Search

The use of mobile phones has been identified as a potential way to bring the benefits of educational technology to a wider audience, including in low-connectivity settings. This is a topic that has received renewed interest recently as a result of the COVID-19 pandemic and school closures. While a number of recent studies have demonstrated good potential for mobile phones and SMS to be used to support learning, there are also questions about how equitable this medium is in practice. We conducted a telephone survey with learners (n = 122) and their caregivers (n = 124) who use M-Shule, an SMS-based educational platform in Kenya, in order to understand their attitudes towards mobile learning, and the benefits and constraints. In particular, we consider whether there are differences in responses according to gender and/or location, to shed light on whether use is equitable. We find that girls and boys face similar barriers to use, and the technology is perceived to be equally beneficial. We identify some areas for potential further support for all learners through mobile learning.

Abstract Background Open defecation (OD) is the disposal of human excreta in the fields, bushes, water bodies and other open spaces. It poses a public health risk as it can lead to the spread of diarrhoea, cholera, soil-transmitted helminths and trachoma. Kenya aims to achieve 100% open defecation free status by 2030 in line with Sustainable development goal number 6. This study sought to determine factors influencing OD at the household level as well as quantify the number of households practicing OD in each of the 47 Kenyan counties. Methods Data from the household questionnaire of the Kenya Demographic and Health Survey, 2022 was analysed. Bivariate logistic regression was done with open defecation status as the dependent variable. Independent variables were poverty status, place of residence, ownership of farm animals, gender and educational level of household head. The number of households practicing OD per county were determined using the Kenya Census report of 2019. Results Poverty was the strongest predictor of a household practicing OD (OR 43.8 95% CI 26.1–73.8) followed by educational status of the household head (OR 3.3 95% CI 2.3–4.6 ) and the household not owning livestock ( OR 0.7 95% CI 0.6–0.9). An estimated 7.4% of households practice OD. These are estimated to be 814,223 households. Out of these, 686,051 households (84.3%) are found in the 15 counties ranked as having a high population practicing OD. Five counties have managed to eliminate OD and another nine have OD rates of less than 0.5%. Conclusion Kenya has made commendable progress in eliminating OD. Poverty is a significant predictor of OD at the household level. To eliminate OD, it is advised that more efforts be targeted towards poor households as well as the 15 counties having a high number of OD-practicing households.

Introduction: Approximately 80 % of children with cancer live in resource-limited settings where prompt access to diagnosis and treatment is challenging. Data regarding delays in diagnosis and treatment and outcomes of children with cancer in Kenya are lacking. This study aims to 1) compare the reported and expected number of children with cancer; 2) explore diagnosis, treatment, and total delays; 3) determine patient characteristics that influence delays; and 4) investigate treatment outcomes. Methods: This study combined a retrospective medical records review with a case report. Data on delays and treatment outcomes of children from Bungoma County (Kenya) who were diagnosed with cancer at a large academic hospital between 2010 and 2016 were collected. Results: Between 2010 and 2016, 92 children, an average of 13 per year, were referred from Bungoma. These 13 children constitute only 9 % of the expected 140 children developing cancer in this region. The most common diagnoses were non-Hodgkin lymphoma (17 %) and acute lymphoblastic leukemia (16 %). The median total delay was 108 (7–1731) days. The median diagnosis delay was 97 days, longer than the median treatment delay (3 days; P

Objectives: With optimized antiretroviral treatment youth living with HIV (YLH) now spend most of their time in schools, making schools an important venue to optimize outcomes. We evaluated school support for YLH. Methods: We conducted surveys with public secondary/high schools in 3 Kenyan counties (Nairobi, Homa Bay, and Kajiado) to determine policies and training related to HIV. Chi-squared tests and Poisson regression were used to compare policy availability and staff training by county HIV prevalence and school type. Results: Of 512 schools in the 3 counties, we surveyed 100. The majority (60%) of schools surveyed had boarding facilities. The median student population was 406 (IQR: 200, 775). Only half (49%) of schools had medication use policies; more in boarding than day schools (65% vs 30%, p = 0.003). While most schools (82%) had clinic attendance policies; policy availability was higher in higher HIV prevalence counties (Homa Bay [100%], Nairobi [82%], Kajiado [56%], p < 0.05). Overall, 64% had confidentiality policies with higher policy availability in higher HIV prevalence regions (p < 0.05). Few schools had staff trained in HIV-related topics: HIV prevention (37%), HIV treatment (18%), HIV stigma reduction (36%). Few were trained in confidentiality (41%), psychosocial support (40%), or mental health (26%). Compared to day schools, boarding school were more likely to have staff trained in HIV prevention (prevalence ratio: 2.1 [95% confidence interval 1.0, 4.0], p = 0.037). Conclusion: In this survey of Kenyan schools, there were notable gaps in HIV care policy availability and training, despite high HIV burden. Development and implementation of national school HIV policies and staff training as well as strengthening clinic and family support may improve outcomes for YLH.

The over-60 population in Sub-Saharan Africa is expected to grow rapidly in the coming decades, tripling between 2020 and 2050. Despite this explosive projected growth, few countries in the region have implemented policies designed to support older populations. Further, little research in economics has specifically examined aging in Sub-Saharan Africa, though many opportunities exist for economists to generate research evidence to inform the design of effective policies in this area. This paper combines insights from a cross-disciplinary review with original data analysis to characterize the challenges and opportunities facing older Sub-Saharan Africans in domains such as health and financial security. Informed by these findings, the paper identifies directions for future economic research and discusses policy recommendations, including the need to reform health care systems and expand pension and other public support programs to prepare for an aging Africa.

Abstract Background Alcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers. Methods A longitudinal hospital-based intervention study was conducted in accordance with the WHO’s standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3–5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures. Results Objective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product’s drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml). Conclusion The WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.

The use of Short Messaging Service (SMS) for education has grown in recent years, drawing particular attention to supporting school-level learners, due to the Covid-19 pandemic. This renewed interest has prompted questions about how this form of educational technology could be used in the longer term. However, despite being used in many Covid-19 responses, there are few documented examples of innovative applications in this field during the pandemic, which represents a gap in the literature. As a medium for education, SMS offers potential benefits such as being cost-effective and having positive impacts on learning. In this paper, we present a case study of an educational programme rapidly implemented during the pandemic as part of the ‘Keep Kenya Learning’ program, to support learners remotely in terms of literacy, numeracy, and social and emotional learning topics. Through the case study, we describe the innovative process used to rapidly develop content for SMS, and draw upon usage statistics, quiz scores and user feedback to gain insights into its implementation with learners and caregivers in Kenya. The case study demonstrated that educational television content can be effectively adapted to mobile delivery. Furthermore, we present practical reflections on the development and implementation of SMS educational technology which will help inform future initiatives. These include considering timing in relation to school terms when planning a supporting intervention, and designing content in a modular way to allow flexibility for learners in navigating through courses.

