Missing from the huge literature on women’s attitudes and beliefs concerning specific contraceptive methods is any detailed quantitative documentation for all major methods in low- and middle-income countries. The objectives are to provide such a documentation for women living in Matlab (rural Bangladesh), Nairobi slums and Homa Bay (rural Kenya) and to compare the opinions and beliefs of current, past and never users towards the three most commonly used methods (oral contraceptives, injectables and implants). […]
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In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. […]
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The health and development potential of young children is dependent on nurturing care (NC) provided by primary caregivers. NC encompasses attention to nutrition; symptom management; early learning, attachment, and socialization; and security and safety. Despite the importance of NC to child health and development, the measurement and study of NC are neglected. This has become a point of major concern in the public health field in low‐ and middle‐income countries (LMICs) such as Colombia where many families are hard pressed for childcare resources. […]
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The 2005 expansion of the Ethiopian abortion law provided minors access to legal abortions, yet little is known about abortion among adolescents. This paper estimates the incidence of legal and clandestine abortions and the severity of abortion-related complications among adolescent and non-adolescent women in Ethiopia in 2014. […]
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In developing countries, maternal and child mortality continues to be a major health problem. According to the recent estimate by the Maternal Mortality Estimation Inter-Agency Group (MMEIG), an estimated 303,000 maternal deaths occurred in 2015 globally (WHO 2015b). This was a 43% change from the 1990 level, but yet 99% of the deaths occurred in low and middle-income developing countries (WHO 2010, 2015b). Sub-Saharan Africa accounted for 66% (201,000) of the deaths and had the highest Maternal Mortality Ratio (MMR) at 546 maternal deaths per 100,000 live births (WHO 2015b). Ethiopia’s maternal mortality was 676 per 100,000 live births according to the 2011 Ethiopian Demographic and Health Survey (EDHS) (Central Statistical Agency & ICF 2012) but estimated at 350 per 100,000 live births in the recent MMEIG estimate. […]
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Non-communicable diseases (NCDs) currently constitute a serious threat to health worldwide, with the situation expected to worsen if concerted actions are not urgently taken. The World Health Organisation (WHO) identified population-based interventions addressing four NCD risk factors – tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity; also known as “best buys” – and proposes the use of multi-sectoral approaches (MSA) to engage the public, private, and non-profit sectors to implement these best buys. The African Population and Health Research Centre (APHRC) led Cameroon and five other African countries in a study to analyse how countries are addressing NCD prevention in order to best facilitate MSA for NCD prevention in Africa.
The aims of this study were to:
1. Describe the development of policies in multiple sectors designed to address NCDs or best buys
2. Through key stakeholder interviews and field observations of policy implementation in Cameroon, describe the status of implementation of current policy and perspectives on how to best implement MSA for NCD prevention in Cameroon […]
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High incidence of HIV infection among adolescent girls and young women (AGYW) has been attributed to the numerous and often layered vulnerabilities that they encounter including violence against women, unfavourable power relations that are worsened by age-disparate sexual relations, and limited access to sexual and reproductive health information and services. For AGYW living in urban informal settlements (slums), these vulnerabilities are compounded by pervasive poverty, fragmented social networks, and limited access to social services including health and education. In this paper, we assess sexual risk behaviours and their correlates among AGYW in two slum settlements in Nairobi, Kenya, prior to the implementation of interventions under the Determined Resilient Empowered AIDS-free Mentored and Safe (DREAMS) Partnership. […]
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Understanding the link between HIV knowledge, risky sexual behaviors, and social intolerance such as stigma and discrimination is important for HIV prevention and treatment program planning. We investigated whether intolerant attitudes and practices among Ugandan adults were associated with HIV-transmission knowledge.
