The Shrinking Grazing Fields of the Maasai Land Under the Changing Climate System in Kajiado County, Kenya

The Maasai pastoralists have in the last decade experienced disruptions in their economies and livelihoods following climate shifts. For instance, they have been losing up to 30 % of their herd annually to drought related disasters, yet information on the various land uses is still fragmented. This has been worsened by the shortening famine cycles which has impacted pastoral livelihood system as they highly depend on natural resource. Yet, these key resources have been dwindling over the past 30 years compromising their ability to meet basic need such as food. To address this gap, the study focused on long term evaluation of land use. The study’s objective was to determine land use transformations and their impacts particularly on the pastoral livelihood system. Keywords: Climate change, Arid and Semi-Arid Lands, Natural resources, food insecurity, pastoral livelihood system, socio-ecological system

Determinants of Improved Maize Seed and Fertilizer Use in Kenya: Policy Implications

Maize is a key food crop in Kenya. While maize yields increased from 1.25 t ha-1 in early 1960s to over 2 tonnes in 1982, they fell below 1.5 t ha-1 in 2000. Given the limited land area, there is no doubt that Kenya will have to rely more on modern technologies for increased yields .Use of improved maize varieties and fertilizers will therefore continue to be critical inputs for improving productivity. To improve production, it is important to understand factors determining adoption and intensity of use of modern technologies. A stratified 2-stage sampling design was used to select 1800 households, subsequently interviewed by means of structured questionnaire. Econometric models were used to explore factors influencing adoption and intensity of use of the improved varieties and fertilizer. Access to credit was positively related to adoption and intensity of use of the two inputs. Extension contacts positively influenced the likelihood of adoption of improved maize seed, while amount of planting fertilizer used positively influenced both the adoption and intensity of use of improved varieties. Distance to market negatively determined the adoption and intensity of use of fertilizer. In addition gender and access to hired labour had negative impacts on the intensity of use of fertilizer. There is need to think of alternative sources of credit to farmers and also revamp the existing extension service (including privatization in the long term) for efficient delivery of information.Maize, adoption, improved seed, fertilizer, credit, extension, Kenya, Crop Production/Industries,

Drivers of adoption of Improved Maize varieties in Moist Transitional zone of Eastern Kenya

Despite its role in food security in Kenya, maize deficit has increased in the recent years posing serious food security threat. This worrying trend necessitates careful review of adoption. The paper quantifies determinants of adoption and intensity of use of improved maize varieties in moist transitional zone of Eastern Kenya based on data collected between September and October 2013 from 314 farming households.  Double hurdle model was used to estimate the determinants of adoption and intensity of use of improved maize varieties.  Many of the institutional factors: extension contacts, farmer group membership, distance to input market and extension office were significant in explaining the probability of adoption. Fertilizer use, livestock and consumer worker ratio were identified as important farm characteristics in the adoption. Age was the only household characteristic that was associated with the likelihood of adoption. These factors were not important in the intensity of adoption. Intensity of adoption was explained by intercropping of maize and legumes, ownership of mobile phones, household size, remittances, confidence in extension workers and availability of seed of improved maize varieties.   Given that different sets of factors determined the probability and intensity of adoption, considering the two decision processes for the purpose of identifying appropriate strategies for increasing productivity is critical. The results suggest strengthening of farmer’s groups, particularly innovation platforms, and extension services.  Since distance to input and output market was factor in adoption, improving infrastructure would reduce transaction cost and encourage farmers to adopt modern technologies.  Policies aimed at enhancing maize productivity and the adoption of improved maize by improving and maintaining the household asset base should also be central to food security strategies. Key words: Double hurdle, food security, Kenya, maiz

Does Adoption of Improved Maize Varieties Enhance Household Food Security in Maize growing Zones of Eastern Kenya?

The paper evaluates the effect of intensity of adoption of improved maize varieties on household food security measured by per capita consumption expenditure, per capita maize consumption and farmer’s assessment. Three hundred and fourteen households were interviewed in the moist transitional zones of Embu, Meru South and Imenti South sub-counties in Kenya in September and October 2013. Intensity of adoption of improved maize varieties varies continuously and this feature allows estimation of the dose response function. The dose response function was estimated using generalized propensity score useful for analyzing causal effects of continuous treatments. The results indicated an increasing dose response function between intensity of adoption and per capita food consumption expenditure. The food consumption expenditure increased from KES 76 at 0.04 area share of improved maize varieties to KES 237 at 1 area share.  Per capita maize consumption increased from 77 kg at 0.04 to 104 kg at 0.20 area shares of improved maize varieties but assumed diminishing return after 0.20 area shares.  Likewise, the probability of food security increased from 58% at about 0.05 acres to 79 % at 1.4 adoption level. After 0.05 area share, the probability of food security decreased. Policies that increase maize productivity and ease farmer’s adoption constraints can enhance food security of households.   Key words: Continuous treatment, generalized propensity score, household food security, maiz

