Public Theology in the face of pain and suffering: A proletarian perspective

A basic understanding of theology is the quest for knowledge of the Divine—the study of God. But why, one may ask, undertake such an endeavour, and to what end? My simple response would be, to know God is to enhance and enrich my life and service. To know God is to understand His creation – humanity and, the created context. I practice theology to learn more about God and His creation. In the process, that knowledge serves to improve my professional practice as a spiritual care provider in a public health institution. Thus, originates the burden of this task – the implication of doing theology in a public domain. My hope is to reflect on the implications of my professional practice as a spiritual care provider engaging in theological discourse in a public health institution. I’ll attempt a discussion of the implications of public theology in a specific context – public health institution, employing a specific approach. By its nature, public theology may serve as a medium through which all the other branches of theology interact with the other disciplines and seek to promote the idea of individuals living out their spiritual values and beliefs for the good of the general public. This can be applied in any field including, educational, social, health, political, and/or religious institutions, whether public or private. Public theology may vary depending on the context and practitioners at any given time and place, but have similar goals. Before getting to how I practice theology publicly, I’ll first discuss my understanding of the term public theology

Kung’s Theory of Paradigm Shifts in Church History: An Evaluation

The theory of paradigms is a broad subject that has been discussed extensively from various perspectives including science, religion and history. Its strengths and weaknesses have been aptly considered. This research article seeks to investigate the extent of the theory\u27s applicability to church history. The question that we wish to address is: To what extent, is this theory of paradigms applicable in explaining the changes that have taken place through the history of Christianity

Factors that Contributed to the Growth of the Kenya Assemblies of God Church: An Analysis of Multi-paradigms

Many churches in Africa lack recorded history for various reasons, such as scarcity of funds and/or scholars in the field of church history (cf. Kalu, 1993:166ff). This situation is more prevalent among the Pentecostal movements which, initially and for genuine reasons, were anti-intellectualist and emphasized ministry alone (Clark & Lederle et al, 1983:41; McNamee, 1974:27; and Hollenweger). Another possible explanation results from the fact that these churches are relatively young compared to their counterpart mainline churches. This lack of recorded history poses a hindrance to any efforts in evaluating the growth of such churches. There is an immediate need to understand the complex nature of the Pentecostal churches and how growth is motivated within their congregations. This is only possible if history is documented. Marwick (1989: 14) states that as memory is to the individual, so history is to the community or society. To fully appreciate history, it is necessary to have it recorded, not just for the present but also for future generations. A church may not be able to adequately evaluate its growth or understand itself without recorded history. This fact applies also to Assemblies of God Church (hereafter KAG) as one of the major Pentecostal movements in Kenya and other parts of the world (Anderson, 1992 & 1993; and Saayman, 1993). Recorded history is a treasure to any people, society or organisation (Brumback, 1977:iii). If history is not recorded within the life-span of pioneer members, it is likely that when the pioneers have departed, important information that makes the history complete, may die with them. The KAG church has over three decades worth of history and obviously, most of the pioneer members (both missionaries and nationals) are either gone or leaving the stage, one way or the other. As such, a reflection on its history is timely for the purpose of . evaluating both its growth and significance (cf. McIntire, 1984:40)

Kung’s Theory of Paradigm Shifts in Church History: An Evaluation

The theory of paradigms is a broad subject that has been discussed extensively from various perspectives including science, religion and history. Its strengths and weaknesses have been aptly considered. This research article seeks to investigate the extent of the theory\u27s applicability to church history. The question that we wish to address is: To what extent, is this theory of paradigms applicable in explaining the changes that have taken place through the history of Christianity

Design and implementation of a community-based mother-to-mother peer support programme for the follow-up of low birthweight infants in rural western Kenya

Background: Globally, low birthweight (LBW) infants ( Methods: Key informant interviews were conducted with 10 mothers of neonates (infants days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen completing all the visits over a 6-month period. A mixed methods approach was used to evaluate the implementation of the programme. Quantitative data of peer mother socio-demographic characteristics, recruitment, and retention was collected. Two post-training focus group discussions were conducted with the peer mothers to explore their experiences of the programme. Descriptive statistics were generated from the quantitative data and the qualitative data was analysed using a thematic framework. Results: The median age of the peer mothers was 26 years (range 21–43). From March-August 2019, each peer mother conducted a median of 28 visits (range 7–77) with fourteen (88%) completing all their assigned follow-up visits. Post training, our interviews suggest that peer mothers felt empowered to promote appropriate infant feeding practices. They gave multiple examples of improved health seeking behaviours as a result of the peer mother training programme. Conclusion: Our peer mother training programme equipped peer mothers with the knowledge and skills for the post-discharge follow-up of LBW infants in this rural community in Kenya. Community-based interventions for LBW infants, delivered by appropriately trained peer mothers, have the potential to address the current gaps in post-discharge care for these infants

Caregiver experiences and health care worker perspectives of accessing health care for low birth weight infants in rural Kenya.

