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This paper presents findings of an experimental investigation on sodium sulphate (Na2SO4) activated calcined clay – Portland cement blends in sulphuric acid media. Calcined clays were blended with Ordinary Portland Cement (OPC) at replacement levels of 40% 45% and 50 % by mass of OPC to make blended cement labelled PCC40, PCC45 and PCC50 respectively. Initially, pozzolanicity and setting time tests were conducted. Mortar prisms measuring 40 mm × 40 mm × 160 mm were cast using 0.5M Na2SO4 solution and their compressive strengths determined on the 2nd, 7th, 28th and 90 th day of curing. The 28th day cured mortar prisms were subjected to porosity test. Moreover, 5 × 5 × 5 cm mortar cubes were also prepared and their weight and strength loss was taken as a measure of their acid resistivity after an immersion time of 7, 14, 28, 56, 84 and 120 days in 3 % of sulphuric acid at 23 ± 1 °C. OPC, commercial Portland Pozzolana Cement (PPC) and PCC40, PCC45 and PCC50 cement were cast using water and similarly investigated for comparison purposes. The results obtained showed that chemically activated cements exhibited higher pozzolanic activity, lower porosity, shorter setting times and higher resistance to acid attack compared to non-activated cements. However, OPC was found to be non-pozzolanic.

Introduction: Children growing up in arid and semi-arid regions of Sub-Saharan Africa (SSA) face heightened risks, often resulting in poor developmental outcomes. In Kenya, the arid and semi-arid lands (ASAL) exhibit the lowest health and developmental indicators among children. Despite these risks, some children grow up successfully and overcome the challenges. However, there is limited comprehensive data on sources of risks and resilience in these children, particularly research that incorporates community perspectives and indigenous knowledge. Systematic documentation of factors influencing child outcomes is crucial for understanding the overall burden, informing policy and implementing targeted interventions. This study aimed at bridging this gap., Methods: The study was conducted in 10 ASAL counties in Kenya. Purposive and snowballing techniques were used to recruit 11 key informants per site with varied levels of involvement in early childhood development and primary caregivers. Using a semi-structured interview guide, 103 telephonic interviews were conducted between June and August 2022, involving 68 key informants and 35 caregivers. Thematic approach was used to analyze the data, using NVIVO software., Results: The mean age of the participants was 44years (SD = 11 years). The findings, viewed through the lens of Bronfenbrenner's ecological systems theory, reveal a complex interplay of contextual factors impacting children's development. These factors range from individual and biological aspects to family, community, systemic, and environmental level, including climatic challenges. Identified risk factors encompassed issues such as young caregiver's age, low literacy, mental health issues, drug abuse, domestic violence, malnutrition, poverty, lack of paternal involvement, early marriages, female genital mutilation, drought, heat stress, and insecurity. Nonetheless, sources of resilience include breastfeeding, immunization, responsive caregiving, family and community support, higher socio-economic status (SES), cultural practices, self-motivation, hard work, community role models, religious activities and quality service provision., Conclusion: Urgent attention is needed to address the multifaceted challenges faced by children in ASAL regions. The study underscores the importance of addressing the root causes of risks while harnessing community strengths and resources to safeguard and promote the holistic development of these children., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2025 Chongwo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial in Nairobi's informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from one developed in Australia (SMS4dads)., Methods: A multi-phased mixed-methods study, which included an exploratory qualitative phase and pre-post evaluation of the adapted SMS4baba text-only intervention was conducted between 2019 and 2022. Three focus-group discussions (FGDs) with 19 fathers were conducted at inception to inform SMS4baba content development; two post-pilot FGDs with 12 fathers explored the acceptability and feasibility of SMS4baba implementation; and 4 post-intervention FGDs with 22 fathers evaluated SMS4baba programme experiences. In the intervention phase, 72 fathers were recruited to receive SMS4baba messages thrice weekly from late pregnancy until over six months postpartum. A pre-enrolment questionnaire captured fathers' socio-demographic characteristics. Pre-post surveys were administered telephonically, and outcome measures evaluated using a paternal antenatal attachment scale, generalised anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and researcher-developed questionnaire items assessing paternal involvement, childcare and parenting practices. Qualitative data were analysed using a thematic approach. Statistical analysis performed included descriptive statistics, tests of association, and mixed model regression to evaluate outcomes., Results: Fathers perceived SMS4baba messages as educational, instilling new knowledge and reinforcing positive parenting, and helped fathers cope with fatherhood transition. High levels of engagement by reading and sharing the texts was reported, and fathers expressed strong approval of the SMS4baba messages. SMS4baba's acceptability was attributed to modest message frequency and utilising familiar language. Fathers reported examples of behaviour change in their parenting and spousal support, which challenged