Elizabeth Kimani‐Murage
Dados Biográficos
| ID | 6576308 |
|---|---|
| NOME | Elizabeth Kimani‐Murage |
| PRENOMES | Elizabeth |
| SOBRENOME | Kimani‐Murage |
| ASSINATURA | MURAGE E K |
| AFILIAÇÕES | African Population and Health Research Center |
| ORCID | 0000-0001-5272-616X |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 51 |
| TOTAL DE CITAÇÕES | 41 |
| TOTAL COMO AUTOR | 51 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2007 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 4 |
Factors Influencing Wasting in Children Under 5 in Arid Regions of Kenya
Child wasting is a major public health problem in low- and middle-income countries. Our study aimed to identify immediate, underlying and basic factors influencing wasting among children in Turkana and Samburu, two arid and semi-arid regions in Kenya. Data are from a longitudinal study of children under 3 years of age at baseline, with follow-up every 4 months for 2 years. Generalized estimating equations were used to assess risk factors of wasti…
Understanding the Purchasing and Consumption Dynamics of Commercially Processed Complementary Foods and Caregiver Motivations and Reasons for Purchasing These Foods in Nairobi
Commercially processed complementary foods (CPCFs) are consumed in Kenya, but little is known about caregiver perceptions and reasons for their consumption. We explored caregiver perceptions, motivations and reasons for purchasing CPCFs. This cross-sectional mixed-methods study was conducted in Nairobi among caregivers of children aged 6-23 months. A four-stage sampling strategy was used to select study sites non-slum (Westlands) and slum (Mathar…
The effect of the Covid-19 pandemic on the baby-friendly community initiative and maternal infant and young child nutrition in Kenya
On balance, the pandemic negatively impacted the BFCI, MCH services and MIYCN practices in Kenya. In such a context, there is a need for innovative approaches to ensure continued provision of and access to facilities and community health services in the future if the country finds itself in a similar position with the challenges of a pandemic. The pandemic revealed that remote working support policies could have the potential to improve breastfee…
Magnitude, trends, transitions, and drivers of the double burden of malnutrition among adolescent girls in urban slums, Kenya
The prevalence of overweight/obesity, as well as transitions to overweight/obesity were higher compared to undernutrition (stunting and thinness). Double-duty and multi-sectoral interventions that consider demographic (family, ethnicity), environmental (neighbourhood, school), and psychosocial (ACE, depression score) factors that may drive DBM in adolescent girls living in urban slums are recommended, to address DBM and reverse the growing trend …
Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya
Objective: To explore the perceptions, drivers and potential solutions to the consumption of unhealthy, ultra-processed foods (UPF) and foods high in fat, salt and sugar (HFSS) and their contribution to the double burden of malnutrition among adolescents living in urban slums, Kenya. Design: Qualitative participatory research, through Photovoice, group discussions and community dialogues. Inductive, thematic analysis was undertaken. Setting: Thre…
Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya
Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-op…
Examining the complex dynamics influencing acute malnutrition in Turkana and Samburu counties
Acute malnutrition in children under 5 years is persistent in Eastern Africa's arid and semiarid lands. This study aimed to identify the drivers of acute malnutrition in Turkana and Samburu counties, Kenya. This was a population-based longitudinal mixed-methods observational study. Qualitative and quantitative data were collected at Wave 1, but only quantitative data were collected during follow-up. Participants were a representative sample of ch…
Treatment of moderate acute malnutrition through community health volunteers is a cost‐effective intervention
Treatment outcomes for acute malnutrition can be improved by integrating treatment into community case management (iCCM). However, little is known about the cost-effectiveness of this integrated nutrition intervention. The present study investigates the cost-effectiveness of treating moderate acute malnutrition (MAM) through community health volunteer (CHV) and integrating it with routine iCCM. A cost-effectiveness model compared the costs and ef…
The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya
Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition…
The feasibility, acceptability, cost and benefits of a “communities of practice” model for improving the quality of childcare centres
Background Informal childcare centres have mushroomed in the informal settlements of Nairobi, Kenya to meet the increasing demand. However, centre providers are untrained and the facilities are below standard putting children at risk of poor health and development. We aimed to co-design and test the feasibility, acceptability, cost and potential benefits of a communities of practice (CoP) model where trained community health volunteers (CHVs) pro…
Predictors of quality of childcare centers in low-income settings
