Prevalence and correlates of stunting among a high-risk population of Kenyan children recently hospitalized for acute illnesses
Atlas, Hannah E.; Brander, Rebecca L.; Tickell, Kirkby D.; Bunyige, Lucy; Oongo, Susan; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Singa, Benson O.; Denno, Donna M.; Walson, Judd L.; Pavlinac, Patricia B. . Article in press
Atlas, Hannah E.; Brander, Rebecca L.; Tickell, Kirkby D.; Bunyige, Lucy; Oongo, Susan; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Singa, Benson O.; Denno, Donna M.; Walson, Judd L.; Pavlinac, Patricia B. . Article in press
DOI : 10.4269/ajtmh.23-0050
Potential effectiveness of integrating human milk banking and lactation support on neonatal outcomes at Pumwani Maternity Hospital, Kenya
Wilunda, Calistus; Israel-Ballard, Kiersten; Wanjohi, Milka; Lang'at, Nelson; Mansen, Kimberly; Waiyego, Mary; Kibore, Minnie; Kamande, Eva; Zerfu, Taddese; Kithua, Angela; Muganda, Rosemarie; Muiruri, Juliana; Maina, Beth; Njuguna, Emily; Njeru, Faith; Kiige, Laura W.; Codjia, Patrick; Samburu, Betty; Mogusu, Esther; Ngwiri, Thomas; Mirie, Waithera; Kimani-Murage, Elizabeth W. . 2024
Wilunda, Calistus; Israel-Ballard, Kiersten; Wanjohi, Milka; Lang'at, Nelson; Mansen, Kimberly; Waiyego, Mary; Kibore, Minnie; Kamande, Eva; Zerfu, Taddese; Kithua, Angela; Muganda, Rosemarie; Muiruri, Juliana; Maina, Beth; Njuguna, Emily; Njeru, Faith; Kiige, Laura W.; Codjia, Patrick; Samburu, Betty; Mogusu, Esther; Ngwiri, Thomas; Mirie, Waithera; Kimani-Murage, Elizabeth W. . 2024
DOI : 10.1111/mcn.13594
Abstract | Link (37 B)
We assessed the potential effectiveness of human milk banking and lactation support on provision of human milk to neonates admitted in the newborn unit (NBU) at Pumwani Maternity Hospital, Kenya. This pre–post intervention study collected data from mothers/caregivers and their vulnerable neonates or term babies who lacked sufficient mother's milk for several reasons admitted in the NBU. The intervention included establishing a human milk bank and strengthening lactation support. Preintervention data were collected between 5 October 2018 and 11 November 2018, whereas postintervention data were collected between 4 September 2019 and 6 October 2019. Propensity score-matched analysis was performed to assess the effect of the intervention on exclusive use of human milk, use of human milk as the first feed, feeding intolerance and duration of NBU stay. The surveys included 123 and 116 newborns at preintervention and postintervention, respectively, with 160 newborns (80 in each group) being included in propensity score matched analysis. The proportion of neonates who exclusively used human milk during NBU stay increased from 41.3% preintervention to 63.8% postintervention (adjusted odds ratio [OR]: 2.68; 95% confidence interval [CI]: 1.31, 5.53) and those whose first feed was human milk increased from 55.0% preintervention to 83.3% postintervention (adjusted OR: 5.09; 95% CI: 2.18, 11.88). The mean duration of NBU stay was 27% (95% CI: 5.8%, 44.0%) lower in the postintervention group than in the preintervention group. The intervention did not affect feeding intolerance. Integrating human milk banking and lactation support may improve exclusive use of human milk among vulnerable neonates in a resource limited setting.
Dairy consumption and household diet quality in East Africa: Evidence from survey-based simulation models
Ecker, Olivier; Pauw, Karl. 2024
Ecker, Olivier; Pauw, Karl. 2024
DOI : 10.1016/j.foodpol.2023.102562
Abstract | Link (37 B)
Dairy foods are an important source of essential macro- and micronutrients in household diets, and their consumption is associated with reduced malnutrition, especially among young children. Low dairy consumption in many developing countries is a justification for programs that promote dairy livestock ownership, help develop dairy value chains, or stimulate dairy demand. While several studies confirm the beneficial effects of such dairy-specific interventions on nutritional outcomes, the purpose in this study is to consider more broadly the contribution of dairy to overall diet quality. Our assessment of consumer preferences for dairy, coupled with simulations of consumption responses to dairy price and household income changes, provide quantitative evidence that can inform policymakers about the possible effects of public policies on dairy consumption and diet quality. While our analysis is based on data from Kenya and Uganda, both countries with established dairy sectors, our findings are relevant for other East African countries with similar dietary patterns and emergent dairy sectors.