We analyzed data from a nationally representative population-based household survey, the 2011 Uganda AIDS Indicator Survey. A total of 15,526 participants who responded to questions on HIV knowledge, social intolerance and risky sexual behavior were included in this analysis. […]
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Globally, urbanisation is associated with the increased generation of solid waste. City authorities are struggling to provide adequate waste management services, especially in developing countries. In Kenya, approximately 50 per cent of solid waste generated daily in Nairobi is disposed of unsafely. Poor solid waste management (SWM) has negative health impacts, including the proliferation of infectious and non-communicable diseases. It also contributes to environmental degradation and greenhouse gas emissions. A research study carried out in Nairobi and Mombasa revealed high variability in SWM practices, from storage to collection, transport and disposal. Residents of both cities who participated in the study reported high levels of awareness about health risks associated with poor SWM, yet limited awareness of waste reduction, reuse and recycling. The findings set out policy implications for integrated SWM. […]
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Dakar can efficiently handle current and future volumes of solid waste if the following steps are taken: i) informal waste collection is synchronised with that of the municipal authorities; ii) environmental laws and regulations are enforced; iii) public awarenesss of proper solid waste management (SWM) practices is promoted; and iv) sustainable financing of the sector is assured. These steps are critical for informal settlements which are home to most of the urban population, yet are underserved by the municipal authorities. In addition, a reliance on open dumpsites continues to place public health at risk. This brief assesses current SWM practice and outlines stakeholder opinions on ways to improve SWM, both in the short and long term. The findings indicate inefficient SWM practices that put residents at risk, due to direct impacts and through secondary pathways, such as flooding. […]
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In the 2017 World Health Organization report, it was estimated that more than 2.5 billion adults globally had a high Body Mass Index (BMI >25 kg/m2); 1.9 billion were classified as overweight and 650 million as obese. Obesity has tripled over the last four decades with a faster increase in low- and middle income countries (LMICs) mainly attributed to a rapid urbanization. It is estimated that by 2025, three quarters of the obese population will live in non-industrialized countries. The rise in overweight and obesity is particularly worrying because of the associated health consequences such as cardiovascular diseases, diabetes, cancers and osteoarthritis. It is projected that by 2030, more than 50% of Africa’s population will be living in urban areas [4], with majority living in slums where access to social services including health is limited. An analysis of Demographic and Health Survey (DHS) data from seven countries in Sub-Saharan Africa (SSA) including Kenya showed that the prevalence of urban overweight and obesity increased by nearly 35% between 1992 and 2005. […]
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The objective of this paper is to examine the perceptions of community elders and parents on their roles regarding support to their children’s education. Data come from the qualitative component of a baseline survey conducted in Korogocho and Viwandani, two urban informal settlements in Nairobi, Kenya. Data were collected in April-May 2016 through in-depth interviews, key informant interviews and focus group discussions. Results demonstrated that community elders internalized their role as the face of government in their respective communities, and enforced the implementation of education policies on behalf of all children. The community leaders also saw as part of their role the need to encourage parents to be active participants in their children’s education. […]
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Attaining the first of the 90-90-90 global HIV targets requires focused testing approaches to reach people with undiagnosed HIV. In 2014, men took only 30% of all HIV tests in 122 LMICs. Typically, men receive care at later stages of disease and have been shown to experience nearly twice the mortality rate of women. Men are also more likely to delay, refuse or discontinue HIV treatment. Identifying more men at high-risk and providing them HIV testing is an important starting point for meeting targets. […]
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Introduction HIV testing services are an essential gateway to HIV prevention, care and treatment. In order to meet the Joint United Nations Program on HIV/AIDS 90-90-90 global targets by 2020, people with undiagnosed HIV need opportunities to test and learn their HIV status. However, 30% of people living with HIV in 2016 were unaware of their HIV status.
Study objective:
To quantify and compare reasons given for not testing for HIV among adult men and women in sub-Saharan Africa who have ever had sex and who had never previously tested for HIV. […]
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The objective of this study was to examine how young people in Nairobi, Kenya, are making sense of marriage, both in terms of their own lives and its social significance. In many sub-Saharan African communities, marriage has been a fundamental marker of the transition to adulthood. However, union formation is changing, particularly in urban areas—partnering is occurring later and non-marital cohabitation is increasingly common with the pathways to union formation differing by gender. Young people’s perspectives on marriage are valuable for a deeper understanding of these trends. A total of 74 in-depth interviews with youth living in the slums of Nairobi, Kenya, were qualitatively analyzed with particular attention to personal and normative understandings of marriage along with how they vary by gender. Read the article here […]
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The use of helplines to deliver sexual and reproductive health (SRH) education to girls seeking such information and services can break down barriers created by low access and top-down approaches. However, it is important to interrogate their effectiveness in addressing the SRH needs of girls, particularly in contexts in which hierarchical social relations prevail and conservative religious and cultural norms dictate appropriate expressions and experiences of sexuality for girls and young women. In this article I use data drawn from a qualitative case study of a children’s helpline in Kenya to interrogate the interplay of power and culture in the delivery of SRH information to girls. The findings reveal that while this particular communication technology presents, potentially, a revolution in such delivery, power dynamics and cultural norms still pose barriers. Read more here […]
