Share research - Kenya

Designing a Food Hygiene Intervention in Low-Income, Peri-Urban Context of Kisumu, Kenya: Application of the Trials of Improved Practices Methodology

shareadmin — Fri, 03 Apr 2020 11:55:31 +0000

This paper by Simiyu et al. (2020) was published in the American Journal of Tropical Medicine and Hygiene. The paper discusses the Safe Start trial. Caregiver practices are important determinants of exposure to foodborne pathogens, and can therefore play a role in reduction in infant food contamination. Through a qualitative approach, the team used the Trials of Improved Practices methodology to design a food hygiene intervention in a low-income settlement of Kisumu city in Kenya. These settlements in Kisumu city host a large portion of the city’s population and are faced with a high diarrheal disease burden. Caregivers were selected if they had a child aged 6–9 months, and together, the researchers codesigned a combination of hardware and messaging components targeting handwashing with soap, hygienic feeding, reheating, and hygienic storage of infant food. Results showed that feeding items were easily adopted by caregivers, whereas reheating of food was less observed. Households reportedly improved their food storage and handwashing practices. As a result, the hardware components were further refined and tested among the caregivers. Messaging components spurred the aspirations that caregivers had for their children and acted as reminders of practicing good food hygiene. The outcomes of the codesign process provided valuable insights on the knowledge of caregivers, a delivery approach for implementing the intervention, and further informed a subsequent trial that adopted the designed intervention to target early childhood exposure to enteric pathogens through contaminated food.

Download (1.01 MB) Safe Start Marni Brennan Kenya

Outcome mapping and research into use: analysing monitoring data for effective strategies

shareadmin — Mon, 13 Jan 2020 15:33:06 +0000

This article by Balls and Nurova (2020) was published in Development in Practice. The paper analyses outcome mapping data to uncover effective strategies for engaging practitioners and policymakers with research projects. The project focuses on SHARE and the four countries it works in - Kenya, Malawi, Tanzania and Zambia. The article identifies three emerging themes: early engagement, using existing and new forums and seizing opportunities. It discusses the contextual difference and the relevance of outcome mapping methodology for research into use and is relevant for those seeking to engage and influence stakeholders with their research and programmes.

Download (1.39 MB) Marni Brennan Kenya Malawi Tanzania Zambia

The Safe Start trial to assess the effect of an infant hygiene intervention on enteric infections and diarrhoea in low-income informal neighbourhoods of Kisumu, Kenya: a study protocol for a cluster randomized controlled trial

shareadmin — Fri, 03 Jan 2020 17:24:12 +0000

This paper by Mumma et al. (2019) was published in BMC Infectious Diseases. The paper describes the Safe Start trial which aimed to assess the effectiveness of a novel infant food hygiene intervention on infant enteric infections and diarrhoea in peri-urban settlements of Kisumu, Kenya. The researchers carried out a cluster randomised control trial with 50 clusters, representing the catchment areas of Community Health Volunteers (CHVs), randomly assigned to intervention or control. A total of 750 infants were recruited on a rolling basis at 22 weeks of age and then followed for 15 weeks. The intervention targeted four key caregiver behaviours related to food hygiene: 1) hand washing with soap before infant food preparation and feeding; 2) bringing all infant food to the boil before feeding, including when reheating or reserving; 3) storing all infant food in sealed containers; and, 4) using only specific utensils for infant feeding which are kept separate and clean. The primary outcome of interest was the prevalence of one or more of 23 pre-specified enteric infections, determined using quantitative real-time polymerase chain reaction for enteric pathogen gene targets. In addition, infant food samples were collected at 33 weeks, and faecal indicator bacteria (Enterococcus) isolated and enumerated to assess the impact of the intervention on infant food contamination.

Download (1.19 MB) Safe Start Marni Brennan Kenya

Infant Food Hygiene and Childcare Practices in Context: Findings from an Urban Informal Settlement in Kenya

shareadmin — Mon, 02 Dec 2019 19:25:03 +0000

This study was published by Mumma et al. (2019) in the American Journal of Tropical Medicine and Hygiene. The paper explores the wider contextual issues facing complementary food hygiene interventions in low- and middle-income settings. Such interventions are crucial for reducing infant exposure to diarrhoea-causing enteric pathogens. This study was conducted in an informal settlement in Kenya. Observational and qualitative data on childcare was collected. The findings demonstrate that behaviours associated with food contamination, such as hand feeding and storing food for extended periods, are determined largely by the larger social and economic realities of primary caretakers. Data also show how caregiving within an informal settlement is highly dynamic and involves multiple individuals and locations throughout the day. Findings from this study will help inform the development and implementation of food hygiene interventions in informal urban communities.

