Meet Winnie Nyamboki, Health Economist and Mawazo Scholar


The Economic Burden of Poor Health in Kenya

By Winnie Nyamboki

The economics literature identifies health as having both direct and indirect effects on the population as well as a country’s output.  Economists have argued that a healthier workforce is more productive and this is an illustration of the direct effect. The indirect effect is mostly analysed from a long-term perspective. For example, healthy individuals are less likely to be absent from school thereby diminishing the quality of their education and impacting labour market outcomes over time. The economic burden that is associated with poor health outcomes poses a twofold threat to any economy. Over and above the macroeconomic costs of ill health which are linked to variables like Gross Domestic Product (GDP), mounting evidence shows that microeconomic costs are also significant. Besides the diminished capacity to work, the dilemma of dealing with additional medical and related expenditures can be catastrophic, making households and individuals vulnerable to poverty.

The Government of Kenya, through its ‘Big Four’ agenda , is keen on providing universal health coverage by 2022 to guarantee quality and affordable health care for all. While such an initiative goes a long way in redistributing health resources, Kenya is struggling to cope with the burden of traditional communicable diseases, which continue to account for a sizeable share of health spending. Notably, over the 2012 - 2013 period, the total health expenditures on HIV/AIDS, malaria, TB, diarrhoeal diseases, nutritional deficiencies, vaccine preventable diseases, and diseases of the respiratory system amounted to 106 billion Kenya shillings, which translates to approximately 3% of our GDP.  With such huge investments, favourable health outcomes are expected. However, these diseases are among the key drivers of both morbidity and mortality, which describe rates of poor health and death, respectively, among the Kenyan population.  According to recent data from the Kenya National Bureau of  Statistics, morbidity cases for both communicable and non - communicable diseases have increased from 31.2 million in 2007 to 47 million cases in 2015. Malaria and diseases of the respiratory system continue to be the leading causes of morbidity and together account for 55.3% of all reported morbidity cases in 2015. While the prevalence of these conditions is still rising, it is not clear how this affects labour supply in the Kenyan context.

Previous studies on the relationship between health status and labour market behaviour have generally focused on developed countries. The findings suggest that the relationship between health and labour market outcomes remains ambiguous owing to measurement errors, reverse causality, and omitted variable bias. First and foremost, there is no universal consensus on what really constitutes health. Secondly, there may be other unmeasured factors such as time preferences, risk, and motivation, that simultaneously affect both health and labour supply. These factors all introduce significant complexities when analysing this relationship.  Additionally, while self- assessed summary measures of health have been studied widely (i.e. individuals are asked to rate their health on a scale of 1 to 5 where “1 = poor health” to “5 = excellent health”), little attention has been paid to the contribution of specific health conditions on the capacity to work, with a few exceptions in developed countries which concentrate on certain types of chronic illnesses.

It is against this background that my PhD research aims to examine and quantify the contribution of specific types of acute illness on the propensity to participate in the labour market in Kenya. This study focuses on four disease groups:  malaria, diseases of the respiratory system, stomach ache complications, as well as injuries resulting from burns, fractures, wounds, and poisoning. These four acute conditions were responsible for 68.9% of Kenya's morbidity burden in 2015. In particular, I will: (1) explore the association between health and participation outcomes across socioeconomic and demographic variables, (2) examine and compare the labour supply outcomes of groups with different acute diseases, and (3) test whether is there a bidirectional relationship between participation in the workforce and specific acute illnesses outcomes among the working age population (“endogeneity”). I anticipate that this research will provide sound economic analysis on the burden of illness and injuries in Kenya, and provide important evidence for investment targeting specific diseases at both the National and County levels.



Winnie Adhiambo Nyamboki is an Economist at the National Treasury and is a Ph.D. student at the University of Nairobi’s School of Economics. Her research title is “The Economic Consequences of Poor Health in Kenya”. She is passionate about contributing to the economic aspects of different health outcomes in Kenya.

