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The onset of COVID-19 made governments and other education actors prioritize distance learning, particularly through education technologies (EdTechs). Most sub-Saharan African countries adopted and adapted this approach. This paper examines the extent of EdTechs' deployment in Kenya during the COVID-19 pandemic among marginalized and vulnerable populations. A cross-sectional study design was adopted for the study from which this paper drew its data, with both secondary and primary data utilized. The findings show that marginalized/vulnerable learner populations are still left out on EdTech supported learning. This article proposes salient recommendations that could help advance inclusive education discussion and related EdTechs' discourse.

The 2017 general comment (GC21) to the United Nations Convention on the Rights of the Child (UNCRC) on children in street situations, provides a framework of legal guidance for governments developing policies aimed at protecting street-connected children and sets up the rationale for more awareness raising and public education to counter negative and deficit attitudes towards street-connectedness. Within this framework, the media has a role to play in either challenging conceptualisations of street-connected children as out-of-place within the public and predominantly adult domain described by urban streets, or in reinforcing ideological constructions of citizenship and normalised notions of childhood that result in negative stereotypes of these children. GC21 recommends that interventions targeted at street-connected children should be ethically responsible -- adopting child rights approaches aimed at using accurate data/evidence that upholds the dignity of children, their personal integrity, and their right to life. As such, these approaches should also extend to how organisations engage with and utilise the media to represent street-connected children. Focusing on media representations of street-connected children during the six pandemic-affected months of February to July 2020, this paper provides a review of the content of the sources to provide an insight into the structural barriers that face street-connected children because of how they are positioned in society, during the pandemic and in general, and the extent to which the media reinforces or counters the rescue or removal narratives that can lead to inappropriate intervention responses.

The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.

Housing is a key social determinant of health with implications for both physical and mental health. The measurement of healthy housing and studies characterizing the same in sub-Saharan Africa (SSA) are uncommon. This study described a methodological approach employed in the assessment and characterization of healthy housing in SSA using the Demographic and Health Survey (DHS) data for 15 countries and explored healthy housing determinants using a multiple survey-weighted logistic regression analysis. For all countries, we demonstrated that the healthy housing index developed using factor analysis reasonably satisfies both reliability and validity tests and can therefore be used to describe the distribution of healthy housing across different groups and in understanding the linkage with individual health outcomes. We infer from the results that unhealthy housing remains quite high in most SSA countries. Having a male head of the household was associated with decreased odds of healthy housing in Burkina Faso (OR = 0.80, CI = 0.68-0.95), Cameroon (OR = 0.65, CI = 0.57, 0.76), Malawi (OR = 0.70, CI = 0.64-0.78), and Senegal (OR = 0.62, CI = 0.51-0.74). Further, increasing household size was associated with reducing odds of healthy housing in Kenya (OR = 0.53, CI = 0.44-0.65), Namibia (OR = 0.34, CI = 0.24-0.48), Nigeria (OR = 0.57, CI = 0.46-0.71), and Uganda (OR = 0.79, CI = 0.67-0.94). Across all countries, household wealth was a strong determinant of healthy housing, with middle and rich households having higher odds of residing in healthy homes compared to poor households. Odds ratios ranged from 3.63 (CI = 2.96-4.44) for households in the middle wealth group in the DRC to 2812.2 (CI = 1634.8-4837.7) in Namibia's wealthiest households. For other factors, the analysis also showed variation across countries. Our findings provide timely insights for the implementation of housing policies across SSA countries, drawing attention to aspects of housing that would promote occupant health and wellbeing. Beyond the contribution to the measurement of healthy housing in SSA, our paper highlights key policy and program issues that need further interrogation in the search for pathways to addressing the healthy housing deficit across most SSA countries. This has become critical amid the COVID-19 pandemic, where access to healthy housing is pivotal in its control., (© 2022. The New York Academy of Medicine.)

Amid a rise of misinformation worldwide, this paper examines digital misinformation literacy as it relates to COVID-19 news in East Africa. The study is grounded in inoculation theory and contributes to the body of scholarship examining misinformation literacy beyond the Western world. Data came from a comparative, cross-national survey in Kenya, Uganda and Rwanda (N = 3,203), making this the largest known empirical investigation into digital misinformation literacy in the region within the context of a pandemic. Paper surveys were distributed throughout all three countries in 2021. The data revealed differences in actual and perceived misinformation literacy levels. Kenyans and Rwandans were better at detecting false COVID-19 statements in the media, whereas Ugandans were better at detecting true messages. Similarly, Kenyans' and Rwandans' perceived levels of digital misinformation literacy were higher than Ugandans'. Regarding perceived exposure to COVID-19 information, Kenyans felt they were exposed to fake COVID-19 news online more often than Ugandans, who felt more exposed than Rwandans. This research contributes to the growing literature on digital misinformation literacy, an area which isn't significantly studied in many world regions, especially in Africa. [ABSTRACT FROM AUTHOR]

Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

Public imagination and academic scholarship present queer migrants as being uprooted due to their embodiment of non-normative sexual identities. Drawing from ethnographic research with a male sex worker-led organisation (SLO) in Nairobi, including 41 in-depth interviews with members, this paper explores this perceived uprootedness by highlighting Kenyan queer migrants' multi-layered and multi-dimensional social experiences of home. Using the concept of 'homing', the paper explores the men's lifelong efforts to feel at home, and the embeddedness of queer identities in this process. The SLO generates feelings of safety, acceptance and recognition and provides a 'second home' in the city. In the process of creating ties with chosen families in the city, the men still maintain close ties with family back in their villages, while economic opportunities induce back-and-forth mobilities. The men's individual trajectories might fluctuate yet still fit within a more linear route in which they aspire to acquire land and properties in their ancestral homeland. The analysis of queer homing supports a reimagining of queer people's mobilities that stresses their embeddedness in society and illustrates how it relates to the 'queering' of queer in the African context. [ABSTRACT FROM AUTHOR]

