Children’s Activities on Peace-building Processes in Post Conflict Kenya

This study sought to establish the role of children in peacebuilding in Post-conflict Kenya. The research explored children intercommunal peacebuilding activities in Kenya with special emphasis on the Abagusii and Maasai communities of southern Kenya. The research was informed by the New Sociology of Childhood by James and Prout’s (1997). The study adopted a mixed research approach with a multiple case study design. The research was carried out along the border of Transmara and Gucha/Kenyenya sub-counties of Narok and Gusii counties respectively. The Transmara and Gucha/ Kenyenya border was purposively selected based on the frequent intercommunal conflict between the Maasai and Abagusii communities in the area. Six public primary schools, three from Narok and three from Kisii counties, respectively, were purposively selected for the study because they were adversely affected by the conflict between the two communities. 435 Class Seven and Class Eight pupils from the six sampled schools were purposively sampled to take part in the study. Twenty three teachers, six head teachers and six key informants, four county education officers and two chiefs were also purposively selected to participate in the study. The tools of data collection included interviews, focus group discussions and observation for qualitative data while quantitative data were collected through semi-structured questionnaires. Secondary data were gathered through document analysis of Nation Newspaper articles and National Music and Drama Festival videos. The research findings demonstrated that Kenyan children engage in a range of peacebuilding activities within their local contexts and at the national level. The activities include, inter-communal games and sports, music and dance, poems and drama, debates,visiting each other’s homes,  sharing schools, taking part in inter-communal educational and environmental activities and inter-communal exchange programmes enhance inter-communal peace in Kenya. The study concluded that children have the potential to participate in peacebuilding processes in Kenya. The study recommends that government and other peace stakeholders, including local and international peace NGOs ought to come up with and fund more initiatives to enhance children participation in the country’s peacebuilding processes at local and national levels. Such initiatives should aim to scale up children voices and space from the confines of music and drama festivals to more strategic fora, such as children’s assembly, so as to inform policy. Keywords: Children,  Peace building Activities,Conflict and Peace Building DOI: 10.7176/DCS/9-8-06 Publication date: August 31st 201

Quality of post rape care given to sexually abused minors: A qualitative study of Homa Bay District Hospital, Homa Bay County in Western Kenya

ABSTRACT Despite high proportion of minors who have experienced sexual abuse in Kenya are presenting at health facilities for post rape care, literature shows post rape care health services are fragmented and health providers lack confidence in their skills. Thus, this study assesses the quality of post rape care among sexually abused minors in Homa Bay district of Western Kenya. The study examines the health facility s capacity to provide post rape care to sexually abused minors in addition to exploring the perceptions of health care providers on post rape care for survivors of sexual abuse. Accordingly, the study uses triangulation of different qualitative methods such as; review of health records, in-depth interviews as well as observations and case studies. Forty two medical records were reviewed and fifteen health providers and 2 adolescent girls who had been defiled were interviewed. The 2 girls were subsequently followed up as a case study. In addition, observation was used concurrently with the aforementioned data collection methods. The findings show that Homa Bay District Hospital receives an alarming number of sexually abused minors. Despite so, the quality of post rape care in the district hospital is hampered by a lack of medical supplies, drugs and stationery. The health providers had limited knowledge on post rape care and were not conversant with existing guidelines on management of sexual violence in Kenya. Moreover, the staff interviews demonstrated that some of the staff has negative attitudes toward sexually abused minors as well as certain aspects of post rape care. Therefore, the study recommends the development of post rape care delivery algorithms, equipping of the health facility with medical supplies, drugs, stationery and training of health providers on post rape care. In addition, the study proposes sensitization of the community on sexual and gender based violence and collaboration between relevant stakeholders involved in post rape care delivery

Health research systems in Somaliland: a qualitative study on perspectives of government and non-governmental staff

BackgroundGlobally, the importance of effective national health research systems has gained considerable attention. Literature indicates low research output in Africa; Africa accounts for only 2% of the world's research output and 1.3% of global publications. In Somaliland, where provision of quality healthcare services is crucial, understanding and enhancing the health research system is a critical endeavor.AimThe aim of this study is to explore the perspectives of government and non-governmental stakeholders on the health research systems in Somaliland.MethodThe study employed an exploratory qualitative study design that entailed in-depth interviews with participants. Thirty-four study participants were interviewed; they included key persons in the academic and health sector, government and international and local non-governmental organisations (NGOs) involved in health research systems. A semi structured interview guide was used to conduct the in-depth interviews with purposively selected participants. The collected data was analyzed thematically.FindingsWe found that there was no national health research center in Somaliland. The country also lacked a national health research policy. There was limited funding for research, funds were mostly from international organisations and researchers' own funds. In addition, staff working in research centers were ill equipped to conduct research and study participants highlighted the need for national health research governance.ConclusionThis study highlights the importance of health research systems in Somaliland. We recommend the establishment of a national health research institute, development of a national health research policy and priorities, allocation of sufficient and sustainable funding, capacity building of staff and strengthening of the national health research governance in health research systems

Missed treatment opportunities and barriers to comprehensive treatment for sexual violence survivors in Kenya: a mixed methods study

