Reproductive Health and Gender Issues: 2005 -2008
Gender inequalities in Kenya.
Author:
Creighton C; Yieke F; Okely J; Mareri L; Wafula C
Source:
Paris, France, UNESCO, 2006.
Abstract:
The papers in this volume are a selection of those presented at the
Conference on Understanding Gender Inequalities in Kenya, held at
Egerton University, Kenya, from 5th to 8th April 2004. Organised by the
Centre (now Institute) for Women's Studies and Gender Analysis at
Egerton, in conjunction with the Department of Comparative and
Applied Sciences at the University of Hull, it brought together academics
from inside and outside Kenya, practitioners and politicians to explore
the many dimensions of women's subordination and to discuss ways of
confronting the entrenched legacy of male domination. Despite many
years of academic analysis and practical feminist activity, despite
prestigious international resolutions and declarations of intent, despite
the increased prominence of women's issues in the discourses of
governmental and non-governmental organisations alike, progress
towards gender equality is still painfully slow. Moreover, just as
advances seem to be made on particular fronts, new problems emerge.
Economic restructuring, the crisis of the state, the explosion of ethnic
conflicts and the toll of HIV/AIDS are all examples of issues which have
had a profound impact on gender relations and perhaps nowhere have
women felt their effects quite so sharply as in sub-Saharan Africa. Given
the scope and speed of contemporary change it is thus essential to keep
the changing patterns of gender relations under continual examination, to
monitor the extent to which progress is being made towards women's
emancipation and to interrogate the adequacy of prevailing strategies
towards this goal. (excerpt)
Language:
English
Keywords:
KENYA | PROGRESS REPORT | EVALUATION | WOMEN IN
DEVELOPMENT | GENDER ISSUES | SEX DISCRIMINATION |
INEQUALITIES | WORKPLACE | UNIVERSITIES |
MICROECONOMIC FACTORS | EDUCATION | PLANNING |
ENVIRONMENTAL POLICY | WAR | CULTURE | DEVELOPING
COUNTRIES | AFRICA, EASTERN | AFRICA, SUB SAHARAN |
AFRICA | ECONOMIC DEVELOPMENT | ECONOMIC FACTORS |
SOCIOCULTURAL FACTORS | SOCIAL DISCRIMINATION |
SOCIAL PROBLEMS | SOCIOECONOMIC FACTORS |
EMPLOYMENT | MACROECONOMIC FACTORS | SCHOOLS |
ORGANIZATION AND ADMINISTRATION | POLICY |
POLITICAL FACTORS | ENVIRONMENT
1
Reproductive Health and Gender Issues: 2005 -2008
Document Number: 313131
Programming to address violence against women: 10 case studies.
Author:
Melek M; Albrectsen AB; Agduk M; Bojorquez N; Cordoba A
Source:
New York, New York, United Nations Population Fund [UNFPA], 2006.
Abstract:
During the UNFPA Global Meeting in December 2004, a number of
country offices reviewed their success in implementing UNFPAsupported projects to address violence against women. Some of these
experiences were local adaptations of these model standards and
strategies. To build upon lessons discussed at the global meeting,
UNFPA, with support from the Swiss Agency for Development and
Cooperation (SDC), launched a review of ten projects to identify what
works in terms of programming to address violence against women,
particularly in terms of community ownership and programme
sustainability. The result is this publication. It is one of a series of
booklets, including 'Culture Matters', 'Working from Within' and '24 Tips
for Culturally Sensitive Programming' produced as part of UNFPA's
Culture Initiative, which started in 2002 with funding from the SDC and
the German Government. Other products include a training manual that
is being used to train UNFPA staff and build capacity within UNFPA on
culturally sensitive approaches in programming areas including
reproductive rights and health, HIV/AIDS, and female genital
mutilation/cutting. This publication is a joint effort of UNFPA's Technical
Support Division--the Culture, Gender and Human Rights Branch--and
it’s Geographic Divisions. Country offices in Bangladesh, Colombia,
Ghana, Kenya, Mauritania, Mexico, Morocco, Romania, Sierra Leone and
Turkey gave their full support in providing information to the research
team leader and the national and international consultants who reviewed,
analysed and documented the country projects. (excerpt)
Language:
English
Keywords:
MAURITANIA | ROMANIA | SIERRA LEONE | MOROCCO |
COLOMBIA | KENYA | TURKEY | MEXICO | BANGLADESH |
GHANA | SUMMARY REPORT | CASE STUDIES | WOMEN |
VIOLENCE AGAINST WOMEN | NURSE-MIDWIVES | RAPE |
DOMESTIC VIOLENCE | HUMAN RIGHTS | SEXUAL
HARASSMENT | PREVENTION AND CONTROL | AFRICA,
NORTHERN | AFRICA | DEVELOPING COUNTRIES | EUROPE,
SOUTHEASTERN | EUROPE | AFRICA, WESTERN | AFRICA
SOUTH OF THE SAHARA | SOUTH AMERICA, NORTHERN |
SOUTH AMERICA | LATIN AMERICA | AMERICAS | AFRICA,
EASTERN | NORTH AMERICA | ASIA, SOUTHERN | ASIA |
2
Reproductive Health and Gender Issues: 2005 -2008
STUDIES | RESEARCH METHODOLOGY | DEMOGRAPHIC
FACTORS | POPULATION | CRIME | SOCIAL PROBLEMS |
SOCIOCULTURAL FACTORS | HEALTH PERSONNEL | DELIVERY
OF HEALTH CARE | HEALTH | POLITICAL FACTORS | DISEASES
Document Number: 312499
Engendering health sector responses to sexual violence and HIV in
Kenya: Results of a qualitative study.
Author:
Kilonzo N; Taegtmeyer M; Molyneux C; Kibaru J; Kimonji V
Source:
AIDS Care. 2008 Feb
Abstract:
In Kenya many people who have been affected by sexual violence turn to
the health sector for clinical treatment and preventive therapies. This
interface provides a vital opportunity to impact on the dual epidemics of
HIV and sexual violence. Despite this, the uptake of post-rape care
services in health facilities as low and health care providers felt illprepared to deal with the consequences of sexual violence. A qualitative
study was conducted to better understand the reasons for the low uptake
of services and to establish perceptions of sexual violence in Kenya.
Thirty-four key informants were interviewed and sixteen focus group
discussions with women and men were held in three districts in Kenya.
Blurred boundaries between forced and consensual sex emerged.
Important implications for the delivery of HIV post exposure prophylaxis
(PEP) after sexual violence include the need for gender-aware patientcentred training for health providers and for HIV PEP interventions to
strengthen on-going HIV-prevention counselling efforts. Further research
needs to determine the feasibility of on-going risk reduction measures in
the context of PEP delivery. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | QUALITATIVE RESEARCH |
INTERVIEWS | FOCUS GROUPS | SEXUAL ABUSE | RAPE |
GENDER ISSUES | HIV | HEALTH PERSONNEL | HEALTH
SERVICES | AWARENESS | DEVELOPING COUNTRIES | AFRICA,
EASTERN | AFRICA, SUB SAHARAN | AFRICA | RESEARCH
METHODOLOGY | DATA COLLECTION | CRIME | SOCIAL
PROBLEMS | SOCIOCULTURAL FACTORS | HIV INFECTIONS |
VIRAL DISEASES | DISEASES | DELIVERY OF HEALTH CARE |
HEALTH | KNOWLEDGE
3
Reproductive Health and Gender Issues: 2005 -2008
Document Number: 324185
Teacher identities and empowerment of girls against sexual
violence.
