Nairobi Research Articles

The Effects of Development Control Policy Implementation on Investor Attraction in Nairobi City County

This report examines the impact of development control policy implementation on investor attraction in Nairobi City County. The rapid urbanization and economic dynamism of Nairobi City County present both opportunities and challenges in attracting investment. This study aimed at assessing the impact of development control policy implementation on investor attractions in the region. As the capital of Kenya, Nairobi serves as a significant economic and cultural hub in East Africa, yet it faces competition from other emerging markets and struggles with the complexities of urban growth. The specific objectives included assessing the impact of development regulations on investment decisions, exploring the role of stakeholder engagement in shaping these policies, and analyzing how policy enforcement affects investor confidence. The methodology employed in this study is a mixed-methods approach, combining qualitative and quantitative research techniques. The findings revealed a relationship between development control policy implementation and investor attraction. Effective policy enforcement and clarity significantly enhance investor confidence, leading to increased project initiation and completion rates. Conversely, poorly defined regulations and inconsistent enforcement can deter investment, creating a perception of risk among potential investors. The study concludes that there is a positive relationship between robust development control policies and investment attraction in Nairobi City County. The study recommends the need for streamlined approval processes, enhanced communication between government and investors, and consistent policy enforcement. By prioritizing effective policy implementation, Nairobi can solidify its position as a premier investment destination in East Africa, driving sustainable economic growth while improving the quality of life for its residents. Keywords: Development control policies, investor attraction, urbanization, policy implementation, stakeholder engagement

Enteric Pathogens in Humans, Domesticated Animals, and Drinking Water in a Low-Income Urban Area of Nairobi, Kenya.

To explore the sources of and associated risks with drinking water contamination in low-income, densely populated urban areas, we collected human feces, domesticated animal feces, and source and stored drinking water samples in Nairobi, Kenya in 2019; and analyzed them using microbial source tracking (MST) and enteric pathogen TaqMan Array Cards (TACs). We established host-pathogen relationships in this setting, including detecting Shigella and Norovirus─which are typically associated with humans─in dog feces. We evaluated stored and source drinking water quality using indicator Escherichia coli (E. coli), MST markers, and TACs, detecting pathogen targets in drinking water that were also detected in specific animal feces. This work highlights the need for further evaluation of host-pathogen relationships and the directionality of pathogen transmission to prevent the disease burden associated with unsafe drinking water and domestic animal ownership.

Employee Training and Delivery of Services at the Postal Corporation of Kenya

Purpose: Service delivery is an essential aspect for an organization to gain competitive advantage, since service delivery deals with how a service or a product is delivered to the client and whether it’s fairly or unfairly done hence determining prosperity or downfall of organization. A sure way of realizing full potential of an organization is use relevant human resource development mechanisms appropriately. Human resource development mechanisms describe an organization’s strategies of investing in activities and programs that are intended to develop competence, skills, and knowledge of employees. The study aimed to examine possible association between employee training efforts and service delivery in Postal Corporation of Kenya in Nairobi. Methods: The study is anchored on SERVIQAL model and it deployed a positive research philosophy paradigm and quantitative research design, targeting a population of 400 respondents comprising 300 employees and 100 clients, 40% sample size is obtained from target population translating to 160 respondents. Results: Key finding of the study was that employee training is a significant determinant of service delivery at Postal Corporation of Kenya. As such, the corporation’s efforts at enhancing the capacity of its employees were established to be significantly linked to the quality of the corporation’s services. Conclusion: The study recommends deliberate planning and enhancement of the employees’ skills and knowledge to ensure continued competitiveness of the corporation.