Background: Ethiopia and Kenya have adopted the community-based integrated community case management (iCCM) of common childhood illnesses and newborn care strategy to improve access to treatment of infections in newborns and young infants since 2012 and 2018, respectively. However, the iCCM strategy implementation has not been fully integrated into the health system in both countries. This paper describes the extent of integration of iCCM program at the district/county health system level, related barriers to optimal integration and implementation of strategies., Methods: From November 2020 to August 2021, Ethiopia and Kenya implemented the community-based treatment of possible serious bacterial infection (PSBI) when referral to a higher facility is not possible using embedded implementation research (eIR) to mitigate the impact of COVID-19 on the delivery of this life-saving intervention. Both projects conducted mixed methods research from April-May 2021 to identify barriers and facilitators and inform strategies and summative evaluations from June-July 2022 to monitor the effectiveness of implementation outcomes including integration of strategies., Results: Strategies identified as needed for successful implementation and sustainability of the management of PSBI integrated at the primary care level included continued coaching and support systems for frontline health workers, technical oversight from the district/county health system, and ensuring adequate supply of commodities. As a result, support and technical oversight capacity and collaborative learning were strengthened between primary care facilities and community health workers, resulting in improved bidirectional linkages. Improvement of PSBI treatment was seen with over 85% and 81% of estimated sick young infants identified and treated in Ethiopia and Kenya, respectively. However, perceived low quality of service, lack of community trust, and shortage of supplies remained barriers impeding optimal PSBI services access and delivery., Conclusion: Pragmatic eIR identified shared and unique contextual challenges between and across the two countries which informed the design and implementation of strategies to optimize the integration of PSBI management into the health system during the COVID-19 pandemic. The eIR participatory design also strengthened ownership to operationalize the implementation of identified strategies needed to improve the health system's capacity for PSBI treatment., (© 2024. The Author(s).)

The COVID-19 pandemic has triggered several changes in countries' health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run., (© World Health Organization, 2024. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.)

The recently emerged coronavirus disease 2019 (COVID-19) has caused considerable morbidity and mortality worldwide and disrupted health services. We describe the effect of the COVID-19 pandemic on utilization of childhood vaccination services during the pandemic. Using a mixed methods approach combining retrospective data review, a cross-sectional survey, focus group discussions among care givers and key informant interviews among nurses, we collected data between May and September 2021 in Mombasa and Nakuru counties. Overall, there was a <2 % decline in the number of vaccine doses administered during the pandemic period compared to the pre-pandemic period but this was statistically insignificant, both for the pentavalent-1 vaccine (ß = -0.013, p = 0.505) and the pentavalent-3 vaccine (ß = -0.012, p = 0.440). In government health facilities, there was 7.7 % reduction in the number of pentavalent-1 (ß = -0.08, p = 0.010) and 10.4 % reduction in the number of pentavalent-3 (ß = -0.11, p < 0.001) vaccine doses that were administered during the pandemic period. In non-government facilities, there was a 25.8 % increase in the number of pentavalent-1 (ß=0.23, p < 0.001) and 31.0 % increase in the number of pentavalent-3 (ß = -0.27, p < 0.001) vaccine doses that were administered facilities during the pandemic period. The strategies implemented to maintain immunization services during the pandemic period included providing messaging on the availability and importance of staying current with routine vaccination and conducting catch-up vaccinations and vaccination outreaches. Our findings suggest that the COVID-19 pandemic did not impact childhood vaccination services in Mombasa and Nakuru counties in Kenya. The private health facilities cushioned vaccination services against the effects of the pandemic and the strategies that were put in place by the ministry of health ensured continuation of vaccination services and encouraged uptake of the services during the pandemic period in the two counties in Kenya. These findings provide useful information to safeguard vaccination services during future pandemics., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This paper contributes to the scarce literature on factors affecting EdTech use in households. These factors were considered through exploratory mixed‐methods analyses of cross‐sectional data on Kenyan girls and caregivers, captured during the COVID‐19 pandemic. Quantitative analysis of the child dataset (n = 544) suggested the importance of both structural factors—such as technology hardware availability—and non‐structural factors—including caregiver permission. Findings were supported by a thematic analysis of interview data from girls' caregivers (n = 58), which emphasised the role they play in girls' use of EdTech. Interviews also highlighted numerous caregiver concerns with EdTech, related to the relevance and rigour of educational content, the possibility of children accessing age‐inappropriate material and child health (especially eyesight). Policy makers could alleviate these concerns by providing guidance on EdTech use and clearly signalling their approval of verified initiatives. Practitioner notesWhat is already known about this topicEdTech can benefit girls' education, yet there are various barriers to it being used.Existing research shows clearly that EdTech use can be impeded by structural factors (eg, hardware ownership).However, we find insufficient empirical evidence on the role of non‐structural or behavioural factors.What this paper addsThis paper addresses this gap, using a mixed‐methods approach to explore the influence of 33 different measures (including non‐structural factors) that could affect the number of hours girls spend using EdTech at home.Findings from a quantitative sample of girls (n = 544) and a qualitative sample of girls' caregivers (n = 58) highlighted the importance of non‐structural factors, especially caregiver permission.The variable most strongly associated with girls' EdTech usage in our selected quantitative model concerned whether this was sanctioned by their caregivers.Our qualitative data suggested why caregiver permission to use EdTech might be withheld: caregivers emphasised perceived concerns about the risks and rigour of EdTech.Implications for practice and/or policyOur findings suggest the viability of policy interventions that provide EdTech guidance to caregivers.Caregivers uncertain about EdTech could be reassured of the appropriateness of verified initiatives, while those already convinced might be aided in their attempts to support EdTech learning.Such guidance could provide a low‐cost means of further exploiting the benefits that household EdTech learning can provide. [ABSTRACT FROM AUTHOR]

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This paper deals with COVID-19-hit Kenyan slums and the numerous interventions civil society organizations implemented during the first waves of the pandemic since it was initially detected in March 2020. As part of a comprehensive project using mixed methodology, including desk research and key informant interviews, community-based organizations and non-governmental organizations, together with other stakeholders of their collaborative networks, were investigated regarding the roles that they played, the projects they carried out, and the interventions they were involved in in the mitigation of the negative impacts of COVID-19. This paper investigates how COVID-19 actually hit Kenyan slums and how it affected civil society organizations during the pandemic. [ABSTRACT FROM AUTHOR]

