Challenges and Opportunities in Cassava Production among the Rural Households in Kilifi County in the Coastal Region of Kenya

In Kenya, food security and poverty alleviation are some of the most important factors that the country must address in order to achieve the vision 2030. Cassava has potential not only as food for humans, but also as feed for livestock and as a substrate for biofuel production.  Although various constraints have been reported to afflict farmers in cassava production, a base line survey in the study sites (Kilifi and Kaloleni) was necessary to identify specific constraints facing farmers in this region so as to identify areas of intervention in production and utilization. Lack of disease free planting materials was identified as one of the major constraints since cassava mosaic disease (CMD) and the cassava brown streak disease (CBSD) pose serious threats in yield losses. The two diseases are transmitted by vectors and by diseased planting materials and almost all the farmers obtain their planting materials from their neighbours thus aiding in disease dissemination and compounding the problem. There is need to enable the community produce quality cassava seed and operate sustained cassava business, integrate legumes into cassava cropping systems and create an innovative value addition chain for utilization of cassava. Eighty percent of Kenya is marginal area and cassava being drought tolerant can enable the potential of these areas to be tapped thus helping to deal with the persistent food insecurity which is a common feature in these areas. Key words: Cassava, cowpeas, cultivars, production constraints, utilizatio

Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey

Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases

Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

<p>Abstract</p> <p>Background</p> <p>A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG) 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care.</p> <p>Methods</p> <p>A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice.</p> <p>Results</p> <p>Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170) were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170) of the deliveries while in 11.7% (137/1170) of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have <3 years of education (Adjusted Odds ratio [AOR] 19.2, 95% confidence interval [CI] 1.7 - 212.8) and with more than three deliveries in a life time (AOR 3.8, 95% CI 2.3 - 6.4). Mothers with perceived similarity in delivery attendance among skilled and unskilled delivery attendants were associated with unsafe delivery practice (AOR 1.9, 95% CI 1.1 - 3.4). Mother's with lower knowledge score on safe delivery (%) were more likely to have unskilled delivery attendance (AOR 36.5, 95% CI 4.3 - 309.3).</p> <p>Conclusion</p> <p>Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.</p

Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria

BACKGROUND: Malaria is one of the leading causes of mortality and morbidity in Nigeria. It is not known how user fees introduced under the Bamako Initiative (BI) system affect healthcare seeking among different socio-economic groups in Nigeria for diagnosis and treatment of malaria. Reliable information is needed to initiate new policy thrusts to protect the poor from the adverse effect of user fees. METHODS: Structured questionnaires were used to collect information from 1594 female household primary care givers or household head on their socio-economic and demographic status and use of malaria diagnosis and treatment services. Principal components analysis was used to create a socio-economic status index which was decomposed into quartiles and chi-square for trends was used to calculate for any statistical difference. RESULTS: The study showed that self diagnosis was the commonest form of diagnosis by the respondents. This was followed by diagnosis through laboratory tests, community health workers, family members and traditional healers. The initial choice of care for malaria was a visit to the patent medicine dealers for most respondents. This was followed by visit to the government hospitals, the BI health centres, traditional medicine healers, private clinics, community health workers and does nothing at home. Furthermore, the private health facilities were the initial choice of treatment for the majority with a decline among those choosing them as a second source of care and an increase in the utilization of public health facilities as a second choice of care. Self diagnosis was practiced more by the poorer households while the least poor used the patent medicine dealers and community health workers less often for diagnosis of malaria. The least poor groups had a higher probability of seeking treatment at the BI health centres (creating equity problem in BI), hospitals, and private clinics and in using laboratory procedures. The least poor also used the patent medicine dealers and community health workers less often for the treatment of malaria. The richer households complained more about poor staff attitude and lack of drugs as their reasons for not attending the BI health centres. The factors that encourage people to use services in BI health centres were availability of good services, proximity of the centres to the homes and polite health workers. CONCLUSIONS: Factors deterring people from using BI centres should be eliminated. The use of laboratory services for the diagnosis of malaria by the poor should be encouraged through appropriate information, education and communication which at the long run will be more cost effective and cost saving for them while devising means of reducing the equity gap created. This could be done by granting a properly worked out and implemented fee exemptions to the poor or completely abolishing user fees for the diagnosis and treatment of malaria in BI health centres

A facility-based study of women' satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program

Background: This is a facility-based study designed to assess perceived quality of care and satisfaction of reproductive health services under the output-based approach (OBA) services in Kenya from clients’ perspective. Method: An exit interview was conducted on 254 clients in public health facilities, non-governmental organizations, faith-based organizations and private facilities in Kitui, Kilifi, Kiambu, and Kisumu counties as well as in the Korogocho and Viwandani slums in Nairobi, Kenya using a 23-item scale questionnaire on quality of reproductive health services. Descriptive analysis, exploratory factor analysis, reliability test, and subgroup analysis using linear regression were performed. Results: Clients generally had a positive view on staff conduct and healthcare delivery but were neutral on hospital physical facilities, resources, and access to healthcare services. There was a high overall level of satisfaction among the clients with quick service, good handling of complications, and clean hospital stated as some of the reasons that enhanced satisfaction. The County of residence was shown to impact the perception of quality greatly with other social demographic characteristics showing low impact. Conclusion: Majority of the women perceived the quality of OBA services to be high and were happy with the way healthcare providers were handling birth related complications. The conduct and practice of healthcare workers is an important determinant of client’s perception of quality of reproductive and maternal health services. Findings can be used by health care managers as a guide to evaluate different areas of healthcare delivery and to improve resources and physical facilities that are crucial in elevating clients’ level of satisfaction

