Search

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.

Medical education in Africa is in desperate need of reforms, evident in widespread diseases, and an inability to mobilise and train the required medical workforce to deal with these health issues. However, the exponential rise in the use of mobile technologies due to the spread of the Internet and increased telecommunication networks offer an opportunity for the transformation of medical education and practice through the deployment of mobile devices as a medium for learning and conveying health care services to the remote and resource-constrained locations of Sub-Saharan Africa (SSA). This paper reviewed articles on the affordances of m-learning for distributed medical education in SSA published between 2010-2018. Results from 18 articles identified in the review revealed a slow-paced ascendancy of practice and research in the field; it further exposed competing priorities, infrastructural deficit, and chronic workforce shortages as the bane of m-learning implementation in the subregion. This paper makes recommendations that will enhance the growth of mobile-based distance medical education and practice in SSA.

This study examined the social and spill-over benefits as motivating factors to investment in formal education in selected countries in Africa. The paper had three objectives, namely) to profile the key statistics of formal schooling; ii) examine the formal education and iii) link national goals of education with expectations in Ghana, Kenya and Rwanda. The major contention of the paper is that investment in education is not a matter of random choice but rather an imperative led by the fact that education holds returns and externalities to the largest society. Authors reviewed theory of human capital, local and international publications on social and spill over benefits of education focusing on Ghana, Kenya and Rwanda. The analysis of government policies and other publications from these three African nations have shown that education is considered as a key sector in these developing nations. Nevertheless, the researchers found out that mostly only primary and secondary education are distinctively accorded considerable public financial resources which might be associated with the countries limited financial ability, competitive needs, national and global trends. However, the fact that Ghana, Kenya and Rwanda strive to become democratic, self-reliant and middle income nations by conquering long terms set visions in which caliber manpower, welfare, self-employment, reduced social inequalities, increase in average income, knowledge based society, ICT driven and sustainable economy are key characteristics; it is imperative to invest substantially in TVET and higher education. It is also recommended that Ghana, Kenya and Rwanda put in place strong institutions that objectively, effectively and rationally ensure the efficient use of all available resources towards maximum educational outputs.

This paper compares the mixed-methods evaluation findings of the ukuFUNda Virtual School (UVS) with evaluations of three different mobile learning (m-learning) programmes in Africa: the information and communication technologies for rural education (ICT4RED); the Kenya Primary Math and Reading (PRIMR) study and the Nokia Mobile Mathematics (MoMath) evaluation. The comparison applies a conceptual model based on m-learning affordances and configurations (Strigel & Pouezevara, 2012), as well as on uptake, use, and responses by program beneficiaries; and on stakeholder learning. The findings show varied successes across all four programs and highlight important lessons for stakeholders with particular reference to scaling up of m-learning interventions in an African context.

Purpose: This paper aims to critically analyze the empirical literature on health and human development in high-, middle- and low-income countries to develop a sustainable model for investing in human health. The model is critical in building a comprehensive health-care system that fosters the stakeholders' financial stability, economic growth and high-quality education for the local community. Design/methodology/approach: A comprehensive literature review was carried out on health, human development and sustainable health investment. After thoroughly examining theoretical frameworks underlying the strategies of successful human health systems, a summary of empirical articles is created. Summaries provided in this paper represent relevant health-care strategies for Kenya. Findings: Based on the empirical review of literature, a Nexus Health Care model focusing on human development, social and cultural development, economic development and environmental development in high-, middle- and low-income countries is proposed. The goal of this model is to enhance sustainable development where wealth creation is accompanied with environmental uplifting and protection of social and material well-being. Research limitations/implications: This paper is limited to a comprehensive literature review presenting empirical evidence of human development and sustainability. Originality/value: Kenya like other developing nations aspires to contribute significantly in improving health through development of health products but the approaches used have been limiting. In most cases, the use of Western theories, lack of empowering the community and dependence on donor support have hindered the country from achieving comprehensive health and human development. This papers seeks to develop a model for health-care investment and provide strategies, operations and structure of successful health systems and human development for a developing country, such as Kenya.

The workplace in the modern world continues to demand higher qualifications and refined competencies. In the recent past, workers would respond to such demands through learning by correspondence. When the Internet and e-Learning emerged, it received widespread accolade as a solution to the challenges experienced by distant learners. The technology was also seen as an opportunity for educational institutions to leverage their technological uptake to benefit regular students. However, desktop computers and Internet connectivity, which were the drivers of e-learning technologies, were expensive, bulky and scarce. So when mobile technologies emerged, educationist saw an opportunity for addressing the limitations associated with correspondence, "e" and tethered learning. Mobile devices being cheap, portable and reliable received widespread acceptance and possession. So, educators, hardware designers and program developers started to design hardware and applications that would infuse learning content into the devices. The purpose of this review is to demonstrate the potential of mobile technologies in the education market place, highlighting global initiatives and trends. The paper will also review how universities around the world, Africa and in Kenya have oriented themselves for learning with mobile technologies. The study was a documentary analysis of virtual documents stored electronically for access through the Internet, text books, archival repositories and encyclopedias. The study observed a significant high global mobile ownership and usage rates, but was able to demonstrate that despite its pedagogical advantages, the use of the technology for learning purposes at university level is still at the infantry.