BACKGROUND Low-birthweight (LBW) infants (<2500 g) are at greatest risk of mortality in the neonatal period, particularly in low- and middle-income countries. Timely access to quality healthcare averts adverse outcomes. AIM To explore caregiver experiences and healthcare provider perspectives of accessing healthcare for LBW infants in rural Kenya. METHODS This qualitative study was undertaken in Homa Bay County of in rural western Kenya in June 2019. In-depth interviews with eleven caregivers and four healthcare providers were conducted by a trained research assistant. All interviews were transcribed verbatim, and transcripts in the local languages were translated into English. A thematic framework was used to analyse the data. RESULTS At the community and individual level,community misconceptions about LBW infants, inadequate infant care practices after discharge, lack of maternal support networks, long distances from healthcare facilities and lack of financial support were key challenges. In addition, long hospital waiting times, healthcare worker strikes and the apparent inadequate knowledge and skills of healthcare providers were disincentives among caregivers. Among healthcare providers, health system deficiencies (staff shortages and inadequate resources for optimal assessment and treatment of LBW infants) and maternal illiteracy were key challenges. Education by staff during antenatal visits and community support groups were enablers. CONCLUSION Accessing healthcare for LBW infants in this community is fraught with challenges which have implications for their post-discharge outcome. There is an urgent need to develop and test strategies to address the barriers at the community and health system level to optimise outcome.

A qualitative study on the feasibility and acceptability of institutionalizing health technology assessment in Malawi

OBJECTIVE: The objective of this study was to assess the feasibility and acceptability of institutionalizing Health Technology Assessment (HTA) in Malawi. METHODS: This study employed a document review and qualitative research methods, to understand the status of HTA in Malawi. This was complemented by a review of the status and nature of HTA institutionalization in selected countries.Qualitative research employed a Focus Group Discussion (FGD ) with 7 participants, and Key Informant Interviews (KIIs) with12 informants selected based on their knowledge and expertise in policy processes related to HTA in Malawi.Data extracted from the literature was organized in Microsoft Excel, categorized according to thematic areas and analyzed using a literature review framework. Qualitative data from KIIs and the FGD was analyzed using a thematic content analysis approach. RESULTS: Some HTA processes exist and are executed through three structures namely: Ministry of Health Senior Management Team, Technical Working Groups, and Pharmacy and Medicines Regulatory Authority (PMRA) with varyingdegrees of effectiveness.The main limitations of current HTA mechanisms include limited evidence use, lack of a standardized framework for technology adoption, donor pressure, lack of resources for the HTA process and technology acquisition, laws and practices that undermine cost-effectiveness considerations. KII and FGD results showed overwhelming demand for strengthening HTA in Malawi, with a stronger preference for strengthening coordination and capacity of existing entities and structures. CONCLUSION: The study has shown that HTA institutionalization is acceptable and feasible in Malawi. However, the current committee based processes are suboptimal to improve efficiency due to lack of a structured framework. A structured HTA framework has the potential to improve processes in pharmaceuticals and medical technologies decision-making.In the short to medium term, HTA capacity building should focus on generating demand and increasing capacity in cost-effectiveness assessments. Country-specific assessments should precede HTA institutionalization as well as recommendations for new technology adoptions

Barriers and enablers of crop varietal replacement and adoption among smallholder farmers as influenced by gender: the case of sweetpotato in Katakwi district, Uganda

Sweetpotato is climate smart crop, grown with limited external inputs (fertilisers, pesticides, less labour) making it an attractive crop for resource-constrained smallholder farmers. It is also a major cash and food crop for many countries in sub-Saharan Africa. However, adoption of the high yielding and nutritious improved varieties has been disappointingly low. This study uses qualitative methods to explore the barriers and enablers of farmer varietal replacement and adoption. Unlike the extant quantitative studies that identify the determinants of adoption, we delve deeper into understanding the reasons for or against the preference for specific varieties. We used a rich set of information collected via focus group discussions which explore why farmers prefer certain varieties over others and how they perceive the new improved varieties from the national breeding programs. Doing so enabled us to unravel specific traits or trait combinations that farmers seek and identify those that they perceive needing improvement. We find that the most preferred traits were ‘yield’ and ‘good taste’. Implying that the neglect of sensory attributes by breeders contributes to the low adoption of improved sweetpotato varieties. Moreover, we find that altruism among the respondents plays an important role in farmer use of, and sharing of information about improved sweetpotato varieties. Women and men farmers obtained most of their information from neighbours, NGOs and radios. For women, the most important source of planting materials doubled as their most important source of information. Thus, concerted efforts to minimise information constraints are essential for unravelling the adoption puzzle

Design and implementation of a community-based mother-to-mother peer support programme for the follow-up of low birthweight infants in rural western Kenya

