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This paper examines changes in children's concepts of health and illness following an action-oriented health education intervention in Bondo district of Western Kenya. The study is a feasibility study exploring a specific educational approach, and it combines elements of health education research and anthropological research. Forty primary schoolchildren aged 10-15 years of age underwent a 2-month intervention and were thereafter enrolled as health communicators in a longitudinal study for an additional period of 12 months. Data were collected before, during and after the intervention using in-depth interviews and the draw-and-write technique. Students' actions and their active participation were key elements in the intervention. Although the intervention from the beginning focused on two specific diseases (malaria and diarrhea), the students were involved in developing their own ideas and visions about which changes to make, which actions to carry out and which target groups to approach. Data showed that children had acquired new concepts of health, some of which incorporated elements of the old ones. More action-oriented health concepts were identified and a general change from an external locus of control towards an internal locus of control was found. The study concludes that students can modify and broaden their concepts of health and illness through action-oriented health education. Key factors are the development of students' ownership through active and participatory teaching and learning approaches. (Contains 4 figures and 2 tables.)

This paper introduces a set of four collaborative papers exploring temporal heterogeneity in the analysis of African land use over a decadal time period, from 10 to 50 years, in the second half of the twentieth century. The four cases were chosen amongst the seven teams of anthropologists, human geographers and remote sensing specialists who had carried out long-term research and who met to discuss their findings at a workshop in 2003. All seven teams’ work and the collective discussion—on Casamance (Senegal), Brong Ahafo (Ghana), Southern Niger/Northern Cote d’Ivoire, Oyo State (Nigeria), Maasai Mara (Kenya and Tanzania), Gwembe (Zambia), and Malawi—inform this introduction. We identify several temporal processes in all the cases, each operating on its own temporal frame: population growth and, above all, mobility; livelihood change through crop and occupational change; tenure ambiguity; powerful though “punctuated” interventions by state policy; and climate change. Conceptual and methodological implications are disussed. [ABSTRACT FROM AUTHOR]

This paper pivots around an exceptional moment of colonial missionary encounter—the attempted "murder" in the 1930s of an incarnation of Samburu Divinity (pastoralists, northern Kenya). Examining this event through a comparative focus on other strange cases of "divinicide," I elucidate certain key moments of intense metaphysical struggle that typically become effaced, forgotten, or flattened in the process of colonial witness. Focus on the ontological micropolitics of exceptional moments of the colonial encounter such as these affords us the opportunity to illuminate crucial, often elusive, even substantially forgotten dimensions of the unequal process by which shared cultural imaginaries are forged. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic overstretched health systems in developed and developing nations. Like other African nations, Kenya has a frail health system, making responding to the pandemic a problem. Recent studies during COVID-19 have shown that Kenya's health systems were either strained to their maximum capability or worse in handling patients. Therefore, citizens were advised not to go to the hospital unless necessary. This advice applies to all, including pregnant mothers. This article utilized the anthropological description of the healthcare system, viewed as a cultural system attached to particular provisions of social institutions and forms of social connections. It is a social and cultural system in origin, structure, function, and significance. In every society, healthcare systems are forms of social reality in which they embody specific social roles and relationships between these roles. There is a dearth of information on how healthcare providers experienced the effects of COVID-19 on Kenya's healthcare system, which this study addresses for those in Coastal Kenya. This rapid qualitative study utilized data from sixteen purposefully selected healthcare providers in charge of various departments in Kilifi County of Coastal Kenya. We utilized thematic analysis and textual description to present our findings. It emerged that there was a diversion in resources allocated for maternal health programs, health facilities were temporarily shut down due to inadequate resources and equipment for health workers, there was a lack of preparation by health workers, there was a reduced flow of pregnant mothers and missing scheduled appointments for ante- and postnatal clinics, maternal mortality increased, and mothers resorted to traditional midwives for deliveries. These findings show that maternal health services were negatively affected. Thus, the government needs to institute alternative measures for continued access to maternal health services during pandemics. We recommend expanding and supporting the existing community midwifery model (CMM). For instance, incorporating community health workers (CHWs) and other local health institutions in the community, such as traditional birth attendants (TBAs), and creating midwifery centers managed by trained midwives in communities. [ABSTRACT FROM AUTHOR]

This paper seeks to analyze a decade of international development in Kenya through the lens of a multi-sited and multi-level ethnographic analysis. It demonstrates the inherently messy and political nature of development as well as the need to analyze the social and cultural contexts in which policies are debated, negotiated, and implemented. An anthropological approach provides insight into the complexity of development policy and the unpredictability of development outcomes which are obscured by research that relies on policy texts and/or eschews empirical fieldwork. [ABSTRACT FROM AUTHOR]

