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2004
NTHIA PROFNJERUEH. "Combating HIV/AIDS in Kenya: Priority setting and resource allocation. Christopher Onyango & Enos Njeru. 64p. ISBN 9966-948-06-6.". In: Discussion Paper No. DP059/2004. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract

The HIV/AIDS pandemic has emerged as one of the leading challenges to global public health and development. Sub-Saharan Africa, in particular, has become the epicenter of the pandemic, with over 29.4 million people currently living with the virus and more than 2.4 million people having succumbed to the
disease. In Kenya, the agonies of the HIV/AIDS to individuals, families and societies are overwhelming. Much of the hard-won gains in economic growth, life expectancy and child survival have been wiped out. Besides, many sectors, including education, agriculture, industry and health are staggering under the
burden of the disease. These sectors lose trained professionals and have to contend with higher costs of production and delivery of services.

In Kenya, the Sessional Paper No.4 of 1997 on AIDS lays down the contemporary long-term framework for response to the pandemic. After declaring AIDS a national disaster in 1999, the government established the National AIDS Control Council (NACC) to guide implementation of the National HIVIAIDS Strategic
Plan 2000-2005, within the framework of the multi-sectoral approach. But despite these efforts, successes have been far too few and on too small a scale to reverse the pandemic. This study looked into the priorities and allocation of resources among alternative HIV-related interventions within the framework of the AIDS strategic plan. It also examined the link between the national HIV/AIDS Programme, the macroeconomic framework and the participatory role played by various actors in HIVIAIDS-related activities. Finally, the study
assessed the impacts of alternative patterns of resource allocation with regard to reduction of HIV prevalence, programme coverage and future expenditures averted.

The study entailed the use of both qualitative and quantitative analysis. HIV related demographic, behavioral and financial data, gathered by the National AIDS Control Council during the year 2002 was heavily used. In particular, we used the GOALS simulation model to assess the consequences and trade-offs
of HIVIAIDS resource allocation options. The study also investigated the policies, planning and budgetary commitments to HIV/AIDS-related priorities using secondary data sources, complemented with primary data collected mainly through in-depth interviews with key informants based in Nairobi.

The study established that the costing of the multi-sectoral HIVIAIDS strategic plan lies outside the center of the national budget allocation decisions and the Mid Term Expenditure Framework (MTEF), despite the existence of a strong institutional framework and enabling policy environment. Further, our analysis showed that given available resources, there is great potential to improve the national response to HIV/AIDS by increasing expenditures on preventive measures and treatment and care services as opposed to policy development and management in the coming years. The study therefore strongly recommends,
among others, the need to fully integrate the HIV/AIDS strategic plan into the national framework of the poverty reduction and economic recovery strategies in order to achieve a more comprehensive and effective response to the pandemic. An effective way of mainstreaming HIV/AIDS and supporting an
effective multi-sectoral response to illY/AIDS will be through ensuring that HIV/AIDS is adequately addressed as part of the poverty reduction agenda and economic recovery strategies, the objective being to get HIV/AIDS routinely mainstreamed into government planning, programming and budgeting processes
(ERS and MTEF). This will ultimately result in HIV/AIDS being mainstreamed into sector strategies.

NTHIA PROFNJERUEH. "Gender Aspects in HIV/AIDS Infection and Control in Kenya. Enos H.N. Njeru, Peter Mwangi & Mary N. Nguli. 42p.". In: Discussion Paper No. DP057/2004. IPAR Discussion Paper Series. ISBN 9966-948-77-5. African Wildlife Foundation. Nairobi; 2004. Abstract

Men are expected to be physically strong, robust, and daring, the world over.
Some of these expectations translate into attitudes and behaviours that become
unhelpful or lethal with the advent of AIDS. Others, to the contrary, represent
valuable potential that could be gainfully tapped by AIDS programmes for
enhanced effectiveness. Extra challenges for HIV prevention therefore arise
from societal expectations that allow men to take risks; have frequent sexual
intercourse (often with more than one partner) and exercise authority over
women. These expectations among others encourage men to force sex on
unwilling female partners and to reject condom use among other risky behaviours
regarding HIVIAIDS infection and prevention. Changing the commonly held
attitudes and behaviours should be part and parcel of the efforts to curb the
AIDS pandemic. On the other hand, due to their lack of social and economic
power, many women and girls are unable to negotiate relationships based on
abstinence, faithfulness and use of condoms. This paper points out these
inequalities and offers policy options that could reduce vulnerability of both men
and women to HIV/AIDS.
The data used in this presentation was obtained largely through desk review,
with limited primary data collected to supplement the secondary sources. The
study confirms the continuous spread of HIV/AIDS despite the government's
efforts to combat the pandemic and attributes the trends of prevalence and
infection to, among others: increase in cases of violence against women; negative
attitudes and socio-cultural practices; and power imbalances between men and
women. The study recommends: transformation of gender roles through gender
mainstrearning; policy shift primarily targeting men as the dominant sex in sexual
relations; law on prostitution to be enforced; those found guilty of crimes of
sexual violence to face very stiff penalties; laws should be enacted to facilitate
women's ownership ofland and other property; generate comprehensive gender
disaggregated data to help design better policies for addressing the gender gap.