Background Rapid urbanization and increased women’s involvement in paid work have contributed to the upsurge of informal childcare centers, especially in low-income settings where quality is a major issue. However, there are limited data on the factors associated with the quality of childcare centers in informal settlements in Africa. Methods We conducted a quantitative observation and questionnaire survey of 66 childcare centers to identify the …
Developing an intervention to improve the quality of childcare centers in resource-poor urban settings
Background Globally, 350 million under-5s do not have adequate childcare. This may damage their health and development and undermine societal and economic development. Rapid urbanization is changing patterns of work, social structures, and gender norms. Parents, mainly mothers, work long hours for insecure daily wages. To respond to increasing demand, childcare centers have sprung up in informal settlements. However, there is currently little or …
Parental experiences of the impacts of Covid-19 on the care of young children; qualitative interview findings from the Nairobi Early Childcare in Slums (Necs) project
Introduction The Covid-19 pandemic, and societal attempts to control it, have touched almost every aspect of people’s lives around the world, albeit in unequal ways. In particular, there is considerable concern about the way that stringent ‘lockdowns’, as implemented in Kenya and many other countries, affected young children, especially those living in informal settlements. However, to date, there has been little research attempting to unpack and…
Potential effectiveness of integrating human milk banking and lactation support on neonatal outcomes at Pumwani Maternity Hospital, Kenya
We assessed the potential effectiveness of human milk banking and lactation support on provision of human milk to neonates admitted in the newborn unit (NBU) at Pumwani Maternity Hospital, Kenya. This pre-post intervention study collected data from mothers/caregivers and their vulnerable neonates or term babies who lacked sufficient mother's milk for several reasons admitted in the NBU. The intervention included establishing a human milk bank and…
Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana
Objective: To explore communities’ perspectives on the factors in the social food environment that influence dietary behaviours in African cities. Design: A qualitative study using participatory photography (Photovoice). Participants took and discussed photographs representing factors in the social food environment that influence their dietary behaviours. Follow-up in-depth interviews allowed participants to tell the ‘stories’ of their photograph…
Association of women's empowerment with anaemia and haemoglobin concentration in children in sub‐Saharan Africa
We assessed the associations between women's empowerment and anaemia and haemoglobin concentration among children (6-59 months) in 31 sub-Saharan African (SSA) countries. We included 72,032 mother-child pairs from Demographic and Health Surveys conducted between 2006 and 2019. A three-dimensional women's empowerment index (attitude towards violence, decision making and social independence) was constructed using principal components analysis, and …
Covid- 19 and human right to food
The government's COVID-19 restrictive measures exacerbated the already existing vulnerability of the urban poor to food insecurity and violated their human right to food. Future response measures should be executed in ways that respect the human right to food and protect marginalized people from resultant vulnerabilities
An optimal diet for planet and people
Effectiveness of the baby‐friendly community initiative on exclusive breastfeeding in Kenya
The baby-friendly hospital initiative (BFHI) promotes exclusive breastfeeding (EBF) in hospitals, but this is not accessible in rural settings where mothers give birth at home, hence the need for a community intervention. We tested the effectiveness of the baby-friendly community initiative (BFCI) on EBF in rural Kenya. This cluster randomized study was conducted in 13 community units in Koibatek sub-county. Pregnant women aged 15-49 years were r…
Communities and employers show a high level of preparedness in supporting working mothers to combine breastfeeding with work in rural Kenya
Community Readiness Model (CRM) through pragmatic mixed methods design, combining quantitative CRM survey with qualitative data, was used to assess the level of preparedness and readiness among local leaders, employers and community members in supporting working mothers to combine breastfeeding with work. The study was conducted in one of the tea state farms in Kericho County of Kenya. A total of 17 purposively selected men (fathers), lactating m…
Effect of a baby‐friendly workplace support intervention on exclusive breastfeeding in Kenya
Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby-friendly workplace support intervention on EBF in Kenya. This pre-post intervention study was conducted between 2016 and 2018 on an agricultural farm in Keri…
Prevalence and overlap of known undernutrition risk factors in children in Nairobi Kenya
We aimed to describe the co-occurrence of known risk factors for undernutrition and the prevalence of modifiable risks in wasted, stunted and healthy children. Quota sampling was used to recruit healthy [weight for age Z scores (WAZ) > -2 SD] and undernourished [weight for length (WLZ) or WAZ scores ≤ -2 SD] children aged 6-24 months from seven clinics in low-income areas of Nairobi. Structured interviews were used to identify exposure to socioec…
