Just in case: undergraduate students identifying and mitigating barriers to their sexual and reproductive health needs.

BACKGROUND: Many U.S. colleges and universities offer access to a healthcare center that provides sexual and reproductive health (SRH) resources, services, and products. The importance of health centers in college and university settings in reducing sexual health disparities in student populations cannot be stressed enough. This article evaluates a student-led, mutual-aid, grassroots health promotion strategy for students with limited access to healthcare services, supplies, and tools via an anonymous and discrete distribution of SRH resources without charge. METHODS: In partnership with faculty, undergraduate students worked to address their school's unmet SRH needs by increasing on-campus access to comprehensive, evidence-based, and sex-positive resources. Referred to as Just in Case, this student-led, grassroots health promotion program provided students with supply kits containing contraceptives, sexual health wellness products, basic hygiene supplies, and education materials. Students were surveyed in a pre- (n = 95) post- (n = 73) pilot study to identify contraception acquisition barriers, discern perceptions of on-campus SRH resources, and elucidate trends in this program's use and impact. Chi-square tests of independence were used to compare survey group responses, and association rule mining was employed in tandem to identify SRH items that students requested. RESULTS: Students identified cost and privacy as significant barriers to acquiring sexual health products on campus. Of the 182 Just in Case supply kits requested by students during the 2022-2023 academic year, condoms were requested most frequently in 75% of fulfilled kits, while emergency contraception and pregnancy tests were asked most often in 61% of kits. 50% of students reported access to contraceptives on campus before this program's implementation, growing to 75% (p < 0.001) 1 year later post-implementation. Similar jumps were observed for reported access to sexual health education (30 to 73%, p < 0.001) and services (36 to 73%, p < 0.001). CONCLUSION: A student-led SRH supply and resource delivery strategy may immediately reduce SRH inequities and decrease barriers to contraceptive use for students with limited access to on-site SRH product availability.

Assessment of farmers' compliance in implementing recommended cow comfort changes and their effects on lying time, stall and cow cleanliness within smallholder dairy farms in Kenya.

Our study aimed to evaluate farmers' compliance in implementing recommendations of farm-specific cow comfort changes, and the effects of these changes on lying time, stall cleanliness and cow cleanliness using a randomized controlled trial carried out on 100 smallholder dairy farms in Kenya, with 62 and 11 farms remaining in the intervention and control groups, respectively. On the first farm visit, data loggers were attached on lactating cows to determine lying time and questionnaires utilized to collect baseline data. Three days later, stall design and management recommendations were given to the intervention group of farmers orally and in written form. After an average of 39 ±â€¯7 days, data loggers were re-attached, compliance was assessed, and a post-intervention questionnaire was administered to the intervention group on the third visit. Three days subsequent to the first and third visits, data loggers were removed from all cows. Data were analysed in Stata 14.2® using proportion tests and Kruskal-Wallis rank tests to compare cleanliness scores and lying time, respectively. Interaction effects between treatment groups and visits were assessed using multivariable mixed linear and logistic regression models. While 46 of the 62 intervention farmers (74%) made at least one recommended change to cow comfort, 63% of the 324 overall recommendations were implemented. The odds of a recommendation being implemented were significantly higher when:1) major recommendations were given relative to minor recommendations (OR = 6.28); 2) recommendations were related to floor characteristics (floor softness and flatness) in comparison to recommendations related to stall design (OR = 3.14). The odds of compliance were lower on: 1) farms where the farm-hands received the recommendations compared to farms that had the female principal farmer receive the recommendations (OR = 0.01); 2) farms that had recommended changes related to roof, alley and sharps fixes relative to stall design fixes (OR = 0.13). Post-intervention, stall, udder and upper hind-leg cleanliness scores improved significantly (p < 0.0001, p = 0.021 and p = 0.017, respectively) in the intervention farms but not in the control farms. There was no significant difference in lying times between intervention and control farms, with 0.6 and 0.2 h/day increases being recorded in the intervention and control groups, from the 10.9 and 10.4 h/day at baseline, respectively. Giving farm-specific cow comfort recommendations to smallholder dairy farmers in Kenya, and providing them with a participatory role in the formulation and implementation of improvement recommendations ensured good acceptance and a high degree of implementation, and led to a subsequent improvement in cow comfort and cleanliness.

A cross-sectional study of the welfare of calves raised in smallholder dairy farms in Meru, Kenya, 2017.

AIM: This study was aimed at describing calf comfort and determining the individual and pen level factors that affect comfort status (in particular, calf leg hygiene scores) of smallholder dairy farms in Meru County, Kenya. MATERIALS AND METHODS: A cross-sectional study was carried out on 52 calves that were up to 1 year old in 38 dairy farms (mean±standard deviation: Herd size=1.71±0.7 milking cows and milk production=6.7±3.1 L/day) in Meru, Kenya, in 2017, with the intention to describe their comfort and determine the factors associated with leg hygiene as a critical parameter for calf comfort assessment. Calves' biodata, health status, and leg hygiene were assessed, along with pen characteristics such as area, hygiene, and knee impact and knee wetness scores, while a questionnaire was administered to the farmers to gather information regarding calf housing management practices in the farm. RESULTS: The calves had a mean body weight of 85.2±32.8 kg and average daily weight gain of 0.50±0.45 kg per day. 71% of calves had a good body condition score (≥2.5), and the mean space allowance per calf was 2.52±1.56 m2. Approximately 75% of the calves (39/52) were kept in pens, and the rest were reared outdoors. For 39 calves kept indoors, 26% (10/39) of them had wooden or concrete floors while 74% (29/39) had dirt floors. Nearly two-thirds (62%) of indoor calves (26/39) were reared in pens with bedding, and 23% (9/39) and 33% (13/39) of the calves reared indoors were kept in pens displaying a failed knee impact test and failed knee wetness test. Indoor housed calves had an increased probability of having dirty calf legs (cleanliness score of >2.5) by 8.6 times (p=0.031), compared to outdoor-housed calves. In the final multivariable logistic regression model of 39 calves in pens, concrete or wood floors (odds ratio [OR]=7.9, p=0.047), poor body condition (OR=17.1, p=0.020) and use of bedding (OR=12.5, p=0.046) appeared to be positively correlated with dirtiness of calf legs, compared to dirt floors, good body condition, and no bedding, respectively. CONCLUSION: Overall, some calf comfort aspects were covered for the majority of calves examined, but 69% of the pens were categorized as dirty, especially those with wooden or concrete floors and poor bedding management. Smallholder dairy farmers in Kenya should be trained on calf housing management to improve calf comfort and productivity.