Urban Development Together with Girls and Young Women

Public spaces are crucial to everyday life, providing sites for community interaction, mobility, and recreation. Traditionally, however, urban planning has been shaped by a gendered perspective that privileges masculine assumptions that overlook intersectional needs and reinforce societal inequalities for women and girls. This special issue, ‘Let Her Guide You’, developed in partnership with UN-Habitat as part of the Her City initiative, underscores the imperative of incorporating gender and youth perspectives into urban planning and design. The Her City Initiative, a collaboration between UN-Habitat and the Shared City Foundation, advances this goal by equipping urban actors worldwide with tools to integrate the perspectives of girls and young women into urban development. Launched in 2021, the Her City Toolbox has supported over 350 independent initiatives with registered users in 120 countries, demonstrating its effectiveness in fostering inclusive urban environments. This special issue features papers by young academic scholars selected from the Her City Master students alumni network, including case studies of feminist planning from Heerlen (The Netherlands), Nairobi (Kenya), Stockholm (Sweden), and Weimar (Germany). It also includes a diverse range of invited viewpoints advocating for collaborative approaches to urban development together with girls and young women, complemented by illustrative case studies from around the globe, including Belgium, Iran, Italy, Jamaica, Mozambique, Palestine, Peru, South Africa, Sweden, Thailand, Uganda, and the United Kingdom. By centring gender and youth perspectives in the urban planning process, this special issue highlights the potential to transform public spaces into more equitable, engaging, and sustainable environments. It calls on city makers, researchers, and community leaders to ensure that contemporary cities are designed with and for everyone.

Influence Of Grief Counselling On Psychological Wellbeing Among Widows At Africa Inland Church, Nairobi Area Church Council, Kenya

The death of a spouse can be extremely unbearable and even psychologically incapacitating. Widows face challenges that deeply affect their psychological wellbeing. The church has remained the best place for most widows in seeking consolation. This study investigated the influence of grief counselling on psychological wellbeing among widows at the Africa Inland Church, Nairobi Area Church Council, Kenya. Materials and Methods: The study was informed by the Cognitive Behavioral Theory and the Dual Process Model of Coping with Bereavement. The study used a causal research design, and census sampling technique was adopted. The sample size of the study was 114 widows. The Brief Grief Questionnaire (BGQ), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Psychological Well-being Scale (PWB) were used for data collection. The data was analyzed using SPSS version 25. Results: The findings showed that most (n = 66, 64.1%) of the widows were at high grief reaction, 22.4% (n = 31) of the widows had moderate grief reaction, while 13.5% (n = 15) were at low grief reaction. Also, 62.2% (n = 50) of the participants scored a high level of psychological wellbeing, 24.3% (n = 34) were at moderate level of psychological wellbeing, while 13. % (n = 28) of the participants were at low level of psychological wellbeing. Conclusion: The study established that grief counseling influenced the psychological wellbeing among widows (F- value (1, 5013.255) = .208, p = .030 ≤ 0.05). The study recommended that the leadership of the Africa Inland Church could work in collaboration with psychologists to formulate programs to reach out to the widows for psycho-education and possible coping strategies with regards to grief reaction

Effect of Transfer Pricing on Corporation Tax Compliance Among Multinational Corporations in Nairobi Kenya

Purpose: Tax is a compulsory contribution that is made by the citizens of a country to the government for the provision of public utilities. It is evident from the National Tax Policy, 2024 that the Kenya Revenue Authority (KRA) and the government at large have recently shown a lot of interest in multinationals due to the complexity of their operations and the tendency for them to come up with complex tax avoidance mechanisms. This has also been complicated by the widespread abuse of transfer pricing models adopted when dealing with multinational corporations operating in Kenya. This study looked into effect of transfer pricing on corporate tax compliance among multinational corporation companies in Kenya. The study was guided by the following theories, AS theory, the Slippery Slope Framework, and the theory of the planned behavior. Methodology: The study employed an explanatory research design. The target population was 221 multinational corporations’ companies and a sample size of 142 respondents. Questionnaires were used to collect primary data and analysis was descriptive statistics include frequency, percentage, and mean while inferential statistics included correlation and multiple regression. Results: The study findings found out most companies in Nairobi, Kenya have transfer pricing policies that are moderately but not adequately in line with domestic tax statutes. Most companies will use transfer pricing as a tool to reduce their tax liabilities. Further, KRA is moderately but not adequately efficient in monitoring and regulating transfer pricing practices in our company. Conclusion: The study results concluded that transfer pricing affects corporation tax compliance Based on the findings, the study recommends there is a need for exchange of information and more international collaborative efforts from a policy, legal, and academic front to address aggressive tax avoidance practices from MNCs. Therefore, future studies can be conducted on the impact of Dispute resolution mechanism on corporation tax performance.