Objective: To estimate the economic cost of GBV from the perspective of a women survivor who sought help from two identified programs (Makueni GBVRC and Life Bloom Services International [LBSI]). Design: A mixed method research design combining qualitative and quantitative approaches. Site: Makueni GBVRC in Makueni County, overseen by the Makueni County government, and LBSI in Naivasha, Nakuru County, a non-profit organization devoted to serving local communities. Participants: Study participants include women survivors of GBV, aged 18 and above, actively seeking services at Makueni GBVRC and LBSI. Interventions: The study adopts a qualitative approach to delve into the intricate economic costs of GBV on survivors. Additionally, quantitative data analysis employs an accounting model to ascertain the financial implications. Main measurements: The costs analyses were done from the perspective of the women survivors. An accounting model was utilized to evaluate the cost of GBV on selected survivors. Furthermore, the research explores the enduring consequences for survivors, including psychological trauma and susceptibility to stress-related diseases. Results: The findings reveal substantial economic costs linked to GBV, adversely affecting survivors, their children, and society at large. These costs encompass direct expenditures on medical care, legal representation, and counseling, as well as indirect costs, such as lost productivity. Conclusions: Beyond immediate and indirect costs, the study underscores the existence of opportunity costs—what survivors and affected children could attain in the absence of GBV. Resumen: Objetivo: Estimar el costo económico de la violencia de género desde la perspectiva de una mujer sobreviviente que buscó ayuda de dos programas identificados (Makueni GBVRC y Life Bloom Services International [LBSI]). Diseño: Un diseño de investigación de método mixto que combina enfoques cualitativos y cuantitativos. Sitio: Makueni GBVRC en el condado de Makueni, supervisado por el gobierno del condado de Makueni, y LBSI en Naivasha, condado de Nakuru, una organización sin fines de lucro dedicada a servir a las comunidades locales. Participantes: Los participantes del estudio incluyen mujeres sobrevivientes de violencia de género, de 18 años o más, que buscan activamente servicios en Makueni GBVRC y LBSI. Intervenciones: El estudio adopta un enfoque cualitativo para profundizar en los intrincados costos económicos de la violencia de género para los sobrevivientes. Además, el análisis de datos cuantitativos emplea un modelo contable para determinar las implicaciones financieras. Mediciones principales: Los análisis de costos se realizaron desde la perspectiva de las mujeres sobrevivientes. Se utilizó un modelo contable para evaluar el costo de la violencia de género en sobrevivientes seleccionados. Además, la investigación explora las consecuencias duraderas para los supervivientes, incluido el trauma psicológico y la susceptibilidad a enfermedades relacionadas con el estrés. Resultados: Los hallazgos revelan costos económicos sustanciales relacionados con la violencia de género, que afectan negativamente a los sobrevivientes, sus hijos y la sociedad en general. Estos costos abarcan gastos directos en atención médica, representación legal y asesoramiento, así como costos indirectos, como la pérdida de productividad. Conclusiones: Más allá de los costos inmediatos e indirectos, el estudio subraya la existencia de costos de oportunidad: lo que los sobrevivientes y los niños afectados podrían lograr en ausencia de violencia de género.

Abstract Background As oral PrEP scales up in Nigeria, information about uptake, use pattern and client preference in a real-world, implementation setting is invaluable to guide refining service provision and incorporation of oral PrEP and other prevention measures into routine health services. To add to this body of knowledge, our study examines factors associated with discontinuation of PrEP among HIV negative individuals across two large scale programs in Nigeria. Methods Using program implementation data from two large-scale HIV projects in Akwa Ibom and Cross River states in Nigeria between January 2020 and July 2021, we used logistic regression to explore factors associated with early discontinuation (i.e., stopping PrEP within one month of starting) among HIV-negative individuals who initiated PrEP in the programs. Results Of a total of 26,325 clients; 22,034 (84%) discontinued PrEP within the first month. The odds of PrEP discontinuation were higher among clients who enrolled in community-based distribution sites (aOR 2.72; 95% C.I: 2.50–2.96) compared to those who enrolled in program-supported facilities and never married (aOR 1.76; 95% C.I: 1.61–1.92) compared to married clients. Clients who initiated PrEP because of high-risk sexual behaviour (aOR 1.15, 95% C.I 1.03–1.30) or inconsistent use or non-use of condoms (aOR 1.96, 95% C.I 1.60–2.41) had greater odds of discontinuing PrEPthan those who initiated PrEP because they were in a serodifferent relationship. Conclusion The behavioural and demographic factors associated with early discontinuation of PrEP suggest that risk stratification of pre-initiation and follow up counselling may be helpful in raising continuation rates. On the service delivery side, strategies to strengthen follow-up services provided by community-based distribution sites need to be introduced. Overall, the low continuation rate calls for a review of programmatic approaches in provision of PrEP services in Nigeria.

