BackgroundKenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.FindingsFour themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.ConclusionKenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.

We propose four methods for finding local subspaces in large spectral libraries. The proposed four methods include (a) cosine angle spectral matching; (b) hit quality index spectral matching; (c) self-organizing maps and (d) archetypal analysis methods. Then evaluate prediction accuracies for global and subspaces calibration models. These methods were tested on a mid-infrared spectral library containing 1907 soil samples collected from 19 different countries under the Africa Soil Information Service project. Calibration models for pH, Mehlich-3 Ca, Mehlich-3 Al, total carbon and clay soil properties were developed for the whole library and for the subspace. Root mean square error of prediction was used to evaluate predictive performance of subspace and global models. The root mean square error of prediction was computed using a one-third-holdout validation set. Effect of pretreating spectra with different methods was tested for 1st and 2nd derivative Savitzky–Golay algorithm, multiplicative scatter correction, standard normal variate and standard normal variate followed by detrending methods. In summary, the results show that global models outperformed the subspace models. We, therefore, conclude that global models are more accurate than the local models except in few cases. For instance, sand and clay root mean square error values from local models from archetypal analysis method were 50% poorer than the global models except for subspace models obtained using multiplicative scatter corrected spectra with which were 12% better. However, the subspace approach provides novel methods for discovering data pattern that may exist in large spectral libraries.

This paper examines the impact of real exchange rate volatility on economic growth in Kenyan. The study employed the Generalized Autoregressive Condition of Heteroscedasticity (GARCH) and computation of the unconditional standard deviation of the changes to measure volatility and Generalized Method Moments (GMM) to assess the impact of the real exchange rate volatility on economic growth for the period January 1993 to December 2009. Data for the study was collected from Kenya National Bureau of Statistics, Central Bank of Kenya and International Monetary Fund Data Base by taking monthly frequency. The study found that RER was very volatility for the entire study period. Kenya's RER generally exhibited a appreciating and volatility trend, implying that in general, the country's international competitiveness deteriorated over the study period. The RER Volatility reflected a negative impact on economic growth of Kenya.

Objectives: This paper presents a simulation model for evaluating the possible effects of a screening and vaccination campaign against Human Papillomavirus [HPV] in Kenya.Method: A System Dynamics model was developed using the iThink™ computer simulation package. The model was based on data extracted from epidemiological, demographic and published research and where data was not available, expert opinion was sought. The deterministic model stratified the population by vaccination status, screening status and HPV infection status. The model was simulated to estimate outputs for the next 50 years from 2011. Cost Utility indicators of Disability Adjusted Life Years (DALYs) and cost per averted DALY were used for economic evaluation. Results:The model predicted that catch up vaccination had the greatest impact in reducing the prevalence of cervical cancer. This was followed by Primary vaccination, with early detection through Screening having the lowest impact of the three choices of interventions in respect of averted cases of cervical cancer and DALY estimates.Conclusion: Kenya as a country should consider adoption of secondary /catch up vaccination as an immediate measure to curb cervical cancer followed by primary vaccination of pre-adolescent girls. Screening should be a complementary measure(s). This model provides a policy decision support vehicle that can allow for choice between different interventions based on their expected outcomes. It also allows modification to accommodate new research results and information to assess the clinical impact of different policies and interventions in cervical cancer management in Kenya.

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