Meet Melisa Allela, Storyteller and Interactive Media Design Maven

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Re-imagining the Traditional Forms of Storytelling in Africa

by Melisa Allela

Human beings are storytelling animals; this is how we make sense of the world. In a rapidly changing world, how do we leverage the capabilities of emerging technologies to preserve African oral traditions of storytelling? Infusion of Artificial Intelligence with immersive technologies such as Virtual Reality (VR), which enable social interaction between users and animated virtual characters, are already revolutionizing the ways in which computational systems are used to entertain, educate, and train humans. My research on storytelling through experimental animation explores the use of animation techniques and emerging technologies as a medium for relaying works of African oral literature (“orature”).

We communicate through stories, but also use stories to entertain, educate and inform. Presentation of events within a story can take the form of either of the three main types of narrative structures. The first is a linear narrative, in which events are presented in a chronological order and the user has no control over the story and plot development. The second is a nonlinear narrative, where the plot does not conform to a direct causality pattern and the user may have limited control over the plot progression. The third is an interactive narrative, where the plot is either linear or nonlinear and is driven by the user’s interaction. In the field of animation, interactive narratives exist at the convergence of film and gaming technologies. This allows for interaction between users and virtual agents, and in doing so, mimics the experience of a face-to-face encounter between storyteller and audience.

Works of African orature, owing to their performative and participatory nature, cannot be adequately documented in textual format or via linear media such video recordings (combinations of animated or live action footage, text, and audio). To address this, I study and create animation systems that bring together interactive narratives, virtual reality, and animated virtual humans, and thus have the potential to relay the unique features of African oral storytelling in a digital medium. These systems should exhibit narrative intelligence, which means that they are capable of restructuring the plot and can react to the user’s narrative experience. In addition, the virtual characters must be believable with human-like qualities. These are virtual humans that can emote, communicate, and read the user’s verbal and non-verbal behaviour in real-time. This is no simple task, and requires a cross-disciplinary approach traversing computer graphics, artificial intelligence (AI), human-computer Interaction (HCI), and animation. Some key technical challenges include contextual kinesics (generating relevant gestures and facial expressions) of an autonomous animated character, synchronising speech and non-verbal behaviours, and lastly, natural language processing to enable human-like dialogue and verbal interaction between a user and the virtual character.

My research employs a studio-based research design, which is commonly used by practitioners in the creative industries. This involves a balance of both theory and practice, and will culminate in an exhibition of works. The resulting work will be an immersive and interactive animated adaptation of Ugandan poet Okot p’Bitek’s narrative poem, Song of Lawino. Its symbolic and affective properties, as well as rich figurative imagery, provide narrative content and visual reference for interpretation in the interactive animated format.

Through this research project, I seek to make a conceptual and technical contribution to the use of emerging technologies in reimagining traditional forms of storytelling in Africa. Virtual Reality is already widely used for cultural preservation of historical sites and archaeological artefacts in the emerging field of  Virtual Heritage. However, preservation of intangible culture is still an overlooked aspect of cultural heritage preservation in VR. UNESCO’s Convention for the Safeguarding of the Intangible Cultural Heritage emphasizes the “importance of the intangible cultural heritage as a mainspring of cultural diversity and a guarantee of sustainable development.” Thus, my research also contributes to advancing these broader global goals by leveraging modern technologies towards the preservation of our intangible cultural heritage.



Melisa Allela is an Assistant Lecturer and 2nd year doctoral student at the Technical University of Kenya, enrolled in the Design and Creative Media department. Her research topic is “Storytelling Through Experimental Animation: Challenging Traditional Frameworks of Representation.” She is interested in the convergence of experimental animation and emerging technologies that push the boundaries of artistic and scientific practice in Interactive Media. She looks forward to the tipping point moment for women in tech and their increased participation in the fields of Animation and Interactive Media production.