BackgroundGlobally, almost 15 million infants are born prematurely each year, disproportionately affecting low and middle-income countries. In the absence of mother's milk, the World Health Organization recommends using donor human milk (DHM) due to its protective effect against necrotizing enterocolitis, a life-threatening intestinal disorder. The use of DHM is increasing globally, with many low and middle-income countries integrating donor milk banks into their public health strategies to reduce neonatal mortality, yet very little is known about the nutritional composition of DHM. Additional knowledge gaps include how DHM composition is influenced by milk banking practices, and whether preterm nutrient recommendations are achieved when DHM is used with commercially available fortifiers.MethodsWe designed a multi-site study with eight geographically diverse milk bank partners in high, middle, and low-income settings that will examine and compare a broad range of nutrients and bioactive factors in human milk from 600 approved milk bank donors around the world to create comprehensive, geographically diverse nutrient profiles for DHM. We will then simulate the random pooling of 2 to 10 donors to evaluate the impact of pooling as a potential strategy for milk banks to manage nutrient variability in DHM. Finally, we will evaluate whether commercially available fortifiers meet nutrient recommendations when used with DHM.DiscussionWe expect that results from this study will improve nutritional care globally for the growing number of preterm infants who receive donor human milk.

Objective To estimate the economic costs of selected tobacco-related illnesses (TRI) in Kenya in 2022. Research Design and Methods This study was conducted in 2 phases. Phase 1, conducted between 2021 and 2022, entailed conducting a cross-sectional study conducted in 4 national public referral hospitals in Kenya. Patients with cardiovascular disease, cancer, chronic obstructive pulmonary disease, or tuberculosis were interviewed to compute the indirect and direct medical costs related to the illness. Activity-Based Costing approach was used to capture costs for services along the continuum of care pathway. In the second phase, the Tobacco Attributable Factor was used to estimate the direct, indirect, and ultimately economic cost due to tobacco smoking. Results The estimated health care cost attributed to tobacco use in Kenya is US$396,107,364. Among TRIs included in the study, myocardial infarction had the highest health care cost at US$158,687,627, followed by peripheral arterial disease and stroke with health care cost of US$64,723,181 and US$44,746,700 respectively. The main cost driver across all the illnesses is the cost for medication accounting for over 90% of the total health care cost. The productivity losses from the diseases ranged between US$148 to US$360 and accounted for 27% to 48% of the economic costs. The total cost attributable to tobacco use to Kenya’s economy for the selected TRIs was between US$544.74 million and US$756.22 million. Conclusions/interpretation Tobacco related illnesses impose a significant economic burden as reported for direct and indirect costs. These findings underscore the need for strengthened implementation of the provision of the Framework Convention on Tobacco Control and the Tobacco Control Act (2007) to facilitate a reduction in tobacco consumption in the population.

This study examined how mattering related with satisfaction with school life among secondary school students in Kenya (N= 446, M = 17.40, SD = 1.22; 55.8 % Male). Age and gender differences were also explored. Mattering had a moderate correlation with school life satisfaction. Both age and mattering explained 11 % variance in satisfaction with school life. Age and gender did not moderate the prediction of satisfaction with school life by mattering. The relationship was similar for middle and late adolescent students, but prediction was only significant among the middle adolescent group. No significant gender differences were reported among the study variables. The findings suggest that when students feel important and when their age is taken into account, they are more likely to have higher levels of satisfaction with their school experience.

