Exploring the Role of Decentralization in Resource Marginalization in Kenya

Against a background of increased decentralization, limited previous research examines its role in resource marginalization in Kenya. Specific objectives include identifying the socioeconomic sources of resource marginalization and identifying solutions to the socio-economic resource marginalization. The results of the study will improve our understanding of decentralization. Qualitative data was collected and analysed using thematic analysis. Quantitative data was collected and analysed using Statistical Package for the Social Sciences (SPSS). The study found that decentralisation has led to some form of marginalization. Recommendations for policy and further studies are made from the conclusions emanating from the academic study

Exploring the Role of Decentralization in Resource Marginalization in Kenya

Against a background of increased decentralization, limited previous research examines its role in resource marginalization in Kenya. Specific objectives include identifying the socioeconomic sources of resource marginalization and identifying solutions to the socio-economic resource marginalization. The results of the study will improve our understanding of decentralization. Qualitative data was collected and analysed using thematic analysis. Quantitative data was collected and analysed using Statistical Package for the Social Sciences (SPSS). The study found that decentralisation has led to some form of marginalization. Recommendations for policy and further studies are made from the conclusions emanating from the academic study

The Benefits of research partnerships to the community at KEMRI/Walter Reed Project

9TH Annual ethics conference. Theme : Bioethics medical, legal, environmental and cultural aspects in healthcare ethics at STRATHMORE UNIVERSITY, 25-26 OCTOBER 2012.Ethical Principles on Human Subject Protection in Clinical Research revolves around Autonomy, Beneficence and Justice. Beneficence requires that the benefits to research participants are maximized as you minimize the risk There’s need to enhance health, healthcare and general well being of communities participating in research Background well being of communities participating in research. Many local communities in developing countries have limited access to basic healthcare making them vulnerable and open to undue influence. Without collaborative partnership, strong interest and investment by government, research results may not influence policy making decisions and allocation of scarce healthcare resources. The KEMRI/Walter Reed Project a collaborative research program has conducted clinical trials for over 20 years in Kenya. During this period its objectives have included working with partners to maximize research benefits in the community in which it works by effectively utilizing the available resources to address local health needs

Economic analysis of zoonotic disease control in Uganda and the Lao People’s Democratic Republic

