Kenya is rapidly urbanising. In the growing cities and towns, there is an increasing need for food supplies, creating demand for agricultural products. High unemployment rates, urban poverty, and food and nutrition insecurity force some urban dwellers to partly adopt livelihood strategies based on urban agriculture. Presently in Kenya, urban and peri-urban agriculture plays an important role in urban food system, because it enhances livelihood strategies for urban households, not least the poor. Using a sample of 2,009 households, this study characterised urban farming and urban-based rural farming in medium-sized towns of Thika and Kisumu, Kenya. It further assessed food security levels of urban households engaged in farming and households that do not farm. Results demonstrate that more than half of the households produced part of their food, either in urban or rural areas. About 37 per cent and 25 per cent of the respondents produced food in rural and urban areas, respectively. Generally, more of the households engaged in both urban farming and urban-based rural agriculture are more food secure compared with the non-farming households. Urban farming has a potential of improving household food security and provision of fungible income; hence, the practice should be included in the urban food policies.

To inform targeted HIV testing, we developed and externally validated a risk-score algorithm that incorporated behavioral characteristics. Outpatient data from five health facilities in western Kenya, comprising 19,458 adults ≥ 15 years tested for HIV from September 2017 to May 2018, were included in univariable and multivariable analyses used for algorithm development. Data for 11,330 adults attending one high-volume facility were used for validation. Using the final algorithm, patients were grouped into four risk-score categories: ≤ 9, 10–15, 16–29 and ≥ 30, with increasing HIV prevalence of 0.6% [95% confidence interval (CI) 0.46–0.75], 1.35% (95% CI 0.85–1.84), 2.65% (95% CI 1.8–3.51), and 15.15% (95% CI 9.03–21.27), respectively. The algorithm’s discrimination performance was modest, with an area under the receiver-operating-curve of 0.69 (95% CI 0.53–0.84). In settings where universal testing is not feasible, a risk-score algorithm can identify sub-populations with higher HIV-risk to be prioritized for HIV testing.

Homa Bay, Siaya, and Kisumu counties in western Kenya have the highest estimated HIV prevalence (16.3–21.0%) in the country, and struggle to meet program targets for HIV testing services (HTS). The Kenya Ministry of Health (MOH) recommends annual HIV testing for the general population. We assessed the degree to which reducing the interval for retesting to less than 12 months increased diagnosis of HIV in outpatient departments (OPD) in western Kenya. We conducted a retrospective analysis of routinely collected program data from seven high-volume (>800 monthlyOPD visits) health facilities in March–December, 2017. Data from persons ≥15 years of age seeking medical care (patients) in the OPD and non-care-seekers (non-patients) accompanying patients to the OPD were included. Outcomes were meeting MOH (routine) criteria versus criteria for a reduced retesting interval (RRI) of <12 months, and HIV test result. STATA version 14.2 was used to calculate frequencies and proportions, and to test for differences using bivariate analysis. During the 9-month period, 119,950 clients were screened for HIV testing eligibility, of whom 79% (94,766) were eligible and 97% (92,153) received a test. Among 92,153 clients tested, the median age was 28 years, 57% were female and 40% (36,728) were non-patients. Overall, 20% (18,120) of clients tested met routine eligibility criteria: 4% (3,972) had never been tested, 10% (9,316) reported a negative HIV test in the past >12 months, and 5% (4,832) met other criteria. The remaining 80% (74,033) met criteria for a RRI of < 12 months. In total 1.3% (1,185) of clients had a positive test. Although the percent yield was over 2-fold higher among those meeting routine criteria (2.4% vs. 1.0%; p<0.001), 63% (750) of all HIV infections were found among clients tested less than 12 months ago, the majority (81%) of whom reported having a negative test in the past 3–12 months. Non-patients accounted for 45% (539) of all HIV-positive persons identified. Percent yield was higher among non-patients as compared to patients (1.5% vs. 1.2%; p-value = <0.001) overall and across eligibility criteria and age categories. The majority of HIV diagnoses in the OPD occurred among clients reporting a negative HIV test in the past 12 months, clients ineligible for testing under the current MOH guidelines. Nearly half of all HIV-positive individuals identified in the OPD were non-patients. Our findings suggest that in the setting of a generalized HIV epidemic, retesting persons reporting an HIV-negative test in the past 3–12 months, and routine testing of non-patients accessing the OPD are key strategies for timely diagnosis of persons living with HIV.

Purpose The purpose of this paper is to investigate the profitability of urban chicken production in the medium-sized cities of Kisumu and Thika, Kenya. Design/methodology/approach Data were collected in 2016 from a sample of 157 indigenous chicken producers in the two cities. Descriptive analyses were used to characterize indigenous chicken production, marketing and profitability. In addition, multivariate regression models were estimated to determine factors influencing profitability of the enterprise. Findings Urban indigenous chicken production mainly serves a dual role of food provision and income generation. The enterprise is profitable, generating an average gross margin of Ksh. 756/bird. The multivariate regression models show that access to high-value markets, household income level and the type of production system used significantly affect profitability of indigenous chicken farming. However, poultry diseases and high input costs especially feed are the major constraints to poultry farming. Research limitations/implications This study has used cross-sectional data that provides information for only one point in time. Future research should be able to capture the seasonality of indigenous chicken production. Social implications This study has shown that indigenous chicken production in urban areas is a viable and profitable enterprise, which could provide an avenue for employment and income generation. Originality/value Studies assessing profitability of urban agricultural enterprises are scant. Thus, this study provides insights on the profitability of a common urban agriculture enterprise.