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The 1998 UNESCO World Conference on Higher Education in Paris recommended that global higher education institutions should internationalize and reduce inequalities between developed and emerging countries. Since then, universities strive to incorporate an international dimension in their service. The aim was initially guided by the 20th century understanding of internationalization being just, fair, and an equitable process that promotes peace and mutual understanding. However, under the influence of the General Agreement on Trade in Services and competition, internationalization changed focus and became less inclusive. This paper explores inclusive international education in East Africa using narrative review methodology. Findings suggest that rather than promoting access and equity in higher education, internationalization, for example, excludes economically disadvantaged, disabled, and adult learners. Thus, in addition to internationalization at home, inclusive internationalization abroad strategies should be devised. Internationalization of higher education is more valuable if it translates into fair, just, and peaceful social systems.

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]

Background: Conceptualisations of what it means to use evidence in policymaking often appear divided between two extremes. On the one side are works presenting it as the implementation of research findings - particularly evaluations of intervention effect. In contrast stand theoretically informed works exploring the multiple meanings of evidence use, political complexities, and the constructed nature of research evidence itself. The first perspective has been criticised as over-simplistic, while the latter can make it difficult to answer questions of what might be good, or improved, uses of evidence in policymaking. Methods: To further debate, this paper develops a 'programmatic approach' to evidence use, drawing on theories of institutional decision making and empirical work on evidence use within 11 National Malaria Control Programmes in Africa. We apply the programmatic approach by investigating the key goals and tasks of programme officials, recognising that these will shape the routines and logics followed affecting evidence utilisation. We then map out the forms, sources, features, and applications of evidence that serve programme officials in their goals. Findings: In the case of malaria programmes, evidence use was understood in relation to tasks including: advocacy for funding, budget allocation, regulation development, national planning, and identification of information gaps - all of which might require different evidence sources, forms, and applications. Discussion and conclusions: Ultimately the programmatic approach aims to facilitate clearer understanding of what uses of evidence are appropriate to policymakers, while also allowing critical reflection on whether such uses are 'good' from both programme and broader social perspectives.

The development and practice of inclusive research with people with intellectual disabilities is complex, revealing challenges and lessons that inform innovative and novel methodological approaches. In Africa, inclusive research still lags for various reasons. First, due to societal misconceptions that portray people with intellectual disabilities as unable to self-advocate or as lacking agency and self-determination; second, due to a lack of trained researchers and ethics committees on inclusive research practices. This paper critically reflects on and discusses the strategies and methods used to conduct an inclusive research study in Kenya. The focus was on the methodological approach of including people with intellectual disabilities as researchers in Kenya. Two people with intellectual disabilities were trained as research assistants. This paper describes the experiences with Institutional Review Boards, the processes and experiences while training this research assistants using a UK-developed curriculum, and fieldwork experiences while piloting interview guides, conducting interviews, and conducting focus groups with this research assistants. This study findings indicate the need to culturally adapt co-researcher training, the importance of working with support personnel who empower researchers with intellectual disabilities, and the need for greater advocacy to change negative attitudes towards people with intellectual disabilities that hinder their participation in research. [ABSTRACT FROM AUTHOR]

This study sought to understand how fathers perceived schooling of their children with intellectual disabilities and how this impacted upon their involvement. The paper reports specifically on the views of fathers, teachers and mothers of children with intellectual disabilities regarding how fathers understood schooling and how the understanding affected father involvement at a special school. The findings are a part of a larger case study conducted at one special school for children with intellectual disabilities in Kenya. Purposive sampling was used to recruit nine teachers, eight fathers, and six mothers of children with intellectual disabilities from the special school. Individual interviews, focus group discussions and a document review were the data collection methods. Data were transcribed and analysed thematically. Fathers' understanding of schooling was expressed in the two themes emerging: the ambivalence of the purpose of the school and a focus on functional skills. Fathers want their children with disabilities to be educated, which means gaining knowledge and skills that would lead to becoming self-reliant, but they do not always agree with schooling which is the way that society has chosen to educate children. While fathers may not be involved in schooling they often are involved and concerned about education. [ABSTRACT FROM AUTHOR]

As rivalry between China and the United States (US) for global dominance of the digital landscape intensifies, countries across the globe are responding to the impact, with serious implications for their foreign policy postures. This article extends the concept of rational choice to an examination of strategies directed by China and the US to influence African policy positions. By applying this framework to an examination of the Huawei ban in the US and pressure on its allies to follow suit, the article distinguishes the overriding emphasis of research on global power competition and foreign policymaking on the interests and values of China and the US from an emerging strategy of agency in Kenya. The rational choice perspective enables us to understand what informs Kenya’s interests, preferences, choices, and foreign policy decisions in the US Huawei ban. By focusing on the role of domestic factors shaping Kenya’s foreign policy choices, we come to see how individuals, local businesses, consumers, interest groups, bureaucracies, and policymakers in Kenya are self-interested rational actors influencing collective action and shaping the country’s policy choices rather than passive recipients of great power influences. The article aims to contribute to a strategy of re-centring domestic actors in Kenya’s foreign policymaking and exerting their agency in the rivalry between China and the US. [ABSTRACT FROM AUTHOR]

• The paper analyzes long-term impacts of electoral violence on health and education. • Areas exposed to violence in Kenya suffer inflation and fall in annual consumption. • Children and adolescents exposed to violence have stunted height as adults. • The sons of those exposed to violence during growing age also have stunted growth. • No long-term impact on education is found as violence peaks during school holidays. This paper examines whether prenatal, childhood, and teenage exposure to electoral violence has any long-term effects on height and human capital in Kenya. First, using the difference-in-difference estimator, we show that areas impacted by electoral violence see increases in local food prices and a decrease in annual nightlight, suggesting important local consumption shocks. We then identify people exposed to such violence using a nationally representative survey and take advantage of the temporal and spatial variation of electoral violence in Kenya between 1992 and 2013. Using coarsened exact matching, we find that exposure to electoral violence between prenatal and the age of sixteen reduces adult height. Previous research has demonstrated that protracted, large-scale armed conflicts can cause significant nutritional shocks and pass down stunting effects to descendants. In line with these studies, we find that the low-scale but recurrent electoral violence in Kenya has impacted the height-for-age of children whose parents were exposed to such violence while they were growing up. Only boys exhibit this intergenerational effect, possibly due to their increased susceptibility to malnutrition and stunting in Sub-Saharan Africa. The fact that most electoral violence in Kenya occurs over the school holidays may help explain why, in contrast to previous studies on large-scale conflicts, childhood exposure to electoral violence has no lasting impact on educational attainment. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to study whether entrepreneurial performance can be explained by entrepreneurial orientation among female entrepreneurs in Kenya. This empirical research is based on the data from 301 small and medium enterprises (SMEs) located in Kenya. A linear multiple regression analysis on the effect of entrepreneurial orientation on entrepreneurial performance among female entrepreneurs was conducted. The paper focused on the five aspects of entrepreneurial orientation (risk-taking, innovativeness, pro-activeness, competitive aggressiveness, and, autonomy) and their ability to prompt entrepreneurial performance which was defined as firm performance, development of personal wealth, and social performance. Social performance was rather well predicted by entrepreneurial orientation (by 4 out of 5 aspects), whereas firm performance was only limitedly predicted by entrepreneurial orientation (only by 2 out of 5 aspects) and development of personal wealth was not predicted by entrepreneurial orientation at all (by 0 out of 5 aspects). On the other hand, we see that the entrepreneurial orientation aspects of innovativeness and pro-activeness have the most predictive value (for 2 out of 3 entrepreneurial performance indicators), whereas risk-taking and autonomy have only limited predictive value (for only 1 out of 3 entrepreneurial performance indicators) and competitive aggressiveness has no predictive value at all (for 0 out of 3 entrepreneurial performance indicators). The paper is based on own-collected empirical data. The paper indicates that the benefits of aligning high levels of entrepreneurial orientation are not unanimous but vary across the different aspects of entrepreneurial orientation and the different entrepreneurial performance indicators. [ABSTRACT FROM AUTHOR]

