Vaccine Safety

Despite increasing awareness, mental health remains stigmatized, leading to discrimination, misunderstanding, and inadequate support. One of the greatest challenges in recent years has been gaining widespread recognition of mental health as a critical health issue. This global health crisis affects people of all ages, backgrounds, and socioeconomic statuses but often goes undiagnosed and untreated in many parts of the world. This has left many people suffering in silence, battling invisible wounds that have a significant impact on their lives. A few years ago, I had a deeply personal experience with mental health issues through a close friend who meant a great deal to me. During the COVID-19 pandemic and related lockdowns, we spent a good amount of time together, and our friendship grew even stronger. We had a great bond that others admired, filled with laughter, cookouts, shopping, and simply enjoying life. Everything felt normal for a while, but then small changes began to happen. He stopped coming to our morning workouts, which he enjoyed and had proposed we do together. At first, I didn’t think much of it since we still spent time on other routines. But as time passed, I began to notice significant changes that hinted something was not quite right. Being outspoken, I decided to talk to him about it and ask whether everything was all right. I even proposed taking a short vacation to get a change of scenery now that the lockdown had ended and traveling was easier. But every time I tried to ask how he was doing or what was the matter, he quickly shut me down and changed the subject. He became more sensitive, reacting strongly to situations that seemed minor to me. I remember he got extremely upset because I didn’t stand beside him while he cooked our special meal. He started shouting, asking why I couldn’t just stay by his side, which felt completely out of proportion to me. Small disagreements that we used to laugh off began turning into serious arguments, sometimes escalating far beyond what seemed necessary. I’ll never forget how angry he would get whenever his favorite football team lost, often directing his frustration at me as if I were somehow to blame. I was confused by his behavior but brushed it off as mood swings, convincing myself it was just a phase that would eventually pass. As time went by, my friend seemed to struggle even more. He withdrew more and more from the activities he once loved. He had previously committed to therapy, something he told me he started in his early 20s to deal with challenges from his childhood. But as his motivation went down, he began skipping sessions, and soon, he stopped going altogether. I even offered to accompany him to therapy, hoping it might encourage him, but he quickly dismissed the idea. His behavior became increasingly concerning. His eating habits also became erratic; some days he would overeat, while on others, he’d go a day or two without food. There were times he would lock himself in his room, surrounded by silence, skipping showers and daily routines. This was someone who had always taken pride in how he looked and smelled. Slowly, the best friend I knew seemed to be slipping away, buried under emotions he could no longer express. The breaking point came when he attempted suicide. He had secretly purchased a rope, hiding his intentions well. We had just spent a weekend together with a few of our friends, and he seemed to be doing exceptionally well. He was his old self, even hugging me goodbye while cracking a joke as we left his house with one of his neighbors. However, as soon as we were gone, he took the opportunity to try and end his life. Fortunately, the neighbor had left his laptop charger at my friend’s house, and attempts to reach him through the phone (friend) were futile). He got so worried, decided to rush back and when he arrived, the front door was locked. After ringing the bell with no response, he went around to the back and found him hanging, from a rope, unconscious. He quickly took control of the situation, and my friend was rushed to the hospital. This occurrence greatly shocked and worried me. The weekend had been a time well spent, and he seemed to be in high spirits. Later on, I came to learn that his struggles were rooted in traumas that stretched back to childhood; layered pains that had accumulated and finally became unbearable, leading him to severe depression. This incident taught me that mental health issues aren’t always visible, but there are signs we can learn to recognize. Beyond my personal experience, working at the African Population and Health Research Center (APHRC) has allowed me to engage with significant professionals who are dedicated to addressing mental health issues. Initiatives such as the Mental Health Data Prize Africa (MHDPA) are seeking to bridge critical gaps in the understanding of anxiety, depression, and psychosis across Africa and beyond. With at least 116 million people globally living with mental health issues, including depression, the Mental Health Data Prize Africa (MHDPA) initiative has created a vital platform for innovators, researchers, startups, and people with lived experience to propose solutions to these pressing challenges. Supporting someone facing mental health challenges requires patience, understanding, and compassion, often from their loved ones. Recognizing the signs and encouraging them to seek help can make all the difference. It’s essential to educate ourselves on the symptoms of mental health disorders and learn to recognize the signs that our loved ones may need help. A simple gesture, a conversation, a shared meal, a listening ear, or a paid therapy session gift can serve as the lifeline that someone desperately needs.

