Kenyan Population Research Articles

Bühlmann credibility approach to systematic mortality risk modeling for sub-Saharan Africa populations (Kenya)

The classical mortality models such as the Cairns-Blake-Dowd (CBD), Lee-Carter (LC), Linear Regression (LR) models are used to model Systematic Mortality Risk (SMR) for many developed countries populations for actuarial product valuations. This research study aims at incorporating the Bühlmann credibility approach (BCA) to improve the SMR models to fit sub-Saharan African populations like Kenya. Since the Kenyan population does not exhibit the Gaussian properties used in modeling the classical error terms, we proposed using Normal Inverse Gaussian distribution to model these error terms instead of a Gaussian distribution. We model the error terms of the classical models (LC, CBD, and LR) as a Normal Inverse Gaussian (NIG) distribution through the Bühlmann credibility approach. This novel approach demonstrates an improved precision of the predicted SMR as shown by the values of MAPE and RMSE measures compared to those under classical mortality risk models. Ultimately, we have done actuarial valuations of annuities and assurances using our determined SMR, thus concluding that this BCA approach improves the accuracy of actuarial products sold in the Kenyan market.

High Level of Pre-Treatment HIV-1 Drug Resistance and Its Association with HLA Class I-Mediated Restriction in the Pumwani Sex Worker Cohort.

Background: We analyzed the prevalence of pre-antiretroviral therapy (ART) drug resistance mutations (DRMs) in a Kenyan population. We also examined whether host HLA class I genes influence the development of pre-ART DRMs. Methods: The HIV-1 proviral DNAs were amplified from blood samples of 266 ART-naïve women from the Pumwani Sex Worker cohort of Nairobi, Kenya using a nested PCR method. The amplified HIV genomes were sequenced using next-generation sequencing technology. The prevalence of pre-ART DRMs was investigated. Correlation studies were performed between HLA class I alleles and HIV-1 DRMs. Results: Ninety-eight percent of participants had at least one DRM, while 38% had at least one WHO surveillance DRM. M184I was the most prevalent clinically important variant, seen in 37% of participants. The DRMs conferring resistance to one or more integrase strand transfer inhibitors were also found in up to 10% of participants. Eighteen potentially relevant (p < 0.05) positive correlations were found between HLA class 1 alleles and HIV drug-resistant variants. Conclusions: High levels of HIV drug resistance were found in all classes of antiretroviral drugs included in the current first-line ART regimens in Africa. The development of DRMs may be influenced by host HLA class I-restricted immunity.

Comparative performance of WANTAI ELISA for total immunoglobulin to receptor binding protein and an ELISA for IgG to spike protein in detecting SARS-CoV-2 antibodies in Kenyan populations.

Many SARS-CoV-2 antibody detection assays have been developed but their differential performance is not well described. In this study we compared an in-house (KWTRP) ELISA which has been used extensively to estimate seroprevalence in the Kenyan population with WANTAI, an ELISA which has been approved for widespread use by the WHO. Using a wide variety of sample sets including pre-pandemic samples (negative gold standard), SARS-CoV-2 PCR positive samples (positive gold standard) and COVID-19 test samples from different periods (unknowns), we compared performance characteristics of the two assays. The overall concordance between WANTAI and KWTRP was 0.97 (95% CI, 0.95-0.98). For WANTAI and KWTRP, sensitivity was 0.95 (95% CI 0.90-0.98) and 0.93 (95% CI 0.87-0.96), respectively. Specificity for WANTAI was 0.98 (95% CI, 0.96-0.99) and 0.99 (95% CI 0.96-1.00) while KWTRP specificity was 0.99 (95% CI, 0.98-1.00) and 1.00 using pre-pandemic blood donors and pre-pandemic malaria cross-sectional survey samples respectively. Both assays show excellent characteristics to detect SARS-CoV-2 antibodies.

Biodiversity and Efficacy of Fungal Isolates Associated with Kenyan Populations of Potato Cyst Nematode (Globodera Spp.)

Biodiversity and Efficacy of Fungal Isolates Associated with Kenyan Populations of Potato Cyst Nematode (Globodera Spp.)