Background: Despite the acknowledged importance of economic assessments for public health interventions at the human-animal-ecosystem interface, there are currently limited economic methodologies for doing so. In this thesis studies were undertaken to ascertain the economic impact of interventions to control trypanosomiasis and taeniasis/cysticercosis in south-east Uganda and northern Lao PDR respectively. Also, in Uganda studies were done to find out if demand of draft cattle would be an important economic driver for spreading trypanosomiasis due to inter-district trade. Method: In Uganda, a one year recall cross-sectional baseline survey and an 18 month longitudinal survey of 660 households was conducted; to determine the benefits and changes due to restricted application of deltamethrin insecticide to only the legs, belly and ears of cattle. During the 18 month study, the households participating in the study were divided into six regimes depending on the type of intervention done in their cattle and these were; diminazine injection only, deworming only, no treatment and those had 25%, 50% and 75% of the total village cattle sprayed. Thus, the first three regimes were those households that had their cattle not sprayed with insecticide at all as opposed to the last three. Additionally, cattle trade data was collected for network and value chain analysis in all markets in Tororo and Namutamba districts from 199 cattle traders. In northern Lao PDR, stochastic modelling was done to determine the burden of neurocysticercosis associated epilepsy and soil transmitted helminthes. A cross-sectional study was carried out in 49 households, focusing on the prevalence of cysticercosis and soil transmitted helminths before and after a twelve month intervention to control a hyperendemic focus of Taenia solium. The village data was then extrapolated to the wider northern Lao PDR population. Results: The Uganda study indicated that the restricted application of deltamethrin in cattle induced change of USD 31 per head of adult bovine per year; this was the change in income that directly occurred due to restricted spraying of cattle with deltamethrin. During the intervention period, the annual difference in income between those households that had their cattle sprayed using restricted application protocol and those that did not was USD 123; and this was significant (t= 7.18, p= <0.001). Analysis of variance using households that had their cattle receive no treatment as control showed that restricted application of deltamethrin significantly increased household income compared to diminazine aceturate injection and deworming of cattle only. The incremental benefit cost ratio of spraying 0% to 25% of the cattle was found to be the highest (16:1) compared to spraying 25% to 50% (3:1) and 50% to 75% (1:1) of the cattle. Cattle trade network and value chain analysis revealed that the key cattle markets from which trypanosomiasis is likely to spread into Tororo District are Molo, Namutumba and Soroti. Also, it was found that the risk of spread of human African trypanosomiasis from south-east to north-west Uganda is high due to the increased demand for male cattle for draft work. In northern Lao PDR, 5,094 (95% CI: 25.6-28,940) DALYs were estimated to be imposed annually due to Taenia solium associated epilepsy, with 446.4 (95% CI: 2.2- 2,536) DALY imposed per 100,000 person-years. Due to the high benefits to pig production, the net monetary cost per DALY averted for simultaneously controlling T. solium, soil transmitted helminthes and classical swine fever was only USD 14, which fell to USD 11 if the separable cost method were applied. If the intervention did not target pigs, then the cost per DALY averted was USD 44; well below the current standard for ’very cost effective ‘of the 1 year’s per capita GDP. Conclusion: This study provided empirical evidence for evaluating the impact of quantifying the benefits of controlling zoonotic diseases in the livestock sector (Uganda case study) and in both livestock and human health populations (Lao PDR case study); this economic assessment approach can be used for planning future integrated health interventions. The results of this study support the policy of preventing the spread of infection by spraying at least 25% of the cattle using RAP, as well as injecting all cattle in key livestock markets in south east Uganda with diminazine aceturate to prevent HAT. In northern Lao PDR, simultaneous control of T. solium, soil transmitted helminths and classical swine fever is the most cost-effective approach. There are still difficulties in incorporating human and animal parameters into a single analytical framework; consequently there is a need to adapt the approaches undertaken in this study to the analysis of other zoonotic diseases in different settings to improve on their robustness

Contribution of Agricultural Extension to Promotion of Value Addition of Insects for Enhanced of Nutritional Security Among Smallholder Farmers

The study intended to investigate the contribution of agricultural extension on edible insect farming for food and feed nutritional security among smallholder farmers of Siaya County in Kenya. The study aimed at examining the role of agricultural extensions towards value addition of insects among smallholder farmers in the study area. In so doing, the study probed relevant questions to establish the role of agricultural extension in the promotion of insects for food, sought to identify factors determining adoption of insect farming and the role of agricultural extension in the value addition of insects among food and feed industry. The study adopted a descriptive survey design since it allows for collection of large amounts of data from the target population. Both primary and secondary data was collected from the respondents which included small holder farmers, extension service providers and stakeholders in the insect food farming and value addition sectors. A sample size of 210 respondents from a population of 443 were interviewed using questionnaires. Additional data was obtained from intermediary respondents through the use of interview guides.  Regression analysis was run to estimate the relationships between value addition as the dependent variable and mechanization of the insect farms, rearing methods, pest and disease management, breeding technologies, marketing, consumption and other forms of utilization, credit acquisition and management and finally climate change and its effects. The general outcome of the analysis indicated that extension service provision had influence on production, rate of adoption and value addition of insects among small holder farmers. The study has generated crucial knowledge to various stakeholders and players in the agricultural sector, key among them being Governments and Non-Governmental agencies promoting new technologies to enhance food and nutritional security. Keywords: contribution of agricultural extension, insect farming for food and feeds, small holder farmer, value addition, adoption, nutrition security DOI: 10.7176/DCS/13-1-04 Publication date: January 31st 202

Contribution of Agricultural Extension to Insect Farming for Food and Nutritional Security among Smallholder Farmers in the Kenyan Lake Victoria Basin