In the global fight against HIV, numerous interventions have been directed towards supporting adolescent girls and young women (AGYW), who are more than twice as likely to acquire HIV as their male peers. This is due to a variety of factors, including  gender inequality and unequal power dynamics,which undermine their ability to make decisions about their sexual and reproductive health. Consequently, reducing the risk of HIV infection among AGYW has been a global priority.  Programs such as the Determined, Resilient, Empowered, AIDS-free, Mentored and Safe lives (DREAMS), backed by PEPFAR, aim to do this among AGYW in Sub-Saharan Africa by addressing structural and behavioural factors that increase their vulnerability. The African Population and Health Research Center (APHRC) conducted an impact evaluation of the DREAMS program in Korogocho and Viwandani from 2017 to 2022. The evaluation assessed the impact of DREAMS interventions in reducing HIV infections among AGYW by examining various outcomes, such as changes in HIV incidence, improvements in Sexual and Reproductive Health (SRH) knowledge, and the overall empowerment of young women while also looking at the program’s scalability. The DREAMS program comprises a layered multi-component package of evidence-based interventions. These interventions address the biomedical, structural, and social risks of HIV acquisition by empowering AGYW and reducing their risk of infection. It also provides an opportunity to strengthen their families with social protection through programs like parent/caregiver programs, mobilize communities for change and reduce the risk of HIV among men who are likely to be sexual partners to AGYW. The interventions include: sexual and reproductive health (SRH) education, HIV prevention services, education support, social protection and economic empowerment activities like vocational training and business start-ups among others. While the focus of DREAMS is primarily on AGYW, some interventions do target young men. These include HIV testing, condom distribution, PrEP education and participation in health promotion sessions. However, the level of engagement and tangible benefits for adolescent boys and young men (ABYM) remains limited in comparison to those available to girls. The DREAMS program reached many AGYW identified as vulnerable, offering them substantial educational support, vocational training, and resources for business start-ups. However, boys received fewer tangible interventions in comparison.. Some adolescent boys and young men (ABYM) were engaged in biomedical and behavioral interventions. However, due to the nature of the interventions they received they would only be engaged for a short period of time and their participation often waned with time. Despite the understanding that the DREAMS program was a girl-centered initiative, ABYM expressed concerns about being left out of the program. The issue raised was DREAMS being seen largely as a girls-only initiative which limited their involvement in the program. While ABYM appreciated the benefits they received from the program, they felt these services were either inadequate or fell short of addressing their broader needs. These programs have made great progress in reducing the rate of HIV incidence among AGYW but, the question that arises is: Are we leaving adolescent boys and young men behind? It is understandable why AGYW have been the focus of most HIV interventions, yet we cannot ignore that ABYM are also vulnerable to HIV infection. There are some interventions available for ABYM such as MenEngage which engages men and encourages testing for HIV, enrollment on treatment for those who are HIV positive and adherence to treatment. Additionally, Voluntary Medical Male Circumcision (VMMC) which has proven to reduce risk of HIV acquisition in men by 60% and has been promoted widely as a core HIV prevention strategy. Interventions like this are, however, minimal compared to those for AGYW. As a result, many ABYM lack access to sexual and reproductive health education and services, creating a knowledge gap that often contributes to risky behaviors like unprotected sex, multiple sexual partners, and low condom use. This is evident in the Kenya Population-Based HIV Impact Assessment report (KENPHA 2018), which found that HIV testing services are predominantly accessed by young women, leaving many young men untested and uninformed.The consequences of this could be girls being more economically stable compared to their peers, increased HIV incidences among ABYM, resentment towards future HIV programs which will further limit ABYM’s access to prevention services and contribute to power imbalances with AGYW’s, potentially leading to relationship issues like gender-based violence, separation, divorce, and restricted access for girls to HIV prevention services. We must realize that boys and young men without proper education and resources can be both vulnerable to infection and vectors of transmission. An example of a key challenge of HIV prevention in adolescents and young men is the resistance to or lack of understanding of VMMC. In cultures where circumcision is not traditionally practiced, it may be viewed as unnecessary or even harmful, dismissing its proven benefits in reducing HIV risk. This resistance, in