The Practices and Processes of Foreign Aid to Africa: A Kenyan Case Study

Indigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to contribute to strengthening the health care systems in low income countries. This paper examines the state of traditional medicine using evidence from three case studies in Central Kenya. While the cases are too few to represent the broad diversity of cultures and related healing systems in the Sub-Sahara African Region, the way they seem to refute the main assumptions in the integration discourse is important, also because studies from other countries in the region report perspectives, similar to the case studies in Kenya. It is often argued that people continue to use traditional medicine because it is affordable, available, and culturally familiar. Its integration into the health care system would therefore promote cultural familiarity. The case studies however point to the loss of essential cultural elements central to traditional medicine in this particular area while users travel long distances to reach the healers. In addition, there are significant paradigm differences that may present obstacles to integration of the two systems. More problematic however is that integration is, as in many development interventions, a top-down policy that is rarely based on contextual realities and conditions. Instead, integration is often defined and dominated by biomedical professionals and health planners who may be unfamiliar or even hostile to some aspects of traditional medicine. Furthermore, integration efforts have tended to embrace selected components mostly herbal medicine. This has led to isolating herbal medicine from spiritualism, which may in turn affect the holistic perspective of traditional medicine. While familiarity and relevance may explain the continued use of traditional medicine, its services may not be as readily available, accessible, or even affordable as is often asserted. Globalization set in motion through colonization and ensuing modernization processes, including urbanization, education, religion, and a neo-liberal economic system, have introduced a social order creating physical as well as social distances between users of traditional medicine and the healers.

Socio-economic and environmental conditions play an important role in driving technological transformation and sustainability. Based on an innovation project conducted in Kenya, this study demonstrates how socio-ecological analyses can facilitate the adoption of agricultural technologies. This project focused on subsurface water retention technology (SWRT), a climate adaptation approach for sandy soils with proven effectiveness under different ecological conditions. Using maize production data to represent local biophysical conditions, we conducted a cost–benefit analysis (CBA) of SWRT to assess its profitability under current conditions and alternative investment scenarios. We also conducted a livelihood survey and stakeholder dialogue to assess what farmers can afford and identify possible enabling factors for technology adoption and sustainability. The CBA results for maize suggest a long-term return on investment, mainly due to high initial investment costs in terms of labour requirements for SWRT installation (about 70% of initial costs) and a need for irrigation during droughts. In simulations of investments, the break-even point varied depending on the specific investment measures taken alongside SWRT adoption. The livelihood survey indicated that farmers possess resources that could cover the initial investment in SWRT on small plots. However, uptake at scale would require a range of enabling factors, including information on suitable crops and the benefits of investment, and incentives from input and service suppliers. The current yields and prices of maize are not enough for the scaling-up of SWRT. Future studies should incorporate cost–benefit information on high-value crops and analyses of how farmers, and input and service suppliers can better share the investment risks.

Due to the changes in the climate, more extreme weather conditions occur. Weather extremes (such as heat, drought, freeze, etc.) are limiting conditions for the cultivation of agricultural crops. Long term monitoring of particular quantities such as temperature, humidity, wind conditions and so on are essential for decision making in agriculture. Since the monitoring is an expensive process, the physical monitoring stations are usually very coarse. The common approach to combine these data with a global model. This paper presents steps which can be done further, using temperature as an example. The paper first presents a workflow, how to create a denser model of temperature distribution from a course one model of temperatures. Next, the paper outlines a method of how to analyze the temperature spatial distribution in time. The aim is to use historical meteorological series (e.g. of temperatures) to help farmers and producers of agriculture’s products with decision making.

Due to low rates of grid access in many countries in Sub Sahara Africa (SSA), many households with the ability to pay rely on off-grid stand-alone systems for their electricity supply. However, the arrival of the grid in households previously served by these off-grid systems comes with technical integration challenges considering that currently many African countries do not have grid-feed-in policies for small micro-generation. The problem is further complicated by a lack of unified industry standards of practice for deployment of microgrid control systems, leading to suboptimal use of distributed generation assets. In this paper, model predictive control (MPC) algorithm is employed to solve the dispatch problem of a grid connected solar PV-Battery microgrid without grid feed in option. The proposed model is applied to a case study in Kenya and its performance compared with the switched control strategy currently implemented at the case study site to test the economic gains of the MPC. We find that the investment required to implement the MPC algorithm has a payback period of about 7 years.