The study intended to investigate the contribution of agricultural extension on edible insect farming for food and feed nutritional security among smallholder farmers of Siaya County in Kenya. There was no explicit study on the contribution of agricultural extension on insect farming as evidenced by the existing literature. Specifically, the study aimed at determining the influence of agricultural extension on the production of insects as food and feeds among smallholder farmers in the study area. In so doing, the study probed relevant questions to establish the role of agricultural extension in the promotion of insects for food. The study adopted a descriptive survey design since it allows for collection of large amounts of data from the target population. Both primary and secondary data was collected from the respondents which included small holder farmers, extension service providers and stakeholders in the insect food farming and value addition sectors. A sample size of 210 respondents from a population of 443 were interviewed using questionnaires. The data collected was analysed quantitatively using standard statistical packages to extract various  pieces of information namely household characteristics, insect food and feed technology within households, status of food and nutritional security, status of livelihoods and challenges to improvement of food and feed nutritional security and general livelihoods. The general outcome of the analysis indicated that extension service provision had influence on the production of insects among small holder farmers. The study generated crucial knowledge to various stakeholders and players in the agricultural sector, key among them being Governments and Non-Governmental agencies promoting new technologies to enhance food and nutritional security. Keywords: contribution of agricultural extension, insect farming for food and feeds, small holder farmer, value addition, adoption, nutrition security DOI: 10.7176/DCS/13-1-03 Publication date: January 31st 202

Clinico-pathologic characteristics and treatment outcomes in children with neuroblastoma at the Kenyatta National Hospital, Nairobi.

Objective: To determine clinical-pathologic characteristics, treatment modalities and treatment outcomes of children diagnosed with neuroblastoma. Design: Cross- sectional descriptive study based on secondary data from patient records. Setting: Records department of Kenyatta National Hospital (KNH), a tertiary teaching and referral hospital based in Nairobi. Subjects: Children aged 15 years and below, admitted with the diagnosis of neuroblastoma, between January 1997 and December 2005. Main outcome measures: Presenting clinical features, diagnostic modalities including laboratory and imaging data, treatment modalities, response to treatment and patient survival. Results: Twenty six patients were eligible for the study; 13 males and 13 females giving a M: F ratio of 1: 1. The age range was 5 days to 12 years, with a median age of five years. Abdominal swelling (53.8%), inability to walk due to bone pains,(50%), and cranial or periorbital swelling, (38.5%) were the commonest presenting features. Diagnosis of neuroblastoma was based on tissue biopsy in 50% (95% CI40.6-79.8%) of the patients, and on fine needle aspiration cytology of mass or bone marrow in the rest. Bone marrow involvement was present in 16, (75%). Anaemia,was common with 72.7% patients having a haemoglobin (HB) \u3c8g/dl at presentation. Immunohistochemistry and cytological grading were done in two, (8%), patients. Urinary vanilly l mandelic acid (VMA), screening was positive in 50% (95% CI 29.9%-70.1%). The most frequently involved organs were abdomen (88.9%), and skeleton,(84.6%). Majority of patients, (92.3%), presented with advanced stage IV disease. Three patients died before commencement of treatment. All treated patients (100%), received cytotoxic therapy. Only two patients (8.6%) had surgery as part of treatment while one, (4.3%) was treated with radiotherapy. The initial treatment regimen was similar for all the patients. Although most patients had a complete initial response to treatment, early relapse, treatment failure, death or loss to follow up of patients with progressive disease were common. Overall survival (OS) at one year and two years were 19.2% (95% CI 6.6-39.4%) and 7.7% (95% CI 0.9%-25 1%) respectively. Only one patient was alive, (also free of disease), five years after diagnosis. Conclusion: Although other clinical- pathologic findings of the patients were similar to those reported elsewhere, virtually all study patients presented with advanced stage IV disease, which would be associated with poor prognosis irrespective of quality of care. Priority must therefore be on ensuring early diagnosis and referral of patients with neuroblastoma before any other interventions can be expected to positively impact on outcome. The limited role of surgery and radiotherapy observed over the study period may be attributed to late presentation of the patients. Pathologic evaluation of patients was inadequate, to some extent due to unavailability of facilities, but extra important information could have been availed at minimal extra cost. To be at par with current internationally accepted treatment approaches that have been associated with improved survival, there is need to base choice of regimens for individual patients on clinical and readily accessible pathologic markers

