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Muthiru AW, Bukachi SA. Male involvement in maternal and child nutrition in low-income informal settlements, Nairobi, Kenya. J Health Popul Nutr 2024; 43:47. [PMID: 38576056 PMCID: PMC10993492 DOI: 10.1186/s41043-023-00476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/18/2023] [Indexed: 04/06/2024]
Abstract
BACKGROUND Maternal and child nutrition is a significant public health concern because adequate nutrition is essential for the health, development, and well-being of mothers and children. Men can play a critical role in improving maternal and child health, including through their involvement in the nutrition of the mother and child. However, little has been studied on male involvement in maternal and child nutrition; therefore, this qualitative exploratory study focused on the level of male involvement and factors influencing male involvement in maternal and child nutrition in low-income urban informal settings. METHODS Qualitative data collection methods were triangulated in the exploratory study to inform the study objectives. In-depth interviews (IDIs) were conducted with 30 men and 20 women based on the inclusion criteria that they have children aged between 6 and 23 months. An additional 10 key informant interviews with stakeholders in nutrition within the study setting were also carried out. Data from the qualitative interviews were captured in audio files with informed consent and permission to record from the study participants. The interviews were transcribed and translated into English transcripts for coding and analysis. Themes were derived from the five levels of the socio-ecological model of human behavior, namely, (i) individual factors; (ii) interpersonal factors; (iii) community factors; (iv) institutional factors guided the analysis. RESULTS Findings from the study revealed that personal beliefs and values, the nature of work, mistrust and stigma and discrimination, and the association clinic visits with HIV testing, were some of the factors that influenced male involvement in maternal and child nutrition. CONCLUSION It is important to recognize the potential value of research on the role of men in maternal and child nutrition and to identify ways to overcome the barriers to their involvement. By better understanding the factors that influence male involvement in maternal and child nutrition and the impact of this involvement on maternal and child nutrition, it may be possible to develop more effective interventions to promote the nutritional well-being of mothers and children.
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Affiliation(s)
- Ann W Muthiru
- Department of Anthropology, Gender, and African Studies (DAGAS), University of Nairobi (UON), Nairobi, Kenya.
| | - Salome A Bukachi
- Department of Anthropology, Gender, and African Studies (DAGAS), University of Nairobi (UON), Nairobi, Kenya
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Mettenleiter TC, Markotter W, Charron DF, Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Becerra NC, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Hayman DTS, Khaitsa M, Koopmans MPG, Machalaba C, Mackenzie JS, Morand S, Smolenskiy V, Zhou L. Correction: The One Health High-Level Expert Panel (OHHLEP). One Health Outlook 2024; 6:6. [PMID: 38539273 PMCID: PMC10976718 DOI: 10.1186/s42522-024-00096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Affiliation(s)
- Thomas C Mettenleiter
- Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany.
| | - Wanda Markotter
- Center for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | | | | | - Salama Almuhairi
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
| | | | - Pépé Bilivogui
- World Health Organization, Guinea Country Office, Conakry, Guinea
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Natalia Casas
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
| | | | | | - Janice R Ciacci Zanella
- Brazilian Agricultural Research Corporation, Embrapa Swine and Poultry, Concórdia, Santa Catarina, Brazil
| | | | - Osman Dar
- Global Operations Division, United Kingdom Health Security Agency, London, UK
| | - Nitish Debnath
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
| | - Baptiste Dungu
- Faculty of Veterinary Science, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Elmoubasher Farag
- Ministry of Public Health, Health Protection & Communicable Diseases Division, Doha, Qatar
| | - George F Gao
- Institute of Microbiology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - David T S Hayman
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | | | | | | | - John S Mackenzie
- Faculty of Health Sciences, Curtin University, Perth, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | | | - Vyacheslav Smolenskiy
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russian Federation
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
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3
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Bardosh K, Guinto RR, Bukachi SA, Minh Hang T, Bongcac MK, de Los Santos MYM, Mburu CM, Abela J, Kelly D, Maller C. Correction: Wet market biosecurity reform: Three social narratives influence stakeholder responses in Vietnam, Kenya, and the Philippines. PLOS Glob Public Health 2024; 4:e0002859. [PMID: 38236799 PMCID: PMC10796023 DOI: 10.1371/journal.pgph.0002859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
[This corrects the article DOI: 10.1371/journal.pgph.0001704.].
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Majiwa H, Bukachi SA, Omia D, Fèvre EM. Knowledge, perceptions, and practices around zoonotic diseases among actors in the livestock trade in the Lake Victoria crescent ecosystem in East Africa. Front Public Health 2024; 11:1199664. [PMID: 38264255 PMCID: PMC10805025 DOI: 10.3389/fpubh.2023.1199664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
Background Zoonotic diseases such as anthrax, rabies, brucellosis, and Rift Valley fever pose a direct threat to health and undercut livelihoods in the communities in which they occur. A combination of anthropogenic and animal activities like migration and interaction with wildlife and their respective parasites and vectors drives the emergence and re-emergence of zoonotic diseases. Consequently, One Health interdisciplinary approaches that incorporate social scientists can provide key insights into complex local perceptions. The approach calls for collaboration between the human and animal health sectors, including the sharing of disease surveillance data necessary to alleviate disease impacts. Livestock traders interact closely with livestock, which puts them at elevated risk of infection and creates conditions by which they may spread zoonotic disease. It is thus essential to examine practices among actors involved in the livestock trade to understand the most appropriate ways to mitigate these risks. Methods A qualitative study was conducted among the actors in the livestock trade in Busia County on their knowledge and perceptions of zoonotic diseases and practices that may contribute to the spread, control, and prevention of zoonotic disease transmission. A thematic analysis framework was used to categorize and synthesize data from in-depth interviews (IDIs), key informant interviews (KIIs), and structured observations. Results Whereas participants could list livestock diseases, they could not identify which ones were zoonoses, demonstrating insufficient knowledge of zoonosis. They identify sick animals by checking for dropped ears, excess mucus production, diarrhea, bloody urinal discharge, and general animal activity levels. To prevent the spread of these diseases, they wash their animals, isolate sick animals from the rest of the stock, and vaccinate their animals. They seek help from animal health professionals for sick animals as part of curative practices. This shows that they perceive the diseases as serious and that they need to be attended to by professionals. The results also show that they perceive animals from outside the region to be more vulnerable to diseases compared to those from within. The actors in the livestock trade engage in practices like skinning dead animals before burying them; to them, this is a normal practice. Some also consume dead carcasses. These increase the risk of zoonotic disease transmission. Conclusion The actors involved in the livestock trade are critical in the prevention and elimination of zoonotic diseases; hence, they need to be involved when developing intervention programs and policies for animal health extension services. Training them as a continuum of animal health workers blends lay and professional knowledge, which, alongside their intense contact with large numbers of animals, becomes a critical disease surveillance tool. Increasing awareness of zoonoses by using multi-disciplinary teams with social scientists is urgently needed so that practices like skinning dead animals before disposing of them and consumption of dead carcasses can be minimized.
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Affiliation(s)
- Hamilton Majiwa
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Dalmas Omia
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
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Mettenleiter TC, Markotter W, Charron DF, Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Becerra NC, Chaudhary A, Zanella JRC, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Hayman DTS, Khaitsa M, Koopmans MPG, Machalaba C, Mackenzie JS, Morand S, Smolenskiy V, Zhou L. The One Health High-Level Expert Panel (OHHLEP). One Health Outlook 2023; 5:18. [PMID: 38062534 PMCID: PMC10704771 DOI: 10.1186/s42522-023-00085-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Affiliation(s)
- Thomas C Mettenleiter
- Friedrich-Loeffler-Institut, Bundesforschungsinstitut Für Tiergesundheit, Federal Research Institute for Animal Health, Südufer 10, Greifswald, 17493, Insel Riems, Germany.
