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Purpose: In the last few years, the interest on professional identity development (PID) and the factors that influence PID has become central in higher education (HE) literature. However, the knowledge developed in this domain has focussed on a factor at a time and on a degree or discipline, thus being difficult to have a general picture of all the factors that influence the development of professional identity in HE. The purpose of this paper is to try to go further by proposing a systematic and integrative conceptual framework on the factors that influence PID of HE students. Design/Methodology/Approach: To identify the influencing factors on PID the authors used primary and secondary data sources. In particular, the authors first conducted a thorough literature review to identify the influencing factors on PID already studied, and second the authors conducted a qualitative pilot study through four Focus Groups to identify new factors not acknowledged before. Findings: The resulting integrative conceptual framework considers the following categories of influencing factors on PID: social experience, educational context, perceived congruence with the profession, demographic characteristics, professional image, professional experience, personal development and self-engagement. Research Limitations/Implications: The proposed framework constitutes a roadmap for future research on career development and counselling to develop in order to enhance PID at university. Nonetheless, this proposed conceptual framework needs to be validated with empirical data. Originality/Value: This paper integrates all the existing knowledge on the influencing factors on PID from different disciplines by constructing a conceptual framework to be validated with further research.

Mass higher education is a huge force to be reckoned with and its existence, already in the expansion of tertiary institutions is undeniable. This study will focus on three countries: Lebanon, Kenya and Oman. The purpose of this study is to evaluate mass tertiary education progress in these countries. It will synthesize data results of gross enrollment ratios, demographics, internationalization and GDP per capita of these countries which we will use as indicators of the progress and direction that mass tertiary education is taking. The principal conclusions of our data will reveal that all 3 countries are experiencing progress only at different rates for varied and different reasons. The findings of this paper are significant as they will aid in informing the governments of the specific countries and other stakeholders who invest in higher education to understand the challenges hindering progress and ensuring that world class academic standards are upheld.

This paper assesses the type of services delivered by the existing Guidance and Counselling units in secondary schools in Kenya based on a survey conducted in Eldoret Municipality in Uasin Gishu County, Kenya. The study adopted an ex-post facto research design the target population being all secondary schools in the Municipality where a sample was obtained by both random and stratified sampling techniques. A total of 204 secondary school students (103 girls and 101 boys), from nine secondary schools, 41 teachers (14 male and 27 female) and the officer in Charge of Guidance and Counselling in the District constituted the sample. All categories of schools were considered, that is, boarding and day; single sex and co-educational; public and private. The research instruments for the study involved the use of structured questionnaires (open- and closed-ended). The data were subjected to descriptive and inferential statistical techniques for analysis and interpretation. The findings were described in the form of frequencies, percentages, means, variances and standard deviations. Chi-Square was use to test the hypotheses, where results were accepted as significant at P ~ 0.05. From the results, the services delivered within these units were varied. Physical and human resources were also not well distributed in all schools. The type of school did not have an influence on services delivered. Both private and public were not aware of the MOEST guidelines on the provision of Guidance and Counseling services. Each school had its own guidelines on service delivery, though they were almost similar. It is thus recommended that more teachers should also be trained in Guidance and Counselling and more than one posted per school. In addition, teachers in charge of Guidance and Counselling should be relieved of their teaching duties or their teaching loads reduced so that they devote more time to the service.

This paper was designed to be an empirical study, looking at the disparity between quantity and quality in higher education in Kenya. To enable a systematic look at quality and quantity within context, a combination of approaches: case study, Delphi technique, observation and interviews were adopted for the purpose of this study. The research validated the common perception of massification and corresponding poor quality in the higher education sector in Kenya; reflected by the poor measures in all the aspects of HE quality: Breadth of teaching, learning and assessment activities, students' achievement, the curriculum, learning resources, student support and guidance, and academic management at subject/department level. The results present serious concerns which require urgent attention and action. Several action points have been suggested that can prove useful in bringing about the necessary reforms in order to revitalise HE for the sake of enabling the achievement of Vision 2030 (the country's grand development programme).

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

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]

Background: In Kenya, infant mortality rate increased from 59 deaths per 1000 live births in 1988 to 78 deaths per 1000 live births by 2003. This was an increase of about 32 percent in 15 years. The reasons behind this upturn are poorly understood. This paper investigates the probable factors behind the upsurge in infant mortality in Kenya during the 1988-2003 period. Understanding the causes behind the upsurge is critical in designing high impact public health strategies for the acceleration of national and international public health goals such as the Millennium Development Goals (MDGs). The reversals in early child mortality is also regarded as one of the most important topics in contemporary demography. Methods: A merged dataset drawn from the Kenya Demographic and Health Surveys of 1993, 1998 and 2003 was used. The merged KDHS included a total of 5265 singletons. Permission to use the KDHS data was obtained from ICF international on the following website: http://www.measuredhs.com. Stata version 11.0 was used for data analysis. The paper used regression decomposition techniques as the main method for analysing the contribution of the selected covariates on the upsurge in infant mortality. Results: The duration of breastfeeding; maternal education, regional HIV prevalence and malaria endemicity were the factors that appeared to have contributed much to the observed rise in infant mortality in Kenya over the period. If all the live births that occurred in the 1996/03 period had the same mean values of all explanatory variables as those of live births that occurred in the 1988/95 period, then infant mortality would have increased by a massive 14 deaths per 1000 live births. However, if the live births that occurred in the 1988/95 period had the same mean values of all explanatory variables as those that occurred in the 1996/03 period, the upsurge in infant mortality would have been negligible. While the role of HIV in the upturn in infant mortality in Kenya and other sub Saharan African countries is indisputable, this study demonstrates that it is the duration of breastfeeding and Malaria endemicity that played a more significant role in Kenya's upsurge in infant mortality during the 1988-2003 period. Conclusions: Efforts aimed at controlling and preventing malaria and HIV should be stepped up to avert an upsurge in infant mortality. There is need to step up alternative baby feeding practices among mothers who are HIV positive especially after the first six months of breastfeeding. Owing to the widely known inverse relationship between maternal education and infant mortality, there is need for concerted efforts to promote girl child education. Owing to the important role played by the short preceding birth interval to the upsurge in infant mortality, there is need to promote family planning methods in Kenya. [ABSTRACT FROM AUTHOR]

