Water, women and local social organization in the Western Kenya highlands

Safe water is widely recognized as both a fundamental human need and a key input into economic activity. Across the developing world, the typical approach to addressing these needs is to segregate supplies of water for domestic use from water for large-scale agricultural production. In that arrangement, the goal of domestic water supply is to provide small amounts of clean safe water for direct consumption, cleaning, bathing and sanitation, while the goal of agricultural water supply is to provide large amounts of lower quality water for irrigated agriculture. A new third use of water is now being given more attention by researchers: small amounts of water employed in selected household enterprises. This third use may be particularly important for women. There is a potential, therefore, that provision of modest amounts of water to smallholder farmers can enhance household economic production, save labor time for women and girls, and improve family health. This paper adds to the merger literature on the multiple values of improved water supplies – improved health, time savings, and small-scale production for individual farmers and collectives – for the case of a rural community in the western highlands of Kenya. With minimum external support, two groups in this community have managed to install and operate systems of spring protection and piped water to their members’ homesteads. A third group is in the process of replicating this success. The experience of this community also illustrates some of the challenges that must be faced for a community to effectively selforganize the investment and maintenance of a community-based water scheme. There are challenges of finance, gender relations, conflicts over scarce water supplies, group leadership, enforcement of community bi-laws, and policy. Data from a census of springs in the same area show that successful collective action for water management is unusual, but certainly not unique, in this region of Kenya. Although women emerge as the main beneficiaries of improved water management in the community, their substantial contributions are largely hidden behind social norms regarding gender roles and relations. Research methods need to carefully triangulate information sources in order to clarify the very substantial and active roles performed by women.Length: 21p.WomenGenderWater supplyWater rightsHealthCollective actionParticipatory management

The Pattern of Electoral Management Practices Towards Kenya’s 2007 Post-Election Violence in Uasin Gishu and Trans-Nzoia Counties

The study sought to investigate the pattern of electoral management practices towards Kenya’s 2007 Post-Election Violence (PEV) in Uasin Gishu and Trans-Nzoia counties. The many post election violence in Kenya over the years have had unique patterns. This have often found themselves in influencing electoral management practices. The pattern of electoral management practices towards Kenya’s 2007 post election violence however, seemed to have had a departure from the previous many other elections as to their visibility in different stages of election, intensity within the electoral management, and their nature being cyclical. This study used a survey and descriptive research design with mixed method approach. The researchers opted for both methods because each paradigm is appropriate for finding different outcomes. This study examined Pattern of Electoral Management Practices to 2007 Post-Election Violence and Trends of electoral management practices on election violence in Kenya. It is evident that ethnic animosities characterised post-election violence of 2007 and hence a component of the cause to patterns. This research recommends that for peaceful elections to be conducted, effective measures should be put in place to address ethnic animosities. Keywords: Pattern of Electoral Management/ Electoral Management/ Electoral Violence/ Electoral Management Practices/ Post Election Violence/ Kenya’s PEV DOI: 10.7176/JRDM/55-05 Publication date:May 31st 201

Utilization of PMTCT Services among HIV Positive Mothers Who Delivered At Home: A Case Of Turbo Health Centre, Eldoret North District, Kenya

Background: The transmission of the Human Immune Deficiency Virus (HIV) from mother to child during pregnancy, birth and breastfeeding period is the most common way of HIV infection in children. Prevention of Mother to Child Transmission (PMTCT) of HIV program is aimed at reducing the Mother to Child Transmission of HIV. The study aimed at exploring and describing factors which affect compliance to the utilization of PMTCT service package among HIV positive mothers who delivered outside a health facility. Methods: The study adopted a descriptive qualitative study design and entailed in-depth interviews with the HIV positive postnatal mothers attending the maternal child health and family planning clinic (MCH/FP) at Turbo Health Centre as key informants.  The interviews were taped with a voice recorder, transcribed and analysed using NVivo computer software for qualitative research to document emerging themes. Results: Four themes emerged from the results as follows 1) Knowledge of PMTCT services 2) Utilization of PMTCT services 3) Patient Factors that hinder compliance to PMTCT program and 4) Health centre related factors that hinder compliance to PMTCT program. Mothers did not take up the option to deliver at the health due to abrupt onset of labour, lack of transport and fees to pay for the delivery services at the health centre. Also, health related factors such as lack of incentives, staff attitude and lack of consistent information contributed to the mothers delivering at home. Conclusion: It was apparent that the HIV + mothers were recruited in the PMTCT program, and appropriate follow-up made to ensure that they remain on course and comply fully with the PMTCT program. Home delivery was the missing link towards full compliance to PMTCT program