Women's seed entrepreneurship in aquaculture, maize, and poultry value chains in Ghana, Kenya, and Tanzania
Farnworth, Cathy Rozel; Galie, Alessandra; Gumucio, Tatiana; Jumba, Humphrey; Kramer, Berber; Ragasa, Catherine. 2024
Farnworth, Cathy Rozel; Galie, Alessandra; Gumucio, Tatiana; Jumba, Humphrey; Kramer, Berber; Ragasa, Catherine. 2024
Abstract | Link
Seed systems are essential to bring good genetic material to farmers. Women farmers, however, have benefited less than men farmers from seed systems in low and middle income countries. We identify factors that inhibit and promote women's success in seed businesses through three case studies of women's and men's entrepreneurship across seed-related value chains and country contexts: tilapia seed production in Ghana, marketing and trading of improved maize and sorghum seeds in Kenya, and chicken seed dissemination in Tanzania. Applying a gender lens, we use key informant interviews and focus group discussions to analyze women's and men's motivations to engage in seed businesses, the challenges they confront to start and build their enterprises, and prospects for sustainability and continued success. We use quantitative data to characterize the levels of empowerment of the agripreneurs sampled. For women, the results show that the social normative context of the sector is critical. Time flexibility and profitability are important considerations for women's engagement. Furthermore, across all three country cases, family and external support are frequently key to women's participation and success in seed agripreneurship. The article discusses the importance of government bodies, NGOs, and donors in challenging the normative context around gender resource gaps, as well as provide technical packages and training to develop business acumen. Supporting change of restrictive gender norms in non-threatening ways - such as ICTs - is key.
Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya
Wambui, Elizabeth; Wilunda, Calistus; Donfouet, Hermann Pythagore Pierre; Mwangi, Bonventure; Zerfu, Taddese Alemu; Daniel, Tewoldeberha; Agutu, Olivia; Samburu, Betty; Kavoo, Daniel; Karimurio, Lydia. 2024
Wambui, Elizabeth; Wilunda, Calistus; Donfouet, Hermann Pythagore Pierre; Mwangi, Bonventure; Zerfu, Taddese Alemu; Daniel, Tewoldeberha; Agutu, Olivia; Samburu, Betty; Kavoo, Daniel; Karimurio, Lydia. 2024
Abstract | Link
Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to manage acute malnutrition in the community. This study explored the perceptions of community members regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions and key informant interviews were used to explore perceptions towards the management of acute malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to be acceptable, effective, and easily accessible. The community health structure provided a platform for commodity supply and management and CHV support supervision. This was a major enabler in implementing the intervention. The intervention faced operational and systemic challenges that should be considered before scale-up.
Upside risk, consumption value, and market returns to food safety
Hoffmann, Vivian; Kariuki, Sarah; Pieters, Janneke; Treurniet, Mark. 2023
Hoffmann, Vivian; Kariuki, Sarah; Pieters, Janneke; Treurniet, Mark. 2023
DOI : 10.1111/ajae.12349
Abstract | Link
We investigate the effect of a modest food safety premium on semisubsistence farmers' investment in a food safety technology. We demonstrate theoretically that in the face of production uncertainty, a market incentive below the marginal production cost of achieving the safety standard can increase food safety investment among farmers motivated by private health returns. We test this prediction through a randomized controlled trial in Kenya through which members of existing farmer groups were offered an opportunity to purchase a food safety input, and half were offered a 5% market premium for produce that met the associated regulatory standard. Access to the premium more than doubled investment in the food safety technology. In line with the model's prediction, most premium-induced adoption was by farmers motivated by a combination of health and financial rewards.
Action against invasive species: Charcoal production, beekeeping, and Prosopis eradication in Kenya
Tabe-Ojong, Martin Paul Jr.. 2023
Tabe-Ojong, Martin Paul Jr.. 2023
DOI : 10.1016/j.ecolecon.2022.107614
Abstract | Link
Prosopis juliflora is an invasive alien leguminous tree introduced as a way of combating desertification, deforestation, and improving soil fertility. Over time, the tree has reported significant negative externalities to farmers. Different strategies such as management through utilization and complete eradication have been proposed to reduce these externalities. We investigate the various factors associated with adherence to these strategies. In the first place, we assess the correlates of charcoal production, beekeeping, and willingness to completely eradicate Prosopis. We then examine the welfare effects of charcoal production and beekeeping. We use survey data from 530 smallholder households in the Baringo county of Kenya who are currently contending with infestation from the invasive tree. Besides other factors, we show that a positive perception about Prosopis invasion increases the probability of engaging in charcoal production and is adversely related to beekeeping and the willingness to completely eradicate Prosopis. Delving into welfare and poverty effects of these activities, we find charcoal production to be income increasing. We argue that a blend of both management and eradication of Prosopis could offer a win-win solution to both improving the welfare and socio-economic conditions of households while also ensuring environmental and ecological safeguards, with implications for broad-based sustainability.