Effect of Strategic Change on Performance of Media Firms in Nairobi Kenya

Purpose: Given the rapidly evolving media landscape in Nairobi, Kenya, which presents a unique opportunity to explore the impact of strategic change on organizational performance, this study addresses the effectiveness of various change strategies thereby offering valuable insights for media managers and policymakers striving to enhance the resilience and growth of media enterprises in Nairobi. Design/Methodology/Approach: Employing descriptive and correlational research design, the study used closed ended questionnaires with a sample of 122 departmental heads out of a target population of 176 departmental heads from 6 major media firms in Nairobi; Nation Media Group, Standard Group, Royal Media Services, Mediamax Network Limited, Radio Africa Group and Capital Group Limited. The departmental heads for editorial, technical, sales and marketing, administrative and public relations formed the target and sample. Simple random sampling and stratified sampling techniques were adopted. Data was analyzed using descriptive and inferential statistics. Data was presented using tables. Findings: Strategic Change significantly affected performance in media firms P 0.00<0.05. This suggests that strategic change variables had a significant effect on performance of media firms hence rejection of null hypothesis. Implications/Originality/Value: The study recommends that media firms should adopt a systematic change management strategy to facilitate seamless transitions and cultivate leadership abilities at all levels to enable leaders to proficiently initiate and oversee changes.

Content and effectiveness of TVET teacher CPD in Kenya

AbstractContinuing Professional Development (CPD) for teachers can improve teaching and wider school practices. However, within developing country contexts, research on the CPD practices of vocational teachers remains limited. This study therefore investigated the CPD practices of Technical and Vocational Education and Training (TVET) teachers in Kenya, focusing on the content, outcomes and effectiveness of their CPD practices. Adopting a questionnaire survey approach, data was collected from 170 TVET teachers drawn from six TVET institutes in Kenya's Nairobi Metropolitan Area.TVET teachers in Kenya were found to more frequently focus their CPD on subject content knowledge and less frequently on pedagogical knowledge. Their CPD activities are not always effective as the CPD activities often do not involve active learning and collaboration, and are not always of sufficient duration. Cluster analysis showed that for some teachers, CPD activities are rarely effective and result in limited impact on practice. However, Initial Teacher Education was found to encourage teachers to focus on broader content and to adopt more effective CPD practices.To improve the effectiveness of TVET teacher CPD practices in Kenya, it is recommended that TVET teachers in Kenya are supported to adopt active and collaborative learning activities that are spread over extended time durations.

Polysubstance Use and Related Risk Behaviors among People Who Inject Drugs in Kenya Preparing for Hepatitis C Virus Treatment.

Polysubstance use (PSU), injection drug use (IDU), and equipment sharing are associated with bloodborne infection (BBI) transmission risk, particularly Hepatitis C Virus (HCV), yet data on PSU in low- and middle-income countries (LMICs) is limited. We report on baseline PSU, medication-assisted treatment (MAT) engagement, and motivation to reduce IDU among 95 people who inject drugs (PWID) who accessed needle and syringe programs (NSP) in Nairobi and Coastal Kenya prior to HCV treatment. Bivariate and multivariate logistic regression were used to examine the associations between PSU and behaviors that confer HCV transmission and acquisition risks. Most participants (70.5%) reported PSU in the last 30 days, and one-third (35.8%) reported PSU exclusive to just heroin and cannabis use. Common combinations were heroin and cannabis (49.3%), and heroin, cannabis, and bugizi (flunitrazepam) (29.9%). Participants at baseline were receiving MAT (69.5%), already stopped or reduced IDU (30.5%), and were HIV-positive (40%). PSU was significantly associated with IDU (p = 0.008) and the number of times (p = 0.016) and days (p = 0.007) injected in the last 30 days. Participants reported high PSU and equipment sharing, despite high MAT engagement. While co-locating BBI treatment within existing harm reduction services is necessary to promote uptake and curb re-infection, tailored services may be needed to address PSU, particularly in LMICs.

Television Viewing Frequency and Mode of Delivery Preferences among Primiparous Women in Nairobi, Kenya