Lung health in Africa is of great public health concern. To exchange knowledge, communicate the latest scientific advances in lung health, build the capacity of young researchers, and provide a platform for networking of lung health stakeholders in Africa, the Pan African Thoracic Society (PATS), in partnership with the Respiratory Society of Kenya organized and held the 3rd Biennial PATS congress, from June 7–10, 2023 in Mombasa, Kenya. There were a total of 30 conference sessions, which included six skills building workshops, two research dissemination workshops, six plenary sessions, and five each of pediatric, adult, and thoracic surgery symposia. A total of 60 abstracts were presented, including 27 oral abstracts and 33 posters. A wide range of issues for lung health in Africa emerged. These include the emerging role of the environment, especially climate change and global warming, on lung health, the threat posed by the use of tobacco and other nicotine products in Africa, the high burden of lung infections, insecurity of medical oxygen supply systems, and high burden of chronic respiratory disease. In this paper, we summarize the proceedings of this conference and draw lessons that can be used to advance lung health in the African continent. [ABSTRACT FROM AUTHOR]

This paper discusses how African organisations and countries construct their geographical indication (GI) systems. It makes three primary arguments. First, that the nascent GI agenda in Africa is driven by the European Union (EU) to principally promote European interests. Nonetheless, African countries can benefit from GI regimes by crafting laws that promote African interests. Second, that simply embracing the introduction of GI laws will not result in the EU's promised socioeconomic development in Africa. This is because multifarious factors including infrastructure, investment, branding, marketing and security are required to realise successful GI regimes. Third, that African countries must leverage contextually customised GI regimes to maximise the potentials they present. Contextually customised GI regimes can engender socioeconomic development. Beyond the EU's agenda‐setting technologies, international affiliations and treaty boundaries shape GI laws in Africa, which inform the marked variation in its GI systems. This variation reflects the dissonance in international treaties for GIs. While African countries align with demandeurs that espouse stronger GIs laws at the international level, the only regional instrument on GIs in Africa is its Continental Strategy for GIs. In examining examples from the Organisation Africaine de la Propriété Intellectuelle, the African Regional Intellectual Property Organisation, South Africa, Kenya and Nigeria, this timely paper maintains that although GIs present promises of socioeconomic development, policymakers, lawmakers and relevant African stakeholders must caution against their often‐overlooked pitfalls. As ultimately, it is the responsibility of Africans, not foreigners, to guarantee the generation of thriving GI ecosystems for African products. [ABSTRACT FROM AUTHOR]

Front-line workers, or street-level bureaucrats, who interact directly with clients, have significant discretion over clients' lives. Drawing upon ethnographic observation in Kakuma refugee camp in Kenya and interviews with aid workers, I argue that front-line workers are not a uniform group. I examine three types of front-line aid workers (international, national, and refugee), who work directly with refugee clients. Workers use day-to-day work practices to structure where, when, and how they interact with refugee clients. Yet, workers at the bottom of the organizational hierarchy are less equipped to use these practices. As a result, they are vulnerable to increased criticism and accusations of corruption from co-workers and are uniquely affected by criticism from the refugee client community. By examining their day-to-day work practices, this paper illuminates how inequalities in power among workers contribute to differences in work practices and vulnerability in workplace interactions. [ABSTRACT FROM AUTHOR]

It was feared that the digital divide would deny citizens in developing countries opportunities for increased participation in politics through internet-enabled communication technologies. However, the divide has been bridged by citizens through the appropriation of Western technologies like internet access through mobile phones and cyber cafes. In fact, the difference between North and South in the use of the internet to participate in politics is quickly becoming unnoticeable, especially regarding the use of social media. This paper describes the unforeseen impact of the rapid adoption of social media in Africa, a continent that has been lethargic to other Western technological advances. The paper uses Anderson's (1991/1983) theory of imagined community and Billig's (1995) banal nationalism thesis to describe the role of social media groups in building banal nationalism, a process that unobtrusively legitimises the otherwise artificial nation-state. Through analysis of the activities of social media groups, the paper describes how, besides enabling the formation of social groups, social media has created a new sense of consciousness and deep attachment to the concept of a nation-state in Kenya. [ABSTRACT FROM AUTHOR]

Article 43 of the African Charter on the Rights and Welfare of the Child mandates state parties to report on their efforts made towards implementing treaty provisions to the African Committee on the Rights and Welfare of the Child (ACERWC). The aim of this process is to afford states an opportunity to internally assess their progress and to grant the ACERWC an opportunity to guide states in the implementation of the treaty provisions through constructive dialogue during the state reporting process and through concluding observations which states are required to implement. While much has been written about the value of the state reporting process, not much has been said about the measures taken by states to implement the concluding observations from the state reporting process. The concluding observations offer a premise on which to advance a discourse on state implementation of the regional norms, given that they emanate from an incisive reflection of state parties' reports by the ACERWC. This paper finds that while the ratification of the African Children's Charter by the countries under consideration has led to normative and institutional changes in these countries, there are pertinent challenges that need to be addressed in the realisation of children's rights in Africa. Through the concluding observations, this paper examines the domestic implementation of children's rights in four African countries, namely: Kenya, Nigeria, South Africa and Egypt. [ABSTRACT FROM AUTHOR]

Sub-Saharan Africa is often presented as the continent most vulnerable to climatic change with major repercussions for food systems. Coupled with high rates of population growth, continued food insecurity and malnutrition, thus the need to enhance food production across the continent is seen as a major global imperative. We argue here, however, that current models of agricultural development in Eastern Africa frequently marginalise critical smallholder knowledge from the process of future agricultural design due to a lack of a methodological tools for engagement. This paper addresses this by outlining a potential means to capture and share locally produced agronomic information on a large scale. We report on a 'Citizen Science' pilot study that worked with smallholder farmers in Elgeyo-Marakwet County, Western Kenya, to co-design a mobile application using the well-developed Sapelli platform that easily allows farmers to identify, record and geolocate cropping patterns and challenges at multiple stages in the agricultural calendar using their own understanding. The pilot project demonstrated the technical and epistemological benefits of co-design, the abilities of smallholder farmers to co-design and use smartphone applications, and the potential for such technology to produce and share valuable agricultural and ecological knowledge in real time. Proof-of-concept data illustrates opportunities to spatially and temporally track and respond to challenges related to climate, crop disease and pests. Such work expounds how smallholder farmers are a source of largely untapped ecological and agronomic expert knowledge that can, and should, be harnessed to address issues of future agricultural resilience and food system sustainability. [ABSTRACT FROM AUTHOR]

