APHRC News January - June 2019 APHRC SPREADS ITS WINGS TO WEST AFRICA APHRC Newsletter | January - June | 2019 1 Transforming lives in Africa Vision through research Generating evidence, strengthening research Mission capacity, and engaging policy to inform action on population health and wellbeing 2 APHRC Newsletter | January - June | 2019 C O N T E N T S 1 Out with the old: Introducing APHRC’s new culture shift program 1 Kenya’s first human milk bank targets vulnerable infants 3 It’s dinnertime! Why do you eat the food you eat? 4 10 Take five: Dr. Kanyiva Muindi 6 Women’s reproductive health hangs in the balance 8 Deliver for good: Using your power for gender equality 10 Women Deliver: Reflections on power 13 Seizing the opportunity to address social exclusion in Africa 15 APHRC spreads its wings to West Africa 16 Sex for survival: Tales of a prostitute 18 18 APHRC Newsletter | January - June | 2019 iii Out with the old: Introducing APHRC’s new culture shift program By Moreen Nkonge, communications officer Since taking the helm of APHRC in 2017, you championed the initiation of a culture shift at the Center. What prompted this initiative? The realization of the need for a culture shift at APHRC became apparent during a leadership training session that took place shortly before I took office in October 2017. The training provided an opportunity to interrogate APHRC’s existing culture and what Executive Director, Catherine my contribution had been to the institution’s Kyobutungi shared beliefs and perceptions over 13 years of serving in different capacities. Following Culture is like an iceberg. The part that can this introspective exercise, my sense of be seen above the surface reflects the isolated the prevailing culture was that there were behaviors and outcomes. The bulk of it--the critical aspects that needed improvement to submerged part, comprises the shared beliefs create a healthier work environment. With and assumptions that are often shaped over the transition in leadership, the timing also the years. felt right to have an initiative that was more rganizational culture is widely defined inward looking. I would later share the idea as a company’s beliefs, values and with the board, the executive leadership and attitudes, and how these influence senior management teams, and with their Othe behavior of its employees. Whether support, we took up the idea of a culture defined or perceived, culture often affects shift as an institutional agenda. how employees experience an institution: either positively or negatively. What approach will the program take? When Catherine Kyobutungi was informed that she would be APHRC’s incoming executive To successfully operationalize the program, director in 2017, her focus at the time was there was great need to make the process on how she would keep the ecosystem collaborative. In consultation with the efficiently running as it had been over the last senior management team, we embarked on 15 years. She sought to maintain and nurture defining the areas of focus. The outcome relationships with funders and partners, and of the discussions narrowed down to three to steer the Center’s strategic direction. The focus areas: how to maintain a culture of thought of initiating a culture shift at APHRC excellence in the face of rapid growth and was the last thing on her mind. In this interview, changing institutional structure; how to she discusses how the idea was born and why challenge the culture of silence inspired by she is determined to see it through. the fear of retribution and encourage staff 1 APHRC Newsletter | January - June | 2019 A word cloud representation of positive behaviors to reinforce at APHRC engagement; and how to cultivate and Deconstructing an existing culture in sustain a work-life balance among teams an organization is no mean feat. What for improved productivity. Following this, role will staff members play towards the committees were formed in line with the actualization of the shift? themes to come up with solutions on how to change the culture around the identified Staff involvement is a critical component in issues. Parallel to the three, was also the the program. As part of the roll-out in May, we need to nurture positivity among staff by conducted a baseline survey to assess people’s being appreciative and respectful of each perceptions about the existing institutional other’s efforts, providing constructive culture and what their expectations of the feedback, and lauding the small and program were. Further, through the committees, big wins, to foster a sense of pride and staff will be able to channel their feedback on ownership among employees. the challenges and possible solutions aligned to the three focus areas. Also important is the initiative by individuals to be agents of change What outcomes in terms of behavior within their spheres of influence at the