Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Ethnopharmacological relevance: Traditional medicines play an important role in the management of chronically painful and debilitating joint conditions, particularly in the rural Africa. However, their potential use as sources of medicines has not been fully exploited. The present study was carried to find the medicinal plants traditionally used to manage chronic joint pains in Machakos and Makueni counties in Kenya. Materials and methods: To obtain this ethnobotanical information, 30 consenting traditional herbal med-ical practitioners were interviewed exclusively on medicinal plant use in the management of chronic joint pains, in a pre-planned workshop. Results and discussion: In this survey, a total of 37 plants belonging to 32 genera and 23 families were cited as being important for treatment of chronic joint pains. The most commonly cited plant species were Pavetta crassipes K. Schum, Strychnos henningsii Gilg., Carissa spinarum L., Fagaropsis hildebrandtii (Engl.) Milve-Redh. and Zanthoxylum chalybeum Engl. Acacia mellifera (Vahl) Benth., Amaranthus albus L., Balanites glabra Mildbr. & Schltr., Grewia fallax K. Schum., Lactuca capensis, Launaea cornuta (Oliv. & Hiern) O. Jeffrey, Lippia kituiensis Vatke, Pappea capensis Eckl. & Zeyh. and Pennisetum glaucum (L.) R. Br. are documented for the first time as being important in the management of chronic joint pains. Conclusions: The findings of this study show that a variety of medicinal plants are used in the management of chronic joint pains and the main mode of administration is oral. Keywords: Ethnobotanical survey; Medicinal plants; Chronic joint pains; Rheumatoid arthritis; Akamba; Machakos-Kenya

Department of Dental Surgery, Kenyatta National Hospital, Nairobi. A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

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Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

Vaccination of five baboons with an anti-idiotypic vaccine to irradiated Schistosoma mansoni cercariae resulted in nearly 19% protection compared to 39% protection conferred to five baboons vaccinated with an irradiated vaccine. Vaccination with the anti-idiotypic antibodies resulted in a significant reduction of pathology and granuloma size following challenge with live unattenuated cercariae. Results presented in this work are considered highly significant because the anti-idiotypic vaccine markedly influenced schistosomiasis morbidity which is the main consideration in this disease.

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This book addresses a wide array of issues in botany through a series of chapters. The chapters have been contributed by leading botanists from South America, Africa, Europe and

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

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Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

A retrospective study of the hospital records revealed that 39 cases of mandibular fractures presented at Kisii District Hospital during a two-year period. 27 cases were due to interpersonal violence while road traffic accidents and accidental falls accounted for 9 and 3 of the cases respectively. The male ratio was 2.9:1. Majority (26 cases) of the patients were aged between 20 and 39 years. The commonly involved fracture site was the left body of the mandible accounting for 20 of the fractures.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

The gene Q13L coding for the Capripoxvirus group specific structural protein P32 was expressed in Escherichia coli using plasmid pGEX-2T as a fusion protein with glutathione-s-transferase and purified on glutathione sepharose affinity chromatography column. The protein was then employed for diagnosis of sheeppox, goatpox and lumpyskin disease, by a latex agglutination test (LAT) using the purified P32 antigen and guinea pig detector antiserum raised against the P32 antigen. The LAT and virus neutralization test (VNT) were used to screen one hundred livestock field sera for antibodies to Capripoxvirus, in comparison the LAT was simpler, rapid and 23% more sensitive than the VNT. In addition the LAT was found to be specific for Carpripoxvirus because it did not pick antibodies to Orthopoxvirus and Parapoxvirus. The LA test can be taken for a simple and quick diagnostic tool for primary screening of Carpripoxvirus infection and will reduce the reliance of diagnostic laboratories on tissue culture facilities. Keywords: Carpripox, latex agglutination test, attachment gene J. Trop. Microbiol. Biotechnol. Vol. 3 (2) 2007: pp. 36-43

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

 The  research evaluated clinical training provided by the academic institutions that offer Bachelor of Science in Nursing (BScN) program. The purpose of the study was to describe the adequacy of clinical training and the graduates preparedness for nursing practice. The study was conducted from Sept. 2008 to March 2010. Design was cross sectional using questionnaires and focus group interviews (FGI) methods to collect data. The sample comprised of 232 subjects including pre-service BScN graduates and nursing supervisors at four teaching and referral hospitals in Kenya. Results revealed that clinical training provided by academic institutions was adequate but quality of training varied widely among the training institutions. The conclusion was that clinical training provided by BScN programs in Kenya was of high quality. The study recommends that urgent attention was required by nurse educators to address identified gaps in clinical training especially clinical instruction and supervision.   