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Non-communicable disease (NCD) are increasing in low and mid income countries (LMICs). The greatest burden of NCDs is from cardiovascular diseases, diabetes, cancers and chronic respiratory illnesses. These four diseases/ disease groups share a set of four risk factors: tobacco use, unhealthy diets, harmful alcohol consumption and physical inactivity. Developing NCD prevention policies that target the major risk factors is critical in LMICs that have weak health care systems and policies as well as inadequate resource capacity to implement existing health interventions. Following global commitments to address the increasing burden of NCDs, African countries have been developing policies and programs to address NCDs. […]
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Emerging evidence has shown a gradual increase in sexually transmitted infections among elderly. This study explores the views of elderly Yoruba men and women (60+) on condoms use and its suitability against sexual infections. The research design was a sequential exploratory mixed method that consisted of vignettes based focus group discussion and a structured questionnaire. Twelve vignettes based Focus Group Discussion and a survey of 252 elderly Yoruba people (aged 60+) were carried out. The findings revealed limited awareness and experience with condoms. Few of the male (20.4%) and 2.8% of the female respondents felt condom use can prevent sexually transmitted infections. A marginally proportion of the females (29.2%) than the males (25.0%) perceived condom as more useful for younger people. […]
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Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. In addition to low educational attainment and health risks – including early marriage, teenage pregnancy, early and unprotected sexual activity, non-consensual sex, and HIV/STIs – other factors that impact education and health outcomes include household poverty, lack of economic independence, limited income-earning opportunities, illiteracy, violence, and social isolation. Younger adolescent girls who live in environments laden with these vulnerabilities are at risk of experiencing negative outcomes such as school dropout, early sexual initiation, unintended pregnancy, early marriage, and sexual and gender-based violence. Therefore, it is critical to intervene before the myriad of challenges girls face result in outcomes that are irreversible or are costly to compensate for or reverse.
The Adolescent Girls Initiative–Kenya (AGI-K) delivered multi-sectoral interventions to over 6,000 girls ages 11–15 in two marginalized areas of Kenya: 1) the Kibera informal settlement in Nairobi and 2) Wajir County in Northeastern Kenya. Implemented by Plan International in Kibera and Save the Children in Wajir, these interventions were carried out for two years and comprised a combination of girl-level, household-level, and community-level interventions. […]
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Despite an extensive evidence base on contraceptive method choice, it remains uncertain which factors are most influential in predisposing women toward certain methods and against others. This paper addresses this gap in knowledge by making use of rarely-measured perceptions about specific methods, perceived social network experience of methods, and women’s own past experiences using specific methods. […]
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This fact sheet highlights evidence on contraceptive use among women in five selected countries in East Africa: Ethiopia, Kenya, Rwanda, Tanzania and Uganda. Data are drawn largely from Demographic and Health Surveys (DHSs) conducted between 1990 and 2016. […]
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In Kenya, overweight and obesity have increased by almost tenfold over the last six years (25% in 2008 to 33% in 2014) and are higher among urban dwellers compared to those in the rural areas. […]
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This study examines multidimensional social supports as predictors of health services utilization among community-dwelling older Ghanaians. Using data from a 2016/2017 Aging, Health, Psychological Wellbeing, and Health-Seeking Behavior Study, Poisson regression models estimated the associations of aspects of informal social support and health facility utilization among older people. […]
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Health literacy offers an opportunity to effectively direct health information and services to poor and marginalized groups. However, minimal attempts have been made to understand the state and determinants of health literacy, and its association with health-related behaviors among street-involved youth (SIY). This paper explores the status and sociodemographic correlates of functional health literacy (FHL) among SIY in Kumasi in Ghana. It also assesses the relationship between FHL, sociodemographic factors and two of the commonest health-related behaviours— alcohol use and smoking—among SIY. The study purposively sampled 337 SIY, aged 12 to 24 years, from five suburbs in the central business district of Kumasi Metropolitan Area in Ghana. The mean age of participants was 18 years (± 3.3). About 48%, 37% and 15% of them had inadequate, problematic and sufficient FHL respectively. Approximately 37% consumed alcohol and 14% smoked. Sex (female) and ethnicity (Ewe) were associated with inadequate FHL. Also, having some education and having been involved with the streets for three years or more were associated with inadequate FHL. Furthermore, being older, having some education, ethnicity, traditional religious affiliation, being male, having health insurance and inadequate FHL were associated with alcohol use. Smoking was associated with age (being older) and having been involved with the streets for three years or more. The paper argues that relevant health interventions must compensate for the heterogeneity of SIY as regards their FHL and sociodemographic characteristics to curb deleterious health behaviors. […]
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The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. […]
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