Winstone Nyandiko
Dados Biográficos
| ID | 6763382 |
|---|---|
| NOME | Winstone Nyandiko |
| PRENOMES | Winstone |
| SOBRENOME | Nyandiko |
| ASSINATURA | NYANDIKO W |
| AFILIAÇÕES | Moi University |
| ORCID | 0000-0002-7639-9287 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 28 |
| TOTAL DE CITAÇÕES | 11 |
| TOTAL COMO AUTOR | 28 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 2 |
Human-centered design of an adapted differentiated service delivery model for pregnant and postpartum women living with HIV in Kenya
Differentiated service delivery (DSD) models for pregnant and postpartum women living with HIV (WLH) are lacking despite guidelines recommending DSD for this population. We used human-centered design (HCD) to develop a DSD model for pregnant and postpartum WLH at the Academic Model Providing Access to Healthcare (AMPATH) in Kenya. We conducted co-creation workshops with 11 postpartum women, 9 male partners and 9 providers from three AMPATH-affili…
Challenges Faced by Perinatally-Infected Kenyan Adolescents and Youth Living with HIV During the Covid-19 Pandemic
Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV
Background: The HADITHI study is a cluster-randomized trial of children living with HIV and their caregivers in Kenya that aimed to increase rates of caregiver disclosure of their child's HIV status, encourage earlier status disclosure, and improve pediatric mental health and HIV outcomes. This analysis identified characteristics predicting caregiver non-responsiveness and compared outcomes among children based on disclosure status. Methods: A pe…
A Global Health Reciprocal Innovation grant programme
Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as ‘reciprocal innovation’ (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core eleme…
Multi-media teacher training and HIV-related stigma among primary and secondary school teachers in Western Kenya
HIV stigma is associated with delayed HIV disclosure and worse clinical outcomes for adolescents living with HIV (ALWH). Teachers critically influence school environments, but are understudied in terms of HIV stigma. We implemented a school-level, cluster-randomized trial to assess the impact of a one-day multi-media training on the knowledge, attitudes and beliefs (K/A/B) of school teachers in western Kenya. Teachers' K/A/B were evaluated at bas…
Ethical Considerations for Engaging Children and Adolescents Living with HIV in Research in African Countries
Research engaging children and adolescents living with HIV (CALWH) is critical for youth-friendly services and HIV care, and researchers need to ensure that such engagement is ethical. We conducted a systematic review to identify key ethical considerations for the engagement of CALWH in research. The review focused on primary research articles conducted in African countries that examined ethical issues in CALWH engaged in research. Ten studies me…
Ethical Considerations for Engaging Youth Living with HIV in Research
Introduction: Engaging youth living with HIV (YLWH) in research is critical to improving HIV-related outcomes, but their involvement raises unaddressed bioethical questions. Methods: This study used qualitative inquiry with Kenyan YLWH, caregivers, and subject matter experts (SMEs) to evaluate ethical considerations and strategies for research involving YLWH. Results: Interviews were conducted with 99 participants: 40 YLWH (median age 17.5, 50% f…
A systematic review of interventions to reduce HIV-related stigma among primary and secondary school teachers
Reciprocal innovation
Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined 'reciprocal innovation.' Reciprocal innovation harnesses a bidirectional, co-const…
I have never talked to anyone to free my mind” – challenges surrounding status disclosure to adolescents contribute to their disengagement from HIV care
Complex challenges surrounding HIV status disclosure to adolescents contribute to care disengagement. There is need to enhance training and resources for HCW, and to empower caregivers to support children and adolescents before, during, and after HIV status disclosure. This should include counseling caregivers on how to provide children with developmentally-appropriate and accurate information about their health from an early age, and to support …
Social Stigma Related to Covid-19 Disease Described by Primary and Secondary School Teachers and Adolescents Living With HIV in Western Kenya
Introduction: Understanding community members' knowledge, attitudes, and beliefs about the novel SARS-CoV-2 virus and the prevalence of associated stigma are critical steps for increasing accurate public health knowledge, encouraging uptake of preventative or mitigating health behaviors, and ultimately bringing the COVID-19 pandemic under control. Methods: We conducted a one-time, phone-based assessment to assess the presence of perceived COVID-1…
Barriers to ART adherence among school students living with HIV in Kenya
HIV has transformed from a serious acute illness with high rates of morbidity and mortality to a fairly easily managed chronic disease. However, children and adolescents living with HIV are yet to achieve similar improvement in their HIV care outcomes compared to adults. There have been a number of studies assessing the reasons for slower improvement in these age categories, mainly focusing on health systems, drug- and family- related barriers to…
Perspectives of education sector stakeholders on a teacher training module to reduce HIV/Aids stigma in Western Kenya
Data from interviews with education sector stakeholders demonstrate that our process for developing a culturally appropriate multi-media intervention to reduce HIV stigma in the schools was feasible
A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya
Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp ® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in…
“A problem shared is half solved” – a qualitative assessment of barriers and facilitators to adolescent retention in HIV care in western Kenya