This paper adopts Leiper's ([1990]. Tourist attraction systems. Annals of Tourism Research, 17(3), 367–384. https://doi.org/10.1016/0160-7383(90)90004-B) tourism system theory to examine the impact of COVID-19 on Kenya's tourism sector. The authors argue that tourism remains an important source of national revenue in Kenya and the severe negative effects of the pandemic as well as the resulting government measures to curb the spread of the disease threaten to undermine the gains made in recent years to revive the sector. The paper identifies that while much emphasis has been put on the impact of the disease on countries' national health systems and its epidemiology, few studies have been conducted to examine the relationship between COVID 19 and the tourism sector, especially in developing countries. The paper provides researchers and practitioners with an analysis of the impact of COVID-19 on the social and economic dimensions of tourism in Kenya and concludes with a set of recommendations that can shape Kenya's post-pandemic tourism sector recovery plans. [ABSTRACT FROM AUTHOR]

Evidence suggests that, during pandemics such as COVID-19, people with low incomes within developing countries suffered disproportionately. Households across countries differentially experienced the socio-economic impact of the pandemic. In sub-Saharan Africa, the extended family and the community have provided valuable support in crises, given that state-administered backing may not be sufficient or may differ from the family's expectations. Many studies have been conducted on community safety nets, yet little description and understanding of community safety nets has been provided. The components of the non-formal safety nets are yet to be adequately defined or evaluated for effectiveness. Traditional family and community safety nets have been under stress due to the impact of COVID-19. Many countries, including Kenya, have associated COVID-19 with an increased number of households facing social and economic crises. Families and communities got fatigued due to the extended period and the further strain the pandemic had on individuals and societies. Utilizing existing literature on the socio-economic impact of COVID-19 in Kenya and the roles and perceptions of community safety nets, this paper seeks to explain the roles and perceptions of social relationships and kinship networks as safety nets in Africa, specifically in the Kenyan context. This paper employs the concept of culture of relatedness to understand the informal safety nets in Kenya better. During the COVID-19 pandemic, individuals strengthened the previously weakened kinship structures. They addressed some of the challenges experienced within the networks through the involvement of neighbors and friends embracing the culture of relatedness. Therefore, government strategies for social support during pandemics need to design programs to strengthen the community safety nets that remained resilient throughout the health crisis., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nyabundi.)

Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study ( n = 1003); hence data collection was paused. In June 2020, the study clinic was re-opened after consultations with violence and mental health experts and the FSW community. Between June 2020 and January 2021, data were collected in person and remotely following ethical procedures. A total of 885/1003 (88.2%) FSWs participated in the follow-up behavioural-biological survey and 47/47 (100%) participated in the qualitative in-depth interviews. A total of 26/885 (2.9%) quantitative surveys and 3/47 (6.4%) qualitative interviews were conducted remotely. Researching sensitive topics like sex work, violence, and mental health must guarantee study participants' safety and privacy. Collecting data at the height of COVID-19 was crucial in understanding the relationships between the COVID-19 pandemic, violence against women, and mental health. Relationships established with study participants during the baseline survey-before the pandemic-enabled us to complete data collection. In this paper, we discuss key issues involved in undertaking violence and mental health research with a vulnerable population such as FSWs during a pandemic. Lessons learned could be useful to others researching sensitive topics such as violence and mental health with vulnerable populations.

The onset of COVID-19 made governments and other education actors prioritize distance learning, particularly through education technologies (EdTechs). Most sub-Saharan African countries adopted and adapted this approach. This paper examines the extent of EdTechs' deployment in Kenya during the COVID-19 pandemic among marginalized and vulnerable populations. A cross-sectional study design was adopted for the study from which this paper drew its data, with both secondary and primary data utilized. The findings show that marginalized/vulnerable learner populations are still left out on EdTech supported learning. This article proposes salient recommendations that could help advance inclusive education discussion and related EdTechs' discourse. [ABSTRACT FROM AUTHOR]

This paper aims to deal with the impact of COVID-19 on the livelihoods of disadvantaged persons living in slums in Kenya. Months after the first case of COVID-19 was reported in Kenya in March 2020, most of the studies that have been carried out pertaining to its impact on slum dwellers have concentrated on narrowly defined concerns e.g. the impact of COVID-19 on youth, gender based violence and nutrition. It is thus difficult to get a clear global picture of the overall impact of COVID-19 on the livelihoods of slum dwellers in Kenya. This paper relies on information gathered during a comprehensive qualitative micro study covering numerous aspects of slum dwellers' livelihoods, as well as information that has been produced by the Ministry of Health, civil society organizations that work in specific slums, private research organizations as well as local and foreign media houses. The slums whose information is reported in this paper were selected to be indicative of the over 300 slums that are located in Nairobi and Mombasa, the two most important cities in Kenya. The analysis concludes that slum dwellers were potentially at a higher risk under the pressures of COVID-19 of deteriorating conditions with regard to the provision of health services, employment, gender-based violence, education and youth-related problems, and human rights violations, and offers several recommendations to the government. [ABSTRACT FROM AUTHOR]

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies., Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling., Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs' response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution., Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption., Competing Interests: The authors declare no competing interests., (Copyright: Sugitha Sureshkumar et al.)

Background: Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning (FP) methods. This paper draws on social norms theory to explore the role of key influencers (partners, parents and friends) in women's FP use and how women anticipate normative reactions or sanctions., Methods: A qualitative study with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya. Interviews were conducted during the COVID-19 pandemic in 2020 by phone. A thematic analysis was conducted., Results: Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as key influencers on FP. Their interactions with these key influencers varied based on trust, the information they needed about FP, and whether they perceived a key influencer to perpetuate or challenge existing social norms on FP. Mothers were perceived to understand the social risks of using FP and thus could advise on discreet FP use, and aunts were trusted and approachable sources to impartially describe the benefits and drawbacks of FP. Although women identified partners as key FP decision makers, they were cognisant of possible power imbalances affecting a final FP choice., Conclusions: FP interventions should consider the normative influence key actors have on women's FP choices. Opportunities to design and deliver network-level interventions which seek to engage with social norms surrounding FP in order to challenge misconceptions and misinformation among key influencers should be explored. Intervention design should consider dynamics of secrecy, trust and emotional closeness that mediate discussions of FP to address changing norms. Further training to change norms held by healthcare providers about why women, in particular unmarried young women, access FP should be provided to reduce barriers for FP access., (© 2023. The Author(s).)