This paper presents the overall results of a research project that investigated factors determining how speakers of Ugandan English express futurity, ability and obligation. Findings reveal that forms identified to convey these meanings in American, Indian, Kenyan or Nigerian English, and whose use would reveal influence from these, are seldom used. Rather, persisting exonormative orientation towards British English and first‐language influence seem to determine how many forms are tolerated and which ones are preferred. This challenges epicentre theory, according to which an endonormatively stable variety influences varieties in neighbouring countries, as well as models that assume that varieties with a high impact in terms of the demographic and economic weight of their speakers influence those with a lower impact, whilst findings furthermore indicate that regular long‐term exposure to another variety results in accommodation, making this a factor that needs to be better accounted for. [ABSTRACT FROM AUTHOR]

Background: Health in low and middle income countries is on one hand characterized by a high burden associated with preventable communicable diseases and on the other hand considered to be under-documented due to improper basic health and demographic record-keeping. health and demographic surveillance systems (HDSSs) have provided researchers, policy makers and governments with data about local population dynamics and health related information. In order for an HDSS to deliver high quality data, effective organization of data collection and management are vital. HDSSs impose a challenging logistical process typically characterized by door to door visits, poor navigational guidance, conducting interviews recorded on paper, error prone data entry, an extensive staff and marginal data quality management possibilities., Methods: A large trial investigating the effect of odour-baited mosquito traps on malaria vector populations and malaria transmission on Rusinga Island, western Kenya, has deployed an HDSS. By means of computer tablets in combination with Open Data Kit and OpenHDS data collection and management software experiences with time efficiency, cost effectiveness and high data quality are illustrate. Step by step, a complete organization of the data management infrastructure is described, ranging from routine work in the field to the organization of the centralized data server., Results and Discussion: Adopting innovative technological advancements has enabled the collection of demographic and malaria data quickly and effectively, with minimal margin for errors. Real-time data quality controls integrated within the system can lead to financial savings and a time efficient work flow., Conclusion: This novel method of HDSS implementation demonstrates the feasibility of integrating electronic tools in large-scale health interventions.

Background Although Shigella is an important cause of diarrhea in Kenyan children, robust research platforms capable of conducting incidence-based Shigella estimates and eventual Shigella- targeted clinical trials are needed to improve Shigella -related outcomes in children. Here, we describe characteristics of a disease surveillance platform whose goal is to support incidence and consequences of Shigella diarrhea as part of multicounty surveillance aimed at preparing sites and assembling expertise for future Shigella vaccine trials. Methods We mobilized our preexisting expertise in shigellosis, vaccinology, and diarrheal disease epidemiology, which we combined with our experience conducting population-based sampling, clinical trials with high (97%–98%) retention rates, and healthcare utilization surveys. We leveraged our established demographic surveillance system (DSS), our network of healthcare centers serving the DSS, and our laboratory facilities with staff experienced in performing microbiologic and molecular diagnostics to identify enteric infections. We joined these resources with an international network of sites with similar capabilities and infrastructure to form a cohesive scientific network, designated Enterics for Global Health (EFGH), with the aim of expanding and updating our knowledge of the epidemiology and adverse consequences of shigellosis and enriching local research and career development priorities. Conclusions Shigella surveillance data from this platform could help inform Shigella vaccine trials. [ABSTRACT FROM AUTHOR]

Background: Tsetse flies are the primary vector for African trypanosomiasis, a disease that affects both humans and livestock across the continent of Africa. In 1973 tsetse flies were estimated to inhabit 22% of Kenya; by 1996 that number had risen to roughly 34%. Efforts to control the disease were hampered by a lack of information and costs associated with the identification of infested areas. Given changing spatial and demographic factors, a model that can predict suitable tsetse fly habitat based on land cover and climate change is critical to efforts aimed at controlling the disease. In this paper we present a generalizable method, using a modified Mapcurves goodness of fit test, to evaluate the existing publicly available land cover products to determine which products perform the best at identifying suitable tsetse fly land cover., Results: For single date applications, Africover was determined to be the best land use land cover (LULC) product for tsetse modeling. However, for changing habitats, whether climatically or anthropogenically forced, the IGBP DISCover and MODIS type 1 products where determined to be most practical., Conclusion: The method can be used to differentiate between various LULC products and be applied to any such research when there is a known relationship between a species and land cover.