Adolescents living with HIV (ALHIV, ages 10-19) are retained in care at low rates, resulting in poor clinical outcomes. We investigated barriers and facilitators to retention experienced by perinatally infected ALHIV in western Kenya. This qualitative study purposefully sampled hospitalized ALHIV (engaged and not currently engaged in care), ALHIV engaged in outpatient care, and caregivers of ALHIV. In total, 116 ALHIV and caregivers participated …
Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers
Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics
Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV
This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week …
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of …
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
Models of care for orphaned and separated children and upholding children’s rights
BACKGROUND: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human righ…
The government of Kenya cash transfer for orphaned and vulnerable children
BACKGROUND: The 'Cash Transfer to Orphans and Vulnerable Children' (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people's health and well-being and other international human rights. The objective of this analys…
The Vulnerabilities of Orphaned Children Participating in Research
Orphans are a subpopulation with a unique set of additional vulnerabilities. Increasing focus on children's rights, pediatric global health, and pediatric research makes it imperative to recognize and address unique vulnerabilities of orphaned children. This paper describes the unique vulnerabilities of the orphaned pediatric population and offers a structured set of factors that require consideration when including orphans in biomedical research…
Community Perspectives on Research Consent Involving Vulnerable Children in Western Kenya
Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in res…
Rooting Inquiry in Tradition
The baraza is a customary form of community assembly in East Africa. We examined the use of the health baraza as a process that can improve data collection and deepen community understanding of sociocultural issues surrounding HIV/AIDS. In the evaluation of the United States Agency for International Development (USAID)-Academic Model for Prevention and Treatment of HIV/AIDS Partnership (USAID-AMPATH) in Kenya, investigators facilitated mabaraza (…
Impact of the Kenya post-election crisis on clinic attendance and medication adherence for HIV-infected children in western Kenya
During a period of humanitarian crisis, the vulnerable, HIV-infected pediatric population had disruptions in clinical care and in medication adherence, putting children at risk for viral resistance and increased morbidity. However, unique program strengths may have minimized these disruptions
Rooting Inquiry in Tradition
The baraza is a customary form of community assembly in East Africa. We examined the use of the health baraza as a process that can improve data collection and deepen community understanding of sociocultural issues surrounding HIV/AIDS. In the evaluation of the United States Agency for International Development (USAID)-Academic Model for Prevention and Treatment of HIV/AIDS Partnership (USAID-AMPATH) in Kenya, investigators facilitated mabaraza (…
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
Pediatric Assent for a Study of Antiretroviral Therapy Dosing for Children in Western Kenya
MULTINATIONAL COLLABORATORS IN health research face particular ethical challenges when conducting studies involving vulnerable populations such as children. We use an example from our first attempt to implement pediatric assent in the context of a longstanding research and clinical partnership between Kenyan and American medical schools to highlight the ethical and procedural issues related to pediatric assent that must be considered for multinat…
Community Perspectives on Research Consent Involving Vulnerable Children in Western Kenya
Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in res…
Impact of the Kenya post-election crisis on clinic attendance and medication adherence for HIV-infected children in western Kenya
During a period of humanitarian crisis, the vulnerable, HIV-infected pediatric population had disruptions in clinical care and in medication adherence, putting children at risk for viral resistance and increased morbidity. However, unique program strengths may have minimized these disruptions
Pediatric Assent for a Study of Antiretroviral Therapy Dosing for Children in Western Kenya
MULTINATIONAL COLLABORATORS IN health research face particular ethical challenges when conducting studies involving vulnerable populations such as children. We use an example from our first attempt to implement pediatric assent in the context of a longstanding research and clinical partnership between Kenyan and American medical schools to highlight the ethical and procedural issues related to pediatric assent that must be considered for multinat…
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
Triangulating' Ampath
Clinical programmes are typically evaluated on operational performance metrics of cost, quality and outcomes. Measures of patient satisfaction are used to assess the experience of receiving care, but other perspectives, including those of staff and communities, are not often sought or used to assess and improve programmes. For strategic planning, the Kenyan HIV/AIDS programme AMPATH (Academic Model Providing Access to Healthcare) sought to evalua…
Rooting Inquiry in Tradition
The baraza is a customary form of community assembly in East Africa. We examined the use of the health baraza as a process that can improve data collection and deepen community understanding of sociocultural issues surrounding HIV/AIDS. In the evaluation of the United States Agency for International Development (USAID)-Academic Model for Prevention and Treatment of HIV/AIDS Partnership (USAID-AMPATH) in Kenya, investigators facilitated mabaraza (…
The Vulnerabilities of Orphaned Children Participating in Research
Orphans are a subpopulation with a unique set of additional vulnerabilities. Increasing focus on children's rights, pediatric global health, and pediatric research makes it imperative to recognize and address unique vulnerabilities of orphaned children. This paper describes the unique vulnerabilities of the orphaned pediatric population and offers a structured set of factors that require consideration when including orphans in biomedical research…