Due to the changes in the climate, more extreme weather conditions occur. Weather extremes (such as heat, drought, freeze, etc.) are limiting conditions for the cultivation of agricultural crops. Long term monitoring of particular quantities such as temperature, humidity, wind conditions and so on are essential for decision making in agriculture. Since the monitoring is an expensive process, the physical monitoring stations are usually very coarse. The common approach to combine these data with a global model. This paper presents steps which can be done further, using temperature as an example. The paper first presents a workflow, how to create a denser model of temperature distribution from a course one model of temperatures. Next, the paper outlines a method of how to analyze the temperature spatial distribution in time. The aim is to use historical meteorological series (e.g. of temperatures) to help farmers and producers of agriculture’s products with decision making.

Journal Article A CASE STUDY IN KENYA: C.D. BUILDS A NURSERY SCHOOL Get access Community Development Journal, Volume 6, Issue 1, Winter 1971, Pages 12–18, https://doi.org/10.1093/cdj/6.1.12 Published: 01 January 1971

Access to timely and comprehensive neuro-oncology care remains a significant challenge in East Africa, where health insurance coverage is limited, and out-of-pocket payments dominate healthcare financing. In Kenya and Uganda, uninsured neuro-oncology patients often face catastrophic health expenditures, delayed diagnosis, and poor outcomes. This case study examines the systemic, financial, and clinical challenges of managing neuro-oncology patients without health insurance in these two countries, offering insights into potential solutions for equitable healthcare access. A qualitative case study approach was employed, drawing on a combination of literature review and expert interviews with neurosurgeons, oncologists, and healthcare administrators in Kenya and Uganda. Data sources included peer-reviewed publications, health policy documents, and hospital-based neuro-oncology registries. Thematic analysis was used to identify recurring barriers to care, financial toxicity, and survival outcomes, with a focus on the impact of health insurance status. The analysis revealed several critical challenges, including significant preoperative delays due to unaffordable diagnostic imaging and surgical fees, treatment discontinuation resulting from financial exhaustion, and limited access to postoperative oncology services. Uninsured neuro-oncology patients in both countries were more likely to present with advanced disease, experience longer hospital stays, and have lower 12-month survival rates compared to insured counterparts. Systemic issues such as inadequate public-sector neurosurgical capacity, prolonged referral pathways, and a lack of national cancer financing programs further compounded these difficulties. This case study highlights the urgent need for targeted policy interventions to mitigate financial toxicity and improve access to neuro-oncology care in Kenya and Uganda. Recommendations include expanding national health insurance coverage to include neuro-oncology services, creating cancer-specific financial assistance programs, and establishing regional centers of excellence with streamlined referral networks. A collaborative, multi-sectoral approach is essential to build sustainable, patient-centered neuro-oncology care systems and improve survival outcomes in East Africa.

The discussion on regime fragmentation and interaction has traditionally occurred within the context of international law with its latest manifestation being the quest for a fisheries subsidies discipline in the World Trade Organisation (WTO). However, with deepening poverty and regulatory challenges especially in many economically less advanced countries, it is important to examine how their domestic regimes interact to address perennial sustainable development challenges. Using the case study of Kenya’s marine fisheries, the thesis therefore examines fragmentation in its regime and existing, if any, mechanisms for regulatory interaction. The thesis uses triangulated methodology by relying on doctrinal research, case studies, field interviews and observations, and on-site study to test the hypothesis. Moreover, further review of literature is undertaken in different chapters of the thesis due to the conceptual nature of some of the issues raised therein.
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\nThe thesis hypothesises that although there are indisputable multilateral aspects to Kenya’s marine fisheries, it is the country’s fragmented regime characterised by chaotic legal and institutional duplicity that has mostly limited interaction within its regime thereby leading to ineffective regulatory intervention in the sector.
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\nThe thesis extensively relies on Margaret Young’s formulation of regime fragmentation in international fisheries law to examine domestic fragmentation in Kenya’s marine fisheries. Young argued that fragmentation in international fisheries law is characterised by three normative tendencies of regulatory exclusivity, hierarchical bias and forum shopping that have particularly impeded inter-regime interaction. This has eventually contributed to the failure to effectively discipline global marine fisheries resources. It is the thesis’ finding that although fragmentation in Kenya’s marine fisheries regime has somewhat exhibited these three normative elements or tendencies, it is the continued emergence of disparate regulatory practices anchored on formal and informal instruments of the regime that has been more pronounced. Accordingly, the thesis proposes alternative and further measures for regime interaction and coherence towards effective and optimal regulation of the country’s marine fisheries resources. The significance of the thesis lies in its contribution to further contextual understanding of regime fragmentation in domestic settings, especially in the regulation of the commons in developing countries.
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\nTo test the hypothesis, the thesis is guided by two inter-related research questions namely:
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\n(i) To what extent, if any, does regime fragmentation bearing in mind Young’s three normative claims, explain ineffective regulation of the marine fisheries sector in Kenya?
\n(ii) What legal, institutional and policy measures would be necessary in the sector to enhance greater regime interaction and effectively regulate the country’s marine fisheries?