NTHIA PROFNJERUEH. "The Impact of HIV/AIDS on Primary Education in Kenya. Enos H.N. Njeru & Urbanus Kioko, 32p. ISBN 9966-948-16-3.". In: Discussion Paper No.044/2004. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract

Since the first case was reported in Kenya in 1984, HIV/AIDS has been rising
steadily, with the increase being widespread between and within the ages 15-49.
Given that the population in this age bracket forms the key reproductive and
vital manpower, HIV/AIDS has therefore had serious consequences for various
sectors ofthe economy, including education. Evidence shows that the pandemic
is affecting the supply, demand and quality ofeducation, and its capacity
to respond to new and complex demands. Existing literature indicates that research
specifically addressing the actual and likely impacts of the HIV/AIDS
pandemic on primary education is largely undocumented. This creates, a need
for further understanding to faci:litate formulation ofappropriate interventions to
effectively mitigate the impact of HIV/AIDS on the demand and supply of primary
education in Kenya. The purpose ofthis study, therefore, is to provide data
that will contribute to critical needs in development of pertinent basic planning
tools for education and policy managers within the government, particularly focusing
on the impact of HIV/AIDS on demand, supply and quality of educational
services in primary schools.
The study entails a quantitative and qualitative analysis of the impact ofHIV/
AIDS on primary education, based mainly on secondary data sources and key
informant interviews with officers from the Ministry ofEducation, Science and
Technology, Ministry ofPlanning and National Development, Central Bureau of
Statistics, Teachers Service Commission, and National AIDS Control Programme.
Among the key findings is the glaring contrast of the status of education between
Kenya without HIVIAIDS and Kenya with HIVIAIDS. The study shows
that under Kenya without AIDS, the number of school age children would increase
to 9.27 million by 2015, as contrasted to 7.9 million under Kenya with
AIDS projections in the same period. Under Kenya without AIDS, the required
number of primary school teachers would be 266,052 in 2010 as opposed to
229,412 teachers under Kenya with AIDS. Overall teacher deaths increased
from 1,216 in 1997 to 2,133 in 2001, while teacher mortality, among primary
school teachers, rose from 191 in 1997 to 336 in 2001.
The study recommends that: (i) MoES&T should consider posting teachers to
districts most affected by HIV/AIDS and give priority for admission into teacher
training colleges and other incentives to candidates from the affected districts;
(ii) MoES&T should ensure that all teachers have access to adequate knowledge
ofthe aetiology ofHIV/AIDS and wherever possible, the infected teachers
have access to anti-retroviral therapy; (iii) MoES&T should ensure that the potential consequences of HIVIAIDS are factored into the education plan as
accurately as possible; (iv) Government should develop effective strategies to
promote primary school enrolment for the needy children among those affected
by HIVIAIDS; (v) Government should work out effective strategies to improve
enrolment for orphans; (vi) Government should facilitate sustained enrolment of
children, especially girls, and ensure that they complete schooling beyond the
primary level; (vii) MoES&T should institutionalise an effective data collection
and reporting system on teacher absenteeism and morbidity, with a view to
disaggregating the teacher work and deaths statistics by cause, gender, age, and
regional backgrounds.

NTHIA PROFNJERUEH. "Policy Brief: Volume 10, Issue 7, 2004. Funding the fight against HIV/AIDS: Budgetary analysis of Kenya.". In: ISBN 9966-948-50-x. African Wildlife Foundation. Nairobi; 2004. Abstract

The Abuja Declaration, adopted at the Africa Union special summit on AIDS in 2001, called upon African governments to allocate 15% of their national budgets to health spending, with more emphasis on HIV/AIDS programmes. This commitment echoes the United Nations General Assembly Special Session on HIV/AIDS
(UNGASS), which calls for an increase in spending on HIV/AIDS programmes to US$ 7-10 billion by 2005. The declaration of commitment by the Africa Union calls for minimum spending that provides coverage of essential prevention, care, and mitigation services in an effort to reduce the spread of the epidemic. In Kenya,
despite the government's commitment to fight the pandemic, very little information is available on the actual expenditures on HIV/IDS activities. The objective of this study was to track HIV/AIDS expenditure and analyse the budget from an HIV/AIDS perspective. Understanding how the financial and other national resources
are used towards realization of the national objectives as outlined in the HIV/AIDS related strategic goals in each country, will help the planners to choose pertinent, useful and attainable interventions.

NTHIA PROFNJERUEH. "Policy Brief: Volume 10, Issue 8, 2004, The Sociology of Private Tuition. Indeje Wanyama and Enos H.N. Njeru.". In: ISBN 9966-948-87-2. African Wildlife Foundation. Nairobi; 2004. Abstract

This paper discusses the issue of private tuition mainly at primary educational
level within various contexts, including governance. The paper notes that even
though the practice ofprivate tuition has been in existence for quite some time,
very little, if any, research has been undertaken to explain its nature, extent and
implications for the education system. Besides, nothing is known about its overall
socio-economic setups at the international as well as the national levels.
Technically, private tuition is not allowed in Kenya. However, there is ample
evidence to show that the practice is taking place on a very large scale. The
most affected is the mainstream system, with some of its teachers engaging in
the practice. The emphasis on examination as a basis for staff recruitment and
promotion has further aggravated this problem. Indeed, even some Ministry of
Education, Science and Technology (MoES&T) officials - who are supposed to
articulate Government Policy on Education - take their children to private tuition
classes. This is because they too, have to equally compete for the limited places
at higher levels oflearning and this can only be achieved through good performance
in National Examinations. This paper focuses on the genesis of private
tuition and schooling in comparison to public education, as well as the factors
that sustain the behind-the-scenes private tuition system, leading to consumers
of education (pupils and parents) demanding for private tuition services, and
those that lead to producers (tutors, including teachers and other entrepreneurs)
producing and supplying the commodity - private tuition.
This study was limited to a desk review ofpertinent literature and selected key
informant interviews. The study's key findings indicate that socio-economic inequalities
continue to be pervasively manifest in the practice ofprivate tuition;
quality service is not guaranteed as long as private tuition continues to get no
official recognition; and while private tuition constitutes a serious financial burden
to the low income households, strong support for it comes from both parents
and students.
The study recommends urgent recognition ofthe integral role played by private
tuition in the management and delivery ofeducation services, hence strong evidence
that banning private tuition is unlikely to achieve the intended levels of
compliance, especially on the part ofthe producers and consumers. Such recognition
should therefore pave way for stakeholder dialogue between parents and
education managers, while incorporating the expertise and views of education
scholars, to improve equity in education financing without compromising quality.
It is further recommended that a study of a larger primary data-based scale be
carried out to facilitate an authoritative authentication of the findings, and, in
effect, be used to guide the way forward in terms of formulating an effective
policy on private tuition and related planning and implementation issues.

NTHIA PROFNJERUEH. "Funding the Fight. Budgeting for HIV/AIDS in Developing Countries Edited by Teresa Guthrie and Alison Hickey. KENYA CHAPTER: pp 13-52. Co-authored by Urbanus Kioko & Enos H.N. Njeru. Cape Town: AIDS Budget Unit, IDASA.". In: ISBN 1-919798-71-4. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Funding the Fight. Budgeting for HIV/AIDS in Developing Countries. Edited by Teresa Guthrie and Alison Hickey. BOOK CHAPTER Pp 13-52, by Urbanus Kioko & Enos H.N. Njeru.". In: Cape Town: AIDS Budget Unit, IDASA. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Policy Brief: Social Health Insurance Scheme for all Kenyans: Opportunities and sustainability potential. Enos Njeru Robert Arasa & Mary Nguli. ISBN 9966-948-18-x.". In: Discussion Paper No. DP060/2004. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Policy Brief: Volume 10, Issue 12, 2004. Gender aspects in HIV/AIDS infection and control in Kenya. Enos Njeru, Peter Mwangi and Mary Nguli.". In: ISBN 9966-948-77-5. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Policy Brief: Volume 10, Issue 13, 2004. Combating HIV/AIDS in Kenya: Priority setting and resource allocation. Christopher Onyango and Enos Njeru. ISBN 9966-948-06-6.". In: Discussion Paper No. DP059/2004. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Policy Brief: Volume 10, Issue 9, 2004. The Impact of HIV/AIDS on Primary Education in Kenya. Enos Njeru & Urbanus Kioko.". In: ISBN 9966-948-16-3. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "Social Health Insurance Scheme for all Kenyans: Opportunities and sustainability potential. Enos Njeru, Robert Arasa & Mary N. Nguli. 49p. ISBN 9966-948-18-x. (ttp://www.ipar.or.ke/dp60dp.pdf).". In: Discussion Paper No. DP060/2004. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
NTHIA PROFNJERUEH. "The Sociology of Private Tuition. Indeje Wanyama & Enos H.N. Njeru, 41p. ISBN 9966-948-87-2.". In: Discussion Paper No.037/2003. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2004. Abstract
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.
2003
NTHIA PROFNJERUEH. "Access and Participation in Secondary School Education: Emerging Issues and Policy Implications. Enos H.N. Njeru & John Orodho. 55p. ISBN 9966-948-27-9.". In: Discussion Paper No.037/2003. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2003. Abstract

On attainment of political independence in 1963, the Government of Kenya (GoK), households and the private sector collectively endeavoured to enhance the development of education in the country. The rapid development of education and training in Kenya was an aftermath of the Sessional Paper No. 10 of 1965 on African Socialism and its Application to Planning in Kenya, which emphasized combating ignorance, disease and poverty. It was based on two long-standing concerns that: (i) every Kenyan child, irrespective of gender, religion and ethnicity, has the inalienable right to access basic welfare provision, including education; and (ii) the GoK has an obligation to provide opportunity to all citizens to fully participate in socio-economic and political development of the country and also to empower the people to improve their welfare. Development of education since independence has been marked by various changes and challenges. For nearly four decades therefore, the sector has undergone several reviews by special commissions and working parties appointed by the government, with the aim of improving efficiency and effectiveness of the education provision.

NTHIA PROFNJERUEH, NTHIA PROFNJERUEH. "Education Financing in Kenya: Secondary School Bursary Scheme Implementation and Challenges. Enos H.N. Njeru & John Orodho. 59p. ISBN 9966-948-98-8.". In: Discussion Paper No.035/2003. IPAR Discussion Paper Series. African Wildlife Foundation. Nairobi; 2003. Abstract