Community Perspectives on Research Consent Involving Vulnerable Children in Western Kenya
Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in res…
Models of care for orphaned and separated children and upholding children’s rights
BACKGROUND: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human righ…
The government of Kenya cash transfer for orphaned and vulnerable children
BACKGROUND: The 'Cash Transfer to Orphans and Vulnerable Children' (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people's health and well-being and other international human rights. The objective of this analys…
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of …
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV
This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week …
Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers
Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics
“A problem shared is half solved” – a qualitative assessment of barriers and facilitators to adolescent retention in HIV care in western Kenya
Adolescents living with HIV (ALHIV, ages 10-19) are retained in care at low rates, resulting in poor clinical outcomes. We investigated barriers and facilitators to retention experienced by perinatally infected ALHIV in western Kenya. This qualitative study purposefully sampled hospitalized ALHIV (engaged and not currently engaged in care), ALHIV engaged in outpatient care, and caregivers of ALHIV. In total, 116 ALHIV and caregivers participated …
Social Stigma Related to Covid-19 Disease Described by Primary and Secondary School Teachers and Adolescents Living With HIV in Western Kenya
Introduction: Understanding community members' knowledge, attitudes, and beliefs about the novel SARS-CoV-2 virus and the prevalence of associated stigma are critical steps for increasing accurate public health knowledge, encouraging uptake of preventative or mitigating health behaviors, and ultimately bringing the COVID-19 pandemic under control. Methods: We conducted a one-time, phone-based assessment to assess the presence of perceived COVID-1…
Barriers to ART adherence among school students living with HIV in Kenya
HIV has transformed from a serious acute illness with high rates of morbidity and mortality to a fairly easily managed chronic disease. However, children and adolescents living with HIV are yet to achieve similar improvement in their HIV care outcomes compared to adults. There have been a number of studies assessing the reasons for slower improvement in these age categories, mainly focusing on health systems, drug- and family- related barriers to…
Perspectives of education sector stakeholders on a teacher training module to reduce HIV/Aids stigma in Western Kenya
Data from interviews with education sector stakeholders demonstrate that our process for developing a culturally appropriate multi-media intervention to reduce HIV stigma in the schools was feasible
A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya
Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp ® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in…
A systematic review of interventions to reduce HIV-related stigma among primary and secondary school teachers
Reciprocal innovation
Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined 'reciprocal innovation.' Reciprocal innovation harnesses a bidirectional, co-const…
I have never talked to anyone to free my mind” – challenges surrounding status disclosure to adolescents contribute to their disengagement from HIV care
Complex challenges surrounding HIV status disclosure to adolescents contribute to care disengagement. There is need to enhance training and resources for HCW, and to empower caregivers to support children and adolescents before, during, and after HIV status disclosure. This should include counseling caregivers on how to provide children with developmentally-appropriate and accurate information about their health from an early age, and to support …
Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV
Background: The HADITHI study is a cluster-randomized trial of children living with HIV and their caregivers in Kenya that aimed to increase rates of caregiver disclosure of their child's HIV status, encourage earlier status disclosure, and improve pediatric mental health and HIV outcomes. This analysis identified characteristics predicting caregiver non-responsiveness and compared outcomes among children based on disclosure status. Methods: A pe…
A Global Health Reciprocal Innovation grant programme
Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as ‘reciprocal innovation’ (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core eleme…
Multi-media teacher training and HIV-related stigma among primary and secondary school teachers in Western Kenya
HIV stigma is associated with delayed HIV disclosure and worse clinical outcomes for adolescents living with HIV (ALWH). Teachers critically influence school environments, but are understudied in terms of HIV stigma. We implemented a school-level, cluster-randomized trial to assess the impact of a one-day multi-media training on the knowledge, attitudes and beliefs (K/A/B) of school teachers in western Kenya. Teachers' K/A/B were evaluated at bas…
Ethical Considerations for Engaging Children and Adolescents Living with HIV in Research in African Countries
Research engaging children and adolescents living with HIV (CALWH) is critical for youth-friendly services and HIV care, and researchers need to ensure that such engagement is ethical. We conducted a systematic review to identify key ethical considerations for the engagement of CALWH in research. The review focused on primary research articles conducted in African countries that examined ethical issues in CALWH engaged in research. Ten studies me…
Medicine (24 obras) · HIV/AIDS Research and Interventions (19 obras) · Adolescent Sexual and Reproductive Health (14 obras) · Family medicine (14 obras) · Psychiatry (14 obras) · Psychology (14 obras) · Nursing (13 obras) · Political science (10 obras) · Public health (9 obras) · Global Maternal and Child Health (7 obras)