BackgroundScalable PTSD screening strategies must be brief, accurate and capable of administration by a non-specialized workforce.MethodsWe used PTSD as determined by the structured clinical interview as our gold standard and considered predictors sets of (a) Posttraumatic Stress Checklist-5 (PCL-5), (b) Primary Care PTSD Screen for the DSM-5 (PC-PTSD) and, (c) PCL-5 and PC-PTSD questions to identify the optimal items for PTSD screening for public sector settings in Kenya. A logistic regression model using LASSO was fit by minimizing the average squared error in the validation data. Area under the receiver operating characteristic curve (AUROC) measured discrimination performance.ResultsPenalized regression analysis suggested a screening tool that sums the Likert scale values of two PCL-5 questions—intrusive thoughts of the stressful experience (#1) and insomnia (#21). This had an AUROC of 0.85 (using hold-out test data) for predicting PTSD as evaluated by the MINI, which outperformed the PC-PTSD. The AUROC was similar in subgroups defined by age, sex, and number of categories of trauma experienced (all AUROCs>0.83) except those with no trauma history- AUROC was 0.78.ConclusionIn some East African settings, a 2-item PTSD screening tool may outperform longer screeners and is easily scaled by a non-specialist workforce.

Purpose Globally, the number of children/adolescents exposed to HIV but uninfected (HIV-exposed uninfected, HEU) is growing. The HEU outcomes: population-evaluation and screening strategies study was designed to provide population-level evidence of the impact of HIV and recent antiretroviral therapy regimen exposure on neurodevelopmental, hearing and mental health outcomes from infancy to adolescence.Participants The study includes a prospective mother–infant cohort and cross-sectional child/youth–caregiver cohorts conducted in Kenya.Between 2021 and 2022, the study enrolled 2000 mother–infant pairs (1000 HEU and 1000 HIV-unexposed uninfected (HUU)) for longitudinal follow-up. Infants were eligible if they were aged 4–10 weeks and healthy. Mothers were eligible if their HIV status was known and were ≥18 years. Study visits are 6 monthly until the child reaches age 3 years.Cross-sectional cohorts spanning ages 3–18 years started enrolment in 2022. Target enrolment is 4400 children/youth (4000 HEU and 400 HUU). Children and youth are eligible if they are HIV negative, maternal HIV status and timing of diagnosis is known, and caregivers are ≥18 years.Data on infant/child/youth growth, neurodevelopment, mental health, morbidity and hearing are collected at enrolment using standardised tools. Dry blood spots samples are collected for telomere length assessment at baseline and yearly for the longitudinal cohort. Growth z-scores, neurodevelopmental scores, telomere length and prevalence of developmental and hearing problems will be compared between HEU/HUU populations.Findings to date Full cohort enrolment for the longitudinal cohort is complete and participants are in follow-up. At 1 year of age, comparing HEU to HUU neurodevelopment using the Malawi developmental assessment tool, we found that HEU infants had higher language scores and comparable scores in fine motor, gross motor and social scores. The cross-sectional cohort has enrolled over 2000 participants and recruitment is ongoing.Future plans Longitudinal cohort follow-up and enrolment to the cross-sectional study will be completed in June 2024.

Abstract Background In the face of drought and food insecurity emergency, evidence on access to health and nutrition services is important. Karamoja is one of the regions that have experienced extreme drought and food insecurity emergency in Uganda. As a part of the drought and food insecurity emergency response, World Health Organization (WHO) with Ministry of Health (MoH) has designed and implemented a qualitative study in 15 districts that have experienced drought and food insecurity emergency in north-east Uganda. Thus, we aimed to explore the barriers of access to health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda. Methods We employed a descriptive qualitative study design. We interviewed 30 patients and 20 Village Health Teams (VHT) from 15 districts. We employed an in-depth interview with semi-structured questions to collect data until information saturation reached. We used thematic data analysis approach by ATLAS.ti version 7.5.1.8 software. Results Of the 30 interviewed subjects, 15 were female, and the median age of the subjects was 29 years with interquartile range (IQR) of 23 to 37 years. Majority (68.8%) of subjects reported that access to health and nutrition services was harder to them. Four themes: sociocultural and economic; environmental; health system, and individual related factors were identified as the barriers of access to health and nutrition services. Conclusion The present study identified several modifiable barriers that hinder access to health and nutrition services in drought and food insecurity affected districts. Comprehensive interventions aimed at addressing sociocultural, economic, environmental, health system and subject related challenges are required to improve access to health and nutrition services in drought and food insecurity affected setups.

