Small and sick newborns need high quality specialised care Background: within health facilities to address persistently high neonatal mortality in low-income settings, including Kenya.We examined neonatal admissions in 12 public-sector County Methods: (formerly District) hospitals in Kenya between November 2014 and November 2016. Using data abstracted from newborn unit (NBU) admission registers and paediatric ward (PW) medical records, we explore the magnitude and distribution of admissions. In addition, interviews with senior staff were conducted to understand admission policies for neonates in these facilities.Of the total 80,666 paediatric admissions, 28,884 (35.8%) were aged Results: ≤28 days old. 24,212 (83.8%) of neonates were admitted to organisationally distinct NBUs and 4,672 (16.2%) to general PWs, though the proportion admitted to NBUs varied substantially (range 59.9-99.0%) across hospitals, reflecting widely varying infrastructure and policies. Neonatal mortality was high in NBUs (12%) and PWs (11%), though varied widely across facilities, with documentation of outcomes poor for the NBUs.Improving quality of care on NBUs would affect almost a third of Conclusion: paediatric admissions in Kenya. However, comprehensive policies and strategies are needed to ensure sick neonates on general PWs also receive appropriate care.

Background: Small and sick newborns need high quality specialised care within health facilities to address persistently high neonatal mortality in low-income settings, including Kenya. Methods: We examined neonatal admissions in 12 public-sector County (formerly District) hospitals in Kenya between November 2014 and November 2016. Using data abstracted from newborn unit (NBU) admission registers and paediatric ward (PW) medical records, we explore the magnitude and distribution of admissions. In addition, interviews with senior staff were conducted to understand admission policies for newborns in these facilities. Results: Of the total 80,666 paediatric admissions, 28,884 (35.8%) were aged ≤28 days old. 24,212 (83.8%) of newborns were admitted to organisationally distinct NBU and 4,672 (16.2%) to general PW, though the proportion admitted to NBUs varied substantially (range 59.9-99.0%) across hospitals, reflecting widely varying infrastructure and policies. Neonatal mortality was high in NBU (12%) and PW (11%), though varied widely across facilities, with documentation of outcomes poor for the NBU. Conclusion: Improving quality of care on NBUs would affect almost a third of paediatric admissions in Kenya. However, comprehensive policies and strategies are needed to ensure sick newborns on general PWs also receive appropriate care.

Background: Parenting in adolescence is gendered in many dimensions including communication, control, discipline and styles of parenting. Gendered parenting reinforces harmful stereotypical gender norms which can lead to gender inequalities in society. Gender inequalities put adolescent boys and girls at a heightened risk of poor SRH outcomesMethods: The study was conducted in an informal urban settlement, Viwandani, in Kenya’s capital city, Nairobi. Focus group discussions were used to collect data from 48 parents of adolescents in grades 5 and 6 in two public day primary schools. Interviews were audio-recorded, transcribed and uploaded to NVivo 12 for coding and thematic analysis.Findings: We found differences in parenting approaches based on the parent’s and/or adolescent’s gender. Based on parents’ gender, fathers had more differential parenting approaches for their sons and daughters while mothers were more consistent for both boys and girls. Fathers held different expectations for their adolescent girls and boys with respect to their roles and responsibilities presently and in the future. Based on the gender of the adolescent, boys had more freedom of movement than girls and girls were more likely to be engaged in SRH discussions with parents as compared to boys. There were also differences in the roles that mothers and fathers played in the family setting.Conclusion: Gender differences in parenting do exist along with male and female roles differing considerably within households. The disconnect in gendered beliefs between men and women implies a greater need to engage men in gender-equitable programming given they have been found to hold gender inequitable attitudes.