RP-Department of Environmental Health

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Browsing RP-Department of Environmental Health by Author "Keraka, M."

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    The background, social support and behavioural characteristics associated with health insurance coverage among the older population in Kisii County, Kenya
    (2012-07) Nyagero, J.; Gakure, R.; Keraka, M.; Mwangi, M.; Wanzala, P.
    Introduction: Universal health coverage has increasingly become the focus for improved health systems worldwide. In Kenya, the older populations are characterized by low health insurance coverage, resulting in either limited access to quality health care services or catastrophic expenditure on health. This paper seeks to assess the background, social support and behavioural characteristics that are associated with being insured among the older population. Methods: A two level random cluster sampling technique was used to select two rural sites in Kisii County and 1,104 older persons interviewed. The Pearson chi square and the adjusted odds ratio at 95% confidence interval computed in the binary logistic regression was used to analyze the data. Results: Only 5.9% of the older population had been insured. The multivariate regression model found that health insurance coverage was significantly associated with secondary school level of education (p<0.001, AOR 3.68, 95% CI 1.92 7.07), employment history (p=0.002, AOR 2.64, 95% CI 1.43 4.86); being a member of a social welfare group (p=0.002, AOR 3.03, 95% CI 1.51 6.08) and taking of alcohol (p=0.050, AOR 1.85, 95% CI 1.00 3.33). Conclusion: Health insurance coverage remains low among the older population in rural Kenya. Contrary to previous studies, social support such as from the adult children and relatives do not significantly influence being insured among the older population. There is need to enhance the number of older persons who are insured through strengthened sensitization of social support and health promotion.
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    Child Morbidity and Mortality in Slum Environments along Nairobi River
    (Organization for Social Science Research in Eastern and Southern Africa, 2003) Keraka, M.; Wamicha, W. N.
    The problem that guided this study was that child mortality and morbidity disparities continue to be observed in the era of improved expansion of the provision of health care services. Some areas have low mortality and morbidity while others such as the slums of Nairobi have high. Various factors may account for this scenario. On the one hand, this would be because of uneven distribution of health facilities. On the other hand, environmental factors may be the major contributors to this high rate of morbidity and mortality. Environmental factors have been analysed in thecontext of socio-economic, socio-cultural and health environments. The aim of this study was therefore to examine the impact of slum environments on morbidity and mortality profile in slum environments along Nairobi River. The main objectives were: first, to assess the influence of environmental factors on child morbidity and mortality, and second, to analyse the influence of the perception and behaviour patterns of slum dwellers on child mortality and morbidity. The data used in this study was collected using in-depth interviews and extensive literature review. The key findings of the study included the fact that poverty is a major factor in child morbidity and mortality. It is because of low-income levels that the families concerned were not able to improve the sanitation that was in turn going to improve the health status of the children. The study therefore recommended that the government should give small loans to slum dwellers, which they can use to start income- generating activities. This can help generate some money that may improve childcare practices.