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DIRECTORATE OF CAPACITY BUILDING THE AMREF VIRTUAL NURSING SCHOOL Community Diagnosis Report: Kibagare informal settlements, Westlands. Activity Date: June 2010 COMPILED BY: September 2008 Class, AMREF Virtual Training School, P.O .Box 27691-00506, Nairobi. Tel.6993000 Email:[email protected]
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Page 1: DIRECTORATE OF CAPACITY BUILDING THE AMREF …training.amref.org/images/stories/health action day - kibarage.pdf · DIRECTORATE OF CAPACITY BUILDING THE AMREF VIRTUAL NURSING SCHOOL

DIRECTORATE OF CAPACITY BUILDING

THE AMREF VIRTUAL NURSING SCHOOL

Community Diagnosis Report: Kibagare informal settlements, Westlands.

Activity Date: June 2010

COMPILED BY:

September 2008 Class,

AMREF Virtual Training School,

P.O .Box 27691-00506, Nairobi.

Tel.6993000

Email:[email protected]

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PREAMBLE

The AMREF Virtual Nursing School has been training nurses through eLearning for close to

three years. AVNS aims to provide nursing students across African countries with increased

access to quality nursing education, thus improving health care. As part of its community

health module, AVNS introduced a practical community diagnosis exercise geared towards

equipping the diploma nurse with the critical skills required to deal with community health

needs, designing community health programmes and implementation through a

participatory community approach. A community diagnosis is a means of examining

aggregate and social statistics in a community in order to determine the health needs of

that community. By means of a community diagnosis, a health worker is able to evaluate the

health status of a community and identify priority health needs, then determine the

required plan of action. AVNS nurses carried out a community diagnosis in June 2010 in

Kibagare informal settlements. This was the third community diagnosis to be carried out by

AVNS students. The students with the help of their trainers analyzed the data and came up

with findings which will inform the organization of the health action day.

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1.0 BACKGROUND INFORMATION

Kibagare village is located in Kitisuru sub-location, Kitisuru location of Kangemi division in

Westlands district within Nairobi province. It is approximately fifteen (15) kilometres from

the city centre on the western side of Nairobi. The village is bordered by Loresho estate on

the North & West, Kyuna estate on the South and Nairobi school, Kabete water treatment

works & Communications Commission of Kenya (CCK) to the East. The village (Kibagare) has

approximately (3,000) three thousand households with a total population of around 15,000

people.

Economically most people in the village are casual labourers engaged in menial jobs for daily

upkeep. A few do small scale business like green groceries, food vendors and water vendors.

The main means of communication in the village is mobile telephone and mass media (Radio

& television) .The main means of transport in the community is public transport, hired taxis

and motorcycle (boda-boda) transport. The village gets its water supply from bore-holes

drilled in the area and piped water from Nairobi water company. The dominant social

practices in the community includes church attendance on weekends, weddings and women

group meetings. The community has a few social amenities including churches and a few

private schools.

The community faces a myriad of problems from poor social-economic problems, poor

environmental sanitation (no latrines, poor drainage system), and lack of enough social

amenities such as hospitals, schools and social halls.

1.1 Objectives of community diagnosis

i. To assess the community health status

ii. To assess the health needs of Kibagare community.

iii. To establish the common communicable diseases in the area

iv. To identify the demographic characteristics of the slum dwellers.

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2.0 FINDINGS

2.1 DEMOGRAPHIC CHARACTERISTICS

Men are less (45%) than women (55%). The most dominant age group is 25-59 yrs (31%).

Most of the residents are Christians (99.4%). Only 34% of household heads had a social net.

Table 1: Age and gender distribution

Out of the 104 household that were randomly selected, 36 % had 1-3 members, 35% had 4-

5 members per household and the rest had over 5 members (27%).

Figure 1 : A bar graph showing the number of individuals living in one house

36%

35%

27%

0% 10% 20% 30% 40%

Less than 3

4_5

More than 5

% of households

No

. o

f fa

mil

y m

em

be

rs

NO. OF FAMILY MEMBERS PER HOUSEHOLD

AGE MALE FEMALE TOTAL

Below 5yrs 10% 10% 20%

6-12rys 8% 10% 18%

13-24 yrs 10% 19% 19%

25-59yrs 16% 15% 31%

Above 60rys 1% 1% 2%

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Most of the households (65%) ar

and 7% by others who included grandparents and elder siblings

Figure 2: A pie chart showing heads of house holds

Most residents of Kibagare (63%) have primary edu

education. Respondents with

Figure 3: Level of education

30%

5%

HOUSE HOLD HEADS

30%

LEVEL OF EDUCATION

5

Most of the households (65%) are headed by a male (father), 30% are headed by

included grandparents and elder siblings.

showing heads of house holds

(63%) have primary education with very few (6%) with tertiary

secondary education accounts for 30%.

