The Government of Kenya initiated COVID-19 vaccination program in March 2021. However, vaccine uptake remains low, especially in rural areas in Kenya. We interviewed 40 residents of Eldoret town to ...explore the knowledge, beliefs, and meanings they attach towards vaccines generally, and why they chose to vaccinate or not. Two-thirds of our participants perceived themselves to be at risk of COVID-19 infections. About half demonstrated willingness to be vaccinated and about a third had been vaccinated. All participants were knowledgeable about the broader benefits of vaccination. Yet, widespread beliefs that vaccination programmes target children and pregnant women decreased vaccine acceptance. Also, we found that concerns about vaccine safety, lack of knowledge, misinformation from social media, and conspiracy theories contributed to COVID-19 vaccine hesitancy in Eldoret. Low COVID-19 vaccination rates and hesitancy - even when the vaccines are accessible and free in Kenya - cannot be ignored. The current COVID-19 vaccination prioritisation schedule (distinct from the usual structure where children, childbearing women are prioritised) and beliefs that older people are targeted to test vaccines efficacy must be addressed through improved communication and mass education. More research is needed to investigate the socio-economic, political, and historical factors that influence vaccine hesitancy in Kenya.
Over-exposure to the sun's ultraviolet rays is a major environmental risk factor for skin cancer. Shortcomings associated with the use of synthetic sunscreens can be overcome by the use of herbal ...based sunscreens. Plant phytochemicals have antioxidant activity and Sun Protection Factor (SPF) activity, however their hydrophilic nature limits their ability to penetrate into deeper areas of the skin thereby affecting their bioavailability. The aim of this study was to formulate phytosomes with antioxidant and SPF activity using ethanolic extracts of Agave americana americana and Agave americana marginata leaves. Soxhlet extraction was used to extract phytochemicals from dried leaves. The presence of phenols, flavonoids, and tannins were confirmed using various tests. The antioxidant activity was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay while SPF activity was determined using UV spectroscopy. Phytosomes were formulated and characterized for size, Polydispersity Index (PDI) and zeta potential. A. americana americana had a higher content of flavonoids, phenols, and tannins which also resulted in better antioxidant activity (IC50) 4.77 μg/ml versus 5.66 μg/ml and SPF activity of 9.95 versus 5.84, when compared to A. americana marginata. The phytosome formulations using A. americana americana had SPF activity of 9.96 to 13.3 with 40 mg extract and 60 mg soy lecithin having the highest activity. This formulation had the smallest particle size of 91nm, PDI and zeta potential of 0.235 and -4.95, respectively. These results indicate the formulation of the extracts into phytosomes enhances their SPF activity.
Access to essential childhood cancer medicines is a core determinant of childhood cancer outcomes. Available evidence, although scarce, suggests that access to these medicines is highly variable ...across countries, particularly in low-income and middle-income countries, where the burden of childhood cancer is greatest. To support evidence-informed national and regional policies for improved childhood cancer outcomes, we aimed to analyse access to essential childhood cancer medicines in four east African countries—Kenya, Rwanda, Tanzania, and Uganda—by determining the availability and price of these medicines and the health system determinants of access.
In this comparative analysis, we used prospective mixed-method analyses to track and analyse the availability and price of essential childhood cancer medicines, investigate contextual determinants of access to childhood cancer medicines within and across included countries, and assess the potential effects of medicine stockouts on treatment. Eight tertiary care hospitals were included, seven were public sites (Kenyatta National Hospital KNH; Nairobi, Kenya, Jaramogi Oginga Odinga Referral and Teaching Hospital JOORTH; Kisumu, Kenya, Moi University Teaching and Referral Hospital MTRH; Eldoret, Kenya, Bugando Medical Centre BMC; Mwanza, Tanzania, Muhimbili National Hospital MNH; Dar es Salaam, Tanzania, Butaro Cancer Centre of Excellence BCCE; Butaro Sector, Rwanda, and Uganda Cancer Institute UCI; Kampala, Uganda) and one was a private site (Aga Khan University Hospital AKU; Nairobi, Kenya). We catalogued prices and stockouts for 37 essential drugs from each of the eight study siteson the basis of 52 weeks of prospective data that was collected across sites from May 1, 2020, to Jan 31, 2022. We analysed determinants of medicine access using thematic analysis of academic literature, policy documents, and semi-structured interviews from a purposive sample of health system stakeholders.