Mawazo Scholars Participate in Open Africa Power Initiative Training

 Mawazo Scholars Susan Gichuna and Judith Koskey at the OAP training hosted at Strathmore University, Nairobi 

Mawazo Scholars Susan Gichuna and Judith Koskey at the OAP training hosted at Strathmore University, Nairobi 

Three Mawazo Ph.D. Scholars participated in the inaugural training module of the Open Africa Power (OAP) programme last month. OAP is a collaboration between the Enel Foundation and academic institutions in Africa and Italy, and aims to build the next generation of African leaders who are equipped to drive a clean energy future in their countries. The training module was hosted in Nairobi by Strathmore University and the University of Nairobi. It featured in-depth sessions covering core technology, policy and business aspects of the electricity sector, as well as their interactions with broader societal issues such as sustainable development goals, climate change, and urbanization. The training course is part of a four-month intensive leadership development programme for 34 postgraduates who were competitively selected from across the continent.  Mawazo Scholars Susan Gichuna, Judith Koskey, and Marilyn Ronoh, who have backgrounds in mathematics, environmental studies, and urban studies, were invited to participate in the training module alongside OAP students. In addition to the formal training sessions, the event also gave Mawazo Scholars a chance to interact with peers from different African countries and academic backgrounds. Finally, Mawazo's CEO Dr. Rose M. Mutiso also delivered remarks during the event. 

Meet Susan Gichuna, Sustainable Urban Development Expert and Mawazo Scholar

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Understanding How Climate Change Impacts Residents of Nairobi’s Informal Settlements

by Susan Gichuna

Globally, climate change is now recognized as the greatest threat to humanity. Climate impacts such as droughts and extreme weather events have increased in recent times and are projected to grow over the coming decades. Although these impacts are being experienced globally, the effects are disproportionate. Lower income countries in sub-Saharan Africa and other developing regions, who are the smallest contributors to global warming, are the most vulnerable because they lack the capacity to respond to and recover from climate impacts.

As the burden of climate change in developing countries continues to grow, the effects are most pronounced among the poorest segments of population, such as the urban poor residing in informal settlements. African countries such as Kenya are fast urbanizing resulting in increased growth of the informal settlements. In Nairobi, for example, an estimated 60 to 70 percent of residents live in slums.  The urban poor who reside in these informal settlements are particularly vulnerable to the effects of climate change for a number of reasons. These settlements tend to be located in risk-prone areas such as hillsides, river banks and near damping sites. Poverty compounds these environmental risks, limiting the ability of the inhabitants to cope when disasters such as flooding strike, as was the case during the recent heavy rain season. The county government of Nairobi has since allocated an emergency fund of Ksh. 194 million to deal with impacts of the floods in the city. However, the initiative came a little too late to avert the catastrophe, pointing to poor planning and failed disaster management. Thus, there is an increasingly urgent need to understand the unique effects of climate change phenomena such as extreme weather events on the urban poor, as well as identify effective strategies to mitigate these risks and build their resilience to the impacts.

The challenge of climate change is a complex multi-faceted issue that requires a combination of scientific, societal and political knowledge to address it. For instance, climate impacts such as floods affect multiple sectors including housing, agriculture, health, transport, and energy. Such problems cannot be solved by one sector or academic discipline, nor through a single perspective. The Institute for Climate Change and Adaptation (ICCA) at the University of Nairobi where I am a PhD student emphasizes the use of a transdisciplinary approach in addressing climate change and adaptation. This approach requires close cooperation and collective learning by various stakeholders.

My Ph.D. research will focus on climate change impacts and adaptation in Nairobi’s informal settlements, specifically Majengo Slums.  Majengo is located in Pumwani Ward, a few kilometres from Nairobi’s central business district and bordering the highly polluted Nairobi River. The settlement has been in existence since 1921 and comprises four smaller settlements including Sofia, Mashimoni, Katanga and Digo. According to the Kenya National Housing and Population Census 2009, Majengo has over 16,000 residents.  The geographic location and poor condition of the settlements increases the vulnerability of Majengo residents to climate impacts. The goals of my research are three-fold. First, I will identify the specific impacts of climate change on Majengo residents, and secondly, establish how the residents of Majengo cope and respond to the climate impacts. Finally, I will use my findings to develop recommendations for policy actions that government and city authorities can take to enhance resilience of the urban poor against the climate impacts. My research will involve close engagement with the Majengo community and key stakeholders such as relevant government ministries and bodies, local and county government, non-governmental organizations, and community-based organizations. Data collection will entail both quantitative and qualitative methods including household surveys, key informant interviews, and focus group discussions.

Nairobi’s informal settlements have certainly been studied widely. However, focus has mainly been on issues such as healthcare, poverty and education access, with little emphasis on the growing impacts of climate change in these settings. More systematic studies specific to climate change are required, and my research aims to contribute to addressing this gap in the literature. Ultimately, I aim to provide concrete insights to inform climate adaptation policy and planning, and thus strengthen pro-poor development outcomes in Nairobi county.  


Susan Gichuna is a researcher on Climate Change and Adaptation, and Sustainable Urban Development. She is a Ph.D. student at the Institute for Climate Change and Adaptation at the University of Nairobi.

Meet Jacqueline Owigo, Migration Policy Expert and Mawazo Scholar

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Linking Return Migration and Development in Somalia

By Jacqueline Owigo

International migration is increasingly seen as a high-priority policy issue by governments, practitioners, scholars and the public at large. In recent years, there has been a significant increase in human displacement, which has resulted from conflict and environmental factors. Further, UNHCR cautions that the number of displaced people has continued to soar and it is estimated that globally, one in every 113 persons is now either a refugee, internally displaced or seeking asylum.

Return migration is a component of international migration. The main forms of return migration include voluntary return and involuntary return associated with, for example, deportation of migrants to their country of origin. Governments and international organizations have adopted policies that are aimed at improving return processes and outcomes, such as  linking return with national development. Kenya, for example, has a diaspora policy to harness the diverse skills, expertise, and potential of Kenyans living abroad. This recognizes that people who’ve spent years abroad often return with financial capital, new skills or international business connections, which can be leveraged to foster growth.

On the global policy agenda, return migration has proved problematic, as experienced in the ongoing negotiations for the Global Compact for Safe, Orderly and Regular Migration. The zero-draft  released in February, makes no commitments in relation to addressing the increasing challenge of ‘forced return’ of migrants i.e. deportation and expulsion. Equally important, the number of returning refugees and migrants is on the rise whether through voluntary repatriation, deportation, or other circumstances in which lines between forced and voluntary returns are indistinct as refugees are confronted with a choice between detention or repatriation. While acknowledging the sovereign prerogative of states to conduct removals, states are also obliged to respect the principle of non-refoulement as well as human rights during returning or removing migrants from their territories.   

My research focuses on Somalia, which is experiencing significant return migration encompassing migrants from the diaspora, deportees (failed asylum seekers) and voluntary repatriation of refugees. Somalia is also home to over 1.5 million internally displaced persons. These returns are not all voluntary, and the returnees do not have the same needs. Given the increasing number of coerced returns to Somalia, more research is needed to understand their experiences and reintegration strategies. The study will highlight the experiences Somali returnees face from their very own perspective, with a view to identify areas for policy intervention that may be effective in improving reintegration outcomes. 


Jacqueline Owigo is currently in the second year of her PhD in International Relations at the United States International University – Africa in the School of Humanities and Social Sciences. Her research interests include links between return migration and development, specifically the social inclusion of forced migrants in a community and diaspora returnees.

Meet Edinah Song'oro, Molecular Geneticist and Mawazo Scholar

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My Work Using Genomics to Study Antimicrobial Resistance in Kenya

By Edinah Song’oro

Mawazo Scholar Edinah Song'oro authored the following blog post on her research as part of the global DNA Day celebrations. Learn more about DNA Day and the ‘15 for 15’ Celebration here

The science of genomics is the application of genetics and molecular biology towards studying genetic materials of organisms. The field of genomics is rapidly growing in Kenya with major applications in several fields. This includes research into drought-tolerant plants in agriculture and HIV vaccine development in medicine. A unique application of genomics in Kenya has been in efforts to stem wildlife poaching and trafficking. In this setting, molecular approaches are used to investigate semi-processed or physically indistinguishable wildlife products. For example, in my research I have used sequencing of Mitochondrial DNA (mtDNA) cells to identify wildlife species sold as bushmeat in rural markets using small samples taken from meat, skin and, blood stains. In addition, DNA barcoding has become a promising tool for rapid and accurate identification of wildlife and plant species in Kenya and in many other geographies.

