Summary report of a community health survey carried out in Bungoma county, western Kenya in August 2013 by Afro-European Medical & Research Network (AEMRN)

1. Report on a
Community Health Survey
Bungoma County, Kenya
August 2013

2. 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

3. 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

4. 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

5. The survey team

6. Location and sample
Sample
Pop.
%
227
4445
5.1
107
5229
2.1
Matisi
121
7050
1.7
All areas
464 29145
1.6
Households
Bungoma South
Mateka
Lumboka
Muanda
Bungoma West
Menu
Namwela

7. Characteristics of housing
Percent of households
Floor material
100
90
80
70
60
50
40
30
20
10
0
Bungoma South
Bungoma West
Matisi
Earth
Cement
Carpet
Other
Percent of households
Roof material
100
90
80
70
60
50
40
30
20
10
0
Bungoma South
Bungoma West
Matisi
Mabati
Makuti
Other

8. Water and sanitation
Percent of households
Source of water
100
90
80
70
60
50
40
30
20
10
0
Bungoma South
Bungoma West
Matisi
Public Covered Covered Open Piped Piped
tap
well in public public into plot into
plot
well
well
home
Other
P ercent of households
Type of toilet
100
90
80
70
60
50
40
30
20
10
0
Bungoma South
Bungoma West
Matisi
Pit latrine
VIP latrine
Other

9. Percent of households (weighted)
Main source of drinking water
70
65.8
60
50
40
30
20
10
11.2
5.4
9.0
1.8
1.8
3.6
1.4
0
Open
Public Covered Covered Open
tap well - in well - well - in well public
plot
public
plot
Piped - Piped - Lake,
into river or
into
home spring
plot

10. Sanitation – type of toilet
Percent of households (weighted)
70
66.1
60
50
40
31.1
30
20
10
2.7
0.1
0
Pit latrine
VIP latrine
Flush toilet
None

11. Sanitation - sharing
Percent of households (weighted)
70
62.6
60
50
37.4
40
30
20
10
0
Shared
Not shared

12. 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.

13. Frequency of illness in past year
Percent of interviewees (weighted)
40
35
36.6
32.1
30
22.5
25
20
15
8.8
10
5
0
Never
Once
Several times
Continuously

14. 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.

15. Adult respiratory illness in past month
Percent of households (weighted)
70
57.8
60
50
40.6
40
30
20
11.8
10
0
Interviewee
Anyone in household
No-one in household

16. 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?

17. Malaria in past year
Percent of households (weighted)
70
62.1
59.3
60
50
40
30
19.3
20
10
0
Interviewee
Any adult in household Any child in household

18. 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.

19. Long-term disability
Percent of households (weighted)
100
88.5
90
80
70
60
50
40
30
20
10
10.1
4.1
0
Interviewee
Any adult in
household
No adult in household

20. Percent of disabled sample (weighted)
Long-term disability – by function
80.0
70.0
67.2
60.0
50.0
40.0
30.0
20.0
14.1
7.7
7.4
10.0
1.8
1.8
0.0
Mobility
Mental
Hearing
functioning
Vision
Other
Multiple

21. 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.

22. Injury in past year
Percent of households (weighted)
90
81.9
80
70
60
50
40
30
16.3
20
10
4.4
0
Interviewee
Anyone in household
No-one in household

23. Injury caused a long-term disability
Percent of injured sample (weighted)
90.0
79.6
80.0
70.0
60.0
50.0
40.0
30.0
20.0
16.8
10.0
0.0
Yes
No

24. (e
.g
.
co
o
kin
10.0
3.0
Ot
he
r
ite
)
Pe
de
st
ria
n
t
11.0
e.
g.
b
5.0
3.8
al
(
15.0
As
sa
ul
20.0
An
im
35.0
Bi
cy
c le
g)
M
ot
or
W
bi
or
ke
ka
cc
id
en
M
ot
t
or
ve
hi
cle
Ho
m
e
Percent of injured sample (weighted)
Injuries - circumstances
32.2
30.0
25.0
18.2
15.2
11.5
4.9
0.2
0.0

25. (e
.g
.
co
o
kin
0.0
0.0
Ot
he
r
As
sa
ul
al
t
(e
.g
.b
ite
)
Pe
de
st
ria
n
0.0
An
im
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
Bi
cy
cle
g)
M
ot
or
W
bi
or
ke
ka
cc
id
en
M
ot
t
or
ve
hi
cle
Ho
m
e
Percent of injured sample (weighted)
Injuries causing disability circumstances
41.6
28.6
20.0
4.5
4.5
0.8

26. na
lh
ist
ea
ler
0.9
Ot
he
r
De
nt
1.2
Tr
ad
iti
o
gh
t
oc
to
r
so
u
10.0
Ot
he
rd
ca
re
ac
is t
20.0
No
ar
m
lin
ic
30.0
Ph
al
c
60.0
Lo
c
Ho
sp
ita
l
Percent of illness sample (weighted)
Illness - source of care when ill
51.5
50.0
40.0
28.1
11.1
6.6
0.6
0.0
0.0

27. dn
'
ap
p
oi
nt
m
en
t
3.6
Ot
he
r
no
ug
h
tra
ve
l
4.3
No
us
e
fa
rt
o
10.0
se
rio
To
o
it
er
ca
re
ffo
rd
30.0
No
t
ta
70.0
er
ot
h
ul
Pr
ef
Co
Percent of those without medical care
(weighted)
Illness – reasons for no medical
care
64.8
60.0
50.0
40.0
25.4
20.0
1.8
0.1
0.0

28. 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)