Bed net use and associated factors in a rice farming community in Central Kenya

<p>Abstract</p> <p>Background</p> <p>Use of insecticide-treated nets (ITNs) continues to offer potential strategy for malaria prevention in endemic areas. However their effectiveness, sustainability and massive scale up remain a factor of socio-economic and cultural variables of the local community which are indispensable during design and implementation stages.</p> <p>Methods</p> <p>An ethnographic household survey was conducted in four study villages which were purposefully selected to represent socio-economic and geographical diversity. In total, 400 households were randomly selected from the four study villages. Quantitative and qualitative information of the respondents were collected by use of semi-structured questionnaires and focus group discussions.</p> <p>Results</p> <p>Malaria was reported the most frequently occurring disease in the area (93%) and its aetiology was attributed to other non-biomedical causes like stagnant water (16%), and long rains (13%). Factors which significantly caused variation in bed net use were occupant relationship to household head (χ²= 105.705; df 14; P = 0.000), Age (χ²= 74.483; df 14; P = 0.000), village (χ²= 150.325; df 6; P = 0.000), occupation (χ²= 7.955; df 3; P = 0.047), gender (χ²= 4.254; df 1; P = 0.039) and education levels of the household head or spouse (χ²= 33.622; df 6; P = 0.000). The same variables determined access and conditions of bed nets at household level. Protection against mosquito bite (95%) was the main reason cited for using bed nets in most households while protection against malaria came second (54%). Colour, shape and affordability were some of the key potential factors which determined choice, use and acceptance of bed nets in the study area.</p> <p>Conclusion</p> <p>The study highlights potential social and economic variables important for effective and sustainable implementation of bed nets-related programmes in Sub-Saharan Africa.</p

Malaria vector control practices in an irrigated rice agro-ecosystem in central Kenya and implications for malaria control

<p>Abstract</p> <p>Background</p> <p>Malaria transmission in most agricultural ecosystems is complex and hence the need for developing a holistic malaria control strategy with adequate consideration of socio-economic factors driving transmission at community level. A cross-sectional household survey was conducted in an irrigated ecosystem with the aim of investigating vector control practices applied and factors affecting their application both at household and community level.</p> <p>Methods</p> <p>Four villages representing the socio-economic, demographic and geographical diversity within the study area were purposefully selected. A total of 400 households were randomly sampled from the four study villages. Both semi-structured questionnaires and focus group discussions were used to gather both qualitative and quantitative data.</p> <p>Results</p> <p>The results showed that malaria was perceived to be a major public health problem in the area and the role of the vector <it>Anopheles </it>mosquitoes in malaria transmission was generally recognized. More than 80% of respondents were aware of the major breeding sites of the vector. Reported personal protection methods applied to prevent mosquito bites included; use of treated bed nets (57%), untreated bed nets (35%), insecticide coils (21%), traditional methods such as burning of cow dung (8%), insecticide sprays (6%), and use of skin repellents (2%). However, 39% of respondents could not apply some of the known vector control methods due to unaffordability (50.5%), side effects (19.9%), perceived lack of effectiveness (16%), and lack of time to apply (2.6%). Lack of time was the main reason (56.3%) reported for non-application of environmental management practices, such as draining of stagnant water (77%) and clearing of vegetations along water canals (67%).</p> <p>Conclusion</p> <p>The study provides relevant information necessary for the management, prevention and control of malaria in irrigated agro-ecosystems, where vectors of malaria are abundant and disease transmission is stable.</p

Ecohealth Capacity Building Workshop, Nairobi, Kenya, November 26 - 30, 2007

The workshop explored how the Ecohealth framework plays out differently in different contexts. Included in Ecohealth is better understanding of gender and related social inequities, and as well, reducing inequity through this enhanced knowledge. Participants were able to recognize links between the project monitoring method of Outcome Mapping (OM), and Ecohealth approaches, and how they are mutually supportive. The workshop ended with an exploration around issues of knowledge translation and some successes participants have had. Annex 1 provides a table that organizes information regarding Integration of OM and Ecohealth