Author:
Chege F
Source:
[Unpublished] 2006. Prepared for United Nations Division for the
Advancement of Women (DAW), in collaboration with UNICEF. Expert
Group Meeting: Elimination of all Forms of Discrimination and Violence
against the Girl Child, UNICEF Innocenti Research Centre, Florence,
Italy, 25-28 September 2006.
Abstract:
Exploring teachers' gendered lives and how these influence teacherlearner relationships and pedagogical practices offers valuable insights
into the broader understandings of how schools could play a meaningful
role in empowering not only girls, but all children and young people in
establishing violent-free relationships within and outside formal
educational environments. In doing this, it is important to examine
closely how teachers talk about their experiences as women and men
generally, how they interpret their professional lives and how they
perceive their relationships with their female and male colleagues and
with the learners in gendered ways. Such exploration would enable us to
understand how teachers, as gendered beings construct non-cooperation
between the genders, thus enhance or reinforce sexism, which provides
fertile grounds for gender-based violence against girls and women in
particular. Using various studies in countries of the Eastern and Southern
Africa Region (ESAR), the author contends that professional behaviour including that of teachers - is determined not just by institutional cultures
and contexts, but also by a person's life history and experiences that are
continually and variably transforming Self and Other through dialogue,
within and outside their places of work. (excerpt)
Language:
English
Keywords:
KENYA | RECOMMENDATIONS | CRITIQUE | EVALUATION |
TEACHERS | INFLUENTIALS | ADOLESCENTS, FEMALE |
WOMEN IN DEVELOPMENT | RAPE | WOMEN'S
EMPOWERMENT | INTERPERSONAL RELATIONS | GENDER
RELATIONS | ATTITUDE | SEX DISCRIMINATION | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
DEVELOPING COUNTRIES | EDUCATION | KNOWLEDGE
SOURCES | COMMUNICATION | ADOLESCENTS | YOUTH |
AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | ECONOMIC
DEVELOPMENT | ECONOMIC FACTORS | CRIME | SOCIAL
PROBLEMS | SOCIOCULTURAL FACTORS | WOMEN'S STATUS |
4
Reproductive Health and Gender Issues: 2005 -2008
SOCIOECONOMIC FACTORS | BEHAVIOR | GENDER ISSUES |
PSYCHOLOGICAL FACTORS | SOCIAL DISCRIMINATION
Document Number: 316321
Gender, children, and family planning networks in Kenya.
Author:
Source:
Musalia J
Social Science Journal
Abstract:
This study examines how having young children (those aged less than 18
years) in the households influences the patterns of social interaction
between men and women. The study reveals that women's social
networks are influenced more than men's by having more young
children. Most women are recognizing that having many young children
is not only an economic but also a social burden. As such, a large young
family forces women to seek instrumental, informational, and emotional
support from their friends, thus enlarging their social networks,
increasing the intensity of their interactions, and diversifying the
composition of their social networks. (author's
Language:
English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | CHILDREN |
COUPLES | HOUSEHOLDS | SOCIAL NETWORKS | GENDER
RELATIONS | FAMILY RELATIONSHIPS | HOME ECONOMICS |
SEX FACTORS | EMOTIONS | DEVELOPING COUNTRIES |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
SURVEYS | SAMPLING STUDIES | STUDIES | RESEARCH
METHODOLOGY | YOUTH | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| FAMILY CHARACTERISTICS | FAMILY AND HOUSEHOLD |
SOCIOCULTURAL FACTORS | FRIENDS AND RELATIVES |
GENDER ISSUES | MICROECONOMIC FACTORS | ECONOMIC
FACTORS | PSYCHOLOGICAL FACTORS | BEHAVIOR
Document Number: 324919
5
Reproductive Health and Gender Issues: 2005 -2008
Gender-role attitudes and reproductive health communication
among female adolescents in South Nyanza, Kenya.
Author:
Obare F; Agwanda A; Magadi M
Source:
African Population Studies
Abstract:
In this paper, we use data from three districts of Nyanza Province in
Kenya to examine gender-role attitudes and reproductive health
communication among adolescent females aged 12-19 years. We test for
differences in gender-role attitudes between younger (12-15) and older
(16-19) adolescents. We explore the possible association between
educational attainment and gender-role attitudes by estimating a
random-effects model. We also examine the association between genderrole attitudes and reproductive health communication via an unordered
multinomial logit model. The results show that adolescent females in this
setting hold conservative views on decision making within the home and
at the same time portray less conservative views concerning marriage and
reproductive behaviour. We also find some differences by age regarding
gender-role attitudes and reproductive health communication. Our
findings further indicate that educational attainment is significantly
associated with gender-role attitudes, which in turn are significantly
associated with reproductive health communication. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS |
MATHEMATICAL MODEL | ADOLESCENTS, FEMALE | WOMEN
IN DEVELOPMENT | GENDER RELATIONS | FEMALE ROLE |
ATTITUDE | AGE FACTORS | EDUCATIONAL STATUS | SEX
EDUCATION | DECISION MAKING | PARTNER
COMMUNICATION | REPRODUCTIVE BEHAVIOR | AFRICA,
EASTERN | AFRICA, SUB SAHARAN | AFRICA | DEVELOPING
COUNTRIES | SURVEYS | SAMPLING STUDIES | STUDIES |
RESEARCH METHODOLOGY | MODELS, THEORETICAL |
ADOLESCENTS | YOUTH | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | ECONOMIC
DEVELOPMENT | ECONOMIC FACTORS | GENDER ISSUES |
SOCIOCULTURAL FACTORS | SOCIAL BEHAVIOR | BEHAVIOR |
PSYCHOLOGICAL FACTORS | SOCIOECONOMIC STATUS |
SOCIOECONOMIC FACTORS | EDUCATION | INTERPERSONAL
RELATIONS | FERTILITY | POPULATION DYNAMICS
Document Number: 310309
6
Reproductive Health and Gender Issues: 2005 -2008
Bypassing districts? Implications of sector-wide approaches and
decentralization for integrating gender equity in Uganda and
Kenya.
Author:
Elsey H; Kilonzo N; Tolhurst R; Molyneux C
Source:
Health Policy and Planning
Abstract:
While the concept of gender mainstreaming has gained acceptance
among many national and international development organizations,
many obstacles are faced in translating the concept into tangible
improvements in the health and well-being of women and men. This
paper presents two qualitative case studies, one from Kenya and one
from Uganda, of experiences of mainstreaming gender at district level;
experiences which are set against the context of decentralization and
sector-wide approaches (SWAPs). The conceptual framework of social
movement theory, as used by Hafner-Burton and Pollack, is drawn upon
to analyze the findings of both case studies. This paper has been written
in conjunction with a paper by Theobald et al. which explores gender
mainstreaming at national level. (author's)
Language:
English
Keywords:
UGANDA | KENYA | RESEARCH REPORT | CASE STUDIES |
GOVERNMENT AGENCIES | ADMINISTRATIVE PERSONNEL |
GENDER ISSUES | INEQUALITIES | DECENTRALIZATION |
HEALTH SERVICES ADMINISTRATION | HEALTH POLICY |
AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA
| DEVELOPING COUNTRIES | STUDIES | RESEARCH
METHODOLOGY | ORGANIZATIONS | POLITICAL FACTORS |
SOCIOCULTURAL FACTORS | ORGANIZATION AND
ADMINISTRATION | SOCIOECONOMIC FACTORS | ECONOMIC
FACTORS | MANAGEMENT | POLICY
Document Number: 285950
The intersection of gender, access, and quality of care in
reproductive services: examples from Kenya, India, and Guatemala.
Author:
Hardee K
Source:
[Washington, D.C.], United States Agency for International Development
[USAID], Interagency Gender Working Group, Gender, Access, and
Quality of Care Task Force, 2005 Apr.