Weather variability and conflict forecasts: Dynamic human-environment interactions in Kenya

While conflict prediction has gained considerable attention in recent years, the existing literature has relied mainly upon aggregated data for large administrative areas or even entire countries. Such approaches obscure significant geographic variation of conflict dynamics based on household and individual experiences. Conflicts are highly localized, shaped by social and economic contexts that vary across space and change throughout time. We predict two types of conflict reported by respondents in a 2018 Kenyan population survey (N = 1,400) using an identical survey carried out in 2014 in the same enumeration areas (sample locations). We use a conditional random forest (CRF) machine learning method for forecasting. Due to heavy reliance on agriculture in Kenya, we expect that adding weather variability and vegetation health (“environmental”) predictors to a CRF model with 29 demographic and contextual variables will improve the performance of our baseline forecasts. Against our expectations, adding environmental predictors does not enhance our 2018 predictions. Models with only environmental data have the worst fit. A logical extension of many “climate-conflict” studies is that environmental data should improve our ability to predict the location and timing of conflict, yet we find that they generally do not. We interpret this finding through the lens of human-environment interactions research developed in human geography and political ecology. These studies similarly emphasized that circumstantial and historical political, economic, and social relationships have greater credibility for understanding conflict than the weather.

Environmental consciousness amongst indigenous youth in Kenya: The role of the Sengwer religious tradition

Environmental destruction has contributed to climate change, a contemporary threat to the survival of the human race. Currently, many young people across the world are increasingly and actively involved in climate action, because of the realisation that climate change will disproportionately affect them. Kenya is adversely affected by climate change, with erratic and unpredictable rainfall patterns now being the norm. Given that the youth make up a large segment of the Kenyan population, they are well placed to contribute efficaciously to combating climate change. This article relied on both primary and secondary sources of data. Interviews, participant observations, focus group discussions, articles, books and archival material were used to generate data. Purposive and snowball sampling techniques were used to get key informants. Data were analysed thematically as per the topic under study. The article focuses on how the Sengwer indigenous community created environmental awareness and utilised their epistemological approaches to ensure a conscious mindset amongst the youth on the sustainability of the environment. In this article, we argue that the complex social systems that have religious underpinnings in traditional society play a critical role in ensuring that young people are environmentally conscious. Religion facilitates knowledge acquisition amongst the youth and shapes their understanding and consciousness of the environment. The findings indicate that indigenous communities had an effective system of ensuring that young people are conscious of their environment.Contribution: This article seeks to contribute to an instauration of indigenous knowledges and epistemologies on environmental issues. It proffers for a holistic approach of incorporating indigenous ways of creating environmental consciousness and awareness amongst the youth.

Organization Social Practice and Performance in the Kenya National Police Service: A Case of Central Police Division, Nairobi

The National Police Service of Kenya has gone through numerous transformations which are aimed at making it more effective and socially aligned to the needs of the Kenyan population. The transformation has seen the renaming of the policing unit from Kenyan Police Force to its current name. The Strategy such as renaming the institution to National Police Service implies that the institution is improving its commitment to improve service delivery to the citizens in a favorable social framework. However, minimal studies have been done to determine the existence of any relationship between organizational social practices and performance of the police institution. Therefore, the current study was formulated to establish the influence of organizational social practices on the performances of the National Police Service. The independent variables of the study included leadership style, organization structure, professionalism, and organization politics. Practice and system theories were reviewed alongside relevant sources of empirical literatures were reviewed to give the current studies sound theoretical and empirical foundations. Descriptive research design was used to guide collection, analysis, and interpretation of the research data. Semi-structured questionnaires were used to collect quantitative and qualitative data was collected from 150 police officers who were purposively sampled from Central Police Division in Nairobi County. A combination of descriptive and inferential analyses were performed to establish the current trends of the study variables and relationships thereof. The study found out that the respondents were in agreement with almost statements on the four organizational social practices including leadership style, organization structure, and professionalism and organization politics. Leadership style and professionalism were established to have the highest impact (0.300; p= 0.000) and the least impact (0.093; p=0.000) respectively. Organization politics, on the other hand had a significant negative impact (-0.254; p=0.001) on the NPS performance. The study concludes that the main belief or attitude influencing leadership style is the perceived manager versus subordinates’ role. Effective decision making is improved by decentralization, narrow control span and efficiency relate positively, task routine positively and negatively affect productivity. A respectful culture is fostered by professionalism, which ensure proper handling of conflicts. Boundaries are clearly understood and minor issues solve efficiently and respectfully by professional employees. Workers are motivated with the hope that there won’t be hampering of their interest due to existence of organizational politics. Employee’s indiscipline may be resisted by the organizational politics’ help. The study recommends that transactional and transformative leadership be embraced by national police service to assist in tapping the workers’ potential, they should be involved in making decisions and new idea be welcomed into the system for positive contribution to the entities’ exponential performance. National police service should adopt an efficient, simple and universally accepted organizational structure. Employees at national police service should exercise workplace expectations and rules by following all workplace rules, completing all projects and tasks and understanding what is expected of them. Delegation of duties depending on employees’ academic achievements, specialization and interests. Transparency must be maintained at all levels to reduce politics.