This paper is a reading of the "Free Primary Education" (FPE) policy in Kenya through the lenses of critical theory/pedagogy. The study critiques the National Alliance Rainbow Coalition (NARC) government for adoption of the Freirian banking model to design and implement the policy. The paper argues that such a model has ended up marginalizing the voices of other FPE stakeholders and sustaining educational inequalities in the country. The paper also examines how neoliberal policies like Structural Adjustment Programs (SAPS) have influenced and shaped the FPE policy, and other educational reforms in the country. Such policies are read as colonial projects functioning to produce particular meanings and serving the interests of the dominant stakeholders--top government leaders and transnational capital markets. The paper concludes by theorizing an anticolonial pedagogy that aims at transforming FPE to an educational program that works to serve the interests of the local populace. The anticolonial pedagogy theorized also proposes strategies that different government and education stakeholders can employ in order to resist and counter the colonial, neo-colonial and neo-liberal structures and ideologies that continue to be perpetuated in the country.

Purpose: The purpose of this paper is to examine the development of entrepreneurship education and training in Kenya as a strategic approach to addressing the unemployment problem among the school and university graduates in Kenya and Africa in general. Design/methodology/approach: The study adopted a critical review of the literature method to achieve its purpose and to answer the key research question. The literature search included a computerized search of accessible and available material on entrepreneurship, entrepreneurial spirit, entrepreneurship education and training programs, history of entrepreneurship, and entrepreneurship models, Africa and entrepreneurship development. Findings: It is shown that the development of entrepreneurial spirit and competencies should be a lifelong process. Addressing Africa's socioeconomic development in an entrepreneurial way requires learning successful lessons from within and without Africa. Specific examples of successful use of entrepreneurship to develop micro, small and medium-sized enterprises in Africa and other parts of the world, especially the USA, are cited in the paper. A case study of using technology to promote entrepreneurship in Africa is provided. Research limitations/implications: The paper is limited since it is based on a review of the literature. Quantitative and qualitative research studies focusing on entrepreneurship and socioeconomic development in Africa are recommended. Originality/value: There are limited studies that focus on the issue of entrepreneurship and socioeconomic development in Africa. This paper and the special issue in particular have laid down pioneering ground work for research on entrepreneurship and socioeconomic development in Africa.

In their introduction of "Music and the Racial Imagination," co-editors Ronald Radano and Philip Bohlman assert that although music is "saturated with racial stuff", "musicology--in its historical, structural-analytical, and ethnographic expressions--has sought to deny the racial dimension." Much as the author agrees with them, he also thinks that racism or racial discrimination is a sensitive topic in which many scholars in the field of musicology or ethnomusicology are reticent to engage. As an African musicologist and music educator, the author is especially interested in the two essays featuring the continent of Africa namely, D.A. Masolo's study of popular music in Kenya and Thomas Turino's paper on race, class and musical nationalism in Zimbabwe. However, he has elected to focus on a single chapter from "Music and the Racial Imagination," D.A. Masolo"s "Presencing the Past and Remembering the Present: Social Features of Popular Music in Kenya," in light of his experience with several of the socio-musicological issues Masolo discusses which have relevance not only in Kenya but other African countries as well. In this essay, the author deals with two issues raised by Masolo, which are often debated by scholars in the fields of musicology/ethnomusicology and music education. They are: (1) the use of contentious terms or terminologies by scholars with regard to the categorization or description of types of music, philosophy, religion, arts and so forth; and (2) the influence of colonialism on music and cultural education at the formal scholastic level in Africa. (Contains 1 note.)

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]

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]

Purpose: The main purpose of using technology in the delivery of virtual learning programs in higher education in Africa is to ensure access and equity as a strategy to develop human resources. Examining how specific educational innovations in higher education are working is necessary. The purpose of this study is to examine the World Bank's education policies in Africa with special focus on AVU Kenyatta University Project. In addition, the paper seeks to critically examine the use of information technology (IT) distance learning project initiated by the World Bank in Kenya. The project served as an important pioneering role to eLearning in Africa. Design/methodology/approach: To achieve the primary purpose of the study, a critical analysis of relevant literature was conducted. The literature search included computerized search of accessible and available material on AVU and distance education in Africa. Findings: The results of the study show that AVU's design and implementation in Africa was initially flawed like many other World Bank education projects. While distance learning should lower costs of higher education, this was not the case. The AVU project was initially faced with challenges, but, over a period of 16 years, the Africa Region is now considered one of the most dynamic e-learning markets on the planet. The continent has witnessed increased digitization of universities, booming enrollment in online higher education and the rapid adoption of self-paced learning. Research limitations/implications: The concept of virtual learning if appropriately applied could be of great benefit to universities and students in Africa. Thus, design and implementation of innovations in education should be grounded in the relevant theories of learning and should involve educational experts. Originality/value: There are limited studies that focus on the issues of access, efficiency, equity and use of innovative technologies in the design and successful delivery of virtual learning courses in African universities, hence the importance of this study.