7
Reproductive Health and Gender Issues: 2005 -2008
Abstract:
The 1994 International Conference on Population and Development
(ICPD) in Cairo stressed the importance of gender and noted that
reproductive health programs should be implemented from a gender
perspective. However, little has been written about how reproductive
health programs that focus on improving quality of care and access to
care can integrate gender. This paper describes the experiences of three
types of programs (government, reproductive health NGO, and women’s
health NGO) in Kenya, India, and Guatemala that integrate gender in
their work and examines how they integrate gender into programs that
improve quality of care and access to care. It should be emphasized that
this report does not document whether gender integration results in
higher quality and access, but rather documents how gender integration
can take place. This report is based on data that were collected in the
three countries, through interviews with a total of 27 program staff and
34 providers and through focus groups with 136 clients. These three types
of programs engage clients in the clinic and community setting in a
manner closely related to their mandates and perspectives on gender. In
the government and reproductive health (RH) NGOs, the emphasis is on
quality and access, with gender included as a means to reach those goals.
The women’s NGOs have the mandate to first promote gender equity
(primarily through women’s empowerment), and also to use it as a means
to promote reproductive health care. The organizations with the strongest
internal gender policies, namely the women’s and RH NGOs, are also the
most committed to integrating gender into their programs for clients. The
RH NGOs are most committed to gender equity or equal participation of
women and men in the organization. (excerpt)
Language:
English
Keywords:
INDIA | KENYA | GUATEMALA | SUMMARY REPORT |
REPRODUCTIVE HEALTH | HEALTH SERVICES | QUALITY OF
HEALTH CARE | GENDER ISSUES | PROGRAM ACCESSIBILITY |
DEVELOPING COUNTRIES | ASIA, SOUTHERN | ASIA | AFRICA,
EASTERN | AFRICA, SUB SAHARAN | AFRICA | CENTRAL
AMERICA | LATIN AMERICA | AMERICAS | HEALTH |
DELIVERY OF HEALTH CARE | HEALTH SERVICES EVALUATION
| PROGRAM EVALUATION | PROGRAMS | ORGANIZATION
AND ADMINISTRATION
Document Number: 289744
8
Reproductive Health and Gender Issues: 2005 -2008
Family size, economics and child gender preference: a case study in
the Nyeri district of Kenya.
Author:
Kiriti TW; Tisdell C
Source:
International Journal of Social Economics
Abstract:
Purpose:
The objective is to determine the influence of economic and
social/cultural factors on family size and child gender preferences in
rural Kenya and to draw public policy implications from the results. This
is an important matter because the fertility rate in Kenya is high; higher
than in most developing countries. It is especially high in rural areas. This
may be an impediment to Kenya’s development.
Design/methodology/approach:
First relevant economic literature is reviewed to identify factors that
economists and others claim are important influences on family size.
Then follows a case study of families in the Nyeri district of Kenya. Data
are obtained from a random sample of households in this district using a
semi-structured questionnaire in direct interviews. The survey results are
summarised and then analysed using Tobit analysis and least squares
regression.
Findings:
Both economic and social/cultural factors are found to be important
influences on family size. For example, preference for male children has
an important positive influence on family size in the Nyeri district.
Women are found to prefer male offspring to daughters, possibly because
they are afraid of being disinherited if they do not produce a male heir for
their husbands.
Research limitations/implications:
Support for the conclusions reached could be strengthened or further
assessed by increasing the sample size in the Nyeri district and be
conducting similar surveys in other rural districts of Kenya. Practical
implications – Introducing social security systems in Kenya to assist the
elderly and the infirm would reduce the need for Kenyan women to have
many children as security and women should be granted greater
inheritance rights, especially to land. Furthermore, education of women
should be promoted as a way to reduce family size.
Originality/value:
This paper reinforces the view that both economic and social/cultural
factors must be considered simultaneously when examining determinants
of the number of children in a family and child gender preference.
(author's)
9
Reproductive Health and Gender Issues: 2005 -2008
Language:
English
Keywords:
KENYA | RURAL AREAS | RESEARCH REPORT | CASE STUDIES |
WOMEN | FAMILY SIZE | ECONOMIC FACTORS | SEX
PREFERENCE | GENDER ISSUES | INEQUALITIES | EDUCATION
| CHILD WORTH | DEVELOPING COUNTRIES | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
GEOGRAPHIC FACTORS | POPULATION | STUDIES | RESEARCH
METHODOLOGY | DEMOGRAPHIC FACTORS | FAMILY
CHARACTERISTICS | FAMILY AND HOUSEHOLD | VALUE
ORIENTATION | PSYCHOLOGICAL FACTORS | BEHAVIOR |
SOCIOECONOMIC FACTORS | MICROECONOMIC FACTORS
Document Number: 291637
Female sexuality in Nairobi: Flawed or favoured?
Author:
Spronk R
Source:
Culture, Health and Sexuality
Abstract:
Studies of female sexuality in Africa tend to adopt an instrumental
approach, many times problematizing sexual conduct in relation to HIV
infection and/or reproduction. This study aimed to explore sexuality as a
relational concept. Using interviews and participant observation, the
paper shows how sexuality becomes a point of self-identification for
young professional women in Nairobi between 20 and 30 years-old.
These women form a group who implicitly and explicitly criticize
conventional gender roles through the overt pursuit of sexual pleasure as
recognition of their womanhood. This aspect of the feminine sense of self
is at odds with normative notions of femininity. To avoid criticism for
being ?un-proper?, women adopt a deferential attitude towards men. The
focus on upwardly mobile professional women and their experiments
with new types of heterosexual relations in dating provides insight into
both sexuality and gender. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | SOCIOMETRIC TECHNICS |
WOMEN | SEXUALITY | FEMALE ROLE | SELF-PERCEPTION |
GENDER RELATIONS | PREMARITAL SEX BEHAVIOR | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
DEVELOPING COUNTRIES | MEASUREMENT | RESEARCH
METHODOLOGY | DEMOGRAPHIC FACTORS | POPULATION |
10
Reproductive Health and Gender Issues: 2005 -2008
PERSONALITY | PSYCHOLOGICAL FACTORS | BEHAVIOR |
SOCIAL BEHAVIOR | PERCEPTION | GENDER ISSUES |
SOCIOCULTURAL FACTORS | SEX BEHAVIOR
Document Number: 315455
Intimate partner violence and reproductive health of women in
Kenya.
Author:
Emenike, E.; Lawoko, S., and Dalal, K.
Source:
Int Nurs Rev. 2008 Mar; 55(1):97-102.
Abstract:
Background:
Reproductive age represents an augmented risk of intimate partner
violence (IPV) despite its occurrence in women of all ages. IPV has been
associated with various reproductive health outcomes (e.g. terminated
pregnancies and infant mortality), although multi-country studies
indicate that the findings may not be consistent across all cultures.
Study aim and method:
The current work describes the association between IPV and reproductive
health of women in Kenya using the Demographic and Health Survey of
2003.
Results:
A significant association between physical/emotional/sexual abuse of
women and negative reproductive health outcomes such as terminated
pregnancies and infant mortality was identified. In addition, IPV
exposure was associated with use of family planning methods and high
fertility.
Conclusion and recommendations:
Practitioners in the healthcare sector should inquire about abuse.
Provision of counselling services and information regarding IPV effects
on reproductive outcomes as well as referring abused women to relevant
institutions is recommended in secondary prevention of IPV and to
improve the reproductive health status of abused women.
11
Reproductive Health and Gender Issues: 2005 -2008
Increased risk of HIV in women experiencing physical partner
violence in Nairobi, Kenya.