Objectives: Human population totals are used for generating burden of disease estimates at global, continental and national scales to help guide priority setting in international health financing. These exercises should be aware of the accuracy of the demographic information used., Methods: The analysis presented in this paper tests the accuracy of five large-area, public-domain human population distribution data maps against high spatial resolution population census data enumerated in Kenya in 1999. We illustrate the epidemiological significance, by assessing the impact of using these different human population surfaces in determining populations at risk of various levels of climate suitability for malaria transmission. We also describe how areal weighting, pycnophylactic interpolation and accessibility potential interpolation techniques can be used to generate novel human population distribution surfaces from local census information and evaluate to what accuracy this can be achieved., Results: We demonstrate which human population distribution surface performed best and which population interpolation techniques generated the most accurate bespoke distributions. Despite various levels of modelling complexity, the accuracy achieved by the different surfaces was primarily determined by the spatial resolution of the input population data. The simplest technique of areal weighting performed best., Conclusions: Differences in estimates of populations at risk of malaria in Kenya of over 1 million persons can be generated by the choice of surface, highlighting the importance of these considerations in deriving per capita health metrics in public health. Despite focussing on Kenya the results of these analyses have general application and are discussed in this wider context.

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Much previous work on the relationship between respondent's reported frequency of discussion with spouse about family planning and correctness of reporting spouse's approval of family planning has led to the conclusion that discussion promotes approval. In this paper, data from the 1998 Kenya Demographic and Health Surveys are used to show that a focus on the relationship between frequency of discussion and correctness of reporting partner's disapproval of family planning leads to sceptical conclusions about the effects of discussion in improving knowledge of partner's attitude or in promoting approval. [ABSTRACT FROM AUTHOR]

Background: Healthcare financing through health insurance is gaining traction as developing countries strive to achieve universal health coverage and address the limited access to critical health services for specific populations including pregnant women and their children. However, these reforms are taking place despite limited evaluation of impact of health insurance on maternal health in developing countries including Kenya. In this study we evaluate the association of health insurance with access and utilization of obstetric delivery health services for pregnant women in Kenya.Methods: Nationally representative data from the Kenya Demographic and Health Survey 2008-09 was used in this study. 4082 pregnant women with outcomes of interest - Institutional delivery (Yes/No - delivery at hospital, dispensary, maternity home, and clinic) and access to skilled birth attendants (help by a nurse, doctor, or trained midwife at delivery) were selected from 8444 women ages 15-49 years. Linear and logistic regression, and propensity score adjustment are used to estimate the causal association of enrollment in insurance on obstetric health outcomes.Results: Mothers with insurance are 23 percentage points (p < 0.01) more likely to deliver at an institution and 20 percentages points (p < 0.01) more likely have access to skilled birth attendants compared to those not insured. In addition mothers of lower socio-economic status benefit more from enrollment in insurance compared to mothers of higher socio-economic status. For both institutional delivery and access to skilled birth attendants, the average difference of the association of insurance enrollment compared to not enrolling for those of low SES is 23 percentage points (p < 0.01), and 6 percentage points (p < 0.01) for those of higher SES.Conclusions: Enrolling in health insurance is associated with increased access and utilization of obstetric delivery health services for pregnant women. Notably, those of lower socio-economic status seem to benefit the most from enrollment in insurance. [ABSTRACT FROM AUTHOR]

The article provides an assessment and overview of the life's work and career of Robert Levine, the leading psychologist anthropologist. His personal biography, awards, career, and accomplishments are described, along with his professional contributions. Special attention is devoted to his contributions to the cross-cultural examination of human development, including his advocacy and thinking regarding the utilization of mixed methods (qualitative and quantitative) and multidisciplinary (e.g., psychology, anthropology, demography, sociology, psychiatry, psychoanalytic) approaches. Attention is also given to description of his contributions to the history of psychological anthropology, to the intersection of culture and psyche, to person-centered studies of the Gusii in Kenya, and to comparative studies of human development, in India, Asia, Africa, and beyond. A critical assessment of the relevance of his fifty year career for culture and psychology today is offered. [ABSTRACT FROM AUTHOR]

This paper examined the existence and impact of population policy in Kenya. The findings show that Kenya has adopted an antinatalist population policy which also aims at promoting balanced population distribution. This policy is, however, not well-designed and integrated. The demographic targets are often not specified or vague; the program measures are limited; and the policy does not encompass most geographical areas and subpopulation in terms of needs and resource endowments. There is need to reformulate the existing population policy in Kenya and make it well-designed and more rigorous. The policy must have set demographic targets to be achieved within specified time periods. The program measures must be broadened to include a wider range of factors directly and indirectly implied in a population resource equation at the present and in the future. Such a policy will achieve controlled population growth and balanced population distribution.

"In this paper the determinants of internal migration in Kenya are analyzed on the basis of a human capital model. Explanatory variables included in the specification are both economic (wage rates and employment rates) and noneconomic (for example, population density and educational attainment). Also incorporated are variables which reflect intervening opportunities.... The econometric results show that destination variables are important determinants of internal migration, as is distance between the districts. Further, the variables for the intervening opportunities add significantly to the explanatory power of the model.", (excerpt)

The region around Tendaguru Hill in southeastern Tanzania has provided a rich, Late Jurassic dinosaur fauna. Among them, thousands of bones of the basal iguanodontian ornithopod Dysalotosaurus lettowvorbecki have been excavated in the Ig/WJ-quarry northwest of the Tendaguru Hill. The incomplete record of the taphonomic information from the excavation is the main reason for the still inconclusive interpretation of the assemblage as either catastrophic or attritional in origin. In this study, all available historical notes, sketches and field catalogues were analysed and combined with data from CT scans, new taphonomic observations and from bone histological as well as demographic analyses. According to these combined results, the mass accumulation of remains of D. lettowvorbecki consists of four closely associated bonebeds in at least three different stratigraphic levels. The bonebeds are classified as mixed, multitaxic, and monodominant. There is no evidence of abrasion and preburial weathering on the bones suggesting minimal transport distances and duration as well as short preburial exposure times. Although the size/age distributions are bimodally U-shaped, the bonebeds are interpreted as catastrophic in origin due to the restricted spatial extent and the overall uniform preservation of the bones. It is proposed that different herds of D. lettowvorbecki crossed a tidal channel several times during seasonal migration and that each time several to dozens of individuals died. The bodies decomposed and were buried at a barrier or a bend nearby. The demographic conditions as well as the modes of death and burial of D. lettowvorbecki are very similar to the observations made from the modern blue wildebeest in the Masai-Mara Reserve in Kenya. [ABSTRACT FROM AUTHOR]