Background: Secondary cities tend to be better linked with local food systems than primate cities, acting as important platforms to trade agricultural produce with rural surrounding. COVID-19, conflicts and climate change continue to expose inefficiencies in food systems and have further exacerbated malnutrition, calling for substantial food systems transformations. However, tackling current food systems' challenges requires new approaches to ensure food and nutrition security. Nutritious and agroecologically produced food offer the potential to transform food systems by improving diets and alleviating pressure on the environment, as well as by creating jobs and reducing poverty. This paper describes the design of a project by a Swiss public-private consortium to improve food and nutrition security and to reduce poverty in city ecosystems in six secondary cities in Bangladesh, Kenya and Rwanda through governance/policy and supply and demand side interventions., Methods: The Nutrition in City Ecosystems (NICE) project promotes well-balanced nutrition for city populations through interdisciplinary agricultural, food, and health sector collaborations along city-specific value chains. Adopting a transdiciplinary systems approach, the main interventions of NICE are (i) advocacy and policy dialogue, (ii) building of decentralized institutional capacity in multi-sectoral collaborations, (iii) support of data-driven planning, coordination and resource mobilization, (iv) anchoring of innovations and new approaches in city-level partnerships, (v) capacity building in the agricultural, retail, health and education sectors, as well as (vi) evidence generation from putting policies into practice at the local level. NICE is coordinated by in-country partners and local offices of the Swiss public-private consortium partners., Discussion: The NICE project seeks to contribute to urban food system resilience and enhanced sustainable nutrition for city populations by (A) strengthening urban governance structures involving key stakeholders including women and youth, (B) generating income for producers along the supply chain, (C) triggering change in producers' and consumers' behavior such that nutritious and agroecologically produced foods are both in demand as well as available and affordable in urban markets, and (D) allowing a scale up of successful approaches to other national and international cities and city networks., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Speich, Barth-Jaeggi, Musard, Havugimana, Nwokoro, Gakuba, Zamil, Sécula, Thönnissen, Six, Kraemer, van Zutphen, Sonnevelt, Tshering, Erismann, van den Berg, Winter, Johnson-Chadwick, Pannatier, Gavin-Smith, Barjolle and Prytherch.)

This article analyses the intersection of response to Covid-19 and human rights in Nigeria and Kenya, as both countries illustrate two Covid-19 endemic and rapidly responding states to the Covid-19 pandemic. However, in Nigeria and Kenya, response to Covid-19 has to be understood in relation to their respective legal and policy frameworks and policy enforcement mechanisms. The paper notes that cases of police brutality, extortion and assault on civilians during Covid-19 pandemic raise the issue of insecurity and the whole question of human rights. The paper demonstrates that governments' emergency measures have serious implications for fundamental rights in Nigeria and Kenya, particularly those of perceived violators of the measures, the poor and vulnerable people, and women and girls. [ABSTRACT FROM AUTHOR]

Background: Vaccination refusal exacerbates global COVID-19 vaccination inequities. No studies in East Africa have examined temporal trends in vaccination refusal, precluding addressing refusal. We assessed vaccine refusal over time in Kenya, and characterized factors associated with changes in vaccination refusal., Methods: We analyzed data from the Kenya Rapid Response Phone Survey (RRPS), a household cohort survey representative of the Kenyan population including refugees. Vaccination refusal (defined as the respondent stating they would not receive the vaccine if offered to them at no cost) was measured in February and October 2021. Proportions of vaccination refusal were plotted over time. We analyzed factors in vaccination refusal using a weighted multivariable logistic regression including interactions for time., Findings: Among 11,569 households, vaccination refusal in Kenya decreased from 24 % in February 2021 to 9 % in October 2021. Vaccination refusal was associated with having education beyond the primary level (-4.1[-0.7,-8.9] percentage point difference (ppd)); living with somebody who had symptoms of COVID-19 in the past 14 days (-13.72[-8.9,-18.6]ppd); having symptoms of COVID-19 in the past 14 days (11.0[5.1,16.9]ppd); and distrusting the government in responding to COVID-19 (14.7[7.1,22.4]ppd). There were significant interactions with time and: refugee status and geography, living with somebody with symptoms of COVID-19, having symptoms of COVID-19, and believing in misinformation., Interpretation: The temporal reduction in vaccination refusal in Kenya likely represents substantial strides by the Kenyan vaccination program and possible learnt lessons which require examination. Going forward, there are still several groups which need specific targeting to decrease vaccination refusal and improve vaccination equity, including those with lower levels of education, those with recent COVID-19 symptoms, those who do not practice personal COVID-19 mitigation measures, refugees in urban settings, and those who do not trust the government. Policy and program should focus on decreasing vaccination refusal in these populations, and research focus on understanding barriers and motivators for vaccination., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks-59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90-1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07-1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88-1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11-1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The health burden due to mental health has historically been underestimated with focus on communicable diseases and deaths and little consideration of disability and comorbidity effects of poor mental health. Recent data show increasing trends of mental health disorders as a share of global health burdens and vulnerability of adolescents. This paper aims to explore social determinants of mental health as experienced by adolescent girls, drawing attention to gendered risks during the COVID-19 pandemic. Semi-structured interviews with twenty-two adolescent girls in urban informal settlements in Kenya and Nigeria reveal unique environmental, socio-cultural, economic and educational factors that threatened their mental wellbeing. The pandemic exacerbated these determinants. An equitable recovery will require a consideration of not only disproportional mental health outcomes, but also social determinants that contribute to these outcomes. As more than half of the urban population in sub-Saharan Africa reside in informal settlements, this study has implications for youth-focused mental health interventions in these and similar settings.