Having accepted the rationality of cost-sharing, the Ministry of Education, Science
and Technology (MoES&T) bursary scheme was introduced as one of the
safety-nets to cushion the poor and the vulnerable groups against the consequent
adverse effects. The bursary scheme, however, remains inefficient and
ineffective. Other characteristics that contribute to bottlenecks in its implementation
at the secondary school education level include limited access and participation
due to poor quality of service, bad governance and management weaknesses.
It is, therefore, arguable that against the background of more than half
of Kenya's population living below the poverty line, and the rising cost of education,
majority of households, especially among the poor and vulnerable groups,
are unable to invest in the development it of quality secondary education.
The objectives of this study included documentation of the patterns and trends in
financing secondary education in the public sector in Kenya; analysis of implementation
of the bursary scheme at the secondary school level in Kenya, with
special focus on disbursement procedures, equity considerations according to
socio-economic groups; and the overall impact on access to secondary school
education with regard to the income-poor and other vulnerable groups.
The study adopted an exploratory approach using a descriptive design. Four
provinces were randomly sampled and one district purposively selected from
each province. Three target populations considered were MoES&T staff; school-based
education staff and opinion leaders. Questionnaires, semi-structured interview
schedules, and focus group discussions were used in data gathering.
Data analysis was carried out using SPSS.
Study results indicated that the patterns and trends of education financing in
Kenya incorporated a partnership between the state, households, and communities
long before the introduction of the cost-sharing policy. The financing of
secondary education has, however, become problematic, ~s parents have to
,houlder an increasingly large proportion of the cost.
The government's financing of secondary education has largely been directed
towards Tecurrent expenditure, mainly to meet teachers' salaries and allowances,
at the expense of development expenditures, which would be essential to
provide and improve the physical and instructional facilities. This has resulted in
poot quality education as O1ost schools are inadequately provided with basic
learning resources.
.Tbe cost-sharing strategy has hada negative impact on the poor and vulnerable
households. The latter either do not enroll their children in secondary schools, or
fail to sustain a continuous participation of those enrolled due to inability to meet
cost requirements. This results in inadequate provision of learning facilities to
the enrolled, poor quality education, and high dropout rates.
The operatrion of the MoES&T bursary scheme is handicapped by inadequate
guidelines with regard to the amounts to be allocated per student; poor criteria
for selection of genuinely needy; inadequate awareness creation about the
scheme's existence and operations; limited funds hence limited coverage; poor
co-ordination and delays in funds' disbursement; and lack of monitoring mechanisms
by the MoES&T at the school and higher levels. This has resulted in lack
of transparency and accountability, nepotism, among other aspects of mismanagement.
A critical issue that requires redress is awarding of the bursaries to
less deserving, and sometimes completely undeserving, but well-connected applicants,
at the expense of the poor and vulnerable groups.
Policy options - the MoES&T should:
• Either abolish fee levies charged to parents or ensure foolproof enforcement
ofthe fee guidelines in order to eradicate loopholes in financial management
practices in schools.
• Consider increasing the current bursary funding from Ksh. 210 million
to Ksh. 1.5 billion. This will enable be~eficiariesto meaningfully meet at least
60% oftheir outstanding fees.
• Put in place clear guidance regarding eligibility and the socio-economic
categories to benefit from the bursary scheme; the amount to be allocated per
student; and a monitoring mechanism to ensure transparency and accountability
in the disbursement ofthe bursary funds. .
• In consultation with other stakeholders in the secondary education subsector,
work out ways to allow individual schools to evolve a 'fees waiver mechanism'
and income generating activities at the school level to raise funds for
various purposes to benefit learning resources, quality improvement, school
projects, and, where possible, supplement student fees requirements. .

and Orodho PROFNJERUNTHIAJAEH. "Poverty and Human Security in Kenya." Regional Development Dialogue. 2003;24(2):114-119. Abstract

