This article analyses the pilot public housing project in Kibera Soweto East in Nairobi under the Kenya Slum Upgrading Programme (KENSUP), courtesy of a partnership between the Government of Kenya and the United Nations Human Settlements Programme (UN-HABITAT), which began in 2004. The article examines the process of temporary relocation of Soweto East Zone A residents, seven years after the launch of this project, and takes a critical look at the effects of this relocation on the affected population. In order to achieve this, data on Soweto East will first be presented followed by information obtained from surveys conducted on Soweto East residents by Amnesty International and UN-HABITAT. The temporary relocation of residents shall then be analysed with reference to book reviews, interviews and site visits. Finally, the key points analysed within this article shall be presented briefly along with the recommendations derived from this study.
In this chapter, the authors examine the work done by the United Nations to improve the status of women from its origin until 1995, when the fourth and final United Nations World Conference on Women took place. The study shall be divided into three periods. The first spans the era of legal defence of women's rights. The second period begins with the turn of events spurred by the Programme of Concerted International Action for the Advancement of Women in 1970 and continues with the proclamation of the United Nations' International Women's Year in 1975 and the United Nations Decade for the Advancement of Women (1975–1985). Over this 10-year period, three conferences were held: the one that took place in Mexico (1975), the one in Copenhagen (1980) and finally the one in Nairobi (1985). The third period takes a look at the Beijing Conference (1995) and the unprecedented advances it brought about in terms of equality. While the work done by the United Nations was undeniably valuable, as shown in this study, its efforts were not accompanied by marketing work that would have enabled it to make a greater impact on the international public opinion.
This book was published by the Water, Engineering and Development Centre (WEDC) at Loughborough University. ; For centuries, Small Water Enterprises (SWEs) have supplied a large share of the water market in the urban centres of most low-income countries. Such SWEs have proved themselves economically viable, and often operate in competitive conditions. They extend water services to informal settlements that have little prospect of being supplied with piped water from the local utility. Unfortunately, they attract comparatively little investment, and even less support from governments. The incremental but critically important improvements they can provide tend to be overlooked by governments and international agencies. This book is one of a series of outputs from a project designed to identify and test out ways of improving the water services delivered to the urban poor through SWEs. Along with the other books in the series listed below, it will prove an invaluable resource for water utility managers and policymakers. How Small Water Enterprises can contribute to the Millennium Development Goals (including evidence from four African cities); Small Water Enterprises in Africa 1: Tanzania; Small Water Enterprises in Africa 2: Kenya; Small Water Enterprises in Africa 3: Sudan; Small Water Enterprises in Africa 4: Ghana.
Globally, urban slums (in most cases, informal settlements) have been hit badly by novel coronavirus (COVID-19). The reasons for this include the cramped living conditions that make social distancing impossible, and high levels of poverty and unemployment that make masks and clean water for hand washing unaffordable to many slum residents. This paper makes the case for upgrading Kibera, which is long overdue. The United Nations General Assembly endorsed the upgrading of urban slums as a priority Sustainable Development Goal in 2015. To win the war against coronavirus in Kibera, the Government should adopt a bottom-up approach, using the existing community leadership and youth groups, as opposed to a top-down approach. Given the increasing number of positive cases of coronavirus in Kibera, the Government must apply a selective lockdown, as it did in Eastleigh, Mandera and old town Mombasa. Winning the war in Kibera ultimately depends not only on Government efforts, but also on the commitments of local communities and individual residents.
The Nairobi Summit, held in November 2019 and convened by the United Nations Fund for Population Activities, claims to have represented "all nations and peoples, and all segments" of society during its high-level conference. The overall aim of the summit was to mobilize political will and financial commitments that are urgently needed to "finally and fully" implement the 1994 International Conference on Population and Development (ICPD) Program of Action. Despite the recommendation by ICPD to incorporate infertility care in reproductive health services, the new Nairobi Statement largely neglects the topic of infertility. This is particularly troublesome as infertility is a global health problem affecting between 52.6 and 72.4 million couples worldwide, with a high prevalence in low- and middle-income settings. For many people around the world, infertility constitutes an emotional, social, and financial burden, yet appropriate services directed toward preventing and addressing infertility are often inaccessible, unaffordable, or nonexistent. With the impetus of a wider reproductive justice community, we call for the integration of infertility into global reproductive health research and practice, urging policy makers, practitioners, researchers, activists, and funders worldwide to bring focused attention to addressing challenges posed by a lack of safe, effective, and dignified fertility management among those in need.