| | - Wanda Markotter
- Center for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Dominique F Charron
- Visiting Professor, One Health Institute, University of Guelph, Guelph, ON, Canada
| | | | - Salama Almuhairi
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
| | | | - Pépé Bilivogui
- World Health Organization, Guinea Country Office, Conakry, Guinea
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenia
| | - Natalia Casas
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
| | | | | | - Janice R Ciacci Zanella
- Brazilian Agricultural Research Corporation, Embrapa Swine and Poultry, Concórdia, Santa Catarina, Brazil
| | | | - Osman Dar
- Global Operations Division, United Kingdom Health Security Agenca, London, UK
| | - Nitish Debnath
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
| | - Baptiste Dungu
- Faculty of Veterinary Science, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Elmoubasher Farag
- Ministry of Public Health, Health Protection & Communicable Diseases Division, Doha, Qatar
| | - George F Gao
- Institute of Microbiology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - David T S Hayman
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | | | | | | | - John S Mackenzie
- Faculty of Health Sciences, Curtin University, Perth, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | | | - Vyacheslav Smolenskiy
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russian Federation
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
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Hayman DT, Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Becerra NC, Charron DF, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Khaitsa M, Machalaba C, Mackenzie JS, Markotter W, Mettenleiter TC, Morand S, Smolenskiy V, Zhou L, Koopmans M. Developing One Health surveillance systems. One Health 2023; 17:100617. [PMID: 38024258 PMCID: PMC10665171 DOI: 10.1016/j.onehlt.2023.100617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 12/01/2023] Open
Abstract
The health of humans, domestic and wild animals, plants, and the environment are inter-dependent. Global anthropogenic change is a key driver of disease emergence and spread and leads to biodiversity loss and ecosystem function degradation, which are themselves drivers of disease emergence. Pathogen spill-over events and subsequent disease outbreaks, including pandemics, in humans, animals and plants may arise when factors driving disease emergence and spread converge. One Health is an integrated approach that aims to sustainably balance and optimize human, animal and ecosystem health. Conventional disease surveillance has been siloed by sectors, with separate systems addressing the health of humans, domestic animals, cultivated plants, wildlife and the environment. One Health surveillance should include integrated surveillance for known and unknown pathogens, but combined with this more traditional disease-based surveillance, it also must include surveillance of drivers of disease emergence to improve prevention and mitigation of spill-over events. Here, we outline such an approach, including the characteristics and components required to overcome barriers and to optimize an integrated One Health surveillance system.
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Affiliation(s)
- One Health High-Level Expert Panel (OHHLEP)
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
- University of Indonesia, West Java, Indonesia
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
- Centres for Disease Control and Prevention, Atlanta, GA, United States of America
- World Health Organization, Guinea Country Office, Conakry, Guinea
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
- School of Agricultural Sciences, Universidad de La Salle, Bogotá, Colombia
- Visiting Professor, One Health Institute, University of Guelph, Guelph Ontario, Canada
- Department of Civil Engineering, Indian Institute of Technology (IIT) Kanpur, India
- Brazilian Agricultural Research Corporation (Embrapa), Embrapa Swine and Poultry, Santa Catarina, Brazil
- Institute of Zoology, Zoological Society of London, United Kingdom
- Global Operations Division, United Kingdom Health Security Agency, London, United Kingdom
- Global Health Programme, Chatham House, Royal Institute of International Affairs, London, United Kingdom
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
- One Health, Bangladesh
- Afrivet B M, Pretoria, South Africa
- Qatar Ministry of Public Health (MOPH), Health Protection & Communicable Diseases Division, Doha, Qatar
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- Mississippi State University, Starkville, MS, United States of America
- EcoHealth Alliance, New York, United States of America
- Faculty of Health Sciences, Curtin University, Perth, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Centre for Viral Zoonoses, Department of Medical Virology, University of Pretoria, South Africa
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Germany
- MIVEGEC, CNRS-IRD-Montpellier, Montpellier University, Montpelier, France
- Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
- Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation
- Erasmus MC, Department of Viroscience, Rotterdam, the Netherlands
| | - David T.S. Hayman
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | | | - Salama Almuhairi
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
| | | | - Pépé Bilivogui
- World Health Organization, Guinea Country Office, Conakry, Guinea
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Natalia Casas
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
| | | | - Dominique F. Charron
- Visiting Professor, One Health Institute, University of Guelph, Guelph Ontario, Canada
| | - Abhishek Chaudhary
- Department of Civil Engineering, Indian Institute of Technology (IIT) Kanpur, India
| | - Janice R. Ciacci Zanella
- Brazilian Agricultural Research Corporation (Embrapa), Embrapa Swine and Poultry, Santa Catarina, Brazil
| | | | - Osman Dar
- Global Operations Division, United Kingdom Health Security Agency, London, United Kingdom
- Global Health Programme, Chatham House, Royal Institute of International Affairs, London, United Kingdom
| | - Nitish Debnath
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
- One Health, Bangladesh
| | | | - Elmoubasher Farag
- Qatar Ministry of Public Health (MOPH), Health Protection & Communicable Diseases Division, Doha, Qatar
| | - George F. Gao
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Margaret Khaitsa
- Mississippi State University, Starkville, MS, United States of America
| | | | - John S. Mackenzie
- Faculty of Health Sciences, Curtin University, Perth, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, University of Pretoria, South Africa
| | | | - Serge Morand
- MIVEGEC, CNRS-IRD-Montpellier, Montpellier University, Montpelier, France
- Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
| | - Vyacheslav Smolenskiy
- Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Marion Koopmans
- Erasmus MC, Department of Viroscience, Rotterdam, the Netherlands
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Markotter W, Mettenleiter TC, Adisasmito WB, Almuhairi S, Barton Behravesh C, Bilivogui P, Bukachi SA, Casas N, Cediel Becerra N, Charron DF, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Hayman DTS, Khaitsa M, Koopmans MPG, Machalaba C, Mackenzie JS, Morand S, Smolenskiy V, Zhou L. Prevention of zoonotic spillover: From relying on response to reducing the risk at source. PLoS Pathog 2023; 19:e1011504. [PMID: 37796834 PMCID: PMC10553309 DOI: 10.1371/journal.ppat.1011504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Affiliation(s)
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Thomas C. Mettenleiter
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | | | - Salama Almuhairi
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
| | | | - Pépé Bilivogui
- World Health Organization, Guinea Country Office, Conakry, Guinea
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Natalia Casas
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
| | | | - Dominique F. Charron
- Visiting Professor, One Health Institute, University of Guelph, Guelph, Ontario, Canada
| | - Abhishek Chaudhary
- Department of Civil Engineering, Indian Institute of Technology (IIT), Kanpur, India
| | - Janice R. Ciacci Zanella
- Brazilian Agricultural Research Corporation (Embrapa), Embrapa Swine and Poultry, Concórdia/SC, Brazil
| | | | - Osman Dar
- Global Operations Division, United Kingdom Health Security Agency, London, United Kingdom
- Global Health Programme, Chatham House, Royal Institute of International Affairs, London, United Kingdom
| | - Nitish Debnath
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
| | - Baptiste Dungu
- Onderstepoort Biological Products SOC (OBP), Afrivet, B M, Pretoria, South Africa
- Faculty of Veterinary Science, University of Kinshasa, Kinshasa, DR Congo
| | - Elmoubasher Farag
- Ministry of Public Health, Health Protection & Communicable Diseases Divison, Doha, Qatar
| | - George F. Gao
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - David T. S. Hayman
- Molecular Epidemiology and Public Health Laboratory, Massey University, Palmerston North, New Zealand
| | - Margaret Khaitsa
- Mississippi State University, Starkville, Mississippi, United States of America
| | | | | | | | - Serge Morand
- IRL HealthDEEP, CNRS - Kasetsart University - Mahidol University, Bangkok, Thailand
| | - Vyacheslav Smolenskiy
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russian Federation
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
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Bardosh K, Guinto RR, Bukachi SA, Hang TM, Bongcac MK, de los Santos MYM, Mburu CM, Abela J, Kelly D, Maller C. Wet market biosecurity reform: Three social narratives influence stakeholder responses in Vietnam, Kenya, and the Philippines. PLOS Glob Public Health 2023; 3:e0001704. [PMID: 37672556 PMCID: PMC10482282 DOI: 10.1371/journal.pgph.0001704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/26/2023] [Indexed: 09/08/2023]
Abstract
In 2020, Covid-19 led to global policy statements promoting bans and reforms to wet markets in Asia and Africa to prevent future pandemics. We conducted a comparative, exploratory qualitative study in 2021 in three countries (Kenya, Vietnam and the Philippines) to understand the social and political dimensions to biosecurity reform at wet markets. This included 60 key informant interviews and rapid ethnographic research in 15 markets, as well as a review of policy documents and online media articles. We found no evidence that the rhetoric of pandemic spillover that emerged in 2020 had any influence on policy or reform efforts apart from those related to Covid-19 infection control. Rather, we identified three main narratives that frame the problem of biosecurity and preferences for reform. The first, a human health narrative, questioned global framings about pandemic risk, viewed markets as sources for food security rather than disease, emphasized the need to strengthen the control of endemic diseases, and conceptualized health through the lens of 'freshness' rather than biomedical categories. A second modernization narrative approached biosecurity as part of a broader process of socio-economic development that emphasized infrastructural gaps, spatial arrangements, cleanliness and a conflict between reform and economic interests. A third narrative centered on local livelihoods and the tension between local market stakeholders and biosecurity and modernization efforts. This final narrative called into question the appropriateness of certain regulations and policies, including bans and closures, emphasized the importance of preserving cultural heritage and highlighted the need for collective political action to resist certain veterinary policies. In conclusion, wet market biosecurity strategies occur in the context of three contrasting narratives that emphasize different aspects of health and risk, and reflect different worldviews and interests. Within this context, there is a need for local government to strengthen market management and biosecurity in ways that enhance the agency of market stakeholders and strengthen local livelihoods and food security as part of a pluralistic and democratic politics.