This issue of Regional Development Dialogue (RDD) focuses on the theme: "Reflecting
on 'Human Security Now'" and is divided into two sections, focusing on Asia and Africa.
The African section looks at selected parts ofthe African continent, incorporating elements
of competition for scarce resources and attendant procurement and utilization strategies.
Application of the strategies in question, once institutionalized, often contradicts the
conventionally and culturally palatable social exchange norms, with consequences that
have turned out to be inimical to the peaceful co-existence of members of societies and
communities in different regions in Africa and among different socioeconomic categories,
especially where there are differences in race, ethnicity, religion, culture, and modes of
livelihoods at different levels of social change in different parts and within the cultural and
economic diversities that characterize many African social contexts. Cases of internally
displaced persons (IDPs), refugees, starving and relatively deprived citizens in every sense
of the word, thus abound in different regional settings in Africa. Associated impacts and
consequences of such structural imbalances have mainly been expressed through conflict,
hence the common outcomes of prolonged human insecurity in its various forms, loss of
lives, abject poverty, and other forms of perpetuated human rights abuses. It is in the light
of these observations that this introduction critically introduces the constituent articles in
this section of the journal.
A key editorial note should bear reference to the comments attending each article, i.e.,
critical remarks made by various scholars, regarding the content, relevance, and application
of the issues raised in the Africa section of this RDD. These comment are themselves part
and parcel of the dialogue, and as such, constitute a series of motivating invitations to the
reader, in effect, serving as useful supplements to the subject matter presented in the
referent articles. The comments include those by Ludeki Chweya, on the article "Poverty
and Human Security in Kenya" and also on "Displacement, Minorities, and Human
Security: The African Experience". The article on "Poverty and Human Security in
Kenya" has also received comments from Asfaw Kumssa. Other commentaries are made
by Charles B. K. Nzioka on "Banditry and Conflict in the Kapotur Triangle: An Alternative
Menu for Resolution"; and by Pius Mutuku Mutie on "Food Insecurity in Sierra Leone:
Overcoming the Challenges in Post-Conflict Reconstruction".
The first article, "Displacement, Minorities, and Human Security: The African
Experience" is by Adam Hussein Adam and fits well into the theme of this issue reflecting
the critical thinking of a renowned scholar and reformist thinker and crusader for minority rights, articulating his views with regard to practice and processes that support
antidiscrimination. The position taken represents a richly textured examination of the
origin and nature of displacement within the context of human security in Africa. The
author's major contention is that displacement is an attribute oftwo major related positions,
namely power and vulnerability. It is argued that the need to survive has always triggered
displacement while advancement in technology has facilitated the process. Tracing the
phenomenon of displacement in Africa from the time when Aboriginal people first entered
Eastern Africa about 10,000 years ago through Arabia and Persia up to the present day
globalization era, Hussein observes that major migrations that resulted in displacement
stemmed from people's vulnerability and need to survive. He uses the examples of the
migrations of the Ngoni people northwards, the southwards migration of the Nilotic
communities from present-day Sudan to Eastern Africa and those of the Bantu speaking
people from today's Central Africa to South, East, and Western Africa to illustrate how
these newcomers displaced the Aboriginal communities they found along the way. During
such interactions, some newcomers co-existed in good symbiosis, especially in the case of
pastoralists and the hunters, while others were assimilated altogether. The author also notes
that displacement takes place on two planes: evolutionary and induced processes (using
force). The article focuses on a discussion of the constituent process which has two aspects,
one being intranational and national in character and the other being international. The two
types of displaced produce refugees and lOPs.
Within this context, the article notes that, as with reasons for displacement, the results
of displaced persons are disastrous, with long-term social and psychological implications.
It has been succinctly pointed out that politics influences society, the economy, security,
development, and every other imperative for human survival including the processes that
precede the status of displacement. At this juncture, the challenging question is, if
displacement today is highly politics-driven, who then benefits from the displacement?
Displacement is seen to affect the collective and individual survival of the majority of
people not only by threatening their lives but also the livelihoods of those affected, spilling
over into kinship and the friends of friends networks, and beyond formal and informal
institutional and structural destructiveness.
Displacement is presented as a resource-driven phenomenon, while it is clearly
domination-oriented. As such, and while displacement remains resource-based and uses
technological advancement (guns) to enhance effectiveness and timeliness in results
production, the political forces are to a large extent known to playa much greater role in
the process. To authenticate the impacts of displacement, the author employs diverse
examples to demonstrate the infectious nature ofdisplacement as it affects large populations,
while benefiting only a small number of politicians and power wielders. Sadly, the
prevailing trend is such that political expediency takes precedence over security and
protection of people's lives and property.
The dominant message of the article is that there is need to forestall both sporadic
violence and also the planned acts of violence designed to displace people without options
on how to protect human lives. Part of these acts must be to ensure that ifthe displacement
is planned then the affected people should be fully involved in decision making. Where
displacement is sporadic, it is the duty of the state to prevent its victims from being exposed
to conflict. As a way forward, institutionalization of appropriate means of empowering communities to strengthen their problem-solving capacities, dialogue and adequate consultation,
rapport-creation between people and the state, involvement of the people in conflict
resolution, and enhancement of the facilitation capacity by the state in community conflict
mediation are all recommended.
The presentation makes a compelling argument for the reconstruction of politics and
the development agendas ofhope in order to counter the disillusionment and pessimism that
have been associated with change processes resulting in displacement in recent years. The
article is an excellent discussion on different aspects of displacement in the context of
human security and makes useful reading for all development scholars and practitioners.
The second article, "Banditry and Conflict in the Kapotur Triangle: An Alternative
Menu for Resolution" by Katumanga Musambayi, is a comprehensive narrative of the state
of banditry and conflict in the Karamoja, Pokot, and Turkana (KAPOTUR) triangle, in the
border areas between northeastern Uganda and northwestern Kenya in Eastern Africa. In
effect, the presentation constitutes a far-reaching intellectual discourse, an articulate
analysis of the nature, causes, and consequences of banditry and, at the end, proposes an
alternative menu for conflict resolution. The article argues that conflict in the Kapotur
region is as a result of the dysfunctionality of the state at the international level and the
collapse at the regional level. The contention is that the underlying dysfunctionality of the
state has to do with such factors as the nature and inability of the state to respond to the
challenges of frontier citizenship, regional state collapse, and elite instrumentalization of
violence. It is written against the background of people whose lifestyles have over time
been informed by harsh weather patterns, and the people themselves are neglected and
marginalized with regard to the benefits associated with basic infrastructural development.
As to coping mechanisms, in times when weather patterns affect their livestock, the people
are compelled to resort to social predation on their neighbours, in a bid to replenish their
stocks, as a result of little or no serious attempts being made to integrate the region in the
overall development within the wider Eastern Africa.
The crises dealt with in this article are seen to date back to, and indeed lie squarely
attributed to, the state's failed post-independence strategies towards national development.
The Government of Kenya, like that in most African states, has been unable to demonstrate
its own de facto sovereignty, instead concentrating on de jure sovereignty status. The de
facto status is connected with the state's capacity to function in the domestic realm, while
the de jure sovereignty has more to do with the state's ability to command recognition in
an international setting and within partnerships. This presupposes a capacity to monopolize
violence on its territory to the extent of enhancing its law within clearly demarcated
boundaries and an identified and controllable population. The key underlying shortcoming
shared by both Kenya and Uganda is that the two gained independence at a time when they
had limited institutional and infrastructural resource capacities to effectively control their
mutual border.
Against this background, and unable to exercise sovereignty in the Kapotur region, or
indeed guarantee security, the respective governments of Kenya and Uganda opted to
disproportionately arm and organize some members of these hostile communities into what
would be seen, and later came to be known, as "local defence units". Consequently, lack
of proper leadership and monitoring mechanisms, for example, on the part of the Kenyan
Government, allowed some of the armed groups in these communities to drift into banditry.