Another important area of application is in the identification of resistant genes and their relationship to the environment. Antimicrobial resistance refers to the ability of microorganisms to develop resistance to antibacterial, antiviral, antiparasitic, and antifungal medications. This emergence of antimicrobial resistant genes in microorganisms is becoming a major global public and animal health issue. A major driver of this phenomenon is the increased use of microbial agents in a range of agricultural and medical applications, which in turn find their way into the environment. Regular exposure of humans and animals to these compounds may lead to transfer of antimicrobial genes to these populations, ultimately serving as reservoirs for resistant genes.

For several decades antimicrobial resistance has been a growing threat to the effective treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi, making the treatment of patients difficult, costly, or even impossible. The impact on particularly vulnerable patients is most obvious, resulting in prolonged illness and increased mortality. The magnitude of this problem motivated me to carry out my doctoral research in this field, with a focus on determining the diversity of resistant genes in Nairobi and Naivasha Counties of Kenya. As a molecular geneticist, I use genomic tools to isolate antimicrobial resistant genes from various environmental samples such as soil, river water, and sewage, as the non-clinical environment is a vital factor in the propagation and dissemination of these genes. This research will increase our understanding of the relationship between resistance in the environment and the spread of antimicrobial resistance in human and animal populations.  I will also sequence the resistant genes and generate a data map that will show antimicrobial resistance hotspots and areas of unique resistance genotypes. I also hope to communicate my research findings to local stakeholders and help find better ways to reduce the burden of infections that may be caused by environmental microorganisms.



Edinah Song'oro is a Tutorial Fellow and 2nd year Ph.D. student at Jomo Kenyatta University of Science and Technology’s Molecular Biology and Biotechnology department. Her dissertation research project is titled “Occurrence and dynamics of antimicrobial resistance genes in selected environments in Nairobi and Naivasha, Kenya.” She has academic and research experience in multiple biological disciplines including biotechnology, genetics, microbiology and molecular biology. As a female genomic scientist in Kenya, she hopes to encourage more women to enter the field of genomics and explore all its exciting opportunities.


Meet Peris Ambala, Molecular Virologist and Mawazo Scholar

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Applying Molecular Genetics to Study Zoonotic Viruses in Kenya 

By Peris Ambala

Mawazo Scholar Peris Ambala authored the following blog post on her research as part of the global DNA Day celebrations. Learn more about DNA Day and the ‘15 for 15’ Celebration here

As a Ph.D. scholar and a young female scientist at the Institute of Primate Research Kenya, I am part of a group of scientists who use molecular genetics tools for virus discovery and diagnosis of pathogenic viruses, bacteria and parasites in different animal species.

In the recent decade, dangerous human pathogenic viruses have emerged in different geographical locations within Africa, with outbreaks occurring almost annually. Majority of these viruses are zoonotic viruses, which means they can be transmitted directly from animals to humans. Bats, non-human primates, and rodents are known to harbor zoonotic viruses, which circulate silently in hosts. These viruses have a high mortality rate of up to 90% in some cases. The Ebola virus, a member of the filovirus family, is an example of a zoonotic virus that made global headlines recently during a deadly outbreak in West Africa, resulting in over 11,000 deaths.

Microbial adaptation, which is the ability of microorganisms such as viruses to endure selective pressures of their environment, as well as the influence of human activities, are two major drivers of the emergence of these zoonotic viruses. As a result, most of these viruses have ribonucleic acid (RNA) genomes with high mutation rates. For my PhD dissertation, I am studying the zoonotic potential of filoviruses circulating in rodents, bats, non-human primates and humans in Laikipia and Turkana counties of Kenya. In these counties, animals live in close proximity to humans. In addition, climate change has led to acute water scarcity in these areas, forcing humans and animals to share the limited watering points available. Furthermore, inhabitants of these areas have been known to feed on bushmeat during prolonged dry seasons. These interactions have thus exposed humans to ongoing life cycles of zoonotic viruses. While this is an area of increasing importance, there is scarce scientific data on filoviruses in Kenya. My research aims to fill some of these knowledge gaps to help improve the prevention and control of these zoonotic viruses in the country. Moreover, further studies of the isolated viruses will be of benefit to drug, vaccine, and diagnostic kit development studies.