This paper focuses on patterns of population growth in Kenya. The historical pattern of population growth from the close of the nineteenth century to 1992 is explored in the first two major sections. Estimates of the annual rate of natural population growth have not exceeded 2.5 per cent prior to 1960, Since 1960 the annual natural population growth rate has increased from 3 per cent in 1962 to 3.8-3.9 per cent for the 1977-1990 period. The rate has fallen slightly to 3.6 per cent for 1992, and data from the 1989 Kenya Demographic and Health Survey indicate that the total fertility rate declined significantly during the 1980s. The applicability of demographic transition theory to the study of population growth and development in Kenya is addressed in the third section. A four- stage model grounded in the work of Petersen, Caidwell and Chesnais is developed and applied to Kenya. Kenya is observed to have passed through the underdeveloped stage characterised by increasing birth and death rates and entered the transition/developing stage during the 1980s. Issues concerning the prospects of substantial continued reductions in the fertility level are addressed in the concluding section. [ABSTRACT FROM AUTHOR]

We analyse social demography, livelihood diversification and land tenure among the Maasai people inhabiting Kenya (three sites) and Tanzania (one site) with contrasting land tenure policies. In Kenya, land was communally owned in the rural Amboseli, fully privatized in the peri-urban Kitengela in Athi-Kaputiei and partially privatized and communally owned in the rural Maasai Mara. In Tanzania, the government owned the land but granted user rights to local villages in rural Simanjiro in Tarangire-Manyara. We interviewed 100 households per site from May to July 2006. There were regional distinctions in social demography, livelihood diversification, hiring herding labour and settlement arrangements, portraying differential transition away from traditional pastoral Maasai society. The transition is most advanced in Kitengela located near Nairobi City, where privatization of land tenure in the 1980s triggered land sub-division, unprecedented land fragmentation and large-scale collapse of the commons, pastoralism and conservation. Land privatization and sub-division in Maasai Mara and Amboseli started in 2000s and were followed similarly by unprecedented fragmentation through fences and accelerated collapse of the commons, pastoralism and conservation, except where wildlife conservancies were later established. We found several differences at the household, regional and national levels. The average age of household heads was lower in Maasai Mara and Amboseli than in Kitengela and Simanjiro. The average number of wives per male household head was lowest in Kitengela, intermediate in Mara and Amboseli and highest in Simanjiro. Correspondingly, the mean number of children per family was lowest in Kitengela, intermediate in Mara and Amboseli and highest in Simanjiro. Household heads were more educated closer to urban centres. Household heads without formal education were thus most common in Amboseli, intermediate in Mara and Simanjiro and fewest in Kitengela. Livelihood diversification was marked in all the sites. Notably, cultivation was widespread and most of those interviewed were interested in crop cultivation. The average number of acres cultivated per household was far higher in Simanjiro than in all the other sites. The mean number of hired herders per household was higher in Kitengela, with the highest number of children enrolled in schools, than in the Mara, Amboseli or Simanjiro. The average number of households per settlement was highest in the Mara, intermediate in Amboseli and Simanjiro and lowest in Kitengela. The marked regional variation in social demography, livelihood diversification and land tenurial arrangements reflects underlying variation in proximity to urban centres, agro-climatological and national developmental and policy environments. [ABSTRACT FROM AUTHOR]

Background: African annual killifishes (Nothobranchius spp.) are adapted to seasonally desiccating habitats (ephemeral pools), surviving dry periods as dormant eggs. Given their peculiar life history, geographic aspects of their diversity uniquely combine patterns typical for freshwater taxa (river basin structure and elevation gradient) and terrestrial animals (rivers acting as major dispersal barriers). However, our current knowledge on fine-scale inter-specific and intra-specific genetic diversity of African annual fish is limited to a single, particularly dry region of their distribution (subtropical Mozambique). Using a widespread annual killifish from coastal Tanzania and Kenya, we tested whether the same pattern of genetic divergence pertains to a wet equatorial region in the centre of Nothobranchius distribution. Results: In populations of Nothobranchius melanospilus species group across its range, we genotyped a part of mitochondrial cytochrome oxidase subunit 1 (COI) gene (83 individuals from 22 populations) and 10 nuclear microsatellite markers (251 individuals from 16 populations). We found five lineages with a clear phylogeographic structure but frequent secondary contact. Mitochondrial lineages were largely congruent with main population genetic clusters identified on microsatellite markers. In the upper Wami basin, populations are isolated as a putative Nothobranchius prognathus, but include also a population from a periphery of the middle Ruvu basin. Other four lineages (including putative Nothobranchius kwalensis) coexisted in secondary contact zones, but possessed clear spatial pattern. Main river channels did not form apparent barriers to dispersal. The most widespread lineage had strong signal of recent population expansion. Conclusions: We conclude that dispersal of a Nothobranchius species from a wet part of the genus distribution (tropical lowland) is not constrained by main river channels and closely related lineages frequently coexist in secondary contact zones. We also demonstrate contemporary connection between the Ruvu and Rufiji river basins. Our data do not provide genetic support for existence of recently described cryptic species from N. melanospilus complex, but cannot resolve this issue. [ABSTRACT FROM AUTHOR]

