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Kimani-Murage E.W.,African Population and Health Research Center | Fotso J.C.,Concern Worldwide | Egondi T.,African Population and Health Research Center | Abuya B.,African Population and Health Research Center | And 4 more authors.
Health and Place | Year: 2014

Background: We describe trends in childhood mortality in Kenya, paying attention to the urban-rural and intra-urban differentials. Methods: We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). Results: Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban-rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. Conclusions: The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums. © 2014 Elsevier Ltd. Source

McCallion P.,Concern Worldwide
Appropriate Technology | Year: 2012

Technology systems made in the developing world offer much more scope to enhance technologies and add a long term, more sustainable result. With electrical installations such as micro hydro, generators, photovoltaic in schools and clinics, critical severs and inverter systems, there needs to be a good low resistant system for making an electrical connection to the earth which is essential for user safety and equipment integrity. Across Africa and Asia, information and know-how on all aspects of earthing is long established. In most regions local electricians or technicians will augment the earthing process, using locally trusted solutions. These solutions may seem unusual. When these materials are mixed with the soil and water, a highly effective low resistance earth can be created. This method is an artificial process, maintenance is required and the entire process will have to be repeated every five years. Source

Bliss J.R.,Cornell University | Njenga M.,Concern Worldwide | Stoltzfus R.J.,Cornell University | Pelletier D.L.,Cornell University
Maternal and Child Nutrition | Year: 2016

Acute malnutrition affects millions of children each year, yet global coverage of life-saving treatment through the community-based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid-upper arm circumference of the child: normal status (n=327), moderate acute malnutrition (MAM, n=241) and severe acute malnutrition (SAM, n=143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66-8.03, P<0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under-recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition-associated stigma and adopt effective means of de-stigmatization. © 2016 John Wiley & Sons Ltd. Source

Speizer I.S.,University of North Carolina at Chapel Hill | Fotso J.C.,Concern Worldwide | Okigbo C.,University of North Carolina at Chapel Hill | Faye C.M.,University of North Carolina at Chapel Hill | And 2 more authors.
BMC Public Health | Year: 2013

Background: Although the majority of postpartum women indicate a desire to delay a next birth, family planning (FP) methods are often not offered to, or taken up by, women in the first year postpartum. This study uses data from urban Senegal to examine exposure to FP information and services at the time of delivery and at child immunization appointments and to determine if these points of integration are associated with greater use of postpartum FP. Methods. A representative, household sample of women, ages 15-49, was surveyed from six cities in Senegal in 2011. This study focuses on women who were within two years postpartum (n = 1879). We also include women who were surveyed through exit interviews after a visit to a high volume health facility in the same six cities; clients included were visiting the health facility for delivery, post-abortion care, postnatal care, and child immunization services (n = 794). Descriptive analyses are presented to examine exposure to FP services among postpartum women and women visiting the health facility. Logistic regression models are used to estimate the effect of integrated services on postpartum FP use in the household sample of women. Analyses were conducted using Stata version 12. Results: Among exit interview clients, knowledge of integrated services is high but only a few reported receiving FP services. A majority of the women who did not receive FP services indicated an interest in receiving such information and services.Among the household sample of women up to two-years postpartum, those who received FP information at the time of delivery are more likely to be using modern FP postpartum than their counterparts who also delivered in a facility but did not receive such information. Exposure to FP services at an immunization visit was not significantly related to postpartum FP use. Another key finding is that women with greater self-efficacy are more likely to use a modern FP method. Conclusion: This study's findings lend strong support for the need to improve integration of FP services into maternal, newborn, and child health services with the goal of increasing postpartum women's use of FP methods in urban Senegal. © 2013 Speizer et al.; licensee BioMed Central Ltd. Source

Hoy D.G.,University of Queensland | Rickart K.T.,Child Protection Unit | Durham J.,Curtin University Australia | Puntumetakul R.,Khon Kaen University | And 3 more authors.
Disability and Rehabilitation | Year: 2010

Purpose. Disability has an enormous impact throughout the world. An increasing amount of important disability research and practice is being undertaken in low-income settings; however, success and sustainability of programmes in these contexts can often be challenging. We share lessons from our experiences. Method. We reviewed past literature and international consensus statements relating to disability and development practice. We then held several face to face and email discussions to document the key lessons we have learnt from working in this context. We report on these in this paper. Results. The key lessons are to invest adequate time and develop trusting relationships, undertake sufficient consultation and collaboration, include and empower persons with disability, and view capacity building as a two-way process. Conclusions. Improving the lives of persons with disability in development contexts is likely to be best achieved through processes that are inclusive, owned and driven by local communities. © 2010 Informa UK Ltd. Source

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