Healthcare-use for Major Infectious Disease Syndromes in an Informal Settlement in Nairobi, Kenya.
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Date
2011-04
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Abstract
A healthcare-use survey was conducted in the Kibera informal settlement in Nairobi, Kenya, in July 2005
to inform subsequent surveillance in the site for infectious diseases. Sets of standardized questionnaires
were administered to 1,542 caretakers and heads of households with one or more child(ren) aged less than
five years. The average household-size was 5.1 (range 1-15) persons. Most (90%) resided in a single room
with monthly rents of US$ 4.50-7.00. Within the previous two weeks, 49% of children (n=1,378) aged
less than five years (under-five children) and 18% of persons (n=1,139) aged ≥5 years experienced febrile,
diarrhoeal or respiratory illnesses. The large majority (>75%) of illnesses were associated with healthcareseeking.
While licensed clinics were the most-frequently visited settings, kiosks, unlicensed care providers,
and traditional healers were also frequently visited. Expense was cited most often (50%) as the reason for
not seeking healthcare. Of those who sought healthcare, 34-44% of the first and/or the only visits were
made with non-licensed care providers, potentially delaying opportunities for early optimal intervention.
The proportions of patients accessing healthcare facilities were higher with diarrhoeal disease and fever
(but not for respiratory diseases in under-five children) than those reported from a contemporaneous study
conducted in a rural area in Kenya. The findings support community-based rather than facility-based surveillance
in this setting to achieve objectives for comprehensive assessment of the burden of disease.
Description
Keywords
Acute respiratory infection, Diarrhoeal diseases, Febrile illness, Healthcare-seeking, Healthcareuse, Informal settlements, Pneumonia, Slums, Urbanization, Kenya
Citation
Breiman Robert F, Olack Beatrice, Shultz Alvin, Roder Sanam, Kimani Kabuiya, Feikin Daniel R, Burke Heather. Healthcare-use for Major Infectious Disease Syndromes in an Informal Settlement in Nairobi, Kenya. Journal of Health, Population and Nutrition. 2011 Apr; 29(2): 123-133.