The COVID‐19 pandemic prompted social distancing, workplace closures, and restrictions on mobility and trade that had cascading effects on economic activity, food prices, and employment in low‐ and middle‐income countries. Using longitudinal data from Bangladesh, Kenya, and Nigeria covering a period from October 2020 to April 2021, the paper assesses whether knowledge of a person infected with COVID‐19 is associated with food insecurity, job loss and business closures, and coping strategies to smooth consumption. The likelihood of households to experience food insecurity at the extensive and intensive margins increased among those who knew an infected person in Bangladesh and Kenya. [ABSTRACT FROM AUTHOR]

The vaccine decision-making process of pregnant and lactating women is complex. Regarding COVID-19, pregnant women are at increased risk for severe disease and poor health outcomes. While pregnant and lactating women were excluded from COVID-19 vaccine trials, available evidence suggests that COVID-19 vaccines are safe and protective during pregnancy. In this study, we used a socio-ecological approach to explore factors influencing the decision-making process for COVID-19 vaccines in pregnant and lactating women in Kenya, for the purpose of informing demand generation strategies. As pregnant and lactating women are influenced by many factors, we conducted 84 in-depth interviews with a variety of stakeholders, including 31 pregnant or lactating women, 20 healthcare workers such as nurses, midwives, doctors, and frontline workers, 25 male family members of pregnant or lactating women, and 8 gatekeepers such as community leaders and faith-based leaders. These individuals were recruited from six communities in Kenya: three urban, and three rural. We applied a grounded theory approach to identify emerging themes and organized emerging themes using the SAGE Vaccine Hesitancy model, which includes three categories of determinants of vaccine acceptance, including contextual influences, individual and group influences, and vaccine and vaccination specific issues. Myths, interpersonal norms, and religion emerged as themes related to contextual influences. Safety, risk perception, and the role of the healthcare worker emerged as themes related to individual and group influences. For vaccine and vaccination specific issues, emerging themes included availability, accessibility, and eligibility. While maternal immunization can substantially reduce the effect of infectious diseases in mothers and infants, vaccine acceptance is critical. However, vaccines do not save lives; vaccination does. We hope the results of this study can be used to tailor communication efforts to increase vaccine demand among pregnant and lactating women., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The post-COVID-19 era has witnessed intensive engagements on latest datasets on COVID-19 experiences and the need for robust data systems to understand emerging policy pathways. There have also been extensive deliberations on how public organisations can deliver beyond immediate concerns with economic recovery and improved livelihoods. This paper draws insights from the Afrobarometer round 9 dataset on how different African governments' economies have been recovering from COVID-19 and how this has affected citizens' well-being in Kenya. The results show that despite the good recovery progress, the government has yet to stabilise high food prices, inflation, debts, job creation, etc. While national policy priorities may explain how this situation plays out, these challenges remain complex and linked to external factors that African governments may have little control over. [ABSTRACT FROM AUTHOR]

Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, usually conducted in ICUs with specialised staff, facilities and technologies. This paper estimates the incremental cost of EECC and advanced critical care for the planning of care for critically ill patients in Tanzania and Kenya. The incremental costing took a health systems perspective. A normative approach based on the ingredients defined through the recently published global consensus on EECC was used. The setting was a district hospital in which the patient is provided with the definitive care typically provided at that level for their condition. Quantification of resource use was based on COVID-19 as a tracer condition using clinical expertise. Local prices were used where available, and all costs were converted to USD2020. The costs per patient day of EECC is estimated to be 1 USD, 11 USD and 33 USD in Tanzania and 2 USD, 14 USD and 37 USD in Kenya, for moderate, severe and critical COVID-19 patients respectively. The cost per patient day of advanced critical care is estimated to be 13 USD and 294 USD in Tanzania and USD 17 USD and 345 USD in Kenya for severe and critical COVID-19 patients, respectively. EECC is a novel approach for providing the essential care to all critically ill patients. The low costs and lower tech approach inherent in delivering EECC mean that EECC could be provided to many and suggests that prioritizing EECC over ACC may be a rational approach when resources are limited. [ABSTRACT FROM AUTHOR]

Hunger and food insecurity has worsened due to the COVID-19 pandemic. The types of food environments (e.g., natural/built) that people can access may improve household resilience to food-system shocks. This paper examines (1) urban and rural differences in the perceived influence of the COVID-19 pandemic on agricultural, livelihoods, food environment attributes, diets; and (2) whether access to different food environments was associated with food security. A two-part telephonic survey (COVID-19 Surveillance Community Action Network Food Systems Tool and Household Food Insecurity Access Scale) was conducted in Western Kenya (n = 173) and an informal settlement in Nairobi (n = 144) in January/February 2021. Limitations on the acquisition of farm inputs and movement restrictions had an adverse impact on agriculture and food sales. Urban residents reported a more significant impact on livelihoods (97% vs. 87%, p < 0.001), with day laborers being the most impacted. Rural respondents reported access to significantly more food environments and lower food insecurity. Multiple linear regression analysis revealed that younger respondents, ≤1 income source, had more difficulty acquiring food, decreased access to cultivated environments, and increased access to informal markets were predictors for higher food insecurity. These data indicate that access to specific types of food environments may improve household resilience.

Background: People who inject drugs are at an increased risk for contracting SARS-CoV-2 and have experienced barriers to accessing harm reduction services during the COVID-19 pandemic. Understanding how to best provide these services is essential for COVID-19 mitigation. The goal of this study was to ascertain challenges and successes for caring for people who inject drugs in Kenya during the COVID-19 pandemic., Methods: We conducted focus group discussions and one-on-one key informant interviews with healthcare providers who work with people who inject drugs in Kenya. Interviews explored how COVID-19 and social distancing measures impacted service provision, as well as what strategies were used to overcome these barriers. We used thematic analysis to analyze transcribed interviews., Results: Participants included 29 service providers from 11 healthcare professions at three medication assisted treatment (MAT) and four drop-in center (DIC) sites (N=15 males and N=14 females, with an average age of 35 years). Four overarching themes emerged in our thematic analysis in which providers described both barriers to providing care and solutions to overcome them: (1) COVID-19-related misconceptions; (2) Limited COVID-19 testing and screening; (3) Structural changes related to service provision; and (4) Access to material resources such as meals, needle and syringe program kits, and personal protective equipment., Conclusions: Our findings demonstrate the COVID-19 pandemic-imposed challenges for substance use disorder treatment providers and patients, however with ingenuity many of these challenges were able to be overcome., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

