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Research Papers
Using lean manufacturing principles to evaluate wait times for HIV-positive patients in an urban clinic in Kenya
As HIV treatment programs expand in Africa, strengthening clinic systems is essential for improving patient retention. This study used lean manufacturing principles to assess patient flow and experience in an urban Kenyan HIV clinic. Key barriers identified included inconsistent patient arrivals and staffing, filing system issues, and serving patients out of order—all contributing to long, variable wait times. Focus group discussions revealed how these inefficiencies hinder patient engagement. Clinic staff welcomed the findings and proposed low-cost solutions. Applying lean methods in low-re
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Research Papers
Implementing a regional integrated laboratory proficiency testing scheme for peripheral health facilities in East Africa
The East African Regional External Quality Assessment Scheme (EA-REQAS), launched in 2004, provides proficiency testing (PT) to support laboratory quality in resource-limited settings. Between 2008 and 2015, 16 surveys were conducted, with facility enrollment rising from 195 to 560. Although average response rates remained steady, performance scores improved from 51% to 68%, and the number of facilities scoring 80% or higher increased from none to 25. Facilities with more frequent participation performed better, highlighting PT’s value in identifying gaps, supporting post-market surveillance
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Research Papers
Macpherson Cystic Echinococcosis in Turkana, Kenya: The Role of Cross-Sectional Screening Surveys in Assessing the Prevalence of Human Infection
Cystic echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus, was once highly prevalent in northwest Turkana, Kenya. Following the launch of a control program by AMREF and KEMRI in 1983, CE prevalence dropped from 5.6% in 1985 to between 1.9% and 3.8% by 2010–2012. Over time, cases shifted from younger to older age groups, and infection rates among females declined, indicating the program’s long-term impact in reducing CE burden in the region. Read More >>>
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Research Papers
National disability-adjusted life years (DALYs) for 257 diseases and injuries in Ethiopia
Ethiopia has significantly reduced the burden of communicable, maternal, neonatal, and nutritional diseases over the past 25 years, shifting the health landscape toward non-communicable diseases. In 2015, leading causes of disability-adjusted life years (DALYs) included lower respiratory infections, diarrheal diseases, and tuberculosis, despite major declines. Non-communicable diseases like heart disease and stroke are rising, with disability burdens persisting. To guide health priorities, Ethiopia must strengthen data systems, address neonatal and chronic disease-related disabilities, and tai
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Research Papers
The impact and cost-effectiveness of the Amref Health Africa-Smile Train Cleft Lip and Palate Surgical Repair Programme in Eastern and Central Africa
Cleft lip and palate (CLP) cause significant disability in low- and middle-income countries, prompting Amref Health Africa and Smile Train to provide corrective surgeries in eastern and central Africa since 2006. An analysis of 37,274 patients operated on between 2006 and 2014 revealed a median surgery age of 5.4 years, with 207,879 Disability-Adjusted Life Years (DALYs) averted at a cost of $13 million—averaging $62.8 per DALY. Despite a delayed burden of 36,352 DALYs due to late surgeries, the intervention yielded substantial economic benefits: $292 million using the human capital approach
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Research Papers
Walking Together: Towards a Collaborative Model for Maternal Health Care in Pastoralist Communities of Laikipia and Samburu, Kenya
In response to low uptake of skilled birth attendance in pastoralist areas, a collaborative model was developed in Laikipia and Samburu, integrating traditional birth attendants (TBAs) with skilled birth attendants (SBAs) to improve maternal care. Through community engagement and research, the model promotes shared roles in antenatal and postnatal care, respectful maternity practices, and facility redesigns to better serve local needs, aiming to enhance safety and ease the transition to SBA-led births. Read More
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Research Papers
Neonatal, infant, and child mortality among women exposed to intimate partner violence in East Africa: a multi-country analysis
This study analyzed data from five East African countries to explore the link between intimate partner violence (IPV) and child mortality. Among 11,512 women surveyed, those who experienced IPV were significantly more likely to lose children as newborns (aOR = 1.3), infants (aOR = 1.9), and under-fives (aOR = 1.5). Socioeconomic factors like education, wealth, and media exposure were also associated with IPV. Notably, women using contraceptives had lower odds of child mortality. The findings highlight IPV as a critical risk factor for child survival, underscoring the need to integrate IPV prev
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Research Papers
Geographic variation and determinants of help seeking behaviour among married women subjected to intimate partner violence: evidence from national population survey. Int J Equity Health 20, 13 (2021)
This study analyzed help-seeking behavior among married Ethiopian women aged 15–49 who experienced intimate partner violence (IPV), using data from the 2016 Ethiopian Demographic and Health Survey. Only 19.8% sought help, and just 9.2% turned to formal sources like police or doctors. Key factors positively associated with help-seeking included experiencing physical violence, higher education, a partner’s alcohol use, controlling behavior, employment status, and higher household wealth. Geographic disparities were also noted, with the lowest help-seeking rates in regions like Benishangul-Gu
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