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Background: In western Kenya, a cluster-randomized trial is assessing the impact of attractive targeted sugar baits (ATSBs) on malaria in children enrolled in three consecutive cohorts. Here, characteristics of children and households at enrolment, and factors associated with baseline malaria prevalence are described. Methods: Children aged 1 to < 15 years were randomly selected by cluster (n = 70) from a census database. Cohorts were enrolled in March–April 2022, September–October 2022, and March–April 2023. ATSBs were deployed in March 2022. At enrolment, all participants were tested for malaria by rapid diagnostic test (RDT). After enrolment a household survey was conducted. Household structures were classified as 'improved' (finished walls and roofs, and closed eaves) or 'traditional' (all other construction). A generalized linear mixed model was used to assess factors associated with malaria prevalence. Results: Of 3705 children screened, 220 declined and 523 were excluded, due to plans to leave the study area (n = 392), ineligible age (n = 64) or other reason (n = 67). Overall, 2962 children were enrolled. Bed net use the previous night was more common in children aged 1–4 years (746/777 [96%]) than those aged 5–<15 years (1806/2157 [84%], p < 0.001). Of the 2644 households surveyed (for 2,886 participants), information on house construction was available for 2595. Of these, only 199 (8%) were categorized as 'improved', as most houses had open eaves. While 99% of households owned at least one bed net, only 51% were adequately covered (one net per two household residents). Among 999 children enrolled in the first cohort (baseline), 498 (50%) tested positive by RDT. In an adjusted multivariable analysis, factors associated with RDT positivity included sub-county (Alego-Usonga vs Rarieda, adjusted odds ratio [aOR] 4.81; 95% CI: 2.74–8.45; p < 0.001), house construction (traditional vs improved, aOR 2.80; 95% CI: 1.59–4.95; p < 0.001), and age (5–< 15 vs 1–4 years, aOR 1.64; 95% CI: 1.13–2.37; p = 0.009). Conclusions: In western Kenya, the burden of malaria in children remains high. Most households owned a bed net, but coverage was inadequate. Residents of Alego-Usonga sub-county, those living in traditionally constructed households, and older children were more likely to test positive by RDT. Additional tools are needed to effectively control malaria in this area. Trial registration The ATSB trial is registered under Clinicaltrials.gov NCT05219565 [ABSTRACT FROM AUTHOR]

Sub-Saharan Africa, of which Kenya is part, is considered the most vulnerable region to climate change impacts due to its dependence on rain-fed agriculture and natural resources. Since the rural livelihood systems in Kenya are expected to bear some of the worst effects of climate change, it is imperative to assess rural households' vulnerability to climate change impacts to facilitate the development of adaptation strategies. Therefore, this paper determines the level and sources of households' livelihood vulnerability to climate variability in the Migori River watershed, Kenya. The Livelihood Vulnerability Index (LVI) framed within the Intergovernmental Panel on Climate Change (IPCC) vulnerability framework (LVI-IPCC) was applied. A cross-sectional household survey conducted on 318 randomly selected households was used to assess how vulnerability differs across three watershed zones, upstream, midstream, and downstream. The LVI-IPCC scores were −0.047, −0.003, and 0.008 for the upstream, midstream, and downstream zones, respectively, with significant differences noted in the scores (ANOVA, p < 0.05). Findings indicate that while the livelihoods in all three zones showed moderate vulnerability to environmental and socio-economic stressors, there are notable variations between them. The downstream households exhibit the highest vulnerability, attributed to their lower adaptive capacity, increased exposure, and heightened sensitivity. Conversely, the upstream households demonstrate the least vulnerability compared to the other zones, owing to their lower sensitivity and exposure, as well as better adaptive capacity. Policy recommendations for reducing households' exposure to climate risks and for strengthening their adaptive capacity are discussed. [ABSTRACT FROM AUTHOR]

Coastal mangrove-dependent communities face various risks due to climate change, thus rendering them vulnerable. This study explored the vulnerability of these communities in the Tana Delta in Kenya using an indicator-based vulnerability assessment framework to better understand their exposure, sensitivity and adaptive capacity. Data was collected through household surveys (n = 377), focus group discussions (FGDs), and key informant interviews (KIIs). The analysis revealed mean vulnerability indices at the sub-location level ranged from 0.850 for Kipini to − 0.913 for Kilelengwani and − 2.702 for Ozi. The statistically significant indicators of vulnerability were (i) exposure—high temperatures and rainfall changes; (ii) sensitivity—household numbers, head of household's age, dependents' education, and dependents' employment; and (iii) adaptive capacity—ownership of assets, access to community infrastructure and services, condition/quality of houses, total income, and alternative sources of income. The findings highlight the need for adaptation strategies that ensure greater financial assets supported by education and skills enhancement to utilize existing opportunities. Attention to community infrastructure and services is crucial. Policy should focus on financial, physical, and human assets to reduce community vulnerability alongside the continued conservation and management of mangrove resources. The results will help policymakers in addressing the impacts of climate change and benefit households in the study area. These insights can be applied to regions with similar climate conditions and livelihood systems. [ABSTRACT FROM AUTHOR]

This study examines the farm-level effects of stemborers' biological control (BC) using biological and household survey data collected in rural Kenya. The authors use a continuous treatment impact-evaluation method to estimate BC's average and marginal treatment effects. Findings indicate that, on average, a one percent increase in the intensity of BC increases maize yield by 9.3 kg per hectare and reduces the poverty level of maize-growing farm households by 0.5%. Developing and promoting biological control can be seen as an additional tool in the fight against food insecurity and poverty in Africa through controlling important pests. [ABSTRACT FROM AUTHOR]

This article details the gendered micro-politics of livestock management in a pastoralist community in southern Kenya. It centers on traditionally underemphasized women's spaces within homesteads and women's livestock caretaking activities therein, and in so doing demonstrates how gendered labor is co-constitutive of gendered norms and resource access norms. Moreover, in focusing on access to cattle, access to milk, milk use, and decision-making concerning these cornerstones of livestock-based economies, it illuminates the variety of women's responsibilities and challenges regarding resource management, food security, and wellbeing. Drawing from an ethnographic mixed methods research project, including an in-depth focal household study, household surveys, intra-household surveys, and interviews, this article also illuminates the norms, rules, and institutions governing gendered labor and resource management decisions in the gendered, multispecies spaces of milking. Findings presented here reveal how processes of rule-making and rule-breaking around milk management (access, use, and sales) come to be, why they are challenged or perpetuated, and their impacts on everyday gendered practices during rare times of plenty and more frequent times of hardship. These findings contribute to literatures that highlight the importance of understanding spatialized and gendered intra-household dynamics for reducing inequities in food systems. [ABSTRACT FROM AUTHOR]

