Public Health Data

                                    OUR CURRENT CHALLENGES

Food Insecurity
Most households in Kakamega County only eat one meal a day[1]. 90% of orphaned and vulnerable children in food insecure[2].

Poverty
57% of people in Kakamega County are living in poverty[3], leading to high infant mortality rates, HIV/AIDS, respiratory diseases, malaria (38% prevalence[4]), diarrhea and skin diseases. Respiratory diseases are further exacerbated by use of kerosene lamps, which 92% of households in Kenya use[5].

High Infant & Under 5 Mortality Rates
The infant mortality rate is at 77 deaths per 1,000 live births and the under five mortality is 115/110 live births[6]. This is much higher than the overall infant mortality rate in Kenya at 44 deaths per 1,000 live births[7]. This is likely due to malnutrition.

Malnutrition
40.4% of children in Kakamega County are not adequate height for their age, indicating malnutrition, much of it being protein and mineral deficiency[8]. This increases their likelihood of becoming ill with many infectious diseases, including HIV/AIDS and TB. UNICEF notes the importance of maternal and infant nutrition in the first 1,000 days of life for mental, social and behavioral development throughout life[9]. Overall, in Kenya, 34.8% of children have stunted growth[10]. 76% of children under five years old are Vitamin A deficient, 73% are anemic (low iron) and 55% of pregnant women are anemic[11].

Waterborne Diseases
We have a problematic supply of clean water and resulting high rates of water borne diseases[12]. Every year, 23,000 Kenyans die from diarrheal diseases, many due to unsafe drinking water and lack of proper sanitation[13]. An estimated 70-80% of our local health issues are due to these waterborne diseases[14]. Many of these diseases, such as cholera, flourish during El Nino, which will continue more frequently due to the effects of climate change[15]. The Western Province of Kenya has a diarrhea prevalence rate of 17.2%, which is the 2nd highest in the country[16]. This is 3rd most common cause of death for children under 5 years old[17].  Waterborne diseases often exacerbate malnutrition, by making it more difficult for our bodies to absorb nutrients consumed[18]. Malnutrition makes our bodies less able to fight the waterborne diseases[19]. Bilharziasis is problematic all over Kenya and recommended preventive measures, which are rarely implemented due to cost and resource shortages, include boiling drinking water, wearing shoes and not bathing in fresh water[20]. We have opportunities to greatly enhance health and child survival rates by implementing training in household water collection, treatment, safe storage, sanitation and hygiene and building more pit latrines so that everyone in the community has regular access to a safe latrine[21].

Expensive & Distant Drinking Water
We walk roundtrip about 1,000 meters to 2.4 kilometers every day to get drinking water. This takes about half an hour. We pay $ 0.10 for a 20-liter container and then carry the 20 kg (44 pound) container home.

HIV/AIDS
HIV/AIDS is the leading cause of death in Africa; the compromised immune system is often not strong enough to fight a TB infection. Personal lack of awareness of HIV status is the main contributor to spreading the disease. The HIV prevalence rate in Kakamega County is 23.8%, much higher than the overall prevalence in Kenya[22].

HIV Prevalence

Area

6.6%[23]

Kenya

4.7%[24]

Sub-Saharan Africa

0.8%[25]

Globally

Orphans
Over 2 million orphans (many whom lost parents to HIV/AIDS) and vulnerable children are living in Kakamega County[26].

Violence against Women
Men usually have the decision-making power in our community. An estimated 70% of women in Kakamega County have been victims of domestic violence[27]. Their stated priority concerns are wife battery, widow disinheritance, domestic violence, widow eviction (52%) and defilement[28]. Female circumcision in Kenya is illegal and is on the decline, with 27% of women and girls having had this, tying with Nigeria for 17th place in African countries that practice female circumcision[29]. Women that do not have access to a latrine are more likely to experience violence or sexual assault while looking for a place to relieve themselves in the bush[30].

Lack of Education
Many families cannot afford to send their children to school[31]. Girls are less likely to attend school due to shortage of funds and lack of availability of sanitary napkins[32]. As a result, they lack the necessary knowledge and skills for gainful employment, including entrepreneurship, computer literacy, program monitoring, evaluation skills and market survey skills. Only 3.6% of households in Kenya own a computer and most of them are in urban areas [33]. The majority of our rural youth migrate to the urban areas to access computer and Information and Connections Technology (ICT) trainings, which is costly for the poor youths. Some people end up in doing odd jobs, including prostitution.

Deforestation & Environmental Degradation
Our population has quickly grown and to meet basic needs (including space to grow food and build homes) many trees have been removed for fuel [34].  Kakamega County now only has 1.7% tree cover [35] (compared to overall 10.4% in Kenya[36]). This results in soil and water erosion and loss of arable topsoil. It also has caused changes in the composition of Lake Victoria due to runoff. The impacts of the lack of a carbon buffer (trees) will continue to be exacerbated by the effects of climate change.

Youthful Population
57.8% (or 959,681 people) of Kakamega County population is under 20 years old[37]. With such a young population youth have less access to social capital and financial opportunities.

Import Restrictions
Increasing food security through planting seeds from donors outside of Kenya is challenging due to Kenya Plant Inspectorate Service (KEPHIS) import restrictions[38]. This makes it difficult to accept/import shared food seeds intended to diversify diet, decrease malnutrition and increase sustainability.

Waste Management
Community waste education, waste management policies and waste disposal sites have opportunities for improvement in Kakamega County[39]. One irregular dumpsite in Kakamega County poses public health problems and risks for people who live close by[40]. Some municipalities in Kenya do not have designated disposal sites[41]. In our community every family finds its own way of disposing waste.

Climate Change
We’ve been noticeably experiencing and documenting the effects of climate change in Kakamega County since 2010[42]. Our seasonal patterns have shifted; the rainy season starts later and ends sooner and we have more intense bouts of torrential rain other times of the year[43]. This extreme variability in rainfall causes either drought or flooding and often ruins our food supply, fields and potential income[44]. Soil fertility is increasingly declining, as floods wash nutrients away. This leads to even more poverty, starvation, recalcitrant epidemics, ultimately social unrest and political upheaval[45].

Local inputs to climate change are the pressures of overpopulation; deforestation, intensive monocropping and livestock rearing[46]. The Kakamega County Meteorological Services believes we can mitigate the increasing negative effects using crop rotation, adding manure to increase nutrients in soil, harvesting water, using irrigation, using flood control measures, introducing windbreak trees and providing training and capacity building for the community[47]. The Institute for Security Studies says that irrigation, environmental education and targeted inclusion of women and other vulnerable people are necessary to adapt and build resiliency towards the impacts of climate change[48].

Malaria
Approximately 26.7% of Kakamega County inhabitants use bed nets and 38% have malaria[49]. Malaria causes about 20% of all deaths for children under five years in Kenya and pregnant women are most susceptible to infection; this can cause a variety of developmental problems with the fetus and poor perinatal outcomes[50]. HIV infection makes malaria infection even more likely[51]. Incidence of malaria infection is expected to increase due to flooding events associated with climate change[52].


[1] Sayo, 2013[2] Elite Community Based Organization, 2011[3] Kenya Mpya[4] West FM 2012[5] sunny money[6] Elite Community Based Organization, 2011[7] CIA World Factbook, n.d.[8] Commission on Revenue Allocation, 2011[9] West Fm, 2012[10] Scaling Up Nutrition, 2013[11] Republic of Kenya Ministry of Public Health and Sanitation, 2012[12] Marshall, 2011[13] Nation Reporter, 2013; UNICEF, 2005[14] Kenya Aid Progamme, 2009[15] Olago  et al., 2007[16] PATH, n.d.[17] PATH, n.d.[18] UNICEF, 2005[19] Olago, 2007 [20] Maosa, n.d.[21] Kioki & Oribi, 2012[22] National Coordinating Agency for Population and Development, 2005[23] Ngetich, 2013[24] Henry J. Kaiser Family Foundation[25] Henry J. Kaiser Family Foundation[26] Elite Community Based Organization, 2011[27] Fida Kenya, 2012[28] Fida Kenya, 2012[29] UNICEF, 2013[31] Elite Community Based Organization, 2011[32] Elite Community Based Organization, 2011; UNICEF, 2012[33] Kenya National Bureau of Statistics, 2009[34] Wanyonyi, 2013[35] Sayo, 2013[36] United Nations Environment Programme, 2012[37] Kenya Open Data, n.d.[38] KEPHIS, n.d.[39] National Coordinating Agency for Population and Development, 2005; Muniafu & Otiato, 2010[40] Standard Digital, 2013[41] National Environment Management Authority- Kenya, 2008[42] Nganyi, n.d.[43] Nganyi, n.d.[44] Institute for Security Studies, 2010; Nganyi, n.d.[45] Institute for Security Studies, 2010; Nganyi, n.d.[46] Nganyi, n.d.[47] Nganyi, n.d.[48] Institute for Security Studies, 2010[49] Kenya Open Data, n.d.; West fm, 2012[50] KEMRI, 2014; Uneke, 2007[51] Uneke, 2007[52] Omukubi & Kamau, 2011

