Making voluntary medical male circumcision services sustainable: Findings from Kenya's pilot models, baseline and year 1.

Voluntary medical male circumcision is a crucial HIV prevention program for men in sub-Saharan Africa. Kenya is one of the first countries to achieve high population coverage and seek to transition the program to a more sustainable structure designed to maintain coverage while making all aspects of service provision domestically owned and implemented. Using pre-defined metrics, we created and evaluated three models of circumcision service delivery (static, mobile and mixed) to identify which had potential for sustaining high circumcision coverage among 10-14-year-olds group, a historically high-demand and accessible age group, at the lowest possible cost. We implemented each model in two distinct geographic areas, one in Siaya and the other in Migori county, and assessed multiple aspects of each model's sustainability. These included numerical achievements against targets designed to reach 80% coverage over two years; quantitative expenditure outcomes including unit expenditure plus its primary drivers; and qualitative community perception of program quality and sustainability based on Likert scale. Outcome values at baseline were compared with those for year one of model implementation using bivariate linear regression, unpaired t-tests and Wilcoxon rank tests as appropriate. Across models, numerical target achievement ranged from 45-140%, with the mixed models performing best in both counties. Unit expenditures varied from approximately $57 in both countries at baseline to $44-$124 in year 1, with the lowest values in the mixed and static models. Mean key informant perception scores generally rose significantly from baseline to year 1, with a notable drop in the area of community engagement. Consistently low scores were in the aspects of domestic financing for service provision. Sustainability-focused circumcision service delivery models can successfully achieve target volumes at lower unit expenditures than existing models, but strategies for domestic financing remain a crucial challenge to address for long-term maintenance of the program.

The impact of conventional and organic farming on soil biodiversity conservation: a case study on termites in the long-term farming systems comparison trials in Kenya.

BACKGROUND: A long-term experiment at two trial sites in Kenya has been on-going since 2007 to assess the effect of organic and conventional farming systems on productivity, profitability and sustainability. During these trials the presence of significant numbers of termites (Isoptera) was observed. Termites are major soil macrofauna and within literature they are either depict as 'pests' or as important indicator for environmental sustainability. The extent by which termites may be managed to avoid crop damage, but improve sustainability of farming systems is worthwhile to understand. Therefore, a study on termites was added to the long-term experiments in Kenya. The objectives of the study were to quantify the effect of organic (Org) and conventional (Conv) farming systems at two input levels (low and high) on the abundance, incidence, diversity and foraging activities of termites. RESULTS: The results showed higher termite abundance, incidence, activity and diversity in Org-High compared to Conv-High, Conv-Low and Org-Low. However, the termite presence in each system was also dependent on soil depth, trial site and cropping season. During the experiment, nine different termite genera were identified, that belong to three subfamilies: (i) Macrotermitinae (genera: Allodontotermes, Ancistrotermes, Macrotermes, Microtermes, Odontotermes and Pseudocanthotermes), (ii) Termitinae (Amitermes and Cubitermes) and (iii) Nasutitiermitinae (Trinervitermes). CONCLUSIONS: We hypothesize that the presence of termites within the different farming systems might be influenced by the types of input applied, the soil moisture content and the occurrence of natural enemies. Our findings further demonstrate that the organic high input system attracts termites, which are an important, and often beneficial, component of soil fauna. This further increases the potential of such systems in enhancing sustainable agricultural production in Kenya.

Termite-Induced Injuries to Maize and Baby Corn under Organic and Conventional Farming Systems in the Central Highlands of Kenya.

Termite-induced injuries to maize and baby corn were evaluated in on-going comparison experiments on organic and conventional farming systems at two trial sites in the Central Highlands of Kenya (Chuka and Thika). The farming systems were established in 2007 at two input levels: Low input level, representing subsistence farming (Conv-Low, Org-Low) and high input level, representing commercial farming (Conv-High, Org-High). Termite-induced injuries to maize and baby corn, such as tunneling the stem or lodging the whole plant were assessed over two cropping seasons. The lodging occurred exclusively at Thika. It first became apparent in the Org-Low system, with most of lodging occurring during the vegetative stage. Baby corn grown under high input systems showed increasing lodging from the late vegetative crop stage and peaked before the final harvest. Tunneling was recorded at both sites, but was generally below 5%, with no significant differences between the farming systems. Overall, the injury patterns caused by termites appear to be a function of the plant growth stage, termite colony activities, trial site, and the types and levels of fertilizer input. Thus, the management practice used in each farming system (organic or conventional) might have greater influence on crop injuries than the type of farming system itself or the termite abundance within each system.