Rainwater harvesting reliability, the proportion of days annually when rainwater demand is fully met, is challenging to estimate from cross-sectional household surveys that underpin international monitoring. This study investigated the use of a modelling approach that integrates household surveys with gridded precipitation data to evaluate rainwater harvesting reliability, using two local-scale household surveys in rural Siaya County, Kenya as an illustrative case study. We interviewed 234 households, administering a standard questionnaire that also identified the source of household stored drinking water. Logistic mixed effects models estimated stored rainwater availability from household and climatological variables, with random effects accounting for unobserved heterogeneity. Household rainwater availability was significantly associated with seasonality, storage capacity, and access to alternative improved water sources. Most households (95.1%) that consumed rainwater faced insufficient supply of rainwater available for potable needs throughout the year, with intermittencies during the short rains for most households with alternative improved sources. Although not significant, stored rainwater lasts longer for households whose only improved water source was rainwater (301.8 ± 40.2 days) compared to those having multiple improved sources (144.4 ± 63.7 days). Such modelling analysis could enable rainwater harvesting reliability estimation, and thereby national/international monitoring and targeted follow-up fieldwork to support rainwater harvesting. [ABSTRACT FROM AUTHOR]

Efforts to ensure households transition to modern fuels are expected to reduce household air pollution. However, exposure to toxic particles and gases in fuel stacking households remains under-researched. We implemented a household survey to identify household energy sources and assess exposure to particulate matter with diameter of ≤5 microns (PM2.5), ≤10 microns (PM10) and select polluting gases (Sulfur Dioxide (SO2), Total Volatile Organic Compounds (TVOCs), Carbon Dioxide (CO2), Nitrogen Dioxide (NO2), Carbon Monoxide (CO)) in a rural community. Wood was the main cooking fuel in 94.2% (1615/1703) households with fuel stacking reported in 86.1% (1462/1703) of total households. Daily time-weighted average concentrations of PM2.5 and PM10 were beyond World Health Organization (WHO) limits in wood-using households (189.53 (Standard deviation (SD) = 268.80) µg/m3 and 592.38 (SD = 623) µg/m3, respectively) and Liquid Petroleum Gas (LPG) -using households (57.2 (SD = 53.6) µg/m3 and 189.86 (SD = 168) µg/m3, respectively). Only daily average CO and TVOC concentration in wood-using households exceeded recommended levels. Household socio-economic status, education level of the head of household, use of a separate kitchen and household size influenced household energy choices. Rural households using wood as the main cooking fuel are exposed to high levels of particulate matter, carbon monoxide and total volatile organic compounds. LPG-using households may not realize health benefits if stacking with polluting fuels is practiced. [ABSTRACT FROM AUTHOR]

We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from caregivers or guardians on child's demographics, HIV testing, and treatment history. Blood specimens were collected for HIV serology and if HIV-positive, the samples were tested for viral load and antiretrovirals (ARV). For participants <18 months TNA PCR is performed. We computed weighted proportions with 95% confidence intervals (CI), accounting for the complex survey design. We used bivariable and multivariable logistic regression to assess factors associated with HIV prevalence. Separate survey weights were developed for interview responses and for biomarker testing to account for the survey design and non-response. HIV burden was estimated by multiplying HIV prevalence by the national population projection by age for 2018. Of 9072 survey participants (< 15 years), 87% (7865) had blood drawn with valid HIV test results. KENPHIA identified 57 HIV-positive children, translating to an HIV prevalence of 0.7%, (95% CI: 0.4%–1.0%) and an estimated 138,900 (95% CI: 84,000–193,800) of HIV among children in Kenya. Specifically, children who were orphaned had about 2 times higher odds of HIV-infection compared to those not orphaned, adjusted Odds Ratio (aOR) 2.2 (95% CI:1.0–4.8). Additionally, children whose caregivers had no knowledge of their HIV status also had 2 times higher odds of HIV-infection compared to whose caregivers had knowledge of their HIV status, aOR 2.4 (95% CI: 1.1–5.4)". From the unconditional analysis; population level estimates, 78.9% of HIV-positive children had known HIV status (95% CI: 67.1%–90.2%), 73.6% (95% CI: 60.9%–86.2%) were receiving ART, and 49% (95% CI: 32.1%–66.7%) were virally suppressed. However, in the clinical cascade for HIV infected children, 92% (95% CI: 84.4%–100%) were receiving ART, and of these, 67.1% (95% CI: 45.1%–89.2%) were virally suppressed. The KENPHIA survey confirms a substantial HIV burden among children in Kenya, especially among orphans. [ABSTRACT FROM AUTHOR]

The need for rigorous and timely health and demographic summaries has provided the impetus for an explosion in geographic studies in low- and middle-income countries. Many of these studies present fine-scale pixel-level maps in an attempt to answer the needs of the current era of precision public health. However, even though household surveys with a two-stage cluster design stratified by region and urbanicity are a major source of data, cavalier approaches are taken to acknowledging the survey design. We investigate the extent to which accounting for the sample design affects the predictive performance at the aggregate level of interest for health policy decisions. We consider various commonly used models and introduce a new Bayesian cluster-level model with a discrete spatial smoothing prior. The investigation is performed through a simulation study in which realistic sampling frames are created for Kenya, based on the population and demographic information, with a survey design that mimics a Demographic Health Survey (DHS). We find that including stratification and cluster-level random effects can improve predictive performance. Spatially smoothed direct (weighted) estimates and area-level models accounting for stratification were robust to the underlying population and survey design. Continuous spatial models showed some promise in the presence of fine-scale variation; however, these models require the most "hand holding." Subsequently, we examine how the models perform on real data, estimating the prevalence of secondary education for women aged 20–29 and neonatal mortality rates, using data from the 2014 Kenya DHS. [ABSTRACT FROM AUTHOR]

This paper analyses the effects of gender and institutional support services on commercialisation patterns of maize by female-headed households (FHHs) and male-headed households (MHHs) in Western Kenya. Using primary household survey data from 297 maize farmers, we estimate a Tobit model and a treatment effect model to assess the determinants and gender-induced differences in commercialisation patterns, respectively. Results show that commercialisation levels of FHHs and MHHs were significantly and variably affected by institutional support services. The exogenous switching treatment effect model showed that the commercialisation intensity gap between MHHs and FHHs is explained by both observable and unobservable characteristics. [ABSTRACT FROM AUTHOR]