Influence of Different Spherical Binary Plasmonic NPs on HTM Layer in Methyl Ammonium Lead Triiodide Solar Cell

Methylammonium lead triiodide perovskite solar cells have attracted huge research interest. Its optoelectronic properties are competing with those of silicon wafers. It is a hybrid absorber with a direct band gap of about 1.53 eV with good light-absorption capability appropriate for optoelectronic applications. A typical perovskite solar cell HTML layer rarely incorporates ZnO or Cu2O or TiO2 nanoparticles to increase charge carrier transport. These ZnO, Cu2O, TiO2 nanoparticles can be introduced into the HTM layer to modify its PSCs efficiency and performance. These nanoparticles are direct band gap binary semiconductors with a wide band gap energy range of 2.17 eV to 3.37 eV respectively which can lead to higher transport mobility and enhanced HTM nanostructured layer. In this paper, two model solar cell having a ITO/TiO2/CH3NH3PbI3/P3HT/Ag and ITO/TiO2/Ag:CH3NH3PbI3/P3HT/Ag structures were proposed, geometrically modelled  and simulated using SCAPS-1D software. Their HTM layer (composed of P3HT) was doped with ZnO, Cu2O, and TiO2 nanoparticles respectively to determine their influence on PCEs of this solar cells. It was revealed that starting from undoped P3HT layer all through the Cu2O, ZnO to TIO2 doped layers, efficiency reduced from 13.123 % and 9.071% respectively; fill factor (FF) also reduced from 69.4% to 48.9 % for the doped CH3NH3PbI3 perovskite solar cell while efficiency of doped CH3NH3PbI3 perovskite solar cell reduced from 13.033 % and 9.091%, the fill factor (FF) also reduced from 66.4% to 52.9 % respectively. It was noted that the solar cell employing P3HT undoped layer had the best performance and concluded that introducing nanoparticles onto P3HT layer has a negative impact on the performance of CH3NH3PbI3 perovskite solar cell

Factors that Influence Citizen Participation in Devolved Funds in Uasin Gishu County, Kenya

The important role that devolved funds plays in Kenya’s development process is recognised. The overall image that emerges from the literature on devolved funds is on importance, absorptive capacities, and allocative rationale and governance issues surrounding the operations of the funds. However, conceptual awareness on the factors that influence citizen participation in devolved schemes is not known. The main objective of the study is to examine the factors that influence citizen participation in devolved funds in Uasin Gishu (UG) County, Kenya. Specifically, the study examined the socio-demographic characteristics, the social institutions, and the devolved funds design influence on citizen participation in the funds. It further sought to determine the proportion of households participating in the funds, draw lessons of experience on the funds, what does and does not work, where, why and under what conditions, and identify policy options and appropriate program designs to improve the funds. The study draws from institutional theory to analyse participation because institutions provide frames of meaning which guide human action. Building on the theory, the study developed a conceptual framework to describe concepts guiding the study. The framework explains graphically the main things studied and the presumed relationships among them. The study area is in Kenya, a country with devolved form of government. Fieldwork was located in UG County. Primary data was gathered through expert interviews with 32 funds officials and household survey with 530 respondents. Further data was obtained from secondary sources. Data from expert interviews was analysed using thematic analysis, survey data was analysed using Statistical Package for the Social Sciences (SPSS), while data from secondary sources was analysed by documentary review. Results indicate that community participation in the funds occur in the identification of projects, allocation of funds, operation of programmes, access to benefits, as well as the monitoring and evaluation of programmes. Socio-demographic factors including gender, age, education and residence; and social institutions including educational, religious, family, financial and media influence citizen participation in devolved funds. The devolved schemes are not necessarily pro-poor as is the intension. Further research is needed to delineate which kind of design and implementation characteristics could increase participation in the devolved fund