This paper measures how often audiences in Kenya, Nigeria and South Africa consume Chinese media, and investigates whether a positive relationship exists between the consumption of English language Chinese media and attitudes towards China. We analyze three waves of survey data collected in 2017/2018, 2020 and 2021 (N = 5876) in Kenya, Nigeria, and South Africa. We show that, while Chinese State-owned news media have a growing but limited following, the minority of media users who report getting news from Chinese media have better attitudes towards China than those who don't. Our findings suggest that Beijing's external communication activities might have the potential to fulfil Beijing's goal of improving the country's image overseas, provided that media reached a wider audience. The paper overcomes the limitations of previous studies on the reception of Chinese external communication practices in Africa (i.e., small sample sizes, failure to differentiate between increased presence and increased impact, and use of indirect rather direct measures of media use to infer possible effects on public opinion). [ABSTRACT FROM AUTHOR]

Regulation is usually justified by the public interest in theory but in practice may end up serving special interests. This paper evaluates the regulatory frameworks for engineers and engineering technologists in Kenya with the view to establishing whether they take the public interest into consideration or only other special interests. Taking public interest into account is necessary to foster development and avoid regulatory conflicts. The study used qualitative document analysis (QDA) to collect and analyze the documentary data available in relevant statutes, namely the Engineers Registration Act (1969–2012), the Engineers Act (from 2012), and the Engineering Technology Act, as well as the Auditor-General's annual reports. The main aim of the study is to establish whether the regulators are motivated by public interest or not. The findings are that public interest is not the main goal because regulators focus on non-regulatory activities such as business investments, there is capture of regulatory instruments by the regulator, there is limited inclusion of other actors in the regulatory operations, there is engagement in extraprofessional activities with the risk of distraction from the core mandate of professional regulation, there is budgeting for excess funds, a lack of clear definition of the public interest in the relevant sections of the statute. The findings confirm pursuit of special interests by the regulators, rather than the public interest. The main contribution of the study is that in developing and African countries, regulatory mechanism of professions can be captured by the regulators to further narrow or special interests, just as it happens with the regulation of businesses. [ABSTRACT FROM AUTHOR]

African countries seek to intensify their industrialization while also increasingly pursuing green growth and, more recently, circular economy strategies. The competitive implications of this are, however, little researched empirically. We seek to investigate how African countries, examplified in this paper by Kenya, are experiencing a green and circular structural change of their economies. On the basis of early findings from a survey among 27 mixed manufacturing companies in Ruaraka industrial area in Nairobi, we highlight green and circular innovation trends, conditions and dynamics for different types of industries and firms (size). We apply a strong business perspective in framing the questions. We conclude that the companies are reaching a moderate stage of greening,although with a high degree of variability. Circular innovations are relatively widespread and ensuring resource supply seems to be a more important incentive than cutting costs. There seems overall to be quite strong business incentives to go circular among Kenyan companies, although these incentives are not necessarily realized by the companies, a factor that could be utilized in policymaking. We suggest a strong business-oriented survey methodology as a way forward to expand insights into the greening of industries in Africa and similar economies. [ABSTRACT FROM AUTHOR]

Background : A key factor driving the development and maintenance of antibacterial resistance (ABR) is individuals' use of antibiotics (ABs) to treat illness. To better understand motivations and context for antibiotic use we use the concept of a patient treatment-seeking pathway: a treatment journey encompassing where patients go when they are unwell, what motivates their choices, and how they obtain antibiotics. This paper investigates patterns and determinants of patient treatment-seeking pathways, and how they intersect with AB use in East Africa, a region where ABR-attributable deaths are exceptionally high. Methods: The Holistic Approach to Unravelling Antibacterial Resistance (HATUA) Consortium collected quantitative data from 6,827 adult outpatients presenting with urinary tract infection (UTI) symptoms in Kenya, Tanzania, and Uganda between February 2019- September 2020, and conducted qualitative in-depth patient interviews with a subset (n = 116). We described patterns of treatment-seeking visually using Sankey plots and explored explanations and motivations using mixed-methods. Using Bayesian hierarchical regression modelling, we investigated the associations between socio-demographic, economic, healthcare, and attitudinal factors and three factors related to ABR: self-treatment as a first step, having a multi-step treatment pathway, and consuming ABs. Results: Although most patients (86%) sought help from medical facilities in the first instance, many (56%) described multi-step, repetitive treatment-seeking pathways, which further increased the likelihood of consuming ABs. Higher socio-economic status patients were more likely to consume ABs and have multi-step pathways. Reasons for choosing providers (e.g., cost, location, time) were conditioned by wider structural factors such as hybrid healthcare systems and AB availability. Conclusion: There is likely to be a reinforcing cycle between complex, repetitive treatment pathways, AB consumption and ABR. A focus on individual antibiotic use as the key intervention point in this cycle ignores the contextual challenges patients face when treatment seeking, which include inadequate access to diagnostics, perceived inefficient public healthcare and ease of purchasing antibiotics without prescription. Pluralistic healthcare landscapes may promote more complex treatment seeking and therefore inappropriate AB use. We recommend further attention to healthcare system factors, focussing on medical facilities (e.g., accessible diagnostics, patient-doctor interactions, information flows), and community AB access points (e.g., drug sellers). [ABSTRACT FROM AUTHOR]

This paper deals with the relationship between Foreign Direct Investment from China in Africa and the growth level in five African countries. Based on the high degrees of persistence observed in the data, we use techniques based on long memory models, and our results indicate that of the five countries examined, namely Kenya, Zimbabwe, Zambia, Nigeria and South Africa, only for Nigeria do we find a significant positive relationship between the two variables though under some assumptions, this evidence is also found in the cases of Kenya and South Africa. Several arguments are put forward at the end of the article to justify these results. [ABSTRACT FROM AUTHOR]

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]

The subject of this paper is the legitimacy and purpose of concluding a free trade agreement (FTA) between the USA and Kenya. The main research problem lies in whether the US-Kenya FTA can become a template for strengthening trade cooperation between the US and Africa and strengthening the American economic position on the continent. The main hypothesis is that the successful negotiations leading to the conclusion of an FTA, satisfactory for both the US and Kenya, might motivate other African countries to negotiate with the US in this regard. The US-Kenya FTA could become a model document, helping the US and African countries to negotiate free trade cooperation. It may prove to be a milestone on the road to closer economic cooperation between the United States and Africa. [ABSTRACT FROM AUTHOR]