The Nairobi Summit, held in November 2019 and convened by the United Nations Fund for Population Activities, claims to have represented "all nations and peoples, and all segments" of society during its high-level conference. The overall aim of the summit was to mobilize political will and financial commitments that are urgently needed to "finally and fully" implement the 1994 International Conference on Population and Development (ICPD) Program of Action. Despite the recommendation by ICPD to incorporate infertility care in reproductive health services, the new Nairobi Statement largely neglects the topic of infertility. This is particularly troublesome as infertility is a global health problem affecting between 52.6 and 72.4 million couples worldwide, with a high prevalence in low- and middle-income settings. For many people around the world, infertility constitutes an emotional, social, and financial burden, yet appropriate services directed toward preventing and addressing infertility are often inaccessible, unaffordable, or nonexistent. With the impetus of a wider reproductive justice community, we call for the integration of infertility into global reproductive health research and practice, urging policy makers, practitioners, researchers, activists, and funders worldwide to bring focused attention to addressing challenges posed by a lack of safe, effective, and dignified fertility management among those in need.
Background: Quality pharmaceutical services are an integral part of primary healthcare and a key determinant of patient outcomes. The study focuses on pharmaceutical service delivery among private healthcare facilities serving informal settlements within Nairobi County, Kenya and aims at understanding the drug procurement practices, task-shifting and ethical issues associated with drug brand preference, competition and disposal of expired drugs. Methods: Forty-five private facilities comprising of hospitals, nursing homes, health centres, medical centres, clinics and pharmacies were recruited through purposive sampling. Structured electronic questionnaires were administered to 45 respondents working within the study facilities over an 8-week period. Results: About 50% of personnel carrying out drug procurement belonged to non-pharmaceutical cadres namely ; doctors, clinical officers, nurses and pharmacy assistants. Drug brand preferences among healthcare facilities and patients were mainly pegged on perceived quality and price. Unethical business competition practices were recorded, including poor professional demeanour and waiver of consultation fees veiled to undercut colleagues. Government subsidized drugs were sold at 100% profit in fifty percent of the facilities stocking them. In 44% of the facilities, the disposal of expired drugs was not in conformity to existing government regulatory guidelines. Conclusions: There is extensive task-shifting and delegation of pharmaceutical services to non-pharmaceutical cadres and poor observance of ethical guidelines in private facilities. Strict enforcement of regulations is required for optimal practices.
Background: Quality pharmaceutical services are an integral part of primary healthcare and a key determinant of patient outcomes. The study focuses on pharmaceutical service delivery among private healthcare facilities serving informal settlements within Nairobi County, Kenya and aims at understanding the drug procurement practices, task-shifting and ethical issues associated with drug brand preference, competition and disposal of expired drugs. Methods: Forty-five private facilities comprising of hospitals, nursing homes, health centres, medical centres, clinics and pharmacies were recruited through purposive sampling. Structured electronic questionnaires were administered to 45 respondents working within the study facilities over an 8-week period. Results: About 50% of personnel carrying out drug procurement belonged to non-pharmaceutical cadres namely; doctors, clinical officers, nurses and pharmacy assistants. Drug brand preferences among healthcare facilities and patients were mainly pegged on perceived quality and price. Unethical business competition practices were recorded, including poor professional demeanour and waiver of consultation fees veiled to undercut colleagues. Government subsidized drugs were sold at 100% profit in fifty percent of the facilities stocking them. In 44% of the facilities, the disposal of expired drugs was not in conformity to existing government regulatory guidelines. Conclusions: There is extensive task-shifting and delegation of pharmaceutical services to non-pharmaceutical cadres and poor observance of ethical guidelines in private facilities. Strict enforcement of regulations is required for optimal practices.