PurposeThe purpose of this paper is to explain how public libraries have been instrumental in early child school literacy teaching and learning. Most African public schools do not usually afford enough core textbooks and supplementary readers.Design/methodology/approachThis was a qualitative case study in Western Kenya amongst public library staff members, public primary school teachers and parents of library children clients. The following questions were addressed: What is the book situation in public primary schools in the study site? What school-type literacy-related services are offered by the sampled public library? and What are library staff members’, teachers’ and parents’ feelings about the public library services offered? Observations, interviews and document studies were used to collect data. Data were analysed thematically.FindingsPublic schools do not have enough core textbooks and the situation is worse for supplementary readers; the public library branch studied offers critical school-type literacies to school children both at the library building as well as at public schools registered with it; and library staff members, teachers, and parents express positive feelings about the services offered.Research limitations/implicationsThis was a case study whose findings might not apply to the larger situation and the study did not confirm actual literacy benefits of the library services amongst school children by, for instance, conducting literacy tests. The findings are, however, an index to the possible situation in the macro context.Practical implicationsThe relevant stakeholders should find ways of co-opting public libraries as associates of public schools in literacy teaching. This relationship is not straight forward in Kenya.Originality/valueThe findings reported are from original research.

PurposeThe purpose of this case study is to describe the experiences of a development organization operating in Africa to make mental health services accessible to communities in Kenya and Uganda through partnerships. The lessons that can be learnt from this work are also considered.Design/methodology/approachThe paper is a case study that builds on operations research gathered over five to seven years by the authors who have managed the country mental health programmes in Uganda and Kenya. The case study describes the problem of mental illness and its magnitude in Kenya and Uganda, and why it is important that this is addressed. Existing mechanisms in place and gaps in current service provision are also discussed.FindingsMethods used to address gaps in current service provision include capacitating different service providers, their roles and their contribution to community mental health. The inclusion and training of non‐psychiatrists can contribute to the management, treatment and recovery of people with mental health problems in African communities.Research limitations/implicationsThe case study is limited in its applicability in full to other low to middle income countries (LMICs). Causality cannot be established between improvement in access and training of the different health service providers.Practical implicationsThe case study gives practical experiences that practitioners in LMICs can further test in improving access to community‐based mental health services. These experiences can help to form a promising practice in how LMICs can reduce health workforce gaps in mental health and planners can consider using this to reduce such gaps.Social implicationsThe case study shows how the participation of service users and other stakeholders and using family resources can bring ownership and sustainability of mental health care at the community level.Originality/valueThe case study adds value to practice and social development theories and models of care.

Regardless of the efforts to encourage the use of renewable energy sources such as solar and biogas in developing countries, their adoption and use is still low especially in Kenya. The purpose of this research was to investigate effects of renewable energy and accessibility on household fuel choices in Kenya among households in rural and peri-urban areas. Random sampling technique was used to select a sample of 199 households in the county of Uasin Gishu. Data for the study were collected using a structured questionnaire and analyzed using different quantitative and qualitative statistical procedures and methods. Analysis reveals that rural households are still dependent largely on kerosene and electricity for lighting their houses and majorly firewood for cooking, while electricity and charcoal form a major source of energy for lighting and cooking in peri-urban households respectively. A small portion of households in rural (11.6%) and peri-urban (12.9%) use biogas energy for cooking. The results also shows negative association between the use of renewable energy and the use of conventional household energy sources for cooking (firewood, kerosene and charcoal) and lighting (kerosene) implying reduction in deforestation, indoor pollution and dependency on imported fuels. Further, it was found that there is positive association between accessibility and the type of fuel used at household level for cooking indicating that nearness to diverse supplying shops selling fuel is positively associated with household energy changing behaviour. The effects of renewable energy will reduce the use of conventional fuels and household’s energy diversification while accessibility on the other hand increases household fuel choices. The finding offers insights that could increase the uptake of renewable energy and reduce the problems associated with traditional fuels. Keywords: Household energy, renewable energy, accessibility, cooking and lighting DOI : 10.7176/JETP/9-7-04 Publication date :October 31 st 2019