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Affiliation(s)
- Kevin Bardosh
- School of Public Health, University of Washington, Seattle, Washington, United States of America
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Urban Research, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Renzo R. Guinto
- Planetary and Global Health Program, St. Luke’s Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi’, Kenya
| | - Tran Minh Hang
- Institute of Anthropology, Vietnam Academy of Social Sciences, Hanoi, Vietnam
| | - Marianne K. Bongcac
- Planetary and Global Health Program, St. Luke’s Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
| | - Mara Ysabella M. de los Santos
- Planetary and Global Health Program, St. Luke’s Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
| | - Caroline M. Mburu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi’, Kenya
- Department of Social Anthropology, University of St Andrews, St Andrews, United Kingdom
| | - Jackielyn Abela
- Palawan State University, Puerto Princesa, Palawan, Philippines
| | - David Kelly
- Centre for Urban Research, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Cecily Maller
- Centre for Urban Research, Royal Melbourne Institute of Technology, Melbourne, Australia
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Blake CE, Monterrosa EC, Rampalli KK, Khan ANS, Reyes LI, Drew SD, Dominguez-Salas P, Bukachi SA, Ngutu M, Frongillo EA, Iruhiriye E, Girard AW. Basic human values drive food choice decision-making in different food environments of Kenya and Tanzania. Appetite 2023; 188:106620. [PMID: 37271253 PMCID: PMC10423943 DOI: 10.1016/j.appet.2023.106620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Increased access to a variety of foods in low-and-middle-income countries (LMICs) has led to greater autonomy in food choice decision-making. Autonomy allows individuals to make decisions through negotiation of considerations in ways that are consistent with basic values. The aim of this study was to identify and describe how basic human values drive food choice in two diverse populations with transitioning food environments living in the neighboring East African countries of Kenya and Tanzania. Secondary data analysis was carried out on focus group discussions conducted with men and women in Kenya (n = 28) and Tanzania (n = 28) as part of prior studies on food choice. A priori coding based on Schwartz's theory of basic human values was conducted, followed by a narrative comparative analysis, which included review by original principal investigators. Values of conservation (security, conformity, tradition), openness to change (self-directed thought and action, stimulation, indulgence), self-enhancement (achievement, power, face), and self-transcendence (benevolence-dependability and -caring) were prominent drivers of food choice in both settings. Participants described how values were negotiated and highlighted existing tensions. For example, the value of tradition was cited as important in both settings but changing food contexts (e.g., new foods, diverse neighborhoods) increased prioritization of values like stimulation, indulgence, and self-directed thought and action. The application of a basic values framework was useful for understanding food choice in both settings. A focused understanding of how values drive food choice decision-making in the context of changing food availability in LMICs is essential for the promotion of sustainable healthy diets.
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Affiliation(s)
- Christine E Blake
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Eva C Monterrosa
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202, Geneva, Switzerland.
| | - Krystal K Rampalli
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | | | - Ligia I Reyes
- Cornell University, Division of Nutritional Sciences, Ithaca, NY, 14853, USA.
| | - Shiny Deepika Drew
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, UK; International Livestock Research Institute, Nairobi, Kenya.
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies (IAGAS), University of Nairobi, Kenya.
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies (IAGAS), University of Nairobi, Kenya.
| | - Edward A Frongillo
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Elyse Iruhiriye
- University of South Carolina, Arnold School of Public Health, Columbia, SC, 29208, USA.
| | - Amy Webb Girard
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Isanovic S, Constantinides SV, Frongillo EA, Bhandari S, Samin S, Kenney E, Wertheim-Heck S, Nordhagen S, Holdsworth M, Dominguez-Salas P, Ambikapathi R, Laar A, Patil CL, Kulkarni B, Bukachi SA, Ngutu M, Blake CE. How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries. Curr Dev Nutr 2023; 7:100015. [PMID: 37181131 PMCID: PMC10100931 DOI: 10.1016/j.cdnut.2022.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/30/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety. Results The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food. Conclusions Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.
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Affiliation(s)
- Sejla Isanovic
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shilpa V. Constantinides
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, the Netherlands
| | | | - Michelle Holdsworth
- Montpellier Interdisciplinary Center on Sustainable Agri-food Systems, University of Montpellier, French Agricultural Research Centre for International Development, International Center for Advanced Mediterranean Agronomic Studies, Mediterranean Agronomic Institute of Montpellier, French National Institute for Agricultural Research, Institut Agro, French National Research Institute for Sustainable Development, Montpellier, France
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, USA
- Department of Global Development, Cornell University, Ithaca, NY, USA
| | - Amos Laar
- University of Ghana, Department of Population, Family and Reproductive Health, School of Public Health, Accra, Ghana
| | - Crystal L. Patil
- Department of Human Development Nursing Science, University of Illinois–Chicago, Chicago, IL, USA
| | - Bharati Kulkarni
- Division of Reproductive Biology, Maternal and Child Health and Nutrition, Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Christine E. Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Waweru KM, Omia DO, Kiganane L, Miroro O, Chemuliti J, Nyamongo IK, Bukachi SA. Socio-economic and structural barriers in Newcastle disease vaccines uptake by smallholder women farmers in Southeastern Kenya. PLoS One 2023; 18:e0283076. [PMID: 36928483 PMCID: PMC10019603 DOI: 10.1371/journal.pone.0283076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023] Open
Abstract
The exploitation of the full benefits of chicken rearing by smallholder farmers in Sub-Saharan (SSA) Africa is often impeded by poultry diseases which is compounded by limited uptake of vaccination. We interrogate the structural and socioeconomic factors associated with vaccine uptake by women farmers in Southeastern Kenya. A mixed methods design with a convergent approach for comparison of quantitative and qualitative findings was adopted. This involved the administration of a cross section survey to 1274 households, conduct of 23 Focus Groups Discussions (FGDs) and 7 Key informant Interviews (KIIs). Chi Square and t-tests were used to identify factors associated with vaccine uptake. Logistics regression analysis was used to identify the influence of the structural and socioeconomic barriers to vaccine uptake. Findings indicate that having knowledge of Newcastle disease (ND) vaccine increases the likelihood of farmers vaccinating their chicken by up to 32.5 times (95% CI [8.46-124.53]) with a 1 unit increase in vaccine knowledge. A farmer's distance away from the nearest ND vaccine vendor was found to reduce the likelihood of farmers vaccinating their chicken by up to 4% (95% CI ([0.93-1.00]) for every 1-kilometre increase in distance away from the vaccine vendors. Farmers who considered vaccines to be effective in preventing ND were 39 times (95% CI [6.23-239.8]) more likely to use ND vaccines than those that did not consider ND vaccine to effective. We surmise that a comprehensive approach that addresses increased ND vaccine knowledge among smallholder women chicken farmers, proximity of ND vendors, as well as cost holds the potential for regular and increased ND vaccine uptake.
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Affiliation(s)
- Kennedy M. Waweru
- School of Business and Economics, Cooperative University of Kenya, Nairobi, Kenya
- * E-mail:
| | - Dalmas O. Omia
- Institute of Anthropology Gender and African Studies, Nairobi, Kenya
| | - Lucy Kiganane
- School of Business and Economics, Cooperative University of Kenya, Nairobi, Kenya
| | - Obadia Miroro
- School of Cooperatives and Community Development, Business and Economics, Cooperative University of Kenya, Nairobi, Kenya
| | - Judith Chemuliti
- Biotechnology Research Institute, Kenya Agricultural Research and Livestock Organization, Kikuyu, Kenya
| | - Isaac K. Nyamongo
- Cooperative Development Research and Innovation Division, Cooperative University of Kenya Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology Gender and African Studies, Nairobi, Kenya
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12
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Bukachi SA, Ngutu M, Muthiru AW, Lépine A, Kadiyala S, Domínguez-Salas P. Gender and sociocultural factors in animal source foods (ASFs) access and consumption in lower-income households in urban informal settings of Nairobi, Kenya. J Health Popul Nutr 2022; 41:30. [PMID: 35818082 PMCID: PMC9275060 DOI: 10.1186/s41043-022-00307-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Gender shapes household decision-making and access for nutritious diets, including animal source foods (ASFs) that impact on child health and nutrition status. However, research shows that the poorest households in the urban informal settlements of Nairobi have low ASFs consumption. This study was conducted to explore further from a qualitative perspective the gender, sociocultural factors affecting household ASF consumption this study. Methods To explore further on the topic of study, an exploratory qualitative study was carried out to establish the factors that influence access, allocation and consumption of animal source foods (ASFs) by households in urban informal settings of Nairobi. Nineteen focus group discussions with men and women were conducted to enable in-depth exploration of ASFs consumption. Results Gender influences decision-making of household ASFs dietary intake. Gendered power dynamics prevail with men as breadwinners and household heads often determining the food access and consumption of ASFs. Women are increasingly accessing short-term waged-based incomes in urban informal settings and now play a role in food and nutrition security for their households. This enforces the idea that women’s decision-making autonomy is an important aspect of women empowerment, as it relates to women’s dietary diversity and subsequently, better household nutritional status. As evidenced in this study, if a woman has bargaining power based on accessing incomes to support their household food needs, she will not jeopardize food security. The mobile digital money platform was key in enabling access to resources to access food. Use of trust to access food on credit and purchasing smaller packaged quantities of food were also enablers to access of food/ASFs.