Author:
Fonck, K.; Leye, E.; Kidula, N.; Ndinya-Achola, J., and Temmerman, M.
Source:
AIDS Behav. 2005 Sep; 9(3):335-9.
Abstract:
As part of a study on etiology of sexually transmitted infections (STI)
among 520 women presenting at the STI clinic in Nairobi, data on partner
violence and its correlates were analyzed. Prevalence of lifetime physical
violence was 26%, mainly by an intimate partner (74%). HIV seropositive
women had an almost twofold increase in lifetime partner violence.
Women with more risky sexual behavior such as early sexual debut,
number of sex partners, history of condom use and of STI, experienced
more partner violence. Parity and miscarriage were associated with a
history of lifetime violence. We found an inverse association between
schooling and level of violence. Six percent of the women had been raped.
Gender-based violence screening and services should be integrated into
voluntary counseling and testing programs as well as in reproductive
health programs. Multi-sector approaches are needed to change
prevailing attitudes towards violence against women.
Genetic analysis of HIV-1 subtypes in Nairobi, Kenya
Author:
Khoja, S.; Ojwang, P.; Khan, S.; Okinda, N.; Harania, R., and Ali, S.
Source:
PLoS ONE. 2008; 3(9):e3191.
Abstract:
Background:
Genetic analysis of a viral infection helps in following its spread in a
given population, in tracking the routes of infection and, where
applicable, in vaccine design. Additionally, sequence analysis of the viral
genome provides information about patterns of genetic divergence that
may have occurred during viral evolution.
Objective:
In this study we have analyzed the subtypes of Human
Immunodeficiency Virus -1 (HIV-1) circulating in a diverse sample
population of Nairobi, Kenya.
Methodology:
69 blood samples were collected from a diverse subject population
attending the Aga Khan University Hospital in Nairobi, Kenya. Total
DNA was extracted from peripheral blood mononuclear cells (PBMCs),
and used in a Polymerase Chain Reaction (PCR) to amplify the HIV gag
12
Reproductive Health and Gender Issues: 2005 -2008
gene. The PCR amplimers were partially sequenced, and alignment and
phylogenetic analysis of these sequences was performed using the Los
Alamos HIV Database. RESULTS: Blood samples from 69 HIV-1 infected
subjects from varying ethnic backgrounds were analyzed. Sequence
alignment and phylogenetic analysis showed 39 isolates to be subtype A,
13 subtype D, 7 subtype C, 3 subtype AD and CRF01_AE, 2 subtype G
and 1 subtype AC and 1 AG. Deeper phylogenetic analysis revealed HIV
subtype A sequences to be highly divergent as compared to subtypes D
and C.
Conclusion:
Our analysis indicates that HIV-1 subtypes in the Nairobi province of
Kenya are dominated by a genetically diverse clade A. Additionally, the
prevalence of highly divergent, complex subtypes, intersubtypes, and the
recombinant forms indicates viral mixing in Kenyan population, possibly
as a result of dual infections.
Social inequalities in intimate partner violence: a study of women
in Kenya.
Author:
Lawoko, S.; Dalal, K.; Jiayou, L., and Jansson, B.
Source:
Violence Vict. 2007; 22(6):773-84.
Abstract:
This study examines social inequalities in intimate partner violence (IPV)
among women of reproductive age in Kenya. A sample comprising 3,696
women was retrieved from the Kenyan Demographic and Health Survey
of 2003. The study design was cross-sectional. Chi-square tests and
logistic regression were used to analyze the data. Results indicated that
while high education among women reduced the risk of IPV exposure,
both being employed and having a higher education/occupational status
than her partner increased a woman's vulnerability to IPV. Age
differences between the partners, illiteracy, and lack of autonomy and
access to information increased the likelihood of IPV. Finally, being in
polygamous relationships was associated with IPV exposure. The
findings indicate demographic, social, and structural differences in
exposure to IPV with important implications for interventions.
13
Reproductive Health and Gender Issues: 2005 -2008
Gender, equity: new approaches for effective management of
communicable diseases.
Author:
Theobald, S.; Tolhurst, R., and Squire, S. B.
Source:
Trans R Soc Trop Med Hyg. 2006 Apr; 100(4):299-304.
Abstract:
This editorial article examines what is meant by sex, gender and equity
and argues that these are critical concepts to address in the effective
management of communicable disease. Drawing on examples from the
three major diseases of poverty (HIV, tuberculosis [TB] and malaria), the
article explores how, for women and men, gender and poverty can lead to
differences in vulnerability to illness; access to quality preventive and
curative measures; and experience of the impact of ill health. This
exploration sets the context for the three companion papers which outline
how gender and poverty shape responses to the three key diseases of
poverty in different geographical settings: HIV/AIDS in Kenya; TB in
India; and malaria in Ghana.
Begin community dialogue on FGM / C by discussing cultural
justification. Kenya FGM / C.
Abstract:
The Somali ethnic community, including those living in Kenya, primarily
practices infibulation, the most severe type of female genital mutilation/
cutting (FGM/C) in which the external female genitalia are removed and
the remaining tissue is stitched or glued closed with a natural substance,
leaving a small opening for the passage of urine and menstrual blood.
This type of cut is associated with increased incidence and seriousness of
obstetric and gynecological problems relative to uncut women and those
with less severe forms of FGM/C. In 2004 FRONTIERS collaborated with
UNICEF on a four-month diagnostic study on FGM/C practices among
the Somali community in Kenya. The study, undertaken in eastern
Nairobi and North Eastern Province, sought to better understand the
community's perception and practice of FGM/C, determine approaches
to encourage its abandonment, and identify how the health system could
be more actively engaged in managing complications and discouraging
the practice. (excerpt)
Intimate partner violence and HIV risk in Kenya.
Author:
Dude, A. M.
Abstract:
HIV is a prevalent health problem in Kenya, as an estimated 6.1% of the
adult population is currently HIV positive. Intimate partner violence has
14
Reproductive Health and Gender Issues: 2005 -2008
been associated with increased HIV risk in both women and in men in
other settings. Using nationally-representative data from 2003 Kenya
Demographic and Health Survey that includes information on both HIV
serostatus and intimate partner violence to explore whether there is a
correlation between physical, sexual, or emotional violence and HIV in
currently married Kenyan men and women. Although I find that men
whose wives report emotional abuse are more likely to be HIV positive,
this association is otherwise not significant. Rather, among women, HIV
infection is significantly associated with being in a polygamous marriage,
as well as the number of years of exposure to premarital sexual activity.
Among men, being in a polygamous marriage is associated with a higher
rate of HIV, while being circumcised is associated with a lower
probability of infection. In both genders, being of Luo ethnicity is also
often positively associated with HIV infection. (author's)
Strengthening HIV / AIDS programs for women: lessons for U.S.
policy from Zambia and Kenya.
Author:
Fleischman, J.
Source:
A report of the CSIS Task Force on HIV / AIDS.
Abstract:
The President’s Emergency Plan for AIDS Relief (PEPFAR) completed its
first full year of funding in January 2005. This provides a useful vantage
point from which to analyze the program’s performance thus far, notably
with regard to programs targeting women and girls. This paper, based on
a CSIS field mission to Kenya and Zambia in February 2005 to assess
PEPFAR implementation from a gender perspective, looks at this critical
dimension of the HIV/AIDS epidemic— the disproportionate impact on
women and girls—to suggest how PEPFAR can be adjusted and
strengthened to better target and enhance its response moving forward.
