Many cultures regard the issue of food and feeding the family as the role of the woman. Women are expected […]
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We live in an urban century. Already more than 50% of the global population lives in urban areas. […]
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Non-communicable diseases are often described as lifestyle diseases because they are associated with the excesses of an ageing or privileged population. […]
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Non-communicable diseases (NCDs) were once described as lifestyle diseases: the problems of an aging or privileged population arising from excess. […]
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The main cardio-metabolic diseases – mostly cardiovascular diseases such as stroke and ischemic heart disease share common clinical markers such as raised […]
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Introduction:
The main cardio-metabolic diseases – mostly cardiovascular diseases such as stroke and ischemic heart disease – share common clinical markers such as raised blood pressure and blood glucose. The pathways of development of many of these conditions are also interlinked. In this regard, a higher level of co-occurrence of the main cardio-metabolic disease markers is expected. Evidence about the patterns of occurrence of cardio-metabolic markers and their interlinkage in the sub-Saharan African setting is inadequate.
Objective:
The goal of the study was to describe the interlinkage among common cardio-metabolic disease markers in an African setting.
Design:
We used data collected in a cross-sectional study from 5,190 study participants as part of cardiovascular disease risk assessment in the urban slums of Nairobi, Kenya. Five commonly used clinical markers of cardio-metabolic conditions were considered in this analysis. These markers were waist circumference, blood pressure, random blood glucose, total blood cholesterol, and triglyceride levels. Patterns of these markers were described using means, standard deviations, and proportions. The associations between the markers were determined using odds ratios.
Results:
The weighted prevalence of central obesity, hypertension, hyperglycemia, hypercholesterolemia, and hypertriglyceridemia were 12.3%, 7.0%, 2.5%, 10.3%, and 17.3%, respectively. Women had a higher prevalence of central obesity and hypercholesterolemia as compared to men. Blood glucose was strongly associated with central obesity, blood pressure, and triglyceride levels, whereas the association between blood glucose and total blood cholesterol was not statistically significant.
Conclusions:
This study shows that most of the common cardio-metabolic markers are interlinked, suggesting a higher probability of comorbidity due to cardio-metabolic conditions and thus the need for integrated approaches.
Keywords:
interlinkage; cardio-metabolic markers; urban; sub-Saharan Africa […]
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Nearly half a million induced abortions occurred in Kenya in 2012, according to a nationally representative study by the African Population and Health Research Center (APHRC). Women younger than 25 years constituted almost half of patients (49%) treated for severe complications of induced abortion in that year. More than a quarter of these young women (26%) received poor quality post-abortion care treatment (such as dilation and curettage and digital [bare finger] evacuation). Worse, 30% of those receiving post-abortion treatment did not receive contraceptives upon discharge.
The quality of post-abortion care (PAC) services for young people is compromised for a number of reasons, including barriers faced by health care providers themselves. This brief highlights findings of a study on the barriers faced by health providers in Kenya’s public and private health facilities in delivering PAC services to adolescents and young women. The study, conducted in 2014, relied on in-depth individual and focus group interviews with PAC providers. It is hoped that the research and recommendations will guide investment in better quality sexual and reproductive health services for young people. […]
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There are different types and levels of policies addressing solid waste management in Kenya. These include sector-specific, general, stand-alone and […]
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Since independence, there have been various policy frameworks developed to guide the management of solid wastes in Kenya. Analysis of the progressive development of the policy landscape would be useful to inform the implementation of existing policies and the formulation of future policies relevant to solid waste management in the country.
Objectives:
To explore the evolution of solid waste management policies in Kenya from the perspective of policy priorities and strategies for solid waste management that address health outcomes.
Methods:
This study was an integrative synthesis of the policy priorities and strategies stipulated by the major solid waste management policies in Kenya since independence and how they address SWM associated health outcomes. The synthesis addressed the evolvement, devolvement and segmentation of solid waste management policies as well as the institutional mechanisms for policy processes and external policies shaping the policy landscape.
Results:
Analysis of the progressive development of policy architecture indicated that solid waste management policies in Kenya has evolved to specificity in terms of focus, functions and scope. There is a magnificent shift from focusing criminalizing offences to promoting good practices; from generic Acts to specific ones; and from centralized mandates to more decentralized responsibilities. The roles of local level implementation mechanisms is also increasing. However, the environment perspective is more emphasized than the health and economic perspectives of solid waste management principles.
Conclusion:
Despite the progressive and chronological development of solid waste management policy priorities and strategies, their focus on environment dominates over health outcomes. […]
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This report presents the findings of the Kenya STEPwise survey for non communicable diseases (NCD) risk factors 2015. The Kenya STEPs survey is the first nationally representative survey to collect comprehensive information on risk factors for NCDs and Injuries.
The aim of this survey is to establish an NCD surveillance platform that collects baseline indicators on determinants of NCD and their risk factors for policy and planning purposes. […]
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The study examines the combined effects of key elements in parental leadership on academic performance. In the wake of inadequate learning resources, parental leadership becomes an indispensable learning input for children’s academic performance. The discourse utilized data collected from 2005 to 2010 in a longitudinal study involving 1,549 children who sat for the national standardized examination in Kenya. Our findings showed that monitoring and aspirations are essential elements of parental leadership and have direct and positive effect on children’s learning achievement. The effects were stronger among children from urban informal settlements compared with those from urban formal settlements. The effect of parental aspiration on children’s performance was mediated through parental support and monitoring in informal settlements. The study provides evidence on the extent to which parental leadership enhances academic performance. This is useful to parents, teachers, and policy makers in their efforts to secure effective mechanisms for improving learning outcomes. […]
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International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. […]
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With support from the David and Lucile Packard Foundation, the ‘Reversing the Stall in Fertility Decline in Western Kenya’ project was launched in 2009 to counter stagnating and deteriorating reproductive health indicators in western Kenya.