Kenya has made significant gains in the field of genomics through the establishment of molecular genetics and molecular biology laboratories in research institutes, health clinics, and food and agricultural units. For example, molecular genetics is used to study population genetics in animals, pathogens and plants in local research institutes, while in clinical setups, molecular genetics is used in the detection of viruses such as HIV and human papilloma viruses (HPV). Universities have also developed courses in molecular biology, which are building critical capacities in this field. However, most learning institutions in Kenya do not have access to molecular genetics laboratories, and there are also very few laboratories that offer gene sequencing services. As a result, many Kenyan researchers are forced to ship their samples to other countries where sequencing is relatively affordable. Expanding the field of genomics in Kenya will require greater investment in laboratory infrastructure, increased training of local scientists in the use of sequencing and bio-informatics tools, and continued exposure of younger generation students to the field through coursework.


About the Author

Peris Ambala is a 2nd Year Ph.D. Student at Kenyatta University’s Medical Laboratory Sciences department and a Research Scientist at the Institute of Primate Research in Kenya. She is a member of Mawazo Institute’s inaugural cohort of Ph.D. Scholars, and is passionate about creating a positive impact through her research.



Effective budgeting for research


As part of the PhD Scholars programme at Mawazo, we're developing a training curriculum on professional development for researchers.  It covers a range of research skills which are broadly applicable across disciplines, including budgeting, academic writing, navigating the publication process, and public speaking.  The training sessions are only available for participants in the Scholars programme at present, but we are committed to making all of the training materials publicly available after the sessions.

We held our first training last month on effective budgeting and financial management for research.  I developed a set of guidelines for creating budgets which are easy to understand and update, and which can used to track expenses as well.   The guidelines drew on my previous experience managing a large portfolio of research projects and their associated budgets at Innovations for Poverty Action.  I also shared examples from a previous iteration of budgeting for my own PhD research in Ghana.

There are three major principles of budgeting which shaped the guidelines.

  • Explain your cost assumptions clearly.  Funders want to see that you've come up with reasonable cost estimates.  Documenting them clearly helps to establish the credibility of your estimates.
  • Provide lots of detail about your activities and calculations.  A budget doesn't have to simply be a list of costs.  It can also include a description of your research question, a project timeline, and information about how you carried out your calculations.  This helps funders to understand why each expense is necessary for your work.  A budget narrative can be used to provide additional detail as well.
  •   Let Excel do the work for you.  Excel has lots of features that make it easy to automatically update the values in your budget; handle complex calculations; and keep large budgets organised.  Taking advantage of them will make your budget look professional.

The training documents are below.  They are free for anyone to download, modify, and use.

Introducing the 2018 PhD Scholars!

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We're thrilled to introduce our first cohort of Mawazo PhD Scholars!  We received 170 applications for the 10 spots in this programme, demonstrating the high levels of demand for research funding and training amongst Kenyan PhD students.  After a difficult selection process, we chose ten exceptionally talented women.  Keep an eye out for profiles of each Scholar and their work over the coming weeks!

Front row (left to right):

  • Marilyn Ronoh, Mathematics, University of Nairobi
  • Elizabeth Benson, Computer Science, Jomo Kenyatta University of Agriculture and Technology
  • Teresiah Njihia, Agriculture, Jomo Kenyatta University of Agriculture and Technology
  • Jacqueline Owigo, Political Science, United States International University
  • Judith Koskey, Environmental Studies, Egerton University

Back row (left to right):

  • Winnie Nyamboki, Economics, University of Nairobi
  • Edinah Song'oro, Biology, Jomo Kenyatta University of Agriculture and Technology
  • Peris Ambala, Medicine, Kenyatta University
  • Susan Gichuna, Environmental Studies, University of Nairobi
  • Melisa Achoko Allela, Visual Arts, Technical University of Kenya