NTHIA PROFNJERUEH, NTHIA PROFNJERUEH. "The Role of Higher Education Loans Board in pro-poor management approaches to enhancing access to University Education in Kenya. Enos H.N. Njeru & Paul Odundo. 46p.". In: Discussion Paper No.036/2003. IPAR Discussion Paper Series. ISBN 9966-948-15-5. African Wildlife Foundation. Nairobi; 2003. Abstract

The Republic of Kenya, through the Ministry of Education, Science and Technology
(MoES&T) has, since independence in 1963, been committed to providing
quality and relevant education to its citizens at all levels. With increasing
population, adverse macroeconomic performance, and increasing cost of education
against increasing demand, the government introduced cost-sharing in
education at all levels. As such, payment of fees by those pursuing degree programmes
was introduced as part of the efforts by government to transfer the
cost of financing university education to the beneficiaries. To cushion the income-
poor against adverse financial difficulties, and to ensure that no eligible
students dropped out ofuniversity due to inability to finance their education, the
loan and bursary schemes were introduced to benefit all university students who
could not fully finance their education. In essence, the government established
the Higher Education Loans Board (HELB) in July 1995 to improve both loans'
disbursement and recovery.
The financial arrangements and processes in question have given rise to a number
ofkey questions and issues, including the need for efficiency in the management
of the scheme; extent to which the loan and bursary schemes effectively cushion
the vulnerable against dropping out ofuniversity; eligibility criteria; alternative
sources of financing university education; other factors against participation;
pertinent information handling; quality of governance in the disbursement
of loans; loan recovery and loan beneficiary tracer efforts; commitment to loan
repaying on the part ofthe beneficiaries; legal empowerment to enable the board
to deliver on its mandates through legislative status with regard to both loan
recovery and alternative sourcing of funds to supplement its regular budgetary
allocations; nature and levels ofnetworking with employers ofuniversity graduates
and other institutions; quality ofinformation content in loan application forms
to control cheating; parallel bursary schemes managed by HELB and MoES&T,
and equity issues as some needy students fail to benefit while some less needy
do benefit; nature and levels of funding co-ordination between HELB and other
bursary/scholarship/grant awarding and sponsor organizations. Other important
issues concern the high default rates, low visibility of HELB's activities, and
underdeveloped loans repayment monitoring structures.
Recommendations include revitalizing HELB into a revolving fund with minimal
budgetary allocation; strengthening and reforming attendant administrative and
efficiency monitoring structures where these exist, and creation of the same
where they do not exist.

NTHIA PROFNJERUEH. "Guest Editor for Africa, Regional Development Dialogue (RDD), Vol. 24, No. 2, Autumn 2003.". In: On the Theme: . African Wildlife Foundation. Nairobi; 2003. Abstract
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.
NTHIA PROFNJERUEH, NTHIA PROFNJERUEH. "Policy Brief: Volume 9, Issue 6, 2003. .". In: ISBN 9966-948-27-9. African Wildlife Foundation. Nairobi; 2003. Abstract
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.
NTHIA PROFNJERUEH. "Policy Brief: Volume Volume 9, Issue 5, 2003. The Role of Higher Education Loans Board in pro-poor management approaches to enhancing access to University Education in Kenya. By Njeru and Odundo.". In: ISBN 9966-948-15-5. African Wildlife Foundation. Nairobi; 2003. Abstract
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.
2002
PROF. NJERU E. H. NTHIA, M. Ember ES(E)CI. "The Embu People. Encyclopedia of World Cultures Supplement. Pp 107-111. New York:.". In: Macmillan Reference USA, Gale Group. Human Relations Area Files. African Wildlife Foundation. Nairobi; 2002. Abstract

Identification and Location. The Embu people occupy the
Embu District, one of the twelve districts of the Eastern Province
of Kenya. The Embu District is bordered by the Mbeere
District to the east and southeast, the Kirinyaga District to
the west, and the Tharaka Nithi District to the north. The
main physical feature is Mount Kenya to the north and
northwest, 17,058 feet (5,200 meters) above sea level.
The district is located between 0°8" to 0°35" Sand 37°
19" to 37° 42" E, covering an area of 281 square miles (729
square kilometers). The landscape is characterized by highlands
ranging in altitude from 4,920 to 14,760 feet (1,500 to
4,500 meters) and midlands lying at 3,936 to 4,920 feet
(1,200 to 1,500 meters). Other topographical features include
rivers, hills, and valleys. The rainfall pattern is bimodal,
with long rains between March and June and short rains from
October through December.
Demography. In 1918 the Embu population was 53,000
(24,590 males and 28,410 females), increasing to 85,177 by
1962. The population increased constantly, reaching
278,196 in 1999, with a reported annual growth rate 00 percent.
In 1999 there were 63,893 households with 136,499
males and 141,697 females. The annual growth rate had decreased
from 3.86 percent from 1969 to 1979 to 3.41 percent
from 1979 to 1989, with increases in population density attributed
to high fertility and falling mortality rates. The infant
mortality rate decreased from 169 in 1962, to 92 in 1969, to
44 in 1999.
With a crude birth rate of 40.4, the fertility rate remains
high despite having declined from 7.78 in 1969 to 5.9 in
1999. The crude death rate stands at 6.4, with a life expectancy
of 69.7 years for males and 69.4 years for females. According
to the 1999 census, about 38 percent of the people
are children less than 15 years old, while people at the economically
productive ages (fifteen to sixty-four) account for
57 percent. People age 65 years and over account for 4 percent.
Serious outmigration has been reported.
Linguistic Affiliation. The Embu people speak the Kiembu
language, a Bantu language that is part of the larger
Niger-Congo family of languages. The Bantu linguistic cluster
includes languages such as Kiswahili, Kikuyu, Ki-meru,
Ki-mbeere, Ekegusii, and coastal languages. Although Kiembu
and Ki-mbeere are dialects of the same language, the
Ki-embu vocabulary borrows considerably from related
Bantu languages, many of which are mutually intelligible, especially
among the people of central and eastern Kenya.