Rural development is a political topic in which debate has been more focussed on externally identified needs than on demands or aspirations of the rural population and polarised between the attractions of urban income earning opportunities and the importance of rural farming communities for national food provision. The heterogeneity of local aspirations and their implications for development have barely been considered. We explore the aspirations of residents of three contrasting regions in Kenya that vary in their agricultural and off-farm potential. We argue that opportunities are a major framing influence on aspirations but there is important, and routinely overlooked, diversity within the communities which could inform future options for effective development. We outline how development initiatives could be redesigned to align more closely with aspirations. However, aspirations are a complex concept and, while our approach offered novel insights, these would be enriched when combined with household survey data. [ABSTRACT FROM AUTHOR]

Health and development indicators (HDIs) such as vaccination coverage are regularly measured in many low‐ and middle‐income countries using household surveys, often due to the unreliability or incompleteness of routine data collection systems. Recently, the development of model‐based approaches for producing subnational estimates of HDIs using survey data, particularly cluster‐level data, has been an active area of research. This is mostly driven by the increasing demand for estimates at certain administrative levels, for example, districts, at which many development goals are set and evaluated. In this study, we explore spatial modeling approaches for producing district‐level estimates of vaccination coverage. Specifically, we compare discrete spatial smoothing models which directly model district‐level data with continuous Gaussian process (GP) models that utilize geolocated cluster‐level data. We adopt a fully Bayesian framework, implemented using the INLA and SPDE approaches. We compare the predictive performance of the models by analyzing vaccination coverage using data from two Demographic and Health Surveys (DHS), namely the 2014 Kenya DHS and the 2015‐16 Malawi DHS. We find that the continuous GP models performed well, offering a credible alternative to traditional discrete spatial smoothing models. Our analysis also revealed that accounting for between‐cluster variation in the continuous GP models did not have any real effect on the district‐level estimates. Our results provide guidance to practitioners on the reliability of these model‐based approaches for producing estimates of vaccination coverage and other HDIs. [ABSTRACT FROM AUTHOR]

Population-based indicators of the coverage of key elements of high-quality family planning services are tracked via household surveys with female respondents, yet little work has been done to establish their validity. We take advantage of existing data sets from Cambodia and Kenya to compare women's responses at exit interviews following a health facility visit against the observations of a trained third-party observer during the visit. The results, which treat the observations as the reference standard, show that indicators that measure contraceptive methods received are accurately reported while indicators of whether the woman received her preferred method and whether information was "discussed" or "explained" during counseling are less reliably reported. Studies designed explicitly to assess the validity of family planning questions in household surveys, especially questions in large survey programs critical for monitoring demographic trends and programmatic coverage, are needed. [ABSTRACT FROM AUTHOR]

Background: Aedes aegypti is an efficient vector of several arboviruses of public health importance, including Zika and dengue. Currently vector management is the only available avenue for disease control. Development of efficient vector control strategies requires a thorough understanding of vector ecology. In this study, we identified households that are consistently productive for Ae. aegypti pupae and determined the ecological and socio-demographic factors associated with the persistence and abundance of pupae in households in rural and urban Kenya. Methods: We collected socio-demographic, environmental and entomological data monthly from July 2014 to June 2018 from 80 households across four sites in Kenya. Pupae count data were collected via entomological surveillance of households and paired with socio-demographic and environmental data. We calculated pupal persistence within a household as the number of months of pupal presence within a year. We used spatially explicit generalized additive mixed models (GAMMs) to identify the risk factors for pupal abundance, and a logistic regression to identify the risk factors for pupal persistence in households. Results: The median number of months of pupal presence observed in households was 4 and ranged from 0 to 35 months. We identified pupal persistence in 85 house-years. The strongest risk factors for high pupal abundance were the presence of bushes or tall grass in the peri-domicile area (OR: 1.60, 95% CI: 1.13–2.28), open eaves (OR: 2.57, 95% CI: 1.33–4.95) and high habitat counts (OR: 1.42, 95% CI: 1.21–1.66). The main risk factors for pupal persistence were the presence of bushes or tall grass in the peri-domicile (OR: 4.20, 95% CI: 1.42–12.46) and high number of breeding sites (OR: 2.17, 95% CI: 1.03–4.58). Conclusions: We observed Ae. aegypti pupal persistence at the household level in urban and rural and in coastal and inland Kenya. High counts of potential breeding containers, vegetation in the peri-domicile area and the presence of eaves were strongly associated with increased risk of pupal persistence and abundance. Targeting households that exhibit pupal persistence alongside the risk factors for pupal abundance in vector control interventions may result in more efficient use of limited resources. [ABSTRACT FROM AUTHOR]

Baobab (Adansonia digitata L.) is a multipurpose, drought resistant, wild fruit tree, endemic to arid and semi-arid lands of Sub-Saharan Africa. Baobab populations have been showing a lack of regeneration, and therefore causes concern for the species survival. This study investigated the state, distribution and use of baobabs in an under-researched population in Kenya, to identify the potential for further use and development of baobab resources. A baobab population was chosen in Taita–Taveta County, covering a sample area of 2015 km2. A systematic stratified transect survey was done to map baobab distribution using 49 transects (0.5 × 3 km each). The diameter at breast height and other indicators were measured on all baobabs in the transects to assess population status and health. A household survey (n = 46) and focus group discussions (n = 12) were done following the transect survey to gain an idea on the uses and distribution of baobab. In total, 432 baobab trees were measured and recorded in the research area of 2015 km2. The baobabs grew in two clusters (i.e., areas with a baobab density of ≥0.08 baobabs/ha). Both clusters showed rejuvenating populations. The main factors identified by the respondents, positively and negatively influencing baobab distribution were environmental factors, wildlife, human impact and commercial value. The study area shows a great potential for baobab to become an important part of the diet, due to its current use as an emergency food during food scarce times, and the relatively healthy and stable rejuvenating populations. [ABSTRACT FROM AUTHOR]

Background: Alternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied. Methods: A cross-sectional survey of 1217 households in an epidemic highland site and an endemic lowland site in western Kenya collected information on alternative use in three ways: direct observations, participant self-report, and participant reporting of community-level practices. LLIN misuse was defined as use of an intact net for alternative purposes and repurposing as alternatively using an old or damaged net. Associations between households with observed repurposed nets and universal access and household net use were examined. Results: Households describe repurposing nets when they are torn and/or old. Repurposed nets were observed in 8.1% (52/643) highlands households and 33.0% (184/574) lowlands households. Repurposed nets served as chicken coops (33% highlands, 20% lowlands), fences (37% highlands, 25% lowlands), tree covers (22% lowlands), curtains (3% highlands), covering bathrooms (1.5% highlands, 9% lowlands), and washing sponges (13% lowlands). No association was found between repurposing and universal access or household net use. Misuse was rare. Of 379 repurposed nets, 4 (1.06%) were in good condition with no holes. Of 1,758 active nets, 13 (0.74%) were misused. Conclusions: Alternative net use in this study involved repurposing rather than misuse. Repurposing was not detrimental to malaria prevention efforts in these communities. Standardized measurement of alternative net use should be used to better understand the practice and its potential impact on the success of malaria interventions. [ABSTRACT FROM AUTHOR]