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13
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Ogolla KO, Chemuliti JK, Ngutu M, Kimani WW, Anyona DN, Nyamongo IK, Bukachi SA. Women’s empowerment and intra-household gender dynamics and practices around sheep and goat production in South East Kenya. PLoS One 2022; 17:e0269243. [PMID: 35925935 PMCID: PMC9352016 DOI: 10.1371/journal.pone.0269243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Small ruminant production facets like decision-making, ownership, labour allocation, access to- and control over assets are gendered. This study investigates intra-household gender dynamics and practices around sheep and goat production among smallholder farmers in South East region of Kenya. A quantitative study was conducted on 358 dual-headed (married) households to generate gender-disaggregated data on ownership, decision-making and labour allocation around small ruminant production. Qualitative data was collected through focused group discussions to bring out the community perspectives. From the findings, the average number of small ruminants owned by the households as reported by men was slightly higher than women. The average number of small ruminants solely owned by men was significantly higher than by women. Men reported a relatively higher number of jointly owned small ruminants compared to women. More women than men reported that they could give as a gift, sell-off and slaughter jointly owned small ruminants without consulting their spouses. Small ruminants were considered the most important livestock asset in supporting a household’s livelihood by relatively more women than men. Men had more decision-making autonomy over jointly owned small ruminants compared to women. Production tasks around small ruminants such as feeding, watering, selling milk and cleaning housing structures were mostly performed by the women. Qualitative data identified men as the de facto owners of small ruminants with a higher power position in making the important production decisions. The study offers three implications on the design of livestock interventions to empower women, the interventions should ensure that; 1) women are not just owners of livestock assets but also share power and decision-making rights in all aspects of production, 2) production labour is shared equitably between men and women and, 3) women access benefits from livestock production even when animals are owned by men.
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Affiliation(s)
- Kennedy O. Ogolla
- Biotechnology Research Institute, The Kenya Agricultural Livestock Research Organization, Kikuyu, Kenya
- * E-mail:
| | - Judith K. Chemuliti
- Biotechnology Research Institute, The Kenya Agricultural Livestock Research Organization, Kikuyu, Kenya
| | - Mariah Ngutu
- Department of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Winnie W. Kimani
- Biotechnology Research Institute, The Kenya Agricultural Livestock Research Organization, Kikuyu, Kenya
| | - Douglas N. Anyona
- Department of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | | | - Salome A. Bukachi
- Department of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
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14
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Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Cediel Becerra N, Charron DF, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Hayman DTS, Khaitsa M, Koopmans MPG, Machalaba C, Mackenzie JS, Markotter W, Mettenleiter TC, Morand S, Smolenskiy V, Zhou L. One Health: A new definition for a sustainable and healthy future. PLoS Pathog 2022; 18:e1010537. [PMID: 35737670 PMCID: PMC9223325 DOI: 10.1371/journal.ppat.1010537] [Citation(s) in RCA: 123] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
| | | | - Salama Almuhairi
- National Emergency Crisis and Disasters Management Authority, Abu Dhabi, United Arab Emirates
| | | | - Pépé Bilivogui
- World Health Organization, Guinea Country Office, Conakry, Guinea
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Natalia Casas
- National Ministry of Health, Autonomous City of Buenos Aires, Argentina
| | | | | | | | - Janice R. Ciacci Zanella
- Brazilian Agricultural Research Corporation (Embrapa), Embrapa Swine and Poultry, Concórdia, Santa Catarina, Brazil
| | | | - Osman Dar
- Global Operations Division, United Kingdom Health Security Agency, London, United Kingdom
- Global Health Programme, Chatham House, Royal Institute of International Affairs, London, United Kingdom
| | - Nitish Debnath
- Fleming Fund Country Grant to Bangladesh, DAI Global, Dhaka, Bangladesh
| | - Baptiste Dungu
- Afrivet B M, Pretoria, South Africa
- Faculty of Veterinary Science, University of Kinshasa, Kinshasa, Democratic Republic Congo
| | - Elmoubasher Farag
- Ministry of Public Health, Health Protection & Communicable Diseases Division, Doha, Qatar
| | - George F. Gao
- Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - David T. S. Hayman
- Molecular Epidemiology and Public Health Laboratory, Massey University, Palmerston North, New Zealand
| | - Margaret Khaitsa
- Mississippi State University, Starkville, Mississippi, United States of America
| | | | | | - John S. Mackenzie
- Faculty of Health Sciences, Curtin University, Perth
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- * E-mail: (WM); (TCM)
| | - Thomas C. Mettenleiter
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
- * E-mail: (WM); (TCM)
| | - Serge Morand
- MIVEGEC, CNRS-IRD-Montpellier Université, Montpellier, France; Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
| | - Vyacheslav Smolenskiy
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russian Federation
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
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Mutua EN, Bett BK, Bukachi SA, Estambale BA, Nyamongo IK. From policy to practice: An assessment of biosecurity practices in cattle, sheep and goats production, marketing and slaughter in Baringo County, Kenya. PLoS One 2022; 17:e0266449. [PMID: 35390055 PMCID: PMC8989345 DOI: 10.1371/journal.pone.0266449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Globally, biosecurity is instrumental in prevention, control and management of livestock diseases and protection of human health. It is defined, prescribed, adopted and enforced through global, regional and national frameworks, laws, policies and strategies. There is more biosecurity practice research conducted in developed countries than developing ones. Consequently, the gap between the ideals recommended in biosecurity frameworks and what is practical in under-resourced rural settings is poorly understood. This anthropological study sought to assess adoption of biosecurity practices across a cattle, sheep and goat value chains continuum to demonstrate where risks lie. The cross-sectional mixed-methods study took place in Baringo County, Kenya. Qualitatively, it utilized 26 focus group discussions with community members and 10 observational interviews with slaughter facility workers. Quantitatively, it included a household survey with 560 community members and a separate survey with 231 livestock traders. Results show that producers, traders and slaughter facility workers did observe some biosecurity practices but not others due but not limited to personal preference, limitations in veterinary service delivery and enforcement of some biosecurity measures, and lack of requisite infrastructure. The study concludes that the implementation of biosecurity measures in rural settings is more complex than envisioned in biosecurity policies and frameworks. It can be hampered by resource limitations, poor enforcement, and contestations with cultural practices. The study recommends that further studies on willingness to adopt biosecurity measures targeting community members in under-resourced settings be conducted to identify possible critical points of intervention at county and national levels.
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Affiliation(s)
- Edna N. Mutua
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- Animal and Human Health Group, International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
| | - Bernard K. Bett
- Animal and Human Health Group, International Livestock Research Institute, Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Benson A. Estambale
- Research, Innovation and Outreach, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Isaac K. Nyamongo
- Cooperative Development, Research and Innovation, The Cooperative University of Kenya, Nairobi, Kenya
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16
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Nowicki S, Bukachi SA, Hoque SF, Katuva J, Musyoka MM, Sammy MM, Mwaniki M, Omia DO, Wambua F, Charles KJ. Fear, Efficacy, and Environmental Health Risk Reporting: Complex Responses to Water Quality Test Results in Low-Income Communities. Int J Environ Res Public Health 2022; 19:ijerph19010597. [PMID: 35010851 PMCID: PMC8744942 DOI: 10.3390/ijerph19010597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
Reducing disease from unsafe drinking-water is a key environmental health objective in rural Sub-Saharan Africa, where water management is largely community-based. The effectiveness of environmental health risk reporting to motivate sustained behaviour change is contested but as efforts to increase rural drinking-water monitoring proceed, it is timely to ask how water quality information feedback can improve water safety management. Using cross-sectional (1457 households) and longitudinal (167 participants) surveys, semi-structured interviews (73 participants), and water quality monitoring (79 sites), we assess water safety perceptions and evaluate an information intervention through which Escherichia coli monitoring results were shared with water managers over a 1.5-year period in rural Kitui County, Kenya. We integrate the extended parallel process model and the precaution adoption process model to frame risk information processing and stages of behaviour change. We highlight that responses to risk communications are determined by the specificity, framing, and repetition of messaging and the self-efficacy of information recipients. Poverty threatscapes and gender norms hinder behaviour change, particularly at the household-level; however, test results can motivate supply-level managers to implement hazard control measures—with effectiveness and sustainability dependent on infrastructure, training, and ongoing resourcing. Our results have implications for rural development efforts and environmental risk reporting in low-income settings.