Antenatal care is associated with adherence to iron supplementation among pregnant women in selected low-middle-income-countries of Asia, Africa, and Latin America & the Caribbean regions: Insights from Demographic and Health Surveys
Karyadi, Elvina; Reddy, J. C.; Dearden, Kirk A.; Purwanti, Tutut; Asri, Eriana; Roquero, Loreto B.; Juguan, Jocelyn A.; Sapitula-Evidente, Anjali; Alam, M. K.; Das, Susmita; Nair, Gopa K.; Srivastava, Anuj; Raut, Manoj K.. 2023
Karyadi, Elvina; Reddy, J. C.; Dearden, Kirk A.; Purwanti, Tutut; Asri, Eriana; Roquero, Loreto B.; Juguan, Jocelyn A.; Sapitula-Evidente, Anjali; Alam, M. K.; Das, Susmita; Nair, Gopa K.; Srivastava, Anuj; Raut, Manoj K.. 2023
DOI : 10.1111/mcn.13477
Abstract | Link
Anaemia is a global public health problem affecting 800 million women and children globally. Anaemia is associated with perinatal mortality, child morbidity and mortality, mental development, immune competence, susceptibility to lead poisoning and performance at work. The objective of this article is to identify whether antenatal care-seeking was associated with the uptake of iron supplementation among pregnant women, adjusting for a range of covariates. This article used data from the cross-sectional recent Demographic and Health Surveys (DHS) of 12 countries in Asia, Africa and Latin America & the Caribbean regions. The individual-level data from 273,144 women of reproductive age (15−49 years) were analysed from multi-country DHS. Multiple Logistic regression analyses were conducted using Predictive Analytics Software for Windows (PASW), Release 18.0. Receiving at least four antenatal care visits was significantly associated with the consumption of 90 or more iron-containing supplements in 12 low and middle income countries across three regions after adjusting for different household and respondent characteristics, while mass media exposure was found to be a significant predictor in India and Indonesia. Antenatal care seems to be the most important predictor of adherence to iron intake in the selected countries across Africa, Asia, Latin America and Caribbean regions.
Assessing food security among young farmers in Africa: Evidence from Kenya, Nigeria, and Uganda
Adeyanju, Dolapo; Mburu, John; Gituro, Wainaina; Chumo, Chepchumba; Mignouna, Djana; Ogunniyi, Adebayo; Akomolafe, John Kehinde; Ejima, Joseph. 2023
Adeyanju, Dolapo; Mburu, John; Gituro, Wainaina; Chumo, Chepchumba; Mignouna, Djana; Ogunniyi, Adebayo; Akomolafe, John Kehinde; Ejima, Joseph. 2023
DOI : 10.1186/s40100-023-00246-x
Abstract | Link (37 B)
Food insecurity remains a serious challenge for many households in Africa and the situation is even more prevalent among young people. However, there is a dearth of empirical evidence on youth food security status in Africa. We assessed the level and determinants of food security among young farmers in Africa. We adopted a multi-stage sampling technique to select 400, 429, and 606 young farmers in Kenya, Nigeria, and Uganda, respectively. Individual food consumption was assessed following a 7 days recall method. The Food Consumption Score, which combines dietary diversity and consumption frequency was used to assess food security status while the determinants of food security were identified using a logistic regression model. Results suggest low dietary diversity across the three countries. Also, the majority of the respondents had an unacceptable food consumption score, suggesting that despite being food producers, young farmers are still food insecure. The odds of being food secure was positively determined by access to extension services, participation in the ENABLE TAAT business incubation programme, and access to market information but, negatively by access to credit, number of employees, Covid-19 pandemic, and location. Additionally, the food security status of young female farmers was positively influenced by age, suggesting that younger youths are less food secure compared to older ones. These results suggest that more efforts should be directed towards improving the food security of young African farmers and that policy- and programme-level interventions should support access to extension services, market information, and land. Additionally, more investments should be directed towards developing need-based agribusiness incubation programmes with an effort to scale existing programmes beyond the regular one-time period.
Land market responses to weather shocks: Evidence from rural Uganda and Kenya
Tabetando, Rayner; Fani, Djomo Choumbou Raoul; Ragasa, Catherine; Michuda, Aleksandr. 2023
Tabetando, Rayner; Fani, Djomo Choumbou Raoul; Ragasa, Catherine; Michuda, Aleksandr. 2023
DOI : 10.1093/erae/jbad005
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