This paper examines the process from quarrying to sales in the soapstone sculpture industry in the Gusii region of western Kenya. Soapstone is a kind of talc that is smooth to touch. The sculpture style, Kisii Stone is an art form popular with tourists in Kenya and elsewhere in East Africa. This paper is based on surveys in the Tabaka area in Kisii County, which is the center of this industry, and provides information on the establishment of the industry and the involvement of people in the production area. Overall, 126 individuals participated in the interview survey, and the household survey was conducted in a total of 171 households. The results of this research verify that the whole process related to soapstone production constitutes a comprehensive industry in the region comprising many individuals in different roles. Additionally, the results of the supplementary household survey indicate that about 90% of the surveyed households make a living in this industry. The aforementioned findings confirm that the industry creates employment, as well as adds value as an art or craft for products, because individuals perform all processes at the production site. Additionally, the nature of the weight of stone also protects production based employment. [ABSTRACT FROM AUTHOR]

Objective: To investigate key risk factors associated with undernutrition in the first few years of life.Design: A cross-sectional household survey was conducted in January 2018 collecting anthropometric data and other information on household, caregiver and child characteristics. Crude and adjusted odds ratios were calculated to assess the association of these characteristics with stunting and underweight outcomes.Setting: Kitui and Machakos counties in south-east Kenya.Participants: Caregivers and their children aged 0-23 months in 967 beneficiary households of the Government of Kenya's cash for orphans and vulnerable children (CT-OVC) social protection scheme.Results: Twenty-three per cent of the 1004 children with anthropometric data were stunted, 10 % were underweight and 6 % experienced wasting. The strongest predictors of stunting and underweight were being in the second year of life and being born with a low birth weight. Residing in a poor household and having more than one child under 2 years of age in the household were also significant risk factors for being underweight. Although 43 % of children did not receive the minimal acceptable diet, this was not a significant factor associated with undernutrition. When age was removed as a covariate in children aged 12-23 months, being male resulted in a significantly higher risk of being stunted.Conclusions: While only 9 % of children were born with a low birth weight, these were four to five times more likely to be stunted and underweight, suggesting that preventive measures during pregnancy could have significant nutrition and health benefits for young children in this study area. [ABSTRACT FROM AUTHOR]

Kenya is classified as a food-deficit country. Approximately 20 percent of the population does not attain the minimum dietary requirements to sustain a healthy and productive life, according to the National Bureau of Statistics. African Indigenous Vegetables (AIVs) contain beneficial micro-nutrients and are critical for achieving nutrition security. This study used cross-sectional household survey data to test the plausibility of enhancing food access in the context of nutrition security, on the one hand, and the contribution of the AIVs to nutrition security, on the other hand. The results show that, the consumption of AIVs is not widely acknowledged or documented. Hhouseholds spend up to 15 times less money on AIVs when compared with exotic vegetables this is partly attributed to the perceptions that shape their tastes and preference. At a macrolevel, the lack of consistent data makes the promotion of the importance of these vegetables to the policy makers a mundane task since it is difficult to demonstrate and authenticate the nutritional benefits that have been accrued by the consumption of these vegetables. [ABSTRACT FROM AUTHOR]

Climate change projections for marginal lands in East Africa emphasize seasonal variability and unpredictability in rainfall, and a challenging setting for local agriculture. This study focuses on short term dynamics in seasonal precipitation patterns, what people are doing to produce or purchase sufficient food, and how the extraction of woody-plant resources contributes as a locally available environmental entitlement at Mt. Kasigau in southeastern Kenya. In 2011, 2012, and 2013, household surveys (n = 41) described the challenges of food production and diverse income strategies to achieve food sufficiency. Monthly journal accounts (n = 16) provided a temporal and spatial analysis of extractive activities. Most households report insufficient food production and transient engagement with diverse income strategies. Households vary, especially shown among the journal accounts, in how woody plant products contribute to their livelihoods. Mapping journal records of woody plant use identifies broad utilization areas mostly at elevations near and below the homes, and when overlaid for village participants by seasons identifies areas under greater pressure. Study results show application to an adaptive planning approach that emphasizes greater support for local coping strategies, recognizes expertise, and encourages collaborative knowledge creation for sustainable livelihoods. [ABSTRACT FROM AUTHOR]

Understanding how to build livelihood resilience to an uncertain future is critical as livelihood systems must adapt to local and regional climatic change. Agroforestry, the integration of trees into an agricultural landscape, is one potential solution. However, while many intuitively link agroforestry with livelihood resilience, there is little factual evidence. This paper utilizes data from semi-arid Isiolo County, Kenya to explore if and how agroforestry is building livelihood resilience for smallholder farmers. This study included 20 qualitative case study households, 339 quantitative household surveys, and key informant interviews. In order to measure livelihood resilience, we drew from the five livelihood capital assets of the sustainable livelihoods approach: financial, human, social, physical, and natural capital. The major benefits of agroforestry were shade and fruit; the main tree species planted included mango, papaya, banana, guava, and neem. The average of all five livelihood capital scores was 10% higher for households practising agroforestry, indicating that those households may have more resilient livelihoods. Livelihood capitals were improved by both on-farm diversification and off-farm livelihood diversification. Agroforestry improved the overall quality of life for respondents. This paper provides four major findings that may be applied to build livelihood resilience through agroforestry. [ABSTRACT FROM AUTHOR]

Many programs have been initiated to assist farmers diversify food production. The Farmer Field and Life Schools (FFLS), an agricultural extension methodology, is an example. Dietary assessment methods are used for nutrition assessments. This study compared household food consumption patterns, by using the Household Dietary Diversity Score (HDDS) of households who participated in the FFLS at baseline and after intervention and Non-FFLS households in the Gatanga Constituency in Murang'a County. The study was based on a United Nations Joint Program implemented from 2009 to 2013. A comparative cross-sectional design was used in this study to compare FFLS at baseline, after intervention and Non-FFLS households. 112 households (56 for cases and 56 for comparative group) participated in this study. The baseline survey with 390 households was in 2009. Data was analysed using the Statistical Package for Social Science (SPSS) version 21. Paired and independent T-Tests were used to determine the difference in the household dietary diversity score between FFLS at baseline and after intervention, and post intervention FFLS and Non-FFLS, respectively. Results show that 42.8% (n=56) of the FFLS households and 28.5% of non-FFLS household respondents were over 50 years of age. 49% of FLS and 11% non FFLS households have incomes ranging from 0-5,000 Ksh. per month, with 41% of FFLS and 32% non FFLS having incomes ranging from Ksh. 5,001- 10,000¹. Mean for Household Dietary Diversity Score (HDDS) at baseline was 8.16 and Non-FFLS was 8.45. Minimum food groups consumed across all groups were cereals, milk and milk products, oils and fats. Comparing FFLS at baseline and post intervention, the percentage of households consuming all food groups increased with exception of fruits and meat. There was a significant difference (p=0.007 against p<0.0005) in the HDDS when FFLS groups post intervention were compared with their baseline. There was no significant difference (p=0.176, against p<0.0005) in the HDDS between FFLS post intervention and non-FFLS households. Compared with the baseline information, FFLS participants who were of low economic status improved their HDDS. Targeting of vulnerable households to participate in such programs has the potential of improving their HDDS compared with the regular HDDS population. Integration of nutrition in agricultural programs with strong extension systems like the - has great potential to improve access and consumption of diversified foods for vulnerable households. [ABSTRACT FROM AUTHOR]