Background In Kenya, most sexual violence survivors either do not access healthcare, access healthcare late or do not complete treatment. To design interventions that ensure optimal healthcare for survivors, it is important to understand the characteristics of those who do and do not access healthcare. In this paper, we aim to: compare the characteristics of survivors who present for healthcare to those of survivors reporting violence on national surveys; understand the healthcare services provided to survivors; and, identify barriers to treatment. Methods A mixed methods approach was used. Hospital records for survivors from two referral hospitals were compared with national-level data from the Kenya Demographic and Health Survey 2014, and the Violence Against Children Survey 2010. Descriptive summaries were calculated and differences in characteristics of the survivors assessed using chi-square tests. Qualitative data from six in-depth interviews with healthcare providers were analysed thematically. Results Among the 543 hospital respondents, 93.2% were female; 69.5% single; 71.9% knew the perpetrator; and 69.2% were children below 18 years. Compared to respondents disclosing sexual violence in nationally representative datasets, those who presented at hospital were less likely to be partnered, male, or assaulted by an intimate partner. Data suggest missed opportunities for treatment among those who did present to hospital: HIV PEP and other STI prophylaxis was not given to 30 and 16% of survivors respectively; 43% of eligible women did not receive emergency contraceptive; and, laboratory results were missing in more than 40% of the records. Those aged 18 years or below and those assaulted by known perpetrators were more likely to miss being put on HIV PEP. Qualitative data highlighted challenges in accessing and providing healthcare that included stigma, lack of staff training, missing equipment and poor coordination of services. Conclusions Nationally, survivors at higher risk of not accessing healthcare include older survivors; partnered or ever partnered survivors; survivors experiencing sexual violence from intimate partners; children experiencing violence in schools; and men. Interventions at the community level should target survivors who are unlikely to access healthcare and address barriers to early access to care. Staff training and specific clinical guidelines/protocols for treating children are urgently needed

Supporting children and adolescents who have experienced sexual abuse to access services: community health workers’ experiences in Kenya

Child sexual abuse (CSA) is a global health problem with significant health consequences. The World Health Organization recommends immediate and long-term treatment for all survivors. However, in low- and middle-income countries, less than 10 % of sexually abused children seek health services. Community health workers (CHWs) can potentially increase uptake of services, but, the risks and benefits of services provided by CHWs are poorly understood. Methods: Through in-depth interviews, we examined the experiences of CHWs providing services to children in Kenya. Sixteen CHWs were purposively selected from two locations. Data were audio-recorded, transcribed verbatim and analysed thematically. Findings: Nearly all the CHWs reported assisting children who had experienced sexual abuse. Children were brought to their attention by caregivers, neighbours, teachers, local authorities or the police. CHWs roles included providing information and advice, assisting the child to report to the police, access healthcare or find shelter. Multiple challenges were reported including lack of support from formal institutions; community norms; safety concerns; inadequate resources and interference from family, perpetrators and local authorities. Lack of protocols and training on how to handle children was evident. Conclusions: CHWs are a crucial community-level resource for CSA survivors and their caregivers. However, community norms, lack of guidelines and training may compromise the quality of services provided. There is a significant gap in literature on service models for CHWs delivering CSA services. Data are lacking on what services CHWs can effectively offer, how they should be delivered and what factors may influence delivery, acceptance and uptake of services

Impact of the COVID-19 pandemic on intimate partner violence in Sudan, Malawi and Kenya

The COVID-19 infection control and prevention measures have contributed to the increase in incidence of intimate partner violence (IPV) and negatively impacted access to health and legal systems. The purpose of this commentary is to highlight the legal context in relation to IPV, and impact of COVID-19 on IPV survivors and IPV prevention and response services in Kenya, Malawi, and Sudan. Whereas Kenya and Malawi have ratified the Convention on Elimination of all forms of Discrimination against Women (CEDAW) and have laws against IPV, Sudan has yet to ratify the convention and lacks laws against IPV. Survivors of IPV in Kenya, Malawi and Sudan have limited access to quality health care, legal and psychosocial support services due to COVID-19 infection control and prevention measures. The existence of laws in Kenya and Malawi, which have culminated into establishment of IPV services, allows a sizable portion of the population to access IPV services in the pandemic period albeit sub-optimal. The lack of laws in Sudan means that IPV services are hardly available and as such, a minimal proportion of the population can access services. Civil society’s push in Kenya has led to prioritisation of IPV services. Thus, a vibrant civil society, committed governments and favourable IPV laws, can lead to better IPV services during the COVID-19 pandemic period

Sexualised violence against children: A review of laws and policies in Kenya

Child sexual abuse (CSA) is a major global health challenge. Extant literature shows that CSA is prevalent in Kenya. As a signatory of the United Nations Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the Child, the Kenyan government is mandated to ensure that children are protected from sexual abuse through sound laws and policies. This paper reviews existing laws and policies on CSA and highlights their strengths and weaknesses. Our findings indicate that laws on child protection exist and are protective to a large extent, as harsh penalties are outlined for sexual offences. Survivors of CSA are entitled to free legal and medical services. However, there are no reparations offered to survivors in criminal proceedings. Moreover, there is no legislation on age-appropriate comprehensive sexuality education which plays an important role in cultivating positive gender norms and describing what constitutes CSA and reporting procedures. The national standard operating procedures for the management of sexual violence against children lack CSA screening procedures. There is urgent need for review of these laws and policies and development of multisectoral protocols at the national and county level, that outline roles and responsibilities for various service providers, supervisory and accountability measures and referral networks

Postrape care services to minors in Kenya: are the services healing or hurting survivors?

Cynthia Khamala Wangamati,1 Viva Combs Thorsen,1 Abdi Ali Gele,2 Johanne Sundby1 1Department of Community Medicine, Faculty of Medicine, University of Oslo, 2Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway Abstract: Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment. Keywords: child sexual abuse, postrape care, rights, guidelines, sexual violenc

Postrape care services to minors in Kenya: are the services healing or hurting survivors?

Abstract: Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment