AMREF-Kenya Research and Evaluation Priorities

Within the Research and Evaluation, Forum Loop, we address two priority health concerns of AMREF-Kenya: adolescent sexual and reproductive health and traumatic injury prevention.

Adolescent Sexual and Reproductive Health

In light of the HIV/AIDS epidemic in Kenya and in Sub-Sahara Africa generally, there is a readiness on the part of international agencies, NGOs, and governments to implement interventions designed to foster sexual and reproductive health in adolescents. As such, there is an urgency in critically reflecting on intervention designs, and concomitant criteria for the evaluation of proposed interventions.

Current research indicates that the average age of STD patients is getting lower and involving more adolescent youth. Teenage pregnancies, sometimes resulting in unsafe abortions, also threaten the health and well-being of adolescent girls. The present era of HIV/AIDS finds young girls engaging in premarital sex at an earlier age, resulting in high incidence of STD infection and increased risk for HIV transmission. However, young men are a part of the sexual equation, and require innovative interventions that foster the promotion of sexual responsibility. Compared to health interventions for adolescent girls, it would appear that young men are also neglected and need to be the target of complementary interventions.

In this context, the need for appropriate interventions for adolescents is urgently needed: interventions that are effective, efficacious, and culturally-compelling. Yet, there is a paucity of information on what the components of these interventions might be. What kinds of evidence need to be marshalled in the construction of these interventions (egs., epidemiological, ethnographic, participatory, etc.)? How are these interventions evaluated for their effectiveness and efficacy? What aspects of these interventions ensure sustained impact on the sexual and reproductive health of adolescents? How can these interventions be tailored to the needs, resistances, and social-cultural context of young Kenyan girls and boys?

With respect to interventions that foster and sustain the sexual and reproductive health of adolescent boys and girls, the collaborating partners are:

  • delineating the necessary steps required in intervention design (i.e., rationalizing the intellectual steps for this construction; identifying the quantitative and qualitative evidence base required; considering how these interventions can be grounded in the reality of adolescent lives; and delineating criteria for intervention design that is not necessarily sub-culture specific; and
  • delineating the evaluation requirements that correspond to these proposed steps in intervention design.

(Excerpted from: Willms D.G., Sewakambo, N. and Kanato, M. 1996. Research on the Development of Health Interventions and the Evaluation of Proposed Interventions Specifically Targeted to Adolescent Sexual and Reproductive Health. A planning grant proposal submitted to the Rockefeller Foundation. Hamilton, Canada: Department of Clinical Epidemiology and Biostatistics, and the Department of Anthropology; McMaster University.)

Trauma and Injury Prevention

Injury is the most common cause of death and permanent disability in children and young adults in many developing countries like Kenya, and it ranks fifth overall with more than five percent of total mortality. Incidences are increasing. Although local patterns vary considerably, road traffic accidents, assaults, falls, burns, poisoning, and suicides are likely to be the major injury-related causes of death in sub-Saharan Africa (Nordberg 1994).

Most injuries are mild or even trivial and need no formal medical care, but a small proportion are serious and require skilled emergency care at a hospital or other medical services. A large portion of all injuries can be prevented by effective prevention in a resource-poor situation, but require:

  • accurate data and evidence on injury epidemiology and on the potential effects of prevention against each kind of injury,
  • political will and determination, and
  • a policy development process facilitating appropriate decisions and intervention design.

With respect to this priority health area, there is a need for cross-fertilization and exchange of ideas, experiences, and evidence. The Research and Evaluation, Forum Loop calls for an exchange of ideas through AMREF-Kenya and indigenous NGO fora, stimulating interventions for testing and wider application. As indicated, innovative and advanced theoretical and methodological procedures need to be incorporated in intervention design processes, involving a number of stakeholders and sectors: government (responsible for public transportation policies); the business community (owners of trucks and public transportation); NGOs (committed to injury interventions); and the university (generating the evidence that documents the incidence and prevalence of the problem); and by representatives from groups of persons who have been injured through a trauma incident and physically compromised because of it.

Research and evaluation techniques -- appropriate to the study of injury and trauma -- have been incorporated in the following objectives and goals:

  • to create an inventory and critical and systematic evidence-based review on injury/trauma epidemiology in Kenya;
  • to develop standardized descriptions of burden and patterns of injuries;
  • to analyze current injury prevention policies and programs, with emphasis on road traffic accidents, falls, poisonings, assaults, and burns;
  • to pilot test methods of district level preventive action, for example in the form of local prevention policy development, analysis, and formulation of action programs; and
  • through AMREF-Kenya fora and training workshops, to engage a cross-section of stakeholders and sectors in an assessment and planning process that would focus on: injury epidemiology research methods, Kenyan national injury prevention policy formulation, factors influencing local implementation of these policies, and human and institutional resource needs for training in support of stronger preventive action against injuries.

Reference: Nordberg, E. 1996. Injury Prevention in Eastern Africa. A Policy Review and Development
Research Project
. Nairobi: AMREF-Kenya Country Office (manuscript, April 4).

Research & Evaluation Needs

Project Goals, Objectives & Activities 

Benefits to the Partners

 Research & Evaluation, Forum Loop

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