Analysis of effective resistance calculation methods and their effect on modelling evapotranspiration in two different patches of vegetation in semi-arid SE Spain

International audienceEffective parameters are of major importance in modelling surface fluxes at different scales of spatial heterogeneity. Different ways to obtain these effective parameters for their use in meso-scale and GCM models have been studied. This paper deals with patch-scale heterogeneity, where effective resistances were calculated in two patches with different vegetation (Retama sphaerocarpa (L.) Boiss shrubs, and herbaceous plants) using different methods: aggregating soil and plant resistances in parallel, in series or by an average of both. Effective aerodynamic resistance was also calculated directly from patch fluxes. To assess the validity of the different methods used, the Penman-Monteith equation was used with effective resistances to estimate the total ?E for each patch. The ?E estimates found for each patch were compared to Eddy Covariance system measurements. Results showed that for effective surface resistances, parallel aggregation of soil and plant resistances led to ?E estimates closer to the measured ?E in both patches (differences of around 10%). Results for effective aerodynamic resistances differed depending on the patch considered and the method used to calculate them. The use of effective aerodynamic resistances calculated from fluxes provided less accurate estimates of ?E compared to the measured values, than the use of effective aerodynamic resistances aggregated from soil and plant resistances. The results reported in this paper show that the best way of aggregating soil and plant resistances depends on the type of resistance, and the type of vegetation in the patch

Stakeholders perception of HIV sero-discordant couples in western Kenya

Objective: To describe the perceptions of key stakeholders regarding the counselling needs of HI V sero-discordant couples as part of preparation for a clinical trial involving HIV sero-discordant couples. Design: Qualitative study using key informant and couple interviews. Setting: Moi Teaching and Referral Hospital (MTRH). Subjects: A purposive sample of nine key informants and 31 couple interviews totaling 71 participants. The couple interviews consisted of HI V untested, HI V concordant (positive and negative) and discordant couples. Results: Seventy one individuals participated in nine key informant and 31 couple interviews. The responses identified the following as key issues in counselling HIV discordant couples: The need for education on the meaning of HI V sero-discordancy including potential sources of infection; assistance in disclosing HIV test results to one\'s partner; discussion of the stigma surrounding formula feeding. Overall, the participants supported safer sexual practices in discordant partnerships. Conclusions: Psychosocial support of HI V sero-discordant couples should include messages about the meaning, mechanisms and implications of sero-discordancy. Culturally appropriate HI Vdisclosure and safer sex messages are also needed to support these partnerships. East African Medical Journal Vol. 85 (7) 2008: pp. 326-33

Determinants In HIV Counselling And Testing In Couples In North Rift Kenya

Background: Voluntary HIV counselling and testing (VCT) has been shown to be an acceptable and effective tool in the fight against HIV/AIDS. Couple HIV Counselling and Testing (CHCT) however, is a relatively new concept whose acceptance and efficacy is yet to be determined.Objective: To describe factors that motivate couples to attend VCT as a couple. Design: A cross sectional qualitative study.Setting: Moi Teaching and Referral Hospital and Moi University, School of Medicine, Eldoret, KenyaSubjects: Seventy one individuals were interviewed during KII (9) and dyad interviews (31 couples). Ten FGDs involving a total of 109 individuals were held. Results: Cultural practices, lack of CHCT awareness, stigma and fear of results deter CHCT utilisation. Location of centre where it is unlikely to be associated with HIV testing, qualified professional staff and minimal waiting times would enhance CHCT utilisation.Conclusions: CHCT as a tool in the fight against HIV/AIDS in this region of Kenya is feasible as the factors that would deter couples are not insurmountable

Evaluation of a measles vaccine campaign by oral-fluid surveys in a rural Kenyan district: interpretation of antibody prevalence data using mixture models