The Nancy N. Boothe papers, 1980-2009 [bulk 1990-1997], are composed of articles, notes, reports and a wide variety of feminist publications. Much of the material documents the U.N. Fourth World Conference on Women, which Ms. Boothe attended as Executive Director of Atlanta's Feminist Women's Health Center. Artifacts, artwork and textiles relate to the conference and to other women's and health issues. ; Born in Battles Wharf, Alabama (1948), Nancy N. Boothe graduated from the University of South Alabama as a registered nurse (1971). She received a B.S. in nursing from the Medical College of Georgia (1976), and a master's degree in Counseling from Troy State University [Florida Region] (1981). Boothe served in the U.S. Nurse Corps in the U.S. and Korea (1970-1984), and worked as clinical director and consultant at a number of health facilities in Louisiana and Florida. She became Executive Director of the Atlanta Feminist Women's Health Center in 1994. In 1995, she attended the Fourth World Conference on Women in Beijing, China, where she taught the workshop, ""GYN Self-Help."" Boothe has served on the boards of All Women's Health Services in Portland and Eugene, Oregon; the Sexual Assault Center, Atlanta, Georgia; and the Jeanette Rankin Foundation, Athens, Georgia. She is also a member of the Feminist Majority Foundation's ""Women's Commission for Congressional Oversight"" and A.P.D. Citizen Review Panel.; Founded in California in 1971 by Carol Downer (1933-) and Lorraine Rothman (1932-2007), the Feminist Women's Health Center was established to empower women through self-knowledge, education and self-help groups. The Atlanta Feminist Women's Health Center was established in 1977. Its mission is to ""provide accessible, comprehensive gynecological healthcare to all who need it without judgment. As innovative healthcare leaders, [they] work collaboratively within [their] community and nationally to promote reproductive health, rights and justice. [They] advocate for wellness, uncensored health information and fair public policies by educating the larger community and empowering [their] clients to make their own decisions.""; The United Nations convened the Fourth World Conference on Women, September 4-15, 1995, in Beijing, China, with a Platform for Action that aimed at achieving greater equality and opportunity for women. Three previous World Conferences were held in Mexico City (International Women's Year, 1975), Copenhagen (1980) and Nairobi (1985). 189 governments and more than 5,000 representatives from 2,100 non-governmental organizations participated in the Beijing Conference. The principal themes were the advancement and empowerment of women in relation to women's human rights, women and poverty, women and decision-making, the girl-child, violence against women and other areas of concern. The resulting documents of the Conference are The Beijing Declaration and Platform for Action. The U.N. Fourth World Conference on Women manifested a global women's movement for change and has been called ""the Woodstock of the women's movement.""; The World Conference on Women was also accompanied by an informal meeting (August 30-September 8) of non-governmental organizations (NGOs). This NGO Forum on Women, Beijing '95, brought together thousands of women from around the world to exchange information and ideas, celebrate women's achievements and contributions and draw attention and develop solutions to discrimination facing women world-wide.
The Nancy N. Boothe papers, 1980-2009 [bulk 1990-1997], are composed of articles, notes, reports and a wide variety of feminist publications. Much of the material documents the U.N. Fourth World Conference on Women, which Ms. Boothe attended as Executive Director of Atlanta's Feminist Women's Health Center. Artifacts, artwork and textiles relate to the conference and to other women's and health issues. ; Born in Battles Wharf, Alabama (1948), Nancy N. Boothe graduated from the University of South Alabama as a registered nurse (1971). She received a B.S. in nursing from the Medical College of Georgia (1976), and a master's degree in Counseling from Troy State University [Florida Region] (1981). Boothe served in the U.S. Nurse Corps in the U.S. and Korea (1970-1984), and worked as clinical director and consultant at a number of health facilities in Louisiana and Florida. She became Executive Director of the Atlanta Feminist Women's Health Center in 1994. In 1995, she attended the Fourth World Conference on Women in Beijing, China, where she taught the workshop, ""GYN Self-Help."" Boothe has served on the boards of All Women's Health Services in Portland and Eugene, Oregon; the Sexual Assault Center, Atlanta, Georgia; and the Jeanette Rankin Foundation, Athens, Georgia. She is also a member of the Feminist Majority Foundation's ""Women's Commission for Congressional Oversight"" and A.P.D. Citizen Review Panel.; Founded in California in 1971 by Carol Downer (1933-) and Lorraine Rothman (1932-2007), the Feminist Women's Health Center was established to empower women through self-knowledge, education and self-help groups. The Atlanta Feminist Women's Health Center was established in 1977. Its mission is to ""provide accessible, comprehensive gynecological healthcare to all who need it without judgment. As innovative healthcare leaders, [they] work collaboratively within [their] community and nationally to promote reproductive health, rights and justice. [They] advocate for wellness, uncensored health information and fair public policies by educating the larger community and empowering [their] clients to make their own decisions.""; The United Nations convened the Fourth World Conference on Women, September 4-15, 1995, in Beijing, China, with a Platform for Action that aimed at achieving greater equality and opportunity for women. Three previous World Conferences were held in Mexico City (International Women's Year, 1975), Copenhagen (1980) and Nairobi (1985). 189 governments and more than 5,000 representatives from 2,100 non-governmental organizations participated in the Beijing Conference. The principal themes were the advancement and empowerment of women in relation to women's human rights, women and poverty, women and decision-making, the girl-child, violence against women and other areas of concern. The resulting documents of the Conference are The Beijing Declaration and Platform for Action. The U.N. Fourth World Conference on Women manifested a global women's movement for change and has been called ""the Woodstock of the women's movement.""; The World Conference on Women was also accompanied by an informal meeting (August 30-September 8) of non-governmental organizations (NGOs). This NGO Forum on Women, Beijing '95, brought together thousands of women from around the world to exchange information and ideas, celebrate women's achievements and contributions and draw attention and develop solutions to discrimination facing women world-wide.