Purpose: This study aims to establish television viewing frequency and mode of delivery preferences among primiparous women in Nairobi Kenya, aiming at developing informed strategies to minimize health risks and costs, promoting safer childbirth choices in a media-driven urban environment. Methodology: The study utilized a sequential mixed-methods approach, which involved 300 purposefully selected primiparous women from eleven sub-counties in Nairobi during routine child immunization schedules. Among the participants, 150 had vaginal deliveries, while the remaining underwent elective caesarean deliveries. Data collection was carried out through interviewer-administered questionnaires, focus group discussions, and in-depth interviews. Quantitative analysis involved the use of mean-weight scores, Chi-square tests, and Cramer's V using SPSS version 28.0.1.1(15). Thematic analysis was employed for qualitative data using Nvivo 14 to comprehensively understand the research topic. The findings were presented through both numerical analysis and narrative exploration. Findings: Respondents who underwent elective caesarean deliveries had higher mean TV viewing frequencies on both weekdays and weekends, compared to those who had vaginal deliveries. Both for weekdays and weekends had significant associations with moderate effect sizes. The null hypothesis was rejected due to the significant correlation and linear regression explaining 81.3% of the variability. Each additional weekday TV-watching hour increased the odds in preferring a particular mode of delivery by 40%, and on weekends, by 39%. Qualitative analysis confirmed that viewing frequency is influenced by factors such flexible schedules, cost-effectiveness, accessibility, and content preferences. Unique Contribution to Theory, Practice and Policy: The study uses cultivation and medicalization theory to establish that television viewing frequency shapes perceptions and subsequent childbirth preferences among urban women, adding to existing body of knowledge on media effects theories. To promote informed childbirth choices, recommendations include encouraging women to critically evaluate media information and seek reliable sources. Additionally, integrating media literacy into antenatal care, implementing targeted campaigns, and researching other media forms beyond television are essential.

Relationship Between Medical Allowance and Employee Retention at the Teachers Service Commission, Nairobi Kenya

This study looked into the effect of medical allowance on employee retention at Kenya's Teachers Service Commission. Research design was a descriptive survey. 350 TSC employees from the finance, audit, human resource management, development, and administration were targeted. A sample of 186 was obtained using the Yamane formula and stratified random sampling method. Questionnaires were employed. Collected quantitative data was analyzed on a computer using the Statistical Package for Social Sciences (SPSS) summarized into frequencies and percentages and presented in the form of tables, figures, and pie charts. Inferential analysis facilitated the identification of the relationship between study variables. The results revealed a beta value of.610, indicating that a unit increase in medical allowance would result in a 60.3% increase in employee retention. Furthermore, the t-statistic was 9.807, and the associated p-value was 0.000, which is less than the p<.05 level of significance. As a result, the null hypothesis is rejected and the alternative is accepted, leading to the conclusion that there is a statistically significant association between medical allowance and staff retention at Kenya's Teachers Service Commission. To enhance employee retention, the study recommends that the commission should consider providing employees with a dedicated allowance for medical expenses which demonstrates the organization's commitment to supporting their health and well-being, which is crucial for fostering loyalty and satisfaction among the workforce. The commission should ensure that the employees have access to adequate healthcare coverage because it helps them to alleviate financial burdens associated with medical expenses, reducing stress and improving overall job satisfaction.

Perceived Markers of Adulthood in the Peri-Urban Areas of Nairobi, Kenya

Perceived Markers of Adulthood in the Peri-Urban Areas of Nairobi, Kenya

Burnout among medical residents, coping mechanisms and the perceived impact on patient care in a low/ middle income country

BackgroundBurnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.MethodsThis was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and < 33 in personal accomplishment. Overall high risk of burnout was defined as high-risk scores in 2 or more of the 3 categories. Categorical variables were analysed using descriptive statistics and reported as frequency counts and corresponding percentages. Chi-square test was applied to test for association of burnout and the categorical variables. P value of < 0.05 was considered statistically significant. To assess the impressions on patient care and evaluate the coping mechanisms employed in the context of burnout residents participated in four focus group discussions reaching thematic saturation.Results95 out of 120 residents consented to participate in the study, 47.3% of whom had a high risk of burnout. A significant association was found between gender and burnout risk with more female residents having high risk of burnout compared to their male counterparts; 58.0% and 35.6% respectively (P value 0.029). Residents in paediatrics and child health had the greatest risk of burnout (8 out of 10) compared to those in other programmes (P value of 0.01). Thematic analysis from focus group discussions revealed that main sources of stress included departmental conflict and struggle to balance work and other aspects of life. All focus group discussions revealed that burnout and stress are associated with negative coping mechanisms. Respondents reported that when under stress, they felt more likely to make medical errors.ConclusionThis study reported high risk of burnout among post graduate residents which is consistent with other global studies. The sources of stress cited by residents were mostly related to the workplace and many perceived sub-optimal patients care resulted from burnout. This highlights a need for preventive measures such as wellness programs within the training programmes.Trial registration numberNot applicable.