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Affiliation(s)
- Saskia Nowicki
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK; (S.F.H.); (J.K.); (K.J.C.)
- Correspondence:
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, IAS Museum Hill, Parklands Highridge, Nairobi 00100, Kenya; (S.A.B.); (M.M.M.); (D.O.O.); (F.W.)
| | - Sonia F. Hoque
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK; (S.F.H.); (J.K.); (K.J.C.)
| | - Jacob Katuva
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK; (S.F.H.); (J.K.); (K.J.C.)
- FundiFix Miambani Ltd., Mbithe Kimotho Building, Ngaie-Tseikuru Road Junction, Kyuso Centre, Kitui County 90200, Kenya; (M.M.S.); (M.M.)
| | - Mercy M. Musyoka
- Institute of Anthropology, Gender and African Studies, University of Nairobi, IAS Museum Hill, Parklands Highridge, Nairobi 00100, Kenya; (S.A.B.); (M.M.M.); (D.O.O.); (F.W.)
| | - Mary M. Sammy
- FundiFix Miambani Ltd., Mbithe Kimotho Building, Ngaie-Tseikuru Road Junction, Kyuso Centre, Kitui County 90200, Kenya; (M.M.S.); (M.M.)
| | - Martin Mwaniki
- FundiFix Miambani Ltd., Mbithe Kimotho Building, Ngaie-Tseikuru Road Junction, Kyuso Centre, Kitui County 90200, Kenya; (M.M.S.); (M.M.)
| | - Dalmas O. Omia
- Institute of Anthropology, Gender and African Studies, University of Nairobi, IAS Museum Hill, Parklands Highridge, Nairobi 00100, Kenya; (S.A.B.); (M.M.M.); (D.O.O.); (F.W.)
| | - Faith Wambua
- Institute of Anthropology, Gender and African Studies, University of Nairobi, IAS Museum Hill, Parklands Highridge, Nairobi 00100, Kenya; (S.A.B.); (M.M.M.); (D.O.O.); (F.W.)
| | - Katrina J. Charles
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK; (S.F.H.); (J.K.); (K.J.C.)
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Bukachi SA, Ngutu M, Muthiru AW, Lépine A, Kadiyala S, Domínguez-Salas P. Consumer perceptions of food safety in animal source foods choice and consumption in Nairobi's informal settlements. BMC Nutr 2021; 7:35. [PMID: 34261518 PMCID: PMC8281509 DOI: 10.1186/s40795-021-00441-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/17/2021] [Indexed: 11/27/2022] Open
Abstract
Background Animal-source foods (ASFs) are high-quality nutrient-dense products key to reducing stunting and micronutrient deficiencies. However, their consumption among the poorest households in urban informal settlements is low. Several drivers beyond price, including health considerations have been reported to drive ASF choice and consumption among consumers. This current study explores consumer perceptions of food safety associated with animal source foods (ASFs) consumption in urban informal settlements with a view to unpacking the health considerations driving their choice and consumption. Methods Coupled households with children 6–59 months formed the study sample. The Food Environments Working Group (FEWG) Framework of the Agriculture and Nutrition for Health academy (ANH) was used to guide the study which utilized qualitative methods namely, 60 in-depth interviews (IDIs), 19 focus group discussions, and 19 key informant interviews (KIIs) complemented by unstructured observations. Data were transcribed and analysed according to emerging themes. Results Consumer perceptions of food safety are driven by concerns about food production, processing, handling, storage and the health risks associated with consumption of the ASFs. For all the ASFs, lack of traceability of source, unhygienic environments in which they were sold and health risks around consuming too much or improperly cooked products were key perceptions from the community. To mitigate against food safety risks, consumers used strategies such as boiling the ASFs, purchasing their products from trusted retailers, avoiding vendors in unhygienic environments and reducing the amount and frequency of consumption of ASFs or totally avoiding their consumption. These consumer perceptions are increasingly influencing the ASFs choice and consumption in low-income populations besides other drivers. Notably, given limited incomes that influence their purchasing power and the need for nutritious diets that included ASFs, the dilemma of quality vis-a-vis quantity persists and consumers still accessed and consumed these ASF products to supplement their diets. Conclusions To enhance food safety for ASFs, as well as assure consumer access to safe ASFs from informal markets, there is need to contextualize the value chain as informed by consumer perceptions on food safety as these influence their ASFs choice and consumption.
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Affiliation(s)
- Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi (UoN), Nairobi, Kenya.
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies, University of Nairobi (UoN), Nairobi, Kenya
| | - Ann W Muthiru
- Institute of Anthropology, Gender and African Studies, University of Nairobi (UoN), Nairobi, Kenya
| | - Aurélia Lépine
- Institute for Global Health, University College London (UCL), London, UK
| | | | - Paula Domínguez-Salas
- International Livestock Research Institute (ILRI), Nairobi, Kenya.,Natural Resources Institute, University of Greenwich, London, UK
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18
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Thomas LF, Rushton J, Bukachi SA, Falzon LC, Howland O, Fèvre EM. Cross-Sectoral Zoonotic Disease Surveillance in Western Kenya: Identifying Drivers and Barriers Within a Resource Constrained Setting. Front Vet Sci 2021; 8:658454. [PMID: 34169106 PMCID: PMC8217437 DOI: 10.3389/fvets.2021.658454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Collaboration between the human and animal health sectors, including the sharing of disease surveillance data, has the potential to improve public health outcomes through the rapid detection of zoonotic disease events prior to widespread transmission in humans. Kenya has been at the forefront of embracing a collaborative approach in Africa with the inception of the Zoonotic Disease Unit in 2011. Joint outbreak responses have been coordinated at the national level, yet little is currently documented on cross-sectoral collaboration at the sub-national level. Methods: Key informant interviews were conducted with 28 disease surveillance officers from the human and animal health sectors in three counties in western Kenya. An inductive process of thematic analysis was used to identify themes relating to barriers and drivers for cross-sectoral collaboration. Results: The study identified four interlinking themes related to drivers and barriers for cross-sectoral collaboration. To drive collaboration at the sub-national level there needs to be a clear identification of “common objectives,” as currently exemplified by the response to suspected rabies and anthrax cases and routine meat hygiene activities. The action of collaboration, be it integrated responses to outbreaks or communication and data sharing, require “operational structures” to facilitate them, including the formalisation of reporting lines, supporting legislation and the physical infrastructure, from lab equipment to mobile phones, to facilitate the activities. These structures in turn require “appropriate resources” to support them, which will be allocated based on the “political will” of those who control the resources. Conclusions: Ongoing collaborations between human and animal disease surveillance officers at the sub-national level were identified, driven by common objectives such as routine meat hygiene and response to suspected rabies and anthrax cases. In these areas a suitable operational structure is present, including a supportive legislative framework and clearly designated roles for officers within both sectors. There was support from disease surveillance officers to increase their collaboration, communication and data sharing across sectors, yet this is currently hindered by the lack of these formal operational structures and poor allocation of resources to disease surveillance. It was acknowledged that improving this resource allocation will require political will at the sub-national, national and international levels.
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Affiliation(s)
- Lian Francesca Thomas
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
| | - Salome A Bukachi
- Institute of Anthropology, Gender & African Studies, University of Nairobi, Nairobi, Kenya
| | - Laura C Falzon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Olivia Howland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Eric M Fèvre
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
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Mburu CM, Bukachi SA, Shilabukha K, Tokpa KH, Ezekiel M, Fokou G, Bonfoh B, Kazwala R. Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania. BMC Public Health 2021; 21:1075. [PMID: 34090402 PMCID: PMC8180143 DOI: 10.1186/s12889-021-11027-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 05/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. Methods Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. Results Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. Conclusion The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11027-w.
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Affiliation(s)
- Caroline M Mburu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya.