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

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While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

BACKGROUND: Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. OBJECTIVE: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, Kenya. SUBJECTS: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. MAIN OUTCOME MEASURES: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. RESULTS: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82 (4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6 weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. CONCLUSION: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Institute of Tropical Medicine, Antwerp, Belgium. The human immunodeficiency virus type 1 (HIV-1) DNA PCR results of 94 dried blood spot (DBS) samples on filter paper and corresponding venous blood in EDTA obtained from infants born to HIV-1-seropositive mothers were compared. In addition, the results of HIV-1 DNA PCR on DBS and the HIV-1 RNA PCR from plasma of 70 paired samples were compared. A 100% specificity and a 95% sensitivity for HIV-1 DNA PCR on DBS compared with results for venous blood were observed for the 94 paired samples. The results of the DBS HIV-1 DNA PCR and HIV-1 RNA PCR of 70 corresponding plasma samples correlated perfectly (100%). The DBS HIV-1 DNA PCR method proved reliable for HIV-1 detection.

A model for the establishment of a four-dimensional regional geodetic reference datum is presented. Starting from the three-dimensional integrated geodetic network model, formulations for the establishment of a four-dimensional regional datum are developed. Astronomic latitudes, astronomic longitudes, gravity values, gravity potential differences, gravity differences, and GPS-vectors are considered as observables. The estimated parameters defining the datura are point coordinates, deflections of the vertical and geoidai undulations, and velocities and accelerations on the positional coordinates. The network datum is considered observed over several epochs with parameters estimated from previous epochs being introduced into later epochs as stochastic prior information parameters.

One of the critical issues for Community Development, Civil Society action and Governance anywhere and specifically in Africa is to create leaders at the fastest possible rate, at all levels of the society/ community. Such levels of leadership revolve round - skilled, ethical, effective and unifying leadership. Young people are most eager to play a leadership role in these efforts. The values/ benefits of the African young people involvement in Civil Society in the African states will bring energy, catalyze other group members to rethink their priorities, commitment and remove invisible barriers that have kept them from moving forward. Typically and traditionally in many cultures, young people have been excluded from efforts to rebuild their communities. This marginalization of our youth not only harms them and endangers our future, but it also cheats the world of a valuable resource. If we are to function effectively as local and even global communities then we must incorporate all significant voices. This paper argues that an enduring and positive community renewal is possible only if all members are involved and feel a sense of ownership. On the other hand, the spirit of volunteerism by young people helps to create a stable and cohesive society and as a result add value to the services that governments provide. Voluntary action creates bonds of trust and encourages cooperation; in other words it creates social capital. Volunteerism draws people of different ethnic origins, religion and economic status. This compositional aspect enhances social harmony. Voluntary participation in public affairs can also help to create a politically literate public, which is important for the preservation of democratic principles. Volunteer effort is essential to Civil Society action as a way that would enhance community policing and conflict resolution. Service For Peace (SFP) Kenya Chapter as an organization, through its young people empowerment program has the aim to integrate service learning and volunteerism in the processes of capacity development/ building, creating appropriate awareness, dissemination and networking of the youth in the sub-regional and region areas. The Kenyan Chapter serves as a knowledge resource base for periodic value-based training programs on volunteerism.

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Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware.
J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482
 

Kenya Medical Research Institute, Clinical Research Centre, Nairobi. Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions. PMID: 7867549 [PubMed - indexed for MEDLINE]

Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions.

Fusarium wilt caused by Fusarium udum Butler, is an economically important disease of pigeonpea (Cajanus cajan (L.) Mill). Information on the mechanisms of resistance to this disease in pigeonpea is limited. To study the role of vascular occlusion in wilt resistance, isolates of F.udum were inoculated onto resistant and susceptible varieties of pigeonpea and observed under light and transmission electron microscopes. The presence of F. udum in wilt susceptible plants was characterized by mycelia and conidia in the xylem vessels, plugging in some vessels, disintegration of xylem parenchyma cells in the infected areas, and the formation of cavities due to heavy colonization in the pith cortex vascular bundle. Resistance to F. udum in the roots and stems of wilt resistant plants was associated with low fungal colonization and high occlusion due to tyloses and gels in the xylem vessels. There were significant differences (P = 0:05) in the number of xylem vessels occluded by tyloses in resistant and susceptible plants with a maximum of 22.5% and 8.0% occlusion, respectively. It is probable that tyloses and gels formed as a result of F. udum interaction in wilt resistant plants are part of a resistance mechanism. Key words: Fusarium wilt,cajanus cajan, resistance, tylose, vascular occlusion

Fusarium wilt caused by Fusarium udum Butler, is an economically important disease of pigeonpea (Cajanus cajan (L.) Mill). Information on the mechanisms of resistance to this disease in pigeonpea is limited. To study the role of vascular occlusion in wilt resistance, isolates of F.udum were inoculated onto resistant and susceptible varieties of pigeonpea and observed under light and transmission electron microscopes. The presence of F. udum in wilt susceptible plants was characterized by mycelia and conidia in the xylem vessels, plugging in some vessels, disintegration of xylem parenchyma cells in the infected areas, and the formation of cavities due to heavy colonization in the pith cortex vascular bundle. Resistance to F. udum in the roots and stems of wilt resistant plants was associated with low fungal colonization and high occlusion due to tyloses and gels in the xylem vessels. There were significant differences (P = 0:05) in the number of xylem vessels occluded by tyloses in resistant and susceptible plants with a maximum of 22.5% and 8.0% occlusion, respectively. It is probable that tyloses and gels formed as a result of F. udum interaction in wilt resistant plants are part of a resistance mechanism. Key words: Fusarium wilt,cajanus cajan, resistance, tylose, vascular occlusion

Measurement of tooth lengths was carried out on 537 extracted human teeth. The teeth were collected from adults aged 17 years and above and preserved in formalin. The tooth lengths were obtained by taking measurements off calibrated graph paper. The lengths obtained in this study were comparable to previous data reported in the literature. However, this new data will provide useful guidelines in Kenya for the management of endodontic patients especially in the purchase and stocking of the most appropriate endodontic instruments.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

OBJECTIVE: To determine the impact on neutrophils if adriamycin is administered at 60 mg/m2 and cyclophosphamide at 600/m2 (AC 60/600); and at 50 mg/m2 and 500 mg/m2 (50/500) in the treatment of breast cancer. DESIGN: Restrospective analysis of nadir neutrophil counts in female mammary carcinoma patients treated with adriamycin/cyclophosphamide combination. SETTING: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March 1995 and August 1999. SUBJECTS: Eighteen patients with breast cancer were treated either for adjuvant purposes or for metastatic disease. INTERVENTION: Chemotherapy with adriamycin and cyclophosphamide at 60/600 or 50/500. Patients were advised to avoid crowded places and given prophylactic broadspectrum antibiotics whenever grade 4 neutropenia occurred at nadir. RESULTS: Grade 3-4 neutropenia occurred in 75.5% of treatments at 60/600 and in 56.8% of the treatments at 50/500. Febrile neutropenia followed only one treatment and did not result in death. CONCLUSION: Neutropenia is frequent and severe at A/C 60/600 and need to be watched out for. Sepsis on the other hand is prevented if meticulous attention is given and corrective measures taken. A/C 50/500 was associated with less occurrences of neutropenia though still very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even at this dosage.

Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis.

Grains from a high and low tannin sorghum were reconstituted by adding distilled water at a 30% level (w/w) and stored for 20 d at 25 C with an acetic-propionic acid mixture added to deter fungal growth. Another batch of grain from the same sources was used as control (no moisture treatment). The grains treated as above were incorporated at a 75% level in soybean meal-based starter diets for pigs. Reconstitution reduced the tannin content of high tannin sorghum significantly. The weight gains and feed consumptions with untreated and treated sorghums were not different (P>.05). Feed efficiency (G/F) was better (P<.05) with reconstituted than with the untreated sorghums. Dry matter digestibility was improved (P<.05) by reconstitution. The diets containing high tannin sorghum had lower (P<.05) digestible energy than the diets containing low tannin sorghums. Reconstitution improved (P<.05) the protein digestibility of the high tannin sorghum, but not that of the low tannin sorghum.

Papyrus (Cyperus papyrus, Cyperaceae) covers large areas in tropical African wetlands. Analysis of its nutritive value has revealed that crude protein is higher in umbels than culms. Ruminai dry matter digestibility of papyrus is, however, higher in culms than umbels. Both the crude protein and ruminai dry matter digestibility decrease with increasing age of the plant. Values for crude protein and ruminai dry matter digestibility are similar to those reported for the range grasses that constitute the greatest percentage of forage in East Africa. In general, papyrus has some grazing potential and could be used as fodder especially in the dry season when other forage is scarce and of low nutritive value.

