Environmental Conservation Approaches Among Small and Medium-Sized Enterprises (SMEs) with a Focus on Zero Emission Discharges in Kenya

The green economy is an important aspect of environmental conservation and this forms the foundation for Kenya’s goal towards sustainable development. This well highlighted by the green economy which is anchored in the Constitution 2010 under Articles 42 that recognizes a clean and healthy environment as a right. The constitution is integrated into the country’s ambitious development plan, Vision 2030, which aims to attain and sustain a GDP growth of 10 percent per annum in the short to medium term by creating a “just, cohesive and equitable social development in a clean and secure environment”. The transformation towards green economy is underpinned to the five thematic areas viz sustainable infrastructure, building resilience, sustainable natural resource management, resource efficiency, and social inclusion and sustainable livelihoods. By adopting green business practices, and providing products and services through sustainable value chains, SMEs can help in driving green growth while at the same time sustaining job creation. A central emphasis of climate change in Cop 26 was that of Decarbonization as observed by World Health Organization. Decarbonization efforts have initiated innovation opportunities and which have similarly triggered business efficiency gains on which businesses are expected to capitalize on. The impacts of climate change present a significant challenge to SMEs, which are often seen as the drivers of economic growth in Kenya. This study intends to generate and provide an evidence and knowledge base to inform advice design, and implementation of public policies in upscaling private green investments that can generate green growth while creating decent employment. This study adopted desk top literature review relevant to the topic, descriptive and cross sectional survey designs. In this study data on environmental conservation and emission discharges among small and medium-sized enterprises was collected from interviews and observation from a sample of towns visited by the researcher. The study identified various strategies adopted by SMEs in environmental conservation with the aim of reducing emissions. These strategies included; digital marketing and digital operations, Policy and legislative frameworks, environmental footprint assessment and Eco innovation. In conclusion; the study observed that Climate change and waste emissions are serious global issues today. Therefore, meeting the challenges associated with it could provide an opportunity to create and trigger tremendous growth for SMEs. Keywords: Environmental Conservation, Emissions, Green Economy, SMEs and Digitization DOI: 10.7176/EJBM/15-19-07 Publication date: December 31st 2023

Exploring perceptions of community health policy in Kenya and identifying implications for policy change

Background Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. Methods We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. Results There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. Conclusion This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority areas for action if success of policy change through the roll-out of the revised strategy is to be realized

Clinical supervision for clinical psychology students in Uganda: an initial qualitative exploration

Background Burn out in clinical psychologists working in low income countries has been reported. Clinical supervisory structures do not yet exist in Uganda. A way to decrease levels of burn out and increase quality of care for people with mental illness is through clinical supervision. The aim of this study was to explore the initial experiences of supervision for clinical psychology students in Uganda to ascertain whether or not clinical supervision is culturally appropriate, and what aspects of supervision had been helpful and unhelpful. Methods A qualitative design with thematic analysis was utilized. A focus group was held with 12 second year clinical psychology students to ask their experiences of receiving supervision. Results Data analysis created five themes. Firstly, the negative emotions that resulted from the training processed were discussed, and how supervision helped and did not help the students to manage these. Secondly, the students voiced that supervision helped them to learn through observational experiences, co-therapist roles and parallel processes within the supervisory relationship. Thirdly, supervision had taught the clinical psychology students their role as a clinical psychology student, how to act within the Ugandan mental health system and skills to conduct therapy. Fourthly, suggestions for the future of supervision were given, with the students requesting for it to start earlier in the training, for supervisors who can meet with the students on a regular basis to be selected and for the training the students receive at university to match the skills required on their placements, with a request for more practical techniques rather than theory. The final theme related to left over miscellaneous data, such as the students agreeing with each other. Conclusions The students stated that supervision was helpful overall, implying that clinical supervision is culturally appropriate for clinical psychology students in Uganda. Suggestions for future supervision were given. In order to decrease high levels of staff burn out in the mental health systems in Uganda, supervisory structures with an emphasis on self care need to be established

Salaried and voluntary community health workers: exploring how incentives and expectation gaps influence motivation

BACKGROUND: The recent publication of the WHO guideline on support to optimise community health worker (CHW) programmes illustrates the renewed attention for the need to strengthen the performance of CHWs. Performance partly depends on motivation, which in turn is influenced by incentives. This paper aims to critically analyse the use of incentives and their link with improving CHW motivation. METHODS: We undertook a comparative analysis on the linkages between incentives and motivation based on existing datasets of qualitative studies in six countries. These studies had used a conceptual framework on factors influencing CHW performance, where motivational factors were defined as financial, material, non-material and intrinsic and had undertaken semi-structured interviews and focus group discussions with CHWs, supervisors, health managers and selected community members. RESULTS: We found that (a mix of) incentives influence motivation in a similar and sometimes different way across contexts. The mode of CHW engagement (employed vs. volunteering) influenced how various forms of incentives affect each other as well as motivation. Motivation was negatively influenced by incentive-related "expectation gaps", including lower than expected financial incentives, later than expected payments, fewer than expected material incentives and job enablers, and unequally distributed incentives across groups of CHWs. Furthermore, we found that incentives could cause friction for the interface role of CHWs between communities and the health sector. CONCLUSIONS: Whether CHWs are employed or engaged as volunteers has implications for the way incentives influence motivation. Intrinsic motivational factors are important to and experienced by both types of CHWs, yet for many salaried CHWs, they do not compensate for the demotivation derived from the perceived low level of financial reward. Overall, introducing and/or sustaining a form of financial incentive seems key towards strengthening CHW motivation. Adequate expectation management regarding financial and material incentives is essential to prevent frustration about expectation gaps or "broken promises", which negatively affect motivation. Consistently receiving the type and amount of incentives promised appears as important to sustain motivation as raising the absolute level of incentives