References

Central Intelligence Agency (n.d.). The World Factbook. https://www.cia.gov/library/publications/the-world-factbook/

Elite Community Based Organization. (2011). Kakamega County Orphan and Vulnerable Children Proposal. http://elite-ovc.blogspot.com/2011/07/kakamega-county-orphan-and-vulnerable.html

Henry J. Kaiser Family Foundation. (2013). The Global HIV/AIDS Epidemic. http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/

Institute for Security Studies. (2010). The impact of climate change in Africa.

KEMRI. (2014). Kenya Malaria Fact Sheet. http://www.kemri.org/index.php/help-desk/search/diseases-a-conditions/29-malaria/113-kenya-malaria-fact-sheet

Kenya Aid Progamme. (n.d.) Disease in Kenya. http://www.kenyaaidprogramme.org.uk/about-us/disease/

Kenya Mpya. (2012). Welcome to Kakamega County. http://www.kenyampya.com/index.php?county=Kakamega

Kenya National Bureau of Statistics. (2009). Kenya 2009 Population and Housing Census Highlights. http://www.knbs.or.ke/Census%20Results/KNBS%20Brochure.pdf

Kenya Open Data. (n.d.). County Data Sheet Kakamega. Bed Nets and Illness, by County. https://www.opendata.go.ke/Health-Sector/Bed-Nets-and-Illness-by-County/akug-z4w2

Kenya Open Data. (n.d.). County Data Sheet Kakamega. https://opendata.go.ke/facet/counties/Kakamega

Kioki, K., J. & Obiri, J. F. (2012). Jamba: Journal of Disaster Risk Studies, 4(1). http://www.jamba.org.za/index.php/jamba/article/view/49/95

Maosa, P. (n.d.). Combating Schistomsomiasis. Nairobi Digest. http://nairobidigest.co.ke/combating-schistosomiasis/

Marshall, S. (2011). The Water Crisis in Kenya: Causes, Effects and Solutions. Global Marjority E-Journal, 2, pp 31-45. http://www.american.edu/cas/economics/ejournal/upload/Global_Majority_e_Journal_2-1_Marshall.pdf

Maxson, M. (2011). Interactive NGO Community Maps in Western Kenya. http://chewychunks.wordpress.com/2011/05/09/interactive-ngo-community-maps-in-western-kenya/

National Coordinating Agency for Population and Development. (2005). Kakamega District Strategic Plan 2005-2010. http://www.ncapd-ke.org/images/stories/districts/Kakamega.pdf

National Environment Management Authority – Kenya. (2008). Waste. http://www.nema.go.ke/index.php?option=com_content&view=article&id=311:waste-management-in-kenya&catid=120&Itemid=659

Nation Reporter. (2013). Daily Nation. Many Kenyans still use bushes to relieve themselves. http://mobile.nation.co.ke/News/Many-Kenyans-still-use-bushes-to-relieve-themselves-report-/-/1950946/2088438/-/format/xhtml/-/r2bmg7z/-/index.html

Nganyi, W. E. A. (n.d.). Kakamega County Climate change, climate variability Trends & Impacts. Kakamega County Meteorological Services. http://www.meteo.go.ke

Nyangena, W. (n.d). Household Participation in Community Forest Associations: Evidence from Kakamega County in Kenya. http://www.landandpoverty.com/agenda/pdfs/paper/nyangena_full_paper.pdf

Olago, D., Marshall, M., Wandiga, S. O. et al. (2007).  Climatic, Socio-economic, and Health Factors Affecting Human Vulnerability to Cholera in the Lake Victoria Basin, East Africa. Ambio, 36. Royal Swedish Academy of Sciences. https://profiles.uonbi.ac.ke/wandigas/files/ambi-36-04-350_olago.pdf