A study carried out in the semi-arid rangelands of Marsabit during dry and wet seasons assessed the content and seasonal variation of crude protein (CP) and fibre of important forage species for camels. Using a semi-structured questionnaire, herders were interviewed and the important forage species consumed by camels identified. The respondents were mainly men and boys responsible for camel herding in the area. The identified forage species were verified through direct field observation of grazing camels. A total of 109 forages were sampled and analysed for CP, Ash and fibre. Camels preferred dwarf shrubs during the wet season, herbaceous and grass species in the dry season. The mean CP and Neutral Detergent Fibre (NDF) contents of preferred forages were 13.9iS.0% and S3.6iI3.7% of dry matter (DM) respectively. Fibre content of the forages declined while CP increased from dry to wet season. Shrubs were lower in NDF (Sl.OiI2.6%) and ash (1S.Si7.2%) and higher in DM (SO.OiI8.2%) and CP (14.7i4.9%) compared to grasses (NDF 60.4iI4.3%, ash = 18.SiS.2%, DM = 49.7iI7.8%, CP = 12.0iS.0%). It was concluded that the combination of forage species selected by the camels across sites and seasons was adequate in terms of CP.

Four experiments using 900 crossbed pigs were conducted to determine the nutritive value of canola meal (CM) for pigs weaned at 3 or 5 weeks of age. Diets were based on barley and wheat, and CM replaced 0, 25, 50, 75 or 100% of the protein supplied by soya bean meal (SBM) on an isoenergetic and isonitrogenous basis. In Experiments 1 and 2, with pigs weaned at three weeks of age, regression analyses of the results indicated that, for each percent addition of CM to the diets, there was a significant (P < 0.001) linear decrease in average daily feed intake and average daily gain by 4 and 2 g, respectively. Regression analyses of results of Experiments 3 and 4 for pigs weaned at 5 weeks of age indicated that, for each percent inclusion of CM in the diet, there was a significant (P < 0.001) linear decrease in average daily feed intake and average daily gain by 4.3 and 3.6 g, respectively. In all 4 experiments feed-to-gain ratio was not affected (P > 0.05) by the level of CM in the diet.

Nutritional and anti-nutritional factors of preferred woody plants were evaluated in selected drylands of Iringa District. Vangueria infausta (Burch.) and Vitex mombassae (Vatke.) identified as source of edible fruits; Adansonia digitata (L.) and Sterculia africana (Lour.) were preferred for oil products whereas Opilia amentacea (Roxb.) and Maerua angolensis (DC.) were used as sources of vegetables. The nutrients and anti-nutrients were evaluated using laboratory standard methods. Results show that there were significant differences (p<0.05) in percentage moisture content, dry matter, crude protein, crude and carbohydrates in all species used as sources of oils, vegetables and fruits. Percent ash content was different among the preferred species for vegetables and fruits. S. africana as oil producing plants had higher protein content (<25%). O. amentacea and M. angolensis had higher crude protein percent (14-34%) than other species. Crude fiber for all preferred species ranged from 9-27.6% on dry weight basis. The crude lipid content of preferred species ranged from 1.2% for fruit plants to 6.80% for oily plants. V. infausta and A. digitata had high Carbohydrates whereas all edible plants had higher values of Potassium and low Copper, Iron and Zinc content. A. digitata seeds had the highest value of Vitamin C (57.31 mg/100 dry weight) and low levels of tannins and phenols. This study concludes that wild plants are nutritious and have adequate nutrients and levels of anti-nutrients are below the toxic levels. Consequently, use of wild food plants could provide a possible source of food security in Iringa District.

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This study was conducted in the northern part of Kenya, in Kakuma division, Turkana district. Kakuma is a semi-arid area under nomadic pastoralism as the main activity. The presence of a refugee camp has attracted many people from within the Turkana community and also the outside community. The study aimed at documenting the effects of emergent land use changes on vegetation resources and the socio-economic environment in Kakuma. Data on vegetation density and cover was collected. Socio-economic data was collected from the local Turkana population and the settlement camp. The data was analysed using SPSS computer package and descriptive statistics. There was a significant difference (P<0.05) in vegetation cover and density with increasing distance away from the settlement camp. The mean tree crown cover was low near the settlement camp (6.2%) but high away from the settlement camp (57.7%). Mean tree density was high near the settlement camp (13 individuals/ 100m2). Shrub crown cover was low (0.9%) in the areas that had settlements. The need for fencing and building materials was the main cause of low shrub cover. The density of the shrub species generally increased as one moved away from the settlement camp (17 individuals/ 16m2). Herb species cover and density was high near the settlement camp(68% and 202 individuals/ 1m2 respectively) but this comprised mostly of species unpalatable to livestock like Tribulus terrestris and Portulaca oleraceae. The study revealed that droughts and livestock raids in the previous years had set in motion social and ecological changes. The loss of livestock through raids and droughts encouraged sedenterization. This affected the cultural patterns and has had an effect on the rangeland condition. Lack of mobility concentrated livestock in specific areas, thus depleting the forage resources and creating conditions for soil erosion. Trading activities between the refugees and the Turkana had both positive and negative impact on the economic, social and cultural setup of the local community. The increase in population around Kakuma and the settlement camp has set in motion changes that have affected vegetation and social structures. The immediate social and economic returns from the exploitation of resources have overridden the long-term benefits. In regard to this there is a need for education on the impacts, both short-term and long-term, of the various activities on the vegetation, livestock resources and also the pastoral lifestyle. Key words: Pastoralism, Settlement, Land use, Environmental impact.