One of the key challenges is that larger social and economic factors affect
women and girls’ vulnerability to HIV infection and complicate their
illness when infected. In fact, addressing these dimensions is
fundamental to curbing the epidemic among women and girls, and
promising models for doing so already exist. At this juncture, it is critical
for the Office of the Global AIDS Coordinator (OGAC) to remedy this
shortcoming, including by: issuing guidance specific to the needs of
women and girls, strengthening linkages with programs working on
women’s social and economic empowerment, establishing a technical
working group to assist in this process as well as provide ongoing input
to the field, documenting programs targeting women and girls, and
monitoring program impact in each PEPFAR country. (excerpt)
15
Reproductive Health and Gender Issues: 2005 -2008
Social inequalities in intimate partner violence: a study of women
in Kenya.
Author:
Lawoko, S.; Dalal, K.; Jiayou, L., and Jansson, B.
Source:
Violence Vict. 2007; 22(6):773-84.
Abstract:
This study examines social inequalities in intimate partner violence (IPV)
among women of reproductive age in Kenya. A sample comprising 3,696
women was retrieved from the Kenyan Demographic and Health Survey
of 2003. The study design was cross-sectional. Chi-square tests and
logistic regression were used to analyze the data. Results indicated that
while high education among women reduced the risk of IPV exposure,
both being employed and having a higher education/occupational status
than her partner increased a woman's vulnerability to IPV. Age
differences between the partners, illiteracy, and lack of autonomy and
access to information increased the likelihood of IPV. Finally, being in
polygamous relationships was associated with IPV exposure. The
findings indicate demographic, social, and structural differences in
exposure to IPV with important implications for interventions.
Documenting human rights violations against sex workers in
Kenya.
Author:
Lukera, M.
Source:
HIV AIDS Policy Law Rev. 2007 Dec; 12(2-3):76-7.
Abstract:
The human rights of sex workers are an increasing concern for prominent
women's rights organizations such as the Federation of Women Lawyers
(FIDA). As FIDA-Kenya's MaryFrances Lukera writes, documenting
human rights abuses against sex workers is critical to responding to
Kenya's HIV epidemic standards and strategies. To build upon lessons
discussed at the global meeting, UNFPA, with support from the Swiss
Agency for Development and Cooperation (SDC), launched a review of
ten projects to identify what works in terms of programming to address
violence against women, particularly in terms of community ownership
and programme sustainability. The result is this publication. It is one of a
series of booklets, including 'Culture Matters', 'Working from Within' and
'24 Tips for Culturally Sensitive Programming' produced as part of
UNFPA's Culture Initiative, which started in 2002 with funding from the
SDC and the German Government. Other products include a training
manual that is being used to train UNFPA staff and build capacity within
UNFPA on culturally sensitive approaches in programming areas
including reproductive rights and health, HIV/AIDS, and female genital
16
Reproductive Health and Gender Issues: 2005 -2008
mutilation/cutting. This publication is a joint effort of UNFPA's Technical
Support Division--the Culture, Gender and Human Rights Branch--and
it’s Geographic Divisions. Country offices in Bangladesh, Colombia,
Ghana, Kenya, Mauritania, Mexico, Morocco, Romania, Sierra Leone and
Turkey gave their full support in providing information to the research
team leader and the national and international consultants who reviewed,
analysed and documented the country projects. (excerpt)
Combating gender-based violence in Kenya: The experience of
"men for gender equality now".
Author:
Miruka, O
Source:
Critical Half. 2007 Winter; 5(1):21-25.
Abstract:
Following a 2001 consultation for eastern and southern African men to
discuss ways that men could combat GBV, a regional movement of men
against GBV crystallized and led to the creation of Men for Gender
Equality Now (MEGEN) in Kenya. MEGEN argues that not all men are
perpetrators of violence; rather, many men recognize the problem of GBV
and can be effective allies in tackling it, particularly by bringing their
peers together to confront negative behavior and attitudes toward
women and collectively redefine masculinity as a construct that does not
inhere in domination, aggression, and violence. In the words of MEGEN's
Coordinator, Ken Otina, "I talk to my brothers and friends about the
futility of violence. [I] advise them not to raise their hand even when
provoked but instead address the root cause of the problem. And I have
seen a positive change in their lives." This article describes the strategies
developed, challenges faced, and lessons learned by MEGEN as it works
to combat incidences of GBV across Kenyan society and, in the process,
create greater equality between the nation's men and women. (excerpt)
Trauma in African women and children: A study of the Kenyan
experience as illustration of the phenomenon.
Author:
Njenga, F. G.
Source:
South African Psychiatry Review. 2007; 10(1):27-30.
Abstract:
In traditional African societies, roles and responsibilities of its members
were carefully regulated, giving the community a sense of cohesion,
continuity and integrity. Following the periods of colonization, wars of
liberation, independence and post colonial self governments, many
countries in Africa have disintegrated into volatile autocratic
17
Reproductive Health and Gender Issues: 2005 -2008
dictatorships that have led to many wars, genocide, internal and external
displacements of the people, recently complicated by natural and man
made disasters. AIDS is a recent entrant to the equation. In the midst of
these changes (and traumas) the family unit has been denuded of its
security, continuity and order. African traditional education systems have
been replaced by ill tested western models of education, while time tested
rites of passage have been declared health hazards (e.g. circumcision) in
many parts of Africa. Marriage systems that traditionally conferred
stability derived from the nature of the marital bonds have been replaced
by fragile western monogamous unions. These changes have affected
relationships "Behind Closed Doors". This paper describes the effects of
this type of globalization on Africans taking Kenya as a case example,
exploring domestic violence and the abuse of children. (author's)
Sexual Abuse and Gender-based Violence: "An impediment to
economic/social development in Africa - Case study of Kenya"
Author:
Faith Kasiva, Coalition on Violence Against Women, Kenya
Abstract:
Background and Objectives:
The Coalition on Violence Against Women - Kenya, COVAW, is women's
human rights NGO whose vision is a society free from all forms of gender
based violence, hence is committed to building social movements of
change agents that are opposed to and committed to eradicating violence
against women.
Violence against women is the greatest human rights scandal of our
times; it is one of the most pervasive yet invisible human rights
violations. It takes many forms ranging from physical, sexual, emotional
and psychological, economic as well as cultural violence. Violence against
women has far reaching consequences on the victims, their families,
community and society at large.
Violence against women is a negative expression of sexuality, and
because sexuality is so multifaceted and a sensitive issue in Africa, there
is a culture of silence around' sexuality issues more so where it concerns
women sexuality. Violence is perpetrated through use of forces like
power, control and manipulation whereby the perpetrator exudes some
power over another perceived to be powerless. Consequently sexuality
has been used to define women as "weak" hence has been manipulated as
a tool and a base for oppression and abuse of women.
Violence against women is an economic issue, women, who suffer any
forms of violence, hardly are able to contribute to meaningful social and
economic activities. The trauma experienced by the violated women
18
Reproductive Health and Gender Issues: 2005 -2008
negatively affects their productivity and this has a negative impact on the
general economy of the country.
This paper focuses on the impact of violence against women on social and
economic development in Kenya and it draws from an analysis of 4 case
studies to address:
Nature, extent and effects of sexual abuse and violence against women in
Kenya Relationship between sexuality and gender based violence against
women Economic and social implications of violence against women visa
avi development
Findings/lessons learnt:
There is a strong link between violence against Women and perpetuation
of poverty.
Violence against women impoverishes the society economically,
politically and culturally by limiting the active role that women can make
in the development of their community.
Women's inability to engage in economic activities negatively affects the
country's efforts towards economic recovery strategies.
Conclusions and recommendations:
Negative expression of sexuality diminishes a woman's dignity and self
worth and inhibits and hinders women from participation in
development.
Economic impact of violence against women cannot be underestimated.
There is need for more research on the relationship between sexuality,
violence against women and development.
Determinants of Physical Wife Abuse in Kenya.