2000
NTHIA PROFNJERUEH. "Street Children In Kenya: Voices of Children in search of a Childhood. With Kilbride, P. & Suda, Collette. Westport: Bergin & Garvey.". In: Gpg (Greenwood Publishers Group). African Wildlife Foundation. Nairobi; 2000. Abstract

Street Children in Kenya provides an in-depth examination of the experiences of street children in Nairobi, Kenya. Drawing from participant observations, individual and focus group interviews, the authors, Kilbride, Suda, and Njeru allow readers to confront the harsh realities, suffering, and survival skills of nearly 400 of the over 40,000 homeless children in Nairobi. These children are part of the over 110,000 children described by UNICEF as "in need of special protection" (GOK/UNICEF, 1998). Reflecting the anthropological and sociological backgrounds of the scholars, the book's initial chapters introduce the methodology and background for the study, including a description of the study's setting, Nairobi, and relevant information on the communities studied. The text also provides information on social and cultural issues affecting families (e.g., the weakening of family structures due to poverty, the impact of AIDS, and government sanctioned ethnic conflicts), which have contributed to the rapid rise in the number of children living and working on the street. Even though only one chapter is solely devoted to the narratives of the children, most chapters are infused with humanizing accounts and perspectives on the children's lives. A unique contribution of the study is its methodology, which involved giving older street children cameras to document their daily life, thus greatly personalizing the book, since the children were allowed to tell their own stories. A more traditional scholarly analysis is presented in the final chapter, which addresses policy implications, particularly with regards to long-term, culturally framed solutions to this complex and growing problem.

1999
NTHIA PROFNJERUEH. "Impact Assessment of Micro-Enterprise Projects. IDS Discussion Paper No. 298.". In: Reme Project Series. Institute for Development Studies, University Of Nairobi. African Wildlife Foundation. Nairobi; 1999. Abstract

The Department for International Development (DFID) and
the British Aid for Small Enterprises (BASE) are supporting
micro-finance projects in Kenya. The goal of the projects as
set out in the logical framework is to provide additional
employment and self-employment opportunities, especially for
poorer people and increase their incomes through improvement
in the production capacity oftheir micro-enterprises. For this
goal to be attained, the capacity ofprivate sector intermediary
micro-finance institutions to promote micro and small
enterprises (MSEs) on a sustainable basis is being developed.
Indicators that help to measure progress toward attainment of
the goal such as number of jobs created by the MSEs and
growth ofcapacity ofmicro-finance institutions have been spelt
out. However, to know how far this goal is being attained,
impact assessment needs to be carried out.
This paper examines key issues that need to be borne in mind
by those carrying out impact assessment. It considers the
conceptual framework that guides assessment, research design,
methods and techniques, gender relations and the problems of
attribution and fungibility.
Noponen (1997:3) holds that most organisations establish
monitoring and evaluation systems to help them learn from
their experience and use the experiences to improve their
performance, expand their operations or adapt some of their
operations to local situations.
Evaluation has been defined by Scriven (1967), Glass (1969)
and Stufflebeam (1974) as the assessment ofmerit or worth of
a programme. The Joint Committee on Standards of Evaluation (1981) defined evaluation as the systematic investigation of
the worth or merit of some object. Suchman (1967:7) saw
evaluation as referring to the processes of assessment or
appraisal of value. According to Linchfield et al. (1974:4),
appraisal refers to the process of analysing a number of plans
or projects with a view to searching out their comparative pros
and coris and the act of setting down the findings of such
analysis in a logical framework.
These definitions show that the concepts "evaluation",
"assessment" and "appraisal" are synonymous and are used
interchangeably.
The concept "impact assessment", which is widely used in the
literature on micro-enterprise refers to a type of evaluation or
assessment that focuses on outcomes or effect ofa programme
(Oakley, 1987:31). Goldmark and Rosengard (1981: 10) see
impact evaluation as referring to the assessment of a smallscale
enterprise's effect on its intended population. The
assessment entails an analysis ofthe enterprise's viability and
its interaction with and influence on the community as an
outcome of an external programme ofassistance. Goldmark
and Rosengard caution that impact evaluations should not only
describe financial or managerial changes occurring within the .
micro-enterprise and how far the changes are meeting.
developmentobjectives, but also observe the changes that have
taken place in the community.
Impact evaluation studies have become popular with donors·
and, as a corollary, have become a.significant component of
donor funding and, consequently, of recipient institutions
(Hulme, 1997).· Their objectives are:
to figure out the effects ofintervention in changing the
conditions facing the target population (Oketch et aI.,
1991);
b) to objectively justify continuing support to MSEs and
also validate their choice of given modes of
intervention; and
c) as a stage in the project planning process, evaluation
seeks to provide information pertaining to important
implications of the planning process, i.e., it helps to
establish what happened where particular options were
taken up, whether anticipated effects occurred, who
gained or lost, when the effects occurred and the
efficiency of the investment in relation to resources
used and benefits derived (Linchfield, et ai. 1974).
To achieve these objectives, donors seek more information
about programme effectiveness rhan is readily available from
routine impact and monitoring systems ofrecipient institutions.
Besides measuring the efficacy of programmes, donors often
emphasise impact evaluations to meet the accountability
demand oftheir home governments and thus justify continued
support. To this extent, impact evaluations tend to be donordriven
(Hulme, 1997). Donor institutions such as DFID have
legitimate interest in measuring programme impacts as in the
case of the REME project.
Impact evaluation also exposes internal problems and
constraints~ and provides benchmark information for
comparing, ranking and selecting sets ofappropriate methods
(REME Project Proposal, 1997).
These objectives place high demands on the quality and
accuracy of data. However, given" the context of developing countries (limited numbers of professional researchers, few
written records, illiteracy, communication problems, lack of
respondent motivation and limited budgets), such evaluations
might not generate accurate measurements of impacts, and
caution has to be exercised when they are performed.