The rapid rise of the population in most developing countries has posed a challenge to respective governments to provide decent and quality social services to its populace as anchored in their constitutions. This increased population has superseded the existing social amenities such as houses, schools, and hospitals as planned by city planners. This has resulted in the proliferation of informal settlements, whose geographical locations are noted by a poor environment that has hostile living conditions to mankind. This paper elucidates that limited knowledge, pessimistic attitude from the locals, poor leadership, corruption, and lack of accountability are the causal factors for the continued pathetic status of Kibera slums. The paper thus concludes that if barriers that cause marginalization to the people are lifted, there is the accountability of service provision by relevant stakeholders, empowerment, and good leadership; Kibera will thrive and become one of the best places for human settlement.
This book was published by the Water, Engineering and Development Centre (WEDC) at Loughborough University. ; For centuries, Small Water Enterprises (SWEs) have supplied a large share of the water market in the urban centres of most low-income countries. Such SWEs have proved themselves economically viable, and often operate in competitive conditions. They extend water services to informal settlements that have little prospect of being supplied with piped water from the local utility. Unfortunately, they attract comparatively little investment, and even less support from governments. The incremental but critically important improvements they can provide tend to be overlooked by governments and international agencies. In international statistics any household that gets its water from vendors is defined as lacking access to improved water supplies. This book is one of the outputs from a project designed to identify and test out ways of improving the water services delivered to the urban poor through SWEs. As such, it will prove an invaluable resource for water utility managers and policymakers. The book includes accounts of fieldwork undertaken in a number of African cities: Dar es Salaam (Tanzania); Nairobi (Kenya); Khartoum (Sudan) and Accra (Ghana). Even in these cities, where dependence on SWEs is high, the services provided by these SWEs have been poorly documented until now.
Low-income households in Kenya depend on informal dairy sector to access raw milk and meet their nutrient needs. This is because raw milk is cheaper than processed milk by 20–50%; majority prefers its taste and high butterfat content; it is widely accessible; and it is sold in variable quantities suiting every consumer's affordability. Despite the critical nutritional role played by the informal dairy sector on poor households, the need to conform to international standards of food safety has triggered regulatory agencies to formulate policies that restrict informal commercialization of milk. While promoting milk pasteurization is an important public health measure, little is known of its potential effect on household milk consumption and allocation. Methods: We conducted an experimental study to investigate the effect of milk price increase on intra-household milk allocation to children (less than 4-year-old) in peri-urban settlements in Nairobi that would result from elimination of the cheaper informal milk from the market. The study entailed a best-worst choice experiment that posed various hypothetical scenarios, each with four milk allocation alternatives for the respondent to pick the most and least likely choices they would take in the event milk prices increased by 40% from the prevailing retail price. We analyzed the relative importance of milk allocation alternatives and used latent class model to examine the likely impact of such policy on children milk allocation in different groups. Findings and interpretations: Of all the 9 milk allocation alternatives, 4 were the most important/preferred regardless of the household socioeconomic and demographic characteristics and these suggested that an increase in milk price by 40%would decrease overall milk demand and consumption at the household level. Moreover, in three of those, the choices that households consider best/most likely directly affect the amount of milk allocated to children below the age of 4 years. Although participants indicated that they would compensate for the decreased milk amount allocated to children by substituting with another food item, the nutrition value of the replacement, taste and preference, complementarity and price among other factors might not match that of milk. Conclusions: Poor households prefer consuming raw milk sourced from the informal sector due to its relative affordable price, taste and its accessibility. Increasing price would likely decrease household demand as there would be overall decrease on the amounts consumed by its members – including children. Given that the current consumption is below the amounts recommended by WHO, policies streamlining the dairy sector should consider the large informal sector as a strategic partner and strengthen its capacity to market safe milk in an overarching goal of improving consumption instead of eliminating it. ; Government of the United Kingdom ; Bill & Melinda Gates Foundation