Recurrent stockouts of a wide range of cytotoxic and supportive care medicines were observed across sites, with highest mean unavailability in Kenya (JOORTH; 48·5%), Rwanda (BCCE; 39·0%), and Tanzania (BMC; 32·2%). Drugs that had frequent stockouts across at least four sites included methotrexate, bleomycin, etoposide, ifosfamide, oral morphine, and allopurinol. Average median price ratio of medicines at each site was within WHO's internationally accepted threshold for efficient procurement (median price ratio ≤1·5). The effect of stockouts on treatment was noted across most sites, with the greatest potential for treatment interruptions in patients with Hodgkin lymphoma, retinoblastoma, and acute lymphocytic leukaemia. Policy prioritisation of childhood cancers, health financing and coverage, medicine procurement and supply chain management, and health system infrastructure emerged as four prominent determinants of access when the stratified purposive sample of key informants (n=64) across all four countries (Kenya n=19, Rwanda n=15, Tanzania n=13, and Uganda n=17) was interviewed.
Access to childhood cancer medicines across east Africa is marked by gaps in availability that have implications for effective treatment delivery for a range of childhood cancers. Our findings provide detailed evidence of barriers to access to childhood cancer medicine at multiple points in the pharmaceutical value chain. These data could inform national and regional policy makers to optimise cancer medicine availability and affordability as part of efforts to improve childhood cancer outcomes specific regions and internationally.
American Childhood Cancer Organization, Childhood Cancer International, and the Friends of Cancer Patients Ameera Fund.
Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public ...primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public primary schools in Machakos County. A total of 405 respondents were sampled for the study and comprised of 27 parents, 27 teachers and 351 pupils. Data were collected by use of questionnaires and interview guide. Descriptive as well as inferential statistics were used to analyze data and results presented in tables showing frequency, standard deviations and means. The hypothesis was tested using ANOVA which showed the tuition mean prevalence between groups as 1.457 and within groups as 0.056. The post hoc analysis was done using the Scheffe test and the mean difference between teachers and pupils gave a mean of 0.228 and between pupils and parents gave a mean of 0.260. The findings indicate that private tuition is still being offered despite the government ban and that the main reasons given for engagement in holiday tuition include desire to get high marks, stiff competition for placement into particular secondary schools, inadequate teacher pupil ratio and as a way of earning extra income by teachers. The study recommends that the government remunerates teachers adequately and to have other measures of rewarding performance other than academics. The study also recommends that the government needs to improve infrastructure in all secondary schools to minimize the stiff competition for those schools perceived to be prestigious. In addition, there should be stakeholders' awareness of other ways of engaging pupils constructively during their free time other than in private tuition.
In the 20th century, a number of loopholes could be identified where churches were accused of seeming to support oppressive systems like apartheid and colonialism (by not speaking out loud against ...evils, silence is equated to support).26 While we know that the WCC worked hard during all these times, traces of irresponsibility cannot be overruled.