Mental health research is needed in African countries in order to improve quality of care at local levels. This paper presents the results of a study conducted in 2018 among one hundred care givers in two peripheral primary health care facilities in rural Kenya. Opened interviews were performed, with the aim of eliciting relevant issues. The body of knowledge generated by the Global Mental Health (GMH) movement was used as the theoretical frame of reference. Five broad topics emerged as particularly significant in the specific context of this study: a. a globally negative perception of mental illness; b. a lack of trained professionals associated with limited opportunities for task-sharing or task-shifting; c. an intense stigmatization of affected individuals; d. the importance of strengthening the collaboration between the formal health sector and traditional healers, and, e. the necessary efforts to be made in order to reach patients living in remote areas. Our study highlights the importance of actively detecting mental disorders, promoting initiatives to reduce stigma and adapting western designed tools for specific settings in low and middle income countries (LMICs). [ABSTRACT FROM AUTHOR]

The article explores the ways in which FinTech is constituted as a platform economy in two African countries, Kenya and South Africa. Investigating the intersection of FinTech with the social economies of African mutual help groups, it situates the evolvement of such groups in chronic instabilities shaped by the extractive legacies of colonialism and neoliberal restructuring. Seeking to contribute to wider debates about FinTech-mediated financial inclusion, the article contends that FinTech as a political economy does not simply formalize monetary and financial relations. Instead, it works explicitly at the intersection of formal and informal, by combining old and new, digital and non-digital, inanimate and peopled infrastructures. The paper studies how these sociotechnical assemblages are shaped by colonial legacies, transforming financial relations while carrying forward inequalities. It argues that the peculiar constellation of private capital and financial technology around digital platforms seeks to profit from these social networks that are often seen by FinTech actors as driven by various local versions of Ubuntu, the idea of human interdependence rooted in humanist African philosophy. The article makes novel contributions to several literatures, including those of rotating saving and credit associations, financial inclusion, and formalization. [ABSTRACT FROM AUTHOR]

Using decolonial perspective, this paper critically examines how certain child protection interventions in Kenya might increase childhood vulnerabilities among children from poor social backgrounds who are disproportionately represented in the justice system. Findings point to ambivalent child protection practices as a result of entrenched colonial legacies which criminalises juvenile 'delinquents', relying heavily on judicialisation while limiting social welfare investments. The study suggests alternative approaches to better child protection services that take into account southern-centric childcare practices and knowledge. [ABSTRACT FROM AUTHOR]

There is an impasse on the question of whether or not to enumerate identity groups in national censuses, given their potential to variously facilitate dominance and an emergence from marginalisation. In this paper, we theorise the impasse in Kenya as relating to a colonial history of the strategic use of ethnicity to divide and rule; a demographic makeup with both some large ethnic groups and many small ones; and the local social construction of ethnicity, which allows significant latitude for collapse, disaggregation and change of group identities. This case corrects the dominance of Europe and the Americas in census studies and offers insights for assessing the political stakes of counting, namely, the need to bring past and present into conversation; to consider the varied political effects of demography; and to consider the particular significance and meaning of ethnicity and race in context. [ABSTRACT FROM AUTHOR]

Background: Every Newborn Action Plan (ENAP) coverage target 4 necessitates national scale-up of Level-2 Small and Sick Newborn Care (SSNC) (with Continuous Positive Airway Pressure (CPAP)) in 80% of districts by 2025. Routine neonatal inpatient data is important for improving quality of care, targeting equity gaps, and enabling data-driven decision-making at individual, district, and national-levels. Existing neonatal inpatient datasets vary in purpose, size, definitions, and collection processes. We describe the co-design and operationalisation of a core inpatient dataset for use to track outcomes and improve quality of care for small and sick newborns in high-mortality settings. Methods: A three-step systematic framework was used to review, co-design, and operationalise this novel neonatal inpatient dataset in four countries (Malawi, Kenya, Tanzania, and Nigeria) implementing with the Newborn Essential Solutions and Technologies (NEST360) Alliance. Existing global and national datasets were identified, and variables were mapped according to categories. A priori considerations for variable inclusion were determined by clinicians and policymakers from the four African governments by facilitated group discussions. These included prioritising clinical care and newborn outcomes data, a parsimonious variable list, and electronic data entry. The tool was designed and refined by > 40 implementers and policymakers during a multi-stakeholder workshop and online interactions. Results: Identified national and international datasets (n = 6) contained a median of 89 (IQR:61–154) variables, with many relating to research-specific initiatives. Maternal antenatal/intrapartum history was the largest variable category (21, 23.3%). The Neonatal Inpatient Dataset (NID) includes 60 core variables organised in six categories: (1) birth details/maternal history; (2) admission details/identifiers; (3) clinical complications/observations; (4) interventions/investigations; (5) discharge outcomes; and (6) diagnosis/cause-of-death. Categories were informed through the mapping process. The NID has been implemented at 69 neonatal units in four African countries and links to a facility-level quality improvement (QI) dashboard used in real-time by facility staff. Conclusion: The NEST360 NID is a novel, parsimonious tool for use in routine information systems to inform inpatient SSNC quality. Available on the NEST360/United Nations Children's Fund (UNICEF) Implementation Toolkit for SSNC, this adaptable tool enables facility and country-level comparisons to accelerate progress toward ENAP targets. Additional linked modules could include neonatal at-risk follow-up, retinopathy of prematurity, and Level-3 intensive care. [ABSTRACT FROM AUTHOR]

Simple Summary: Designing early warning systems for threats to food crops in Africa must respond to the needs of potential users of the system. This paper provides evidence from professional distributors, retailers, researchers, and agronomists in East Africa who may be able to use and communicate the results of the predictive modeling of pest outbreaks. Understanding the timing and spatial extent of required warnings will help guide research and engagement in these rapidly commercializing countries. Early warnings of the risks of pest and disease outbreaks are becoming more urgent, with substantial increases in threats to agriculture from invasive pests. With geospatial data improvements in quality and timeliness, models and analytical systems can be used to estimate potential areas at high risk of yield impacts. The development of decision support systems requires an understanding of what information is needed, when it is needed, and at what resolution and accuracy. Here, we report on a professional review conducted with 53 professional agronomists, retailers, distributors, and growers in East Africa working with the Syngenta Foundation for Sustainable Agriculture. The results showed that respondents reported fall armyworm, stemborers and aphids as being among the most common pests, and that crop diversification was a key strategy to reduce their impact. Chemical and cultural controls were the most common strategies for fall armyworm (FAW) control, and biological control was the least known and least used method. Of the cultural control methods, monitoring and scouting, early planting, and crop rotation with non-host crops were most used. Although pests reduced production, only 55% of respondents were familiar with early warning tools, showing the need for predictive systems that can improve farmer response. [ABSTRACT FROM AUTHOR]

This paper examines the treatment of customary land rights of indigenous peoples by State law in Nigeria and Kenya. Nigeria is chosen as a case study and Kenya has on-going legal reforms in relation to customary land rights. Both Kenya and Nigeria have plural legal systems. The objective is to demonstrate how Kenya has responded to the challenges of protecting customary land rights and how other African States, like Nigeria, should respond to similar challenges. [ABSTRACT FROM AUTHOR]

