Women, poverty and adverse maternal outcomes in Nairobi, Kenya

<p>Abstract</p> <p>Background</p> <p>The link between poverty and adverse maternal outcomes has been studied largely by means of quantitative data. We explore poor urban Kenyan women's views and lived experiences of the relationship between economic disadvantage and unpleasant maternal outcomes.</p> <p>Method</p> <p>Secondary analysis of focus group discussions and in-depth individual interviews data with women in two slums in Nairobi, Kenya.</p> <p>Results</p> <p>Urban poor women in Nairobi associate poverty with adverse maternal outcomes. However, their accounts and lived experiences of the impact of poverty on maternal outcomes underscore dynamics other than those typically stressed in the extant literature. To them, poverty primarily generates adverse maternal outcomes by exposing women to exceedingly hard and heavy workloads during pregnancy and the period surrounding it; to intimate partner violence; as well as to inhospitable and unpleasant treatment by service providers.</p> <p>Conclusions</p> <p>Poverty has wider and more intricate implications for maternal outcomes than are acknowledged in extant research. To deliver their expected impact, current efforts to promote better maternal outcomes must be guided by a more thorough perspective of the link between women's livelihoods and their health and wellbeing.</p

Beyond wifehood: Harnessing local gender ideologies to inform public health interventions in Africa

Public health discourse surrounding women in Africa has yet to benefit from longstanding, rigorous problematizations and theorizations of gender in African settings. In a word, the African woman, from the public health perspective, is still primarily a ‘wife’. Yet, targeting women solely as wives obscures the other important and varied positions which women in Africa occupy and limits the opportunities available for addressing their myriad health issues. We draw on data emerging from our years of ethnographic work among the Ubang community in Obudu, Cross River State, Southeast Nigeria, examining indigenous/local gender constructions and the attendant implications for women’s decision-making and action related to illness. We conclude by advancing a new public health approach to women in African contexts, and by demonstrating that in engaging with women exclusively as wives, public health interventions have unwittingly overlooked other critical entry points for improving the health status of women in Africa

Kenya country profile: A status check on unintended pregnancy in Kenya

Kenya’s mothers are dying at an alarming rate: a woman giving birth in Kenya has a 1 in 38 chance of dying due to inadequate reproductive health services. In response, in 2014 Kenya’s First Lady Margaret Kenyatta launched the Beyond Zero campaign to create awareness and raise funds to tackle maternal mortality and morbidity and improve child health. This brief offers six policy and programmatic recommendations to address significant sexual and reproductive health challenges highlighted throughout the report. These recommendations take into account the policy context in Kenya, which is evolving at a rapid rate in part because of the new devolution process, and increased interest and public debate surrounding maternal health and family planning. Though the Kenyan government has made key strides in improving reproductive health outcomes for its citizens, the recommendations outlined in the report would help the country move closer to achieving its reproductive health goals

Unintended pregnancy by the numbers: A look at Kenya

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources

Coping with unintended pregnancies: Narratives from adolescents in Nairobi\u27s slums

This qualitative study examined the challenges faced by adolescents in Kenya with regard to unintended pregnancies and how adolescents in urban slum settlements manage and cope with unintended pregnancies. The study’s findings suggest that high levels of unintended pregnancy among young people in Kenya’s urban slums are linked to myths and misconceptions about contraception. Other findings underscore the fact that many young people lack access to contraception and reproductive health services; indicate that unintended pregnancies are linked to sexual violence; and highlight the need for government to manage the high levels of school dropout as a result of an unintended pregnancy. The overall expectations were that the findings would inform the design of sexual and reproductive health intervention programs that respond to the unique needs of adolescent boys and girls living in resource-poor urban settings. The report outlines a number of programmatic implications to address the problem of reducing unintended pregnancies among young people in the urban slums of Nairobi

Invest in urban youth sexual and reproductive health to achieve a demographic dividend in Africa

The future of Africa depends on its ability to harness the potential of its young people. Making the right investments in youth—particularly those in urban areas—can enable the region to experience substantial economic growth and sustainable national development for current and future generations. This policy brief reports on a number of recommendations to help African governments and Ministries of Health and Education realize the demographic dividend; incorporate economic empowerment programs into urban programming and budget allocation; integrate training on the provision of quality and effective youth-friendly services for health workers; and revitalize school health programming

Improving family planning services in public health facilities to reach more women

Although Kenya has made significant progress in ensuring its citizens’ right to reproductive health, many Kenyans still lack access to or fail to use contraceptives, in part because of the lack of quality family planning (FP) services. Through the STEP UP research program, the African Population and Health Research Center developed a comprehensive country profile report that outlines the status, causes, and consequences of unintended pregnancy in Kenya. One of the most prominent findings was how important public health facilities are to reducing unmet need for FP. In order to solidify gains achieved and make further progress, concerted commitment from the Kenyan government and Ministry of Health to actively support FP services in public facilities is crucial. This policy brief makes a number of recommendations to help Kenya move forward

Capacity development for health research in Africa: experiences managing the African Doctoral Dissertation Research Fellowship Program

Africa's progress depends on her capacity to generate, adapt, and use scientific knowledge to meet regional health and development needs. Yet, Africa's higher education institutions that are mandated to foster this capacity lack adequate resources to generate and apply knowledge, raising the need for innovative approaches to enhance research capacity. In this paper, we describe a newly-developed program to support PhD research in health and population sciences at African universities, the African Doctoral Dissertation Research Fellowship (ADDRF) Program. We also share our experiences implementing the program. As health research capacity-strengthening in Africa continues to attract attention and as the need for such programs to be African-led is emphasized, our experiences in developing and implementing the ADDRF offer invaluable lessons to other institutions undertaking similar initiatives

Unintended pregnancies in Kenya: A country profile

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; and 3) traditional and non-hormonal methods of contraception. The report discusses the key challenges facing reproductive health with a special focus on unintended pregnancy in Kenya and ends with policy and programmatic implications

Building capacity for public and population health research in Africa : the consortium for advanced research training in Africa (CARTA) model

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region’s socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA’s program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTA’s focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative’s goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems