Publications

Street-connected young people carry a disproportionate burden of morbidities, and engage in a variety of practices that may heighten their risk of premature mortality, yet there are currently no reports in the literature on the rates or risk factors for mortality among them, nor on their causes of death. In low- and middle-income countries they are frequently in situations that violate their human rights, likely contributing to their increased burden of morbidities and vulnerability to mortality. We thus sought to describe the number of deaths annually, causes of death, and determine the number of deaths attributable to HIV among street-connected young people aged 0 to 30 years in Eldoret, Kenya.

Jamii ina mikakati mbalimbali ambayo hutumika wakati wa mazungumzo. Mikakati hiyo ni ya upole na ina kanuni kadhaa kuhusu namna ya kuwasiliana. Upole ni utambuzi ambao mtu humwonyesha mwingine kwa kuzingatia au kuepuka kaida au desturi fulani za mazungumzo. Ni hali ya kuonyesha heshima kwa washiriki wengine katika mazungumzo. Mikakati ya upole ni mbinu wanazobuni na kuzingatia wahusika wa mazungumzo ili ‘kuokoa nyuso’ zao. Makala haya yalinuia kuchanganua changamoto zinazosawiriwa na wahusika wa mazungumzo ya Sobetab Kapchi (Maisha ya Jamii) wakati wa utekelezaji wa kanuni za upole. Uchunguzi uliongozwa na Nadharia ya Upole, hasa mhimili wa ‘kuokoa uso’, kama ilivyopendekezwa na Brown na Levinson. Sampuli iliteuliwa kimakusudi kwa kunasa vipindi vinne vya Sobetab Kapchi (SK) ili kupata data za uchanganuzi. Mwisho, hoja zinazohusiana na upole zilinakiliwa na kuwekwa kwenye makundi manne ya mikakati ya upole ili kuchanganuliwa. Makundi hayo ni ya mkakati wa kuwa kwenye rekodi, mkakati wa upole chanya, mkakati wa upole hasi na mkakati wa kuwa nje ya rekodi. Uchanganuzi wa data ulifanywa kimaelezo kwa kutumia mazungumzo ya washiriki kama mifano halisi. Matokeo ya utafiti yalionyesha kuwa wahusika wa mazungumzo ya SK hukumbana na changamoto nyingi wanapotekeleza mikakati ya upole wakati wa mazungumzo.

More than 95% of Kenyan women receive antenatal care (ANC) and only 62% access skilled delivery. To explore women's opinion on delivery location, 20 focus group discussions were conducted at an urban and rural setting in western Kenya. Participants included health care workers, traditional birth attendants (TBAs), and women who attended at least four ANC visits and delivered. Six in-depth interviews were also conducted with a combination of women who gave birth in a facility and at home. Discussions were digitally recorded and transcribed for analysis. Data was subjected to content analysis for deductive and inductive codes. Emergent themes were logically organized to address the study topic. Findings revealed that delivery services were sought from both skilled attendants and TBAs. TBAs remain popular despite lack of acknowledgement from mainstream health care. Choice of delivery is influenced by financial access, availability and quality of skilled delivery services, physical access, culture, ignorance about childbirth processes, easy access to familiar TBAs, fear of hospitals and hospital procedures, and social stigma. Appreciation of TBA referral role, quality maternity service, and reproductive health education can encourage facility deliveries. Formal and informal health workers should cooperate in innovative ways and ensure safe motherhood in Kenya.

Voluntary medical male circumcision (VMMC) is a critical component of HIV prevention. VMMC policies have achieved initial targets in adult men yet continue to fall short in reaching younger men and adolescents.