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Khamati Shilabukha
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Kathrin H Tokpa
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Mangi Ezekiel
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gilbert Fokou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Mburu CM, Bukachi SA, H. Tokpa K, Fokou G, Shilabukha K, Ezekiel M, Bonfoh B, Kazwala R, Kreppel K. Lay attitudes and misconceptions and their implications for the control of brucellosis in an agro-pastoral community in Kilombero district, Tanzania. PLoS Negl Trop Dis 2021; 15:e0009500. [PMID: 34111114 PMCID: PMC8219154 DOI: 10.1371/journal.pntd.0009500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/22/2021] [Accepted: 05/21/2021] [Indexed: 12/26/2022] Open
Abstract
Brucellosis is a priority zoonotic disease in Tanzania that causes ill-health in people and affects livestock productivity. Inadequate awareness and behavior risking transmission can impede control efforts. We conducted a cross-sectional survey of 333 livestock owners in three villages in the Kilombero district, Tanzania, to understand their awareness, knowledge and behavior associated with brucellosis. Six Focus Group Discussions (FGDs), two in each village, were conducted, as well as an additional FGD with male herders from one of the villages. Factors associated with knowledge on brucellosis, food consumption and animal husbandry behavior risking transmission of this disease, were identified using generalized linear models. Predictors for knowledge of brucellosis were being male and having a higher educational level, while age was positively associated with a higher level of knowledge. Faith and ethnicity were associated with the performance of practices risking transmission. Following traditional religion and belonging to the Wamaasai ethnicity significantly increased the odds of carrying out these practices. Qualitative analysis gave insight into risk practices and reasoning. Of the 333 respondents, 29% reported that they had experienced abortions in their herds, 14% witnessed retained placentas, and 8% had seen still-births in their cattle within the previous year. However, survey results also showed that only 7.2% of participants had heard about brucellosis as a disease in livestock. Of those who had heard about brucellosis in livestock, 91% associated abortions with it and 71% knew that humans can get infected through raw milk consumption. People overwhelmingly attributed symptoms and transmission of brucellosis in livestock to infection with trypanosomiasis and to supernatural reasons instead. In the community, consumption of raw milk was valued and handling of aborted material was not considered a risk for infection. This agro-pastoralist community holds on to long-held beliefs and practices and lacks understanding of the biomedical concept of brucellosis. Transmission routes and symptoms of brucellosis in humans and livestock are completely unknown. The disparity between risk perception and actual transmission risk related to animal handling and consumption of animal products presents a challenge for disease awareness communication. This study recommends focused community engagement and sensitization to address the limited awareness and misconceptions among agro-pastoralists.
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Affiliation(s)
- Caroline M. Mburu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Kathrin H. Tokpa
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Cote d’Ivoire
| | - Gilbert Fokou
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Cote d’Ivoire
| | - Khamati Shilabukha
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Mangi Ezekiel
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Cote d’Ivoire
| | | | - Katharina Kreppel
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
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Ongolly FK, Bukachi SA. Barriers to men's involvement in antenatal and postnatal care in Butula, western Kenya. Afr J Prim Health Care Fam Med 2019; 11:e1-e7. [PMID: 31368318 PMCID: PMC6676928 DOI: 10.4102/phcfm.v11i1.1911] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Men have a lot of influence on their partners' and children's health. However, studies have shown their involvement in antenatal care (ANC) and postnatal care (PNC) is relatively low owing to several factors. AIM To explore the barriers to men's involvement in ANC and PNC in Butula sub-county, western Kenya. SETTING Butula sub-county, Busia county, western Kenya. METHODS A mixed methods study design, descriptive in nature, was used to collect both quantitative and qualitative data. A total of 96 men were selected to participate in the surveys. Also, four focus group discussions and four key informant interviews were conducted. RESULTS We found out that some men still participate in ANC and PNC despite the barriers. The perception that maternal health is a women's domain and existence of alternative traditional maternal services were key cultural barriers. The men's nature of work, low income and expenses incurred at ANC/PNC clinics were significant economic barriers. The lack of services targeting men, provider attitude, non-invitation to the clinic, time spent at the clinic and lack of privacy at the clinics were key facility-based barriers. CONCLUSION A myriad of cultural, economic and health-facility barriers hinder men from active involvement in ANC and PNC. Awareness creation among men on ANC and PNC services and creating a client-friendly environment at the clinics is key in enhancing their involvement. This should be a concerted effort of all stake holders in maternal health services, as male involvement is a strong influencer to their partners' and children's health outcomes.
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Affiliation(s)
- Fernandos K Ongolly
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; and, Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi.
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Bukachi SA, Mumbo AA, Alak ACD, Sebit W, Rumunu J, Biéler S, Ndung'u JM. Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan. PLoS Negl Trop Dis 2018; 12:e0006826. [PMID: 30273342 PMCID: PMC6181432 DOI: 10.1371/journal.pntd.0006826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 10/11/2018] [Accepted: 09/11/2018] [Indexed: 02/01/2023] Open
Abstract
Background A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primary healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy. Methodology A KAP survey was carried out in Yei County, South Sudan, to identify gaps in community KAP and determine the preferred channels and sources of information on the disease. The cross-sectional KAP survey utilized questionnaires, complemented with key informant interviews and a focus group discussion to elicit communal as well as individual KAP on HAT. Findings Most (90%) of the respondents had general knowledge on HAT. Lower levels of education, gender and geographic locations without a history of HAT interventions were associated with incorrect knowledge and/or negative perceptions about the treatability of HAT. Symptoms appearing in the late stage were best known. A majority (97.2%) would seek treatment for HAT only in a health centre. However, qualitative data indicates that existing myths circulating in the popular imagination could influence people’s practices. Seventy-one percent of the respondents said they would offer social support to patients with HAT but qualitative data highlights that stigma still exists. Misconceptions and stigma can negatively influence the health seeking behaviour of HAT cases. In relation to communication, the top preferred and effective source of communication was radio (24%). Conclusion Gaps in relation to KAP on HAT still exist in the community. Perceptions on HAT, specifically myths and stigma, were key gaps that need to be bridged through effective education and communication strategies for HAT control alongside other interventions. Misconceptions about sleeping sickness, a neglected tropical disease transmitted by tsetse flies, can be a hindrance to effective implementation of control interventions especially in the face of accelerating work to eliminate the disease. Understanding community knowledge, attitudes and practices about sleeping sickness is important in developing appropriate material for educating and sensitizing communities at risk of the disease. We conducted a study to establish community knowledge, attitudes and practices, including preferred channels of disseminating sleeping sickness information. Despite the fact that the community in Yei County knew about the disease, existing myths and stigma have the potential of influencing their health seeking behaviour. The radio, community health workers and village elders were the most preferred sources of sharing information with the community. There is need to develop education and awareness material to address issues of existing myths, potential stigma, treat ability of HAT, importance of testing and treatment, as well as provide information on the new/improved testing and treatment approaches for HAT. In addition, this should be provided through use of preferred and trusted sources of information dissemination, which is critical in uptake of HAT control, management and prevention activities.
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Affiliation(s)
- Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- Research and Development, Passion Africa Limited, Nairobi, Kenya
- * E-mail:
| | - Angeline A. Mumbo
- South Sudan Coordination Office, Malteser International, Juba, Republic of South Sudan
| | - Ayak C. D. Alak
- Preventive Health Services, Ministry of Health, Juba, Republic of South Sudan
| | - Wilson Sebit
- Preventive Health Services, Ministry of Health, Juba, Republic of South Sudan
| | - John Rumunu
- Preventive Health Services, Ministry of Health, Juba, Republic of South Sudan
| | - Sylvain Biéler
- Neglected Tropical Diseases, Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Joseph M. Ndung'u
- Neglected Tropical Diseases, Foundation for Innovative New Diagnostics, Geneva, Switzerland
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Bukachi SA, Wandibba S, Nyamongo IK. The socio-economic burden of human African trypanosomiasis and the coping strategies of households in the South Western Kenya foci. PLoS Negl Trop Dis 2017; 11:e0006002. [PMID: 29073144 PMCID: PMC5675461 DOI: 10.1371/journal.pntd.0006002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 11/07/2017] [Accepted: 09/30/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction Human African Trypanosomiasis (HAT), a disease caused by protozoan parasites transmitted by tsetse flies, is an important neglected tropical disease endemic in remote regions of sub-Saharan Africa. Although the determination of the burden of HAT has been based on incidence, mortality and morbidity rates, the true burden of HAT goes beyond these metrics. This study sought to establish the socio-economic burden that households with HAT faced and the coping strategies they employed to deal with the increased burden. Materials and methods A mixed methods approach was used and data were obtained through: review of hospital records; structured interviews (152); key informant interviews (11); case narratives (12) and focus group discussions (15) with participants drawn from sleeping sickness patients in the south western HAT foci in Kenya. Quantitative data were analysed using descriptive statistics while qualitative data was analysed based on emerging themes. Results Socio-economic impacts included, disruption of daily activities, food insecurity, neglect of homestead, poor academic performance/school drop-outs and death. Delayed diagnosis of HAT caused 93% of the affected households to experience an increase in financial expenditure (ranging from US$ 60–170) in seeking treatment. Out of these, 81.5% experienced difficulties in raising money for treatment resorting to various ways of raising it. The coping strategies employed to deal with the increased financial expenditure included: sale of agricultural produce (64%); seeking assistance from family and friends (54%); sale/lease of family assets (22%); seeking credit (22%) and use of personal savings (17%). Conclusion and recommendation Coping strategies outlined in this study impacted negatively on the affected households leading to further food insecurity and impoverishment. Calculation of the true burden of disease needs to go beyond incidence, mortality and morbidity rates to capture socio-economic variables entailed in seeking treatment and coping strategies of HAT affected households. Sleeping sickness affects people often living in remote rural areas and those who mainly depend on subsistence agriculture. We carried out a study among former sleeping sickness patients in Kenya to find out the socio-economic challenges they faced in seeking treatment and the coping strategies they used to deal with them. This is important because the socio-economic effects of sleeping sickness and its coping strategies have not been adequately researched on yet it is on the strength of these impacts that policies and control programmes are formulated. If the real burden of sleeping sickness is not known, then it will continue to be neglected in terms of the attention it receives world-wide. Sleeping sickness patients and their households spent a lot of money seeking treatment besides facing challenges of disruption of daily activities, food insecurity, neglect of homesteads, poor academic performance/school drop-outs and death. Majority of them faced difficulties in raising the money required for seeking treatment hence resorted to various coping strategies. These negatively impacted on them and their households, already living on less than a dollar per day. There is need to pay attention to these effects of sleeping sickness in establishing the real burden of the disease.
