Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associa-ted with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient

Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associated with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient

The Role of Women and Men in Land Use and Property Rights in Mt. Elgon Region

Gender mainstreaming is a strategy employed to end discrimination against a particular gender and promote equality between men and women using inclusive policies and laws. The Kenyan Government has made great progress in enacting laws aimed at achieving equal benefits and protection of the law in respect to property rights over land. Unfortunately, enforcement remains challenging. With a focus on land ownership and use in Mt. Elgon region, this article seeks to evaluate the impact of gender mainstreaming policies and legal structures, which have been established to help Kenyan women attain equal land rights. The region is an area in the Western part of Kenya near the border with Uganda. It provides an interesting look into land dispute resolution because, apart from being a resource-rich area, it has experienced significant violence related to land use between the years 2006 to 2008, from state and non-state actors.  The study concludes that harmful traditional beliefs and cultural practices influence the role gender plays in the access women and men have to land use and property right. Keywords: patrimony, global political economy, gendered political economy, property rights, land rights, gender mainstreaming DOI: 10.7176/JLPG/119-08 Publication date:March 31st 202

Options for sustaining solar-powered mosquito trapping systems on Rusinga Island, Western Kenya : A social dilemma analysis

Background: In 2012, a donor-supported proof of principle study was launched to eliminate malaria from Rusinga Island, western Kenya, using solar-powered mosquito trapping systems (SMoTS). SMoTS, which also provided power for room lighting and charging mobile telephones, were installed in houses. In view of the involvement of individual and collective benefits, as well as individual and collective maintenance solutions, this study qualitatively examined preferences of some project stakeholders towards SMoTS sustainability components to see if and how they related to social dilemma factors. Methods: The data were collected through participant observation, semi-structured interviews and focus group discussions. Results: The results show that respondents largely preferred individual solutions to various aspects of maintenance. Selective collective solutions such as table banking groups were considered positively for mobilising financial resources for maintenance, but respondents were hardly willing to contribute financially to a collective entity. Few people saw a meaningful role for a collective governing body; people preferred to rely on individual household responsibility and private service delivery for repairs and stocking spare parts. An overriding concern was that people lacked trust in other community members, leaders and/or technicians who would be employed by a governing body. Respondents also had little confidence that a governing body or saving group could effectively impose sanctions to misappropriation of funds, poor leadership, defecting group members or technicians that might abuse a salaried position. Conclusion: There seemed to be linkages between preferences towards organising various components of SMoTS sustainability and known hindrances to addressing social dilemmas. This posed considerable challenges to organising the sustainability of this innovative malaria control strategy. Trial registration: NTR3496

Role of Gender Policies and Laws in Enhancing Women's Participation in the Resolution of Land Conflicts

Gender mainstreaming is a strategy to end women's exclusion and further gender equality by using general policies and laws. The Government of Kenya has made strides in realising gender equality with the adoption of different general and gender-specific policies and laws. The reality is, however, that gender equality is far from being achieved across the country. With a focus on land conflicts, this article seeks to examine gender policies and law frameworks that intend to enhance women's participation in the resolution of land conflicts; what progress has been achieved; and the gaps in terms of making these legal frameworks a reality. The study concludes that empirical studies on the impact of gender policies and laws that aim to enhance women's participation in resolution of land conflicts are lacking across the country calling therefore for more research that seeks to evaluate the impact of the policies and laws on the ground

Community perspectives on parental/caregiver communication on reproductive health and HIV with adolescent orphans and non-orphans in western Kenya

Studies show sexuality dialogue between parents or caregivers with their adolescent children can be a protective factor for engaging in risky sexual behaviours. This study aimed to understand the nature of parent and caregiver sexuality talks with non-orphans and orphans under their care in order to contribute to the knowledge base to inform adolescent and orphan sexual and reproductive health and HIV prevention policies and interventions. We used a cross-sectional qualitative study design with maximum variation sampling to purposively select study participants in three counties of the former Nyanza region in western Kenya. We held 14 focus group discussions with 78 adolescents aged 14–17 and 68 parents and caregivers of children aged 10–17. Thirteen key informant interviews were also held with individuals knowledgeable of issues affecting adolescents and orphans. We used deductive analysis to develop the question domains and coded the data based on our research questions and thereafter followed an inductive approach to review the data and identify emerging themes and patterns, from which we interpreted the findings and drew conclusions. Parents/caregivers-adolescents sexuality talk sometimes occurred but was perceived to be less likely with orphans than non-orphans. Mothers mainly initiated such talks through warnings and lectures about engaging in risky sexual behaviour, with adolescents usually being passive recipients of the messages. Hindering factor included generation gap, failure of some caregivers to bond with orphans under their care, religious/cultural norms, lack of sexuality information and communication skills, and spousal assumptions that the mother is responsible for parent-child communication on sexuality issues. We conclude that adolescent orphans and non-orphans lack an important source of information to help them make informed decisions on their sexuality. Policies and interventions targeting orphans and adolescents should equip parents/caregivers with sexuality knowledge and communication skills to enable them to dialogue on sexuality with adolescents