intensity. This study was carried out concurrently with the RTS,S/AS01 candidate malaria vaccine Phase III trial and estimated PfPR over ≤ 4 standardized cross-sectional surveys. METHODS: This epidemiology study (NCT01190202) was conducted in 8 sites from 6 countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, and Tanzania), between March 2011 and December 2013. Participants were enrolled in a 2:1:1 ratio according to age category: 6 months-4 years, 5-19 years, and ≥ 20 years, respectively, per year and per centre. All sites carried out surveys 1-3 while survey 4 was conducted only in 3 sites. Surveys were usually performed during the peak malaria parasite transmission season, in one home visit, when medical history and malaria risk factors/prevention measures were collected, and a blood sample taken for rapid diagnostic test, microscopy, and haemoglobin measurement. PfPR was estimated by site and age category. RESULTS: Overall, 6401 (survey 1), 6411 (survey 2), 6400 (survey 3), and 2399 (survey 4) individuals were included in the analyses. In the 6 months-4 years age group, the lowest prevalence (assessed using microscopy) was observed in 2 Tanzanian centres (4.6% for Korogwe and 9.95% for Bagamoyo) and Lambaréné, Gabon (6.0%), while the highest PfPR was recorded for Nanoro, Burkina Faso (52.5%). PfPR significantly decreased over the 3 years in Agogo (Ghana), Kombewa (Kenya), Lilongwe (Malawi), and Bagamoyo (Tanzania), and a trend for increased PfPR was observed over the 4 surveys for Kintampo, Ghana. Over the 4 surveys, for all sites, PfPR was predominantly higher in the 5-19 years group than in the other age categories. Occurrence of fever and anaemia was associated with high P. falciparum parasitaemia. Univariate analyses showed a significant association of anti-malarial treatment in 4 surveys (odds ratios [ORs]: 0.52, 0.52, 0.68, 0.41) and bed net use in 2 surveys (ORs: 0.63, 0.68, 1.03, 1.78) with lower risk of malaria infection. CONCLUSION: Local PfPR differed substantially between sites and age groups. In children 6 months-4 years old, a significant decrease in prevalence over the 3 years was observed in 4 out of the 8 study sites. Trial registration Clinical Trials.gov identifier: NCT01190202:NCT. GSK Study ID numbers: 114001

Interventions to reduce pesticide exposure from the agricultural sector in Africa: a workshop report

Despite the fact that several cases of unsafe pesticide use among farmers in different parts of Africa have been documented, there is limited evidence regarding which specific interventions are effective in reducing pesticide exposure and associated risks to human health and ecology. The overall goal of the African Pesticide Intervention Project (APsent) study is to better understand ongoing research and public health activities related to interventions in Africa through the implementation of suitable target-specific situations or use contexts. A systematic review of the scientific literature on pesticide intervention studies with a focus on Africa was conducted. This was followed by a qualitative survey among stakeholders involved in pesticide research or management in the African region to learn about barriers to and promoters of successful interventions. The project was concluded with an international workshop in November 2021, where a broad range of topics relevant to occupational and environmental health risks were discussed such as acute poisoning, street pesticides, switching to alternatives, or disposal of empty pesticide containers. Key areas of improvement identified were training on pesticide usage techniques, research on the effectiveness of interventions targeted at exposure reduction and/or behavioral changes, awareness raising, implementation of adequate policies, and enforcement of regulations and processes

Comprehensive transcriptome of the maize stalk borer, Busseola fusca, from multiple tissue types, developmental stages, and parasitoid wasp exposures

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