Introduction: Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. Methods: This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PAC patient that reduces pregnancy rate by over 99%. Results: Generally, contraceptive counseling was high among all PAC patients (90%). However, only 54% of them received a modern family planning method—45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient’s previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PAC patients. Discussion and conclusion: For better adoption of highly effective FP, counseling of PAC patients requires an understanding of the patient’s past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization now recommends antiretroviral therapy (ART) initiation for all HIV-infected individuals regardless of CD4 cell count or disease status. Understanding the facilitators and barriers to initiation of and adherence to ART is essential to successful scale-up of “universal” ART. Methods: To investigate facilitators and barriers to ART initiation, we conducted 44 in-depth individual or couple interviews with 63 participants (33 participants with HIV and 30 without HIV) already enrolled in a prospective implementation study of oral antiretroviral-based prevention in Kisumu, Kenya between August and September 2014. A semi-structured interview guided discussions on: 1) perceived advantages and disadvantages of ART; 2) reasons for accepting or declining ART initiation; and 3) influence of prevention of transmission to partner or infant influencing ART use. Transcripts from the interviews were iteratively analyzed using inductive content analysis. Results: HIV-infected participants indicated that living a healthier life, preventing HIV transmission to others, and appearing “normal” or “healthy” again facilitated their initiation of ART. While appearing “normal” allowed these individuals to interact with their communities without stigmatization, they also perceived community opposition to their initiating ART, because appearing “normal” again prevented community members from easily identifying infected individuals in their community. Denial of diagnosis, disclosure stigma, perceived side-effects, and challenges in obtaining refills were additional barriers to ART initiation. Conclusions: Community perceptions play an important role in both facilitating and inhibiting ART initiation. Perceived stigma, including perceived community opposition to widespread ART use, is an important barrier to ART initiation. Addressing such barriers, while capitalizing on facilitators, to ART initiation should be central to universal ART scale-up efforts. [ABSTRACT FROM AUTHOR]

Understanding the effects of actions undertaken by human societies on crop evolution processes is a major challenge for the conservation of genetic resources. This study investigated the mechanisms whereby social boundaries associated with patterns of ethnolinguistic diversity have influenced the on-farm distribution of sorghum diversity. Social boundaries limit the diffusion of planting material, practices and knowledge, thus shaping crop diversity in situ. To assess the effect of social boundaries, this study was conducted in the contact zone between the Chuka, Mbeere and Tharaka ethnolinguistic groups in eastern Kenya. Sorghum varieties were inventoried and samples collected in 130 households. In all, 297 individual plants derived from seeds collected under sixteen variety names were characterized using a set of 18 SSR molecular markers and 15 morphological descriptors. The genetic structure was investigated using both a Bayesian assignment method and distance-based clustering. Principal Coordinates Analysis was used to describe the structure of the morphological diversity of the panicles. The distribution of the varieties and the main genetic clusters across ethnolinguistic groups was described using a non-parametric MANOVA and pairwise Fisher tests. The spatial distribution of landrace names and the overall genetic spatial patterns were significantly correlated with ethnolinguistic partition. However, the genetic structure inferred from molecular makers did not discriminate the short-cycle landraces despite their morphological distinctness. The cases of two improved varieties highlighted possible fates of improved materials. The most recent one was often given the name of local landraces. The second one, that was introduced a dozen years ago, displays traces of admixture with local landraces with differential intensity among ethnic groups. The patterns of congruence or discordance between the nomenclature of farmers’ varieties and the structure of both genetic and morphological diversity highlight the effects of the social organization of communities on the diffusion of seed, practices, and variety nomenclature. [ABSTRACT FROM AUTHOR]

The influence of human aesthetic appreciation of animal species on public attitudes towards their conservation and related decision-making has been studied in industrialized countries but remains underexplored in developing countries. Working in three agropastoralist communities around Amboseli National Park, southern Kenya, we investigated the relative strength of human aesthetic appreciation on local attitudes towards the conservation of wildlife species. Using semi-structured interviewing and free listing (n = 191) as part of a mixed methods approach, we first characterized local aesthetic judgments of wildlife species. With a Generalized Linear Mixed Models (GLMM) approach, we then determined the influence of perceiving four species as beautiful on local support for their protection (“rescuing them”), and of perceiving four other species as ugly on support for their removal from the area, while controlling for informant personal and household socioeconomic attributes. Perceiving giraffe, gazelles and eland as beautiful is the strongest variable explaining support for rescuing them. Ugliness is the strongest variable influencing support for the removal of buffalo, hyena, and elephant (but not lion). Both our qualitative and quantitative results suggest that perceptions of ugly species could become more positive through direct exposure to those species. We propose that protected areas in developing countries facilitate visitation by local residents to increase their familiarity with species they rarely see or most frequently see in conflict with human interests. Since valuing a species for its beauty requires seeing it, protected areas in developing countries should connect the people who live around them with the animals they protect. Our results also show that aesthetic appreciation of biodiversity is not restricted to the industrialized world. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess whether the Government of Kenya's Cash Transfer for Orphans and Vulnerable Children (Kenya CT-OVC) can reduce the risk of HIV among young people by postponing sexual debut. The program provides an unconditional transfer of US$20 per month directly to the main caregiver in the household. An evaluation of the program was implemented in 2007–2009 in seven districts. Fourteen Locations were randomly assigned to receive the program and fourteen were assigned to a control arm. A sample of households was enrolled in the evaluation in 2007. We revisited these households in 2011 and collected information on sexual activity among individuals between 15–25 years of age. We used logistic regression, adjusted for the respondent's age, sex and relationship to caregiver, the age, sex and schooling of the caregiver and whether or not the household lived in Nairobi at baseline, to compare rates of sexual debut among young people living in program households with those living in control households who had not yet entered the program. Our results, adjusted for these covariates, show that the program reduced the odds of sexual debut by 31 percent. There were no statistically significant effects on secondary outcomes of behavioral risk such as condom use, number of partners and transactional sex. Since the CT-OVC provides cash to the caregiver and not to the child, and there are no explicit conditions associated with receipt, these impacts are indirect, and may have been achieved by keeping young people in school. Our results suggest that large-scale national social cash transfer programs with poverty alleviation objectives may have potential positive spillover benefits in terms of reducing HIV risk among young people in Eastern and Southern Africa. [ABSTRACT FROM AUTHOR]

