\(
OPPORTUNITIES AND CHALLENGES OF COMMUNITY-BASED FOREST
RESOURCE CONSERVATION IN NARO MORU ECOSYSTEM, MOUNT
KENYA II
.•. {(
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LGATHIMA, VERONICAH NGlMA (B.ED)
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I
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N50/12584/05
A thesis submitted in partial fulfilment for the Degree of Master of Environmental
Studies (Community Development) in the School of Environmental Studies of
Kenyatta University.
November 2008
-
Gathima, Veronica
Opportunities and
challenges of
1"111111111111111111111111111111112009/339327
DECLARATION
This thesis is my original work and has not been presented for a degree or any other
award
Signature: ~\,-~.:..:.:....:~--'-- _ Date: I f I ~'L...--D~_
Gathima Veronicah Ngima
We confirm that the candidate under our supervision carried out the work reported in
this thesis.
Signature: --P~~~=~--- Date: &tlrJ,-=-p=--g __
Dr. Nelson Mango
Department of Environmental Studies (Community Development)
Signature: ---'-----=---!r-I+-f----- Date:-~~-------
Dr. Fuchaka Waswa
Department of Environmental Studies (Community Development)
11
DEDICATION
This work is dedicated to my dear husband Robert Gathigani and our loving children
Lorna and Amy.
III
ACKNOWLEDGEMENT
I wish to acknowledge and appreciate the contribution of the following people in this
study. First, my sincere gratitude goes to my supervisors, Dr.Nelson Mango and
Dr.Fuchaka Waswa, for their keen supervision, scholarly advice and sustained interest
they showed in my work.
Secondly, I thank members of Kenya Forests Working Group and Forest Action
Network for their support. Special thanks to the community at Naro Moru who made
my research work successful.
Finally, I wish to thank my family for the support and encouragement they gave me
throughout the study period particularly my husband Robert Gathigani and my brother
Paul Kamore. My colleagues, who were a real source of encouragement and moral
support. In particular, I thank Peter Mureiithi, Loise and Rachel Diang'a.
Above all, to the Almighty God whose sufficient grace enabled me to have good
health, time and resources to undertake this study.
iv
TABLE OF CONTENTS
DECLARA TION ..................•.....•.......................................................................................... i
DEDICATION •...................................•.••.....•...............................•••••...•..•......•....................••ii
ACKNOWLEDGEMENT iii
TABLE OF CONTENTS .......................................................................•........................... iv
LIST OF TABLES .............................•....••••..••.......•..................................................••••.•....vi
LIST OF FIGURES vii
ABSTRACT .......................••.....•.......••................................................................................. ix
CHAPTER 1: INTRODUCTION 1
1.1 Background to the Study 1
1.2 Problem Statement and Justification 5
1.3 Assumptions 6
1.4 Objectives 6
1.5 Conceptual Framework 7
1.6 Definition of Analytical Concepts 8
CHAPTER 2: LITERATURE REVIEW ,.•................................................. 11
2.1 Introduction 11
2.2 History and Rationale for Community Participation 11
2.3 Lessons on Community Participation in Forest Management 14
2.4 Opportunities and Constraints for Community-based Forest Conservation 18
2.5 Historical Development of Kenya's Forest Policy .20
2.6 An Overview of the Kenya Forest Act, 2005 ; 24
2.7 Rationale for Community-based Forest Conservation .25
CHAPTER 3: METHODOLOGY ........••••................•..••••...............•••••................••.•••......28
3.1 Study Area Characteristics 28
3.2 Choice of the Site 30
3.3 Target Population and Sampling Procedure 31
3.4 Data Collection Methods and Instruments .32
3.5 Data Management and Analysis Method .34
vCHAPTER 4: RESULTS AND DISCUSSION .............................•.....••.••...••..................36
4.1 Socio-economic Characteristics ofthe Sampled Population 36
4.2 Involvement of the local community in conservation of Mount Kenya forest .41
4.3 Benefits Accrued from Mount Kenya Forest .48
4.4 Main Hindrances to Community Involvement in Forest Conservation 55
4.5 SWOT Analysis of Community-based Forest Conservation 61
CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS 66
5.1 Introduction 66
5.2 Conclusions 66
5.3 Recommendations 67
5.4 Recommendation for Further Research 68
6. REFERENCES ...................................................................................................•.....•..... 70
7. APPENDICES ..........................................................................................................•..... 73