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Enteric pathogen diversity in infant foods in low-income neighborhoods of Kisumu, Kenya

shareadmin — Mon, 03 Jun 2019 10:02:24 +0000

Tsai et al. (2019) published this paper in the International Journal of Environmental Research and Public Health. Pathogen spread through food is a crucial transmission route for diarrhoeal disease in children in low and middle-income countries. This paper explores this under-researched area. The authors examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods and assessed household food hygiene risk factors for contamination in Kisumu, Kenya. Enteric pathogen material was detected in 62% of the infant weaning foods and 37% of foods contained more than one pathogen type. The type of infant food best explained the presence and diversity of enteric pathogens in infant food, with cow's milk carrying a particularly high risk. Most household food hygiene risk factors considered in the study were not significantly associated with pathogen contamination. This research demonstrates the importance of interventions to prevent foodborne transmission of diarrhoeal pathogens to infants in low-income urban settings.

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Understanding living conditions and deprivation in informal settlements of Kisumu, Kenya

shareadmin — Fri, 31 May 2019 14:06:34 +0000

Simiyu et al. (2019) published this paper in Urban Forum. The research aims to shed light on living conditions and deprivation in informal settlements of Kisumu, Kenya. As well as describing the living conditions in the settlements, the paper also sets out areas for improvement. Methods included using the living conditions framework and the multi-dimensional poverty index. Results indicated widespread deprivation at the individual and housing level, but the settlements have accessible public services such as school and health centres. Water, sanitation, solid waste disposal and other infrastructural services are lacking at the compound level; and where they do exist, they are often shared. The findings emphasise the importance of basic service provision, upgrading of housing and supporting of existing income-generation opportunities within the settlements.

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Realities and experiences of Community Health Volunteers as agents for behaviour change: evidence from an informal urban settlement in Kisumu, Kenya

shareadmin — Fri, 31 May 2019 13:49:49 +0000

Aseyo et al. (2018) published this paper in Human Resources for Health. The work explores the important role of community health volunteers (CHVs) in delivering health services and behaviour change interventions (including hygiene-related behaviour change). The study focussed on 16 CHVs affiliated with the Kenyan Ministry of Health in a peri-urban settlement in Kenya. Through a mixed-methods approach, the capabilities, opportunities to work effectively and sources of motivation of the CHVs were studied. Results showed that CHVs faced a range of challenges that limited their capacity to get in involved with behaviour change interventions; including lack of resources and coordination and need for additional training in modern behaviour change approaches.

Download (633.18 KB) Marni Brennan Kenya

Applying outcome mapping to plan, monitor and evaluate policy influence; learning from the SHARE research consortium

shareadmin — Fri, 06 Jul 2018 14:23:27 +0000

SHARE has applied outcome mapping as an approach to plan, monitor and evaluate its research into use work. Outcome mapping (OM) is an iterative approach to project planning, monitoring and evaluation which seeks to identify, engage and work with the key stakeholders who are likely to help foster transformative change. This learning report documents SHARE’s OM experience and presents key areas of learning; resourcing OM, context and culture, analysing OM data, adaptive approaches and ways of working. It also makes recommendations for other implementers using OM or OM principles in programmes.

Download (605.2 KB) Emily Balls Kenya Malawi Tanzania Zambia

Behaviour Change for WASH: Policy Brief

shareadmin — Tue, 26 Jun 2018 15:35:12 +0000

Since 2010, the SHARE Consortium has prioritised behaviour change in WASH interventions, championing the importance of identifying novel and creative approaches to changing behaviours across many countries. This policy brief documents SHARE’s contribution to understanding behaviour change and associated health impacts. It provides recommendations for researchers and intervention implementers, policy makers and funders.

Download (473.23 KB) Choose Soap Integrating WASH and Food Hygiene in Malawi Mikono Safi Safe Start San-Dem SuperAmma Weaning Food Hygiene - Bangladesh Weaning Food Hygiene - Mali Weaning Food Hygiene - Nepal Weaning Food Hygiene - The Gambia Sophie Durrans Bangladesh India Kenya Malawi Mali Nepal Tanzania The Gambia Zambia

The association between domestic animal presence and ownership and household drinking water contamination among periurban communities of Kisumu, Kenya

shareadmin — Thu, 07 Jun 2018 08:35:43 +0000

This study, published by Barnes et al (2018) in PLOS ONE, details a cross-sectional household survey of 800 households conducted across three informal peri-urban neighborhoods of Kisumu, Kenya, collecting stored drinking water samples, administering a household survey including water, sanitation and hygiene infrastructure and behaviors, and recording domestic animal presence and ownership. The majority of households sampled had fecally contaminated drinking water (67%), defined by the presence of any colony forming units of the fecal indicator bacteria enterococci. The study concludes that water, sanitation, and hygiene strategies to reduce diarrheal disease should consider the promotion of safe animal contact alongside more traditional interventions focusing on the management of human waste.

Download (1.93 MB) Safe Start Kenya