June 24, 2011 – Healthy schools improve national academic performance
PUPILS WHO STUDY IN SCHOOLS THAT, FOR INSTANCE, PROVIDE WATER AND SOAP ARE MORE LIKELY TO WASH HANDS THAN THOSE IN SCHOOLS THAT DO NOT HAVE THE FACILITIES
NAIROBI (Xinhua) — Schools that promote a healthy learning environment for pupils help to improve their academic performances, a team of researchers has said.
The researchers said such schools, among other things, ensure that the institutions have access to water and sanitation facilities and teachers engage pupils frequently on discussions about health.
This promotes teaching and learning thus increasing student’s chances of excelling in their academics.
The researchers from the Nairobi-based African Population and Health Research Center (APHRC) worked with 22 primary schools in two informal settlements in Nairobi, Kenya under an initiative dubbed Health Promoting Schools ( HPS ).
May 18, 2011 – Affordable healthcare systems boost safe motherhood for poor
When Zacharia Rombo and Samuel Agutu came together in 2008, the mission was simple — to develop a system that embraces technology to provide affordable healthcare.
This was informed by past experiences in their careers as chartered insurer and accountant respectively.
The result of this union was the birth of Changamka Micro Health Limited, a private company in the business of health insurance that targets the poor.
“It was after realising that not more than 10 per cent of Kenyans are insured under health schemes that we decided to go this way. The purpose was to get the uninsured poor who are the majority in the population, to a position to plan and afford medical care,” says Mr Rombo.
At the beginning, the initial focus was on general healthcare.
However, this has since changed to include safe maternal healthcare targeting 60 per cent of Kenyan women who deliver outside medical facilities.
Today, Changamka Micro Health is known for its popular smart card — the Changamka card — which allows members to save in advance for medical expenses to cover inpatient and outpatient services.
Unlike the common insurance schemes that restrict members to certain amounts of premiums for specified values of medical cover, the smart card allows for flexible contributions.
Glob Public Health. 2011 Apr;6(3)
Discourses of illegality and exclusion: when water access matters.
Mudege NN. African Population and Health Research Center, Shelter Afrique Center, Nairobi, Kenya. firstname.lastname@example.org
This paper examines the politics and the underlying discourses of water provisioning and how residents of Korogocho and Viwandani slum settlements in Nairobi city cope with challenges relating to water access. We use qualitative data from 36 focus group discussions conducted in the two slums to unravel discourses regarding water provisioning in the rapidly growing slum settlements in African cities. Results show that the problems concerning water provisioning within Nairobi slums are less about water scarcity and more about unequal distribution and the marginalisation of slum areas in development plans.
Poor water management, lack of equity-based policies and programmes, and other slum-specific features such as land-tenure systems and insecurity exacerbate water-supply problems within slum areas. It is hard to see how water supply in these communities can improve without the direct and active involvement of the government in infrastructural development and oversight of the water-supply actors. Innovative public-private partnerships in water provision and the harnessing of existing community efforts to improve the water supply would go a long way towards improving the water supply to the rapidly growing urban poor population in Africa.
J Urban Health. 2010 Oct 14.
Food Security and Nutritional Outcomes among Urban Poor Orphans in Nairobi, Kenya.
Kimani-Murage EW, Holding PA, Fotso JC, Ezeh AC, Madise NJ, Kahurani EN, Zulu EM.
African Population and Health Research Center, P.O. Box 10787, 00100, Nairobi, Kenya, email@example.com.
The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya.
At the recently constructed semi-permanent Canna Medical Centre in Viwandani slums, Nairobi, Grace Nyambonyi and her baby girl Mary, have come for one of their final post-natal visits.
The happy baby plays on her mother’s lap as the latter chats with Penninah Nyamboke, a friend who has accompanied them.
Ms Nyambonyi and Ms Nyamboke are residents of one of the many slums dotting the city, this one being home to approximately 42,000 residents.
Unlike hundreds of other children born in the slums, Mary was not delivered at home under unsafe conditions, thanks to the Safe Motherhood (SMH) voucher that covered the delivery costs at the health centre.
Ms Nyambonyi is one among hundreds of women in Kenya who have benefited from donor supported programs that have successfully boosted health care provision to the poor.