• Access to resources, both social and material, is central to securing livelihoods. • Persistent drought has called into question male incomes from pastoralism. • Women's growing contributions have enhanced expectations of reciprocity. • Conjugal relationships are being renegotiated in efforts to cope with change. • Understanding the heterogeneity of household relationships is key to adaptation. Access to resources, both material and social, are central elements in responding to social and environmental transition, and adapting to change, yet the ways in which such access is negotiated within and across varying household structures is not well understood. In semi-arid Kenya, persistent drought has made male incomes from pastoralism insecure, and contributed to women's growing engagement with trade, farming and other independent enterprises, for survival. This has, however, raised questions about women's dependence on men for household provisioning, and enhanced expectations of reciprocity in both production and reproduction within households. While demographers note the rise in female headship in sub-Saharan Africa, and female headed households are often the target of policy attention, the situation on the ground is much more complex. Polygamy, separation and consensual unions, multi-generational and multi-locational households, point to a growing diversity in gender and generational relationships, in rights, responsibilities and norms. Based on data from household surveys, focus group discussions and life history interviews with differently positioned women and men within pastoralist communities in northern Kenya, the paper explores the implications of changing household structures beyond headship, in particular the loosening of marriage ties, frequent separation and regrouping, on relational vulnerability and the micro-politics of adaptation in the region. [ABSTRACT FROM AUTHOR]

Within the Kenyan dairy sector, climate change mitigation interventions are striving to sustainably intensify milk production while addressing the gender dynamics that mediate farmers’ ability to effectively participate in, and benefit from, low emissions development. In order to better understand these gender dynamics, household surveys were deployed by the East African Dairy Development (EADD) program to collect information on current practices of decision-making, resources, and labor dynamics within dairy farm households. Using the EADD survey results as secondary data, this study analyzes emergent patterns in these domains among cattle-keeping households in Bomet, Nandi, Uasin Gishu, and Kericho counties in Western Kenya. In analyzing these patterns, paired sample tests revealed statistically significant differences in results based on the gender of the respondent. While there were some categories that women and men reported on similarly, other areas were hotly contested. These results provide important challenges, both methodologically and programmatically, in interpreting gender dynamics across these domains. This paper reflects on the challenges and the opportunities of these data for informing gender-equitable low emissions development in the Kenyan dairy sector. [ABSTRACT FROM AUTHOR]

The study espoused the access analytical framework to investigate how introduction of Participatory Forest Management (PFM) in Kenya has changed the various actors’ ability to benefit from the forest resources of Eastern Mau Forest Reserve. Data collected through key informant interviews, and a household survey showed that implementation of PFM has triggered new income opportunities for forest adjacent communities in seedling production and beekeeping. However, PFM bestowed no real decision-making powers to the established Community Forest Associations (CFAs) over important forest resources such as timber and firewood. Members of the local communities and other actors have continued to access these resources through various structural and relational means, in the same way as before the introduction of PFM. Further, it is documented that PFM has introduced additional burdens on the local communities, especially the poorest households, as a result of increased enforcement of rules. Based on these findings, it is suggested that the PFM policy in Kenya, in its current form, is unlikely to realize its dual objectives of forest conservation and livelihood enhancement. To attain them would require a further devolution of rights to the CFAs. [ABSTRACT FROM AUTHOR]

Background: Access to sanitation facilities is imperative in reducing the risk of multiple adverse health outcomes. A distinct disparity in sanitation exists among different wealth levels in many low-income countries, which may hinder the progress across each of the Millennium Development Goals. Methods: The surveyed households in 397 clusters from 2008–2009 Kenya Demographic and Health Surveys were divided into five wealth quintiles based on their national asset scores. A series of spatial analysis methods including excess risk, local spatial autocorrelation, and spatial interpolation were applied to observe disparities in coverage of improved sanitation among different wealth categories. The total number of the population with improved sanitation was estimated by interpolating, time-adjusting, and multiplying the surveyed coverage rates by high-resolution population grids. A comparison was then made with the annual estimates from United Nations Population Division and World Health Organization /United Nations Children's Fund Joint Monitoring Program for Water Supply and Sanitation. Results: The Empirical Bayesian Kriging interpolation produced minimal root mean squared error for all clusters and five quintiles while predicting the raw and spatial coverage rates of improved sanitation. The coverage in southern regions was generally higher than in the north and east, and the coverage in the south decreased from Nairobi in all directions, while Nyanza and North Eastern Province had relatively poor coverage. The general clustering trend of high and low sanitation improvement among surveyed clusters was confirmed after spatial smoothing. Conclusions: There exists an apparent disparity in sanitation among different wealth categories across Kenya and spatially smoothed coverage rates resulted in a closer estimation of the available statistics than raw coverage rates. Future intervention activities need to be tailored for both different wealth categories and nationally where there are areas of greater needs when resources are limited. [ABSTRACT FROM AUTHOR]

Background: Enhancing accountability in health systems is increasingly emphasised as crucial for improving the nature and quality of health service delivery worldwide and particularly in developing countries. Accountability mechanisms include, among others, health facilities committees, suggestion boxes, facility and patient charters. However, there is a dearth of information regarding the nature of and factors that influence the performance of accountability mechanisms, especially in developing countries. We examine community members' experiences of one such accountability mechanism, the health facility charter in Kericho District, Kenya.Methods: A household survey was conducted in 2011 among 1,024 respondents (36% male, 64% female) aged 17 years and above stratified by health facility catchment area, situated in a division in Kericho District. In addition, sixteen focus group discussions were conducted with health facility users in the four health facility catchment areas. Quantitative data were analysed through frequency distributions and cross-tabulations. Qualitative data were transcribed and analysed using a thematic approach.Results: The majority (65%) of household survey respondents had seen their local facility service charter, 84% of whom had read the information on the charter. Of these, 83% found the charter to be useful or very useful. According to the respondents, the charters provided useful information about the services offered and their costs, gave users a voice to curb potential overcharging and helped users plan their medical expenses before receiving the service. However, community members cited several challenges with using the charters: non-adherence to charter provisions by health workers; illegibility and language issues; lack of expenditure records; lack of time to read and understand them, often due to pressures around queuing; and socio-cultural limitations.Conclusion: Findings from this study suggest that improving the compliance of health facilities in districts across Kenya with regard to the implementation of the facility service charter is critical for accountability and community satisfaction with service delivery. To improve the compliance of health facilities, attention needs to be focused on mechanisms that help enforce official guidelines, address capacity gaps, and enhance public awareness of the charters and their use. [ABSTRACT FROM AUTHOR]