Implemented by a consortium of partners, this six-year initiative, also known as the Packard Western Kenya (PWK) project, aimed to strengthen the supply of and generate demand for family planning services – and ultimately reduce unmet need for contraception and fertility rates – with a focus on long-acting and permanent methods (LAPM) and sustainability.
This brief summarizes key findings from a mixed-methods evaluation of the PWK project. […]
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Ambient air pollution is a growing global health concern tightly connected to the rapid global urbanization. Health impacts from outdoor air pollution exposure amounts to high burdens of deaths and disease worldwide. However, the lack of systematic collection of air pollution and health data in many low-and middle-income countries remains a challenge for epidemiological studies in the local environment. This study aimed to provide a description of the particulate matter (PM2.5) concentration in the poorest urban residential areas of Nairobi, Kenya. […]
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The standard for population-based surveillance of dietary sodium intake is 24-hour urine testing; however, this may be affected by incomplete urine collection. The impact of different indirect methods of assessing completeness of collection on estimated sodium ingestion has not been established.
The authors enlisted 507 participants from an existing community study in 2009 to collect 24-hour urine samples. Several methods of assessing completeness of urine collection were tested.
Until an accurate method of indirectly assessing completeness of urine collection is identified, the gold standard of administering para-aminobenzoic acid is recommended. Efforts to ensure participants collect complete urine samples are also warranted. […]
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Understanding women’s contraceptive method choices is key to enhancing family planning services provision and programming. Currently however, very little research has addressed inter and intra-regional disparities in women’s contraceptive method choice. Using data from slum and non-slum contexts in Nairobi, Kenya, the current study investigates the prevalence of and factors associated with contraceptive method choice among women. […]
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Poverty and food insecurity continue to feature prominently in the global agenda, with particularly close attention being paid to the determinants of food insecurity. However, the effect of education is mixed and remains understudied in low income countries. Using longitudinal data collected between 2007 and 2012 in Kenya, we investigated the effect of household education attainment on food security among poor urban households. Household food security was constructed from a set of four key items while education was the average years of schooling for individuals aged 18 years and above in a household. To determine the association between education attainment and food security, we fitted a random effects generalised ordered probit model. The prevalence of severe food insecurity ranged from 49 % in 2008 to 35 % in 2012.
The ordered probit results showed a significant effect of education on food security. The probability of being food insecure decreased by 0.019 for a unit increase in the average years of schooling for a given household. The effect of education, remained significant even after controlling for household wealth index, a more proximate determinant of food security in a cash-based economy such as the urban slums. The findings highlight the need to focus on the food security status of the urban poor. Specifically, results suggest the need for programs aimed at reducing food insecurity among the urban poor and enhancing household livelihoods. In addition, investment in the education of the slum households may, in the long term, contribute to reduction in the prevalence of food insecurity. […]
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Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost.
Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems. As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs. […]
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Many interventions have been implemented to improve maternal health outcomes in sub-Saharan Africa (SSA). Currently, however, systematic information on the effectiveness of these interventions remains scarce. We conducted a systematic review of published evidence on non-drug interventions that reported effectiveness in improving outcomes and quality of care in maternal health in SSA. […]
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Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development.
We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study. […]
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In the first paper in this series we assessed theoretical and empirical evidence and concluded that the health of people living in slums is a function not only of poverty but of intimately shared physical and social environments. In this paper we extend the theory of so-called neighbourhood effects.
Slums offer high returns on investment because beneficial effects are shared across many people in densely populated neighbourhoods. Neighbourhood effects also help explain how and why the benefits of interventions vary between slum and non-slum spaces and between slums. We build on this spatial concept of slums to argue that, in all low-income and-middle-income countries, census tracts should henceforth be designated slum or non-slum both to inform local policy and as the basis for research surveys that build on censuses. We argue that slum health should be promoted as a topic of enquiry alongside poverty and health.
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Non-communicable diseases (NCDs) are emerging as a public health issue in sub-Saharan Africa. This paper examines the relationship between the risk of NCDs and perceptions about such risk among urban slum populations in Nairobi, Kenya. The analysis is based on data collected between 2008 and 2009 as part of a cross-sectional survey that was designed to assess linkages between socioeconomic status, perceived personal risk, and risk factors of cardiovascular and non-communicable diseases in urban slums of Nairobi.
A total 5,190 study participants were included in the analysis. Low risk perception about NCDs in spite of the presence of NCD risk factors suggests the need for programmes aimed at creating awareness about the diseases and promoting the adoption of preventive healthy lifestyles among the urban poor populations of Nairobi. […]
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This paper assess the association between dietary diversity (DD) score, socioeconomic status (SES) and maternal body mass index (BMI) and the variation of the effects of DD and SES at different points of the conditional distribution of the BMI. […]
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