Appendix 1. Questionnaire for the Community 73
Appendix 2. Questionnaire for the Key Informants 77
VI
LIST OF TABLES
Table 3.1 Key informants 31
Table 4.1 Socio-economic characteristics ofthe sampled population 37
Table 4.2 Gender daily calendar ofNaro Moru community 38
Table 4.3 Pearson correlation coefficient (r) values for respondent's age and
awareness ofthe benefits of Mount Kenya forest 39
Table 4.4 Historical timeline output .40
Table 4.5 Pearson's correlation coefficient for respondents perception on selected
forest management activities 41
Table 4.6 Pearson correlation coefficient (r) values for respondents belonging to
conservation groups and involvement in forest conservation .45
Table 4.7 Frequency of community participation in various conservation activities ..47
vii
LIST OF FIGURES
Figure 1.1: Conceptual framework for community participation in forest resource
conservation 7
Figure 3.1 Map Showing Mount Kenya Forest, Naro Moru Area in Nyeri District.. ..29
Figure 4.2 Frequency of community participation in forest conservation from 2001-
2004 42
Figure 4.3 Community-based forest conservation groups in Naro Moru area of Mount
Kenya forest and the membership among sampled population .43
Figure 4.4 Major activities of community-based forest conservation groups in the
study area 44
Figure 4.5 Respondents obtaining different benefits from Mount Kenya forest, Naro
Moru 49
Figure 4.6 Indirect user benefits ofthe forest to the local community 52
Figure 4.7 Challenges to community participation in forest conservation 56
Figure 4.9: SWOT analysis variables for community-based forest conservation 62
CBO
DDC
DDP
EIA
FAO
FD
FGD
GoK
HWC
IUCN
KEFRI
KFS
KWS
MDG
NGO
NRC
PRA
SWOT
viii
ACRONYMS AND ABBREVIATIONS
Community-based Organization
District Development Committees
District Development Plan
Environmental Impact Assessment
Food and Agriculture Organization of the United Nations
Forest Departments
Focus Group Discussion
Government of Kenya
Human Wildlife Conflicts
International Union for Conservation of Nature
Kenya Forestry Research Institute
Kenya Forest Service
Kenya Wildlife Service
Millennium Development Goals
Non-governmental Organization
Non-resident Cultivation
Participatory Rural Appraisal
Strengths Weaknesses Opportunities and Threats
IX
ABSTRACT
In spite of its significant role in soil and water conservation, production of wood and
non-wood products, carbon sequestration, conservation of biodiversity and social
benefits, the status of Mount Kenya forest ecosystem has deteriorated due to
unsustainable exploitation. Most interventions aimed at forest management in the area
have tended to ignore the participation of local communities, despite their significant
role, towards the sustainability of forests. This study investigated opportunities and
challenges towards community-based forest conservation. The area of study Naro
Mom forest,Mt Kenya was chosen, purposively, due to the serious threats facing the
forest ecosystem. The target population was the communities living adjacent to the
forest. At least 30 respondents were randomly selected from' four villages
neighbouring the forest, giving a sample size of 120. Specific tools used in data
collection were questionnaires, key informant interviews, focus group discussions and
transect survey. Data collected was both quantitative and qualitative in nature and was
analysed using descriptive and inferential statistics. ~lts-from this study
indicated that community involvement in forest conservation is inadequate. The major
forest conservation activity in which the community was involved was agro-forestry
(40%). Up to 87% of the respondents stated that the community has the capacity to
manage the forest resources. Supply of heating and cooking fuel was the major use of
the forest by the local community, and all the respondents interviewed used the forest
for this purpose. Most farmers (71%) strongly agreed that the shamba system was
vital in availing forest resources like wood and land for agriculture to the community
and recommended for its reinstatement by the government. Community members in
conservation groups were more likely to be involved in forest conservation activities
such as management meetings (r=0.54, p=O.Ol, n=120) and reforestation (r=0.55,
p=O.Ol, n=120). More educated respondents were less likely to be involved in forest
conservation (r=-0.22, p=0.05, n=120). The greatest hindrance to community
participation in forest resource conservation was government control over the use of
forest resources as cited by 33% of the respondents. Policy interventions in forest
management should be aimed at improving community participation in conservation
activities, reducing forest ecosystem degradation, and improving community well-
being.