Omukubi, N. & Kamau, D. (2011). First Governor of Kakamega County. Jamhuri Magazine. http://jamhurimagazine.com/index.php/counties/3177-first-governor-of-kakamega-county.html

Oparanya, W. A. (2009). 2009 Population & Housing Census Results. http://www.knbs.or.ke/docs/PresentationbyMinisterforPlanningrevised.pdf

PATH. (n.d.). APHIA II Western Project: Best Practice and Promising Interventions.    http://www.path.org/publications/files/CP_kenya_a2w_bp_rpt_sec_3_5.pdf

Protection of the Human Environment Task Force on Climate ad Health. World Health Organization Sustainable Development and Healthy Environments. (1999). El Nino and Health. http://www.who.int/globalchange/publications/en/elnino.pdf

Uneke, C. J. (2007). Impact of Placental Plasmodium falciparum Malaria on Pregnancy and Perinatal Outcome in Sub-Saharan Africa. II: Effects of Placental Malaria on Perinatal Outcome; Malaria and HIV. Yale Journal of Biologoy and Medicine 80, pp. 95-103. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2248298/pdf/yjbm_80_3_95.pdf

United Nations Environment Programme. (2012). How much forest cover Kenya? http://www4.total.fr/pdf/AMO/Kenya/ecochallenge/the%20expert%20corner/C-Lambrechts-UNEP-Forest-cover-Kenya-overview.pdf

UNICEF (2005). UNICEF water, sanitation and hygiene strategies 2006-2015. http://www.unicef.org/about/execboard/files/06-6_WASH_final_ODS.pdf

UNICEF. (2013). Female Genital Mutilation/Cutting.  http://www.unicef.org/protection/57929_58002.html

UNICEF. (2012). WASH in School Empowers Girls’ Education: Proceedings of the Menstrual Hygiene Management in Schools Virtual Conference 2012. http://www.unicef.org/wash/schools/files/WASH_in_Schools_Empowers_Girls_Education_Proceedings_of_Virtual_MHM_conference%281%29.pdf

Republic of Kenya Ministry of Public Health and Sanitation. (2012). National Nutrition Action Plan 2012-2017. http://scalingupnutrition.org/wp-content/uploads/2013/02/Kenya_KNN_Action-Plan_2012_2017.pdf

Sayo, C. (2013). NGO to develop a County Land Use Plan for Kakamega.http://m.news24.com/kenya/MyNews24/NGO-to-develop-a-County-Land-Use-Plan-for-Kakamega-20130717

Scaling Up Nutrition. (2012). Wanyonyi, R. W. (2012). Impact of Human Population on Land Degradation in Former Lugari District, Kakamega County, Kenya. http://ir-library.ku.ac.ke/handle/123456789/6875

Self Nutrition Data. (2013). Game meat, rabbit, wild, cooked, stewed. http://nutritiondata.self.com/facts/lamb-veal-and-game-products/4650/2

Self Nutrition Data. (2013). Sweet potato, cooked, baked in skin, without salt. http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2667/2

Standard Digital News. (2013). Residents in Kakamega county want dumpsite relocated. http://www.standardmedia.co.ke/ktn/video/watch/2000069460/-residents-in-kakamega-county-want-dumpsite-relocated?articleID=420

Uneke, C. J. (2007). Impact of Placental Plasmodium falciparum Malaria on Pregnancy and Perinatal Outcome in Sub-Saharan Africa. II: Effects of Placental Malaria on Perinatal Outcome; Malaria and HIV. Yale Journal of Biologoy and Medicine 80, pp. 95-103. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2248298/pdf/yjbm_80_3_95.pdf

West fm. (2012). Malaria prevalence cases reduced to 38% in Kakamega County. http://www.westfm.co.ke/index-page-news-bid-8544.htm

West fm. (2012). Sh. 1/35 billion for fighting malnutrition in Kakamega County. http://westfm.co.ke/index-page-news-bid-9604.htm

World Health Organization. (2013). Progreass on Sanitation and Drinking-Water 2013 Update. http://www.childinfo.org/files/JMP2013Final_Eng.pdf