gendered parenting norms. Pre-post measures showed increased father involvement in childcare (Cohen's d = 2.17, 95%CI [1.7, 2.62]), infant/child attachment (Cohen's d = 0.33, 95%CI [-0.03, 0.69]), and partner support (Cohen's d = 0.5, 95%CI [0.13, 0.87])., Conclusion: Our findings provide support for father-specific interventions utilising digital technologies to reach and engage fathers from low-resource settings such as urban informal settlements. Exploration of text messaging channels targeting fathers, to address family wellbeing in the perinatal period is warranted., Trial Registration: This study was part of the integrated early childhood development pilot cluster randomised trial, registered in the Pan African Clinical Trial Registry on 26/03/2021, registration number PACTR202103514565914., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Aga Khan University ethics review committee (004-ERC-SSHA-19-EA) and received clearance from the National Commission for Science Technology and Innovation (NACOSTI/P/1950782/31710), and by the Mount Sinai Hospital’s Research Ethics Board (20-0061-E). Additional approvals were obtained from the Nairobi County Directorate of Health, and the sub-county Ministry of Health Dagoretti sub-county. Study participants in the qualitative component of the study provided written informed consent, while telephonic consent was obtained for fathers involved in the intervention phase. All study participants were provided with a detailed description of the study, its benefits, risks, confidentiality, data storage, and management plans. All participants had a chance to ask questions and seek clarifications prior to their involvement. Informed consent was obtained from all the participants and their legal guardians. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Several measures of adolescent optimism exist. However, none of these measures have been developed in the African setting, and only a few of the available measures have been validated for use in this setting. We aimed to develop and validate a culturally appropriate measure for this context. We employed an exploratory sequential mixed methods design using a five-step approach to tool development, comprising literature reviews, construct clarification, item development, piloting, and scale evaluation. We constructed a six-item scale, the Mabrouk's Measure of Adolescent Optimism (MMAO). In a sample of 1616 adolescents from Kenya, the MMAO demonstrated adequate internal consistency (both Cronbach's alpha and McDonald's Omega > 0.80) and test-retest reliability (ICC = 0.46). Factor analysis supported a unidimensional scale with adequate criterion and divergent validity as well as measurement invariance across sex, age (younger vs. older adolescents), residence (rural vs. urban), schooling status (in-school vs. out-of-school adolescents), and language of administration (Swahili vs. English). We report on the development and validation of a new scale of adolescent optimism that can be used to assess optimism among adolescents in Kenya and similar contexts. Preliminary evidence shows support for this new measure's reliability and validity, although additional tests are needed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Evidence is needed to understand factors that influence child development and caregiving experiences, especially in marginalized contexts, to inform the development and implementation of early childhood development (ECD) interventions. This study explores caregiving practices for young children in an urban informal settlement with Kenyans and embedded refugees, and identifies factors shaping these caregiving experiences, to inform the design and development of potentially appropriate ECD interventions., Methods: A qualitative formative study, which included 14 focus group discussions (n = 125 participants), and 13 key informant interviews was conducted between August and October 2018. Purposive sampling approaches were used to select a diverse range of respondents including caregivers of children below three years of age and stakeholders of Kenyan nationality and refugees. Data were analysed using a thematic approach and the Nurturing Care Framework was used as an interpretative lens., Results: There was a fusion of traditional, religious and modern practices in the care for young children, influenced by the caregivers' culture, and financial disposition. There were mixed views/practices on nutrition for young children. For example, while there was recognition of the value for breastfeeding, working mothers, especially in the informal economy, found it a difficult practice. Stimulation through play was common, especially for older children, but gaps were identified in aspects such as reading, and storytelling in the home environment. Some barriers identified included the limited availability of a caregiver, insecurity, and confined space in the informal settlement, all of which made it difficult for children to engage in play activities. Physical and psychological forms of discipline were commonly mentioned, although few caregivers practiced and recognized the need for using non-violent approaches. Some overarching challenges for caregivers were unemployment or unstable sources of income, and, particularly for refugee caregivers, their legal status., Conclusion: These findings point to the interplay of various factors affecting optimal caregiving for young children in an urban informal settlement with Kenyans and refugees. Integrated ECD interventions are needed for such a mixed population, especially those that strive to anchor along caregivers' social support system, co-designed together with community stakeholders, that ideally focus on parent skills training promoting nurturing care and economic empowerment., (© 2024. The Author(s).)