/
1CHAPTER 1: INTRODUCTION
1.1 Background to the Study
Involvement of local people in partnership with other stakeholders in management
and conservation of forest resources is the key to sustainable utilization of these
resources (Maathai, 1988). According to FAO (2000a), public agitation for
community-based natural resource management began in most African countries in
the repressive natural resource loss from their colonial pas~.The forest laws that came
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to be applied in the post-independence era alienated local- communities' rights to
claim ownership of the forest, putting control to use of resources whose access used to
\,
be free. Since then, the government has been responsible for forest management with
minimal involvement of local communities and other stakeholders, despite their
wealth of indigenous knowledge and constant touch with forest resources. When the
government took over the control of forest resources, local forest management
arrangement, which had existed under traditional tribal law, were effectively
weakened (Brookhaven and Gathaara, 1995). The forests thus became open access
areas leading to unsustainable exploitation and utilization, especially, illegal
commercial lumbering and excision for infrastructure development. Community-
based forest management strategy arose during the 1990s in response to recognition
that existing state-initiated resource management and development strategies were not
succeeding. Community-based natural resource conservation and development
recognizes the need for the involvement of rural communities in the decision-making
process pertaining to natural resource management and conservation.
In the last three decades, Kenya has experienced rapid and severe forest degradation.
As the Kenyan state gradually increased its control over forest resources, the
2community's rights to manage and utilize forest resources have progressively
decreased. At the same time, both commercial and local demand for forest resources
has grown. The 1990s saw the beginning of a shift towards community-based forms
of forest management. This was in response to the perceived need to halt processes of
forest loss and to conserve forest resources in a way that both involves and benefits
the forest-adjacent human population. According to GoK (1994), the Kenya forestry
master plan laid emphasis on sustainable forestry development and recognized
community involvement in forest management. The master plan recommended the
revision of the forest policy and legislation to enable communities and other
stakeholders participate in management of Kenyan forests. The revised Kenya forest
Act (2005) provides for community involvement in forest management.
In 1910, Kenya's colonial administration introduced the shamba system to provide
raw materials for the expanding timber industry, reduce pressure on natural forests by
means of cheap or free labour, and increase employment among technically low-level
community members (Kenya Wildlife Service, 1999). Shamba system is a form of
agro forestry by which farmers cultivate crops on previously cleared forestland as
they replant the forest trees. After three years of cultivation, and when the trees have
grown enough to shade the crops, the farmers are moved out of the allocated plot and
are given another forest plot to be cleared. The cultivated land is returned to the forest
reserve. The system has been banned, on various occasions, due to the degradation of
the forest where it is practiced. This is because, to ensure continued presence of land,
farmers do not replant trees and the land does not return to the reserve.
According to Kagombe and Gitonga (2005), Shamba system practices have changed
over time. From 1910 to 1975, forest· cultivators were integrated into the Forest
3Department (FD) as resident workers. They were allocated forest plots, or"shambas",
and guaranteed work for nine months per year. The produce from the shambas was
considered part of workers' emolument as they tended the young trees. The system
was revised in 1975, when resident workers were permanently employed by the
FD,and required to rent shambas. Offers of tenancy were extended to others as well.
The number of cultivators thus rose significantly, and supervision became
problematic. Many of the new cultivators did not understand the shamba system, and
tree survival rates were low. The system was consequently banned by presidential
decree in 1987, and in 1988 all forest residents were evicted from forest areas.