Center. change would you like to see mani- Subsequent evaluations will be employed to fest in the course of the culture shift? assess the progress of the program. First would be seeing more interactive staff engagement, creating room for exchange And finally, what do you envision its of knowledge and enriched discussions. success to look like? The second aspect is the practice of forming ideas or concepts among individuals and Success will be in the little milestones achieved teams. Staff would be encouraged to have gradually by creating a habit of the positive the confidence to share, own and execute behaviors at the individual level, and seeing these ideas. these eventually reflect in the overall institution’s culture. APHRC Newsletter | January - June | 2019 2 Kenya’s first human milk bank targets vulnerable infants By Florence Sipalla, communications manager has been conducting a longitudinal study over a 15-year period,” says APHRC Executive Director Catherine Kyobutungi. Human milk banks play a critical role in ensuring that babies who need breast milk support get a safe product as they collect, pasteurize, test, store and distribute donated breast. Prior to qualifying as donors, breastfeeding mothers who volunteer at the HMBs are screened for diseases that can Donated human milk in storage. be transmitted through breast milk, such as HIV, syphilis, hepatitis B and C. reast milk contains the right proportion The Maternal and Child Wellbeing unit conducted of nutrients and vitamins essential extensive research to provide evidence for for newborns, particularly those born championing breastfeeding, thus improving Bunderweight or prematurely. When these babies babies’ health and nutrition outcomes. They cannot be breastfed by their mothers, pasteurized believe the donated breast milk will benefit babies donor human milk from a milk bank is the next with low birth weight who are at increased risk of best solution. On 29th March, 2019, Pumwani retardation, infectious disease and development Maternaity in Nairobi opened the doors to delays in their early childhood. Kenya’s first human milk bank, to reach vulnerable Speaking during the launch, Nairobi Governor infants in the city. Mike Sonko highlighted the necessity of such a The continent’s second milk bank was birthed facility. With an average of 60 infants born per from a collaborative initiative spearheaded by day, ten to 12 are in need of donor human milk PATH in partnership with APHRC and Kenya’s for a number of reasons, and this facility is giving Ministry of Health. The project was carried out them new found hope. in two phases: assessment and establishment. With the milk bank at Pumwani hospital joining Phase one analyzed people’s perceptions and over the 500 in existence globally, the Nairobi acceptability of using donated human milk. County Government hopes to extend the initiative Despite concerns about the safety and hygiene to other county hospitals to boost efforts to end of sharing milk, 90% of the women interviewed child mortality rates. were positive about it, and another 80% stated that they would readily donate milk. The launch of the bank marked the beginning of phase two. APHRC’s mission of translating research evidence into action was witnessed with the opening of the facility. “The work behind the HMB started only 2% of about a decade ago with APHRC spearheading children were being the research on it. We found that only 2% of exclusively breastfed in the first six months children were being exclusively breastfed in the in the Nairobi urban first six months in the urban slums where APHRC slums 3 APHRC Newsletter | January - June | 2019 It’s dinnertime! Why do you eat the food you eat? By Michelle Mbuthia, communications officer A street food vendor in one of Nairobi’s informal settlements. he setting of the sun marks the end of yet and evaluation at the University of Washington, another day. As people make their way eight of the 20 nations in the world with the home, one of the many questions they fastest-rising rates of adult obesity are in Africa. Task themselves is what they will have for dinner. In countries such as Ghana, the prevalence of The final meal of the day provides an opportunity adult obesity in the past 36 years has increased for families to come together and discuss the by more than 500%. It is clear that obesity rates in day’s events. However, as life becomes more sub-Saharan Africa are skyrocketing, and Kenya is demanding, there is significantly less time to no exception. prepare fresh and hearty meals and slowly, fast- As Africans migrate to cities in search of a better food has begun appearing more frequently on life, they leave behind a more active lifestyle tables at suppertime. to one that becomes a lot more sedentary. The In Africa, the narrative on food is usually framed affordability of a motorbike or car journey means around malnutrition.