In this paper, we juxtapose two different sectors of China's economic presence in Africa: transport and digital infrastructure. Using the case of Kenya, a country that hosts several flagship corridors funded by Chinese loans and where Chinese "digital champions" have been active for two decades, we highlight some of the differences and similarities between these two forms of China's going-out capitalism in the continent. Our argument is that these 'varieties of capital' are conterminous, and they operate through both strategic and contingent overlaps within the same 'state-market nexus' and at the interface with programmes and goals of the African 'infrastructure state'. To illustrate this point, we draw on a comparative research effort inspired by a growing body of scholarship that has been labelled under the tag of 'Global China' and by a political economy reading of 'the market-in-state' system. This paper thus contributes empirically and conceptually to de-essentializing the Chinese presence in the African continent by recognizing the contextual agencies that shape it—the ambitious developmental agendas of the African state, in particular—as well as the interplay between its different corporate forms. [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]

This paper evaluates risk-oriented frameworks for explaining environmental, social, and economic changes faced by fishing and herding communities in the Turkana Basin during and after the African Humid Period (AHP, 15–5 ka). The orbitally-forced AHP created moist conditions, high lake levels, and unusual hydrological connections across much of northern and eastern Africa. As arid conditions set in and rainfall decreased between 5.3 and 3.9 ka in eastern Africa, Lake Turkana (NW Kenya) shrank dramatically. Shoreline retreat coincided with an expansion of open plains, creating new ecological conditions and potential opportunities for early herders in the basin. In this changing landscape, economies shifted from food procurement (fishing/hunting aquatic resources) to food production (herding), likely through both in-migration by pastoralists and adoption of herding by local fishers. Early pastoralists also built at least seven megalithic pillar sites that served as communal cemeteries during this time. Recent research has shown that local environmental dynamics – both during and after the AHP – were complex, demanding a more careful interrogation of the notion that post-AHP life entailed new and/or heightened risks. Risk-buffering strategies might include mobility, diversification, physical storage, and exchange. Archaeologists working around Lake Turkana have proposed that economic shifts from fishing to pastoralism entailed increased mobility as a risk-buffering strategy to deal with aridity and resource unpredictability, and that pillar sites – as fixed landmarks in an unstable landscape – provided settings for congregation and exchange amongst increasingly mobile herding communities. However, recent research has shown that local environmental dynamics in the Lake Turkana basin – both during and after the AHP – were more complex than previously thought, necessitating re-evaluation of the notion that post-AHP life entailed new and/or heightened risks. Here, we explore risk buffering strategies (e.g. mobility, diversification, physical storage and/or exchange) as only one category of potential explanation for the new social practices observed in the region at this time. Gauging their applicability requires us to (a) assess the spatial mobility of communities and individuals interred at pillar sites; (b) evaluate whether and how mobility strategies may have changed as pastoralism supplanted fishing; and (c) examine alternative explanations for social and economic changes. [ABSTRACT FROM AUTHOR]

While countries in sub-Saharan Africa have made significant progress towards achieving universal school enrolment, millions of students lack basic numeracy skills. This paper reports the results of a pilot study that aimed at using the Emergent Literacy in Mathematics (ELM) software to teach mathematics in early primary grades in Kenya. Designed as a pre- and post-test non-equivalent group research, the study unfolded in 14 grade-one classes from 7 primary public schools. After having learned with ELM for about two terms, the experimental students (𝑁 = 283) considerably outperformed their peers (𝑁 = 171) exposed to traditional instruction with the effect sizes of +0.37 on the overall skills measured by a standardised test of mathematics. The impact of ELM activities was the greatest on students' ability to take language and concepts of mathematics and apply appropriate operations and computation to solve word problems. On this set of skills, the magnitude of difference between the experimental and control groups was +0.77. This study also revealed some positive shifts in the teachers' perceptions about their practice. The teachers who adopted ELM in their practice reported having gained more confidence in mathematics and comfort in teaching mathematics with computers. [ABSTRACT FROM AUTHOR]

Introduction: Assisted partner services (APS) is an effective strategy for increasing HIV testing, new diagnosis, and linkage to care among sexual partners of people living with HIV (PLWH). APS can be resource intensive as it requires community tracing to locate each partner named and offer them testing. There is limited evidence for the effectiveness of offering HIV self‐testing (HIVST) as an option for partner testing within APS. Methods: We conducted a cluster randomized controlled trial comparing provider‐delivered HIV testing (Standard APS) versus offering partners the option of provider‐delivered testing or HIVST (APS+HIVST) at 24 health facilities in Western Kenya. Facilities were randomized 1:1 and we conducted intent‐to‐treat analyses using Poisson generalized linear mixed models to estimate intervention impact on HIV testing, new HIV diagnoses, and linkage to care. All models accounted for clustering at the clinic level and new diagnoses and linkage models were adjusted for individual‐level age, sex, and income a priori. Results: From March to December 2021, 755 index clients received APS and named 5054 unique partners. Among these, 1408 partners reporting a prior HIV diagnosis were not eligible for HIV testing and were excluded from analyses. Of the remaining 3646 partners, 96.9% were successfully contacted for APS and tested for HIV: 2111 (97.9%) of 2157 in the APS+HIVST arm and 1422 (95.5%) of 1489 in the Standard APS arm. In the APS+HIVST arm, 84.6% (1785/2111) tested via HIVST and 15.4% (326/2111) received provider‐delivered testing. Overall, 16.7% of the 3533 who tested were newly diagnosed with HIV (APS+HIVST = 357/2111 [16.9%]; Standard APS = 232/1422 [16.3%]). Of the 589 partners who were newly diagnosed, 90.7% were linked to care (APS+HIVST = 309/357 [86.6%]; Standard APS = 225/232 [97.0%]). There were no significant differences between the two arms in HIV testing (relative risk [RR]: 1.02, 95% CI: 0.96–1.10), new HIV diagnoses (adjusted RR [aRR]: 1.03, 95% CI: 0.76–1.39) or linkage to care (aRR: 0.88, 95% CI: 0.74–1.06). Conclusions: There were no differences between APS+HIVST and Standard APS, demonstrating that integrating HIVST into APS continues to be an effective strategy for identifying PLWH by successfully reaching and HIV testing >95% of elicited partners, newly diagnosing with HIV one in six of those tested, >90% of whom were linked to care. Clinical Trial Number: NCT04774835 [ABSTRACT FROM AUTHOR]

Introduction: Assisted partner services (APS), or exposure notification and HIV testing for sexual partners of persons diagnosed HIV positive (index clients), is recommended by the World Health Organization. Most APS literature focuses on outcomes among index clients and their partners. There is little data on the benefits of providing APS to partners of partners diagnosed with HIV. Methods: We utilized data from a large‐scale APS implementation project across 31 facilities in western Kenya from 2018 to 2022. Females testing HIV positive at facilities were offered APS; those who consented provided contact information for all male sexual partners in the last 3 years. Male partners were notified of their potential HIV exposure and offered HIV testing services (HTS). Males newly testing positive were also offered APS and asked to provide contact information for their female partners in the last 3 years. Female partners of male partners (FPPs) were provided exposure notification and HTS. All participants with HIV were followed up at 12 months post‐enrolment to assess linkage‐to antiretroviral treatment (ART) and viral suppression. We compared HIV positivity, demographics and linkage outcomes among female index clients and FPPs. Results: Overall, 5708 FPPs were elicited from male partners, of whom 4951 received HTS through APS (87% coverage); 291 FPPs newly tested HIV positive (6% yield), an additional 1743 (35.2%) reported a prior HIV diagnosis, of whom 99% were on ART at baseline. At 12 months follow‐up, most FPPs were taking ART (92%) with very few adverse events: <1% reported intimate partner violence or reported relationship dissolution. FPPs were more likely than female index clients to report HIV risk behaviours including no condom use at last sex (45% vs. 30%) and multiple partners (38% vs. 19%). Conclusions: Providing HIV testing via APS to FPP is a safe and effective strategy to identify newly diagnosed females and achieve high linkage and retention to ART and can be an efficient means of identifying HIV cases in the era of declining HIV incidence. The high proportion of FPPs reporting HIV risk behaviours suggests APS may help interrupt community HIV transmission via increased knowledge of HIV status and linkage to treatment. [ABSTRACT FROM AUTHOR]

The valuation of banks is inherently complicated because of the uncertainties arising from their information opaqueness and inherent risks. Unlike non-banking firms, banks require specialised equity-side valuation approaches. This study addresses a gap in the literature by examining valuation methods used by bank equity researchers. The study used a total of 201 reports on South African banks (2018–2023), 56 reports on Nigerian banks (2018–2023), and 27 reports on Kenyan banks (2018–2023) to investigate the bank equity valuation methods utilised by analysts in the employ of Investec Ltd. and Standard Bank Group Ltd. The study's findings show that Investec's South African analysts predominantly used the warranted equity method, based on book value (BV), and return on equity (ROE), for valuing shares throughout the South African, Nigerian, and Kenyan banks surveyed. Furthermore, Standard Bank Group's analysts employed this method, incorporating tangible net asset value (tNAV) and return on tangible equity (ROTE), for South African and Nigerian banks, but in Kenya their analysts used the residual income model to value the equities of the five Kenyan banks they covered. These findings suggest that the warranted equity method and the residual income model are the mostly used bank equity valuation methods in South Africa, Nigeria, and Kenya. The study concludes with relevant recommendations, offering significant insights for banks, regulators, and investors to make knowledgeable decisions concerning equity valuation. [ABSTRACT FROM AUTHOR]

Innovation scholars disseminate their significant findings through international scientific journals. We conducted content analysis of 2,869 peer-reviewed articles on innovation in Africa, examining their origins, themes, collaborative networks, and scholarly influence. These articles, spanning the years 2015–2021, were curated from the Web of Science database across scientific, social science, and humanities journals. The findings reveal that 46.3% of these articles lacked contributions from African organizations or scholars, while 25.1% involved collaborations between African and non-African entities. A remaining 28.6% were exclusively authored by African scholars, with South African universities being the most frequent contributors. Notably, articles authored by scholars from non-African institutions garnered more citations and appeared in journals with higher impact factors. Key themes within these articles revolved around the knowledge economy, African business innovation, agricultural advancements, and the role of mobile phones in knowledge dissemination and marketing. Surprisingly, sustainability topics were notably absent. South Africa, Kenya, and Ghana featured prominently in the discussions. In conclusion, it is imperative to foster broader participation from African nations and scholars in innovation research and ensure a stronger African perspective in international publications. Additionally, as open-access publishing gains momentum, concerns about escalating publishing costs warrant attention. [ABSTRACT FROM AUTHOR]

Why is voting behaviour tied to ethnicity in many new democracies? A predominant view, offered by the instrumentalist theory, argues that voters use candidates' identity -ethnic or partisan- as a signal of expected performance. However, voters will reward well-performing politicians by being more likely to vote for them and punish bad performance regardless of candidates' identity. To test these assumptions, we conduct a nationally representative survey in Kenya asking voters about their spending preference for the country's main anti-poverty programme, which is managed by MPs in collaboration with citizens. We find that voters, regardless of ethnicity or party, have an erroneous view of how their MP spent the anti-poverty funds. Then in an experiment, we share with voters the spending made by the MPs and audit results probing for corruption. Once voters are aware that their MP's spending does not match their spending priorities, their approval and likelihood of voting for the MP decreases if primed to view the politician as partisan. Voters also electorally punish MPs for corruption whether copartisan or non-copartisan. In contrast to instrumentalist expectations, if voters are primed to view their MP in ethnic terms, they are more likely to vote for their coethnic overlooking bad performance and corruption. The availability of alternative parties in local elections may explain why voters attach partisanship to performance evaluation. Still, in our case study, as in other new democracies, politicians continue mobilising support along ethnic lines, perhaps explaining why voters prioritise group loyalties if primed to think about ethnicity. [ABSTRACT FROM AUTHOR]

Some invasive tree species threaten biodiversity and cause irreversible damage to global ecosystems. The key to controlling and monitoring the propagation of invasive tree species is to detect their occurrence as early as possible. In this regard, one-class classification (OCC) shows potential in forest areas with abundant species richness since it only requires a few positive samples of the invasive tree species to be mapped, instead of all the species. However, the classical OCC method in remote sensing is heavily dependent on manually designed features, which have a limited ability in areas with complex species distributions. Deep learning based tree species classification methods mostly focus on multi-class classification, and there have been few studies of the deep OCC of tree species. In this paper, a deep positive and unlabeled learning based OCC framework— ITreeDet —is proposed for identifying the invasive tree species of Eucalyptus spp. (eucalyptus) and Acacia mearnsii (black wattle) in the Taita Hills of southern Kenya. In the ITreeDet framework, an absNegative risk estimator is designed to train a robust deep OCC model by fully using the massive unlabeled data. Compared with the state-of-the-art OCC methods, ITreeDet represents a great improvement in detection accuracy, and the F1-score was 0.86 and 0.70 for eucalyptus and black wattle, respectively. The study area covers 100 km2 of the Taita Hills, where, according to our findings, the total area of eucalyptus and black wattle is 1.61 km2 and 3.24 km2, respectively, which represent 6.78% and 13.65% of the area covered by trees and forest. In addition, both invasive tree species are located in the higher elevations, and the extensive spread of black wattle around the study area confirms its invasive tendency. The maps generated by the use of the proposed algorithm will help local government to develop management strategies for these two invasive species. [ABSTRACT FROM AUTHOR]

Conventional ex-ante evaluations rely on a mix of economic, environmental, and social indicators to assess the potential impacts of Genetically Modified (GM) crops prior to their commercial release. While these predictive studies have produced useful knowledge, they have also consistently overestimated the ex-post outcomes of GM crops for African smallholder farmers. Yet these same assessment methods remain the dominant approach to project farmer outcomes for a new suite of soon-to-be commercialized GM staple crops. The research presented in this paper offers a different evaluative approach for these new GM crops by taking inspiration from farming systems research (FSR). We use the conceptual starting point of FSR scholarship—the farming system—to conduct an exploratory predictive analysis of three GM crops currently in the experimental pipeline: Water Efficient Maize for Africa (WEMA) in Kenya, disease-resistant matooke banana in Uganda, and Bt cowpea in Burkina Faso. Our findings suggest that the lofty projected benefits of these crops are unlikely to be realized by many, if not most, smallholder farmers due to incongruences with the farming systems they are designed to benefit. This research demonstrates the importance of using farming system-based evaluation methods to better anticipate likely farm-level outcomes of new breeding technologies. • Conventional ex-ante evaluations of new GM varieties are too restrictive and narrow. • Farming Systems Research can be used to anticipate farm-level outcomes. • New GM varieties are unlikely to improve livelihoods for smallholder farmers. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report. Methods: A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature. Results: Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had incomplete disease. The mean age was 2.3 years (SD+/-2.2) (range 0.3–10.3) with a male to female ratio of 1:1. The mean duration of fever at diagnosis was 8.3 days (SD+/-4.7) (range 2–20). Oral changes were the most common clinical feature and conjunctivitis the least common. Thrombocytosis at diagnosis was seen in 52% (12/23). Twenty-one patients (91.3%) were treated with intravenous immunoglobulin and all except 1 received aspirin. Baseline echocardiograms were performed in 95.7% (22/23) and found to be abnormal in 3 (13.6%). Follow-up data was limited. Our literature review identified 79 publications with documented cases of Kawasaki disease in children from 22 countries across the African continent with a total of 1115 patients including those from this report. Only 153 reported cases, or 13.7%, are from sub-Saharan Africa. Conclusions: This is the first publication on Kawasaki disease from Kenya and one of the largest reports from sub-Saharan Africa. It is the first to have a complete review of the number of published cases from the African continent. Challenges in the diagnosis and management of Kawasaki disease in many African countries include disease awareness, infectious confounders, access and cost of intravenous immunoglobulin, access to pediatric echocardiography and follow-up. Increasing awareness and health care resources are important for improving outcomes of Kawasaki disease in Africa. [ABSTRACT FROM AUTHOR]

This study examines how journalists in Rwanda, Uganda and Kenya perceive their journalistic role orientations in light of the countries' differing political systems, Rwanda representing the nation with the most restrictive political system, Uganda sitting in the middle and Kenya illustrating the nation that is home to the least restrictive political system. Data were analyzed from a comparative, quantitative online survey completed by 424 journalists from the three East African nations. Overall, the journalistic role orientations that emerged in each country align with the freedoms afforded by the political system in each country, revealing a trend that journalists in non-Western countries lean toward more interventionist roles (at times to the point of actively supporting their government), and journalists in countries with less restrictive political systems lean toward more adversarial roles (keeping their government in check). [ABSTRACT FROM AUTHOR]

Introduction: Many organizations are developing new contraceptive products and approaches that promote self-care including a microarray patch (MAP) that has the potential for self-administration with appropriate training. We studied women's perceptions of the MAP technology with the primary goal of providing feedback on product attributes to inform early technical design decisions regarding various MAP contraceptive products in development by MAP developers. Methods: Our study consisted of a qualitative phase with in-person In-Depth Interviews (IDIs) with a total of 60 women of reproductive age (WRA) and quantitative surveys, via face-to-face computer-assisted interviews of a total of 927 women in Ghana, Kenya and Uganda. Women's perceptions on 12 attributes of the MAP were assessed through written descriptions, a profile, and visual stimuli such as graphics and images. Results: Overall, the most widely preferred attribute set included: a hand-applied MAP, utilizing one circular patch, with a sticky backing, no larger than 2 cm diameter in size, applied by self, to the arm, offering sensory feedback (clicking sound and/or color change signals) to confirm enough pressure, successful application and removal, lasting 6 months with up to 12 months return to natural state of fertility. There is space to allow for variation in MAP designs (including the use of an applicator or provider administered MAP) if the design promotes and reflects the needs and expectations of users and providers. Discussion: The contraceptive MAP had a high and broad level of appeal amongst all groups of women who participated in the study and has a strong value proposition around important contraceptive needs such as ease of use, convenience, and discretion. [ABSTRACT FROM AUTHOR]

Introduction: The negative consequences of stigma for the wellbeing of people with disabilities have raised public and global health concerns. This study assessed the impact of an e-intervention to reduce intellectual disability (ID) stigma among Nigerian and Kenyan internet-users. Method: Participants aged 18+ and citizens of Nigeria and Kenya were recruited through online advertising. Qualtrics, a web survey platform, randomly assigned (1:1) participants to watch either a short experimental or control film, while masked to their assignment. The experimental film featured education about ID and indirect contact. The control film was on an unrelated topic. Their attitudes were measured on three dimensions (affect, cognitions and behaviour) at three time points (baseline, post intervention and one-month follow-up). Between October 2016 and April 2017, 933 participants were randomised, 469 to the experimental condition and 464 to the control condition. Of these, 827 (89%) provided pre-and post-intervention data but only 287 (31%) were retained at follow-up. Results: An intent-to-treat analysis revealed that participants in the experimental but not the control condition showed a positive shift in their attitudes towards people with ID over time. Their willingness to interact with people with ID increased post-intervention. Discussion: A brief intervention that integrates education and indirect contact can make an effective contribution to efforts to reduce stigma faced by people with ID in Africa. Trial registered with the ISRCTN trial registry (number ISRCTN92574712). [ABSTRACT FROM AUTHOR]

• The take-up of the social pension in Kenya has varied across diverse sub-national contexts. • This paper finds that the registration of remote and marginalized populations in Marsabit County was negatively impacted by two factors. • Weak state infrastructural power and the political timing of the social pension registration limited the program's reach. • The quasi-universal social pension has increased coverage and reduced the burdens of targeting. • However, complementary investments in state capacity are required to ensure social assistance access for marginalized populations. In 2017 the government of Kenya transformed its poverty-targeted older persons cash transfer into a '70-plus' social pension. While the literature suggests that a switch from targeted to universal programs would simplify registration and reduce inclusion and exclusion errors, there were significant variations in take-up of the social pension across diverse counties in Kenya, with lower take-up in counties with higher rates of poverty. Drawing on qualitative data collected across six months in 2018, including interviews and focus group discussions with government officials, community leaders, politicians and ordinary citizens, this paper examines why take-up of the social pension has been lower in Marsabit County, an area of the country with high levels of poverty. We find that government officials struggled to register eligible beneficiaries in remote and marginalized communities within the mass registration exercise's tight timelines. As a result, they often relied on local actors to relay information between the state and local communities, which resulted in uneven registration and the exclusion of some marginalized populations, particularly in remote and conflicted affected areas. We argue that pressure from the national government to register potential beneficiaries in the month prior to the highly contested 2017 national election exacerbated the challenges posed by low state infrastructural power, including limited resources, low state oversight and a lack of embeddedness within local communities. The visible expansion of the social pension prior to the election was prioritized over achieving universal registration. This paper contributes to the literature on universal versus targeted approaches to social assistance and furthers our knowledge of the challenges of reaching the poorest of the poor even through nominally 'universal' programs. While universal approaches expand access to social assistance, this paper highlights the importance of ongoing registration and investments in state infrastructural power to ensure that remote and marginalized populations can access social assistance. [ABSTRACT FROM AUTHOR]