Urban physical food environments drive dietary behaviours in Ghana and Kenya
We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home …
Community perceptions and practices of early childhood development in an urban-poor setting in Nairobi
Eating and feeding behaviours in children in low‐income areas in Nairobi, Kenya
Child eating and caregiver feeding behaviours are critical determinants of food intake, but they are poorly characterized in undernourished children. We aimed to describe how appetite, food refusal and force-feeding vary between undernourished and healthy children aged 6-24 months in Nairobi and identify potential variables for use in a child eating behaviour scale for international use. This cross-sectional study was conducted in seven clinics i…
Vulnerability to Food Insecurity in Urban Slums
Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 200…
Trends in childhood mortality in Kenya
The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums
Quality of Water the Slum Dwellers Use
As a result of rapid urbanization in a context of economic constraints, the majority of urban residents in sub-Saharan Africa live in slums often characterized by a lack of basic services such as water and sewerage. Consequently, the urban poor often use inexpensive pit latrines and at the same time may draw domestic water from nearby wells. Overcrowding in slums limits the adequate distance between wells and pit latrines so that micro-organisms …
Food Security and Nutritional Outcomes among Urban Poor Orphans in Nairobi, Kenya
The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO…
Urban physical food environments drive dietary behaviours in Ghana and Kenya
We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home …
Quality of Water the Slum Dwellers Use
As a result of rapid urbanization in a context of economic constraints, the majority of urban residents in sub-Saharan Africa live in slums often characterized by a lack of basic services such as water and sewerage. Consequently, the urban poor often use inexpensive pit latrines and at the same time may draw domestic water from nearby wells. Overcrowding in slums limits the adequate distance between wells and pit latrines so that micro-organisms …
If you start thinking positively, you won't miss sex’
Drawing on qualitative data, this paper examines narratives of sexual activity (or the lack thereof) among people living with HIV in two urban poor contexts in Kenya and the ways in which these narratives intersect with the discourse of a ubiquitous HIV-prevention strategy - the 'ABC' (Abstinence, Be Faithful, Condom Use) approach. The exploration of these narratives gives insight into the ways that the notions and meanings around sexual activity…
ÂYou opened our eyesâ
Caregivers of young children identified as HIV positive, residing in Agincourt, rural South Africa were advised of their child's status. How was this knowledge received, and how did it influence care-giving and support? Interviews were conducted in May to June 2008 with caregivers of HIV positive children aged 1-5 years, 1 year following the child's HIV test and disclosure of status. Drawing on data from 31 semi-structured questionnaires and 21 i…
The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children
The study highlights that in transitional societies, early stunting and adolescent obesity may co-exist in the same socio-geographic population. It is likely that this profile relates to changes in nutrition and diet, but variation in factors such as infectious disease burden and physical activity patterns, as well as social influences, need to be investigated. As obesity and adult short stature are risk factors for metabolic syndrome and Type 2 …
Food Security and Nutritional Outcomes among Urban Poor Orphans in Nairobi, Kenya
The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO…
Childhood vaccination in informal urban settlements in Nairobi, Kenya
The findings show the extent to which children resident in slums are underserved with vaccination and indicate that service delivery of immunization services in the urban slums needs to be reassessed to ensure that all children are reached
Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya
The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning
Predictors of adolescent weight status and central obesity in rural South Africa
Objective To investigate predictors of adolescent obesity in rural South Africa. Design Cross-sectional study. Height, weight and waist circumference were measured using standard procedures. Overweight and obesity in adolescents aged 10–17 years were assessed using the International Obesity Taskforce cut-offs, while the WHO adult cut-offs were used for participants aged 18–20 years. Waist-to-height ratio of >0·5 defined central obesity in those a…
P2-432 Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi, Kenya
Introduction Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study involves 4299 children aged 0–42 months, born between September 2006 and January 2010, for the period they were infants…
Effect of mother’s education on child’s nutritional status in the slums of Nairobi
BACKGROUND: Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that h…
Exploring the paradox