We investigate whether smallholder horticultural commercialization is able to, as often stipulated, reduce poverty in developing countries with the help of panel household survey data from Kenya. We find evidence for a positive association between vegetable commercialization and household welfare, even when controlling for unobserved heterogeneity across households. Interestingly, the effect differs depending on which market vegetables are being produced for: commercialization through the export market is consistently positively associated with income but not wealth, while there is some limited evidence for commercialization through the domestic market channel being positively related to welfare measured by asset holdings and income, depending on the specification. [ABSTRACT FROM AUTHOR]

Highlights: [•] Impacts of tissue culture (TC) banana technology on household income and food security in Kenya are analyzed. [•] First study to use Household Food Insecurity Access Scale (HFIAS) for impact assessment. [•] TC adoption significantly increases income and improves food security among smallholders. [•] Implications for effective technology delivery mechanism are discussed. [ABSTRACT FROM AUTHOR]

Background Access to prompt and effective treatment of malaria is a fundamental right of all populations at risk; many countries have not met the target of 60% of children treated with effective antimalarial drugs within 24 h of fever onset. While community case management of malaria is effective for increasing coverage, evidence is mixed on whether it improves equity. The objective of this study was to assess whether a community case management of a malaria programme delivered by community health workers (CHW) in two districts of Kenya improved access and equity. Methods Data on child fever treatment practices, malaria prevention and CHW visits was collected through cross-sectional household surveys in project communities before (December 2008) and after 1 year of intervention (December 2009). Indicators were analysed by household wealth rank (grouped into poorest [bottom 20%], poor [middle 60%] and least poor [top 20%]) and survey. Results Data were available from 763 households at baseline and 856 households at endline. At endline, access to prompt and effective malaria treatment was higher compared with baseline for all groups, with the highest proportions among the poorest (67.6%) and the poor (63.2%), and the lowest proportion among the least poor (43.4%). Corresponding data suggest this was linked to the household's interaction with a CHW as the source of advice/treatment for child fever. Conclusion These findings provide evidence that in a resource-poor setting, CHWs can provide lifesaving interventions to the poorest. [ABSTRACT FROM PUBLISHER]

Background. Outbreaks of highly pathogenic avian influenza (HPAI) (virus type H5N1) have led to extensive bird culling and other control measures throughout the world, with implications especially for the livelihoods of the poor. There is limited empirical evidence for the impact of HPAI on poultry consumption and nutrition of vulnerable populations. Objective. To test the effect of reduced per capita poultry consumption at the household level due to an HPAI event on anthropometric measurements of children. Methods. This study used data from the Kenya Integrated Household Budget Survey (KIHBS) 2004/05 to characterize the nutritional status of young children 6 to 36 months of age, household dietary diversity (number of food groups consumed), and determinants of anthropometric outcomes, including z-scores for height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ). Propensity score matching (PSM) was applied to ascertain the nutritional impacts of reduced poultry consumption arising from an HPAI event. Results. Thirty-four percent of the children were stunted (HAZ < -2 SD), 16% were underweight (WAZ < -2 SD), and 8% were wasted (WHZ < -2 SD), with the highest prevalences in the Coast, Eastern, North Eastern, Nyanza, and Rift Valley provinces. On average, households reported consuming food from 2.5 ± 1.3 food groups per week. Consistently significant determinants of anthropometric outcomes in these children were child's age, child's sex, household level of education, and various income and wealth determinants. PSM demonstrated that a reduction of consumption of poultry meat and eggs due to HPAI infection would increase the prevalence of stunting by 3.9 percentage points (Average Treatment Effect on the Treated (ATT), p = .06), increase the prevalence of underweight by 5 percentage points, and reduce WAZ by 0.16 (ATT, p = .03). Conclusions. Through the household dietary diversity and consumption pathways, HPAI could have nutritionrelated consequences with public health significance. In the event of HPAI, action may be needed to protect the nutrition of young children 6 to 36 months of age. [ABSTRACT FROM AUTHOR]

Background: Research on demand-side health care financing approaches such as output-based aid (OBA) programs have focused on evaluating the role of the programs improving such outcomes as utilization of services and quality of services with limited focus on the experiences and perceptions of the target communities. This paper examines community members' views of the output-based aid voucher program in Kenya. Methods: A household survey was conducted in 2010 among 1,336 women aged 15-49 years living in the catchment areas of contracted health facilities in three districts participating in the voucher program (Kisumu, Kiambu and Kitui). Twenty seven focus group discussions were conducted with voucher users, non-users, opinion leaders and voucher distributors in the three districts as well as in Nairobi. Analysis of the quantitative data involved frequency distributions and cross-tabulations. Qualitative data were transcribed and analyzed by adopting framework analysis and further triangulation of themes across respondents. Results: Majority (84%) of survey respondents had heard about the safe motherhood voucher compared to 24% and 1% that had heard about the family planning and gender-based violence recovery services (GBVRS) vouchers respectively. Similarly, 20% of the respondents had used the safe motherhood voucher compared to 2% for family planning and none for the GBVRS vouchers. From the community members' perspectives, the voucher program is associated with improvements in access to health services for poor women, improved quality of care, and empowerment of women to make health care decisions. However, community members cited difficulties in accessing some accredited health facilities, limitations with the system of selling vouchers, lack of male involvement in women's reproductive health issues, and poor understanding of the benefits associated with purchasing the voucher. Conclusion: The findings of this paper showed that the voucher program in Kenya is viewed by the community members as a feasible system for increasing service utilization, improving quality of care, and reducing financial barriers to accessing reproductive health services. However, the techniques of program execution such as proper information and availability of the distributors as well as local attitudes influence whether vouchers are purchased and used. [ABSTRACT FROM AUTHOR]

The article discusses research investigating the effectiveness of antenatal clinics (ANC) in Kenya to deliver intermittent-preventive-treatment (IPTp) of the malarial drug sulphadoxinepyrimethamine (SP) and insecticide treated nets (ITNs) for the control of malaria in pregnant women in Kenya's Nyando district. Topics include the consequences for mother and baby of malaria in pregnancy, the research methodology, and a discussion of the challenges of delivering IPTp through ANC versus ITNs and its impact on low birthweight (LBW).