Consquences of external shocks in African-type economies, David Bevan, et al modelling African development prospects, Dominick Salvatore, et al the sequencing of structural adjustment policy instruments in the agricultural sector, Lawrence D.Smith and Neil J.Spooner world bank policy - conditional loans - how did they work in Ghana in the 1980s?, John Toye how weak countries can stand up to the world bank and get away with it - a case study of Kenya, Paul Mosley bilateral aid to Africa and structural adjustment loans conflict or consistency, W.Olive Morrissey potency of budgetary and financial policy instruments in Uganda, Christopher Green and Victor Murinde the process of trade reform in Nigeria and the pursuit of structural adjustment, James W.Robertson Botswana - adjustment to wealth, J.R.Parkinson problems of regional integration in Africa - the case of UDEAC, Richard Kitchen.

BackgroundLarge-scale renewable energy projects are increasingly being rolled out across rural Kenya, with the government playing a frontline role in attracting energy investors through various state-led and state-centric policies and investment incentives such as feed-in-tariffs and power purchase agreements. While these policies are commendable, and are indeed attracting many private investors, existing studies document how social and environmental justice concerns are often overlooked—sometimes causing local contestations against energy projects. However, to date, there has been less attention given to cases where procedural justice elements (e.g., access to information, access to meaningful participation, access to justice, and respect for local culture) led to a successful land negotiation for energy development without outright conflict. Using a case study in Kenya, this article aims to bridge this gap by showing how a fair application of various elements of procedural justice in land consultation has facilitated the establishment of the Kipeto wind farm. This qualitative research is based on semi-structured interviews that took place from February to March 2023, with a follow-up visit in December the same year, supplemented with review of secondary data sources.ResultsThe results indicate that for energy projects to be accommodated in and by communities, access to land must be properly negotiated, particularly with the actual landowners whose livelihoods are most likely to be implicated by the project. Second, local people’s perception of what they regard as a ‘just’ or ‘fair’ process of land consultation constitutes the basis for their acquiescence and compliance.ConclusionEnsuring a ‘just’ procedure in land consultation with the actual landowners is a key strategy to avoid conflicts. Land investors, governments, and policy-makers who interface and negotiate with communities must ensure the provision of procedural justice, particularly in contexts where local livelihood is tied to land and where land is individually owned. Although the findings suggest a positive case of wind energy development in Kenya, the project is barely 4 years old; things may change overtime if agreed conditions are not met as specified in the MoU. Therefore, additional follow-up research is needed to ascertain the extent to which both KEL and landowners live up to their promises.

Bigsten, Arne, "Regional Inequality and Development: A Case Study of Kenya" (Book Review)

Abstract. The Universal Soil Loss Equation (USLE) is the most commonly used model to assess soil erosion by water. The model equation quantifies long-term average annual soil loss as a product of the rainfall erosivity R, soil erodibility K, slope length and steepness LS, soil cover C, and support measures P. A large variety of methods exist to derive these model inputs from readily available data. However, the estimated values of a respective model input can strongly differ when employing different methods and can eventually introduce large uncertainties in the estimated soil loss. The potential to evaluate soil loss estimates at a large scale is very limited due to scarce in-field observations and their comparability to long-term soil estimates. In this work we addressed (i) the uncertainties in the soil loss estimates that can potentially be introduced by different representations of the USLE input factors and (ii) challenges that can arise in the evaluation of uncertain soil loss estimates with observed data. In a systematic analysis we developed different representations of USLE inputs for the study domain of Kenya and Uganda. All combinations of the generated USLE inputs resulted in 972 USLE model setups. We assessed the resulting distributions in soil loss, both spatially distributed and on the administrative level for Kenya and Uganda. In a sensitivity analysis we analyzed the contributions of the USLE model inputs to the ranges in soil loss and analyzed their spatial patterns. We compared the calculated USLE ensemble soil estimates to available in-field data and other study results and addressed possibilities and limitations of the USLE model evaluation. The USLE model ensemble resulted in wide ranges of estimated soil loss, exceeding the mean soil loss by over an order of magnitude, particularly in hilly topographies. The study implies that a soil loss assessment with the USLE is highly uncertain and strongly depends on the realizations of the model input factors. The employed sensitivity analysis enabled us to identify spatial patterns in the importance of the USLE input factors. The C and K factors showed large-scale patterns of importance in the densely vegetated part of Uganda and the dry north of Kenya, respectively, while LS was relevant in small-scale heterogeneous patterns. Major challenges for the evaluation of the estimated soil losses with in-field data were due to spatial and temporal limitations of the observation data but also due to measured soil losses describing processes that are different to the ones that are represented by the USLE.