Gasification of biomass waste has a significant potential to reduce environmental impact and promote sustainability by producing syngas, which is considered as renewable energy. This work investigated the gasification of macadamia nutshells in air-preheated, batch-fed fluidized bed gasifier. The study conducted a parametric analysis to assess the effect of equivalence ratio (ER) and air temperature on the gasifier temperature profile and its performance based on gas composition, higher heating value (HHV), and gas yield. The research was conducted within the range of 0.15–0.35 for the ER and 25–825 °C for the air temperature. Multi-objective numerical optimization was conducted using response surface methodology (RSM). From the parametric study, a distinct temperature profile was observed along the gasifier height, with the peak temperature near the top of the fluidized bed section and the lowest temperature at the top of the gasifier. Air preheating mostly favored gasification temperature at the lower part of the gasifier and showed rare significance at the top. No improvement in gasifier performance was observed beyond an air temperature of 620 °C, which was identified as the ideal air-preheating temperature. Analysis of variance (ANOVA) revealed that the ER was the most influential parameter in the production of combustible gasses, syngas HHV and gas yield. Air preheating did not have a significant effect on methane production and gas yield. The most optimal values for ER and air temperature were obtained as 0.195 °C and 620 °C, respectively, producing optimal values of 9.54, 14.65%, 2.03, 4.02 MJ·Nm−3, and 1.82 Nm3·kg−1 for hydrogen, carbon monoxide, methane, HHV, and gas yield, respectively.

Abstract Background Essential health services can be disrupted due to several naturally occurring public health emergencies such as drought, flood, earthquake and outbreak of infectious diseases. However, little evidence exists on the status of essential health services delivery under the effect of drought and food insecurity. North-east Uganda is severely affected by prolonged drought that significantly affected the livelihood of the residents. Therefore, we aimed to determine the current status of essential health services and quality improvement (QI) actions in health facilities in north-east Uganda. Methods We used a descriptive cross-sectional study design to assess the availability of essential health service and quality improvement activities in drought and food insecurity affected districts of north-east Uganda. We included a total of 150 health facilities from 15 districts with proportionated multistage sampling method. We interviewed health facilities’ managers and services focal persons using structured questionnaire and observation checklist. We used a descriptive statistic to analyze the data with SPSS version 22. Results A few health facilities (8.7%) had mental health specialist. There was also lack of capacity building training on essential health services. Considerable proportion of health facilities had no non-communicable diseases (38.3%), mental health (47.0%), and basic emergency obstetric care (40.3%) services. Stock out of essential medicines were observed in 20% of health facilities. There was lack of supportive supervision, and poor documentation of QI activities. Conclusion Essential health service and QI were suboptimal in drought and food insecure emergency affected districts. Human resource deployment (especially mental health specialist), provision of capacity building training, improving non-communicable diseases, mental health and basic emergency obstetric care services are required to improve availability of essential health services. Supporting supply chain management to minimize stock out of medicines, and promoting QI activities are also vital to assure quality of health service in drought and food insecurity affected districts in north-Eastern Uganda.