COVID-19 transmission dynamics underlying epidemic waves in Kenya.

Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, or infection spreads to susceptible subpopulations. Three COVID-19 epidemic waves have been observed in Kenya. Using a mechanistic mathematical model, we explain the first two distinct waves by differences in contact rates in high and low social-economic groups, and the third wave by the introduction of higher-transmissibility variants. Reopening schools led to a minor increase in transmission between the second and third waves. Socioeconomic and urban-rural population structure are critical determinants of viral transmission in Kenya.

Effect of Cash Transfers on Household Consumption amongst the Vulnerable Population in Awendo Sub-County

Despite the national cash transfer programme, poverty rate among the Kenyan population is still high at a prevalence rate of 48.9% in 2016 up from 45% in 2008. In Kenya, poverty prevalence is disproportionately spread across the 47 counties and sub-counties. In Awendo sub-county, poverty prevalence rate is 49.8 % in 2018 which is higher than the national figure prompting this empirical study. The purpose of this study was to analyze the effects of cash transfer on consumption among vulnerable households in Awendo Sub-County. The study was anchored on the Life Cycle hypothesis of consumption and savings, the study used a correlational design to aid the determination of relationship and association between cash transfers and status of household consumption. Using stratified sampling method, a total of 390 respondents were selected. However, the response rate was 98.7 %. Cronbach’s alpha coefficient was estimated to test for reliability and the value was 0.782 which was greater than the threshold of 0.7. The study used multiple linear regression models which indicated that, there is a positive significant effect of cash transfer on consumption (α1=0.060;p=0.046). In conclusion; cash transfer is an important factor determining levels of consumption of the vulnerable population in Awendo Sub-County. The study recommends for policy to enhance allocations among the vulnerable population in Awendo and Kenya in general. The study provides empirical evidence on the current body of knowledge for researchers and policy makers

Driving Youth Participation in Agriculture: A Synopsis of the Influence of Existing Agricultural Policies in Selected Counties in Kenya

Agriculture is the backbone of Kenya’s economy, contributing (24%) of the GDP. The Agricultural Sector Development Strategy showed that the sector accounts for (65%) of Kenya’s total exports and provides more than (18%) of formal employment, (70%) of informal employment. It provides livelihood to (80%) of the Kenyan population. The Government of Kenya is committed to reducing hunger and malnutrition. To end hunger, achieve food security, improve nutrition, and promote sustainable agriculture as specified in (SDG2), the Government launched the ‘Big 4 Agenda’. These include strategies to build self-reliance, reduce chronic food insecurity. During the quarter under review, there was heightened Agricultural activity that significantly anchored the overall economic performance. The low response to National and County Governments incentives suggests that these efforts have not been met with buy-in of the Youth. The institutional, social, and infrastructural investments have not produced the expected in-flow of the Youth into the Agricultural sector. Under-investigated determinant like Agricultural Policies are perceived to influence Youth Participation. This study sought to explore the influence of these determinant on the dependent variable. Employing a descriptive survey design and inferential statistics as tools of analysis, with a sample size of 194 respondents drawn from (7) Kenyan Counties. A simple linear regression was applied, whereby the independent variable (Agricultural Policies) was regressed against the dependent variable (Participation of Youth in Agriculture). Agricultural Polices did have a statistically significant influence on Youth Participation. It emerged that there were no actively supportive policies on Youth Participation in Agriculture. No pricing policies; absence of Youth specific safeguard policies against competition among others. The study recommends that the National and County Governments through their respective Agricultural authorities (Ministries/Departments) develop intervention strategies policies and services to pull Agricultural Oriented Youth through provision of kinds of capital and initiate the use of extension services.