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Affiliation(s)
- Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- * E-mail:
| | - Simiyu Wandibba
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Isaac K. Nyamongo
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
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Mutua EN, Bukachi SA, Bett BK, Estambale BA, Nyamongo IK. "We do not bury dead livestock like human beings": Community behaviors and risk of Rift Valley Fever virus infection in Baringo County, Kenya. PLoS Negl Trop Dis 2017; 11:e0005582. [PMID: 28542242 PMCID: PMC5460880 DOI: 10.1371/journal.pntd.0005582] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 06/06/2017] [Accepted: 04/19/2017] [Indexed: 11/19/2022] Open
Abstract
Background Rift Valley Fever (RVF), is a viral zoonotic disease transmitted by Aedes and Culex mosquitoes. In Kenya, its occurrence is associated with increased rains. In Baringo County, RVF was first reported in 2006–2007 resulting in 85 human cases and 5 human deaths, besides livestock losses and livelihood disruptions. This study sought to investigate the county’s current RVF risk status. Methodology and principal findings A cross-sectional study on the knowledge, attitudes and practices of RVF was conducted through a mixed methods approach utilizing a questionnaire survey (n = 560) and 26 focus group discussions (n = 231). Results indicate that study participants had little knowledge of RVF causes, its signs and symptoms and transmission mechanisms to humans and livestock. However, most of them indicated that a person could be infected with zoonotic diseases through consumption of meat (79.2%) and milk (73.7%) or contact with blood (40%) from sick animals. There was a statistically significant relationship between being male and milking sick animals, consumption of milk from sick animals, consuming raw or cooked blood, slaughtering sick livestock or dead animals for consumption (all at p≤0.001), and handling sick livestock with bare hands (p = 0.025) with more men than women engaging in the risky practices. Only a few respondents relied on trained personnel or local experts to inspect meat for safety of consumption every time they slaughtered an animal at home. Sick livestock were treated using conventional and herbal medicines often without consulting veterinary officers. Conclusions Communities in Baringo County engage in behaviour that may increase their risk to RVF infections during an outbreak. The authors recommend community education to improve their response during outbreaks. The study focuses on the knowledge and socio-cultural practices around Rift Valley Fever (RVF) in Baringo County. It is intended to identify means through which communities in Baringo County could be exposed to RVF in the event of an outbreak. Specifically, it addresses knowledge of RVF transmission routes, practices in handling and consumption of meat, milk and blood; livestock disease management and disposal of dead animals/aborted foetuses. The study found that community members engaged in practices that would expose them to RVF in the event of an outbreak. These practices include milking and consuming milk from sick animals; consuming meat from slaughtered sick animals and those that die from disease; rarely having animals that were slaughtered at home inspected by a veterinary officer or a local animal expert before consumption; using uncertified techniques to test meat for safety of consumption; and treating sick livestock with both conventional and herbal treatments without the guidance of veterinary personnel. Further, RVF infections are likely to follow a gendered pattern based on the division of labor in livestock production. Based on their results, the study authors recommend community education to increase RVF awareness.
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Affiliation(s)
- Edna N. Mutua
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- Animal and Human Health, International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Bernard K. Bett
- Animal and Human Health, International Livestock Research Institute, Nairobi, Kenya
| | - Benson A. Estambale
- Research, Innovation and Outreach, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Isaac K. Nyamongo
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
- Cooperative Development, Research and Innovation, The Cooperative University of Kenya, Nairobi, Kenya
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Mutua EN, Bukachi SA, Bett BK, Estambale BA, Nyamongo IK. Lay knowledge and management of malaria in Baringo county, Kenya. Malar J 2016; 15:486. [PMID: 27653949 PMCID: PMC5031295 DOI: 10.1186/s12936-016-1542-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/16/2016] [Indexed: 02/03/2023] Open
Abstract
Background Malaria, a disease caused by protozoan parasites of the genus Plasmodium and transmitted by female anopheline mosquitoes, is a major cause of morbidity, mortality and loss in productivity in humans. Baringo County is prone to seasonal transmissions of malaria mostly in the rainy seasons. Methods This cross-sectional study used a mixed methods approach to collect data on knowledge and lay management of malaria. A questionnaire survey was administered to 560 respondents while qualitative data was collected through 20 focus group discussions in four ecological zones covering Baringo North, Baringo South and Marigat sub-Counties of Baringo County. Analyses were done through summary and inferential statistics for quantitative data and content analysis for qualitative data. Results The study communities were knowledgeable of malaria signs, symptoms, cause and seasonality but this biomedical knowledge co-existed with other local perceptions. This knowledge, however, did not influence their first (p = 0.77) or second choice treatments (p = 0.49) and compliance to medication (p = 0.84). Up to 88 % of respondents reported having suffered from malaria. At the onset of a suspected malaria case community members reported the following: 28.9 % visited a health facility, 37.2 % used analgesics, 26.6 % herbal treatments, 2.2 % remnant malaria medicines, 2.2 % over the counter malaria medicines, 1 % traditional healers and 1.8 % other treatments. Nearly all respondents (97.8 %) reported visiting a health facility for subsequent treatments. Herbal treatments comprised of infusions and decoctions derived from roots, barks and leaves of plants believed to have medicinal value. Compliance to conventional malaria treatment regime was, however, identified as a challenge in malaria management. Quick relief from symptoms, undesirable qualities like drug bitterness and bad smell, undesirable side-effects, such as nausea and long regimen of treatment were some of the contributors to non-compliance. Men and women exhibited different health-seeking behaviours based on the cultural expectations of masculinity, femininity, gender roles and acceptability of health services. Conclusions While knowledge of malaria is important in identifying the disease, it does not necessarily lead to good management practice. Treatment-seeking behaviour is also influenced by perceived cause, severity of disease, timing, anticipated cost of seeking treatment and gender, besides the availability of both traditional and conventional medicines.
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Affiliation(s)
- Edna N Mutua
- Institute of Anthropology, Gender and African Studies, University of Nairobi, P. O. Box 30197, Nairobi, 00100, Kenya.,International Livestock Research Institute, P. O. Box 30709, Nairobi, 00100, Kenya
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, P. O. Box 30197, Nairobi, 00100, Kenya
| | - Bernard K Bett
- International Livestock Research Institute, P. O. Box 30709, Nairobi, 00100, Kenya
| | - Benson A Estambale
- Jaramogi Oginga Odinga University of Science and Technology, P. O. Box 210, Bondo, 40601, Kenya
| | - Isaac K Nyamongo
- Institute of Anthropology, Gender and African Studies, University of Nairobi, P. O. Box 30197, Nairobi, 00100, Kenya.
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Lichoti JK, Davies J, Kitala PM, Githigia SM, Okoth E, Maru Y, Bukachi SA, Bishop RP. Social network analysis provides insights into African swine fever epidemiology. Prev Vet Med 2016; 126:1-10. [PMID: 26848113 DOI: 10.1016/j.prevetmed.2016.01.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 11/17/2022]
Abstract
Pig movements play a significant role in the spread of economically important infectious diseases such as the African swine fever. Characterization of movement networks between pig farms and through other types of farm and household enterprises that are involved in pig value chains can provide useful information on the role that different participants in the networks play in pathogen transmission. Analysis of social networks that underpin these pig movements can reveal pathways that are important in the transmission of disease, trade in commodities, the dissemination of information and the influence of behavioural norms. We assessed pig movements among pig keeping households within West Kenya and East Uganda and across the shared Kenya-Uganda border in the study region, to gain insight into within-country and trans-boundary pig movements. Villages were sampled using a randomized cluster design. Data were collected through interviews in 2012 and 2013 from 683 smallholder pig-keeping households in 34 villages. NodeXL software was used to describe pig movement networks at village level. The pig movement and trade networks were localized and based on close social networks involving family ties, friendships and relationships with neighbours. Pig movement network modularity ranged from 0.2 to 0.5 and exhibited good community structure within the network implying an easy flow of knowledge and adoption of new attitudes and beliefs, but also promoting an enhanced rate of disease transmission. The average path length of 5 defined using NodeXL, indicated that disease could easily reach every node in a cluster. Cross-border boar service between Uganda and Kenya was also recorded. Unmonitored trade in both directions was prevalent. While most pig transactions in the absence of disease, were at a small scale (<5km) and characterized by regular agistment, most pig sales during ASF outbreaks were to traders or other farmers from outside the sellers' village at a range of >10km. The close social relationships between actors in pig movement networks indicate the potential for possible interventions to develop shared norms and mutually accepted protocols amongst smallholder pig keepers to better manage the risk of ASF introduction and transmission.