Background: Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods: A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results: Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than Uganda (2.1%). [ABSTRACT FROM AUTHOR]

Kenya's stated policy is to increase dairy production through sustained liberalization of output and input markets. The present study assessed dairy farmers' responsiveness to both market price factors and non-price factors within a liberalized market environment. Econometric analysis used in the study is based on a profit function using farm household survey data collected for a year. Results showed that dairy farmers are more responsive to non-price factors than to price factors. Hence the need for a consistent and a sustained liberalization program in the sub-sector, as well as reinforcing liberalization policies in place by increasing public expenditure on rural infrastructure and other agricultural support services. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper examines community-level association between exposure to the reproductive health vouchers programme in Kenya and utilization of services. The data are from a household survey conducted among 2527 women (15–49 years) from voucher and comparable non-voucher sites. Analysis entails cross-tabulations with Chi-square tests and significant tests of proportions as well as estimation of multi-level logit models to predict service utilization by exposure to the programme. The results show that for births occurring after the voucher programme began, women from communities that had been exposed to the programme since 2006 were significantly more likely to have delivered at a health facility and to have received skilled care during delivery compared with those from communities that had not been exposed to the programme at all. There were, however, no significant differences in the timing of first trimester utilization of antenatal care (ANC) and making four or more ANC visits by exposure to the programme. In addition, poor women were significantly less likely to have used safe motherhood services (health facility delivery, skilled delivery care and postnatal care) compared with their non-poor counterparts regardless of exposure to the programme. Nonetheless, a significantly higher proportion of poor women from communities that had been exposed to the programme since 2006 used the services compared with their poor counterparts from communities that had not been exposed to the programme at all. The findings suggest that the programme is associated with increased health facility deliveries and skilled delivery care especially among poor women. However, it has had limited community-level impact on the first trimester timing of antenatal care use and making four or more visits, which remain a challenge despite the high proportion of women in the country that make at least one antenatal care visit during pregnancy. [ABSTRACT FROM PUBLISHER]

The prevalence of HIV in the adult population in slum areas in Nairobi, Kenya, is higher than for residents in the city as a whole. This disparity suggests that the characteristics of slum areas may adversely influence the HIV-prevention strategies directed at reducing the national prevalence of HIV. The objective of the study was to identify some of the sociodemographic and behavioural correlates of HIV-status awareness among the adult population of two slums in Nairobi. In a household-based survey conducted by the African Population and Health Research Center (APHRC), 4 767 men and women aged between 15 and 54 years were randomly sampled from two slums (Korogocho and Viwandani) in Nairobi and data were collected on the social and health context of HIV and AIDS in these settlements. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with HIV-status awareness. The proportion of respondents that had ever been tested and knew their HIV status was 53%, with the women having greater awareness of their HIV status (62%) than the men (38%). Awareness of HIV status was significantly associated with age, sex, level of education, marital status and slum of residence. The lower level of HIV-status awareness among the men compared with the women in the slums suggests a poor uptake of HIV-testing services by males. Innovative strategies are needed to ensure greater access and uptake of HIV-testing services by the younger and less-educated residents of these slums if the barriers to HIV-status awareness are to be overcome. [ABSTRACT FROM PUBLISHER]

The rapid growth in Africa's mobile communications sector offers new opportunities to address the continent's enduring water service challenges. This paper examines the impacts and implications of mobile water payments in East Africa. Based on interviews with managers from water service providers across four countries and analysis of household survey and billing data from a water supply scheme in Kenya, the study quantifies the impacts of mobile water payments and reveals the factors that drive and curtail customer adoption. Results suggest that if broader behavioural and operational constraints can be overcome, partnerships between mobile network operators and water service providers could lead to more sustainable water service access for inclusive, developmental outcomes. [ABSTRACT FROM AUTHOR]

This paper describes the design and methodology used to assess the impact of free primary education (FPE) policy in Nairobi, Kenya. The key outcome of the study was to assess the impact of FPE on schooling outcomes among the urban poor. The study assesses the impact of FPE by examining how two non-comparable groups responded to the introduction of the policy. Retrospective data were collected for 2000–2004, while prospective data has been collected annually since 2005. This household survey has created both cross-sectional and longitudinal data sets. This provided an opportunity to assess factors, other than lack of fees, which associate with school enrolment and retention. The strength of this paper is in demonstrating how survey design can be utilized to assess the impact of a public policy between different population groups. Based on the design and methodology used in this Nairobi case study, the paper provides lessons on how to utilize household surveys to assess policy impacts. [ABSTRACT FROM AUTHOR]

The article presents a research which examines the distribution of health care benefits in Kenya to assess whether the changes in the system overtime has met the principles of universal coverage. It is reported that, the researchers used the cross-sectional households surveys for 2003 and 2007 were used by the researchers to conduct the research.

Consistent with the increasing focus on issues of equity in developing countries, I extend the literature analyzing the relationship between economic inequality and individual health to the developing world. Using survey data from Bangladesh and Kenya with economic status measured by a wealth index and with three different geographic definitions of community, I analyze six competing hypotheses for how economic inequality may be related to stunting among children younger than 5 years old. I find little support for the predominant hypothesis that economic inequality as measured by a Gini index is an important predictor of individual health. Instead, I find that the difference between a household's wealth and the mean household wealth in the community is the measure of economic inequality that is most closely related to stunting in these countries. In particular, a 1 standard deviation increase in household wealth relative to the community mean is associated with a 30-32 percent decrease in the odds of stunting in Bangladesh and a 16-21 percent decrease in the odds of stunting in Kenya. [ABSTRACT FROM AUTHOR]

A unique census of cell phones in a Western Kenyan village reveals gendered dimensions of access, intensity and breadth of cell phone usage related to contemporary long-distance households and livelihoods. Women bound to marital homesteads far from their birthplace praise the freedom to communicate with family across the country; a housewife uses scarce resources to send ‘greetings’ and ensure peace of mind. Women link with community groups and distant menfolk, spanning rural/urban spaces to manage their increasingly busy and insecure lives. Older women blend these new technologies into traditional agrarian livelihoods and community activities; younger women are eager to navigate into the twenty-first century and away from farms. For cash-strapped rural housewives, their frugal, ingenious, yet constrained uses of “mobile” (stationary) cell phones help them achieve many freedoms. Findings from this village census of cell phones add to a growing body of nuanced research on the social shaping of cell phones and their uses for human development. Research reveals the intersections of adaptive uses with contemporary gendered patterns of poverty, inequality, and deagrarianization. They serve simultaneously as potentially transformative and emancipatory as well as divisive forces in sub-Saharan Africa. [ABSTRACT FROM PUBLISHER]

