Suchergebnisse

Abstract: Sugarcane is an essential crop globally due to its many dietary and commercial uses. In spite of the increased demand for sugarcane as an intermediate input for the production of animal feeds, bioethanol and food stuff, its significance on the livelihood of farmers in Kenya is mixed. There are sections of farmers uprooting this cash crop in favour of maize, a staple food, as a means to enhance their food security status. On the other hand, some policy pronouncement encourages the diversification of this cash crop by intercropping it with other staple food crops. The study was anchored on the agricultural production theory. Based on the application of correlation research design, this paper adopted the Structural Equation Modeling to analyze primary data collected from rural households in three Nyanza region counties of Homabay, Kisumu and Migori to establish the relationship between sugarcane and maize production from their corresponding cost of inputs (labor, land and capital). From the findings, as the cost of sugarcane production increases, the cost of maize production also increases significantly, though inelastic. This implies that mechanization of farm activities can act to reduce production costs. Enhancing sugarcane productivity will contribute significantly towards reducing production cost. Therefore, the government must closely monitor the spikes in cost of sugarcane production since this is bound to result in the cost of maize production also spiking exacerbating the problem of food insecurity. This paper therefore empirically contributes to understanding of the intertlinking complexity between the production structure of a cash crop (sugarcane) and food crop (maize), given their importance in food security in a developing economy.

AbstractIntroductionIntegrating pre‐exposure prophylaxis (PrEP) delivery for pregnant and postpartum women within maternal and child health (MCH) clinics is feasible and acceptable. It is unknown whether a risk‐guided model would facilitate appropriate PrEP use among MCH attendees better than universally offering PrEP.MethodsThe PrEP Implementation for Mothers in Antenatal Care (PrIMA) study was a cluster randomized trial to assess two models for PrEP delivery among pregnant women seeking routine MCH care at 20 public clinics in Kenya between January 2018 and July 2019 (NCT03070600). In the Universal arm, all participants received PrEP counselling and self‐selected whether to initiate PrEP. In the Targeted arm, participants underwent an HIV risk assessment, including an objective risk‐scoring tool and an offer of HIV self‐tests for at‐home partner testing; those determined to be at high risk received a PrEP offer. Participants were followed through 9 months postpartum. Primary outcomes included incident HIV and appropriate PrEP use (defined as PrEP uptake among those at high risk and no PrEP uptake for those not at risk). Outcomes were compared using intention‐to‐treat analyses, adjusting for baseline HIV risk and marital status.ResultsAmong 4447 women enrolled, the median age was 24.0 years (interquartile range [IQR]: 20.9, 28.3), and most were married (84.8%). The median gestational age at enrolment was 24 weeks (IQR: 20, 30). Women in the Targeted arm were more likely to be at high risk for HIV acquisition at baseline (51.6% vs. 33.3%). During 4638 person‐years (p‐yr) of follow‐up, there were 16 maternal HIV infections with no difference in maternal HIV incidence between arms: 0.31/100 p‐yr (95% CI: 0.15, 0.65) Targeted and 0.38/100p‐yr (95% CI: 0.20, 0.73) Universal (adjusted relative risk [aRR]: 0.85 [CI: 0.28, 2.55]). There was no significant difference in the frequency of appropriate PrEP use between the arms (68.2% vs. 59.1% in Targeted vs. Universal, respectively) (aRR: 1.03 [CI: 0.96, 1.10]).ConclusionsGiven comparable maternal HIV incidence and PrEP uptake in Universal and Targeted approaches, and the simplicity that universal PrEP offers, our findings suggest that universal PrEP counselling is optimal for integrating PrEP in MCH systems.