The devastating effects of inadequate basic utilities such as water, sanitation, hygiene, waste management and environmental cleaning (WASH) is underscored by the current global pandemic declared on March 11, 2020. This paper explores the experiences of key informants (n = 15) ie government and non-government organization officials on the impacts of the COVID-19 pandemic in health care facilities (HCFs) and the role of WASH in emergency preparedness in health settings and the communities they serve using Kisumu, Kenya as a case study. The results from interviews with the key informants indicate socioecological challenges shaping access to hygiene services in HCFs and related disparities in social determinants of health such as WASH that serve as barriers to the pandemic response. All participants indicated the healthcare system was ill-prepared for the pandemic. Health care workers experienced such severe psychosocial impacts due to the lack of preparedness that they subsequently embarked on strikes in protest. These situations influenced citizens' perceptions of the COVID-19 pandemic as a hoax and resulted in a surge in other population health indicators (e.g., increased maternal mortality; decreased vaccination rates for other illnesses such as measles). We recommend authentic partnerships among all stakeholders to develop and implement context-driven sustainable solutions that integrate WASH and emergency preparedness in HCFs and the communities they serve across all spatial scales, from the global to the local., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This research examines water, sanitation, and hygiene (WASH) accessibility and opportunity in Kibera and Mathare during the COVID-19 pandemic in 2021. Kibera and Mathare are two of the largest urban informal settlements in Nairobi (the capital city of Kenya) as well as Sub-Saharan Africa. Accessibility indicates how easily a person can reach WASH facilities from their home by walking. Opportunity represents how many WASH options a person has near their home. We utilize the data on water and toilet facilities collected by GroundTruth Initiative in partnership with Map Kibera Trust (local community partners) between February and April 2021 - amid the COVID-19 pandemic. By conducting quantitative geospatial analysis, we illustrate WASH accessibility and related issues that were not evident in previous studies: (1) 77.4% of people living in Kibera have limited WASH facility accessibility or opportunity; (2) 60.6% of people living in Mathare have limited WASH facility accessibility or opportunity; (3) there is a clear geographic pattern in WASH facility accessibility and opportunity; and (4) overall accessibility and opportunity is better in Mathare than in Kibera. This study is one of the first studies to examine WASH accessibility and opportunity in urban informal settlements during the COVID-19 pandemic by utilizing the current data and quantitative geospatial methods. Based on the results, we discuss important public health policy implications for people living in urban informal settlements to improve their WASH facility accessibility and opportunity during the COVID-19 pandemic., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: This paper presents a descriptive analysis of the perceptions of Kenyan midwifery educators regarding the early impact of coronavirus disease 2019 (COVID-19) on the continuity of midwifery education., Methods: A cross-sectional online survey was conducted among 51 midwifery/clinical medicine educators from 35 diploma training colleges from all eight regions of Kenya. Educators' concerns and satisfaction regarding the delivery of training during the early phases of the pandemic were expressed as proportions on a three-point Likert scale., Results: Of the educators, 76% were extremely concerned about face-to-face teaching during the pandemic; 96% of educators had started delivering virtual teaching (VT), with only 41% being extremely confident in facilitating VT; and 97% were unsatisfied with the measures in place in their institutions to continue face-to-face teaching., Conclusion: To minimise the impact of COVID-19 on midwifery education in Kenya, capacity building for VT and mitigation measures for safe in-person training are urgently needed., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Informal settlements have been identified as locations both where the spread of COVID-19 has generally been slower than within the Global North and measures to restrain the pandemic have further intensified local peoples' marginality as income decreases without welfare or financial safety nets. In this paper, qualitative fieldwork is detailed which commenced in Korogocho, an informal settlement in Nairobi, Kenya, immediately prior to national COVID-19 restrictions. This March 2020, pre-COVID phase of the fieldwork focused on a community-based project and the basis for resilience in transforming local lives. During the next 12 months of the pandemic fieldwork continued, exploring experiences and reactions to restraining policies. These findings reinforce concerns about the impact of COVID-19 related restrictions on marginalised peoples' income, food security, health, safety and gender-based violence. How the local people reacted to these effects highlights their creative resilience and adaptability. The paper concludes by examining the impact of, and responses to, the controlling measures on the social relationships and cohesion that underpins the community resilience. [ABSTRACT FROM AUTHOR]

Strengthening the capacity of midwives and nurses in low- and middle-income countries to lead research is an urgent priority in embedding and sustaining evidence-based practice and better outcomes for women and newborns during childbearing. International and local travel restrictions, and physical distancing resulting from the COVID-19 pandemic have compromised the delivery of many existing programmes and challenged international partnerships working in maternal and newborn health to adapt rapidly. In this paper, we share the experiences of a midwife-led research partnership between Kenya, Malawi, Tanzania, Uganda, the UK, Zambia and Zimbabwe in sustaining and enhancing capacity strengthening activities remotely in this period. Whilst considerable challenges arose, and not all were overcome, collectively, we gained new insights and important learning which have shifted perspectives and will impact future design and delivery of learning programmes., Competing Interests: Declaration of competing interest None., (Copyright © 2021. Published by Elsevier Ltd.)

The global spread of the coronavirus pandemic has particularly dramatic consequences for the lives of migrants and refugees living in already marginalised and restricted conditions, whose ongoing crisis is at risk of being overlooked. But refugees are not only extremely vulnerable and at risk of infection, as several reports show, quickly develop their own protection measures like the production of hygienic products, the publication of their situation and calls for action and help. Therefore, this paper aims to research the effects of the coronavirus crisis on refugees in camp settings with a special ethnographic focus on how refugees actively deal with this crisis and if they, through already developed resilience, are capable of adapting to the restrictions as well as inventing strategies to cope with the difficult situation. To account for the variety of refugee camps as well as the different living conditions due to their locality, history and national asylum politics, we will look at three different locations, namely refugee asylum homes in Germany, hotspots on the Greek islands as well as one refugee camp in Kenya. The main questions will be how, under structurally and institutionally framed conditions of power and victimisation in refugee camps, forms of agency are established, made possible or limited. The goal is to show which strategies refugees apply to cope with the enhanced restrictions and exclusion, how they act to protect themselves and others from the virus and how they present and reflect their situation during the coronavirus pandemic. Finally, this discussion offers a new perspective to consider refugees not only as vulnerable victims, but also as actively engaged individuals. [ABSTRACT FROM AUTHOR]