Author:
Sitawa R Kimuna,
Source:
Department of Sociology, East Carolina University, USA
Abstract:
The study examines the levels and determinants of physical wife abuse in
Kenya using data from 4,876 married women interviewed during the
2003 Kenya Demographic and Health Survey. The analysis is guided by
three theoretical hypotheses deriving from social learning, resource, and
gender and power theories. The results show that one third of married
women have been abused by their husbands. Findings from logistic
regression models provide support only for the resource theory
hypothesis that household poverty is positively associated with wife
physical abuse. But the most important predictor of wife abuse was
ethnicity, which suggests the existence of differential local patters of
gender relations. Future research and domestic violence reduction
programs should consider the local norms seriously.
19
Reproductive Health and Gender Issues: 2005 -2008
Wifehood and Marriage in the Academy: Sexuality and academic
performance of freshmen in the Kenyan Public University.
Author:
Nyamasyo E.,
Source:
Centre for Gender Studies, Kenyatta University, Nairobi, Kenya
Abstract:
Recent changes in the funding and forms of support to freshmen and
women in Kenyan public universities have led to the emergence of
various forms of relationships between and among such students on
campus. Among such relationships are unique forms of gender relations
including temporary 'marriages, wifehood' and 'husbands'; contractual
sexual interactions, and social relations that, to a large extent, are unique
in relation to the wider cultural and social environments in which the
institutions are located. Unlike early periods of campus gender relations
of freshmen and women in the Kenyan university, today's campus life
entail students paying for their tuition and overall upkeep:
accommodation, catering and other needs .It is argued that the resulting
freshmen social relations, in particular their sexuality and its related
beliefs and practices are impacting negatively on the personal and social
development of such individuals, more so, the women students. Such
relations are hardly contributing to positive academic performance and
successful qualification on completion of the women students. The status
of being a 'campus wife' is further negated by the fact that most such
relationships hardly go on beyond the duration of the degree
programmes. Anyone child or more born out of such relations remain the
responsibility of the women student in the duration of her degree
programme and after. Women students in such relationships hardly
interact with other fellow female or male colleagues, are non-assertive,
prone to missing lectures, tend not to hand in set assignments, have
generally poor health and are hardly adequately prepared to face the
challenges of life outside studentship. Their predisposition to sexual
transmitted illnesses including HIV/AIDs infection is higher than their
counterparts not in such relationships. Why are some particular freshmen
and women likely to be involved in such unions? What can be learned
and then done by the institutions and the government to either quell and,
or mitigate the impact of such social relations on the studentship of
women in university programmes? What are the consequences of this
type of sexuality on the long-term aspects of Kenya's economy? This
paper begins to provide knowledge into reasons female and male
students contract or are 'forced' into such •unions' and their implications
on the institution of marriage in Kenyan. Based on data derived from
'her-stories' and 'his -stories' the paper provides examples of experiences
of the students engaged in such gender relations. It initiates a focus on
reviewing existing policies on students' academic and social welfare
20
Reproductive Health and Gender Issues: 2005 -2008
especially - health, catering and accommodation: the beliefs and practices
entailed in these; a strengthening of the gender perspectives in the
university students' academic and social well-being. More importantly,
the paper provides baseline knowledge for the institutions and the
government to begin to re-assess current programmes aimed at
developing its human resources, particularly women for its economic
development.
The Impacts of Gender-Based Violence on Sexual And
Reproductive Health In Nairobi: Access To Services In The Context
Of Intra-Household Economics And Health Sector Resource
Allocation.
Author:
Crichton J.,
Source:
Africa Population and Health Research Center: Nairobi, Kenya
Abstract:
Background and objectives:
Between November2005 and April 2006, the Women's Rights Awareness
Programme (WRAP) collaborated in a research project to explore the
relationships between gender-based violence and sexual and
reproductive health rights in Nairobi. WRAP provides counseling,
shelter, mediation, legal advice and referral services to survivors of
gender-based violence (including intimate partner violence, child abuse
and rape) in Nairobi. The research involved qualitative analysis of 2010 of
WRAP's client case histories and unstructured interviews with service
providers. The study was part of a five-year research programme
consortium, entitled 'Realizing Rights: Improving Sexual and
Reproductive Health for Poor and Vulnerable Populations’ funded by the
UK Department for International Development.
Findings/lessons learnt:
WRAP's case histories provide a rich source of data on client's own
expression of gender-based violence (GBV) and its economic, social,
psychotl1gical and health impacts. Analysis of these narratives concurs
with studies on the health impacts of GBV in other parts of the world. The
sexual and reproductive health (SRH) impacts included genital injuries,
irritation and infections, sexually-transmitted infections including HIV,
and complications associated with abuse during pregnancy. A
particularly striking insight from WRAP's data is that some women
experience debilitating long-term or recurrent SRH complications because
they cannot initially access services to treat health conditions resulting
from abuse. This can be due to prohibitive costs of health services (and
the transport necessary to reach them). WRAP's data shows that intimatepartner violence plays a role in denying access to health services and
21
Reproductive Health and Gender Issues: 2005 -2008
technologies, as does 'economic abuse' (such as appropriation of earnings,
denial of material support, and sabotage of income-earning activities),
Financial problems are major factors keeping women in abusive
relationships, are often a trigger cause of disputes that result in violence,
and impact on women's ability to access treatment once abuse has
occurred.
Conclusions and recommendations:
In Kenya, the political economy of resource allocation at national and
provincial levels interact with the micro allocation of power and access to
resources at the household level, denying sexual and reproductive health
rights for survivors of GBV Chronic sexual and reproductive conditions
have high economic costs in addition to the human suffering involved.
Policy makers and service providers could do more to ensure that
services and referral systems meet the long-term SRH needs that result
from GBV Further research is needed to assess the desirability and
feasibility of specialized health services to meet these needs.
Keywords:
GENDER-BASED VIOLENCE| SEXUAL RIGHTS| SEXUAL
HEALTH| ACCESS TO SERVICES| ECONOMICS.
Gender Based Violence and Sexual Violence: Three Years
Experience of Nairobi Women's Hospital.
Author:
Thenya S.,
Source:
Gender Violence Recovery Centre, Nairobi Women's Hospital Nairobi,
Kenya
Abstract:
Background:
Gender based violence (GBV) and sexual violence are on the rise in
Kenya. Newspaper reports as well as scientific research has been showing
an upward trend in cases of GBV and sexual violence. There is a gap in
medical and psychological care for the survivors. It was this recognition
which lead to establishment of GVRC.
Objective:
To ensure immediate access of medical management, HIV post exposure
prophylaxis (PEP) and psychosocial support to all survivors of rape and
sexual violence who report to GVRC.
Methodology:
A monitoring and evaluation toolkit containing both closed and openended questions exploring parameters on physical and sexual abuse, and
22
Reproductive Health and Gender Issues: 2005 -2008
other relevant data such as referrals is used. An appropriate data base has
been developed for purposes of data collection.
Outcome of the project :
From April 2002 to March 2005, the GVRC has provided services to 3128
survivors of sexual abuse (rape 1466/3128 46.9%, children sexual abuse
96513128, 30.9%) and domestic violence (697/3128, 22.2%). Survivors are
drawn mainly from Nairobi Province and its environs. However women
and children survivors have come from as far away as Kisumu (Nyanza
province), Coast Province and various parts of Central Province, Isiolo
district, North Eastern province, demonstrating the GVRCs impact across
the country. Most of GVRC key beneficiaries are drawn from low income
sectors of the population.
