Probiotic Yoghourt for Health, Nutrition and Women\u27s Empowerment in Kenya: A Community-Based Approach

The dissertation aims to examine the impacts of probiotic yoghourt on health, nutrition and women’s empowerment within the context of HIV/AIDS in Kenya. Mixed methods that combine quantiative and qualitative approaches are used to understand the effects of probiotic yoghourt on the health, nutrition and quality of life for men and women. Results of the quantiative analysis (n=227) demonstrated that the probiotic yoghourt confers a variety of health benefits – physiological (fewer urogenital conditions and digestive problems; reduced dependence on medical treatment), and psychological (perceived improvements with bodily appearance, felt an increased meaningfulness with life). Results of the qualitative analysis (n=26) revealed an overall improved quality of life based on the six domains of the WHOQOL assessment tool. A supplemental qualtiative study and analysis that examines the ways in which this health and development initiative promotes empowerment, social and economic development revealed that while there are substantial and important direct and indirect benefits, there are challenges with group dynamics, class, and power structures. Theoretically, the study highlights the need to revisit the group approach of health and development projects. While this method undebiably empowers the women at the individual level within a number of domains, the group structure can be cosnidered to counteract some of the gains and positive effects. Methodologically, the research shows the value of employing a mixed methods design. Usually, biomedical research using clinical study designs do not adopt mixed methods to describe the experiences of the participants. Building on the survey findings, deeper and richer insights into the impacts of the probiotic yoghourt on the health and quality of life of participants is gained. Lastly, the findings from this research provides a platform for policy makers to re-examine the importance and need to incorporate nutritional support programmes that are holistic and mutli-faceted, targeting marginalized groups

Program planning and evaluation framework for a community based food project in Mwanza, Tanzania / by Ellena Andoniou.

The ravaging effects of the HIV/AIDS epidemic in Sub-Saharan Africa are well known. Countries in the region are facing a crisis of unprecedented proportions further compounded by poverty, malnutrition and social inequalities. This is especially true in Tanzania, one of the world’s poorest countries - where the majority of the population lives in absolute poverty; there is a disproportionately high level of food insecurity and poor nutritional standards are extensive. Initiated in 2003, The University of Western Ontario (UWO) in partnership with the National Institute for Medical Research (NIMR), the Kivulini Women’s Rights Organization (KWRO) and a local women’s group, the Tukwamuane, launched a probiotic food based community project in Mwanza, Tanzania - a high-need area as defined by the Canadian International Development Agency. The Western Heads East (WHE) probiotic yoghurt project is an international collaboration fostering community health and development. The project is a microenterprise initiative which aims to improve health and nutrition, while alleviating suffering from malnutrition, diarrhoeal diseases, and urogenital disorders in vulnerable social groups in the context of the HIV/AIDS epidemic. Women with little or no formal education are trained to produce probiotic yoghurt for sale and subsidized distribution to People Living with HIV/AIDS (PLWHAs) at the community level. The project has the potential to foster health improvement, as well as empowerment, advocacy skills among women and promote knowledge transfer to future generations. However, at the inception of WHE, the necessary steps to develop key planning and evaluation frameworks were not taken. As such, the purpose of this project is to prepare a program planning and evaluation framework which will enable project planners, stakeholders, and researchers to evaluate project outcomes, the health impacts and improvements in quality of life for the women making the yoghurt, their families and the broader community; as well as to explore women’s perceptions (if any) of empowerment, and how the project is enabling them to achieve their everyday life objectives

Probiotics in Tanzania: A review

The report is organized in five sections: Stakeholders, Context, Project, Outcomes, and Project Sustainability. The Stakeholders section provides background information on the Canadian and Tanzanian institutional partners and the expertise each brings to the Western Heads East project. The project participants, operating as a Community Based Organization under the name Tukwamuane, are also introduced in this section. For any development project or research programme to be successful it must be both context-specific and context-appropriate; therefore, in Context the project setting is documented. The impact of the AIDS epidemic on Tanzania and its citizens, the nutritional status of the population, social and economic realities, and the current level of gender equity are all explored in this section. The Project section begins with an explanation of probiotics and the role researchers believe beneficial bacteria can play in combating HIV and alleviating diarrhoea. There is a brief explanation of why, from among the many available media, yoghurt was chosen as the preferred delivery method for the probiotics. Rationale for the selection of the project planning and reporting framework and the selection of a gender analysis tool are given and, following this, the project document and the completed gender analysis are presented in their entirety. As Western Heads East organizers prepare to enter the research phase of the project, two preliminary studies were undertaken to measure results thus far. In Outcomes, the results of a Rapid Health Impact Assessment and an Economic Empowerment & Health case study, and a Community Readiness Assessment are presented. A key goal of the Western Heads East collaborators was to create a sustainable project, thereby ensuring that the health and nutritional benefits of probiotic yoghurt would continue to be available to Tanzanian citizens for years to come. To assess Project Sustainability, stakeholders were surveyed on the steps necessary to reach sustainability. This section of the report will be of interest to other groups interested in launching similar initiatives, allowing them to leverage WHE’s successes and avoid unnecessary pitfalls

The experiences and challenges of community health volunteers as agents for behaviour change programming in Africa: a scoping review

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a synthesis of key challenges and considerations that can inform efforts to reduce attrition and improve the sustainability of community health volunteers in Africa. This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist to achieve the objectives. A comprehensive search of six databases returned 2140 sources. After screening, 31 peer-reviewed studies were selected for final review. Analytical themes were generated based on the reviewers’ extraction of article data into descriptive themes using an inductive approach. In reviewing community health volunteers’ accounts of providing health services, five key challenges become apparent. These are: (1) challenges balancing work responsibilities with family obligations; (2) resource limitations; (3) exposure to stigma and harassment; (4) gendered benefits and risks; and (5) health-system level challenges. This scoping review highlights the extent of challenges community health volunteers must navigate to provide services in communities. Sustained commitment at the national and international level to understand the lived experiences of community health volunteers and mitigate common stressors these health actors face could improve their performance and inform future programs