addition to misinformation, leaves boys and men at a greater risk of  infection. To overcome these barriers, it is essential to engage these communities with culturally sensitive education that highlights the role of VMMC in comprehensive HIV prevention strategies. Additionally, gender stereotypes that portray ABYM as less vulnerable to HIV or sexually transmitted infections (STIs) also contribute to their low uptake of services. Harmful gender norms such as initiating sexual activity early in life, having multiple sexual partners and representing themselves as knowledgeable about sexual matters and disease prevention even when they are not, discourages ABYM from accessing the information and services they need. For HIV prevention campaigns to be fully effective, they must actively address these societal barriers and create an environment where ABYM feel empowered to seek help. Without targeted interventions there is a risk that the new generation of young men will be under informed and unprepared to protect themselves and their partners from HIV.  To effectively fight against HIV, a holistic approach should be implemented that addresses the unique needs of both ABYM and AGYW. This has been proven to be possible by evidence from the DREAMS initiative which showcased the importance of education and empowerment in reducing HIV risk. Similar efforts can be made to reach ABYM which will make them more likely to make safer sexual choices reducing both their chances of contracting HIV and the likelihood of spreading the virus.  A few examples include: Sports-Based Programs: Initiatives that combine football tournaments with health education sessions have shown promise in reaching young men effectively. A notable example of this is Grassroot Soccer (GRS) founded in Zambia. GRS leverages soccer’s universal appeal to engage ABYM aged 12-19. The program combines evidence-based health curricula, mentorship from trained coaches, and an inclusive, fun culture to educate participants about HIV prevention and encourage behavioral change. For instance, activities like “Risk Field” use soccer drills to illustrate the consequences of risky behaviors, providing a relatable context for understanding how individual actions impact communities. Data from Zambia showed that nearly 60% of GRS participants sought HIV testing compared to 13% of the general population. School-Based Education: Expanding comprehensive sexual and reproductive health education in schools is crucial. Tailored curricula should emphasize the importance of HIV testing, condom use, and the role of boys in reducing HIV transmission. Peer-led initiatives in schools can create relatable and impactful messaging for ABYM, helping to normalize HIV prevention behaviors. Digital Outreach and Media Campaigns: Leveraging social media, gaming platforms, and apps can provide targeted and engaging content about HIV prevention. Interactive and gamified platforms are particularly more appealing to younger male audiences making learning about HIV prevention more engaging.  The progress made in protecting adolescent girls and young women from HIV is worth celebrating but it is important to recognise that ABYM are a big part of the solution. As the global community continues to fight against HIV, it is time to ensure that no one is left behind!

In Kenya, a complex interplay of socioeconomic and political factors has shaped policymaking processes over the years. While research is vital in driving national development, translating it into evidence-informed decision-making (EIDM) has historically been slow, particularly in sub-Saharan Africa. It is often entangled in intricate political cycles. Research by Zoë Slote Morris,1 Steven Wooding,2 and Jonathan Grant2  has shown that historically, research can take an average of 17 years to influence change and practice. At the African Population and Health Research Center (APHRC), we believe this timeline can be dramatically reduced from 17 years to just 4. By collaborating with governments and key stakeholders, we are working to cut this period by harnessing the power of EIDM to improve the quality of decision-making and enhance policy design. EIDM ensures that the best available evidence is used to inform decisions that are not only data-driven but also context-specific and impactful. Despite the wealth of high-quality research, its integration into policymaking remains subpar. Why are researchers and subject matter experts continuously overlooked and uninvolved in the process? To answer this question, examining the context of policymaking in Kenya and understanding what informs the policy process and the factors at play is essential. In Kenya, policymaking is a cyclical process tied mainly to the five-year election cycle. Politicians often make grandiose promises to the electorate based on prevailing issues of public interest to woo support. Politicians seeking to garner support make ambitious promises to the voters based on prevailing public interest problems. Typically captured in election manifestos, these promises set the tone for the incoming government’s priorities. As these promises are based on populist opinion, they tend to change a lot once a new team is in power. They, however, shape resource allocation for the next five years as the government