Fifteen yearling goats with similar weight were used to evaluate the potential of Zizyphus spina-christi leaves as a supplement to goats fed on Cynodon dactylon grass. Animals were randomly assigned to five feeding regimes and individually stall-fed for a preliminary period of 14 days, followed by 14 days of feeding to determine dry matter intake and digestibility, and a 3-month feeding period to determine body weight changes. The treatments were formulated based on leaf: grass ratios of 0%, 25%, 50%, 75%, and 100%. Z. spina-christi leaves had higher crude protein and lower fibre content than C. dactylon grass (P<0.05). Dry matter intake, digestibility and body weight changes increased significantly (P < 0.05) as the level of supplementation increased. Thus, Z. spina-christi foliage is a potential feed supplement in the dry season, as the dry season grasses are deficient in the required nutrients and cannot meet goat requirements.

Drylands have a multitude of livelihood problems where food insecurity is one of the serious impediments. Both transhumance and settled farmers make their living in the semiarid parts of east Shewa, Ethiopia. They adapt partly to food shortage by using natural resources. The study objective was to determine nutritional value of fruit of Berchemia discolor and analyse the use and management practices and associated indigenous knowledge. Data were collected from three study sites each in Fantalle and Boosat districts in East Shewa Zone. Before the laboratory analysis of fruit, the species was identified through focus group discussions and field observations. Mineral elements and phosphorus were determined in dry matter basis. Vitamin A and C were determined by spectrophotometer and redox titration respectively. Analysis of variance was done and means were separated by LSD at 0.05. Berchemia discolor is a candidate for dry land agroforestry and agrobiodiversity. Ten major uses of B. discolor (food, medicine, fuel wood and others) and food value were the highest. Total carbohydrates, crude protein, crude lipid, moisture and total ash contents of the fruit pulps ranged from 4.17-4.35%. The calculated energy from total carbohydrates was 314.50 kcal/100 g. Transhumance conserves Wild Edible Plants (WEPs) in pasture land and protect of vegetation, while settled farmers in traditional dryland agroforestry, in live fence and farm boarders. Berchemia discolor is one of the potential resources to enhance people’s livelihoods. Technologies for improved use and market chain need policy attention.

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Oyieke H.A. and Misra A.K:

To study the suitability of prosopis pods flour as a feed ingredient in manufacture of animal feeds, prosopis pods were collected from four districts heavily affected by the invasive species. Pods were collected from trees at three levels; green but mature pods still attached to the twigs, yellow (dry) pods still attached to the tree and yellow (dry) pods that had dropped onto the ground from the tree. Pods picked from the ground were inspected against decay or insect damage. These samples were analyzed at the department of animal production laboratory University of Nairobi for proximate chemical composition, fibre composition, and calcium and phosphorus profiles. In addition cost comparisons between prosopis pod flour and animal feedstuffs with approximate chemical composition were done. Pods collected in Tana River and Garissa Districts were drier than those collected in Baringo indicating potentially better keeping quality. The pods protein content averaged 11.7% but the fibre content was on the higher side at 29.8%. The calcium and phosphorus level, at 0.3% and 0.36% respectively, were considerably higher than those found in cereals although its availability on digestion was likely to be affected by the high fibre level. Pending studies on digestibility, degradability and metabolizable energy and performance evaluation will inform appropriate level of use in animal diets. However, the researchers, from the preliminary analysis, concluded that the flour will form a valuable addition to the feed ingredient base in Kenya.

