title: The State and Sexual Politics: An Analysis of Abortion Discourses in Kenya

authors: Njagi, Jane Wambui

subjects: Abortion

abstract: Unsafe abortion, an issue that leads to over 2,000 deaths and health complications for more than 21,000 women annually in Kenya, remains largely unaddressed by the Kenyan state. Despite the significant public importance of abortion, there has been little or no scholarly attention directed at the role of the state in shaping sexual politics through its regulation of abortion. In this thesis, I undertake a feminist analysis of the Kenyan state to explore how the state, through its policy regime, shapes sexual politics.   
I argue that Western-based feminist theorisations of the state, although useful, do not fully account for the Kenyan state’s treatment of the issue of abortion. Consequently, I draw on the range of scholarship in feminist theorisations of the state and in African politics to develop the Critical African Feminist Perspective on the state. Using this perspective, I undertake a discourse analysis of archival material, policy texts, and interviews with key actors in abortion politics.  The analysis of the state over three phases – colonial, dictatorial, and democratic – reveals the neo-patrimonial character of the state, resulting in policies and practices that systematically ignore or marginalise issues affecting women. 
This study demonstrates that across consecutive governments, the Kenyan political elite, in an attempt to consolidate political power and popularity in the face of low levels of legitimacy and complex tribal politics, has deployed a tactic of “strategic ambivalence”, wherein the law criminalising abortion has been sustained but not enforced. State efforts have therefore been directed at presenting a positive image of itself to both pro- and anti-abortion actors, rather than substantively tackling the problem of unsafe abortion.
The study establishes that although neoliberalism, capitalism and patriarchy play significant roles, neo-patrimonial politics is the key impediment to creating policies and institutions that will ensure Kenyan women’s access to safe abortions. I note that although Kenya’s new Constitution guarantees women better access to legal abortion, it has not conclusively addressed neo-patrimonialism, which is therefore likely to continue to have negative implications for sexual politics and issues of gender equality in general.

text: The State and Sexual Politics: An Analysis of Abortion Discourses in Kenya Unsafe abortion, an issue that leads to over 2,000 deaths and health complications for more than 21,000 women annually in Kenya, remains largely unaddressed by the Kenyan state. Despite the significant public importance of abortion, there has been little or no scholarly attention directed at the role of the state in shaping sexual politics through its regulation of abortion. In this thesis, I undertake a feminist analysis of the Kenyan state to explore how the state, through its policy regime, shapes sexual politics.   
I argue that Western-based feminist theorisations of the state, although useful, do not fully account for the Kenyan state’s treatment of the issue of abortion. Consequently, I draw on the range of scholarship in feminist theorisations of the state and in African politics to develop the Critical African Feminist Perspective on the state. Using this perspective, I undertake a discourse analysis of archival material, policy texts, and interviews with key actors in abortion politics.  The analysis of the state over three phases – colonial, dictatorial, and democratic – reveals the neo-patrimonial character of the state, resulting in policies and practices that systematically ignore or marginalise issues affecting women. 
This study demonstrates that across consecutive governments, the Kenyan political elite, in an attempt to consolidate political power and popularity in the face of low levels of legitimacy and complex tribal politics, has deployed a tactic of “strategic ambivalence”, wherein the law criminalising abortion has been sustained but not enforced. State efforts have therefore been directed at presenting a positive image of itself to both pro- and anti-abortion actors, rather than substantively tackling the problem of unsafe abortion.
The study establishes that although neoliberalism, capitalism and patriarchy play significant roles, neo-patrimonial politics is the key impediment to creating policies and institutions that will ensure Kenyan women’s access to safe abortions. I note that although Kenya’s new Constitution guarantees women better access to legal abortion, it has not conclusively addressed neo-patrimonialism, which is therefore likely to continue to have negative implications for sexual politics and issues of gender equality in general.

year: 2013

title: Design, development and optimisation of veterinary intravaginal controlled release drug delivery systems

authors: Ogle, Colin Roger

abstract: This Thesis begins by discussing the application of controlled drug delivery to the intravaginal delivery of hormones to control the oestrous cycle of farmed animals, with particular emphasis on the delivery of progestagens to cattle and sheep. The introduction highlights the recent advances made by animal physiologists in their knowledge of the oestrous cycle in cattle and sheep and how these advances have impacted upon the manner in which currently available intravaginal controlled release products are used. In addition it discusses the advances pharmaceutical scientists have made in response to the new knowledge.

The CIDR®1900 Cattle insert is a commercially available silicone based intravaginal delivery system containing the natural steroid progesterone for fertility regulation in cattle. It was designed in 1987 to be inserted for 12 days. Advances made in oestrous cycle understanding by animal scientists have resulted in this product being inserted for much shorter treatment periods of 7 days. Rathbone et al. recently optimised the CIDR®1900 Cattle insert for seven day insertion periods. The outcome of these scientists work was a manufactured prototype which, when compared to the CIDR®1900 Cattle insert, contained a reduced initial drug load and a much lower residual drug load after use. For commercial production the prototype insert needed to be scaled up. This process required detailed pharmaceutical characterisation, invitro release assessment, invivo bioequivalency and chemical and physical stability studies to be performed on the scaled up product (CIDR®1380 Cattle insert) to ensure the success of the scale up process. This characterisation process forms Chapters Two and Three of this Thesis.