User Involvement, Procurement Practices and Implementation of Building Construction Projects in the Kenyan Judiciary

Kenyan population increased from 20 million in 1985 to approximately 47.6 million in 2019 and with it, demand for justice also increased yet the growth did not come with improved Judiciary infrastructure. This attracted the World Bank through the Judicial Performance Improvement Project (JPIP) to fund 30 major court construction projects while the Kenyan Government also funded another 33 such projects from 2013. However, by January, 2020,only 10 projects had been completed and successfully handed over with all the 63 projects being out of the planned time and with variation on the original scope of works.This gave rise to this study that aimed to evaluate the influence of user involvement on implementation of building construction projects in the Kenyan judiciary as moderated with the procurement practices. The study was based on general systems theory. Pragmatism paradigm and convergent parallel mixed research design was adopted and proportionate stratified sampling was used to select a population of 234 consisting of judiciary staff, construction staff and consultants .Primary data was collected through use of questionnaires, interviews and document content analysis. Reliability was tested using Cronbach’s Alpha while data was analyzed using descriptive statistics which included measures of central tendency. Qualitative data was subjected to thematic analysis to triangulate results derived from quantitative data. Inferential statistics was analyzed by correlation, simple linear regression and multiple regression analysis. Two hypotheses were tested to establish whether there were significant relationships between project delivery attributes and implementation of building construction projects in the Kenyan Judiciary, namely 1.H 0 : User Involvement has no significant relationship with implementation of construction projects in the Kenyan Judiciary and 2.H 0 : There is a significant moderating influence of procurement practices on the relationship between user involvement and implementation of building construction projects in the Kenyan Judiciary. The findings were that there was a significant influence of user involvement on the implementation of construction projects in the Kenyan Judiciary and that procurement practices significantly moderated the relationship between user involvement and implementation of building construction projects in the Kenyan Judiciary. The slope coefficient was significant when p ≤0.05. The findings of the study will be beneficial to policy makers, project managers in public and private sectors and scholars regarding project delivery attributes on implementation of building construction projects. Keywords: User involvement, Procurement Practices and Implementation of Building Construction Projects. DOI: 10.7176/EJBM/13-18-12 Publication date: September 30 th 2021

The Impact of Inflation on Bank Financial Performance: Case of Tunisia

Kenyan population increased from 20 million in 1985 to approximately 47.6 million in 2019 and with it, demand for justice also increased yet the growth did not come with improved Judiciary infrastructure. This attracted the World Bank through the Judicial Performance Improvement Project (JPIP) to fund 30 major court construction projects while the Kenyan Government also funded another 33 such projects from 2013. However, by January, 2020,only 10 projects had been completed and successfully handed over with all the 63 projects being out of the planned time and with variation on the original scope of works.This gave rise to this study that aimed to evaluate the influence of user involvement on implementation of building construction projects in the Kenyan judiciary as moderated with the procurement practices. The study was based on general systems theory. Pragmatism paradigm and convergent parallel mixed research design was adopted and proportionate stratified sampling was used to select a population of 234 consisting of judiciary staff, construction staff and consultants .Primary data was collected through use of questionnaires, interviews and document content analysis. Reliability was tested using Cronbach’s Alpha while data was analyzed using descriptive statistics which included measures of central tendency. Qualitative data was subjected to thematic analysis to triangulate results derived from quantitative data. Inferential statistics was analyzed by correlation, simple linear regression and multiple regression analysis. Two hypotheses were tested to establish whether there were significant relationships between project delivery attributes and implementation of building construction projects in the Kenyan Judiciary, namely 1.H 0 : User Involvement has no significant relationship with implementation of construction projects in the Kenyan Judiciary and 2.H 0 : There is a significant moderating influence of procurement practices on the relationship between user involvement and implementation of building construction projects in the Kenyan Judiciary. The findings were that there was a significant influence of user involvement on the implementation of construction projects in the Kenyan Judiciary and that procurement practices significantly moderated the relationship between user involvement and implementation of building construction projects in the Kenyan Judiciary. The slope coefficient was significant when p ≤0.05. The findings of the study will be beneficial to policy makers, project managers in public and private sectors and scholars regarding project delivery attributes on implementation of building construction projects. Keywords: User involvement, Procurement Practices and Implementation of Building Construction Projects. DOI: 10.7176/EJBM/13-18-12 Publication date: September 30 th 2021