Children in urban informal settlements experience high risks for poor health and development. Understanding health seeking behaviors and childcare patterns of caregivers in urban informal settlements is important for devising effective interventions. This study describes household characteristics and aspects of nurturing care among caregivers of children aged 0-2 years in Dagoretti informal settlement, Nairobi-Kenya. In this cross sectional study, data were collected on household socio-demographic characteristics, antenatal care and child delivery practices, infant and young child feeding practices, activities that promote play, learning and school readiness, and on childcare and protection practices. Descriptive statistics of proportions and means were used to summarize the data. The study covers a total of 458 Kenyan and 118 immigrant households. Caregivers from immigrant households, with low education and from the younger age-group (less than 20 years) were vulnerable to sub-optimal caregiving and health seeking practices, including relatively lower rates of age-appropriate breastfeeding and poor dietary diversity. Seventy-five percent of expectant mothers attended less than four antenatal care visits. Households surveyed had limited possession of children's books (2% with three or more books), limited access to play materials (43% had two or more play materials), and low paternal involvement in child stimulation and early learning activities (14%). One-third and half of the children were left with inadequate care and disciplined using both violent and non-violent methods, respectively. Our findings highlight the urgent need for contextually appropriate and integrated interventions anchored in the WHO's nurturing care framework. These interventions can benefit from extensive involvement of caregivers, facility and community-based healthcare workers, policy makers, and other relevant stakeholders., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2022 Ssewanyana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Community engagement is crucial for the design and implementation of community-based early childhood development (ECD) programmes. This paper aims to share key components and learnings of a community engagement process for an integrated ECD intervention. The lessons shared are drawn from a case study of urban informal settlement with embedded refugees in Nairobi, Kenya., Methods: We conducted three stakeholder meetings with representatives from the Ministry of Health at County and Sub-County, actors in the ECD sector, and United Nations agency in refugee management, a transect walk across five villages (Ngando, Muslim, Congo, Riruta and Kivumbini); and, six debrief meetings by staff from the implementing organization. The specific steps and key activities undertaken, the challenges faced and benefits accrued from the community engagement process are highlighted drawing from the implementation team's perspective., Results: Context relevant, well-planned community engagement approaches can be integrated into the five broad components of stakeholder engagement, formative research, identification of local resources, integration into local lives, and shared control/leadership with the local community. These can yield meaningful stakeholder buy-in, community support and trust, which are crucial for enabling ECD programme sustainability., Conclusion: Our experiences underscore that intervention research on ECD programmes in urban informal settlements requires a well-planned and custom-tailored community engagement model that is sensitive to the needs of each sub-group within the community to avoid unintentionally leaving anyone out., (© 2022. The Author(s).)

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (>80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population.

Background: Over 250 million children in low- and middle-income countries are at risk of not achieving their fullest developmental potential due to co-occurring risks such as poor nutrition and inadequate learning opportunities. Early intervention programs integrating the aspects of nurturing care, that is, good health, adequate nutrition, safety and security, responsive caregiving, and learning opportunities, may ameliorate against the negative impact of these adverse conditions. Methods: This meta-analytic review updates the evidence base of parenting interventions comprising stimulation and responsive caregiving components on developmental outcomes for children under age 2 years in low- and middle-income countries. It also describes and assesses the moderation effects of population characteristics and implementation features on the intervention effectiveness. Studies were identified based on previous systematic reviews and an updated literature search in eight databases and the gray literature up to December 2020. A random-effect model was used to explore the pooled effect sizes accounted for by the intervention for developmental outcome of cognition, language, motor, and social-emotional capacities. Exploratory moderation analyses were also conducted. Results: Twenty-one randomized controlled trials representing over 10,400 children from 12 low- and middle-income countries and regions across three continents (Africa, Latin America, and Asia) were identified. The interventions showed overall small-to-moderate effects on children's cognitive development ( ES = 0.44; 95% CI = [0.30, 0.57]); language development ( ES = 0.33; 95% CI = [0.18, 0.49]); and motor skills ( ES = 0.21; 95% CI = [0.10, 0.32]). The overall effect on social-emotional development was non-significant ( ES = 0.17; 95% CI = [-0.01, 0.34]). Effect sizes (ES) varied significantly across the studies. Parenting programs that targeted vulnerable groups, including rural communities and caregivers with lower education levels, had more significant effects on children's development. Group sessions (vs. individual visits) and high program dose (≥12 sessions) were also associated with stronger effects on child development. Further research is needed to determine the effectiveness of the workforce and training on programmatic outcomes. Conclusion: The findings indicate that parenting interventions that encourage nurturing care are effective in improving the early development of children, especially among vulnerable populations. We discuss opportunities to strengthen the implementation of research-based parenting interventions in such contexts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhang, Ssewanyana, Martin, Lye, Moran, Abubakar, Marfo, Marangu, Proulx and Malti.)