Livelihood strategies in the rural Kenyan highlands

The concept of a livelihood strategy has become central to development practice in recent years. Nonetheless, precise identification of livelihoods in quantitative data has remained methodologically elusive. This paper uses cluster analysis methods to operationalize the concept of livelihood strategies in household data and then uses the resulting strategy-specific income distributions to test whether the hypothesized outcome differences between livelihoods indeed exist. Using data from Kenya’s central and western highlands, we identify five distinct livelihood strategies that exhibit statistically significant differences in mean per capita incomes and stochastic dominance orderings that establish clear welfare rankings among livelihood strategies. Multinomial regression analysis identifies geographic, demographic and financial determinants of livelihood choice. The results should facilitate targeting of interventions designed to improve household livelihoods.Livelihood strategy, Kenya, Smallholder agriculture, Cluster analysis, Community/Rural/Urban Development,

Community health worker interventions are key to optimal infant immunization coverage, evidence from a pretest-posttest experiment in Mwingi, Kenya

Introduction: Immunization is a powerful and cost-effective health intervention which averts an estimated 2 to 3 million deaths every year. Kenya has a high infant and under five mortality and morbidity rates. Increasing routine child immunization coverage is one way of reducing child morbidity and mortality rates in Kenya. Community Health Workers (CHWs) have emerged as critical human resources for health in developing countries. The Community Strategy (CS) is one of the CHW led interventions promoting Maternal and Child Health (MCH) in Kenya. This studysought to establish the effect of CS on infant vaccination Coverage (IVC) in Mwingi west sub-county; Kenya. Methods: This was a pretest - posttest experimental study design with 1 pretest and 2 post-test surveys conducted in intervention and control sites. Mwingi west and Mwingi north sub-counties where intervention and control sites respectively. Sample size in each survey was 422 households. Women with a child aged 9-12 months were main respondents.Results: intervention site end-term evaluation indicated that; the CS increased IVC by 10.1% (Z =6.0241, P <0.0001), from a suboptimal level of 88.7% at baseline survey to optimal level of 98.8% at end term survey. Infants in intervention site were 2.5 times more likely to receive all recommended immunizations within their first year of life [(crude OR= 2.475, P<0.0001; 95%CI: 1.794-3.414) (adj. OR=2.516, P<0.0001; 95%CI: 1.796-3.5240)].Conclusion: CS increased IVC in intervention site to optimal level (98.8%). To improve child health outcomes through immunization coverage, Kenya needs to fast-track nationwide implementation of the CS intervention. Key words: Community health workers, maternal and child health, vaccination coverag

Utilization of Individual Birth Plan Among Women Attending Postnatal Clinic at Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu Kenya: A Hospital-Based Survey

Background: Kenya has a maternal mortality rate (MMR) of 362 women per 100,000, partly attributed to inadequate or lack of birth and emergency preparedness, including the individual birth plan. Moreover, a paucity of data on determinants of individual birth plan use hampers its promotion and utility against MMR. This study assessed the determinants of individual birth plan use among women attending the postnatal clinic at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, Kenya. Methods: Hospital-based survey was conducted among 354 expectant women between November 2018 and February 2019. Data were collected using questionnaires and a Focus Group Discussion guide. A Logistic regression model was also used to determine factors associated with IBP utilization, where only p-value's <0.05 were considered significant. Textual data were analyzed thematically using NVIVO. Results: Most mothers (68.6%) had an individual birth plan. Determinants for having birth plans included client factors such as education, OR 8.93, p<0.001, occupation, OR=2.40, p=0.020, and parity, AOR=3.29, p=<0.034; knowledge of danger signs, AOR 8.1, p=0.001. Health facility factors included birth plan counseling, OR=3.45, p=0.013, emergency preparedness, OR=2.06, p=0.034, access to motorized transport such as a car, OR=3.8, p=0.035 or motorcycle, OR=2.7, p=0.006 and attending a clinic in a referral hospital, OR=5.8, p=0.003 Conclusion: This study has demonstrated most women utilize individual birth plans. However, they were ill-prepared for an emergency. Determinants of IBP use included client factors such as education level, employment status, parity, knowledge of danger signs, maternal attitude; and facility factors including counseling, attending a clinic in a referral hospital, the use of an automobile to reach the hospital, and hostility by the health care providers. Therefore, we recommend that prenatal counseling should emphasize emergency preparedness among pregnant women. There is a need to empower women through education and employment to enhance IBP utilization