Through support from the hospital, survivors of gender based violence
and sexual abuse have access to high quality medical regimes and highly
qualified medical personnel. Medical aid, together with counseling
services have literally saved the lives of survivors whilst ensuring that the
subsequent quality of life of a survivor is much enhanced. GVRC
networks with FIDA, CREAW, COVAW CRADLE, and CLAN as legal
aid advisors protecting women and children's right, facilitates referral for
survivors needing to pursue legal cases. GVRC continues to partner with
Women's Right Awareness Programme (WRAP) to provide survivors
shelter. GVRC has been able to gain political goodwill from the women
parliamentarians.
Conclusions and recommendations:
GVRC has significantly contributed to improvement of health and
wellbeing of survivors of GBV and sexual violence. It has also contributed
its experience in shaping the scale up of similar services by Ministry of
Health and in particular, the development of National guidelines for
management of sexual abuse.
All Kenyans should be educated about GBV so that the problem can be
reduced. The GBV services should be scaled up and integrated with other
health service
Female Genital Cutting (FGC) as a tool to control female sexual
desire among the Somali community in Kenya.
Author:
Maryam Sheikh,
Source:
Population Council (Frontiers), Nairobi, Kenya
Abstract:
Background:
Despite many decades of active campaigning against FGC, and the recent
legislation to make it illegal under the Children's Act, it remains practiced
widely in Kenya. Results from 2003 Kenya Demographic and Health
23
Reproductive Health and Gender Issues: 2005 -2008
Survey indicates prevalence rate of 97% among the Somali community
where the most serious form (infibulation) is practiced. Several related
reasons are used to sustain the practice in the community including
control of sexual desire in women. In 2005, Population Council, with
funding from USAID, initiated a project to understand the extent and
rationale of the practice in the community.
Rationale:
To document reasons used by the Somali community to justify
continuation of FGC in relation to female sexuality.
Methodology:
The studies used in-depth interviews, Focused Group Discussions and
Structured questionnaire.
Key Findings:
The Somali community perceives FGC as a critical component of their
culture to control female sexual desires and a tool for fostering family
honour.
The sample community believes FGC preserves female virginity,
maintains female monogamy during marriage and increases male sexual
pleasure.
FGC is thought to decrease sexual desire in female during and before
marriage Sexually pure women are believed to be fulfilling Islamic
obligation and are eligible for marriage, bringing honour to their family.
Conclusions:
Strategies to correct these believe could be to advocate for reducing the
emphasis on genital cutting and stitching as the main indicators of
virginity.
Major rationales are based on norms concerning female sexual desires
and purity, thus to address these will require open discussions about
sexuality.
Recommendation:
Equality in sexual pleasure is a Sunna and can be justified in Islamic texts,
and that any form of cutting reduces a woman's right to this pleasure
Women and HIV in Africa- the Fasted growing epidemic.
Author:
Kizito Lubano
Source:
P.O Box 548-00202 Nairobi, lubanokizito@yahoo.com, 0722737293
Abstract:
Objectives:
24
Reproductive Health and Gender Issues: 2005 -2008
A review of epidemiology of HIV in women and Children in Sub-Saharan
Africa, and propose strategic approaches for prevention
Outcome Measures:
Current status, demographic and economic impact
Results:
Women constitute 60% of People Living with HIV AIDS in Sub-Saharan
Africa. Among young people, 75% who are infected are women. Most
factors are complex but related to gender inequality and sociocultural
construct of societies in these regions. There is a devastating impact on
population structure and food security. Sub-Saharan Africa is home to
90% of all paediatric HIV infections.
Conclusion:
Strategies are needed to address the structural dynamics of the AIDS
epidemic- particularly the wide-ranging gender inequalities that help
power the spread of HIV.
Recommendations:
Prevention of HIV infection among adolescent girls
Promoting access to new prevention options, including female condoms
and microbicides
Supporting on-going efforts towards universal education for girls
The prevalence of Domestic Violence among Female patients
attending gynaecology clinic at Kenyatta National Hospital.
Author:
Dr Shiphrah Kuria ,
Source:
P O Box 186 00202 KNH shiphonk@yahoo.com
Abstract:
Objectives:
 To document the prevalence of domestic violence among women
attending Gynaecology clinic in the Kenyatta National Hospital.
 To document the social demographic characteristics of the women
with history of having experienced domestic violence.
 To document the pattern of gynaenaecologic diagnosis among
women with history of having experienced domestic violence.
Results:
Of 198 women interviewed 82 (41.4%) had experienced at least one form
of domestic violence. Fifty-four (27%) of all women interviewed had
experienced physical violence. The most common form of violence in this
study was physical. Majority (85%) of those who had ever reported the
violence had done so to family members.
25
Reproductive Health and Gender Issues: 2005 -2008
Majority of the women were married with 84 (42.4%) being in customary
marriages and 49 (25%) in statutory marriages. Those cohabiting had the
highest rate of violence with 43.5% of them having experienced violence
compared to only 6% of those in statutory marriages. Twenty-three
(12%)of the women were divorced with 74% of these citing violence as
the reason for the divorce. The modal age group was 30-39 but the
majority of those who reported violence were in the 50-54 age group.
Most women (65%) experiencing violence were unemployed or poorly
paid compared to 35% with better income, but this association was not
statistically significant (P=. 24). Violence was not associated with the
level of education (P=0.59) but women with higher education were more
likely to report sexual violence (P= 0.003).
The most common diagnosis was uterine fibroids followed by secondary
infertility. Physical violence was more prevalent in the secondary
infertility group.
Conclusion:
The prevalence of domestic violence is high but many victims are
reluctant to disclose. There is need to establish structures in the society
that are sympathetic to domestic violence victims to facilitate more
disclosure.
Recommendations:
Women and girls need to be educated more so that they are more
knowlegeable about with domestic violence and how to deal with it.
Health workers need to be more intentional in looking out for domestic
violence victims and offer the necessary support.
More support is needed so that the women can overcome the barriers that
keep them from seeking help.
Heavy episodic drinking among Kenyan female sex workers is
associated with unsafe sex, sexual violence and sexually
transmitted infections.
Author:
Chersich, M. F.; Luchters, S. M.; Malonza, I. M.; Mwarogo, P.; King'ola,
N., and Temmerman, M.
Source:
Int J STD AIDS. 2007 Nov; 18(11):764-9.
Abstract:
This study examined patterns of alcohol use and its association with
unsafe sex and related sequelae among female sex workers in Mombasa,
Kenya. A community-based cross-sectional study was conducted using
snowball sampling. Binge drinkers (> or =5 alcoholic drinks on > or =1
occasion in the previous month) were compared with non-binge drinkers.
Of 719 participants, 22.4% were lifetime-alcohol abstainers, 44.7% non-
26
Reproductive Health and Gender Issues: 2005 -2008
binge and 33.0% binge drinkers. Compared with non-binge drinkers,
binge drinkers were more likely to report unprotected sex (adjusted odds
ratio (AOR)=1.59, 95% confidence interval [CI]=1.00-2.53; P=0.047) and
sexual violence (AOR=1.85, 95% CI=1.27-2.71; P=0.001) and to have either
syphilis, Neisseria gonorrhoeae or Trichomonas vaginalis infection
(AOR=1.56, 95% CI=1.00-2.41; P=0.048). HIV prevalence was higher
among women having ever drunk (39.9%) than lifetime abstainers (23.2%;
P<0.001), but was not associated with drinking patterns. Interventions
are needed to assist female sex workers adopt safer drinking patterns.
Investigation is needed for the effectiveness of such interventions in
reducing unprotected sex, sexual violence and sexually transmitted
infections.
Fertility differentials in Kenya: The effect of female migration.
Author:
Omondi, C. O. and . = Ayiemba EH.