COVID-19 has unleashed a crisis in public health and rule of law in Africa. In Kenya, narratives of corruption associated with the crisis are rampant. The paper evaluates political factors that amplify the response attempts in the country. It argues that traditional responses have focused on public health and economic issues. However, to develop appropriate responses, the overarching presence of neo-patrimonialism must be considered. Despite attempted governance reforms, neo-patrimonial practices have exacerbated corruption. There is a need for a rethink of governance reform strategy by acknowledging and addressing this fundamental cause, failing which there will be serious adverse public health consequences. [ABSTRACT FROM AUTHOR]

Background: E-learning has been widely adopted as a teaching and learning approach in medical education internationally. However, its adoption in low- and middle-income countries is still at an infantile stage. The use of e-learning may help to overcome some of the barriers to access to quality education and provide flexible, low-cost, user-centred, and easily updated learning. To address the need for research education during the COVID-19 pandemic, we developed and implemented an e-learning course for students enrolled in higher diploma courses at the Kenya Medical Training College (KMTC). In this paper, we report our experience teaching the online research course in resource-constrained settings to enable other medical educators, students and institutions in similar settings to understand the most appropriate approaches to incorporating e-learning interventions., Methods: This was a cross-sectional study that reviewed the experiences of learners and lecturers on a research course at Kenya Medical Training College. All higher diploma students admitted to the college in the 2020/21 academic year were invited to take part in the study. We also included all lecturers that were involved in the coordination and facilitation of the course. We analysed qualitative and quantitative data that were collected from the e-learning platform, an online course-evaluation form and reports from course lecturers., Results: We enrolled 933 students on the online research course. These students had joined 44 higher diploma courses in 11 campuses of the college. The students struggled to complete synchronous e-learning activities on the e-learning platform. Only 53 and 45% of the students were able to complete the pretest and the posttest, respectively. Four themes were identified through a thematic analysis of qualitative data (1) Students gained research competencies (2) Students appreciated the use of diverse e-learning technologies (3) Students felt overwhelmed by the research course (4) Technological challenges reduce the effectiveness of online learning., Conclusion: Our results suggest that e-learning can be used to teach complex courses, such as research in resource-constrained settings. However, faculty should include more asynchronous e-learning activities to enhance teaching and learning and improve student experiences., (© 2021. The Author(s).)

Copyright of European Journal of Development Research is the property of Palgrave Macmillan Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study we propose a Coronavirus Disease 2019 (COVID-19) mathematical model that stratifies infectious subpopulations into: infectious asymptomatic individuals, symptomatic infectious individuals who manifest mild symptoms and symptomatic individuals with severe symptoms. In light of the recent revelation that reinfection by COVID-19 is possible, the proposed model attempt to investigate how reinfection with COVID-19 will alter the future dynamics of the recent unfolding pandemic. Fitting the mathematical model on the Kenya COVID-19 dataset, model parameter values were obtained and used to conduct numerical simulations. Numerical results suggest that reinfection of recovered individuals who have lost their protective immunity will create a large pool of asymptomatic infectious individuals which will ultimately increase symptomatic individuals with mild symptoms and symptomatic individuals with severe symptoms (critically ill) needing urgent medical attention. The model suggests that reinfection with COVID-19 will lead to an increase in cumulative reported deaths. Comparison of the impact of non pharmaceutical interventions on curbing COVID19 proliferation suggests that wearing face masks profoundly reduce COVID-19 prevalence than maintaining social/physical distance. Further, numerical findings reveal that increasing detection rate of asymptomatic cases via contact tracing, testing and isolating them can drastically reduce COVID-19 surge, in particular individuals who are critically ill and require admission into intensive care., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2021 Isaac Mwangi Wangari et al.)

Solicited diaries in audio, written and online forms are increasingly used in qualitative data collection. However, most studies using this approach are set in high-income, high-literacy country settings. This paper discusses the opportunities and challenges of this approach in a low-income, low-resource, low-literacy setting. We used solicited audio-recorded diaries to explore the financial lives of low-income women in Kenya during the COVID-19 pandemic. We enrolled 24 women to submit diary entries every day for seven days. We found that the audio-recorded diaries worked well with low-income women in Kenya, which has high penetration of cell phone ownership. The diaries provided textured, detailed insights into participants' day-to-day challenges, fluctuations, and coping strategies while relying less on recall. Nevertheless, the approach required two pilots to perfect, which may be challenging when research resources and time are limited. This study provides timely evidence on the use of audio-recorded solicited diaries in low-income settings. [ABSTRACT FROM AUTHOR]

Copyright of Gender & Development is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

College students in Kenya have experienced many mental health issues, and there is little well-grounded research on this topic. Therefore, in this current study, we aimed to explore college students' biopsychosocial spiritual wellbeing and problems from an Ecological Systems Theory (EST) perspective. Due to lack of previous well-grounded mental health research and services, we collaborated with the college students from the beginning of the study and acted with them to shape the research. Based on all these, we called our theoretical framework for this current paper as exploring college students' biopsychosocial spiritual wellbeing and problems from the EST perspective. We examined college students' (N = 518) mental health experiences during the COVID-19 pandemic through six items to measure psychosomatic problems (sadness, anxiety, frustration, stress, loneliness, and withdrawal) and their coping mechanisms (talking to family/friends, physical exercise, social media, reading books, hobbies, spiritual activities, alcohol/drugs, COVID-19 information). Gender and age explained a trivial amount of variance, about 1%, in psychosomatic problems in model one. With the inclusion of the coping strategies and demographic factors (age and gender), the second model explained 24% of the variance in psychosomatic problems. In the second model, the highest effect size originated from talking to family/friends and use of social media. In addition, change in sleeping patterns, sadness, anxiety, and frustration were reported with one in three reporting "poor" or "fair" mental health. In light of the larger COVID-19 and college students' mental health literature, we discussed the present findings and provided recommendations. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and country measures to control it can lead to negative indirect health effects. Understanding these indirect health effects is important in informing strategies to mitigate against them. This paper presents an analysis of the indirect health effects of the pandemic in Kenya., Methods: We employed a mixed-methods approach, combining the analysis of secondary quantitative data obtained from the Kenya Health Information System database (from January 2019 to November 2020) and a qualitative inquiry involving key informant interviews (n = 12) and document reviews. Quantitative data were analysed using an interrupted time series analysis (using March 2020 as the intervention period). Thematic analysis approach was employed to analyse qualitative data., Results: Quantitative findings show mixed findings, with statistically significant reduction in inpatient utilization, and increase in the number of sexual violence cases per OPD visit that could be attributed to COVID-19 and its mitigation measures. Key informants reported that while financing of essential health services and domestic supply chains were not affected, international supply chains, health workforce, health infrastructure, service provision, and patient access were disrupted. However, the negative effects were thought to be transient, with mitigation measures leading to a bounce back., Conclusion: Finding from this study provide some insights into the effects of the pandemic and its mitigation measures in Kenya. The analysis emphasizes the value of strategies to minimize these undesired effects, and the critical role that routine health system data can play in monitoring continuity of service delivery., (© 2021. The Author(s).)

