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BackgroundFewer than 10% of people with hypertension in sub-Saharan Africa are diagnosed, linked to care, and achieve hypertension control. We hypothesized that a one-time financial incentive and phone call reminder for missed appointments would increase linkage to hypertension care following community-based screening in rural Uganda and Kenya.MethodsIn a randomized controlled trial, we conducted community-based hypertension screening and enrolled adults ≥25 years with blood pressure ≥140/90 mmHg on three measures; we excluded participants with known hypertension or hypertensive emergency. The intervention was transportation reimbursement upon linkage (~$5 USD) and up to three reminder phone calls for those not linking within seven days. Control participants received a clinic referral only. Outcomes were linkage to hypertension care within 30 days (primary) and hypertension control <140/90 mmHg measured in all participants at 90 days (secondary). We used targeted minimum loss-based estimation to compute adjusted risk ratios (aRR).ResultsWe screened 1,998 participants, identifying 370 (18.5%) with uncontrolled hypertension and enrolling 199 (100 control, 99 intervention). Reasons for non-enrollment included prior hypertension diagnosis (n = 108) and hypertensive emergency (n = 32). Participants were 60% female, median age 56 (range 27-99); 10% were HIV-positive and 42% had baseline blood pressure ≥160/100 mmHg. Linkage to care within 30 days was 96% in intervention and 66% in control (aRR 1.45, 95%CI 1.25-1.68). Hypertension control at 90 days was 51% intervention and 41% control (aRR 1.22, 95%CI 0.92-1.66).ConclusionA one-time financial incentive and reminder call for missed visits resulted in a 30% absolute increase in linkage to hypertension care following community-based screening. Financial incentives can improve the critical step of linkage to care for people newly diagnosed with hypertension in the community.

Purpose: To survive, organizations must have a competitive advantage in order to stay ahead of the competition. Market innovation has remained the driving force behind most market expansions and stability in the turbulent nature of global economies. This study sought to establish the influence of market innovation on the competitive advantage of telecommunication companies in Kenya. Design/Method/Approach: Using the philosophy of positivism, the study adopted an explanatory research design in testing the hypothesis. The main data collection instrument was a structured questionnaire using both physical conduct and online interactions to return 247 responses from mid and top level managers in a total of 26 active telecommunications companies in Kenya. The study used both descriptive and inferential statistics using SPSS computer application to analyze the data. Findings: From the study findings, it was established that innovative distribution channels significantly influenced the competitive advantage while advertising and promotions did not have a significant influence. This led to the conclusion that market innovation has a significant influence on the competitive advantage of telecommunication companies in Kenya. Practical implications: The study recommends that telecommunication companies need to form collaborations and partnerships for ease of establishing market distribution channels that have indicated to bring influence onto the competitive advantage of the companies. Other recommendations include a wider coverage of the East African market for the telecommunications sector. The study provides insights into new companies with interest in the region. Originality/Value: From the results marketing and promotions are not the only major contributing factor in the competitive advantage but the channels of distribution. Research limitations/Future research: The study faced limitations on having to visit the field during the COVID-19 pandemic period thus encountering

Rainy seasons across rural sub-Saharan Africa see a dramatic reduction in the collection of groundwater from water points, exposing communities to health risks and reducing sustainability of service providers. Kenyan water service provider FundiFix operates water points in dispersed rural communities in semi-arid Kitui County and sees five to ten times less water collected, and revenues close to zero, during rainy seasons. Water ATMs record precise volumes of water dispensed and allow for timely price changes. It was hypothesised that reducing price from 3 KES to 1 KES per jerrycan would cheaply maintain clean water collection and possibly increase revenue. FundiFix tested this intervention over the March-April-May 2023 rainy season at three water ATM piped schemes and communicated the price reduction to users, with a fourth control unchanged. This did little to nothing to maintain the collection of water at dry season levels. This shows other practitioners that to address the seasonality challenge price reductions need to be combined with deeper understanding of user behaviour, which requires further study. This study only cost 100 USD in lost revenue from reduced price. Implications for practitioners are outlined. Conditional transfers of water credit to users, rather than price reductions, are discussed.