Salmonella Typhi genotypic diversity, cluster identification and antimicrobial resistance determinants in Mukuru settlement, Nairobi Kenya

BackgroundUnderstanding the source of typhoid infections and the genetic relatedness of Salmonella Typhi (S. Typhi) by cluster identification in endemic settings is critical for establishing coordinated public health responses for typhoid fever management. This study investigated the genotypic diversity, antibiotic resistance mechanisms, and clustering of 35 S.Typhi strains isolated from cases and carriers in the Mukuru Informal Settlement.MethodsWe studied 35 S.Typhi isolates, including 32 from cases and 3 from carriers, from study participants in the informal settlement of Mukuru, Nairobi, Kenya. Genomic DNA was extracted, and whole-genome sequencing (WGS) was performed to determine the phylogenetic relatedness of strains and detect antimicrobial resistance determinants (AMR). WGS data were analyzed using bioinformatics tools available at the Center for Genomic Epidemiology and Pathogenwatch platforms.ResultsGenotype 4.3.1.2 EA3 was found to be dominant at 46% (16/35), followed by 4.3.1.2 EA2 at 28% (10/35), and 4.3.1.1 EA1 at 27% (9/35). A comparison of the isolates with global strains from Pathogenwatch identified close clustering with strains from Uganda, Tanzania, Rwanda, and India. Three isolates (9%) distributed in each cluster were isolated from carriers. All genotype 4.3.1.2 EA3 isolates were genotypically multidrug-resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Single mutations in the quinolone resistance-determining region were identified in the gyrA (S83Y) and gyrB (S464F) genes. All isolates associated with multidrug resistance showed the presence of the IncQ1 plasmid with the following genes: blaTEM-1B, catA1, sul1, sul2, and dfrA7.ConclusionThe close phylogenetic relatedness between antimicrobial-resistant case isolates and carriage isolates indicates that typhoid carriage is a possible source of infection in the community. Comparative analysis with global isolates revealed that the Kenyan isolates share common lineages with strains from neighboring East African countries and India, suggesting regional dissemination of specific MDR clones. AMR was a major feature of the isolates. Surveillance and testing for antimicrobial susceptibility should inform options for the management of cases.

Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya.

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index-deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2-17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices.

A proof-of-concept randomised controlled trial of an intervention designed to improve food hygiene behaviours among caregivers of young children living in low-income areas of Nairobi, Kenya

Young children are particularly vulnerable to foodborne disease due to their immature immune systems. Safe food hygiene behaviours by caregivers can potentially reduce this disease burden. Here, we evaluate the potential for a locally designed intervention to improve caregivers’ food hygiene behaviour in a peri-urban, low-income area of Nairobi, Kenya. In this cluster-randomised proof-of-concept trial, 50 community health volunteers (CHVs) were randomly assigned to intervention or control arm (1:1). 101 households under the CHV’s catchment (2-3/CHV), with at least one child aged 6–24 months, participated. Caregivers in intervention households (n = 50) received the CHV-delivered food hygiene intervention. The control arm (n-51) received no intervention. Blinding was not possible due to the nature of the intervention. Our primary outcome was the proportion of caregivers observed to practice all five pre-specified food hygiene behaviours, four weeks post intervention delivery. Secondary outcomes assessed the five observed behaviours individually plus a sixth behaviour—the proportion of caregivers who report always boiling the child’s drinking water. We found no between-arm difference in the proportion of caregivers practising all five observed behaviours. However individually, five behaviours were significantly improved. Specifically, caregivers in the intervention arm had higher odds of washing their hands before feeding the child (adjusted odds ratio (aOR) = 7.40, 95%CI 1.85, 29.62) and before preparing the child’s food (aOR = 7.05, 95%CI 1.52, 32.71), washing the child’s hands before eating (aOR = 21.57, 95%CI 1.15, 405.93) and heating the child’s food (aOR = 4.03, 95%CI 1.27, 12.85) and drinking water (aOR = 12.82, 95%CI 2.54, 64.77) to boiling. There was no effect on cleaning and storage of feeding utensils. This study offers promising preliminary evidence that a CHV-led intervention targeting caregivers of young children can improve their food hygiene behaviour. Our findings warrant further research to refine the intervention and undertake larger scale trials to explore the intervention’s potential impact more comprehensively. Trial registration: This trial was registered with Open Science Framework: osf.io/eu5kf.