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context. [ABSTRACT FROM AUTHOR]

Climate-induced migration is an increasingly pressing issue in many African regions, as rising temperatures and extreme weather events have caused the displacement of vulnerable populations. This is especially so in Eastern Africa and the Horn of Africa, particularly Kenya and Ethiopia, where extreme weather events have led to rangeland degradation, crop failures, water shortages, and food insecurity. Hence, there is a perceived need to understand these processes better. Against this background, this paper reports on a study investigating the processes associated with climate-induced migration in Kenya and Ethiopia. The research method used consisted of an expert-driven assessment approach, which assesses the causes of climate-induced migration in Kenya and Ethiopia and its human and social implications on local communities. Data were collected from 110 experts residing and working on climate and migration-related issues in Ethiopia and Kenya via e-mail, whose knowledge of the current situation has enabled the identification of some important trends. The results show that climate change is a primary trigger of migration both internally and externally. The high number of migrants, many of whom living within levels of poverty in their home areas is straining resources and services in the receiving regions. Their presence is also leading to increased competition for jobs and resources. Additionally, it has increased urban poverty, as many migrants have little access to living space and health care. This paper provides a welcome addition to the literature in that it lists the causes and implications of climate-induced migration and, by doing so, fosters a better understanding of the current crisis and its implications. The implications of this paper to the overall knowledge of climate change and migration are twofold. First, it highlights the need for governments, international organisations, and other stakeholders better to understand the complex linkages between climate change and migration. Secondly, it shows the usefulness of better recognising how climate change can drive migration and the other factors shaping the decision to migrate. The paper concludes by stating the urgent need for policies and programmes that support climate change-induced migrants. Also, it draws attention to the usefulness of promoting sustainable development in their origin countries and destinations, so that migration is not necessarily perceived as the only response to climate change. A further conclusion is that there is a perceived need for providing access to resources such as education, health care, and livelihood opportunities and establishing mechanisms to ensure a safe and dignified return for those who choose to do so. • Climate change is a significant driver for migration in Kenya and Ethiopia. • Droughts, conflicts, and crop failures are among the key drivers of migration. • Male migration is more prominent than a female one. • Limited access to productive resources leads to outmigration from rural areas. • Lockdowns associated with the COVID-19 pandemic did not cause any major migration. [ABSTRACT FROM AUTHOR]

Pandemics are associated with exponential mortality rates, creating heavy burdens on communities. The high death rates affect how societies traditionally conduct funerary practices as governments impose regulations on the preparation of bodies and the conduct of the funerals to stem the transmission of the virus. In societies associated with deeply entrenched customary funerary practices, such limitative measures attract defiance. The tensions between public health objectives and funerary traditions have played out in a number of societies resulting in litigation. At the core of the disputes is whether the right to manifest religion or belief can be upheld, and relatedly, whether the dead have rights to dignified burials irrespective of pandemics. During the COVID-19 pandemic, some courts had to grapple with these difficult questions. In this paper, I take a jurisprudential excursion on some disputes in Kenya, India and Sri Lanka to assess the adjudication of conflicts which arose from COVID-19 pandemic deaths. [ABSTRACT FROM AUTHOR]

COVID-19 remains an income shock of significant economic consequence to many households across the world. The situation among refugees can be pathetic due to their inherent economic deprivations and vulnerability to income shocks. This paper analyzed the dynamics of poverty among refugees in Kenya during the COVID-19 pandemic and determined their correlates. The data were the first to fifth waves of the COVID-19 Rapid Response Phone Surveys that were conducted among refugees. The data were analysed with heteroscedasticity consistent Ordered Probit model. The results showed that with only 8.14% of the refugees never entering poverty within the survey periods, majority of the refugees were transiently (46.27%) and chronically (45.59%) poor. The error variance differed across household sizes, and heteroscedasticity was properly corrected. Movement from never being poor to chronic poverty was significantly promoted by urban residence, household size, educational levels, and camp of residence (Kakuma, Dadaab and Kalobeyei), while asset disposal income, amount of credit, remittance, and other gifts reduced it. It was concluded that efforts to reduce poverty vulnerability among refugees should among others address maternal fertility and promotion of policies to allow formally educated refugees to be gainfully engaged in the Kenyan labour markets. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, cases of gender-based violence (GBV) dramatically increased. While the Kenyan governmental bodies are held responsible for their inadequate response to this "national disaster of GBV", the role of the Kenyan churches is hardly criticized. The churches neither spoke out against this prevalent injustice, nor did they openly support the victims of GBV. Furthermore, it could be argued that churches, through their patriarchal structures and cultural and doctrinal teachings, have contributed to this disaster. This article is written from a woman's perspective and focused on the notion of vumilia, or perseverance, an important notion in the lived faith of women. Vumilia is the Kiswahili word for "persevere" or "endure." It appears that a gendered vumilia theology applied to gender relations, prevents churches from adequately addressing gender-based violence. Unless and until this vumilia theology is deconstructed and balanced with a liberation theology, the church's response to gender-based violence will be superficial and insufficient. In this article, the narrative method is used to bring about the ideas and experiences of women in two Kenyan churches, the Reformed Church of East Africa (RCEA) and the African Israel Nineveh Church (AINC), related to vumilia and its cultural and theological underpinnings. The article discusses the teachings of vumilia theology in these churches and their effects on women who suffer from gender-based violence. The paper also traces the resistance of church women, indicating the contours of a woman-affirming Christ-centered theology and spirituality. [ABSTRACT FROM AUTHOR]