MSc (Med), Bioethics and Health Law, Faculty of Health Sciences, University of the Witwatersrand
During my interaction with various healthcare professionals while pursuing my post graduate degree, it ...was evident that a number of them were uninformed about refugees‘ rights.1 There was a predominant misconception that refugees are a burden to South Africa‘s already-constrained health care resources. Some of the healthcare professionals that I spoke to pointed out that they would care for all patients regardless of whether they were refugees or not, because they felt that they had a moral obligation to do so and because professional ethics required them to do so. This was the motivation behind my research.2;
As observed by Bilchitz (2005: 5), the term „right to health‟ is a shorthand expression for two elements; the right to health care and the right to a healthy environment. This research report focuses on the right to health which includes access to healthcare services as one of the components of the right to health. It is not oblivious of other related and interdependent rights and it is not in any way intended to undermine the importance of other rights to health. For the most part, I centre my research report in the context of South Africa.;
In line with the above, the research report recognises the fact that the obligation of the states under international law extends to non-state actors. However, this;
1 A refugee is defined by the Department of Home Affairs South Africa (2009) as ―Anyone fleeing from individual persecution, human rights violations or armed conflict in the land of their origin‖.;
2 In my further studies, I hope to compliment this research report with empirical research.;
7;
research is limited to the state‘s obligations within the public healthcare sector. The research report takes an entitlement approach because entitlement empowers refugees by:;
1. It gives them a base on which to stand up for themselves and for all persons past and present who, in the face of persecution, have become refugees; and;
2. It allows refugees to draw attention to and demand the satisfaction of their rights (Liebenberg 2006: 20; Williams 2005: 446);and;
3. It uses the legal process in order to obtain the fulfilment of their needs (ibid: 33-34);and;
4. It aids in the pursuit of social justice as Pieterse (2006: 447) puts it:;
... by demanding the acceleration of structural reforms that would put an end to prevailing hardship and by creating a space for collective mobilisation around such structural reforms.;
Although in some instances the research report refers to provisions and studies conducted on foreigners,3 this study is mainly focused on refugees and asylum seekers. However some of issues affecting foreigners in general inadvertently affect refugees as well.;
Overall, my research looks at the general rights of refugees. It acknowledges that there are specific rights that apply to specific classes of refugees.4 Lastly, the use of;
3 A ‗foreigner means an individual who is neither a citizen nor a resident.‘ ( see Yacoob J.‘s ruling in Lawyers for Human Rights v Minister of Home Affairs & Another CCT 18/03;
4 These include women and children amongst others. See Convention on the Elimination of all forms of Discrimination Against Women (CEDAW 1979); Convention on the Rights of the Child (CRC, 1989), in article 24 and related regional treaties. Also see s 28 of the RSA Constitution.;
8;
the term refugee in the study is intended for convenience and includes asylum seekers.;
The main thesis of the study is that states, as promoters and protectors of refugees‘ right to health, have an obligation to put in place all necessary measures that will aid refugees to full realisation of their right to access healthcare services.
The end of apartheid in South Africa in 1994 brought with it the task of redressing past discriminatory practices. The Employment Equity Act (No. 55 Of 1998) passed in 1998 stipulated that designated ...employers implement affirmative action in order to provide equal employment opportunities to all including the previously disadvantaged or designated groups who are primarily blacks, the disabled and women (Charlton and Niekerk, 1994:. xxii). Affirmative action is not something to be done for political expediency and fear of legislation alone. Shifting markets and consumer needs require demographic representation at all levels in the organization. Addressing the incredible shortage of available skills, compounded by the tendency not to grant equal employment to designated groups who already have skills, suggests the need for demographic considerations in terms of long-term employment needs. Bringing human resources up to world-class standards will mean addressing the deficiencies that have emanated from the apartheid system. This study focuses on the relationship
between gender, equality and the concept of affirmative action. The purpose of this study is to investigate the perceptions of South African male broadcasters towards affirmative action especially where the policy is targeted
towards women. Male broadcasters at SABC KwaZulu-Natal are used as case studies. South African Broadcasting Corporation (SABC) not only embraces affirmative action but also reports on it. Previous studies on affirmative action in media institutions tend to focus on women and thus this study uses men as case studies to make this area of research more complete. South African men are not a homogenous category. There are class, racial, religious,
language, urban/rural, cultural and age lines of division among them (Nzimande and Sikhosana, 1996: 82). This being the case, the study investigates the different
perceptions held by South African male broadcasters of different races concerning gender-based affirmative action. Issues discussed in this study include:
• Understanding of the concept affirmative action
• Need for the implementation of affirmative action
• Perceptions ofmen towards work Men and power in organizations
• Perceptions towards management
• Perceptions towards female broadcasters
• Perceived factors that hinder women from upward mobility
• Possibilities for informal discrimination
Studies on affirmative action have more frequently than not been examined in the context of feminist theories, for example, Susan Manhando's study (1994), 'Towards
affirmative action: Issues of race, gender and equality at the SABC: Case studies of Natal women broadcasters' and Farhana Goga's (2000) 'Towards affirmative action
issues of race and gender in media organizations: A study on South African media organizations,' to cite but two examples. This study moves beyond this rubric to include both patriarchy and masculinity theories as part of the theoretical framework upon which data analysis is interpreted and discussed. I see the findings of this
research as the basis for further investigation into perceptions of South Africans from different races towards affirmative action policy.
Thesis (M.A.)-University of Natal, Durban, 2002.