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]

Two books acknowledge the importance of education in empowering African women and girls, both socially and economically, but differ from the dominant discourse by delving into locally grounded investigations of the dynamics that influence girls' access to education, outcomes, and the nature of the empowerment that education accords them. The scope and limitations of the gender and education discourse are discussed. (SV)

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

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]

Background: Routine Data Quality Assessments (RDQAs) were developed to measure and improve facility-level electronic medical record (EMR) data quality. We assessed if RDQAs were associated with improvements in data quality in KenyaEMR, an HIV care and treatment EMR used at 341 facilities in Kenya. Methods: RDQAs assess data quality by comparing information recorded in paper records to KenyaEMR. RDQAs are conducted during a one-day site visit, where approximately 100 records are randomly selected and 24 data elements are reviewed to assess data completeness and concordance. Results are immediately provided to facility staff and action plans are developed for data quality improvement. For facilities that had received more than one RDQA (baseline and follow-up), we used generalized estimating equation models to determine if data completeness or concordance improved from the baseline to the follow-up RDQAs. Results: 27 facilities received two RDQAs and were included in the analysis, with 2369 and 2355 records reviewed from baseline and follow-up RDQAs, respectively. The frequency of missing data in KenyaEMR declined from the baseline (31% missing) to the follow-up (13% missing) RDQAs. After adjusting for facility characteristics, records from follow-up RDQAs had 0.43-times the risk (95% CI: 0.32–0.58) of having at least one missing value among nine required data elements compared to records from baseline RDQAs. Using a scale with one point awarded for each of 20 data elements with concordant values in paper records and KenyaEMR, we found that data concordance improved from baseline (11.9/20) to follow-up (13.6/20) RDQAs, with the mean concordance score increasing by 1.79 (95% CI: 0.25–3.33). Conclusions: This manuscript demonstrates that RDQAs can be implemented on a large scale and used to identify EMR data quality problems. RDQAs were associated with meaningful improvements in data quality and could be adapted for implementation in other settings. [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]

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 two social enterprises and 25+ informal economy micro-entrepreneurs in Kenya who utilize waste materials to generate income, considered through the conceptual lens of bricolage. Waste materials can all be considered as sources of free or discounted materials that in resource-constrained and poor communities might be leveraged to generate income in the absence of employment. This paper explores three key themes that emerge from the research findings, namely the various strategic dimensions of the cases, the networks and social capital they leverage and how these livelihood models relate to various dimensions of bricolage such as improvisation, making do and the process of 'fiddling' or recombining resources. The findings also suggest that differing waste livelihoods have different rates of return, or profitability, and differing input requirements of capital, skills and knowledge. The paper also stresses the role of boundary spanning organizations such as NGOs and hybrid/social enterprises. © 2016 The Authors. Business Strategy and the Environment published by ERP Environment and John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Birth registration and obtaining physical birth certificates impose major challenges in developing countries, with impact on child and community health, education, planning, and all levels of development. However despite initiatives, universal registration is elusive, leading to calls for new approaches to understanding the decisions of parents. In this paper, we report results of a survey of students in grades six to eight (age ~12–16) in an under-registered area of Kenya regarding their own understanding of registration issues and their suggestions for improvement. These students were selected because they themselves were also nearing the age for high school enrollment/entrance examinations, which specifically requires possession of a birth certificate. This assessment was also a companion to our previous representative survey of adults in the same Kenyan region, allowing for parent-child comparison. Results supported previous research, showing that only 43% had birth certificates. At the same time, despite these low totals, students were themselves quite aware of registration factors and purposes. The students also made quite prescient sources for understanding their households’ motivations, with many of their suggestions—for focus on communication of pragmatic benefits, or automatic measures shifting responsibility from parents—mirroring our own previous suggestions, and showing a level of pragmatism not witnessed when surveying their parents. This paper therefore adds evidence to the discussion of registration policy planning. More generally, it also builds on an important trend regarding the treatment of children as stakeholders and important sources of information, and raising an intriguing new avenue for future research. [ABSTRACT FROM AUTHOR]

As of 2015, only 12 countries in the World Health Organization’s AFRO region had met Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Kenya was one of the countries selected for an in-depth case study due to its insufficient progress in reducing under-five mortality, with only a 28% reduction between 1990 and 2013. This paper presents indicators, national documents, and qualitative data describing the factors that have both facilitated and hindered Kenya’s efforts in reducing child mortality. Key barriers identified in the data were widespread socioeconomic and geographic inequities in access and utilization of maternal, neonatal, and child health (MNCH) care. To reduce these inequities, Kenya implemented three major policies/strategies during the study period: removal of user fees, the Kenya Essential Package for Health, and the Community Health Strategy. This paper uses qualitative data and a policy review to explore the early impacts of these efforts. The removal of user fees has been unevenly implemented as patients still face hidden expenses. The Kenya Essential Package for Health has enabled construction and/or expansion of healthcare facilities in many areas, but facilities struggle to provide Emergency Obstetric and Neonatal Care (EmONC), neonatal care, and many essential medicines and commodities. The Community Health Strategy appears to have had the most impact, improving referrals from the community and provision of immunizations, malaria prevention, and Prevention of Mother-to-Child Transmission of HIV. However, the Community Health Strategy is limited by resources and thus also unevenly implemented in many areas. Although insufficient progress was made pre-2015, with additional resources and further scale-up of new policies and strategies Kenya can make further progress in child survival. [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]

This paper revisits the inverse farm size-productivity relationship in Kenya. The study makes two contributions. First, the relationship is examined over a much wider range of farm sizes than most studies, which is particularly relevant in Africa given the recent rise of medium- and large-scale farms. Second, we test the inverse relationship hypothesis using three different measures of productivity including profits per hectare and total factor productivity, which are arguably more meaningful than standard measures of productivity such as yield or gross output per hectare. We find a U-shaped relationship between farm size and all three measures of farm productivity. The inverse relationship hypothesis holds on farms between zero and 3 hectares. The relationship between farm size and productivity is relatively flat between 3 and 5 hectares. A strong positive relationship between farm size and productivity emerges within the 5 to 70 hectare range of farm sizes. Across virtually all measures of productivity, farms between 20 and 70 hectares are found to be substantially more productive than farms under 5 hectares. When the analysis is confined to fields cultivated to maize (Kenya's main food crop) the productivity advantage of relatively large farms stems at least partially from differences in technical choice related to mechanization, which substantially reduces labor input per hectare, and from input use intensity. [ABSTRACT FROM AUTHOR]

The concept of work-integrated learning (WIL) is significant as it has a considerable influence on a student's fitness for the workplace upon graduation. This paper aims to determine the perception of graduates of the United States International University -- Africa (USIU-A) towards the quality of the internship program and especially the effects of the learning activities of a work-integrated learning course. The study was conducted using an adjusted framework for evaluating the quality of WIL curricula based on six dimensions of WIL including: authenticity; integrated learning supports; alignment of teaching and learning activities and assessments with integrative learning outcomes; supervisor access; and, induction / preparation processes. From the findings, supervisor access and authenticity received high ratings while integrated learning support and alignment of both teaching and learning activities received the lowest rating. The findings will inform the developers and implementers of internship programs by identifying key areas of focus. [ABSTRACT FROM AUTHOR]

This paper documents a positive relationship between maize productivity in western Kenya and women’s empowerment in agriculture, measured using indicators derived from the abbreviated version of the Women’s Empowerment in Agriculture Index. Applying a cross-sectional instrumental-variable regression method to a data set of 707 maize farm households from western Kenya, we find that women’s empowerment in agriculture significantly increases maize productivity. Although all indicators of women’s empowerment significantly increase productivity, there is no significant association between the women’s workload (amount of time spent working) and maize productivity. Furthermore, the results show heterogenous effects with respect to women’s empowerment on maize productivity for farm plots managed jointly by a male and female and plots managed individually by only a male or female. More specifically, the results suggest that female- and male-managed plots experience significant improvements in productivity when the women who tend them are empowered. These findings provide evidence that women’s empowerment contributes not only to reducing the gender gap in agricultural productivity, but also to improving, specifically, productivity from farms managed by women. Thus, rural development interventions in Kenya that aim to increase agricultural productivity—and, by extension, improve food security and reduce poverty—could achieve greater impact by integrating women’s empowerment into existing and future projects. [ABSTRACT FROM AUTHOR]

Context: Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. Objective: To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. Methods: This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15–49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. Findings: A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women experiencing higher quality of care have lower odds of ever expressing ambivalence and higher odds of remaining unequivocal over time, net of other factors. Quality of care was not associated with a shift in ambivalence over time. Conclusion: FP programs offering higher quality of care are likely to support women to be more decisive in their pregnancy intentions. Improving the quality of care can contribute to reduced ambivalence and consequently reduced likelihood of unintended pregnancy among contraceptive users. This study provides further evidence of the benefits gained through providing high quality services. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]