Knowledge of the mechanism of release of a drug from a pharmaceutical product provides the formulation scientist with the necessary insight to optimise, further develop or recognise the potential and limitations of a product. Chapter Four explores the mechanism of release of progesterone from the silicone based CIDR® Cattle insert both invitro and invivo. Cumulative release data from both invitro and invivo studies were fitted against conventional mathematical models to determine the mechanism of release of progesterone from the CIDR® Cattle insert. In addition, an experimental method was developed to assess the validity of the models. The method involved taking thin consecutive horizontal slices from the surface of CIDR® Cattle inserts after various periods of release. Cumulative release of progesterone, both invitro and invivo, was linear when plotted against the square root of time, suggesting that release from the CIDR® Cattle insert occurred in accordance with the square root of time mechanism. However, experimental evidence from the horizontal slicing technique only supported the curve fitting evidence for invitro release. When the insert was investigated invivo, the slicing method indicated that a novel release mechanism was in operation which was better described by a zero order process.

Chapters Five and Six of this Thesis direct their focus to oestrus control in sheep. Chapter Five utilises information gained from both Rathbone et al. and the work performed in this Thesis on the CIDR® Cattle insert to characterise and optimise the commercially available sheep equivalent of the CIDR ® 1900 Cattle insert (known as the CIDR® Sheep and Goat insert). The Chapter successfully characterises the CIDR® Sheep and Goat insert, defines the parameters of, and tests, an optimised version of this sheep product.

The final Chapter of this Thesis investigates the use of poly-(ε-caprolactone) as a platform for the intravaginal delivery of progesterone to control oestrus in sheep. Silicone has certain limitations as a drug delivery platform, and with animal physiologists recent advances in knowledge, pharmaceutical scientists will need more versatile delivery platforms to develop intravaginal drug delivery systems which fulfil the future demands of the animal scientists.

text: Design, development and optimisation of veterinary intravaginal controlled release drug delivery systems This Thesis begins by discussing the application of controlled drug delivery to the intravaginal delivery of hormones to control the oestrous cycle of farmed animals, with particular emphasis on the delivery of progestagens to cattle and sheep. The introduction highlights the recent advances made by animal physiologists in their knowledge of the oestrous cycle in cattle and sheep and how these advances have impacted upon the manner in which currently available intravaginal controlled release products are used. In addition it discusses the advances pharmaceutical scientists have made in response to the new knowledge.

The CIDR®1900 Cattle insert is a commercially available silicone based intravaginal delivery system containing the natural steroid progesterone for fertility regulation in cattle. It was designed in 1987 to be inserted for 12 days. Advances made in oestrous cycle understanding by animal scientists have resulted in this product being inserted for much shorter treatment periods of 7 days. Rathbone et al. recently optimised the CIDR®1900 Cattle insert for seven day insertion periods. The outcome of these scientists work was a manufactured prototype which, when compared to the CIDR®1900 Cattle insert, contained a reduced initial drug load and a much lower residual drug load after use. For commercial production the prototype insert needed to be scaled up. This process required detailed pharmaceutical characterisation, invitro release assessment, invivo bioequivalency and chemical and physical stability studies to be performed on the scaled up product (CIDR®1380 Cattle insert) to ensure the success of the scale up process. This characterisation process forms Chapters Two and Three of this Thesis.

Knowledge of the mechanism of release of a drug from a pharmaceutical product provides the formulation scientist with the necessary insight to optimise, further develop or recognise the potential and limitations of a product. Chapter Four explores the mechanism of release of progesterone from the silicone based CIDR® Cattle insert both invitro and invivo. Cumulative release data from both invitro and invivo studies were fitted against conventional mathematical models to determine the mechanism of release of progesterone from the CIDR® Cattle insert. In addition, an experimental method was developed to assess the validity of the models. The method involved taking thin consecutive horizontal slices from the surface of CIDR® Cattle inserts after various periods of release. Cumulative release of progesterone, both invitro and invivo, was linear when plotted against the square root of time, suggesting that release from the CIDR® Cattle insert occurred in accordance with the square root of time mechanism. However, experimental evidence from the horizontal slicing technique only supported the curve fitting evidence for invitro release. When the insert was investigated invivo, the slicing method indicated that a novel release mechanism was in operation which was better described by a zero order process.

Chapters Five and Six of this Thesis direct their focus to oestrus control in sheep. Chapter Five utilises information gained from both Rathbone et al. and the work performed in this Thesis on the CIDR® Cattle insert to characterise and optimise the commercially available sheep equivalent of the CIDR ® 1900 Cattle insert (known as the CIDR® Sheep and Goat insert). The Chapter successfully characterises the CIDR® Sheep and Goat insert, defines the parameters of, and tests, an optimised version of this sheep product.