Identifying individuals with multiple non-communicable disease risk factors in Kenya: a latent class analysis

ObjectivesNon-communicable diseases (NCDs) are the leading causes of death globally. In Kenya, the number of deaths resulting from NCDs is projected to surpass malaria and tuberculosis by 2030. Studies in Kenya show increasing NCDs; the aim of the present study is to examine the clustering of NCDs and risk factors in Kenya. Study designThis is a cross-sectional study using data from the 2015 Kenya STEPwise Survey. MethodsThis study examined relationships between NCDs (e.g. obesity, hypertension and diabetes) and health behaviours (e.g. sedentary activity, and fruit and vegetable consumption). Survey probability weights, which estimated the sampling design effect, were applied to consider the sampling units, and stratifications were used during sampling so that the results could be generalisable to the national adult Kenyan population. In total, 4350 adults were included in the study sample. ResultsOverall, 24.43% of participants were classified as having hypertension, 1.88% as having type 2 diabetes, and 27.94% were classified as being overweight or obese. The best-fit model was a four-class solution. Class 1 is best described as ‘young with high NCD risk’ and had the highest sedentary activity. Class 2 is best described as ‘poor rural with lower NCD risk’ with a high chance of smoking and alcohol consumption. Class 3 is best described as ‘rural with high NCD risk’ and had the highest fruit and vegetable consumption. Class 4 is best described as ‘wealthy young urban dwellers with high NCD risk’ with a high chance of alcohol consumption and smoking. Individuals in Class 4 had the highest chance (40%) of being overweight/obese, a 2% chance of type 2 diabetes and a 23% chance of having hypertension. ConclusionsNCDs are clustered in groups with high-risk behaviours. The group with the highest chance of having NCDs also had the highest chance of engaging in high-risk behaviours. The findings of this study suggest that smoking and alcohol consumption increase NCD risk in rural areas. Tailored and targeted interventions are needed to curb the increasing NCD prevalence in Kenya.

Quantifying water storage within the north of Lake Naivasha using sonar remote sensing and Landsat satellite data

Endorheic freshwater lakes can be vital water resources for sustaining large populations. However, their land-locked nature can lead to overexploitation and long-term sediment accumulation, reducing water storage and quality. Lake Naivasha supports a rapidly expanding population and agricultural industry. Therefore, maintaining good water storage and quality within this endorheic lake is crucial for the Kenyan economy and population. The lake has a long history of level fluctuations and the region is considered to be suffering from a chronic imbalance between water supply and demand.This study quantifies the sediment deposition rate and its impact on Lake Naivasha's water levels and volume, using inexpensive remote sensing techniques that could be easily replicated for future monitoring.Evidence of sedimentation in the northern area averaging 23 mm yr−1 was identified, which is likely annually displacing between 40.2 – 576 × 103 m³ of water. The volume displaced each year is equivalent to the water required to sustain between 40 – 1152 people. These results imply that current abstraction management, based purely upon lake level readings that govern a ‘traffic lights’ system, are detrimental to the long-term survival of the lake. The results also imply that lake health is decreasing. We recommend that future monitoring of this water resource and all endorheic lakes consider measurements of available water volume in combination with lake level data using the remote sensing methods we describe.

Optimization of a Loop-Mediated Isothermal Amplification Assay as a Point-of-Care Tool for the Detection of Wuchereria bancrofti in Human Blood in Tana River Delta, Kenya.

Introduction Accurate detection of filarial parasites in humans and vectors is essential for the implementation and evaluation of Global and National Programs to eliminate lymphatic filariasis. Immunological methods to detect infection are available; however, cross-reactivity issues have been reported in most of them. Nucleic acid-based molecular assays offer high levels of specificity and sensitivity and can be used to detect the infections. Methods In this study, we evaluated loop-mediated isothermal amplification (LAMP) tests to amplify Wuchereria bancrofti DNA in patients' blood. The amplicons were tested by both pH-sensitive dyes for enhanced visual detection and agarose gel electrophoresis. A closed-tube LAMP assay was also evaluated. Cohen's Kappa statistics was used for statistical analysis of the assays. 125 patients consented for blood sampling which were used for clinical analysis of LAMP assays with the PCR method used as the “gold standard.” Results The sensitivity of the evaluated Wuchereria bancrofti LAMP was 92.3%, with a specificity of 97.3% and kappa statistics value of 0.84, which is in a strong agreement. Conclusion In this study, LAMP assays coupled with fluorescence dye detection have been found to be suitable for diagnosis and monitoring of Wuchereria bancrofti infections in the Kenyan population.

