community health survey in bungoma county, kenya - august 2013
TRANSCRIPT
Report on aCommunity Health Survey
Bungoma County, Kenya
August 2013
Survey aim
• Improve understanding of the patterns of common health problems in western Kenya at detailed, local level
• Identify opportunities for health education and health promotion interventions
• Quantify barriers to accessing care and opportunities for innovation in services
• Test survey methodology
Survey topics
• Residents and type of residence
• Water and sanitation
• Illness in past 12 months
• Healthcare utilisation during illness
• Respiratory illness in past 4 weeks
• Malaria in past 12 months
• Disability (long term)
• Injuries in past 12 months
Methods – key features
• Data collection by student volunteers using low-cost Android tablets
• Pseudo-random sampling (every third occupied dwelling) over 3 days
• Pseudo-random sub-sampling for some questions
• Many questions based on existing surveys and international literature
• Definitions explained to respondents
The survey team
Location and sample
1.629145464All areas
1.77050121Matisi
Menu
Namwela
2.15229107Bungoma West
Mateka
Lumboka
Muanda
5.14445227Bungoma South
%Pop.SampleHouseholds
Characteristics of housingFloor material
0
10
20
30
40
50
60
70
80
90
100
Earth Cement Carpet Other
Perc
en
t o
f h
ou
seh
old
sBungoma South
Bungoma West
Matisi
Roof material
0
10
20
30
40
50
60
70
80
90
100
Mabati Makuti Other
Perc
en
t o
f h
ou
seh
old
s
Bungoma South
Bungoma West
Matisi
Water and sanitationSource of water
0102030405060708090
100
Public
tap
Covered
well in
plot
Covered
public
well
Open
public
well
Piped
into plot
Piped
into
home
Other
Perc
en
t o
f h
ou
seh
old
s
Bungoma South
Bungoma West
Matisi
Type of toilet
0
10
20
30
40
50
60
70
80
90
100
Pit latrine VIP latrine Other
Pe
rce
nt
of
ho
us
eh
old
s
Bungoma South
Bungoma West
Matisi
Main source of drinking water65.8
11.2
5.41.8 1.8
9.03.6
1.4
0
10
20
30
40
50
60
70
Public
tap
Covered
well - in
plot
Covered
well -
public
Open
well - in
plot
Open
well -
public
Piped -
into
plot
Piped -
into
home
Lake,
river or
spring
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Sanitation – type of toilet
66.1
31.1
2.70.1
0
10
20
30
40
50
60
70
Pit latrine VIP latrine Flush toilet None
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Sanitation - sharing
62.6
37.4
0
10
20
30
40
50
60
70
Shared Not shared
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
General question on illness history
• Have you yourself been ill at any time in the past 12 months?
• Include illnesses that made you unable to work or to do normal household tasks for a day or more.
• Don’t include injuries, like cuts or burns.
Frequency of illness in past year
32.1
36.6
8.8
22.5
0
5
10
15
20
25
30
35
40
Never Once Several times Continuously
Pe
rce
nt
of
inte
rvie
we
es
(we
igh
ted
)
Question on respiratory illness
• Have you or any of the adults (aged 16 years and over) in this household had a respiratory illness in the past four weeks?
• I mean an illness that made you cough or sneeze frequently, or wheeze, or have trouble breathing, but don’t count asthma or allergies.
Adult respiratory illness in past month
11.8
40.6
57.8
0
10
20
30
40
50
60
70
Interviewee Anyone in household No-one in household
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Question on malaria
• Have you or any of the adults (aged 16 years and over) in this household suffered from malaria in the past 12 months?
• Have any of the children in this household suffered from malaria in the past 12 months?
• Not shown here: Was the illness definitely confirmed as malaria by a doctor?
Malaria in past year
19.3
62.159.3
0
10
20
30
40
50
60
70
Interviewee Any adult in household Any child in household
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Question on long-term disability
• Are any of the adults (aged 16 years or over) in this household disabled?
• By disabled I mean not able to do the things that people of their age normally do, because of the long-term effects of an illness or injury.
• Examples of disability include being unable to walk because of a leg injury, or being blind from an eye disease.
• By long-term I mean permanent or lasting at least 6 months.
Long-term disability
4.110.1
88.5
0
10
20
30
40
50
60
70
80
90
100
Interviewee Any adult in
household
No adult in household
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Long-term disability – by function
67.2
7.41.8 1.8
14.1
7.7
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
Mobility Mental
functioning
Hearing Vision Other Multiple
Pe
rce
nt
of
dis
ab
led
sa
mp
le (
we
igh
ted
)
Question on injuries
• Have you or anyone in this household suffered a
serious injury, such as a deep cut, burn or
broken bone, in the past 12 months?
• By serious I mean that either it was necessary to
get help from a doctor or other people, or the
effects of the injury were enough to make it
impossible to work or to do normal household
tasks for a day or more.
Injury in past year
4.4
16.3
81.9
0
10
20
30
40
50
60
70
80
90
Interviewee Anyone in household No-one in household
Pe
rce
nt
of
ho
use
ho
lds
(we
igh
ted
)
Injury caused a long-term disability
16.8
79.6
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Yes No
Pe
rce
nt
of
inju
red
sa
mp
le (
we
igh
ted
)
Injuries - circumstances
32.2
18.2
11.0
3.8 3.0
11.5
4.9
0.2
15.2
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Home (e
.g. c
ooking)
Moto
rbik
eW
ork
accid
ent
Moto
r ve
hicle
Bicyc
le
Assau
lt
Anim
al (e
.g. b
ite)
Pedes
tria
n
Oth
er
Pe
rce
nt
of
inju
red
sa
mp
le (
we
igh
ted
)
Injuries causing disability -
circumstances
28.6
41.6
20.0
0.0 0.0
4.5
0.0 0.84.5
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
Home (e
.g. c
ooking)
Moto
rbik
eW
ork
acci
dent
Moto
r veh
icle
Bicyc
le
Ass
ault
Ani
mal
(e.g
. bite
)Ped
estr
ian
Oth
er
Pe
rce
nt
of
inju
red
sa
mp
le (
we
igh
ted
)
Illness - source of care when ill
51.5
28.1
11.16.6
1.2 0.9 0.6 0.00.0
10.0
20.0
30.0
40.0
50.0
60.0
Hospita
lLo
cal c
linic
Pharm
acis
tN
o car
e so
ught
Oth
er d
octo
r
Dentis
t
Oth
er
Trad
itional
hea
ler
Pe
rce
nt
of
illn
ess
sa
mp
le (
we
igh
ted
)
Illness – reasons for no medical
care
64.8
25.4
4.3 3.6 1.8 0.10.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Couldn't
affo
rd it
Prefe
r ot
her ca
reTo
o far
to tr
avel
Not se
rious
enou
gh
Oth
erNo a
ppointm
ent
Pe
rce
nt
of
tho
se w
ith
ou
t m
ed
ica
l ca
re
(we
igh
ted
)
Conclusions
• Successful methodology, can be repeated and scaled up in future
• Large amount of valid data for analysis and publication
• Thanks to local student volunteers and to Dr Geoffrey Kasembeli, Dr Chris Barasa, Mr Stephen Wachira (Kenya), Dr Charles Senessie (AEMRN), Dr Saira Khokhar (USA)