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This paper argues that for any community transformation to be achieved, cultural values and legal frameworks, which influence issues relating to land rights and food security, must form an integral part of any policy intervention efforts. We adopted feminism as both a methodological and an analytical framework. The dominant research paradigm was qualitative. The study sample was 184 people obtained using a systematic sampling method. Data collection was through focus groups and interviews. We challenge contemporary development initiatives, in terms of their intentions and sustainability. Finally, it is important that any development initiatives facilitate the participation and involvement of all genders. [ABSTRACT FROM AUTHOR]

In the climate-development interface, research for development gained a strong interest in climate-smart agriculture and sustainable forms of intensification. Moreover, the urgency to respond to climate change stimulates a strong and sometimes exclusive focus on mitigation, driven by research-based agricultural practices. In the livestock sector, this materialises in strategies to lower emissions from livestock, which centralises the adoption question: what can we do to stimulate the use of best practices by smallholder farmers? This paper flags the risk that this outlook may overlooksmallholder farmers' capacities to navigate sub-optimal conditions of drought or scarcity. The paper applies an alternative lens for understanding 'agriculture-as-performance' and highlights smallholder cattle owners' agency and resourcefulness. It aims to create a conceptual space to examine how adaptive capacities are grounded in the rhythms of agriculture under suboptimal conditions. Empirically, the study focuses on the cattle-feeding practices of five farming households evolving through seasons and lifetimes in a sedentary agricultural system in Kenya. Our frame identifies diverse affordances, conceptualised as opportunities for actions, emerging and disappearing in the immediate material environment, and we portray cattle feeding as a networked response anchored in practices of giving, sharing, and receiving. We use our insights into the dynamics and performance of entangled socio-technical practices to sketch the contours of an alternative pathway for agriculture for development. We argue in favour of a shift from an exclusive focus on the adoption of predefined optimal solutions to a diagnostic and catalytic approach integrating situated adaptive performances through which farming households respond to action opportunities. [ABSTRACT FROM AUTHOR]

Kenya's vulnerability to climate variability and change has been compounded by dependence on rain-fed agriculture with constrained capacity to adapt, a rapidly growing population, low-mechanized and low-input smallholder agricultural systems, and compromised soil fertility. The Ukraine war, COVID-19 and the desert locust invasion have only amplified the prevailing sensitivity to shocks in the agriculture sector, creating an emphasis on the need to strengthen local agricultural production to reduce reliance on imports. This paper seeks to assess the opportunities for improving agriculture adaptation and resilience based on future expected changes in climate, length of the growing period and agro-ecologies. The study uses 2020 as the baseline year and explores changes in agro-ecological zones (AEZs) in "near future" 2040 through two representative concentration pathways, 4.5 and 8.5, representing a medium carbon emissions and a dire emissions future, respectively. Google Earth Engine and R Statistics are used in data-processing. Down-scaled climate projections from CIMP5 are used for future analyses combined with static soil suitability and drainage data. Fuzzy logic is used to normalize inputs and compute the agro-ecological zones (AEZ). Interesting results emerge from the study that validate the hypothesis that the seasons and production potential are shifting. Lowland drylands will experience an increasingly long growing period, creating the potential for diversifying production systems from rangelands to agro-pastoral systems, with the capacity to grow more drought-resistant crops and the potential to take advantage of increased runoff for water harvesting. Midland highland areas, which form part of the food basket areas, have already started experiencing a reduction in the length of the growing period and agricultural potential. In these areas, resilience mechanisms will need to consider the expected future reduction in rain-fed agricultural potential, gendered preferences, convergence of technology and indigenous coping mechanisms, and drought-resilience-focused diversification. [ABSTRACT FROM AUTHOR]