Fifteen yearling goats with similar weight were used to evaluate the potential of Zizyphus spina-christi leaves as a supplement to goats fed on Cynodon dactylon grass. Animals were randomly assigned to five feeding regimes and individually stall-fed for a preliminary period of 14 days, followed by 14 days of feeding to determine dry matter intake and digestibility, and a 3-month  feeding period to determine body weight changes. The treatments were formulated based on leaf: grass ratios of 0%, 25%, 50%, 75%, and 100%. Z. spina-christi leaves had higher crude protein and lower fibre content than C. dactylon grass (P<0.05). Dry matter intake, digestibility and body weight changes increased significantly (P < 0.05) as the level of supplementation increased. Thus, Z. spina-christi foliage is a potential feed supplement in the dry season, as the dry season grasses are deficient in the required nutrients and cannot meet goat requirements

According to UN demographic projections, the world population aged 60 years and above is increasing rapidly. It is estimated that by the year 2025, there will be about 1.2 billion people above the age of 60 years worldwide. The older population in Africa currently estimated to be slightly over 42 million is projected to reach 205 million by 2050. Many of the elderly enter old age after a life of deprivation with limited access to resources. Objectives: The purpose of this study was to determine the nutritional and oral health status of elderly persons as a part of a wider study carried out in Nairobi, Kenya. Methods: Data were collected from 289 persons aged 45 years and above using a semi-structured questionnaire. Oral health status was assessed by dental examination, while nutritional status was assessed using Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC). Results: The study established that many of the elderly persons suffered from dental problems, especially periodontitis, dental caries, tooth mobility and missing teeth. The level of malnutrition using the MUAC was 18.8% while by BMI it was 11.4%. 46.4% had normal nutritional status while some of them (40.9%) were overweight, with more females (48.0%) than males (25.9%) being overweight. Conclusions: Undernutrition, obesity and dental problems are issues of concern among the elderly in Nairobi.

According to UN demographic projections, the world population aged 60 years and above is increasing rapidly. It is estimated that by the year 2025, there will be about 1.2 billion people above the age of 60 years worldwide. The older population in Africa currently estimated to be slightly over 42 million is projected to reach 205 million by 2050. Many of the elderly enter old age after a life of deprivation with limited access to resources. Objectives: The purpose of this study was to determine the nutritional and oral health status of elderly persons as a part of a wider study carried out in Nairobi, Kenya. Methods: Data were collected from 289 persons aged 45 years and above using a semi-structured questionnaire. Oral health status was assessed by dental examination, while nutritional status was assessed using Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC). Results: The study established that many of the elderly persons suffered from dental problems, especially periodontitis, dental caries, tooth mobility and missing teeth. The level of malnutrition using the MUAC was 18.8% while by BMI it was 11.4%. 46.4% had normal nutritional status while some of them (40.9%) were overweight, with more females (48.0%) than males (25.9%) being overweight. Conclusions: Undernutrition, obesity and dental problems are issues of concern among the elderly in Nairobi.

According to UN demographic projections, the world population aged 60 years and above is increasing rapidly. It is estimated that by the year 2025, there will be about 1.2 billion people above the age of 60 years worldwide. The older population in Africa currently estimated to be slightly over 42 million is projected to reach 205 million by 2050. Many of the elderly enter old age after a life of deprivation with limited access to resources. Objectives: The purpose of this study was to determine the nutritional and oral health status of elderly persons as a part of a wider study carried out in Nairobi, Kenya. Methods: Data were collected from 289 persons aged 45 years and above using a semi-structured questionnaire. Oral health status was assessed by dental examination, while nutritional status was assessed using Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC). Results: The study established that many of the elderly persons suffered from dental problems, especially periodontitis, dental caries, tooth mobility and missing teeth. The level of malnutrition using the MUAC was 18.8% while by BMI it was 11.4%. 46.4% had normal nutritional status while some of them (40.9%) were overweight, with more females (48.0%) than males (25.9%) being overweight. Conclusions: Undernutrition, obesity and dental problems are issues of concern among the elderly in Nairobi.

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Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis.

A study was carried out to assess the nutritional status of under-five child population within cassava consuming community in Nambale of western Kenya. A structured questionnaire was used to collect socio economic data, 24-hour food re-call and anthropometric measurements. Data were analyzed using Statistical Package for Social Sciences. Descriptive statistics were used while Pearson’s Chi Square and correlation coefficient (R) were used to test for statistical associations. A total of 320 households with 232 children participated. The findings showed nutrition status of children to be poor (<−2 SD), 26.6% were stunted, 13.9% underweight, and 10.1% were wasting. Malnutrition had reached its peak during the third year affecting boys more than girls despite a high mean score (9.2) for household dietary diversity. The findings established cassava utilization to be high (94.3%) and mainly as “porridge, boiled roots and ugali”. Eight staples including cassava were used for weaning and 66.4% of the children were fed three times daily. Cassava utilization was not a determinant of child nutrition status. Age of child and education level of head of household had strong but negative influence on child nutrition status, (Pearson’s R = −0.207:−0.174) indicating >50% changes in stunting could not be attributed to age of child or education level of the head of household. Farm ownership was a strong positive determinant of nutrition status, Pearson’s R = 0.233. This study has established that cassava cushions hunger and there is need to improve nutrient content.