of the day strives to maintain popular support in preparation for the next election cycle. Decision-making is, therefore, political and always fluid. Decisions and or policies of past regimes and elected leaders at all levels are often set aside, creating gaps in their implementation and losing public resources already invested. It is, therefore, hard to determine the long-term impacts of ‘good’ policies; in our case, assessing the change in practice is hard. Ultimately, this cyclical nature of policy-making hampers sustainable community development as every five-year cycle repeats itself, often resetting progress. Resource allocation plays a crucial role in the decision-making process. Like any other developing nation, Kenya has a scarcity of resources, which means competition for priorities and needs. The two levels of government prioritize what may be essential and visible to capture political expediency and regime interests that sometimes reflect political manifestos. Many times, this is always in a ‘survival mode.’ This leaves it susceptible to influence by external organizations willing to provide commercial loans or grants tied to foreign interests. Usually, ‘’s/he who pays the piper calls the tune’. The funder has priorities that do not necessarily align with community needs. At the individual level, policymakers tend to prioritize policies that have funding. They engage in policy-making activities that assure them of access to compensation and resources as individuals and their constituents. This financial motivation can be a significant determinant and even lead to rushed decisions and policies that lack thorough research and long-term viability. The majority of decision-makers in Kenya occupy both elective and appointive positions. Every new regime at both levels of government brings in its people. Unfortunately,  the election process often generates bitterness, leading to inadequate handovers between administrations. These appointees serve at the discretion of the appointing authority. At the same time, elected leaders are also subject to party positions. They can be whipped to vote in a particular manner on a policy out of fear of being de-whipped from parliamentary committees or losing the party’s support and thus the chance for re-election. This constant threat of de-whipping causes the elected decision-makers to operate in an environment of worry that stifles independent thinking. As a result, some leaders who could otherwise contribute significantly to policy-making are often reduced to  “gallery players” merely endorsing decisions driven by populist opinions, vested business interests, or pre-approved agendas from influential figures. In such an environment, the public’s immediate wants often outweigh rational,  scientific, or evidence-based decision-making. So, how does a research institution seeking to transform lives navigate these complex challenges and move the needle from 17 years to 4 years? Can adoption and adaptation of an EIDM approach make a difference? The simple answer is Yes. Long-term plans such as Kenya’s Vision 2030 and regional declarations have been used to identify and prioritize areas of research and funding. They inform organizational plans and, in some cases, as the yardsticks for understanding the government agenda. No funding can be committed if a research institution’s policy and goals are outside these development plans. In the spirit of co-creation, APHRC must carve out a sphere of influence and lead in providing evidence while creating development plans to align goals and coordinate interventions, making it easier to transform lives. To address and mitigate against changes occasioned by leadership shifts, APHRC needs to support the development of capacities for middle to senior-level technocrats. Through its initiative to develop young researchers, young technocrats can be equipped with similar skills to better inform the decision-making process in government. This will have a lasting impact as senior-level policymakers heavily rely on technocrats in the decision-making process and development planning. It will also help build a network that APHRC can call upon in its work and help achieve the goal of sustained policy engagement. By employing these two strategies—co-creation of development plans and capacity building—APHRC will leverage over 20 years of research and evidence to apply EIDM as a pathway to impact. This will bring the institution closer to transforming lives in Africa and shorten the timeline for Evidence-Informed decision-making.

Medicines are agents (chemical/biological) used to prevent, diagnose or and treat disease. Vaccines are a special kind of preventive medicine that primarily prepares the body’s immune system to fight off diseases.

Yes, all children should be vaccinated against major disease-causing agents for which there is a safe and effective vaccine.  Read more :Answers to Your Most Common Questions about Childhood Vaccines | CDC

Children’s immunization schedules are safe because individual vaccines have been extensively studied in terms of their beneficial effects, side effects, timing of when they are most beneficial, timing of highest risk of exposure and adverse outcomes as well as the most cost-effective delivery mechanism within the healthcare system.