Introduction: The Data‐informed Stepped Care (DiSC) study is a cluster‐randomized trial implemented in 24 HIV care clinics in Kenya, aimed at improving retention in care for adolescents and youth living with HIV (AYLHIV). DiSC is a multi‐component intervention that assigns AYLHIV to different intensity (steps) of services according to risk. We used the Framework for Reporting Adaptations and Modifications‐Expanded (FRAME) to characterize provider‐identified adaptations to the implementation of DiSC to optimize uptake and delivery, and determine the influence on implementation outcomes. Methods: Between May and December 2022, we conducted continuous quality improvement (CQI) meetings with providers to optimize DiSC implementation at 12 intervention sites. The meetings were guided by plan‐do‐study‐act processes to identify challenges during early phase implementation and propose targeted adaptations. Meetings were audio‐recorded and analysed using FRAME to categorize the level, context and content of planned adaptations and determine if adaptations were fidelity consistent. Providers completed surveys to quantify perceptions of DiSC acceptability, appropriateness and feasibility. Mixed effects linear regression models were used to evaluate these implementation outcomes over time. Results: Providers participated in eight CQI meetings per facility over a 6‐month period. A total of 65 adaptations were included in the analysis. The majority focused on optimizing the integration of DiSC within the clinic (83%, n = 54), and consisted of improving documentation, addressing scheduling challenges and improving clinic workflow. Primary reasons for adaptation were to align delivery with AYLHIV needs and preferences and to increase reach among AYLHIV: with reminder calls to AYLHIV, collaborating with schools to ensure AYLHIV attended clinic appointments and addressing transportation challenges. All adaptations to optimize DiSC implementation were fidelity‐consistent. Provider perceptions of implementation were consistently high throughout the process, and on average, slightly improved each month for intervention acceptability (β = 0.011, 95% CI: 0.002, 0.020, p = 0.016), appropriateness (β = 0.012, 95% CI: 0.007, 0.027, p<0.001) and feasibility (β = 0.013, 95% CI: 0.004, 0.022, p = 0.005). Conclusions: Provider‐identified adaptations targeted improved integration into routine clinic practices and aimed to reduce barriers to service access unique to AYLHIV. Characterizing types of adaptations and adaptation rationale may enrich our understanding of the implementation context and improve abilities to tailor implementation strategies when scaling to new settings. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic resulted in disruptions to routine HIV services for youth living with HIV (YLH), provoking rapid adaptation to mitigate interruptions in care. The Adolescent Transition to Adult Care for HIV-infected adolescents (ATTACH) study (NCT03574129) was a hybrid I cluster randomized trial testing the effectiveness of a healthcare worker (HCW)-delivered disclosure and transition intervention — the Adolescent Transition Package (ATP). During the pandemic, HCWs leveraged phone delivery of the ATP and were supported to make adaptations. We characterized real-time, provider-driven adaptations made to support phone delivery of the ATP. Methods: We conducted continuous quality improvement (CQI) meetings with HCWs involved in phone delivery of the ATP at 10 intervention sites. CQI meetings used plan-do-study-act (PDSA) cycles and were audio-recorded. Adaptations were coded by two-independent coders using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS). Adaptation testing outcomes (adopt, retest, or abandon) and provider experience implementing the adaptations were also recorded. We summarized adaptation characteristics, provider experience, and outcomes. Results: We identified 72 adaptations, 32 were unique. Overall, adaptations included modification to context (53%, n = 38), content (49%, n = 35), and evaluation processes (13%, n = 9). Context adaptations primarily featured changes to personnel, format, and setting, while content and evaluation adaptations were frequently achieved by simple additions, repetition, and tailoring/refining of the phone delivery strategy. Nine adaptations involved abandoning, then returning to phone delivery. HCWs sought to increase reach, improve fidelity, and intervention fit within their context. Most adaptations (96%, n = 69) were perceived to increase the feasibility of phone delivery when compared to before the changes were introduced, and HCWs felt 83% (n = 60) of adaptations made phone delivery easier. Most adaptations were either incorporated into routine workflows (47%) or tested again (47%). Conclusion: Adaptation of phone delivery was a feasible and effective way of addressing challenges with continuity of care for YLH during the COVID-19 pandemic. Adaptations were primarily context adaptions. While FRAME-IS was apt for characterizing adaptations, more use cases are needed to explore the range of its utility. Trial registration: Trial registered on ClinicalTrial.gov as NCT03574129. [ABSTRACT FROM AUTHOR]