Source:
African Population Studies
Abstract:
This study uses the Kenya Demographic and Health Survey (KDHS) data
conducted in 1988/89.The hypothesis of the paper is that women who
migrate tend to maximise their other lifetime aspirations at the expense of
their reproductive roles and performance. That is, female migrants are
involved in behaviours and practices that negatively influence fertility
relative to non-migrants. The analysis shows that through the influence of
migration on fertility, reproductive behaviour and performance is
modified; migration is a mechanism through which the changes observed
in fertility behaviour and levels can be explained. The influence of
migration on fertility levels is estimated using two procedures: the
comparison of the mean CEB and multivariate analysis. The study
demonstrated that there is an inverse relationship between migration and
the number of children ever born. (author's)
Learning global lessons from improving family planning,
reproductive health, and child survival in Kenya.
Author:
Source:
Abstract:
Rajani N and Archer, L.
The AMKENI model.
From January 2001 to June 2006, the AMKENI Project worked with the
Kenyan Ministry of Health (MOH) in Coast and Western Provinces to
increase the use of reproductive health (RH), family planning (FP), and
child survival (CS) services at the community level. A partnership of
27
Reproductive Health and Gender Issues: 2005 -2008
EngenderHealth, Family Health International (FHI), IntraHealth
International, Inc., and the Program for Appropriate Technology in
Health (PATH), AMKENI was funded by the U.S. Agency for
International Development (USAID). Working to build and strengthen
sustainable, integrated, and comprehensive RH/FP/CS services,
AMKENI collaborated with the MOH on policy reform, systems
development, and capacity building. AMKENI also worked to engage
and strengthen existing MOH and community structures. At 97 public
and private facilities in 10 districts, the project developed the capacity of
local health providers to deliver a wider array of quality RH/FP/CS
services. And the project mobilized youth, men, women, and families in
nearly 400 communities to practice healthier behaviors and increase their
use of these services. (excerpt)
Risk of STIs, HIV / AIDS, and unintended pregnancies among
domestic workers in Bahati, Nairobi. Results of a formative
assessment.
Author:
Thomsen S; Wainaina M; Johnson L; Toroitich-Ruto C, and Jagemann, C..
Abstract:
With funding from the United States Agency for International
Development through the President's Emergency Fund for AIDS Relief
(USAID/PEPFAR), Family Health International (FHI) and Kenyatta
University (KU) carried out an assessment of the situation of domestic
workers in Bahati Estate, Nairobi with the aim of designing a program to
help reduce their risk of HIV/AIDS and unintended pregnancy. In-depth
interviews with 18 domestic workers aged 18-22, seven employers, and
three other stakeholders from Bahati, Nairobi revealed that domestic
workers are likely at risk of acquiring HIV/AIDS and unintended
pregnancies in the future because of certain predisposing factors and
their lack of knowledge, their current behaviours, and their lack of access
to information and services. The factors that predispose them to poor
health outcomes are 1) their socioeconomic background; 2) their sexual
experience (including coerced sex); 3) their work environment, which is
low status and isolating; and 4) their experiences of abuse at work.
Domestic workers have some knowledge of modes of transmission and
prevention of HIV/AIDS, but knowledge and use of contraception and
condoms is low. Few have accessed family planning services and none
have tested for HIV. Domestic workers would like to be involved in
training, and feel that the best time and place for this is Sundays at
church. Employers were generally favourable about an intervention with
domestic workers, but they would need to have all of the information
about the program first. Furthermore, they were not sure other employers
would agree. In order to address the situation of domestic workers a
multilayered intervention with domestic workers, their employers, the
28
Reproductive Health and Gender Issues: 2005 -2008
Bahati community, and policymakers is recommended. The primary goal
of such an intervention would be to raise the awareness of employers and
the Bahati community, as well as building skills and providing social
support to domestic workers. (excerpt)
Catalyzing efforts-a positive approach towards Sexual health and
the Millennium Development Goals.
Author:
Yassin R.,
Source:
Liverpool VCT & Care, Kenya
Abstract:
Background:
Kenya has embraced the Millennium Development Goals. A report
launched in July 2003, by the Kenyan government and other development
partners indicated there was a high potential to meet some of the
Millennium Development Goals; especially goals 2 and goal 6. However,
the successful implementation of most of the plans and strategies had
problems due to limitations in capacity, financing and governance.
Performance of the country towards realizing Millennium Development
Goals is still low, due to the stagnation of economic growth.
National H IV prevalence is estimated at 7% - approximately 3 million
people (KDHS 2003). It is estimated that about 14,700 women of
reproductive age die each year due to pregnancy-related complications.
Between 294,000 and 441,000 suffer from disabilities caused by
complications during pregnancy and childbirth.
Despite all the strategies to improve maternal health, the proportion of
mothers assisted by skilled health personnel declined from 51% in 1989 to
45% in 1993 and further down to 42% in 2003. Promotion of sexual health
in programs and institutions has been underrated in the past, yet it is one
of the major stepping stones towards meeting the Millennium
Development Goals, thus development in Africa.
Objectives:
To show linkages between Sexual Health and the attainment of the
Millennium Development Goals.
Findings and lessons learnt:
That Sexual Health has not been fully integrated in health programmes.
That Most Millennium Development Goals approaches have not been
engendered .
That Programmes addressing sexual health issue are not gender sensitive.
Conclusion and Recommendations:
Gender mainstreaming, and prioritization in health programmes is vital
in the attainment of the Millennium Development Goals. Promotion and
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Reproductive Health and Gender Issues: 2005 -2008
the continuous sponsor of research and evaluation in sexual health and
the wide dissemination of knowledge derived from it will enhance the
provision of quality health care services thus the successful attainment of
the Millennium Development Goals as the year 2015 deadline
approaches.
The characteristics and presentation of Rape survivors in Kenya.
Author:
Odongo O. F.N,… Rogena…E.A, Mugo N.
Source:
P.O Box 2117 Nakuru
Abstract:
Objectives:
Define the demographic and clinical profile, and complications seen in
rape survivors presenting to Kenyatta National hospital, Nakuru and
Kisumu provincial hospitals between June 2001 and June 2003.
Audit the documentation and management of these sexual assault victims
by medical personnel within that period of time.
Describe the criminal profile of rapists in question using the information
Outcome Measures:
This was a retrospective study conducted at KNH, Nakuru PGH, and
Kisumu PGH. Six medical records officers (research assistants), drawn
from the three centers, i.e. Nairobi, Nakuru, and Kisumu provincial
hospitals, were identified and trained, on the basics of documentation
and management of sexual assaults. The investigators retrieved all files
and documents of sexual assault survivors seen at the respective hospitals
between January 2002 to January 2003. Information was obtained from
these records, by the research assistants, using a structured questionnaire
developed for the purpose of the study
Codes were used to identity the study subjects.
Results:
 Most(75%) survivors never reported the offence.
 Most of the survivors(50%) are minors
 Up to 50% of modus operandi is by attacks
 The majority of the survivors reported to the hospitals
unaccompanied
 Most rapists are strangers and involve in gang rape more often.
 Rape is the most common form of the a crime, and 8% of the
victims died.
 Up to 18% of rape occurred within the neighborhood.
 The assailant use crude weapons to attack.
 Only 1% of the cases were investigated properly.
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Reproductive Health and Gender Issues: 2005 -2008

Most rapists are in middle and old age and most survivors are
minors
Conclusions:
The documentation and management of sexual assaults in Kenya is
deficient and cannot be adequate in prosecution and detection of
complications.
There areas in towns with more risk of rape than others.
Recommendations:
Need for training on care of sexual assault survivors, with adequate
forensic labs. There is strong need to start rape management centers in
Public hospitals.
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