Background: Globally, low birthweight (LBW) infants (<2,500 g) have the highest risk of mortality during the first year of life. Those who survive often have adverse health outcomes. Post-discharge outcomes of LBW infants in impoverished communities in Africa are largely unknown. This paper describes the design and implementation of a mother-to-mother peer training and mentoring programme for the follow-up of LBW infants in rural Kenya. Methods: Key informant interviews were conducted with 10 mothers of neonates (infants <28 days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen completing all the visits over a 6-month period. A mixed methods approach was used to evaluate the implementation of the programme. Quantitative data of peer mother socio-demographic characteristics, recruitment, and retention was collected. Two post-training focus group discussions were conducted with the peer mothers to explore their experiences of the programme. Descriptive statistics were generated from the quantitative data and the qualitative data was analysed using a thematic framework. Results: The median age of the peer mothers was 26 years (range 21–43). From March-August 2019, each peer mother conducted a median of 28 visits (range 7–77) with fourteen (88%) completing all their assigned follow-up visits. Post training, our interviews suggest that peer mothers felt empowered to promote appropriate infant feeding practices. They gave multiple examples of improved health seeking behaviours as a result of the peer mother training programme. Conclusion: Our peer mother training programme equipped peer mothers with the knowledge and skills for the post-discharge follow-up of LBW infants in this rural community in Kenya. Community-based interventions for LBW infants, delivered by appropriately trained peer mothers, have the potential to address the current gaps in post-discharge care for these infants

Blood-stage malaria vaccine candidate RH5.1/Matrix-M in healthy Tanzanian adults and children; an open-label, non-randomised, first-in-human, single-centre, phase 1b trial

Background: A blood-stage Plasmodium falciparum malaria vaccine would provide a second line of defence to complement partially effective or waning immunity conferred by the approved pre-erythrocytic vaccines. RH5.1 is a soluble protein vaccine candidate for blood-stage P falciparum, formulated with Matrix-M adjuvant to assess safety and immunogenicity in a malaria-endemic adult and paediatric population for the first time. Methods: We did a non-randomised, phase 1b, single-centre, dose-escalation, age de-escalation, first-in-human trial of RH5.1/Matrix-M in Bagamoyo, Tanzania. We recruited healthy adults (aged 18–45 years) and children (aged 5–17 months) to receive the RH5.1/Matrix-M vaccine candidate in the following three-dose regimens: 10 μg RH5.1 at 0, 1, and 2 months (Adults 10M), and the higher dose of 50 μg RH5.1 at 0 and 1 month and 10 μg RH5.1 at 6 months (delayed-fractional third dose regimen; Adults DFx). Children received either 10 μg RH5.1 at 0, 1, and 2 months (Children 10M) or 10 μg RH5.1 at 0, 1, and 6 months (delayed third dose regimen; Children 10D), and were recruited in parallel, followed by children who received the dose-escalation regimen (Children DFx) and children with higher malaria pre-exposure who also received the dose-escalation regimen (High Children DFx). All RH5.1 doses were formulated with 50 μg Matrix-M adjuvant. Primary outcomes for vaccine safety were solicited and unsolicited adverse events after each vaccination, along with any serious adverse events during the study period. The secondary outcome measures for immunogenicity were the concentration and avidity of anti-RH5.1 serum IgG antibodies and their percentage growth inhibition activity (GIA) in vitro, as well as cellular immunogenicity to RH5.1. All participants receiving at least one dose of vaccine were included in the primary analyses. This trial is registered at ClinicalTrials.gov, NCT04318002, and is now complete. Findings: Between Jan 25, 2021, and April 15, 2021, we recruited 12 adults (six [50%] in the Adults 10M group and six [50%] in the Adults DFx group) and 48 children (12 each in the Children 10M, Children 10D, Children DFx, and High Children DFx groups). 57 (95%) of 60 participants completed the vaccination series and 55 (92%) completed 22 months of follow-up following the third vaccination. Vaccinations were well-tolerated across both age groups. There were five serious adverse events involving four child participants during the trial, none of which were deemed related to vaccination. RH5-specific T cell and serum IgG antibody responses were induced by vaccination and purified total IgG showed in vitro GIA against P falciparum. We found similar functional quality (ie, GIA per μg RH5-specific IgG) across all age groups and dosing regimens at 14 days after the final vaccination; the concentration of RH5.1-specific polyclonal IgG required to give 50% GIA was 14·3 μg/mL (95% CI 13·4–15·2). 11 children were vaccinated with the delayed third dose regimen and showed the highest median anti-RH5 serum IgG concentration 14 days following the third vaccination (723 μg/mL [IQR 511–1000]), resulting in all 11 who received the full series showing greater than 60% GIA following dilution of total IgG to 2·5 mg/mL (median 88% [IQR 81–94]). Interpretation: The RH5.1/Matrix-M vaccine candidate shows an acceptable safety and reactogenicity profile in both adults and 5–17-month-old children residing in a malaria-endemic area, with all children in the delayed third dose regimen reaching a level of GIA previously associated with protective outcome against blood-stage P falciparum challenge in non-human primates. These data support onward efficacy assessment of this vaccine candidate against clinical malaria in young African children. Funding: The European and Developing Countries Clinical Trials Partnership; the UK Medical Research Council; the UK Department for International Development; the National Institute for Health and Care Research Oxford Biomedical Research Centre; the Division of Intramural Research, National Institute of Allergy and Infectious Diseases; the US Agency for International Development; and the Wellcome Trust