Drought is a complicated natural hazard that has far-reaching social and environmental impacts. In Ethiopia's diverse agro ecological zones, drought remains a severe challenge and problem. Livestock rising is one of the agricultural sub-sectors that provide income and livelihood to around one-third of African inhabitants and accounts for 30–50 percent of agricultural GDP. Pastoralists on the Ethiopia-Kenya-Somalia border endured extreme suffering, including the loss of nearly 80% of their cattle and huge migration out of drought-stricken areas. Drought can cause severe economic hardship and stress for farmers and local economies, like; lost productivity, population reduction, and the trauma of witnessing livestock, crops, soil, and native vegetation damage. Between 1990 and 2000, and 2001-2002/03, drought-related animal death rates in the Somali region increased by 60% and 80% of the entire cattle population, respectively. Drought has the greatest immediate effects on farmers, including depletion of water resources, crop failure, and an increase in food prices, ill health, livestock output losses and death, and a decline in livestock prices in the Borana zone. Drought adaptation and mitigation measures depending on geography and livestock system may improve the study's trajectory in the future if further review is done. [ABSTRACT FROM AUTHOR]

Introduction: In Africa, oral pre‐exposure prophylaxis (PrEP) is largely provided via over‐burdened public HIV care clinics. Successfully incorporating PrEP services into these clinics may require adaptations to practices outlined in national implementation guidelines and modifications to routine existing service delivery. We aimed to describe adaptations made by public HIV clinics in Kenya to integrate PrEP delivery into existing services. Methods: The Partners Scale‐Up Project aimed to catalyse integration of PrEP in 25 public HIV care clinics. Between May and December 2018, we conducted qualitative interviews with health providers and documented clinic observations in technical assistance (TA) reports to understand the process of PrEP service integration. We analysed 36 health provider interview transcripts and 25 TA reports to identify clinic‐level adaptations to activities outlined in Kenyan Ministry of Health PrEP guidelines and modifications made to existing service delivery practices to successfully incorporate PrEP services. Identified adaptations were reported using the expanded framework for reporting adaptations and modifications (FRAME). Results: All clinics (n = 25) performed HIV testing, HIV risk assessment, PrEP education and adherence counselling as stipulated in the guidelines. Most clinics initiated clients on PrEP without creatinine testing if otherwise healthy. While monthly refill appointments are recommended, a majority of clinics issued PrEP users two to three months of pills at a time. Clinics also implemented practices that had not been specified in the guidelines including incorporating PrEP‐related topics into routine health talks, calling clients with missed PrEP appointments, discussing PrEP service delivery in regular staff meetings, 'fast‐tracking' PrEP clients and dispensing PrEP in clinic rooms rather than at clinic‐based pharmacies. PrEP initiation numbers were highest among clinics that did not require creatinine testing, conducted peer on‐the‐job PrEP training and those that discussed PrEP delivery in their routine meetings. Above‐average continuation was observed among clinics that discussed PrEP in their routine meetings, dispensed PrEP in clinic rooms and offered PrEP at nonregular hours. Conclusions: Health providers in public HIV care clinics instituted practices and made innovative adaptations to PrEP delivery to reduce barriers for clients and staff. Encouraging clinic level adaptations to national implementation guidelines will facilitate scale‐up of PrEP delivery. [ABSTRACT FROM AUTHOR]

We explore how seed systems enhance access to seeds, and information for climate-change adaptation in farming communities in Kenya, Tanzania and Uganda, as well as how gender-driven roles and institutional dynamics influence the process. Men and women farmers equally experience climate-change related effects, including drought, short rainy seasons and increased pest and disease incidence. Our study relies on exploratory data analysis of 1001 households surveyed in four sites in 2016. Farmers surveyed preferred early-maturing, heat-tolerant, high-yielding, and pest- and disease-resistant varieties, all important climate-adaptive traits. Seed systems of the focus crops studied are largely informal—overall, 68% women and 62% men use their own seed, indicating women's higher reliance on 'informal' seed and information sources. Only 21% of respondents reported interacting with seed experts who are affiliated with formal organizations. Both formal and informal organizations play a key role in providing access to climate-adapted seed/information, with access for men and women varying across the countries studied. There is a need to support further development of those connections, building on existing social networks. We conclude that inclusive and gender-responsive context- and country-specific seed interventions will ensure equitable outcomes, increase women's empowerment and strengthen both formal and informal seed systems for more effective climate-change adaptation. [ABSTRACT FROM AUTHOR]