The role of the church in poverty eradication in Kenya : a focus of Africa Inland Church Kijabe Region

https://place.asburyseminary.edu/ecommonsatsdissertations/2410/thumbnail.jp

Product Service System for Volvo Trucks: Finding new business value compliant with IFRS 16 leasing regulations.

The International Accounting Standards Board (IASB) in January 2016 published International Financial Reporting Standards (IFRS 16), new guidelines on leasing standards with an effective date of January 1st, 2019. IFRS 16 sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract, i.e. the customer (‘lessee’) and the supplier (‘lessor’). Under IFRS 16 the lease classification test i.e. classifying a lease as being on balance sheet or off balance sheet is done away with. This is as a result of the guideline’s expectations that all leases are treated as on balance sheet entries. The objective of this thesis is to develop a model to support Volvo Truck’s goal of offering IFRS 16 compliant off balance sheet leasing solutions. Utilizing a 3 step framework, this study identifies the off balance sheet threshold set in IFRS16 and matches it to a Product Service System classification. A Business Model Canvas is utilized to develop a business model that supports this off balance sheet contract. The thesis finds that by exercising the substantive right to substitute the truck during a lease deployment and by offering capacity based contracts, Volvo Trucks can provide a Product Service System centered, off balance sheet solution, to its leasing clients in compliance with the IFRS 16 regulations

Flexor digitorum brevis tendon transfer to the flexor digitorum longus tendon according to Valtin in posttraumatic flexible claw toe deformity due to extrinsic toe flexor shortening

AbstractClaw toe deformity after posterior leg compartment syndrome is rare but incapacitating. When the mechanism is flexor digitorum longus (FDL) shortening due to ischemic contracture of the muscle after posterior leg syndrome, a good treatment option is the Valtin procedure in which the flexor digitorum brevis (FDB) is transferred to the FDL after FDL tenotomy. The Valtin procedure reduces the deformity by lengthening and reactivating the FDL. Here, we report the outcomes of FDB to FDL transfer according to Valtin in 10 patients with posttraumatic claw toe deformity treated a mean of 34 months after the injury. Toe flexion was restored in all 10 patients, with no claw toe deformity even during dorsiflexion of the ankle

Evaluating the Potential of Juice from Some Sweet Sorghum Varieties Grown In Kenya to Crystallize

Sweet sorghum (Sorghum bicolor (L) Moench) is a crop analogous to sugarcane with similar accumulation of sugars in its juicy stems. An earlier research study on agronomic trials carried out by Jomo Kenyatta University of Agriculture and Technology established that some of the imported varieties of Sweet Sorghum had sufficiently high amounts of sugar content in their Juice. The present study was undertaken with the objective of determining the potential of some of these sweet sorghum varieties to produce crystal sugar. This was with the long term goal of trying to find alternative uses for sweet sorghum. The sweet sorghum varieties were planted at the University research farm, and stalks of sixteen varieties were crushed using electrical roller mill to produce SS juice which was then subjected to a number of analyses including, total and specific sugar determination and apparent purity. The total sugars in degree Brix varied from 15.050 to 21.500, sucrose concentration ranged from 6.05g/l to72.77g/l, glucose 2.65g/l to 16.41g/l and fructose 2.66g/l to 17.16g/l whereas apparent purity(AP) ranged from 33.89% to 83.91%.The variation could have been  brought about by varietal differences. The juice of variety RIO had the highest sucrose purity of 83.91% which was further clarified by liming and double carbonation method. The resulting juice was concentrated into syrup by evaporation. Supersaturation for crystallization was attained by cooling, followed by seeding. According to the present study, the following sweet sorghum cultivars; Rio, CMSXS636, IESV91018LT, IESV93042SH and SPV1411 could have potential in crystal raw sugar production because they have AP greater than 75% and a relatively higher sucrose concentration. The Rio sweet sorghum variety with the highest sucrose purity of 83.91% and sucrose concentration of 40.86g/l was selected and subjected to crystal sugar production processes. The Rio juice subjected to crystallization process failed to produce crystals probably due to the presence of dextran, aconitic acid and starch. Key words: Brix, Sucrose, apparent purity, Clarification, Crystal Sugar,

Demand satisfied by modern contraceptive among married women of reproductive age in Kenya

Background: Demand for family planning met/satisfied with modern contraceptive methods (mDFPS) has been proposed to track progress in Family Planning (FP) programs for Sustainable Development Goals. This study measured mDFPS among married women of reproductive age (MWRA) in Kenya to identify which groups were not being reached by FP programs. Materials and methods: Performance, Monitoring and Accountability 2020 (PMA2020) survey data from 2014–2018 was used. PMA2020 surveys are cross-sectional including women 15–49 years. PMA2020 used a 2-stage cluster design with urban/rural regions as strata with random selection of households. Univariate and multivariate analysis was done using stata V15. Results: Of the 34,832 respondents interviewed from 2014 to 2018, 60.2% were MWRA. There was a significant decrease in demand for FP from 2014 to 2018, p = 0.012. Lowest demand was among 15–19 and 45–49 years old women. Overall, modern contraceptive prevalence rate increased significantly from 54.6% to 60.8%, p = 0.004, being higher for women from urban areas, home visits by health care worker (HCW), educated, wealthy, visited health facilities and exposed to mass media. Unmet need for FP decreased from 23.0–13.8% over the 5-years, p\u3c0.001. Married adolescent 15–19 had the highest unmet need and those from rural areas, poor, uneducated and not exposed to mass media. mDFPS increased significantly from 69.7–79.4% over the 5-years, p\u3c0.001, with increase in long acting reversible contraception/permanent methods from 19.9–37.2% and decrease in short acting methods from 49.9–42.2%. Significant determinants of mDFPS were age, rural/urban residence, education, wealth, health facility visitation, exposure to FP messages via mass media in the last 12 months, year of study and county of residence. Conclusions: Results show a good progress in key FP indicators. However, not all MWRA are being reached and should be reached if Kenya is to achieve the desired universal health coverage as well as Sustainable Development Goals. Targeted home visits by HCW as well increase in mass media coverage could be viable interventions

Young people’s experiences using an on-demand mobile health sexual and reproductive health text message intervention in Kenya : qualitative study

Background: Digital health usability assessments can help explain how well mobile health (mHealth) apps targeting young people with sexual and reproductive health (SRH) information performed and whether the intended purpose was achieved. However, few digital health assessments have been conducted to evaluate young people’s perceptions regarding mHealth system interactions and content relevance on a wide range of SRH topics. In addition, the majority of randomized controlled trials (RCTs) have focused on push messaging platforms; therefore, the mHealth field lacks sufficient RCTs investigating on-demand mHealth SRH platforms. Objective: The objective of this study was to explore young people’s experiences using an on-demand SRH mHealth platform in Kenya. Methods: We used qualitative data related to the usability of an mHealth platform, Adolescent/Youth Reproductive Mobile Access and Delivery Initiatives for Love and Life Outcome (ARMADILLO), collected at the end of the intervention period. A total of 30 in-depth interviews (IDIs) were held with the intervention participants (15 women and 15 men) to elicit their experiences, opinions, and perspectives on the design and content of the ARMADILLO platform. The study participants were randomly selected from a list of intervention arm participants to participate in the IDIs. The interviews were later transcribed verbatim, translated into English, and coded and analyzed thematically using NVivo version 12 software (QSR International). Results: Respondents reported varied user experiences and levels of satisfaction, ranging from ease of use by the majority of the respondents to systematic frustrations that prevented some participants from progressing to other stages. Interesting features of the mHealth platform included the immediate response participants received when requesting messages, weekly remunerated quizzes, and perceived ability of educative and informative content and messages to change behaviors. Proposed enhancements to the platform included revising some concepts and words for easy understanding and increasing the interactivity of the platform, whereby young people could seek clarity when they came across difficult terms or had additional questions about the information they received. Conclusions: The importance of understanding the range of health literacy and technological variations when dealing with young people cannot be overemphasized. Young people, as mHealth end users, must be considered throughout intervention development to achieve optimum functionality. In addition, young people targeted with mHealth SRH interventions must be sensitized to the interactions on mHealth platforms or any other digital health apps if implemented in a nonresearch setting for optimal use by the targeted audience

Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya

BackgroundMyths and misconceptions around modern contraceptives have been associated with low contraceptive uptake in sub-Saharan Africa and Kenya in particular. Addressing persistent contraceptive knowledge gaps can make a significant contribution towards improved contraceptive uptake among young women. This qualitative study therefore sought to explore and understand young people's knowledge of modern contraception and to identify their key concerns regarding these methods.MethodsWe used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants. Predefined codes reflecting the discussion guides and emerging issues in the FGDs were used to develop the thematic coding framework. Our analysis followed a pattern of association on the key preset themes focusing on myths and misconceptions around contraceptive use.ResultsResults are presented under four key themes: awareness of contraception, myths and misconceptions around contraception, males' contraceptive narratives and young people's preferred sources of contraceptives. Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions were discussed and included perceptions that modern contraception: jeopardized future fertility, could result in problems conceiving or birth defects, made women promiscuous, was 'un-African', and would deny couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. On preferred sources of contraceptives, respondents reported on two main sources, pharmacies and public hospitals, however, they could not agree on which one was suitable for them.ConclusionsThis study revealed the presence of a mixture of biological and social myths and misconceptions around contraception, with young men also strongly adhering to these misconceptions. The low level of contraceptive knowledge, particularly on contraceptive fears as revealed by the study demonstrate critical gaps in sexual and reproductive health (SRH) knowledge among young people. Improved SRH literacy to address contraceptives' fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may therefore contribute to increased uptake of SRH services including modern contraceptive methods

They Destroy the Reproductive System : Exploring the Belief that Modern Contraceptive Use Causes Infertility

© 2018 The Authors. Studies in Family Planning published by John Wiley & Sons Ltd. on behalf of The Population Council, Inc. A common reason for nonuse of modern contraceptives is concern about side effects and health complications. This article provides a detailed characterization of the belief that modern contraceptives cause infertility, and an examination of how this belief arises and spreads, and why it is so salient. We conducted focus group discussions and key informant interviews in three rural communities along Kenya\u27s eastern coast, and identified the following themes: (1) the belief that using modern contraception at a young age or before childbirth can make women infertile is widespread; (2) according to this belief, the most commonly used methods in the community were linked to infertility; (3) when women observe other women who cannot get pregnant after using modern contraceptives, they attribute the infertility to the use of contraception; (4) within the communities, the primary goal of marriage is childbirth and thus community approval is rigidly tied to childbearing; and, therefore (5) the social consequences of infertility are devastating. These findings may help inform the design of programs to address this belief and reduce unmet need

The gender-based violence and recovery centre at Coast Provincial General Hospital, Mombasa, Kenya: An integrated care model for survivors of sexual violence

Sexual violence (SV) is highly prevalent and a major public health problem globally. In Kenya, an estimated 32% of females and 18% of males were reported to have experienced SV before the age of 18 years. This paper presents a data set collected between 2007 and 2018 and describes the gender-based violence and recovery centre (GBVRC) model under which survivors of SV were cared for at a 24-hour public hospital in Mombasa, Kenya—including its development, implementation, achievements, and challenges. The GBVRC model is a partnership that provides (in addition to emergency healthcare) mental health support, paralegal services, and integrated cooperation with police, judiciary, local leaders, and the wider community. The Mombasa GBVRC has provided post-SV care to 6,575 people reporting SV, of whom 88% were female and over 50% were younger than 16 years. Over 90% of the perpetrators were family, neighbours, community members, or in some other way known to the survivors. The low rate (19%) of attendance by survivors for the second counselling visit suggests a more robust strategy is needed for follow-up—for example, by referring people back to smaller, closer health facilities. A second limitation was a lack of trained staff, although this is an expected issue in sub-Saharan Africa. There was also a low rate of legal resolution to the cases. This may be due to the need for education about the standard of evidence required by courts. The experiences of successful and sustainable implementation of the GBVRC model should strengthen arguments for service delivery for people experiencing SV in this and similar settings

Implementation of respondent driven sampling in Nairobi, Kenya, for tracking key family planning indicators among adolescents and youth: lessons learnt

Objective: Adolescents and youth constitute a significant proportion of the population in developing nations. Conventional survey methods risk missing adolescents/youth because their family planning/contraception (FP/C) behavior is hidden. Respondent-driven sampling (RDS), a modified chain-referral recruitment sampling approach, was used to reach unmarried adolescents/youth aged 15–24 in Nairobi, Kenya to measure key FP/C indicators. Seeds were selected and issued with three coupons which they used to invite their peers, male or female, to participate in the study. Referred participants were also given coupons to invite others till sample size was achieved. We report on key implementation parameters following standard RDS reporting recommendations. Results: A total of 1674 coupons were issued to generate a sample size of 1354. Coupon return rate was 82.7%. Study participants self-administered most survey questions and missing data was low. Differential enrolment by gender was seen with 56.0% of females recruiting females while 44.0% of males recruited males. In about two months, it was possible to reach the desired sample size using RDS methodology. Implementation challenges included presentation of expired coupons, recruitment of ineligible participants and difficulty recruiting seeds and recruits from affluent neighborhoods. Challenges were consistent with RDS implementation in other settings and populations. RDS can complement standard surveillance/survey approaches, particularly for mobile populations like adolescents/youth