The final Chapter of this Thesis investigates the use of poly-(ε-caprolactone) as a platform for the intravaginal delivery of progesterone to control oestrus in sheep. Silicone has certain limitations as a drug delivery platform, and with animal physiologists recent advances in knowledge, pharmaceutical scientists will need more versatile delivery platforms to develop intravaginal drug delivery systems which fulfil the future demands of the animal scientists.

year: 1999

title: A case study of using the He Pikinga Waiora Implementation Framework: Challenges and successes in implementing a twelve-week lifestyle intervention to reduce weight in Māori men at risk of diabetes, cardiovascular disease and obesity

authors: Oetzel, John G.

subjects: Science & Technology

abstract: BACKGROUND: Māori men have stark health inequities around non-communicable diseases. This study describes the case of a partnership attempting to develop and implement a culturally centred intervention through a collaborative partnership to potentially address the inequities. In particular, the partnership followed a participatory, co-design approach using the He Pikinga Waiora (HPW) Implementation Framework; the study presents lessons learnt in addressing health inequities following this framework. METHODS: The partnership involved a university research team and a Māori community health provider. They engaged with other stakeholders and several cohorts of Māori men through a co-design process to adapt a 12-week lifestyle intervention. The co-design process was documented through meeting notes and interviews with partners. Two cohorts participated in separate single group pre-intervention/post-intervention designs with multi-method data collection. Key outcome measures included weight loss, self-reported health, physical activity, and nutrition. Post-intervention data collection included qualitative data. RESULTS: The co-design process resulted in a strong and engaged partnership between the university team and the provider. There were significant challenges in implementing the intervention including having two additional partner organisations dropping out of the partnership just after the initial implementation phase. However, a flexible and adaptable partnership resulted in developing two distinct lifestyle interventions run with 32 Māori men (in two different cohorts of 8 and 24). All but one in the first cohort completed the programme. The first cohort had a modest although statistically insignificant improvement in weight loss (d = 1.04) and body mass index (BMI; d = 1.08). The second cohort had a significant reduction in weight loss (d = 1.16) and BMI (d = 1.15). They also had a significant increase in health-related quality of life (d = 1.7) and self-rated health (d = 2.0). CONCLUSION: The HPW Framework appears to be well suited to advance implementation science for Indigenous communities in general and Māori in particular. The framework has promise as a policy and planning tool to evaluate and design interventions for chronic disease prevention in Indigenous communities. Despite this promise, there are structural challenges in developing and implementing interventions to address health inequities. TRIAL REGISTRATION: Retrospectively registered, Australia New Zealand Clinical Trials Registry, ACTRN12619001783112.

text: A case study of using the He Pikinga Waiora Implementation Framework: Challenges and successes in implementing a twelve-week lifestyle intervention to reduce weight in Māori men at risk of diabetes, cardiovascular disease and obesity BACKGROUND: Māori men have stark health inequities around non-communicable diseases. This study describes the case of a partnership attempting to develop and implement a culturally centred intervention through a collaborative partnership to potentially address the inequities. In particular, the partnership followed a participatory, co-design approach using the He Pikinga Waiora (HPW) Implementation Framework; the study presents lessons learnt in addressing health inequities following this framework. METHODS: The partnership involved a university research team and a Māori community health provider. They engaged with other stakeholders and several cohorts of Māori men through a co-design process to adapt a 12-week lifestyle intervention. The co-design process was documented through meeting notes and interviews with partners. Two cohorts participated in separate single group pre-intervention/post-intervention designs with multi-method data collection. Key outcome measures included weight loss, self-reported health, physical activity, and nutrition. Post-intervention data collection included qualitative data. RESULTS: The co-design process resulted in a strong and engaged partnership between the university team and the provider. There were significant challenges in implementing the intervention including having two additional partner organisations dropping out of the partnership just after the initial implementation phase. However, a flexible and adaptable partnership resulted in developing two distinct lifestyle interventions run with 32 Māori men (in two different cohorts of 8 and 24). All but one in the first cohort completed the programme. The first cohort had a modest although statistically insignificant improvement in weight loss (d = 1.04) and body mass index (BMI; d = 1.08). The second cohort had a significant reduction in weight loss (d = 1.16) and BMI (d = 1.15). They also had a significant increase in health-related quality of life (d = 1.7) and self-rated health (d = 2.0). CONCLUSION: The HPW Framework appears to be well suited to advance implementation science for Indigenous communities in general and Māori in particular. The framework has promise as a policy and planning tool to evaluate and design interventions for chronic disease prevention in Indigenous communities. Despite this promise, there are structural challenges in developing and implementing interventions to address health inequities. TRIAL REGISTRATION: Retrospectively registered, Australia New Zealand Clinical Trials Registry, ACTRN12619001783112.

year: 2020