Background: Quality of healthcare is an important determinant of future progress in global health. However, the distributional aspects of quality of care have received inadequate attention. We assessed whether high quality maternal care is equitably distributed by (1) mapping the quality of maternal care in facilities located in poorer versus wealthier areas of Kenya; and (2) comparing the quality of maternal care available to Kenyans in and not in poverty. Methods: We assessed three measures of maternal care quality: facility infrastructure and clinical quality of antenatal care and delivery care, using indicators from the 2010 Kenya Service Provision Assessment (SPA), a standardized facility survey with direct observation of maternal care provision. We calculated poverty of the area served by antenatal or delivery care facilities using the Multidimensional Poverty Index. We used regression analyses and non-parametric tests to assess differences in maternal care quality in facilities located in more and less impoverished areas. We estimated effective coverage with a minimum standard of care for the full population and those in poverty. Results: A total of 564 facilities offering at least one maternal care service were included in this analysis. Quality of maternal care was low, particularly clinical quality of antenatal and delivery care, which averaged 0.52 and 0.58 out of 1 respectively, compared to 0.68 for structural inputs to care. Maternal healthcare quality varied by poverty level: at the facility level, all quality metrics were lowest for the most impoverished areas and increased significantly with greater wealth. Population access to a minimum standard (≥0.75 of 1.00) of quality maternal care was both low and inequitable: only 17% of all women and 8% of impoverished women had access to minimally adequate delivery care. Conclusion: The quality of maternal care is low in Kenya, and care available to the impoverished is significantly worse than that for the better off. To achieve the national targets of maternal and neonatal mortality reduction, policy initiatives need to tackle low quality of care, starting with high-poverty areas. [ABSTRACT FROM AUTHOR]

Background: Violence and Injuries are a significant global public health concern characterized by marked regional variation in incidence. Approximately five million people die from injuries each year, accounting 9% of all deaths worldwide. In Kenya, injuries are increasingly becoming a cause of hospital admissions and mortality where they account for 10% of all the deaths. The objective of this study was to determine the magnitude, demographic profile and pattern of fatal injuries in Nairobi.Methods: Retrospective review of death certificates from the Department of Civil Registration was done for deaths caused by injuries that occurred in Nairobi during the period, January to June 2014. Data was collected using a standardized form. Data entry, cleaning and analysis was done using Epi info version 7.0.Results: A total of 11,443 records were reviewed. From this data, deaths resulting from injuries were 1,208 accounting for 10.6% of all recorded deaths. Majority of the deaths resulting from injuries occurred in persons aged 25 to 44 years (48.1%). Males accounted for 85% of all the injuries. The leading cause of injury was assault by blunt force at 30.5%, followed by road traffic injuries at 25.9% and fire arm injuries at 15%. Pre-hospital deaths accounted for 51.4% of all the deaths. Nineteen percent of the deaths resulting from injuries had autopsies performed on them.Conclusion: Our study found that injuries are an important cause of fatality in Nairobi, accounting for one in ten deaths. There is need for multisectoral collaboration as some of the preventive measures that target the most prevalent injuries such as assault and road traffic injuries lie outside the health sector. There exists information gaps on the death certificates hence there is need to adequately capacity build both clinicians and death certifiers. There is also a need to revise the death certificates and to improve the pre-hospital care system for the injured persons. [ABSTRACT FROM AUTHOR]

The U.S. is the main country in the world that delivers its food assistance primarily via transoceanic shipments of commodity-based in-kind food. This approach is costlier and less timely than cash-based assistance, which includes cash transfers, food vouchers, and local and regional procurement, where food is bought in or nearby the recipient country. The U.S.’s approach is exacerbated by a requirement that half of its transoceanic food shipments need to be sent on U.S.-flag vessels. We estimate the effect of these U.S. food assistance distribution policies on child mortality in northern Kenya by formulating and optimizing a supply chain model. In our model, monthly orders of transoceanic shipments and cash-based interventions are chosen to minimize child mortality subject to an annual budget constraint and to policy constraints on the allowable proportions of cash-based interventions and non-US-flag shipments. By varying the restrictiveness of these policy constraints, we assess the impact of possible changes in U.S. food aid policies on child mortality. The model includes an existing regression model that uses household survey data and geospatial data to forecast the mean mid-upper-arm circumference Z scores among children in a community, and allows food assistance to increase Z scores, and Z scores to influence mortality rates. We find that cash-based interventions are a much more powerful policy lever than the U.S.-flag vessel requirement: switching to cash-based interventions reduces child mortality from 4.4% to 3.7% (a 16.2% relative reduction) in our model, whereas eliminating the U.S.-flag vessel restriction without increasing the use of cash-based interventions generates a relative reduction in child mortality of only 1.1%. The great majority of the gains achieved by cash-based interventions are due to their reduced cost, not their reduced delivery lead times; i.e., the reduction of shipping expenses allows for more food to be delivered, which reduces child mortality. [ABSTRACT FROM AUTHOR]