The dairy value chain of Nairobi is comprised, in its majority, of small-scale independent enterprises that operate within a complex interlinked system. In this complexity, the coordination and power structures of the system may have major influences on the management of dairy food safety. Therefore, the aim of this study was to investigate the governance structure and challenges faced by stakeholders throughout the Nairobi dairy value chain and assess their potential implications on food safety. Qualitative data were collected through focus group discussions and key informant interviews based on a dairy value chain mapping framework previously developed. Thematic analysis enabled identification of governance themes, key challenges and analysis of their implications on food safety. Themes were organized depending on their association with farmers (informal settlement or peri-urban), dairy cooperatives, dairy traders, processing companies, retailers or government officers. The identified governance themes included: i) weak linkage between government and farmers, ii) inadequate compliance with government regulations by traders and retailers, iii) emphasis on business licenses and permits for revenue rather than for food safety, iv) multiple licensing resulting in high business cost and lack of compliance, v) fragmented regulation, vi) unfair competition and vii) sanctions that do not always result in compliance. The key challenges identified included, among others: i) inadequate farmer support, ii) harassment of traders and retailers and iii) high business costs for traders, retailers, dairy cooperatives and large processors. The implication of governance and challenges of food safety were, among others: i) inadequate extension services, ii) insufficient cold chain, iii) delivery of adulterated and low milk quality to bulking centers, iv) inadequate food safety training and v) lack of policies for management of waste milk. The range of issues highlighted are based on stakeholders' perceptions and reflects the complexity of the relationships between them. Many of the governance themes demonstrate the linkages that are both beneficial or confrontational between the formal and informal sectors, and between industry and regulatory authorities, with possible direct food safety consequences. Findings obtained provide indications to decision-makers of potential governance areas that could help improve efficiency and food safety along the dairy value chain. ; Medical Research Council, United Kingdom ; Biotechnology and Biological Sciences Research Council, United Kingdom ; Natural Environment Research Council, United Kingdom ; Economic and Social Research Council, United Kingdom ; Peer Review
Urban livestock keeping in developing cities have an important role in food security and livelihoods, but can also pose a significant threat to the environment and health of urban dwellers. The aim of this study was to identify the different livestock systems in Nairobi, their supply chains and their management and food safety risks. Seven focus group discussions with Livestock production officers in charge of each major Nairobi subcounty were conducted. Data were collected on the type of systems existing for each livestock species and their supply chains, disease management, food safety risks, and general husbandry and gender factors. Supply chain flow diagrams and thematic analysis of the data was done. Results of the study show a large variability of livestock keeping in Nairobi. The majority were small scale with: <5 dairy cows, 1-6 dairy goats, <10 small ruminants, <20 pigs, 200-500 broilers, 300-500 layers, <10 indigenous chickens or <20 rabbits. Beef keeping was mainly described as a 'by the way' system or done by traders to fatten animals for 3 month. Supply chain analysis indicated that most dairy farmers sold milk directly to consumers due to 'lack of trust' of these in traders. Broiler and pig farmers sold mainly to traders, but are dependent on few large dominating companies for their replacement or distribution of products. Selling directly to retailers or consumers (including own consumption), with backyard slaughtering, were important chains for small scale pig, sheep and goat and indigenous chicken keepers. Important disease risk practices identified were associated to consumption of dead and sick animals, with underground network of brokers operating for ruminant products. Qualified trained health managers were used mainly by dairy farmers, and large commercial poultry and pig farmers, while use of unqualified health managers or no treatment were common in small scale farming. Control of urban livestock keepers was reported difficult due to their 'feeling of being outlaws', 'lack of trust' in government, 'inaccessibility' in informal settlements, 'lack of government funding' or 'understaffing'. Findings are useful for designing policies to help to control urban livestock production and minimize its associated health and environment risks. ; Medical Research Council, United Kingdom ; Natural Environment Research Council, United Kingdom ; Economic and Social Research Council, United Kingdom ; Biotechnology and Biological Sciences Research Council, United Kingdom ; Peer Review