The demand for a COVID-19 vaccine in Kenya

ABSTRACT The goal of achieving herd immunity to the coronavirus requires high vaccination acceptance levels on the part of the population. The objectives of this study were to: 1) Measure individuals’ willingness to pay (WTP) for a COVID-19 vaccine in Kenya; 2) evaluate the effect of vaccine characteristics (duration of protection and efficacy) and individuals’ socioeconomic variables on WTP, and 3) estimate the aggregate demand and economic value of a COVID-19 vaccine. The contingent valuation (CV) method was used as the basis for the analyses. Data for this study were obtained from a survey of 1,050 individuals in Kenya conducted from April 7 to April 15, 2020. The survey included CV questions using a double-bounded dichotomous choice format. Results reveal that most of the individuals in Kenya (at least 96%) were willing to accept a COVID-19 vaccine. Approximately 80% of individuals were willing to pay a positive amount. Conservative estimates of individuals’ mean WTP for the vaccine range from USD 49.81 to USD 68.25 (depending on vaccine characteristics). Both vaccine duration of protection and efficacy were found to influence WTP (p < .10). The perceived probability of being hospitalized, age, gender, education, location and region of residence, and household income were also found to be associated with WTP for the vaccine (p < .10). In conclusion, the COVID-19 vaccine is highly valued and accepted by the Kenyan population; however, a high percent of the population is unwilling to pay for it or is only willing to pay a low price.

Small Scale Maize Farmers Attitude towards Opinion Leaders in the Western Region of Kenya in the Agricultural Reform Era

Agricultural reforms in Kenya led to the government cutting down incentives to small scale farmers. These also coincided with reduction of agricultural extension staff hence farmers have to rely on advice from opinion leaders. The study looked at farmers’ attitude towards opinion leaders on maize farming in the western region of Kenya because maize is the main staple for most of the Kenyan population and Western Region is the food basket. The study used Ex-post facto research design via cross sectional survey. The counties were purposively selected to represent the Western Region of Kenya. Two sub-counties from each of the four Counties were selected by simple random sampling. Small scale farmers were selected from focal areas through systematic random sampling. Four key informants were sampled purposefully based on their positions of authority. In addition, 52 extension staffs were sampled through systematic random sampling. The small scale farmers were interviewed with the help of interview schedule containing both open and closed ended questions. Data were analyzed using descriptive statistics. The study revealed that a high percentage of respondents from all the study Counties agreed that what other farmers said about maize production helped them to invest in the enterprise. The study concluded that small scale farmers from all the Counties, were influenced by other farmers to invest in maize production. In addition most of the respondents always followed the recommendations given by the chief and other local leaders concerning agricultural production. The study recommended that extension staff use farmer groups and local leaders to ensure that the innovations are diffused to a large number of farmers.

A Cross-Sectional Study to Determine and Compare the Craniofacial Anthropometric Norms in a Selected Kenyan and Chinese Population.

Background: Craniofacial anthropometry provides essential data for diagnosis and treatment planning, with the norms for many races having been investigated. The results reveal that facial morphometry varies greatly because of geographical, ethnic, and racial variations. This study aims to gather the normative anthropometric data and compare the differences in facial morphometry between the Kenyan population and that of the Chinese. Methods: Four vertical measurements (trichion-nasion, nasion-subnasale, subnasale-gnathion, and superaurale-subaurale) and 6 horizontal measurements (zygion-zygion, exocanthion-endocanthion, endocanthion-endocanthion, pupil-pupil, alare-alare, and chelion-chelion) were obtained manually from subjects with no craniofacial abnormality. Results: A total of 180 participants (90 Kenyans and 90 Chinese) were included. Among the Kenyans, males generally had greater dimensions in comparison to the Kenyan females with the exception of the upper third, lower third, and intercanthal, and interpupillary distances. Among the Chinese, there was a significant difference between the 2 genders with the exception of intercanthal distance. All measurements were greater in Chinese males in comparison to the females. Comparison between races shows that Kenyans had greater vertical measurements with exception of the ear length for both genders. The Chinese males had increased facial width and intercanthal distance, while the Chinese females showed increased intercanthal distance compared to Kenyans. Kenyans exhibited hyperleptoprosopic-type face, while Chinese exhibited mesoprosopic-type face, with none of the 2 groups conforming to the neoclassical canons. Conclusion: Kenyans generally have greater craniofacial measurements versus Chinese, except for the facial width and intercanthal distance for males and interorbital distance for females.