Burden and predictors of anxiety disorder among HIV patients on ART in Nairobi Kenya

Anxiety disorders are prevalent among people living with Human Immunodeficiency Virus (HIV) globally, but data on the prevalence and factors associated with this mental illness are limited among HIV patients on antiretroviral therapy (ART) in Kenya. This study determined the prevalence and correlates of anxiety disorder among HIV patients receiving care and treatment at the Comprehensive Care Clinic (CCC) in Mbagathi Hospital in Nairobi, Kenya. This was a cross-sectional study where 205 eligible and consenting participants were systematically enrolled. The Beck Anxiety Inventory (BAI) Questionnaire was used to assess anxiety levels, with a score of 8 or more indicating moderate to severe anxiety. Structured questionnaires were used to collect information on factors associated with anxiety disorder. Descriptive statistics and logistic regression models were used to analyze data. Of the enrolled 205 patients, 122 (59.5%) were female. The median age and household size were 49 years (Interquartile range IQR 39–54) and 3 people (IQR 2–3) respectively. A large proportion of the participants, 169 (82.4%) were on the first-line ART regimen and the median duration on ART was 13 years (IQR 7–18). Nearly a third of the participants 60 (29.3%) had anxiety disorder. Male participants (adjusted odds ratio—aOR 0.33; 95% confidence interval—CI 0.13–0.78) were less likely to have anxiety disorder. Self-employment (aOR 5.57; 95% CI 2.17–20.06), larger households (aOR 1.48; 95%CI 1.11–2.03) and no history of tuberculosis infection (aOR 2.9; 95% CI; 1.29–6.96) were factors associated with having anxiety disorder. Among PLHIV receiving ART in Nairobi County, Kenya, there is a considerable burden of anxiety disorder which was associated with gender, occupation, household population size and history of tuberculosis infection.

Cancer survival in sub-Saharan Africa (SURVCAN-3): a population-based study

The Cancer Survival in Africa, Asia, and South America project (SURVCAN-3) of the International Agency for Research on Cancer aims to fill gaps in the availability of population-level cancer survival estimates from countries in these regions. Here, we analysed survival for 18 cancers using data from member registries of the African Cancer Registry Network across 11 countries in sub-Saharan Africa. We included data on patients diagnosed with 18 cancer types between Jan 1, 2005, and Dec 31, 2014, from 13 population-based cancer registries in Cotonou (Benin), Abidjan (CÔte d'Ivoire), Addis Ababa (Ethiopia), Eldoret and Nairobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow-up (survival) time was measured from the date of incidence until the date of last contact, the date of death, or until the end of the study, whichever occurred first. We estimated the 1-year, 3-year, and 5-year survival (observed, net, and age-standardised net survival) by sex, cancer type, registry, country, and human development index (HDI). 1-year and 3-year survival data were available for all registries and all cancer sites, whereas availability of 5-year survival data was slightly more variable; thus to provide medium-term survival prospects, we have focused on 3-year survival in the Results section. 10 500 individuals from 13 population-based cancer registries in 11 countries were included in the survival analyses. 9177 (87·4%) of 10 500 cases were morphologically verified. Survival from cancers with a high burden and amenable to prevention was poor: the 3-year age-standardised net survival was 52·3% (95% CI 49·4-55·0) for cervical cancer, 18·1% (11·5-25·9) for liver cancer, and 32·4% (27·5-37·3) for lung cancer. Less than half of the included patients were alive 3 years after a cancer diagnosis for eight cancer types (oral cavity, oesophagus, stomach, larynx, lung, liver, non-Hodgkin lymphoma, and leukaemia). There were differences in survival for some cancers by sex: survival was longer for females with stomach or lung cancer than males with stomach or lung cancer, and longer for males with non-Hodgkin lymphomas than females with non-Hodgkin lymphomas. Survival did not differ by country-level HDI for cancers of the oral cavity, oesophagus, liver, thyroid, and for Hodgkin lymphoma. For cancers for which population-level prevention strategies exist, and with relatively poor prognosis, these estimates highlight the urgent need to upscale population-level prevention activities in sub-Saharan Africa. These data are vital for providing the knowledge base for advocacy to improve access to prevention, diagnosis, and care for patients with cancers in sub-Saharan Africa. Vital Strategies, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer. For the French and Portuguese translations of the abstract see Supplementary Materials section.