The process and lessons of exchanging and managing in-vitro elite germplasm to combat CBSD and CMD in Eastern and Southern Africa

Varieties with resistance to both cassava mosaic disease (CMD) and cassava brown streak disease (CBSD) can reverse food and income security threats affecting the rural poor in Eastern and Southern Africa. The International Institute of Tropical Agriculture is leading a partnership of five national (Malawi, Mozambique, Kenya, Tanzania and Uganda) cassava breeding programs to exchange the most elite germplasm resistant to both CMD and CBSD. This poster documents the process and the key learning lessons. Twenty to 25 stem cuttings of 31 clones comprising of 25 elite clones (5 per country), two standard checks (Kibandameno from Kenya and Albert from Tanzania), and four national checks (Kiroba and Mkombozi from Tanzania, Mbundumali from Malawi, and Tomo from Mozambique) were cleaned and indexed for cassava viruses at both the Natural Resources Institute in the United Kingdom and Kenya Plant Health Inspectorate Services, in Kenya. About 75 in-vitro plantlets per clone were sent to Genetic Technologies International Limited, a private tissue culture lab in Kenya, and micro-propagated to ≥1500 plantlets. Formal procedures of material transfer between countries including agreements, import permission and phytosanitary certification were all ensured for germplasm exchange. At least 300 plantlets of each elite and standard check clones were sent to all partner countries, while the national checks were only sent to their respective countries of origin. In each country, the in-vitro plantlets were acclimatized under screen house conditions and transplanted for field multiplication as a basis for multi-site testing. Except for Tomo, a susceptible clone, all the clones were cleaned of the viruses. However, there was varied response to the cleaning process between clones, e.g. FN-19NL, NASE1 and Kibandameno responded slowly. Also, clones responded differently to micro-propagation protocols at GTIL, e.g. Pwani, Tajirika, NASE1, TME204 and Okhumelela responded slowly. Materials are currently being bulked at low disease pressure field sites in preparation for planting at 5-8 evaluation sites per country. The process of cleaning, tissue culture mass propagation, exchange and local hardening off/bulking has been successful for the majority of target varieties. Two key lessons derived from the process are that adequate preparations of infrastructure and trained personnel are required to manage the task, and that a small proportion of varieties are recalcitrant to tissue culture propagation

Evaluation of AgroZ Hermetic Storage Bag against insect pests on stored maize: Presentation

A study on AgroZ airtight bag was conducted against two major storage insects under simulated farmers' storage practice. Two (2) lots of 50kg white maize of Pioneer variety were put into AgroZ bag and polypropylene woven bag to serve as a control. Four replications of each bag type were used. In each bag, 50 adults of unsexed larger grain borer, Prostephanus truncatus, and maize weevil, Sitophilus zeamais, each were introduced. AgroZ bag had one liner placed inside polypropylene bag to provide support and handling convenience. Each liner had been tested for air tightness before use. The AgroZ bags were securely tied to ensure airtightness thus leading to a hermetic environment. The bags were then randomly placed in a barn on pallets in a randomised complete design (RCD). Sampling was done every 4 weeks up to 24 weeks. A 500g sample was initially taken using a compartmented long spear probe from each bag for baseline data, and subsequent ones at 4, 8, 12, 20 and 24 weeks. Repeated sampling from the same storage device reflected farmer practices of opening the device at regular intervals to draw grain for use as household food. Gas analysis in AgroZ bags showed oxygen level dropping rapidly to 7% within 4 weeks and later increased gradually to 10% at 12 weeks. Conversely, carbon dioxide level increased sharply to 10% and declined gradually to 9% over the same period. The number of insects and percentage damaged grains between AgroZ bag and polypropylene bag significantly differed from 12th week to 24th week. AgroZ bag outperformed the polypropylene bag commonly used by farmers and conveniently protected maize from insect infestation within the 6-month storage period.A study on AgroZ airtight bag was conducted against two major storage insects under simulated farmers' storage practice. Two (2) lots of 50kg white maize of Pioneer variety were put into AgroZ bag and polypropylene woven bag to serve as a control. Four replications of each bag type were used. In each bag, 50 adults of unsexed larger grain borer, Prostephanus truncatus, and maize weevil, Sitophilus zeamais, each were introduced. AgroZ bag had one liner placed inside polypropylene bag to provide support and handling convenience. Each liner had been tested for air tightness before use. The AgroZ bags were securely tied to ensure airtightness thus leading to a hermetic environment. The bags were then randomly placed in a barn on pallets in a randomised complete design (RCD). Sampling was done every 4 weeks up to 24 weeks. A 500g sample was initially taken using a compartmented long spear probe from each bag for baseline data, and subsequent ones at 4, 8, 12, 20 and 24 weeks. Repeated sampling from the same storage device reflected farmer practices of opening the device at regular intervals to draw grain for use as household food. Gas analysis in AgroZ bags showed oxygen level dropping rapidly to 7% within 4 weeks and later increased gradually to 10% at 12 weeks. Conversely, carbon dioxide level increased sharply to 10% and declined gradually to 9% over the same period. The number of insects and percentage damaged grains between AgroZ bag and polypropylene bag significantly differed from 12th week to 24th week. AgroZ bag outperformed the polypropylene bag commonly used by farmers and conveniently protected maize from insect infestation within the 6-month storage period