Exploring women\u2019s childbirth experiences and perceptions of delivery care in peri-urban settings in Nairobi, Kenya

BackgroundKenya continues to have a high maternal mortality rate that is showing slow progress in improving. Peri-urban settings in Kenya have been reported to exhibit higher rates of maternal death during labor and childbirth as compared to the general Kenyan population. Although research indicates that women in Kenya have increased access to facility-based birth in recent years, a small percentage still give birth outside of the health facility due to access challenges and poor maternal health service quality. Most studies assessing facility-based births have focused on the sociodemographic determinants of birthing location. Few studies have assessed women’s user experiences and perceptions of quality of care during childbirth. Understanding women’s experiences can provide different stakeholders with strategies to structure the provision of maternity care to be person-centered and to contribute to improvements in women’s satisfaction with health services and maternal health outcomes.MethodsA qualitative study was conducted, whereby 70 women from the peri-urban area of Embakasi in the East side of Nairobi City in Kenya were interviewed. Respondents were aged 18 to 49 years and had delivered in a health facility in the preceding six weeks. We conducted in-depth interviews with women who gave birth at both public and private health facilities. The interviews were recorded, transcribed, and translated for analysis. Braune and Clarke’s guidelines for thematic analysis were used to generate themes from the interview data.ResultsFour main themes emerged from the analysis. Women had positive experiences when care was person-centered—i.e. responsive, dignified, supportive, and with respectful communication. They had negative experiences when they were mistreated, which was manifested as non-responsive care (including poor reception and long wait times), non-dignified care (including verbal and physical abuse lack of privacy and confidentiality), lack of respectful communication, and lack of supportive care (including being denied companions, neglect and abandonment, and poor facility environment).ConclusionTo sustain the gains in increased access to facility-based births, there is a need to improve person-centered care to ensure women have positive facility-based childbirth experiences.

Risk of Dysglycemia in Pregnancy amongst Kenyan Women with HIV Infection: A Nested Case-Control Analysis from the STRiDE Study

Introduction Gestational diabetes is a common complication, whose incidence is growing globally. There is a pressing need to obtain more data on GDM in low- and middle-income countries, especially amongst high-risk populations, as most of the data on GDM comes from high-income countries. With the growing awareness of the role HIV plays in the progression of noncommunicable diseases and the disproportionate HIV burden African countries like Kenya face, investigating the potential role HIV plays in increasing dysglycemia amongst pregnant women with HIV is an important area of study. Methods The STRiDE study is one of the largest ever conducted studies of GDM in Kenya. This study enrolled pregnant women aged between 16 and 50 who were receiving care from public and private sector facilities in Eldoret, Kenya. Within this study, women received venous testing for glycosylated hemoglobin (HbA1c) and fasting glucose between 8- and 20-week gestational age. At their 24-32-week visit, they received a venous 75 g oral glucose tolerance test (OGTT). Because of the pressing need to assess the burden of GDM within the population of pregnant women with HIV, a nested case-control study design was used. Pregnant women with HIV within the larger STRiDE cohort were matched to non-HIV-infected women within the STRiDE cohort at a 1 : 3 ratio based on body mass index, parity, family history of GDM, gestational age, and family history of hypertension. The measurements of glucose from the initial visit (fasting glucose and HbA1c) and follow-up visit (OGTT) were compared between the two groups of HIV+ cases and matched HIV- controls. Results A total of 83 pregnant women with HIV were well matched to 249 non-HIV-infected women from the STRiDE cohort with marital status being the only characteristic that was statistically significantly different between the two groups. Statistically significant differences were not observed in the proportion of women who developed GDM, the fasting glucose values, the HbA1c, or OGTT measurements between the two groups. Discussion. Significant associations were not seen between the different measures of glycemic status between pregnant women with and without HIV. While significant differences were not seen in this cohort, additional investigation is needed to better describe the association of dysglycemia with HIV, especially in Kenyan populations with a higher prevalence of GDM.