Does the Quality of Antenatal Care Predict Health Facility Delivery Among Women in Kenya? Further Analysis of KDHS Data 2008/09

Improving maternal health remains a priority in Kenya and beyond. It is essential that women get good medical care before, during and after pregnancy to reduce maternal mortality. Skilled delivery care remains low in Kenya and maternal mortality rate high regardless of numerous ongoing interventions. Antenatal care is known to promote maternal and fetal well-being. However less than 50% of women make the recommended four or more antenatal care visits, missing out on key services such as urine and blood tests, and advice on possible pregnancy complications, that determine the quality of ANC. This study examines how the number of ANC visits and the quality of those visits predict health facility use at delivery. Maternal health data from DHS of 2008/2008 in Kenya was analyzed using Stata 11.0 software. Logistic regression was used to evaluate relationships between facility delivery and predictor variables in univariate and multivariate models. Estimates were based on 95% confidence inteval. The models were examined at 95% CI and 80% power and adjusted for maternal age at last birth, education, place and type of residence, level of exposure to media, mother’s religion, wealth index and birth order. The quality of ANC was an index developed based on the number of services received during ANC visits.The quality of ANC visits progressively increased the likelyhood of health facility delivery. Supply and demand should be intervention targets to ensure that women know and understand the services to demand. Health facilities should also be sufficiently prepared and ready with the services

The Maize Green Revolution in Kenya Revisited

The maize green revolution, which increased maize yields through the use of improved varieties and fertilizer, has stalled since the mid-eighties in Kenya. This paper examines whether the stagnation of yields continued in the 1990s in spite of the implementation of the maize liberalization policies by the Kenya Government. Analysis of farm level surveys from 1992 and 2002 indicates slight increases in the use of improved maize varieties and fertilizer, but a substantial decrease in the intensity of fertilizer use. The econometric analysis suggests that the intensity of fertilizer use has a major effect on yield. The use of improved maize varieties, however, did not affect yield, suggesting that there are local varieties for some areas that do as well as improved varieties. Research is needed to develop improved varieties for some areas, and also needed for the development of alternative affordable soil fertility measures.green revolution, maize, adoption, soil fertility, Kenya, Crop Production/Industries, International Development,

Innovative trial approaches in immune-mediated inflammatory diseases: current use and future potential.

BACKGROUND: Despite progress that has been made in the treatment of many immune-mediated inflammatory diseases (IMIDs), there remains a need for improved treatments. Randomised controlled trials (RCTs) provide the highest form of evidence on the effectiveness of a potential new treatment regimen, but they are extremely expensive and time consuming to conduct. Consequently, much focus has been given in recent years to innovative design and analysis methods that could improve the efficiency of RCTs. In this article, we review the current use and future potential of these methods within the context of IMID trials. METHODS: We provide a review of several innovative methods that would provide utility in IMID research. These include novel study designs (adaptive trials, Sequential Multi-Assignment Randomised Trials, basket, and umbrella trials) and data analysis methodologies (augmented analyses of composite responder endpoints, using high-dimensional biomarker information to stratify patients, and emulation of RCTs from routinely collected data). IMID trials are now well-placed to embrace innovative methods. For example, well-developed statistical frameworks for adaptive trial design are ready for implementation, whilst the growing availability of historical datasets makes the use of Bayesian methods particularly applicable. To assess whether and how these innovative methods have been used in practice, we conducted a review via PubMed of clinical trials pertaining to any of 51 IMIDs that were published between 2018 and 20 in five high impact factor clinical journals. RESULTS: Amongst 97 articles included in the review, 19 (19.6%) used an innovative design method, but most of these were relatively straightforward examples of innovative approaches. Only two (2.1%) reported the use of evidence from routinely collected data, cohorts, or biobanks. Eight (9.2%) collected high-dimensional data. CONCLUSIONS: Application of innovative statistical methodology to IMID trials has the potential to greatly improve efficiency, to generalise and extrapolate trial results, and to further personalise treatment strategies. Currently, such methods are infrequently utilised in practice. New research is required to ensure that IMID trials can benefit from the most suitable methods