65%

5%

HOUSE HOLD HEADS

Father

Mother

Other

63%

6%

LEVEL OF EDUCATION

Primary

Secondary

Tertiary

father), 30% are headed by a female

with very few (6%) with tertiary

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Salaried residents accounts for only 20% mo

employed. Self employment is mainly in form of small businesses

consistent source of income.

Figure 4: Sources of income

2.2 ENVIRONMENTAL HYGIENE AND SANITATION

Most of the compounds were

compounds human waste.

Figure 5: Cleanliness of the compound

20%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Salaried

% o

f h

ou

seh

old

s

MAIN SOURCE OF INCOME

0%

Poor

Fair

Good

CO

ND

ITIO

N

CLEANLINESS OF THE COMPOUND

6

Salaried residents accounts for only 20% most of who are casual labourers. 41% are self

Self employment is mainly in form of small businesses. 39% did not mention any

ENVIRONMENTAL HYGIENE AND SANITATION

Most of the compounds were unkempt (71%). There was litter, liquid waste and in some

: Cleanliness of the compound

41%39%

Self Employed Others

SOURCE

MAIN SOURCE OF INCOME

20% 40% 60% 80%

71%

9%

20%

% OF HOUSEHOLDS

CLEANLINESS OF THE COMPOUND

are casual labourers. 41% are self

. 39% did not mention any

(71%). There was litter, liquid waste and in some

80%

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52% of the respondents had a latrine that was functional

fit for use and 33.6% of the housed holds did not have a

the latrines were not in use because they have collapsed or are about to collapse

due to poor maintenance.

LATRINE/TOILET STATUS

Present in use

Present not in use

Absent

Table 2: Presence

85% of the households did not have a hand washing facility

Figure 6: Presence of Hand

Most residents (52%) use water in

basin, 4% use running water only and only 2% use running water and soap.

85%

PRESENCE OF HAND WASHING FACILITY

7

52% of the respondents had a latrine that was functional but shared

fit for use and 33.6% of the housed holds did not have a latrine. It was observed that

were not in use because they have collapsed or are about to collapse

due to poor maintenance.

LATRINE/TOILET STATUS PERCENTAGE

52

14.4

33.6

Presence and use of latrine.

85% of the households did not have a hand washing facility.

of Hand washing facility

Most residents (52%) use water in a basin and soap to wash hands, 41% use plain water in a

basin, 4% use running water only and only 2% use running water and soap.

15%

PRESENCE OF HAND WASHING FACILITY

Present

Absent

but shared, 14.4% were not

latrine. It was observed that

were not in use because they have collapsed or are about to collapse

a basin and soap to wash hands, 41% use plain water in a

basin, 4% use running water only and only 2% use running water and soap.

Present

Absent

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Figure 7

Most households (70%) discard solid waste in the compound, 4% bury,, 4% use

compost pit while 16% use other methods like recycling

METHOD OF DISPOSAL

Burn

Rubbish pit

Compost pit

Scattering

Others

Table 3: Methods of solid waste disposal

The main source of water is piped water (87%).

they are located at different sites in the village.

and river. Most residents (73%) do not use any form of water purification before

drinking only a few boil (15%) and use chemical (12%). The chemical that is

commonly used is chlorine. Other ways included filtering and decantation.

Running water with soap

Running water only

soap and water in a basin

Water in a basin

Me

tho

d o

f h

an

d w

ash

ing

8

7: Methods of hand washing

(70%) discard solid waste in the compound, 4% bury,, 4% use

compost pit while 16% use other methods like recycling.

PERCENTAGE

4

6

4.

70

16

Methods of solid waste disposal

The main source of water is piped water (87%). The water taps are

they are located at different sites in the village. The other sources included borehole

residents (73%) do not use any form of water purification before

drinking only a few boil (15%) and use chemical (12%). The chemical that is

commonly used is chlorine. Other ways included filtering and decantation.

0% 10% 20% 30% 40% 50% 60%

Running water with soap

Running water only

soap and water in a basin

Water in a basin

2%

4%

52%

41%

Proportion (%)

(70%) discard solid waste in the compound, 4% bury,, 4% use

The water taps are communal and

The other sources included borehole

residents (73%) do not use any form of water purification before

drinking only a few boil (15%) and use chemical (12%). The chemical that is

commonly used is chlorine. Other ways included filtering and decantation.

60%

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Figure 8: Methods of water purification

2.3 MATERNAL CHILD HEALTH

All most all the respondents (99%) knew about modern family planning methods

and the same proportion use family planning

facilities (68%). The 34% who

traditional birth attendants or they assist self.

Figure 9: Place of delivery

0%

10%

20%

30%

40%

50%

60%

70%

80%

Boiling

% o

f h

ou

seh

old

s

METHODS OF WATER PURIFICATION

68%

9

thods of water purification

MATERNAL CHILD HEALTH AND NUTRITION

All most all the respondents (99%) knew about modern family planning methods

and the same proportion use family planning. Most residents deliver in health

facilities (68%). The 34% who deliver at home are either assisted by relatives,

traditional birth attendants or they assist self.

