HIV and mobility in the Lake Victoria Basin agricultural sector: A literature review

The Lake Victoria region has the highest HIV prevalence in the East African Community, which comprises Kenya, Uganda, Tanzania, Rwanda, and Burundi. This region also has a significant concentration of commercial agricultural plantations, which rely on mobile workers, an extensive system of out-grower schemes, and linkages with neighboring communities and transportation routes. This paper reviews the relationships between the various components of the plantation system and the spread of HIV, which is a complex and dynamic process. There has been relatively little research on these dynamic interactions, and the relevant policies and programs are generally silent on mobility-induced vulnerability to HIV. As such, this review first examines how the conditions and structure of the migration process may increase HIV vulnerability for migrants, thereby illuminating key challenges. Second, the review considers what may be done to address these issues, particularly within the plantation system. A comprehensive response to HIV would require that the plantation companies engage in efforts against HIV/AIDS across its entire time line (that is, ranging from efforts to prevent infection to attempts to mitigate its full impact on both agricultural workers and the business as a whole). Despite the logic of this argument, we do not yet have strong financial evidence proving that companies should invest in a comprehensive strategy. This critical gap should be addressed. For example, pilot programs on select plantations could be used to show the cost-benefits of addressing HIV/AIDS through a well-designed set of interventions aimed at the different target groups.HIV/AIDS, Mobility, Migrant workers, Agricultural plantations,

A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation

The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues. This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme

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

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

Multisector intervention to accelerate reductions in child stunting: an observational study from 9 sub-Saharan African countries

Background: In sub-Saharan Africa, ;40% of children ,5 y old are stunted, with levels that have remained largely unchanged over the past 2 decades. Although the complex determinants of undernutrition are well recognized, few studies have evaluated strategies that combine nutrition-specific, health-based approaches with food system– and livelihood-based interventions. Objective: We examined changes in childhood stunting and its determinants after 3 y of exposure to an integrated, multisector intervention and compared these changes with national trends. Design: A prospective observational trial was conducted across rural sites in 9 sub-Saharan African countries with baseline levels of childhood stunting .20%. A stratified random sample of households and resident children ,2 y old from villages exposed to the program were enrolled in the study. Main outcome measures included principal determinants of undernutrition and childhood stunting, which was defined as a height-for-age z score less than 22. National trends in stunting were generated from demographic and health surveys. Results: Three years after the start of the program in 2005–2006, consistent improvements were observed in household food security and diet diversity, whereas coverage with child care and diseasecontrol interventions improved for most outcomes. The prevalence of stunting in children ,2 y old at year 3 of the program (2008–2009) was 43% lower (adjusted OR: 0.57; 95% CI: 0.38, 0.83) than at baseline. The average national stunting prevalence for the countries included in the study had remained largely unchanged over the past 2 decades. Conclusion: These findings provide encouraging evidence that a package of multisector interventions has the potential to produce reductions in childhood stunting. Am J Clin Nutr doi: 10. 3945/ajcn.111.020099