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Affiliation(s)
- Jacqueline Kasiiti Lichoti
- Ministry of Agriculture, Livestock and Fisheries, State Department of Veterinary Services, Private Bag-00625, Nairobi, Kenya; University of Nairobi, Department of Public Health, Pharmacology and Toxicology, P.O. Box 29053, Nairobi 00625, Kenya.
| | - Jocelyn Davies
- Commonwealth Scientific and Industrial Research Organization, Land and Water Flagship, Business & Innovation Centre, Desert Knowledge Precinct, Alice Springs 0870, NT, Australia.
| | - Philip M Kitala
- University of Nairobi, Department of Public Health, Pharmacology and Toxicology, P.O. Box 29053, Nairobi 00625, Kenya.
| | - Samuel M Githigia
- University of Nairobi, Department of Veterinary Pathology, Microbiology and Parasitology, P.O. Box 29053, Nairobi 00625, Kenya.
| | - Edward Okoth
- International Livestock Research Institute and Biosciences Eastern and Central Africa, P.O. Box 30709, Nairobi 00100, Kenya.
| | - Yiheyis Maru
- Commonwealth Scientific and Industrial Research Organization, Land and Water Flagship, Business & Innovation Centre, Desert Knowledge Precinct, Alice Springs 0870, NT, Australia; International Livestock Research Institute and Biosciences Eastern and Central Africa, P.O. Box 30709, Nairobi 00100, Kenya.
| | - Salome A Bukachi
- University of Nairobi, Institute of Anthropology, Gender & African Studies, P.O. Box 30197, Nairobi 00100, Kenya.
| | - Richard P Bishop
- Commonwealth Scientific and Industrial Research Organization, Land and Water Flagship, Business & Innovation Centre, Desert Knowledge Precinct, Alice Springs 0870, NT, Australia; International Livestock Research Institute and Biosciences Eastern and Central Africa, P.O. Box 30709, Nairobi 00100, Kenya.
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Ng’ang’a CM, Bukachi SA, Bett BK. Lay perceptions of risk factors for Rift Valley fever in a pastoral community in northeastern Kenya. BMC Public Health 2016; 16:32. [PMID: 26762147 PMCID: PMC4712502 DOI: 10.1186/s12889-016-2707-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 01/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human behavioral factors have been found to be central in the transmission of Rift Valley fever. Consumption of contaminated meat and milk in particular have been identified as one of the key risk factors for the transmission of Rift Valley fever in humans. In pastoral communities, livestock is the main source of livelihood from which many benefits such as food as well as economic and cultural services are derived. Zoonotic diseases therefore have a great impact on pastoral communities livelihoods. However, lay perceptions regarding the transmission of these diseases including Rift Valley fever hampers their effective control. This study investigated the lay perceptions of risks for Rift Valley fever transmission in a pastoral community in northeastern Kenya. METHODS A qualitative study was carried out in Ijara district, Kenya which was one of the hotspots of Rift Valley during the 2006/2007 outbreak. Data were collected using focus group discussions and narratives guided by checklists. Eight focus group discussions consisting of 83 participants and six narratives were conducted. Data was transcribed, coded and analysed according to Emergent themes. RESULTS The participants reported that they had experienced Rift Valley fever in their livestock especially sheep and in humans both in 1997/1998 and 2006/2007. However, they believed that infections in humans occurred as a result of mosquito bites and had little to do with their consumption of meat, milk and blood from infected livestock. The participants in this study indicated that they had heard of the risks of acquiring the disease through consumption of livestock products but their experiences did not tally with the information they had received hence to them, Rift Valley fever was not transmissible through their dietary practices. CONCLUSIONS Though the communities in this region were aware of Rift Valley fever, they did not have elaborate information regarding the disease transmission dynamics to humans. To avoid misconception about transmission of the disease, intervention strategies, require to be accompanied by comprehensive explanations of the dynamics of its transmission. It is necessary to develop appropriate interventions that take into consideration, lay perceptions of risk factors for the disease and communities' livelihood strategies.
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Affiliation(s)
- Caroline M. Ng’ang’a
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
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Byskov J, Marchal B, Maluka S, Zulu JM, Bukachi SA, Hurtig AK, Blystad A, Kamuzora P, Michelo C, Nyandieka LN, Ndawi B, Bloch P, Olsen ØE. The accountability for reasonableness approach to guide priority setting in health systems within limited resources--findings from action research at district level in Kenya, Tanzania, and Zambia. Health Res Policy Syst 2014; 12:49. [PMID: 25142148 PMCID: PMC4237792 DOI: 10.1186/1478-4505-12-49] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). METHODS This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. RESULTS The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. CONCLUSIONS District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This provides arguments for the continued application and further assessment of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications.
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Affiliation(s)
- Jens Byskov
- DBL – Centre for Health Research and Development, Faculty of Health and Medical Sciences, University of Copenhagen, Thorvaldsensvej 57, DK 1871 Frederiksberg, Denmark
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B 2000 Antwerpen, Belgium
| | - Stephen Maluka
- Institute of Development Studies, University of Dar Es Salaam, PO Box 35169, Dar Es Salaam, Tanzania
| | - Joseph M Zulu
- Department of Public Health, School of Medicine, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies University of Nairobi, PO Box 30197, Nairobi 00100, Kenya
| | - Anna-Karin Hurtig
- Umeå International School of Public Health, Umeå University, SE 90185 Umea, Sweden
| | - Astrid Blystad
- Department of Public Health and Primary Health Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway
| | - Peter Kamuzora
- Institute of Development Studies, University of Dar Es Salaam, PO Box 35169, Dar Es Salaam, Tanzania
| | - Charles Michelo
- Department of Public Health, School of Medicine, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Lillian N Nyandieka
- Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), PO Box 20752, Nairobi 00202, Kenya
| | - Benedict Ndawi
- Primary Health Care Institute, PO Box 235, Iringa, Tanzania
| | - Paul Bloch
- Steno Health Promotion Center, Steno Diabetes Center, Niels Steensens Vej 8, DK-2820 Gentofte, Denmark
| | - Øystein E Olsen
- Affiliated to Centre for International Health, University of Bergen, Årstadveien 21 5th floor, N-5009 Bergen, Norway
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Bukachi SA, Onyango-Ouma W, Siso JM, Nyamongo IK, Mutai JK, Hurtig AK, Olsen ØE, Byskov J. Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework. Int J Health Plann Manage 2013; 29:342-61. [DOI: 10.1002/hpm.2197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 04/29/2013] [Accepted: 05/08/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies; University of Nairobi; Nairobi Kenya
| | | | - Jared Maaka Siso
- Institute of Anthropology, Gender and African Studies; University of Nairobi; Nairobi Kenya
| | - Isaac K. Nyamongo
- Institute of Anthropology, Gender and African Studies; University of Nairobi; Nairobi Kenya
- University of the Witwatersrand; School of Human and Community Development; Johannesburg South Africa
| | - Joseph K. Mutai
- Centre for Public Health Research; Kenya Medical Research Institute; Nairobi Kenya
| | - Anna Karin Hurtig
- Umea International School of Public Health; Umea University; Umea Sweden
| | - Øystein Evjen Olsen
- DBL-Centre for Health Research and Development, Faculty of Life Sciences; University of Copenhagen; Denmark
| | - Jens Byskov
- DBL-Centre for Health Research and Development, Faculty of Life Sciences; University of Copenhagen; Denmark
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Abstract
OBJECTIVE To assess the capacity of established community based organisations (CBOs) to disseminate information on sleeping sickness control. DESIGN Participatory interview process administered to randomly selected CBOs in a tsetse and trypanosomosis endemic area. SETTING Busia district, Western, Kenya. RESULTS Community based organisations especially women groups and farmer field schools that are internally initiated have the potential to contribute greatly to sustainable sleeping sickness dissemination strategies. The study indicated a mean reach of between 400-600 persons per day, but with a range of up to 1000 persons per day. CONCLUSION Internally initiated women groups may be the best options for targeting health education programmes with the aim of ensuring sustained community participation.
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Affiliation(s)
- S A Bukachi
- Epidemiology Division, Kenya Trypanosomiasis Research Institute, P.O. Box 399 Busia, Kenya
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