1998
NTHIA PROFNJERUEH. ""Analysis and Evaluation of Poverty in Kenya." CH. 1 pp. 1-36. Co-authored with Bahemuka et al. In Bahemuka J. et al. Poverty Revisited: Analysis and Strategies Towards Poverty Eradication in Kenya. Nairobi:.". In: Ruaraka Printing Press Ltd. African Wildlife Foundation. Nairobi; 1998. Abstract
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.
NTHIA PROFNJERUEH. ""City Slum Single Motherhood and Its Socio-economic Implications for Child Welfare".". In: In African Urban Quarterly (AUQ) Vol. 13 Nos. 1 and 2 of February and May 1998. African Wildlife Foundation. Nairobi; 1998. Abstract
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.
NTHIA PROFNJERUEH. ""Urbanization, Urban Violence and Its implications for Urban Planning".". In: In African Urban Quarterly (AUQ) Vol. 12 No. 4 of November 1997. African Wildlife Foundation. Nairobi; 1998. Abstract
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.
1996
NTHIA PROFNJERUEH. ""Quest for Gender Equality" In Social Focus. Nairobi:.". In: AEF International. African Wildlife Foundation. Nairobi; 1996. Abstract
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.
NTHIA PROFNJERUEH. ""Understanding Female Circumcision from the Circumcisers' Perspective.". In: In Program and Abstracts for the Third Annual Meeting of AFRICLEN and PHSWOW at Hotel Equatoria, Kampala. In East African Medical Journal. African Wildlife Foundation. Nairobi; 1996. Abstract
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.
NTHIA PROFNJERUEH. ""Women-Headed Households: A Critical Factor in Urban Development." Co-authored with J.M. Mbula Bahemuka. In Obudho and Aldershot (Eds.) Nairobi and its Environs:.". In: A Geographical Study of Capital City in African, Vol. 1 & 2. Ashgate Publishing Co. African Wildlife Foundation. Nairobi; 1996. Abstract
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.
1995
NTHIA PROFNJERUEH. ""The Application of Indigenous Knowledge in Pastoral Production Systems".". In: The African Pastoral Forum. Working Paper Series No.6, Jan. 1996. Nairobi: Business Line Ltd. African Wildlife Foundation. Nairobi; 1995. Abstract
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.
1994
NTHIA PROFNJERUEH. ""Socio-Cultural Analysis of Childhood Malnutrition in Embu District". In Social Behaviour and Health Monograph No. 2, March,1996. Co-authored with Dr. W.M. Macharia. .". In: University of Nairobi: IFCP. African Wildlife Foundation. Nairobi; 1994. Abstract
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.
NTHIA PROFNJERUEH. ""Socio-economic Implications of Climate Change and Sea Level Rise for the Tourist and Hotel Industry.".". In: Nairobi: UNEP/IGBP. African Wildlife Foundation. Nairobi; 1994. Abstract
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.
NTHIA PROFNJERUEH. ""Socio-economic Implications of Climate Change and Sea Level Rise for the Tourist and Hotel Industry.".". In: Nairobi: UNEP/IGBP. African Wildlife Foundation. Nairobi; 1994. Abstract
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.
1992
NTHIA PROFNJERUEH. ""The Psychosocial Aspects of Epilepsy". In Medicus:.". In: Magazine of the Kenya Medical association. April 1992. Volume 11 No. 4. African Wildlife Foundation. Nairobi; 1992. Abstract
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.
1990
NTHIA PROFNJERUEH. ""Approaches to Family Planning in East Africa". Co-authored with J. Mbula Bahemuka and Speciosa Kabwegyere. ROMA: FEDEREZIONI ORGANISMI CRISTIANI SERVIZIO INTERNAZIONALE VOLONTARIO (FOCSIV) CENTRO STUDIE RESERCHE AFRICA. Collana CONTRIBUTI 15. NOVEMBRE 19.". In: Magazine of the Kenya Medical association. April 1992. Volume 11 No. 4. African Wildlife Foundation. Nairobi; 1990. Abstract
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.
1989
NTHIA PROFNJERUEH. ""The Perceived Role of Anthropological Research and Teaching in Social Change in Kenya".". In: In The Teaching and Research of Sociology/Anthropologyin the East African Universities. New Delhi: Ossrea Book Series. African Wildlife Foundation. Nairobi; 1989. Abstract
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.
1981
NTHIA PROFNJERUEH. ""Land Adjudication and its Implications for the Social Organization of the Mbeere".". In: In African Journal of Sociology, Vol. 1 No. 1 & 2. University of Nairobi. African Wildlife Foundation. Nairobi; 1981. Abstract
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.
1978
NTHIA PROFNJERUEH. ""Land Adjudication and Its Implications for the Social Organization of the Mbeere.".". In: Research Paper No. 73, Land Tenure Center, University of Wisconsin-Madison. African Wildlife Foundation. Nairobi; 1978. Abstract
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.
1977
NTHIA PROFNJERUEH. ""Some Consequences of Land Adjudication in Mbeere Division, Embu". Co-authored with David Brokensha.". In: Working Paper No. 320, IDS (Institute for Development Studies), University of Nairobi. African Wildlife Foundation. Nairobi; 1977. Abstract
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.

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