This study sought to determine nutrition knowledge and its association with practices in management of stage 5 chronic
kidney disease (CKD) among renal adult patients in Kenyatta National Hospital. A cross-sectional analytical design was used to
facilitate collection of qualitative and quantitative data and enable identification of associations between variables. Cochran formula
was used to calculate a sample of 110 respondents. A research administered questionnaire with closed ended questions was used to
collect information. Descriptive statistics such as frequency and percentage were used to describe demographic and socio-economic
characteristics of the population. Inferential statistics were done using chi square with an alpha of 0.05 to test association between
independent and dependent variables. Most participants had moderate knowledge levels whereas more than half of the participants
(66%) indicated poor nutrition management practices of their condition. There was significant association between period on dialysis
in months and practices in management of stage 5 chronic kidney disease. Knowledge on importance of diet in management of stage 5
CKD (<0.001), moderation of fluid intake (<0.001), reduction in salt/ sodium intake (<0.001), and moderation in protein intake
(<0.004) were significantly associated with nutritional management practices of stage 5 CKD. The study concluded that Knowledge
levels were low in identifying foods rich in phosphorus, calcium and fat soluble vitamins. Practice scores were also poor despite
moderate nutrition knowledge levels. Patients’ knowledge on nutrition management of their condition may be achieved through
frequent and consistent nutrition education and counseling including follow ups.
Key Terms: Knowledge, Practice, chronic kidney disease, nutrition management

CVD is a common killer in both the Western world and the developing world. It is a multifactorial disease that is influenced by many environmental and genetic factors. Although public health advice to date has been principally in the form of prescribed population-based recommendations, this approach has been surprisingly unsuccessful in reducing CVD risk. This outcome may be explained, in part, by the extreme variability in response to dietary manipulations between individuals and interactions between diet and an individual's genetic background, which are defined by the term 'nutrigenetics'. The shift towards personalised nutritional advice is a very attractive proposition. In principle an individual could be genotyped and given dietary advice specifically tailored to their genetic make-up. Evidence-based research into interactions between fixed genetic variants, nutrient intake and biomarkers of CVD risk is increasing, but still limited. The present paper will review the evidence for interactions between dietary fat and three common polymorphisms in the apoE, apoAI and PPARgamma genes. Increased knowledge of how these and other genes influence dietary response should increase the understanding of personalised nutrition. While targeted dietary advice may have considerable potential for reducing CVD risk, the ethical issues associated with its routine use need careful consideration.

Community based composting practices were studied in Nairobi using a questionnaire, and the quality of composts produced characterised for nutrient and heavy metal contents. An inventory of the composting groups was made using existing databases. The quality of different manure types and their sources were also noted. The movement of Municipal Solid Waste (MSW) for composting and its outlets, as well as manures, were investigated through mapping of market and ecological chains. The study objectives aimed at documenting group dynamics in community based composting activities, quality of composts as influenced by different composting techniques and mapping of the movement of organic resources for soil fertility improvement. It was established that composting practices used by the community-based organisations (CBO’s), had an impact on the quality of the composts, which was found to be lower than the recommended international standards. The CBO’s involved regard composting activities as a business enterprise from where their livelihood comes. Low market opportunities (low demand) for their product have hampered their growth and development.. It was also observed that there is an inflow of organic nutrients in the form of animal manure imported into the city from the arid and semi arid livestock producing areas, some of which are as far as 300 km from Nairobi. In contrast, there is a big challenge in the disposal of the same product within the informal settlement areas of the city

Nutrient loss is one of the factors which causes productivity decline in soils when erosion occurs. This paper gives preliminary results on nutrient losses in eroded soil material in relation to original soil material of some commonly occurring soils in Kenya. Results showed that nutrient losses in eroded soil materials are quite high as indicated by the enrichment ratios of 1.0 for all the nine Kenyan soils studied. Soil conservation measures are recommended

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

Abstract in Bellamy, M. and B. Greenshields (eds), Issues in Agricultural Development: Sustainability and Cooperation. IAAE Occasional Paper No. 6. Dartmouth Publishing Co. Ltd, Aldershot.