This paper investigates the effects of the coronavirus disease 2019 (COVID-19) pandemic on financial institutions and on consumers' adoption of Financial Technology (FinTech) for payments. This paper documents the following findings in Kenya. (1) The COVID-19 pandemic accelerated the adoption and increased the payment concentration of FinTech. We document an approximately 54% increase in mobile banking transactions, a 19.56% increase in mobile banking agents, and a 14.56% increase in the number of mobile banking accounts. (2) The use of all types of electronic payment cards declined significantly during the pandemic. (3) The pandemic magnified interbank contagion and liquidity risks and reduced both domestic and international electronic fund transfers via both the Real-Gross Settlement System and the Automated Clearing House. Overall, our results indicate that FinTech not only partially alleviated the negative impact of the COVID-19 pandemic during Q1 of 2021 but also accelerated consumers' adoption of FinTech and digital onboarding, especially in Q3 and Q4 of 2022. • The COVID-19 pandemic has accelerated the adoption of FinTech. • The use of mobile banking has significantly increased during the pandemic. • The use of electronic payment cards has significantly declined during the pandemic. • The pandemic has reduced domestic and international electronic funds transfer. [ABSTRACT FROM AUTHOR]

Background: Carefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/AIDS, without increasing burdens. Such studies, however, must navigate a 'vulnerability paradox', since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/AIDS (ALH) in Kenya, we develop an account of researchers' responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency as 'interacting layers'. Methods: Using a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders' perspectives on vulnerability and resilience of young people living with HIV/AIDS, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna's layered account of vulnerability. Results: ALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences. Conclusions: The most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers' responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities. [ABSTRACT FROM AUTHOR]

Introduction: Young women in sub‐Saharan Africa are a priority population for HIV prevention, yet challenges with adherence and persistence to HIV pre‐exposure prophylaxis (PrEP) are common. This study involved the development and pilot testing of My Way—a novel delivery system for PrEP and co‐packaged sexual health services. Methods: My Way was developed in Kisumu, Kenya through a user‐centred design process (2020). The intervention involves peer‐delivery and support for HIV testing and PrEP use, self‐collected vaginal swabs for sexually transmitted infection (STI) testing, pregnancy testing, oral contraceptive pills, self‐injectable medroxyprogesterone and/or condoms. My Way was assessed among 16‐ to 24‐year‐old sexually active women in a randomized controlled trial versus standard of care (SoC; 2021–2022). Use of PrEP and other sexual health services were tracked at 1, 3 and 6 months for feasibility. Acceptability was determined by questionnaire. The effect of the intervention on tenofovir diphosphate (TFV‐DP) levels was assessed by chi‐square test (primary outcome); other predictors were explored with regression analysis. Results: Among 150 women, the median age was 22 years and the median number of sexual partners was 2. Moderate/severe depression was common (60%). In the intervention arm, peers made 88% (198/225) of possible kit deliveries (177 with PrEP) and 49 STIs were diagnosed. In the SoC arm, 24% (55/225) of expected clinic visits occurred (53 with PrEP); no STI testing was performed. TVF‐DP was detected in 16 participants at 6 months: 16% (12/75) in the intervention arm versus 5% (4/75) in the SoC arm (p = 0.03). Persistence among those with ongoing HIV prevention needs (i.e. prevention‐effective persistence) was 18% (12/67) versus 7% (4/56; p = 0.08). No women acquired HIV. The intervention was significantly associated with detectable TFV‐DP (OR 3.5, 1.1‐11.4; p = 0.04); moderate/severe depression trended towards an association with TFV‐DP (OR 0.2, 0.03–1.6; p = 0.13). Conclusions: My Way is a promising delivery system for PrEP and other sexual health services among young women in Western Kenya. We found high feasibility and acceptability. PrEP use was modest, but higher with My Way compared to SoC. Long‐acting PrEP formulations may overcome important barriers to PrEP use and should be explored in combination with the My Way delivery model. [ABSTRACT FROM AUTHOR]

Background: Timely molecular surveillance of Plasmodium falciparum kelch 13 (k13) gene mutations is essential for monitoring the emergence and stemming the spread of artemisinin resistance. Widespread artemisinin resistance, as observed in Southeast Asia, would reverse significant gains that have been made against the malaria burden in Africa. The purpose of this study was to assess the prevalence of k13 polymorphisms in western Kenya and Ethiopia at sites representing varying transmission intensities between 2018 and 2022. Methods: Dried blood spot samples collected through ongoing passive surveillance and malaria epidemiological studies, respectively, were investigated. The k13 gene was genotyped in P. falciparum isolates with high parasitaemia: 775 isolates from four sites in western Kenya (Homa Bay, Kakamega, Kisii, and Kombewa) and 319 isolates from five sites across Ethiopia (Arjo, Awash, Gambella, Dire Dawa, and Semera). DNA sequence variation and neutrality were analysed within each study site where mutant alleles were detected. Results: Sixteen Kelch13 haplotypes were detected in this study. Prevalence of nonsynonymous k13 mutations was low in both western Kenya (25/783, 3.19%) and Ethiopia (5/319, 1.57%) across the study period. Two WHO-validated mutations were detected: A675V in three isolates from Kenya and R622I in four isolates from Ethiopia. Seventeen samples from Kenya carried synonymous mutations (2.17%). No synonymous mutations were detected in Ethiopia. Genetic variation analyses and tests of neutrality further suggest an excess of low frequency polymorphisms in each study site. Fu and Li's F test statistic in Semera was 0.48 (P > 0.05), suggesting potential population selection of R622I, which appeared at a relatively high frequency (3/22, 13.04%). Conclusions: This study presents an updated report on the low frequency of k13 mutations in western Kenya and Ethiopia. The WHO-validated R622I mutation, which has previously only been reported along the north-west border of Ethiopia, appeared in four isolates collected from eastern Ethiopia. The rapid expansion of R622I across Ethiopia signals the need for enhanced monitoring of the spread of drug-resistant P. falciparum parasites in East Africa. Although ACT remains currently efficacious in the study areas, continued surveillance is necessary to detect early indicators of artemisinin partial resistance. [ABSTRACT FROM AUTHOR]

This study explores poverty dimensions and negative experiences of households living in secondary cities of Kenya with the aim of understanding the determinants of the willingness to pay to access water services. Our findings suggest that negative experiences of households related to poor access to water, like water crises, water borne diseases, and daily time to fetch water, seem to play an important role. Conversely, poverty dimensions are not necessarily influential. More specifically, while daily income of the household is an important factor, other variables, namely, education, food shortages, and access to information do not have significant effects. Our evidence suggests that to raise the awareness of this public good's value, local governments should focus on improving citizens' information especially in poor areas, as well as the ability to pay. [ABSTRACT FROM AUTHOR]