: Place of delivery

Boiling Chemicals Others None

Methods

METHODS OF WATER PURIFICATION

34%

Home

Health facility

All most all the respondents (99%) knew about modern family planning methods

Most residents deliver in health

deliver at home are either assisted by relatives,

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The immunization coverage was 74%. Most children are weaned before time (54%).

Figure 10: Age at weaning

The main source of food is the market with starch being the most easily accessed type of

food. Most residents use smoking method of food preservation. Charcoal is the most

common fuel that the residents use. Half of the residents take less than three meals per day.

On general examination, 9% of the respondents were undernourished.

NO. OF MEALS

One(1)

Two(2)

Three(2)

% OF HOUSE HOLDS

22% 28% 50%

Figure 11: Number of meals per day.

2.4 ACCESS TO HEALTH FACILITIES

Walking is the most common means of transport to health facility. The only other mode of

transport is road in which most residents use public vehicles.

54%

45%

0% 10% 20% 30% 40% 50% 60%

Below 6

At 6 and above

% of children

Ag

e i

n m

on

ths

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Figure 12: Means of transport

3.5 EPIDEMIOLOGY

62% of the respondents reported to have had illness in their family in the last 2 weeks.

Respiratory infections, diarrhoeal diseases and Malaria are the most common diseases.

Figure 13: Illness in the house hold

DISCUSSION

The demographic characteristics show that the f

This can be attributed to the time the data collection was d

evening. Many men, Kibagare

gone to work. In addition, the rations also reflect the national proportions (National census

2008). The proportion of Christians also is similar to the finding of the 2008 census.

According to the findings very few house

attributed to two factors. First

56%

MEANS OF TRANSPORT

0%

20%

40%

60%

80%

Present

62%

% o

f h

ou

seh

old

s

Status of illness

PREVALENCE OF ILLNESS

11

62% of the respondents reported to have had illness in their family in the last 2 weeks.

Respiratory infections, diarrhoeal diseases and Malaria are the most common diseases.

: Illness in the house hold in the Last 2 weeks.

The demographic characteristics show that the female respondents were more than men.

This can be attributed to the time the data collection was done; mid morning to mid

Kibagare being a patriarchal society as the findings show, may have

the rations also reflect the national proportions (National census

2008). The proportion of Christians also is similar to the finding of the 2008 census.

According to the findings very few house hold heads have a social net. This may be

First, most of the heads are men who are not expected culturally

94%

0.8%

MEANS OF TRANSPORT

On foot

Public vehicle

Private vehicle

Absent

38%

Status of illness

PREVALENCE OF ILLNESS

Present

Absent

62% of the respondents reported to have had illness in their family in the last 2 weeks.

Respiratory infections, diarrhoeal diseases and Malaria are the most common diseases.

e more than men.

one; mid morning to mid

ty as the findings show, may have

the rations also reflect the national proportions (National census

2008). The proportion of Christians also is similar to the finding of the 2008 census.

hold heads have a social net. This may be

the heads are men who are not expected culturally

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to form social groups like females are. The other factor is that Kibagare is an urban slum and

therefore people may be reluctant to form social groups due to the high migration rate as

well the weak social associations that characterize most urban slums.

The modal class for family size is 1-3. This relates well with the high awareness and

utilization of family planning. However it is important to note that the most dominant age

group is 24-59 years; this can change future trends as it means most families are in the

expansive stage.

Most residents of Kibagare have attained primary level of education. This may be associated

with the low economic status (only 20% are salaried) but also to the accessibility of schools

having only private schools in the slum. On the other hand, the low level of education could

also be contributing to the low economic status as most of the residents cannot get

professional jobs.

Even though most respondents reported to have a latrine, these latrines are shared by

several households. Sharing of latrines is a risk factor to transmission of diarrhoeal diseases

and other faecal oral transmitted diseases. This is made worse by the poor methods of hand

washing the community uses and also the failure to purify water for drinking. All these can

be the contributing factors to the high prevalence of diarrhoeal diseases as reported by the

respondents.

The method of waste disposal (crude tipping) explains why most compounds were not

clean. The congestion of houses and overcrowding of people in the slum may make waste

generation to be higher than it is possible to dispose it bearing in mind the social economic

status of the community. However, cheaper methods like controlled tipping can be pursued.

The high utilization of family planning and the high immunization coverage together with

the health seeking behaviour of Kibagare community can be linked to the accessibility of the

health centre. The health centre is located approximately 5km from the slum and

considering the main mode of transport (walking) most people can access the health

services. However, in case of mothers in labour it may be cumbersome to walk to the health

facility no wonder a good number (34%) have home deliveries.

CONCLUSION

There are many health problems facing Kibagare slum that requires multisectorial approach

and rigorous community participation.

RECOMMENDATIONS

1. There is need for health education on the following:

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• Proper waste disposal

• Water purification

• Management of diarrhoea

• Proper hand washing technique

2. The local government authority and other partners should work to provide proper

means of waste disposal e.g. controlled tipping.

3. Advocacy for skilled birth attendance needs to be intensified.


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