The Perceptions of Low, Middle and High Income Socio-Economic Groups in Nairobi on Tourist Attraction Sites

Kenya is among the developing countries of the world and has actively supported the development of tourism to promote its economy and the livelihood of the people. Kenyans lack the perception that tourism is essential to life, unlike their counter parts in Western Europe and North America where travel is a symbol of socio-economic status. Tourism products and services are not well understood by many Kenyan’s and therefore not well utilized. The study was conducted in Nairobi, the capital city of Kenya The groups and the study population were selected using the systematic random sampling technique from the zoning map by the Nairobi city council urban policy plan (NCCUP).  The study adopted a descriptive survey design using both quantitative and qualitative research methods to gather data. Data were collected using the questionnaire, likest-scale and the interview schedule. This study purposed to investigate the factors that contribute to the minimal participation by locals in domestic tourism among low, middle and high income socio-economic groups in Nairobi, Kenya. Data were analyzed using the statistical package for social sciences (SPSS) version 12.5. Factors affecting perception of domestic tourists were subjected to Kaiser Criterion principle component (factor analysis) to reduce the number of variables by varimax rotation. Efforts to promote domestic tourism have continued to bear little fruit. Majority of Kenyans believe that the tourism industry and the hospitality industry that goes with it belong to the white man. This attitude was contributed by the ownership and management of economic activities related to the tourism industry that were entirely in the hands of foreign colonial settler population and later a few Indians. Education is an important factor in shaping the level of positive attitude towards domestic tourism. Residents have different perceptions on domestic tourism and vest the responsibility for their education and understanding on government and tourist service providers. The drop in the international tourists in the 1990s led to a decrease in revenue and had to be substituted by domestic tourism. Several approaches by the ministry of Tourism and wildlife (MTW) through Kenya Tourism Development Council of Kenya (DTCK) and African Tours and Hotels (AT & H) did not achieve much participation by locals remained low at 12.7% of the total visitors. The respondents who were negative about game parks were generally more than those who were in the affirmative. Their negative attitude could be because revenues generated from the national park go to the central government and tourist industry operators and little if not none trickles to communities living around these areas and even very little of this is spent on the economic development of the affected population The values of beliefs and the feelings of the people of Kenya if known will assist in alleviating misconceptions about tourist attraction sites and the hospitality industry. The domestic Tourism Council of Kenya (DTCK) should be revived to generate information and statistics on domestic tourists. Key words: perceptions, socio-economic groups, domestic touris

Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance : a multi-hospital, retrospective, cohort study

Background: Management of pneumonia in many low-income and middle-income countries is based on WHO guidelines that classify children according to clinical signs that define thresholds of risk. We aimed to establish whether some children categorised as eligible for outpatient treatment might have a risk of death warranting their treatment in hospital. Methods: We did a retrospective cohort study of children aged 2–59 months admitted to one of 14 hospitals in Kenya with pneumonia between March 1, 2014, and Feb 29, 2016, before revised WHO pneumonia guidelines were adopted in the country. We modelled associations with inpatient mortality using logistic regression and calculated absolute risks of mortality for presenting clinical features among children who would, as part of revised WHO pneumonia guidelines, be eligible for outpatient treatment (non-severe pneumonia). Findings: We assessed 16 162 children who were admitted to hospital in this period. 832 (5%) of 16 031 children died. Among groups defined according to new WHO guidelines, 321 (3%) of 11 788 patients with non-severe pneumonia died compared with 488 (14%) of 3434 patients with severe pneumonia. Three characteristics were strongly associated with death of children retrospectively classified as having non-severe pneumonia: severe pallor (adjusted risk ratio 5·9, 95% CI 5·1–6·8), mild to moderate pallor (3·4, 3·0–3·8), and weight-for-age Z score (WAZ) less than −3 SD (3·8, 3·4–4·3). Additional factors that were independently associated with death were: WAZ less than −2 to −3 SD, age younger than 12 months, lower chest wall indrawing, respiratory rate of 70 breaths per min or more, female sex, admission to hospital in a malaria endemic region, moderate dehydration, and an axillary temperature of 39°C or more. Interpretation: In settings of high mortality, WAZ less than −3 SD or any degree of pallor among children with non-severe pneumonia was associated with a clinically important risk of death. Our data suggest that admission to hospital should not be denied to children with these signs and we urge clinicians to consider these risk factors in addition to WHO criteria in their decision making