This study assesses resilience and general self-efficacy among Kenyan orphans and vulnerable children (n = 1060) active in a community-based program combining economic household strengthening with psychosocial support. Quantile regression analyses modeled associations between the 25th, 50th, and 75th percentiles of resilience and general self-efficacy and multiple covariates. Program participation positively predicted increased general self-efficacy at all levels. Program participation predicted increased resilience at the 25th percentile but decreased resilience at the 75th percentile. Other significant predictors included economic, educational, sexual behavior and other demographic factors. This study suggests support for an integrated approach to economic and psychosocial empowerment. [ABSTRACT FROM AUTHOR]

Background: Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children. Methods: Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital. Clinical measurements were collected using standard forms and entered into a computer database. The proportion of children admitted with hyponatremia was determined. Logistic regression models were used to investigate factors associated with hyponatremia, and death in those with hyponatremia. Results: Abnormal plasma sodium occurred in 46.6% (95% confidence interval (95%CI) 43.5–49.6%) of 1026 pediatric admissions. Hyponatremia occurred in 44.4% (95%CI 41.4–47.5%) and hypernatremia in 2.1% (95%CI 1.3–3.0%). Malaria (40.8%) was the most common underlying primary diagnosis in hyponatremic children. Malaria, hyperglycemia, wasting, high creatinine levels and preserved consciousness were associated with hyponatremia. Pallor and seizures were associated with increased mortality in hyponatremic children. Conclusions: Sodium disturbances are common in pediatric admissions to a County hospital in rural Kenya. Seizures and pallor were predictors of mortality in hyponatremic children. [ABSTRACT FROM AUTHOR]

The health and demographic surveillance system on Rusinga Island, Western Kenya, was initiated in 2012 to facilitate a malaria intervention trial: the SolarMal project. The project aims to eliminate malaria from Rusinga Island using the nationwide adopted strategy for malaria control (insecticide-treated bed nets and case management) augmented with mass trapping of anopheline mosquitoes. The main purpose of the health and demographic surveillance is to measure the effectiveness of the trial on clinical malaria incidence, and to monitor demographic, environmental and malaria-related data variables. At the end of 2014, the 44 km(2) island had a population of approximately 25 000 individuals living in 8746 residential structures. Three times per year, all individuals are followed up and surveyed for clinical malaria. Following each round of surveillance, a randomly selected cross-section of the population is subject to a rapid diagnostic test to measure malaria. Additionally, extensive monitoring of malaria vectors is performed. Data collection and management are conducted using the OpenHDS platform, with tablet computers and applications with advanced software connected to a centralized database. Besides the general demographic information, other health-related data are collected which can be used to facilitate a range of other studies within and outside the current project. Access to the core dataset can be obtained on request from the authors. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have shown that women’s empowerment, though beneficial in many aspects, can also increase the risk of intimate-partner violence (IPV). This study seeks to examine the association between work and experience of physical violence among married adolescents, and to understand the impact of access to independent financial resources on this risk. Authors draw on the asset-building framework and the ecological model. Methods: The data is from a baseline survey of girls aged 15–19 residing in urban slums in four cities and towns in Kenya (Nairobi, Thika, Nakuru and Kisumu). The analytic sample is 452 married girls. Logistic regression is used to examine associations between working status, savings and experience of IPV in the previous six months, controlling for other factors. This is complemented by content analysis of in-depth interviews with 32 adolescent girls and 16 young men. Results: Compared to girls who did not work, working with no regular savings was significantly associated with greater odds (OR = 1.96, p<0.01) of experiencing IPV. There was no difference between girls who did not work and those who worked but had regular savings. Qualitative findings indicate savings decrease girls’ dependency on men and allow them to leave abusive partners. Discussion: Findings imply that in these communities with patriarchal gender norms and high levels of poverty, female employment and financial conflicts can be triggers of violence in marriages. On the other hand, girls’ management of and access to independent financial resources through savings can potentially help to reduce this risk. [ABSTRACT FROM AUTHOR]

Background: Malaria is an important cause of morbidity and mortality in malaria endemic countries. The malaria mosquito vectors depend on environmental conditions, such as temperature and rainfall, for reproduction and survival. To investigate the potential for weather driven early warning systems to prevent disease occurrence, the disease relationship to weather conditions need to be carefully investigated. Where meteorological observations are scarce, satellite derived products provide new opportunities to study the disease patterns depending on remotely sensed variables. In this study, we explored the lagged association of Normalized Difference Vegetation Index (NVDI), day Land Surface Temperature (LST) and precipitation on malaria mortality in three areas in Western Kenya. Methodology and Findings: The lagged effect of each environmental variable on weekly malaria mortality was modeled using a Distributed Lag Non Linear Modeling approach. For each variable we constructed a natural spline basis with 3 degrees of freedom for both the lag dimension and the variable. Lag periods up to 12 weeks were considered. The effect of day LST varied between the areas with longer lags. In all the three areas, malaria mortality was associated with precipitation. The risk increased with increasing weekly total precipitation above 20 mm and peaking at 80 mm. The NDVI threshold for increased mortality risk was between 0.3 and 0.4 at shorter lags. Conclusion: This study identified lag patterns and association of remote- sensing environmental factors and malaria mortality in three malaria endemic regions in Western Kenya. Our results show that rainfall has the most consistent predictive pattern to malaria transmission in the endemic study area. Results highlight a potential for development of locally based early warning forecasts that could potentially reduce the disease burden by enabling timely control actions. [ABSTRACT FROM AUTHOR]

The aim of study was to address the factors influencing landholdings and fertility among women in rural Kenya. The data used are from the 2008–2009 Kenya Demographic and Health Survey (KDHS) of a representative sample size of 6761 women, aged 15–49 years. Statistical tests are utilized to answer the research question, such as Chi-square and logistic regression and P-tests. The results show that the relationship between fertility and landholdings influences family sizes. The relationship between fertility behaviour and occupational status is found to be statistically significant with a P-value of 0.00 and χ2 of 268.24. A high proportion (68.9%) of the women had worked in the preceding reference period. The result of this study is expected to be of particular use for policy makers, planners and other interested stakeholders in population and development spheres. [ABSTRACT FROM AUTHOR]

Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Development in Practice is the property of Routledge 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.)