Amaranthus hybridus was grown as a leafy vegetables in four sites in Dar‐Es‐Salaam, Tanzania. Freshly harvested leaves from each of the growing sites were analyzed for proximate composition of beta‐carotene, reduced ascorbic acid, minerals iron, calcium, phosphorous and the antinutrients oxalates and nitrates. The leaves from the four sites were bulked and cooked by boiling in distilled water in the ratio vegetable to water of 1:4 then drained. The drained vegetables were analyzed for beta‐carotene, reduced ascorbic acid, iron, calcium, phosphorus, oxalate and nitrate. Results indicated that fresh amaranth vegetables from the four sites had comparable high moisture contents ranging between 85.3% to 86.5%, protein of between 28.2% to 31.6%. The level of minerals calcium, iron and phosphorus ranged between 2062 mg/100 g and 2263 mg/100 g, 108 mg/100 g and 128 mg/100 g and 500 mg/100 g and 553 mg/100 g respectively on dry weight basis. The levels of beta‐carotene of between 25.2 mg/100 g to 37.3 mg/100 g, ascorbic acid of between 455 mg/100 g to 535 mg/100 g. Nitrates and oxalates were at levels of between 501 mg/100 g to 560 mg/100 g and 3383 mg/100 g to 4333 mg/100 g respectively on dry matter basis. On cooking, the levels of beta‐carotene did not change significantly but there were significant reductions (P < 0.05) in the levels of ascorbic acid of up to 50.4%, and 41.4% for phosphorus, while the total nitrate was reduced by 39.2%, and the oxalate by 40.2%. The study established that Amaranthus hybridus leaves grown in four sites of Dar‐Es‐Salaam were good sources of nutrients, had low nitrates levels but high oxalate contents. Furthermore the cooking losses of the nutrients were not excessive, while the antinutrients were substantially reduced.

Intimate Partner Violence (IPV) constitute physical, sexual, social or psychological harm by a current or former partner or spouse. Many researchers have observed that intimate partner violence is directly associated with negative maternal and neonatal health outcomes. The purpose of this study was to assess nurse’s perception on non-disclosure of IPV by pregnant women. A mixed method was used to collect both quantitative and qualitative data. A demographic questionnaire was used to collect demographic data and a Likert scale was used to collect quantitative data. A structured interview schedule was used to gather qualitative data. 125 nurses and midwives were voluntarily recruited for this study. The results of this study showed that 52% (n=65) of the respondents had worked for more than 12 years and a majority (62.6%, n=77) were community health nurses. The nurses perceived that non-disclosure of IPV by pregnant was because of various barriers. Majority (n=86, 69.9%) agreed that the reason why they did not disclose IPV was because the abused survivor would still stay with the abuser after disclosure, and 66.7% (n=82) agreed that stigmatizing attitudes towards the IPV survivors from the society prevented disclosure. About 65.3% of the respondents agreed that survivors are not aware of their rights in regard toIPV reporting and that survivor’s view IPV abuse as normal. The results from this study point to the need of addressing barriers that emanate from the survivors of IPV themselves if IPV screening is to be achieved.
Key words: Nurse, Perception, Non-disclosure, Intimate Partner Violence, Pregnant women, Screening

Kenya maintains an extraordinary treatment gap for mental health services because the need for and availability of mental health services are extraordinarily misaligned. One way to narrow the treatment gap is task-sharing, where specialists rationally distribute tasks across the health system, with many responsibilities falling upon frontline health workers, including nurses. Yet, little is known about how nurses perceive task-sharing mental health services. This article investigates nurses' perceptions of mental healthcare delivery within primary-care settings in Kenya. We conducted a cross-sectional study of 60 nurses from a public urban (n = 20), private urban (n = 20), and public rural (n = 20) hospitals. Nurses participated in a one-hour interview about their perceptions of mental healthcare delivery. Nurses viewed mental health services as a priority and believed integrating it into a basic package of primary care would protect it from competing health priorities, financial barriers, stigma, and social problems. Many nurses believed that integrating mental healthcare into primary care was acceptable and feasible, but low levels of knowledge of healthcare providers, especially in rural areas, and few specialists, would be barriers. These data underscore the need for task-sharing mental health services into existing primary healthcare in Kenya.

Review of twenty cases of live-donor kidney transplants in Kenya for a period of 5 years (1985-1989) and the follow up study results revealed that there were both high graft losses, high morbidity and mortality due to various complications pertaining to surgery and immunosuppression. The most serious complications were intercurrent infections, acute or chronic rejection, pulmonary embolism, steroid induced diabetes, pneumonia, and myocardial infarction. At the end of the first year follow up, there were only twelve graft patients alive. Magnetic Resonance Imaging (MRI) was not available for assessing the anatomical and functional behaviour of the transplanted kidneys. This would have assisted in early diagnosis of the degree and onset of rejection for appropriate treatment before the death of the allografts. It would also assist in differentiating perfusional problems from rejection.