Kenya

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low-and middle-income countries.... Show More + Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. The tables in this report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. The quintiles are based on an asset index constructed using principal components analysis. Benefit-Incidence Analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor. The distribution of subsidies depends on the assumptions made to allocate subsidies to households. Under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service divided by the number of units of utilization. Show Less -

Substantial declines in infant and under-5 mortality have taken place in recent years in many countries in Sub-Saharan Africa. Kenya's infant mortality rate has fallen... Show More + by 7.6 percent per year, the fastest rate of decline among the 20 countries in the region for which recent Demographic and Health Survey data is available. Kenya's rate of postneonatal deaths per 1,000 live births fell by more than half over a five-year period, dropping from 47 to 22, as measured using data from the 2003 and 2008-09 Demographic and Health Surveys. Among the possible causes of the decline are various targeted new public health initiatives and improved access to water and sanitation. A Oaxaca-Blinder decomposition using Demographic and Health Survey data shows that the increased ownership of insecticide-treated bednets in endemic malaria zones explains 39 percent of the decline in postneonatal mortality and 58 percent of the decline in infant mortality. Changes in other observable candidate factors do not explain substantial portions of the decline. The portion of the decline not explained may be associated with generalized trends such as the overall improvement in living standards that has taken place with economic growth. The widespread ownership of insecticide-treated bednets in areas of Kenya where malaria is rare suggests that better targeting of insecticide-treated bednet provision programs could improve the cost-effectiveness of such programs. Show Less -

Malaria is a serious public health problem in Kenya. Since pregnant women and children under five bear the brunt of mortality and morbidity, the vast majority of malaria... Show More + interventions focus on these high-risk groups. Because of the growing awareness of linkages between health and educational outcomes, an ongoing study in Kenya evaluates the effectiveness of a malaria control intervention implemented alongside teacher training aimed at enhancing the quality of instruction. This is the first impact evaluation in Africa to measure the combined effects of a disease control and educational intervention on educational achievement. Some modeling evidence already exists that school-based interventions will have positive spillover effects, such as reducing malaria parasitaemia in the wider community, especially in low to moderate transmission settings. Show Less -

Youth unemployment is a problem in many developing countries, where labor market opportunities may be further squeezed by rapid rural migration into big cities, the... Show More + cost of higher education and job seekers' limited information about the best opportunities. Policymakers and aid organizations trying to reduce youth unemployment have a variety of approaches they can use, including vocational training programs to give job seekers necessary skills to be employed. But what works best is still not clear: should governments subsidize job training programs for young adults? Should they limit subsidies to public sector programs or include the private sector? Do government-run and private institutions differ in their ability to attract students and prepare them to find a job? What roles do outside factors, such as distance to a school, play in a young adult's decision to enroll in a training program? In Kenya, the World Bank supported a special voucher program for young adults to evaluate demand for vocational training and the impact of training on job seekers. The evaluation showed that offering young adults vouchers that cover program costs does encourage young adults to enroll, and that those who can use the voucher for a private training program are more likely to sign up and stay in school. The results of the study are in line with research done in Latin America, indicating the benefits of making vocational training more widely available in developing countries. While further research of this program is planned in Kenya, the initial evaluation does show that vouchers for vocational schools especially when private sector schools are included can be an effective way to give job seekers employable skills. Show Less -

The introduction of the Citizen Report Card (CRC) tool in three Kenyan cities formed a basis for dialogue between citizenry and decision makers on urban water and sanitation... Show More + issues. The CRC replicates the private sector practice of collecting and acting on consumer data for self improvement, but applies it to public goods and services, framed in an open and public consultative process. The CRC tool was followed by institutionalized approaches to promoting social accountability, such as specialist civic networks on the demand side, and regulatory supported citizen monitoring and feedback mechanisms on the supply side. This note and accompanying DVD describes the context, processes and results of the initiative which seeks to increasingly bring citizens to the center of urban water and sanitation sector reforms. Show Less -

A US$100 million Health Sector Support Project with components geared at increasing coverage of basic health services to vulnerable groups (especially pregnant women... Show More + and children) is planned for the delivery in 2010. The project does not focus explicitly on nutrition, but the new health sector services fund would provide new opportunities to work at the local level on nutrition issues. Show Less -

Gender is a concept that refers to socially constructed roles, behavior, activities and attributes that a particular society considers appropriate and ascribes to men... Show More + and women. A useful definition of the concept of gender mainstreaming is provided by the United Nations Economic and Social Council (1997), suggests that mainstreaming a gender perspective is the process of assessing the implications for women and men of any planned action, including legislation, policies or programs, in all areas and at all levels. It is a strategy for making the concerns and experiences of women as well as men, an integral dimension of the design, implementation, monitoring and evaluation of policies and programs in all political, economic and societal spheres, so that women and men benefit equally and inequality is not perpetuated. The ultimate goal is to achieve gender equality. The chapters that follow highlight in a short summary form experiences of mainstreaming gender at various levels in the water and sanitation sector. It begins with a discussion on gender responses to policy and its requirement for analysis and clear policy objectives to guide operations. The second section touches on experiences of mainstreaming gender within sector operations, beginning with the importance of mainstreaming in the workplace. Section three addresses gender responses to monitoring and evaluation processes, while the fourth section examines responses to gender issues within accountability and voice initiatives. Section five assesses gender responses within hygiene and behavior change programs, while section six examines the linkages between water, sanitation and HIV/AIDS. This is followed by an assessment of the way ahead. In each section good mainstreaming practices are highlighted, while a checklist summarizes key points to consider when mainstreaming gender. Show Less -

The objective of the Youth Empowerment Project is to support the Republic of Kenya to increase access to youth targeted temporary employment programs and to improve... Show More + youth employability. The Kazi Kwa Vijana (KKV) audit findings were divided into four main categories: 1) governance and oversight mechanism, highlighting that some management and audit committee were inactive or not constituted; 2) transparency and accountability mechanism, highlighting challenges of funds that were not accounted for and some ineligible expenditures; 3) flow of funds and work plans, highlighting slow and late disbursements to line ministries and late submission of work plans; and 4) design, structural and coordination issues, highlighting engagement in activities with contractors with low-labor intensity. Show Less -

Two major approaches on how to address women's land security can be identified: reforming the formal legal sector, and embracing informal community practices. However,... Show More + through research conducted among Kenya's agricultural communities, the authors find that these systems formal, informal, or hybrid are underpinned (and undermined) by the same local power dynamics that control and ultimately prevent women from obtaining land, leaving all of these systems inadequate in ensuring women's access to land. Community leaders play a key role not only as local power brokers, decision makers, and protectors of local practices, but also as gatekeepers to the formal system. Thus, their decisions to support local power dynamics and limit access to the formal system essentially supporting traditions? in lieu of rights can effectively deny women access to their land rights. Based on these findings, the authors argue that the policy debate must shift away from pitting formal legislative approaches against support for 'customary' systems. With economic and political contexts influencing individuals, the debate must look at the social context within communities, whose members must be pressed to reject attempts to 'hijack' custom and legitimize abusive, self-serving behavior. This problem needs to be tackled using the same avenues that currently promote the marginalization of women, that is, the sociocultural value systems that determine which behavior, arguments, and actions are legitimate in a community. By working with existing positive values, the justice system used formal or informal becomes less important and a lasting, positive change on women's access to land rights might be achieved. Show Less -