Sweetpotato (Ipomoea batatas L.) is an essential food crop globally, especially for farmers facing resource limitations. Like other crops, sweetpotato cultivation faces significant production challenges due to viral infections. This study aimed to identify and characterize viruses affecting sweetpotato crops in Uganda, mostly those associated with sweetpotato virus disease (SPVD). Infected leaf samples were collected from farmers’ fields in multiple districts spanning three regions in Uganda. MiSeq, a next-generation sequencing platform, was used to generate reads from the viral nucleic acid. The results revealed nine viruses infecting sweetpotato crops in Uganda, with most plants infected by multiple viral species. Sweet potato pakakuy and sweet potato symptomless virus_1 are reported in Uganda for the first time. Phylogenetic analyses demonstrated that some viruses have evolved to form new phylogroups, likely due to high mutations and recombination, particularly in the coat protein, P1 protein, cylindrical inclusion, and helper component proteinase regions of the potyvirus. The sweet potato virus C carried more codons under positive diversifying selection than the closely related sweet potato feathery mottle virus, particularly in the P1 gene. This study provides valuable insights into the viral species infecting sweetpotato crops, infection severity, and the evolution of sweet potato viruses in Uganda.

Preservice elementary teachers are faced with the daunting task of learning enough about every subject to support their students' development of foundational ideas. Teacher preparation programs and professional development providers therefore have the challenge of supporting those preservice and in-service teachers by providing content and methods courses in all core subject areas. These initiatives often put an emphasis on math and reading rather than science, as these subjects are tested most often and serve as the gatekeepers to other content. Infusing a literacy component into a science course for preservice and in-service teachers allows for connections to be made across content areas and supports the initiatives in reading teachers are expected to implement. This article discusses how the Big Book Project provides an opportunity to infuse literacy content, as preservice and in-service teachers in science for educators courses apply their knowledge of literacy to demonstrate their understanding of science concepts in a way that will be palatable to students in their K-5 classrooms.

The advent of Internet technologies has heralded new skill demands in the media industry. Since journalism education mainly takes its cue from industry trends, media training institutions are now forced to adjust their curricula and teaching styles to produce online-ready graduates. Drawing on aspects of self-efficacy theory, this correlation study employs a questionnaire to explore how different training factors influence students' self-efficacy beliefs for online journalism work. A sample of 182 mass communication students from five Rwandan universities participated in the study. Results showed that the training factors explained 29.7% of the variance in the respondents' self-efficacy beliefs for online journalism work, with positive correlations between all the training factors and the students' self-efficacy. In particular, the types of online skills ([Beta] = 0.069) and availability of teaching facilities ([Beta] = 0.076) contributed a larger part of the online self-efficacy beliefs than teaching styles ([Beta] = 0.018). These results showed that training factors have a role in boosting students' beliefs in their capacity to execute online journalism tasks in the industry. Results suggested that journalism educators especially need to enhance different online journalism teaching approaches in order to better develop future professionals who are online-confident for the workplace.

Background. Taro (Colocasia esculenta) is one of the underutilized crops in Kenya, grown under a wide range of environmental and edaphic conditions. This crop has exceptional dietary value and numerous culinary applications due to its edible leaves and corms. However, the mineral nutrient composition of taro in Kenya is still not well known due to a lack of scientific information concerning production. Objective. To determine the proximate composition and mineral profile of taro under different watering regimes and planting densities in Embu, Kenya. Methodology. A study was conducted at the Kenya Agricultural and Livestock Research Organization (KALRO) – Embu Research Centre, during the long rains (LR) 2021, and short rains (SR) 2021/2022. A factorial experiment with a split-plot layout arranged in a completely randomized block design was adopted. The watering regimes (100 %, 60 %, and 30 % based on the field capacity (FC)) were the main factor while the sub-factor was the planting density, with three replications. The planting densities used were 0.5 m × 0.5 m (40,000 plants ha-1), 1 m × 0.5 m (20,000 plants ha-1), and 1 m × 1 m (10,000 plants ha-1), representative of high, medium, and low planting densities respectively. Proximate analysis and mineral content were determined. Results. Significant differences (P < 0.05) in seasons were noted for protein, fibre, potassium, calcium, sodium, and zinc in the taro corms. The high carbohydrate content observed in this study (35 – 39 %) indicates that taro tubers are a good source of nutritional energy. Potassium (> 5000 mg kg -1) and magnesium (> 1000 mg kg -1) were the most prevalent mineral elements in taro corms and leaves, with copper (< 25 mg kg -1) being the least prevalent. Implications. Consumption of nutrient-rich foods such as taro helps the body to utilize the necessary nutrients to combat malnutrition and promote food security in rural communities. Conclusion. Taro leaves can be recommended as leafy vegetables as they are good sources of potassium, magnesium, calcium, manganese, iron, copper, and zinc; and the corms have low fat and protein content, high calorific energy, and high carbohydrate content. Taro represents one of the main sources of energy in many parts of the tropics and its production can be recommended in sub-humid areas in Kenya.