This article aims to make an empirical and theoretical contribution towards the creation of a continent-wide dataset on African population extending into the pre- 1950 era. We investigate the reliability and the validity of the current population databases with the aim of working towards a consensus on the long-term series of African total population with a reliable 1950 benchmark. The cases of Kenya, Nigeria, and Ghana are explored to show the uneven coverage of census taking in colonial and post-colonial Africa and to demonstrate the need for an upward adjustment of the conventional 1950 benchmark. In addition, we discuss the advantages and disadvantages of Manning's approach of projecting population growth estimates backwards in time by adopting the available Indian census data as African 'default growth rates', and we propose an alternative approach by incorporating the demographic experiences of tropical land-abundant countries in South-East Asia. [ABSTRACT FROM AUTHOR]

Background: The high burden of HIV infections among female sex workers (FSW) in sub-Saharan Africa has been long recognised, but effective preventive interventions have largely not been taken to scale. We undertook a national geographical mapping exercise in 2011/2012 to assess the locations and population size of FSW in Kenya, to facilitate targeted HIV prevention services for this population. Methods and Findings: We used a geographical mapping approach, consisting of interviews with secondary key informants to identify “hot” spots frequented by FSW, their operational dynamics and the estimated numbers of FSW in those spots. This was followed by validation of the estimates through interviews with FSW at each spot identified. The mapping covered Nairobi, the capital city of Kenya, and 50 other major urban centres. In total, 11,609 secondary key informant interviews were conducted to identify FSW spots. Further, a total of 6,360 FSW were interviewed for spot validation purposes. A total of 10,670 spots where FSW congregate were identified. The estimated FSW population in all the towns mapped was 103,298 (range 77,878 to 128, 717). Size estimates in the towns mapped were extended to smaller towns that were not mapped, using a statistical model. The national urban FSW population estimate was 138,420 (range 107, 552 to 169, 288), covering all towns of over 5,000 population. We estimated that approximately 5% of the urban female population of reproductive age in Kenya could be sex workers, which is consistent with previous estimates from other sub-Saharan African countries. Conclusions: This study provides the first national level data on the size of the FSW population in Kenya. These data can be used to enhance HIV prevention programme planning and implementation for FSW, to form the basis for impact evaluations, and to improve programme coverage by directing efforts to locations with the greatest need. [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]

Aims To determine the characteristics of patients with diabetes who reported food insecurity at three diabetes clinics in western Kenya. Methods This study includes routinely collected demographic data at the first presentation of patients with diabetes at clinics in western Kenya from 1 January 2006 to 24 September 2011. A validated questionnaire was used to assess food insecurity with descriptive and comparative statistics being used to analyse the food-secure and food-insecure populations. Results The number of patients presenting to these clinics who were food-secure and those who were food-insecure was 1179 (68.0%) and 554 (32.0%), respectively. Comparative analysis shows a statistically significant difference in weight, BMI, the presence of a caretaker, and use of insulin between the two groups. These variables were lower in the food-insecure group. The overall assessment of the clinic population revealed an abnormally high mean HbA1c concentration of 81 mmol/mol (9.6%). Conclusions Despite the widely recognized contribution of caloric over-nutrition to the development of diabetes, this study highlights the high prevalence of food insecurity amongst patients with diabetes in rural, resource-constrained settings. Other factors, such as the lower prevalence of obesity, poor glucose control, challenges in the use of insulin because of the risk of hypoglycaemia, and varying subtypes of diabetes in this population, point to the need for additional research in understanding the aetiology, pathophysiology and optimum management of this condition, as well as understanding the effects of enhancing food security. [ABSTRACT FROM AUTHOR]

Background: Childbirth with a skilled attendant is crucial for preventing maternal mortality and is an important opportunity for prevention of mother-to-child transmission of HIV. The Maternity in Migori and AIDS Stigma Study (MAMAS Study) is a prospective mixed-methods investigation conducted in a high HIV prevalence area in rural Kenya, in which we examined the role of women's perceptions of HIV-related stigma during pregnancy in their subsequent utilization of maternity services.Methods and Findings: From 2007-2009, 1,777 pregnant women with unknown HIV status completed an interviewer-administered questionnaire assessing their perceptions of HIV-related stigma before being offered HIV testing during their first antenatal care visit. After the visit, a sub-sample of women was selected for follow-up (all women who tested HIV-positive or were not tested for HIV, and a random sample of HIV-negative women, n = 598); 411 (69%) were located and completed another questionnaire postpartum. Additional qualitative in-depth interviews with community health workers, childbearing women, and family members (n = 48) aided our interpretation of the quantitative findings and highlighted ways in which HIV-related stigma may influence birth decisions. Qualitative data revealed that health facility birth is commonly viewed as most appropriate for women with pregnancy complications, such as HIV. Thus, women delivering at health facilities face the risk of being labeled as HIV-positive in the community. Our quantitative data revealed that women with higher perceptions of HIV-related stigma (specifically those who held negative attitudes about persons living with HIV) at baseline were subsequently less likely to deliver in a health facility with a skilled attendant, even after adjusting for other known predictors of health facility delivery (adjusted odds ratio = 0.44, 95% CI 0.22-0.88).Conclusions: Our findings point to the urgent need for interventions to reduce HIV-related stigma, not only for improving quality of life among persons living with HIV, but also for better health outcomes among all childbearing women and their families. [ABSTRACT FROM AUTHOR]