BACKGROUND: This article is a review of the PhD thesis by Elizabeth Kimani-Murage that explores the double burden of malnutrition in rural South Africa. This is in the context of a worryingly rapid increase in obesity and obesity-related diseases in low- and middle-income countries (LMICs) including South Africa, and in the wake of on-going nutrition transition and lifestyle changes in these countries. OBJECTIVE: To understand the profiles of mal…
“It's my secret”
In South Africa, a third of children born are exposed to HIV, while fewer undergo an HIV confirmatory test. Anti-retroviral therapy (ART) coverage among children remains low-despite roll-out of the national ART programme in South Africa in 2004. This study sought to understand critical barriers to seeking HIV-related care for children in rural South Africa. Data presented in this article derive from community-based qualitative research in poor ru…
Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in K enya
Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings. This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbearing age, commu…
We are used to this”
Community-wide education on air pollution and related health effects together with the measures needed to reduce exposure to air pollution are necessary towards reducing air pollution impacts. A similar city-wide study is recommended to enable comparison of perceptions along socio-economic groups and neighbourhoods
Trends in childhood mortality in Kenya
The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums
Vulnerability to Food Insecurity in Urban Slums
Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 200…
Effectiveness of home-based nutritional counselling and support on exclusive breastfeeding in urban poor settings in Nairobi
BACKGROUND: Exclusive breastfeeding (EBF) improves infant health and survival. We tested the effectiveness of a home-based intervention using Community Health Workers (CHWs) on EBF for six months in urban poor settings in Kenya. METHODS: We conducted a cluster-randomized controlled trial in Korogocho and Viwandani slums in Nairobi. We recruited pregnant women and followed them until the infant's first birthday. Fourteen community clusters were ra…
Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations
Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critica…
Differential effects of dietary diversity and maternal characteristics on linear growth of children aged 6–59 months in sub-Saharan Africa
Objective To investigate the differential effects of dietary diversity (DD) and maternal characteristics on child linear growth at different points of the conditional distribution of height-for-age Z -score (HAZ) in sub-Saharan Africa. Design Secondary analysis of data from nationally representative cross-sectional samples of singleton children aged 0–59 months, born to mothers aged 15–49 years. The outcome variable was child HAZ. Quantile regres…
How does poverty affect children’s nutritional status in Nairobi slums? A qualitative study of the root causes of undernutrition
Objective Children in slums are at high risk of undernutrition, which has long-term negative consequences on their physical growth and cognitive development. Severe undernutrition can lead to the child’s death. The present paper aimed to understand the causes of undernutrition in children as perceived by various groups of community members in Nairobi slums, Kenya. Design Analysis of ten focus group discussions and ten individual interviews with k…
Social value of a nutritional counselling and support program for breastfeeding in urban poor settings, Nairobi
The MIYCN intervention showed an important social impact in which mothers and children benefited the most. The intervention resulted in better perceived health of mothers and children and increased confidence of mothers to provide care for their children, while it resulted in negative impacts for day care center owners and health care providers
Exploring the Experiences of Middle Income Mothers in Practicing Exclusive Breastfeeding in Nairobi, Kenya
Perceptions on donated human milk and human milk banking in Nairobi, Kenya
Donor human milk (DHM) is recomended as the best alternative when use of mothers' own milk is not a feasible option. Kenya has not yet established human milk banks (HMBs) for provision of safe DHM, which is free from any physical, chemical, microbiological contaminants or pathogens. This study aimed to establish the perceptions on donating and using DHM, and establishing HMBs in Kenya. Qualitative data were collected through 17 focus group discus…
Integrated and simplified approaches to community management of acute malnutrition in rural Kenya
PACTR201811870943127 ; Pre-results. 26 November 2018
Analysing child linear growth trajectories among under-5 children in two Nairobi informal settlements
Objective We sought to identify factors associated with linear growth among under-5 children in two urban informal settlements in Nairobi. Design We used longitudinal data for the period 2007–2012 from under-5 children recruited in the two sites between birth and 23 months and followed up until they reached 5 years of age. We fitted a generalized linear model on height-for-age Z -scores using the generalized estimating equations method to model l…
Medicine (48 obras) · Child Nutrition and Water Access (42 obras) · Environmental health (39 obras) · Nursing (23 obras) · Economic growth (18 obras) · Pediatrics (18 obras) · Population (18 obras) · Poverty, Education, and Child Welfare (18 obras) · Public health (18 obras) · Demography (17 obras)