Objective Health system leadership plays a critical role in sustaining healthcare delivery during emergencies. Thus, we aimed to assess the contribution of health system leadership in sustaining healthcare delivery under emergency conditions based on adaptive leadership theoretical framework.Design We employed a concurrent mixed-methods study approach to assess health system leadership roles during emergency. This involved a quantitative survey administered to 150 health facilities managers/service focal persons selected via multistage sampling method from 15 districts, and qualitative interviews with 48 key informants who purposively selected.Participants We interviewed health facility managers, services focal persons, district health officers and residential district commissioners. We also reviewed weekly emergency situation reports and other relevant documents related to the emergency response. We used structured questionnaire, observation checklist and semistructured questionnaire to collect data. We employed descriptive statistics to analyse quantitative data and thematic analysis for qualitative data.Main outcome Health system leadership contributions in sustaining healthcare delivery during emergencies.Results Health system leadership was effective in leading emergency response and ensuring the continuity of health service during emergencies. Community engagement, partners coordination and intersectoral collaboration were effectively used in the emergency response and ensuring continuity of healthcare delivery. Deployment of experienced personnel and essential medical and non-medical supplies played a critical role in the continuity of health service. Availability of incidence management teams across health system significantly contributed to health system leadership. Participation of village health teams in community engagement and information communication helped in the success of health system leadership under emergency.Conclusion Adaptive health system leadership played a crucial role in managing health services delivery under emergency conditions. Effective partnership coordination and collaboration across sectors, frequent information communication, building local actor capacity and implementing scheduled supportive supervisions emerged as key strategies for sustaining health services during emergencies.

Abstract Background All countries are required to implement International Health Regulations (IHR) through development and implementation of multi-year National Action Plans for Health Security (NAPHS). IHR implementation requires annual operational planning which involves several tools such as NAPHS, State Party Annual Report (SPAR), Joint External Evaluation (JEE) and WHO IHR Benchmarks tool. Sierra Leone has successfully improved IHR capacities across the years through successful annual operational planning using the above tools. We conducted a study to document and share the country’s unique approach to implementation of NAPHS. Methods This was an observational study where the process of implementing and monitoring NAPHS in Sierra Leone was observed at the national level from 2018 to 2021. Data was obtained through review and analysis of NAPHS annual operational plans, quarterly review reports and annual IHR assessment reports. Available data was supplemented by information from key informants. Qualitative data was captured as notes and analysed for various themes while quantitative data was analyzed mainly for means and proportions. Results The overall national IHR Joint External Evaluation self-assessment score for human health improved from 44% in 2018 to 51% in 2019 and 57% in 2020. The score for the animal sector improved from 32% in 2018 to 43% in 2019 and 52% in 2020. A new JEE tool with new indicators was used in 2021 and the score for both human and animal sectors declined slightly to 51%. Key enablers of success included strong political commitment, whole-of-government approach, annual assessments using JEE tool, annual operational planning using WHO IHR Benchmarks tool and real time online monitoring of progress. Key challenges included disruption created by COVID-19 response, poor health infrastructure, low funding and inadequate health workforce. Conclusion IHR annual operational planning and implementation using evidence-based data and tools can facilitate strengthening of IHR capacity and should be encouraged.