The government is now duplicating such models in developing health financing policy and designing strategies for facilities through performance based funding.
Ms Nyambonyi’s voucher, purchased for Sh200 under the Output Based Approach (OBA) pilot program — a Kenya Government initiative supported by the German Financial Cooperation, Kfw — has given her access to free pre and post-natal clinic visits at a health centre of her choice throughout her pregnancy.
Emergency expenses such as complications and referrals to larger hospitals are also catered for under the program.
The expectant mothers also receive food rations consisting of seven kilograms of corn soya and a litre of cooking oil at each visits courtesy of the World Food Program, to help them at a time when they are not able to work.
“This program has been very helpful because we deliver safely, complications are treated quickly and our babies are healthy” said Ms Nyambonyi.
She was allowed to purchase the voucher after staff hired by the Voucher Management Agency (VMA) – a private firm that manages this program — visited her house and gave her a chance to carry her pregnancy to term and deliver safely under a skilled health official, reducing the risk of complications that sometimes results in a lifetime of infections and even death.
“When mothers deliver at home, screening for HIV cannot be done, use of unsterilized implements leads to infection and birth notification forms are not available” said Mr Joseph Mambo, Director at Canna Medical Centre.
Ms Nyambonyi also has to certify on claim forms that are processed by VMA that she received satisfactory service before payment is made to the health facility — something new in the provision of health services.
Under a Kfw supported pilot project and similar UNICEF supported program in North Eastern Province, the low cost of the vouchers has led to increased health facility deliveries and uptake of family planning methods, an indication that high costs hinder the poor from accessing health care.
There has also been behavioural change with more women choosing to go to hospital for treatment of other ailments.
Am J Trop Med Hyg. 2009 Nov;81(5):770-5.
Seasonal pattern of pneumonia mortality among under-five children in Nairobi’s informal settlements.
Ye Y, Zulu E, Mutisya M, Orindi B, Emina J, Kyobutungi C. African Population and Health Research CenterAPHRC, Nairobi, Kenya. firstname.lastname@example.org
Using longitudinal data from the Nairobi Urban and Demographic Surveillance System (NUHDSS), we examined the seasonal pattern of pneumonia mortality among under-five children living in Nairobi’s slums. We included 17,787 under-five children resident in the NUHDSS from January 1, 2003 to December 31, 2005 in the analysis. Four hundred thirty-six deaths were observed and cause of death was ascertained by verbal autopsy for 377 of these deaths. Using Poisson regression, we modeled the quarterly mortality risk for pneumonia. The overall person-years (PYs) were 21,804 giving a mortality rate of 20.1 per 1,000 PYs in the study population.
Pneumonia was the leading cause of death contributing 25.7% of the total deaths. Pneumonia mortality was highest in the second quarter (risk ratio [RR] = 2.3, confidence interval [CI]: 1.2-4.2 compared with the fourth quarter). The study provides evidence that pneumonia-related mortality among under-fives in Nairobi’s slums is higher from April to June corresponding to the rainy season and the beginning of the cold season.
Trop Med Int Health. 2009 Nov 2.
Is mortality among under-five children in Nairobi slums seasonal?
Mutisya M, Orindi B, Emina J, Zulu E, Ye Y. African Population and Health Research Center, Nairobi, Kenya.
Objective: To investigate the seasonal pattern of overall mortality among children aged below 5 years living in two informal settlements in Nairobi City.
Methods: We used data collected from January 2003 to December 2005 in the Nairobi Urban Health and Demographic Surveillance System on demographic events (birth, death, and migration). Analyses of seasonal effects on under-five mortality are based on Poisson regression controlling for sex, age, study site and calendar year.
Results: During the study period, there were 17 878 children below 5 years in the study sites. Overall 436 under-five deaths were recorded. The overall death rate for the under-five children was 19.95 per 1 000 person years. There is a significant seasonal variation of under-five mortality. The mortality risk was significantly higher in the second and third quarters of year than in the fourth quarter (RR = 1.6, CI: 1.3-2.2 and RR = 1.5, CI: 1.1-2.0).
Conclusion: This paper demonstrates that overall mortality among under-five children in the urban poor is seasonal. Overall during the second quarter of the year, the death rate increases by nearly twofold. This evidence generated here may help to support well targeted interventions in reducing under-five mortality in the slums.