The Kenyan government introduced free primary education in 2003 in order to universalise access to primary education. Although the policy allows universal coverage, it ought to benefit the poor most as they are the ones who were excluded from the education sector before the policy was introduced. Using household-survey data collected in Nairobi, this contribution assesses the impact of the policy on schooling outcomes of the poor. The findings reveal that the free primary-education policy in Kenya still excludes the poorest of the poor. [ABSTRACT FROM AUTHOR]

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Background: Participant nonresponse in an HIV serosurvey can affect estimates of HIV prevalence. Nonresponse can arise from a participant's refusal to provide a blood sample or the failure to trace a sampled individual. In a serosurvey conducted by the African Population and Health Research Center and Kenya Medical Research Centre in the slums of Nairobi, 43% of sampled individuals did not provide a blood sample. This paper describes selective participation in the serosurvey and estimates bias in HIV prevalence figures. Methods: The paper uses data derived from an HIV serosurvey nested in an on-going demographic surveillance system. Nonresponse was assessed using logistic regression and multiple imputation methods to impute missing data for HIV status using a set of common variables available for all sampled participants. Results: Age, residence, high mobility, wealth, and ethnicity were independent predictors of a sampled individual not being contacted. Individuals aged 30-34 years, females, individuals from the Kikuyu and Kamba ethnicity, married participants, and residents of Viwandani were all less likely to accept HIV testing when contacted. Although men were less likely to be contacted, those found were more willing to be tested compared to females. The overall observed HIV prevalence was overestimated by 2%. The observed prevalence for male participants was underestimated by about 1% and that for females was overestimated by 3%. These differences were small and did not affect the overall estimate substantially as the observed estimates fell within the confidence limits of the corrected prevalence estimate. Conclusions: Nonresponse in the HIV serosurvey in the two informal settlements was high, however, the effect on overall prevalence estimate was minimal. [ABSTRACT FROM AUTHOR]

Women are a major human resource and assure adequate nutrition, health and cognitive development of their households and children in their formative years. However, women are over-represented among the poor, suffer heavy workloads and have little control over resources for family care. Poverty and food insecurity are enhanced by lack of access to, and control over assets, and lack of access to institutions that provide opportunities and buffer from shocks and crises. The need to improve household food security and empower women in households has seen the implementation of agricultural projects, particularly livestock projects that target women smallholder farmers. These projects are used as one of the major strategies to expand agricultural output in rural areas. Livestock contributes a higher share of income to rural households, improves food security and possibly enhances women's participation in civic activities. Livestock development projects seek to empower women through increased household incomes, improve household incomes of women and nutritional status of women and other members of the households. This paper sought to establish a link between participation in livestock projects, socio-economic status and nutritional status of index women. A crosssectional survey with a case-control model was conducted to establish the link between participation in a livestock project. Socio-economic and nutritional status of women from beneficiary and non-beneficiary households of livestock projects in Vihiga District, Kenya was assessed using both the Body Mass and the Brokas Index.. A total of 300 beneficiary and non-beneficiary women were interviewed and their heights and weights measured during the study. Results revealed better incomes, education levels and nutritional status among the beneficiary women. Development projects can attain their objectives when there is deliberate effort to ensure that the project goals are understood by all stakeholders, to create commitment to resource re-direction and embrace the purpose of the project. There has to be proper understanding of the familial and community cultures and practices if the course of women is to be addressed profitably, with full support of their husbands and the entire household for the success of the project. [ABSTRACT FROM AUTHOR]

Non-cognitive skills such as locus of control (LOC) and self-efficacy have been theoretically shown to influence behavioural and economic decision-making. While this effect has been confirmed empirically, the factors that can induce change in non-cognitive skills are not yet fully understood. Examining exogenous variation in the spread of invasive species, this study investigates the association between an ecological shock and non-cognitive skills through a survey of smallholder households in Baringo county Kenya. The results show an adverse relationship between ecological shocks and LOC. Individuals are less likely to believe that they have control over outcomes in their lives when faced with shocks. The study also demonstrates a negative association of shocks with self-efficacy which is related to the perceived judgement of capability. In addition to robustness to alternative specifications and the inclusion of additional relevant controls, we establish that the results are unlikely to be driven by unobserved heterogeneity. We find further suggestive evidence indicating that ecological shocks lead to economic adversity, which may well explain reductions in individuals' perceptions of capability and the extent of convictions regarding control over their lives. Overall, ecological shocks diminish perceived LOC and self-efficacy, with associated policy implications for poverty reduction. [ABSTRACT FROM AUTHOR]

Background: Use of insecticide-treated nets (ITNs) continues to offer potential strategy for malaria prevention in endemic areas. However their effectiveness, sustainability and massive scale up remain a factor of socio-economic and cultural variables of the local community which are indispensable during design and implementation stages. Methods: An ethnographic household survey was conducted in four study villages which were purposefully selected to represent socio-economic and geographical diversity. In total, 400 households were randomly selected from the four study villages. Quantitative and qualitative information of the respondents were collected by use of semi-structured questionnaires and focus group discussions. Results: Malaria was reported the most frequently occurring disease in the area (93%) and its aetiology was attributed to other non-biomedical causes like stagnant water (16%), and long rains (13%). Factors which significantly caused variation in bed net use were occupant relationship to household head (?2 = 105.705; df 14; P = 0.000), Age (χ2 = 74.483; df 14; P = 0.000), village (χ2 = 150.325; df 6; P = 0.000), occupation (χ2 = 7.955; df 3; P = 0.047), gender (χ2 = 4.254; df 1; P = 0.039) and education levels of the household head or spouse (χ2 = 33.622; df 6; P = 0.000). The same variables determined access and conditions of bed nets at household level. Protection against mosquito bite (95%) was the main reason cited for using bed nets in most households while protection against malaria came second (54%). Colour, shape and affordability were some of the key potential factors which determined choice, use and acceptance of bed nets in the study area. Conclusion: The study highlights potential social and economic variables important for effective and sustainable implementation of bed nets-related programmes in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the current use and access of Information and Communication Technologies (ICT) situation amongst rural women in Kenya, and suggest mitigating solutions. Using survey research, rural women aged 16-60 were sampled. In total, 200 respondents formed the sampling size, randomly selected from census household data in Kenya. Besides the marked correlation between the respondents' level of education, type of ICTs accessed and information needs and purposes, it was observed that ICTs alone are insufficient for significant benefits to emerge. [ABSTRACT FROM AUTHOR]