Summary The Kilifi Health and Demographic Surveillance System (KHDSS), located on the Indian Ocean coast of Kenya, was established in 2000 as a record of births, pregnancies, migration events and deaths and is maintained by 4-monthly household visits. The study area was selected to capture the majority of patients admitted to Kilifi District Hospital. The KHDSS has 260 000 residents and the hospital admits 4400 paediatric patients and 3400 adult patients per year. At the hospital, morbidity events are linked in real time by a computer search of the population register. Linked surveillance was extended to KHDSS vaccine clinics in 2008. KHDSS data have been used to define the incidence of hospital presentation with childhood infectious diseases (e.g. rotavirus diarrhoea, pneumococcal disease), to test the association between genetic risk factors (e.g. thalassaemia and sickle cell disease) and infectious diseases, to define the community prevalence of chronic diseases (e.g. epilepsy), to evaluate access to health care and to calculate the operational effectiveness of major public health interventions (e.g. conjugate Haemophilus influenzae type b vaccine). Rapport with residents is maintained through an active programme of community engagement. A system of collaborative engagement exists for sharing data on survival, morbidity, socio-economic status and vaccine coverage. [ABSTRACT FROM AUTHOR]

Background: Up till now, nomadic communities in Africa have been the primary focus of ethnoveterinary research. Although mainly arable and/or mixed arable/pastoral farmers, Ameru of central Kenya are known to have a rich history of ethnoveterinary knowledge. Their collective and accumulative ethnoveterinary knowledge (EVK) is likely to be just as rich and worth documenting. The aim of the study was to document and analyse the ethnoveterinary knowledge of the Ameru. Methods: Non-alienating, dialogic, participatory action research (PAR) and participatory rural appraisal (PRA)approaches involving 21 women and men aged between 50 and 79 years old were utilized. A combination of snowball and purposive sampling methods were used to select 21 key respondents. The methods comprised a set of triangulation approach needed in EVK for non-experimental validation of ethnoknowledge of the Ameru. Results: A total of 48 plant species distributed in 26 families were documented with details of diseases/ill-health conditions, parts of plants used and form of preparation and administration methods applied to different animal groups. Of these families, Fabaceae had the highest number of species (16.67%), followed by Solanaceae (12.5%), Asteraceae and Euphorbiacea (each comprising 8.33%), Lamiaceae (6.25%), Apocynaceae and Boraginaceae (each comprising 4.17%), while the rest of the 19 families, each was represented by a single plant species. About 30livestock diseases/ill-health conditions were described, each treated by at least one of the 48 plant species. Most prevalent diseases/ill-health conditions included: - anaplasmosis, diarrhea, East Coast fever, pneumonia, helminthiasis, general weakness and skin diseases involving wounds caused by ectoparasites. Conclusion: The study showed that there was a rich knowledge and ethnopractices for traditional animal healthcare amongst the Ameru. This study therefore provides some groundwork for elucidating the efficacy of some of these plants, plant products and ethnopractices in managing livestock health as further research may lead to discovery of useful ethnopharmaceutical agents applicable in livestock industry. [ABSTRACT FROM AUTHOR]

The article focuses on the study conducted by Nathan Smith and colleagues to examine impact of implementation of a national subsidy scheme on the accessibility, availability and affordability of anti-malarials in Kenya. It mentions the affordability and accessibility of malaria medicines were evaluated with the help of complete census of all public and private facilities. Further it concludes the AMFm-subsidized anti-malarials are less expensive than unsubsidized AL.

Abstract  In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility- and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya’s Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services. [ABSTRACT FROM AUTHOR]

This article examines the allegation that up to 300,000 Kikuyu and others died as a result of the Mau Mau Emergency in Kenya in the 1950s. This figure was based on comparative numbers from the 1948 and 1962 censuses, but they failed to take into account the changes in the tribal classifications and differences in the coverage of the two censuses. Using data from the 1969 Kenya census, we have reconstructed the levels and patterns of mortality in the 1950s, and we show that mortality of the Kikuyu was consistently lower than those of the Kamba, Luhya and Luo peoples. We have also used unpublished data from the 1948 census to estimate infant mortality among the Kikuyu, Embu and Meru prior to the emergency. Using this figure as an indicator of `normal' mortality, we have compared them with the estimates derived from the 1969 census, and so calculated the number of `excess' deaths. They amount to perhaps 50,000; more than half of them were children under 10. Given the fragile nature of the data and assumptions, our estimates are subject to large margins of error, but they at least give us an order of magnitude. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Ecology is the property of Wiley-Blackwell 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.)

Looks at the development of geography in Kenya. Annual population growth rate; Teaching of geography in secondary schools; Undergraduate curricula for geography.

The relationship between parents' stated sex preferences for children and actual parental behaviour towards sons and daughters is examined among the Mukogodo, a group of traditional pastoralists in rural Kenya. Although their cultural values are male-centered and they tend to express a preference for sons, Mukogodo parents actually appear to be more solicitous of daughters, and the Mukogodo have a strongly female-biased childhood sex ratio. Studies of stated sex preferences should therefore be coupled with attempts to assess actual parental investment in sons and daughters. [ABSTRACT FROM AUTHOR]