We evaluated the effectiveness of a measles vaccine campaign in rural Kenya, based on oral-fluid surveys and mixture-modelling analysis. Specimens were collected from 886 children aged 9 months to 14 years pre-campaign and from a comparison sample of 598 children aged 6 months post-campaign. Quantitative measles-specific antibody data were obtained by commercial kit. The estimated proportions of measles-specific antibody negative in children aged 0–4, 5–9 and 10–14 years were 51%, 42% and 27%, respectively, pre- campaign and 18%, 14% and 6%, respectively, post-campaign. We estimate a reduction in the proportion susceptible of 65–78%, with ~85% of the population recorded to have received vaccine. The proportion of ‘weak’ positive individuals rose from 35% pre-campaign to 54% post-campaign. Our results confirm the effectiveness of the campaign in reducing susceptibility to measles and demonstrate the potential of oral-fluid studies to monitor the impact of measles vaccination campaigns

Analysis of effective resistance calculation methods and their effect on modelling evapotranspiration in two different patches of vegetation in semi-arid SE Spain

Effective parameters are of major importance in modelling surface fluxes at different scales of spatial heterogeneity. Different ways to obtain these effective parameters for their use in meso-scale and GCM models have been studied. This paper deals with patch-scale heterogeneity, where effective resistances were calculated in two patches with different vegetation (Retama sphaerocarpa (L.) Boiss shrubs, and herbaceous plants) using different methods: aggregating soil and plant resistances in parallel, in series or by an average of both. Effective aerodynamic resistance was also calculated directly from patch fluxes. To assess the validity of the different methods used, the Penman-Monteith equation was used with effective resistances to estimate the total λE for each patch. The λE estimates found for each patch were compared to Eddy Covariance system measurements. Results showed that for effective surface resistances, parallel aggregation of soil and plant resistances led to λE estimates closer to the measured λE in both patches (differences of around 10%). Results for effective aerodynamic resistances differed depending on the patch considered and the method used to calculate them. The use of effective aerodynamic resistances calculated from fluxes provided less accurate estimates of λE compared to the measured values, than the use of effective aerodynamic resistances aggregated from soil and plant resistances. The results reported in this paper show that the best way of aggregating soil and plant resistances depends on the type of resistance, and the type of vegetation in the patch.This work received financial support from several different research projects: the PROBASE (ref.: CGL2006-11619/HID) and CANOA (ref.: CGL2004-04919-C02-01/HID) projects funded by the Spanish Ministry of Education and Science; and the BACAEMA (“Balance de carbono y de agua en ecosistemas de matorral mediterráneo en Andalucía: Efecto del cambio climático”, RNM-332) and CAMBIO (“Efectos del cambio global sobre la biodiversidad y el funcionamiento ecosistémico mediante la identificación de áreas sensibles y de referencia en el SE ibérico”, RNM 1280) projects funded by the regional government Junta de Andalucía. The first author enjoyed a pre-doctoral grant from the Spanish Ministry of Science and Technology

Home-based HIV counselling and testing in Western Kenya

Background Objective: To describe our experience with the feasibility and acceptance of home-based HIV counselling and testing (HBCT) in two large, rural, administrative divisions of western Kenya.Design: Setting: Results: Conclusion : Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa. More research is needed to describe the cost-effectiveness and clinical impact of this approach. There were 47,066 households approached in 294 villages: 97% of households allowed entry. Of the 138,026 individuals captured, 101,167 individuals were eligible for testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of HIV in these communities was 3.0%: 2.7% in adults and 3.7% among children. Prevalence was highest in the 36-45 year age group and was almost always higher among women and girls. All persons testing HIV-positive were referred to Academic Model Providing Access to Healthcare (AMPATH) for further assessment and care; all consenting persons were counselled on HIV risk-lowering behaviours.Kosirai and Turbo Divisions, Rift Valley Province, Kenya.The USAID-AMPATH Partnership conducted  population-based, house-to-house HIV counselling and testing in western Kenya between June 2007 and June 2009. All individuals aged ≥13 years and all eligible children were offered HBCT. Children were eligible if they were above 13 years of age, and their mother was either HIVpositive or had unknown HIV serostatus, or if their mother was deceased or whose vital status was unknown.: The World Health Organisation (WHO) estimates that only 12% of men and 10% of women in sub-Saharan Africa have been tested for HIV and know their test results. Home-based counselling and testing (HBCT) offers a novel approach to complement facility-based provider initiated testing and counselling (PITC) and voluntary counselling and testing (VCT) and could greatly increase HIV prevention opportunities. However, there is almost no evidence that large-scale, door-to-door testing is even feasible in settings with both limited resources and significant stigma around HIV and AIDS