Assessing local administrative capacity for development purposes: a Kenyan case

This paper is based on field data, collected between 1970-1972. It assesses the administrative potential and capacity that existed in one sub-district at the time an integrated rural development programme was being launched in the area. The findings show that the administrative system which existed at the time was too weak to support the programme. The factors which accounted for the weaknesses are discussed in some details

Decentralization for integrated rural development: some lessons from Kenya

Decentralization for rural development has become a movement of some kind. This paper attempts to assess the experience of Kenya in this field. In doing that the paper focuses on, (i) The District development Committees. ii) The Special Rural Development Programme (SRDP) organization. iii) District Planning Strategy. Several conclusions both positive and negative are arrived at after some detailed analyses

Agricultural administration in Kenya: a review

The paper reviews some of the literature on agricultural administration in Kenya in the light of the reviewers’ own reference. Discussed in some detail, here is a recent work by Christopher Trapman, Change in Administrative Structure, which is a study of Agriculture Administrative System in Kenya

Prevalence of trypanosomosis in camel calves : A pilot study in Laikipia District of Kenya

La trypanosomose est l'une des maladies les plus importantes du chamelon. Elle se présente sous une forme aiguë et est généralement fatale si aucun traitement n'est administré. Une étude a été effectuée au ranch de Mogwooni dans le district de Laikipia au Kenya pour déterminer la prévalence de la trypanosomose chez des chamelons de races diverses et pour évaluer la technique de centrifugation en tube pour microhématocrite (Tcmh), le test d'agglutination sur carte au latex sensibilisé avec des anticorps monoclonaux (Suratex®), l'examen à l'état frais et l'inoculation à la souris (IS) dans le diagnostic de la maladie chez le chamelon. Les tests ont été évalués pendant une période de 16 mois. Les prévalences moyennes de Trypanosoma evansi ont été de 4,5 p. 100 (test à l'état frais), 11,1 p. 100 (Tcmh), 14,6 p. 100 (IS) et 28,3 p. 100 (Suratex®). Le taux de mortalité des chamelons dû à la trypanosomose a été de 12,3 p. 100 pour un taux global de mortalité de 15 p. 100. Le coût des soins vétérinaires (anthelminthiques, acaricides et trypanocides) a été en moyenne de 4,6 dollars américains par chamelon et par an. Il est donc recommandé que le diagnostic soit systématiquement accompagné d'un traitement approprié pour assurer la survie des chamelons dans les zones où la trypanosomose est endémique. (Résumé d'auteur

Effect of education and gender on household ownership of asset types in rural Western Kenya Region

Asset development is a key strategy to promote economic and social development. Measurement of inequality has been given relatively little attention to the asset ownership by households. The study examines relative importance of asset types and extent to which household headship factors affect ownership among households of Western Kenya. The study was cross sectional descriptive using quantitative methods. A total of 538 households were selected for the study comprising 184(34%) households with under-five death and 355(66%) as controls. Findings show that the extent to which asset types demonstrate significant differential inequality in ownership (p-value <0.05) varies by household headship factors, where gender clustered by education shows the highest number of asset types exhibiting significant inequality 17(50%) between households; followed by education 7(21%) and lastly gender 4(12%). Results underscore importance of high education, although the impact is different across the different genders.The impact is greater among the male headed households Key Words: Rural households, asset types, asset ownership, household headship, education, gender

Analysing chemical attraction of gravid Anopheles gambiae sensu stricto with modified BG-Sentinel traps.

BACKGROUND: Cues that guide gravid Anopheles gambiae sensu lato to oviposition sites can be manipulated to create new strategies for monitoring and controlling malaria vectors. However, progress towards identifying such cues is slow in part due to the lack of appropriate tools for investigating long-range attraction to putative oviposition substrates. This study aimed to develop a relatively easy-to-use bioassay system that can effectively analyse chemical attraction of gravid Anopheles gambiae sensu stricto. METHODS: BG-Sentinel™ mosquito traps that use fans to dispense odourants were modified to contain aqueous substrates. Choice tests with two identical traps set in an 80 m(2) screened semi-field system were used to analyse the catch efficacy of the traps and the effectiveness of the bioassay. A different batch of 200 gravid An. gambiae s.s. was released on every experimental night. Choices tested were (1) distilled versus distilled water (baseline) and (2) distilled water versus soil infusion. Further, comparisons were made of distilled water and soil infusions both containing 150 g/l of Sodium Chloride (NaCl). Sodium Chloride is known to affect the release rate of volatiles from organic substrates. RESULTS: When both traps contained distilled water, 45% (95 confidence interval (CI) 33-57%) of all released mosquitoes were trapped. The proportion increased to 84% (95 CI 73-91%) when traps contained soil infusions. In choice tests, a gravid female was twice as likely to be trapped in the test trap with soil infusion as in the trap with distilled water (odds ratio (OR) 1.8, 95% CI 1.3-2.6). Furthermore, the attraction of gravid females towards the test trap with infusion more than tripled (OR 3.4, 95% CI 2.4-4.8) when salt was added to the substrates. CONCLUSION: Minor modifications of the BG-Sentinel™ mosquito trap turned it into a powerful bioassay tool for evaluating the orientation of gravid mosquitoes to putative oviposition substrates using olfaction. This study describes a useful tool for investigating olfactory attraction of gravid An. gambiae s.s. and provides additional evidence that gravid mosquitoes of this species are attracted to and can be baited with attractive substrates such as organic infusions over a distance of several metres

Estimating the need for inpatient neonatal services: an iterative approach employing evidence and expert consensus to guide local policy in Kenya.

Universal access to quality newborn health services will be essential to meeting specific Sustainable Development Goals to reduce neonatal and overall child mortality. Data for decision making are crucial for planning services and monitoring progress in these endeavours. However, gaps in local population-level and facility-based data hinder estimation of health service requirements for effective planning in many low-income and middle-income settings. We worked with local policy makers and experts in Nairobi City County, an area with a population of four million and the highest neonatal mortality rate amongst counties in Kenya, to address this gap, and developed a systematic approach to use available data to support policy and planning. We developed a framework to identify major neonatal conditions likely to require inpatient neonatal care and identified estimates of incidence through literature review and expert consultation, to give an overall estimate for the year 2017 of the need for inpatient neonatal care, taking account of potential comorbidities. Our estimates suggest that almost 1 in 5 newborns (183/1000 live births) in Nairobi City County may need inpatient care, resulting in an estimated 24 161 newborns expected to require care in 2017. Our approach has been well received by local experts, who showed a willingness to work together and engage in the use of evidence in healthcare planning. The process highlighted the need for co-ordinated thinking on admission policy and referral care especially in a pluralistic provider environment helping build further appetite for data-informed decision making

Patient and Provider Perspectives on How Trust Influences Maternal Vaccine Acceptance Among Pregnant Women in Kenya

Background Pregnant women and newborns are at high risk for infectious diseases. Altered immunity status during pregnancy and challenges fully vaccinating newborns contribute to this medical reality. Maternal immunization is a strategy to protect pregnant women and their newborns. This study aimed to find out how patient-provider relationships affect maternal vaccine uptake, particularly in the context of a lower middle- income country where limited research in this area exists. Methods We conducted semi-structured, in-depth narrative interviews of both providers and pregnant women from four sites in Kenya: Siaya, Nairobi, Mombasa, and Marsabit. Interviews were conducted in either English or one of the local regional languages. Results We found that patient trust in health care providers (HCPs) is integral to vaccine acceptance among pregnant women in Kenya. The HCP-patient relationship is a fiduciary one, whereby the patients’ trusts is primarily rooted in the provider’s social position as a person who is highly educated in matters of health. Furthermore, patient health education and provider attitudes are crucial for reinstating and fostering that trust, especially in cases where trust was impeded by rumors, community myths and misperceptions, and religious and cultural factors. Conclusion Patient trust in providers is a strong facilitator contributing to vaccine acceptance among pregnant women in Kenya. To maintain and increase immunization trust, providers have a critical role in cultivating a positive environment that allows for favorable interactions and patient health education. This includes educating providers on maternal immunizations and enhancing knowledge of effective risk communication tactics in clinical encounters

Hospital Mortality - a neglected but rich source of information supporting the transition to higher quality health systems in low and middle income countries.

BACKGROUND: There is increasing focus on the strength of primary health care systems in low and middle-income countries (LMIC). There are important roles for higher quality district hospital care within these systems. These hospitals are also sources of information of considerable importance to health systems, but this role, as with the wider roles of district hospitals, has been neglected. KEY MESSAGES: As we make efforts to develop higher quality health systems in LMIC we highlight the critical importance of district hospitals focusing here on how data on hospital mortality offers value: i) in understanding disease burden; ii) as part of surveillance and impact monitoring; iii) as an entry point to exploring system failures; and iv) as a lens to examine variability in health system performance and possibly as a measure of health system quality in its own right. However, attention needs paying to improving data quality by addressing reporting gaps and cause of death reporting. Ideally enabling the collection of basic, standardised patient level data might support at least simple case-mix and case-severity adjustment helping us understand variation. Better mortality data could support impact evaluation, benchmarking, exploration of links between health system inputs and outcomes and critical scrutiny of geographic variation in quality and outcomes of care. Improved hospital information is a neglected but broadly valuable public good. CONCLUSION: Accurate, complete and timely hospital mortality reporting is a key attribute of a functioning health system. It can support countries' efforts to transition to higher quality health systems in LMIC enabling national and local advocacy, accountability and action