Mt. Elgon Regional Ecosystem Conservation Programme (MERECP) appraisal report

A consultancy team of four persons, contracted by Norad, made during April-May 2002 an external review of the programme proposal ”Mt. Elgon Regional Ecosystem Conservation Programme” (MERECP) prepared by IUCN-EARO. The proposal is partly based on two recent national projects dealing with the Mt. Elgon area in both countries. The MTTI/UWA in Uganda, and KWS/MENR, FD and Mt. Elgon County Council in Kenya will be the main responsible national institutions involved in the MERECP. EAC will constitute the regional umbrella for the programme. National and EAC commitment to the MERECP is outlined, and relevant legislation is discussed. Issues relating to the regional approach, with needs for harmonisation of policies, field activities, research and monitoring, are discussed. Coherence with Norwegian development policies is also outlined. The programme structure is explained, with Norad as external donor, a Programme Steering Committee led by EAC, a Programme Managemnt Unit, and with IUCN as technical facilitator and responsible for the financial flows. IUCN will subcontract institutions at various levels, including NGOs and CBOs, to perform programme activities. The MERECP will have an inception phase of about six months during which more detailed activity plans, budget outlines, recruitment of staff, purchase of equipment, and establishment of an agreed work plan will take place. The general outline of the programme, as well as the participatory process behind its development, is commended. However, the budget proposal has not been developed in the same participatory manner, and it is recommended to revise the budget outline. More resources should generally be spent on field activities, and less resources should be spent on general support to EAC, to IUCN, and to salaries for recruited staff. A major challenge will be to effectively harmonise the programme into a truly regional effort, and to avoid that the implementation phase will be split into a small regional component and two national components. It will also be a challenge to develop a regional integrated ecosystem management plan for Mt. Elgon. It is recommended that more focus is set on the knowledge gaps and the needs for more research activities in the MERECP, both in terms of collating what has already been done, and in terms of biodiversity monitoring, ecosystem functioning, and the various interactions between the forest ecosystem and the socio-economic and socio-cultural issues. Research needs might be discussed in a workshop where relevant stakeholders and institutions are invited. The complicated institutional set-up of the programme, as well as the significant differences between the two countries, are considered to be major risk factors for the success of the MERECP. The collaborative management component will be a particular challenge, as Kenya so far has no official provision for such schemes. Some appropriate indicators for assessing the success of the programme are given in the proposal, but a more complete set of such indicators remains to be developed. To foster a better sense of local responsibility and ownership to the programme, it is recommended that IUCN’s prominent role is gradually phased out, and given over to local bodies over the 4-5 years’ programme period. It is also recommended that the programme activities as far as possible are integrated into mainstream activities like district plans and DEAPs. The issue of corruption is identified as a major concern to the MERECP, and various ways to curb the problem are discussed. For example, funds will basically not pass through central government agencies under the programme, but through IUCN. The long term sustainability of MERECP will to a large extent be dependent on the ability to integrate programme activities into mainstream, national and regional activities, and the ability to find ways of future funding of successful activities. Increased revenue from tourism and from well managed forest plantations are particularly promising alternatives in this regard. It is important that local authorities are given better incentives than today, so that a major share of revenue accumulated locally also is retained locally. Human rights aspects, including resettlement issues; socio-cultural and gender aspects, and the HIV/AIDS problem are discussed in the programme context. It is probable that some of the projects being developed under the Nile Basin Initiative in the Mt. Elgon area will directly overlap with the MERECP. It is recommended that these efforts are co-ordinated through a continuous liaison system to avoid duplication of efforts. Also for other relevant donor-supported activities in the area it is important to develop effective collaborative routines

Ecohealth Capacity Building Workshop, Nairobi, Kenya, November 26 - 30, 2007

The workshop explored how the Ecohealth framework plays out differently in different contexts. Included in Ecohealth is better understanding of gender and related social inequities, and as well, reducing inequity through this enhanced knowledge. Participants were able to recognize links between the project monitoring method of Outcome Mapping (OM), and Ecohealth approaches, and how they are mutually supportive. The workshop ended with an exploration around issues of knowledge translation and some successes participants have had. Annex 1 provides a table that organizes information regarding Integration of OM and Ecohealth

Integrating malaria control interventions with development strategies in Kenya : final technical report

Findings show that the Mwea initiative (in Mwea Division, Kenya) is a true success story in the application of an ecosystem approach in controlling malaria, and improving human health in a rural area of eastern Africa. The report provides a summary of activities and outputs. The project focused on application of an ecosystem approach to malaria research and intervention in Mwea Division, Kenya. It was one of eight similar projects in Africa coordinated by the Centre of the Consultative Group on International Agricultural Research (CGIAR)-led Systemwide Initiative on Malaria and Agriculture (SIMA) between 2004 and 2006