Background: Preventing unintended pregnancies among HIV-positive women through family planning (FP) reduces pregnancy-related morbidity and mortality, decreases the number of pediatric HIV infections, and has also proven to be a cost-effective way to prevent mother-to-child HIV transmission. A key element of a comprehensive HIV prevention agenda, aimed at avoiding unintended pregnancies, is recognizing the attitudes towards FP among HIV-positive women and their spouse or partner. In this study, we analyze FP attitudes among HIV-infected pregnant women enrolled in a PMTCT clinical trial in Western Kenya. Methods and Findings: Baseline data were collected on 522 HIV-positive pregnant women using structured questionnaires. Associations between demographic variables and the future intention to use FP were examined using Fisher's exact tests and permutation tests. Most participants (87%) indicated that they intended to use FP. However, only 8% indicated condoms as a preferred FP method, and 59% of current pregnancies were unintended. Factors associated with positive intentions to use FP were: marital status (p = 0.04), having talked to their spouse or partner about FP (p<0.001), perceived spouse or partner approval of FP (p<0.001), previous use of a FP method (p = 0.006), attitude toward the current pregnancy (p = 0.02), disclosure of a sexually transmitted infection (STI) diagnosis (p = 0.03) and ethnic group (p = 0.03). Conclusion: A significant gap exists between future FP intentions and current FP practices. Support and approval by the spouse or partner are key elements of FP intentions. Counseling services should be offered to both members of a couple to increase FP use, especially given the high number of unplanned pregnancies among HIV-positive women. Condoms should be promoted as part of a dual use method for HIV and STI prevention and for contraception. Integration of individual and couple FP services into routine HIV care, treatment and support services is needed in order to avoid unintended pregnancies and to prevent mother-to-child HIV transmission. [ABSTRACT FROM AUTHOR]

The articles discusses the connection between alimentary systems (food systems) and societal structures in anthropology through an analysis on the core-fringe-legume model (CFLM). After explaining the fundamental basis of the CFLM, developed by Sidney Mintz, the alimentary system of the Luo ethnic group of the western part of Kenya is analyzed. It is concluded that the current application of the CFLM is limited in its applicability but if developed has broader usefulness for analyzing the influences of global daily alimenatry systems.

Viewing the global in the local has become an increasingly central approach in recent anthropology as anthropologists have sought to explicate the ethnographic correlates of globalization. While this approach has produced some of the most important work in recent anthropology, it rests upon long-standing Western notions of space and time that dichotomize "here" and "there" principally by reference to capitalism and the state. Through an examination of transformed geographical models of and about Samburu pastoralists in northern Kenya, it is argued here that this model is itself a global export and that a consideration of Samburu instantiations of it--how and why Samburu have adopted it, what they use it for, and the assumptions that they have adopted in the process--serves to reflect aspects of anthropologists' own cultural constructions of "the local." Recognizing the Western folk elements in global-local models of time and space destabilizes discourses of globalization as a transcultural historical process through an acknowledgment of the cultural specificity through which we situate our own analyses. [ABSTRACT FROM AUTHOR]

Reports on hominin fossils discovered west of Lake Turkana, Kenya in 2001, which differ markedly from other, contemporary hominin fossils. Belief that early hominin phylogeny is best represented by Australopithecus afarensis; Description of the new fossil, which is assigned a genus of hominin and points to an early diet-driven adaptive radiation.

Since the late 19th century archaeologists have struggled to understand the behavioural significance of material remains surviving from the distant reaches of time. A study of the archaeological debris scattered through the lower Okote Member of the Koobi Fora Formation in northwestern Kenya reveals a serious mismatch between the interpretive models being applied to the earliest archaeological data and the empirical structure of those data. Both the low-density scatters and the high-density patches that make up this record are palimpsests of material remains that accumulated over tens of thousands of years. There is a remarkable similarity in the composition and characteristics of the archaeological assemblages recovered from the scatters and the patches. Both represent the material residues of many different and unrelated behavioural episodes, influenced by a different set of variables to those that produced the patterned distributions that archaeologists identify in these data. To decode the behavioural significance of these behavioural traces archaeologists need to investigate both the relationship between the material remains created by an infinitely variable set of behavioural episodes and the patterns and trends in these data created over long time spans and to develop a theory of human action over the middle to long term. [ABSTRACT FROM AUTHOR]