GORDON LYALL PAVER (1913–1988) AND 42ND GEOLOGICAL SECTION, SOUTH AFRICAN ENGINEER CORPS: MILITARY GEOLOGY AND GEOPHYSICS IN WORLD WAR II SUPPORTING BRITISH ARMY OPERATIONS: PART 1, THE EAST AFRICAN CAMPAIGN 1940–1941

ABSTRACT 42nd Geological Section of the South African Engineer Corps was a unique unit that supported British armed forces during World War II. It was co-founded and led for most of the war by Gordon Lyall Paver (1913–1988), one of the few ‘British’ officers serving specifically as geologists during the war to achieve the rank of major. Born in South Africa at Johannesburg and in his early years educated there at St. John's College, from 1926 Paver was educated in England, at Charterhouse School until admitted in 1931 to Pembroke College in the University of Cambridge, where he studied chemistry, geology and mineralogy. He graduated in 1934 and returned to South Africa, being appointed to the Geological Survey of South Africa as one of its first geophysicists and contributing to magnetometric and gravimetric surveys in the Transvaal region, expertise used in 1938 to 1940 to draft his thesis for a PhD degree (awarded in 1942). Although married in 1939 and briefly employed as a consultant geophysicist, in August 1940 Paver was one of the first three geoscientists to be mobilized as officers to found 42nd Geological Section, at Zonderwater near Pretoria in South Africa. After only a month's military training, at the end of September the Section and its vehicles deployed by rail and sea to a base near Nairobi in Kenya for operational service in East Africa, with ‘Acting Captain’ Paver as its Second-in-Command. Detachments from the Section were widely deployed in Kenya and later in Italian and British Somaliland (present-day Somalia) and also in Abyssinia (present-day Ethiopia) for surveys by means primarily of electrical earth resistivity but also vertical force magnetometer. These guided drilling of wells by another unit of the South African Engineer Corps to abstract potable groundwater— thereby facilitating troop concentrations and forward movements in arid or semi-arid regions during the ‘British’ Army's East African Campaign. Members of the Section also compiled geological maps of Kenya at scales of 1:1,000,000 and 1:2,000,000 and pioneered a military geological unit created within the East African Engineers that supported British forces in the region from 1941 to 1945. The Campaign drew to a victorious close during 1941 and, from the end of August, the Section was re-deployed northwards to a base near Cairo in Egypt. It continued to serve within the British Army's Middle East Command but with leadership now by Paver, promoted ‘Acting Major’ from 31 August and in December ‘mentioned in despatches’ for his earlier distinguished service in East Africa.

Productivity, Sustainability, and Economic Growth in Metropolises: Estimates of Long-Time Commuting Effects in Developing Countries

Purpose: The study aimed to investigate the long-time commuting patterns of workers in the developing world, observing metropolises’ samples. The main question to be answered was whether there is scope for labor policy changes towards reducing long-time commuting to obtain productivity gains based on life quality improvements. Theoretical background: Although previous research indicates the presence of symmetric patterns in the developing world, specifically in long-time commuting, there is still a gap in checking the possibilities for labor productivity growth as a consequence of worker´s life quality improvement. Methodology: In this study, we observed six of the biggest metropolises located in very different geographic regions – New Delhi (India), Mexico City (Mexico), São Paulo (Brazil), Manilla (Philippines), Nairobi (Kenya), and Accra (Ghana). Simple random samples of workers in the Metropolitan Areas were surveyed electronically, by ‘Google-Forms e-survey’ during the second half of 2019. Considering error margins below 5 percentage points and with a 95 percent point confidence level, the authors used proportion (p) sample distributions to draw inferences about the population of workers. Results and conclusion: The results showed that long-time commuters are between 12 and 26 percent of the workers. More than 65 percent of workers in all the cities were interested in reducing commuting time. More than half of the workers agreed that reducing commuting time could improve labor productivity, and the same share is aware of the negative effects on quality of life and health. Labor policy changes in these six metropolises have the potential to affect more than 6.5 million workers. Research implications: The study advances in verifying the long-time commuting patterns and consequences, opening doors for labor policy changes towards gaining productivity by reducing time spent commuting, as previous literature has partially done. Originality/value: The approach of the work and its results contribute to expanding empirical research related to the assumptions of labor productivity growth based on life quality improvements.