However, no arrangements were put in place to continue with plantation
establishment and management. Reforestation programmes stagnated. Less than 20%
of clear-felled areas were replanted; 80% of replanted areas were not weeded. The
situation was aggravated by the 1994 civil service retrenchment programme, leading
to an acute shortage of labour in forest stations. ibid
In response to the increasing backlogs and inadequate resource capacity within the FD
to re-establish plantations, the shamba system was reorganized and reintroduced in a
few districts as Non-Resident Cultivation (NRC) in 1994. Under the newsystem,
cultivators were not allowed to reside in forest areas, and the final authority in the
management of NRC was vested with District Development Committees (DDC). By
1997, NRC had started in all major forest plantation districts in the country. The new
system also struggled. The strong influence of politicians and administrators in the
DDCs overshadowed advice from technical departments. By 1999, large areas - some
unsuitable for plantation establishment - had been cleared for cultivation, with little
meaningful replanting of trees.In 2000, the FD Headquarters reissued NRC
4management guidelines and established an inter institutional task force with
representation from the FD, the Kenya Forestry Research Institute (KEFRI), Kenya
Wildlife Service (KWS) and the Nyayo Tea Zones and Development Corporation
(NTZDC) to review the implementation ofthe NRC.( Kagombe and Gitonga ,2005)
Mount Kenya Forest is one of the largest, most ecologically significant and
commercially important natural forest areas in Kenya and is considered to be among
the highest priority forests for national conservation (Wass, 1995). The Forest
Reserve surrounds Mount Kenya National Park, which contains the second highest
mountain in Africa at 5 199 meters above sea level, and a variety of wildlife species
some of which are indigenous and endemic (Emerton, 1999). The forest forms a
major water catchment area from which two ofthe country's five river basins rise: the
Tana and Ewaso Nyiro. These basins supply water to more than a quarter of Kenya's
human population and more than half of the country's land area (Wass, 1995). The
forest spans Embu, Kirinyaga, Meru, Nyeri and Tharaka Nithi districts of the central
highland zone of Kenya, one of the most agriculturally fertile and densely populated
parts of the country. More than 200 000 people live within 1.5 km of the edge of the
forest. Levels of rural poverty are high, while land is extremely scarce, thus informing
the rather high dependence on forest resource for their livelihoods (Emerton, 1996).
Mt. Kenya forest is among the most threatened forests in the country because of its
commercially valuable reserves of indigenous timber, and due to the large human
population living in the land-scarce area around its boundaries (Emerton, 1999).
Rapidly increasing population and thus local and commercial needs for forest
products and agricultural land have placed severe pressure on forest resources at
5Mount Kenya especially Naro Moru area. There have been major changes in forest
composition and cover due to commercial lumbering of valuable species without any
clear regeneration process (Bussmann, 1996). Although originally gazetted to
safeguard commercial timber interests, environmental protection has become an
increasingly important reason for conservation of Mount Kenya Forest.
The current shift towards a paradigm of community-based conservation for Mount
Kenya Forest Reserve is based on a strong economic rationale. that forest-adjacent
communities who face binding livelihood constraints including wide scale poverty,
land pressure and lack of development opportunities currently have a high
dependence on forest resources for both income and subsistence (Emerton, 1999).
Although community-based forest management schemes have been established with
considerable benefits to community income levels and forest conservation, full
community participation has not yet fully been realised. This is because community
members have very limited access to forest resources, usually, under strict supervision
from Forest Department and Kenya Wildlife Service officials.
1.2 Problem Statement and Justification
The government's forest department now Kenya Forest Service has largely failed to
contain forest resource degradation in Naro Moru area. As such, participation of local
communities is a practical necessity towards the achievement of sustainable forest
conservation and management. Failure to involve communities who, through
enjoyment of forest goods and services, would ensure their conservation has resulted
in top-down approaches leading to conflicts and forest degradation. The shamba
system was also put to an end, which, according to the local community, was a source
6of food for many households. Consequently, the community appears to be developing
a negative attitude towards the forest, seeing it as a valuable resource taken away
from them. Community participation, however, comes along with challenges
regarding the extent to which the community can be involved. Consequently, it is
important to investigate the opportunities and hindrances for community-based forest
conservation in the area with the aim of developing strategies for full community
participation in forest conservation in the area.
1.3 Assumptions
Community participation in forest resource conservation present stakeholders in forest
management with opportunities and challenges, which if well understood and factored
in conservation programs, would enhance sustainable forest resource conservation.
1.4 Objectives
The overall objective of this study was to assess opportunities and challenges of
community-based forest resource conservation in order to promote sustainable forest
ecosystem management for human well:!?5'ing.The specific objectives were:
i. To assess the current level of involvement of the local community in the
conservatio~ of Mount Kenya forest, Naro Moru area
-~
ii. To determine the opportunities for community involvement in forest)
conservation
111. To determine the main hindrances to community involvement in forest
conservation
7iv. To suggest policy interventions towards enhanced community
participation for sustainable forest management and enhanced community
well-being
1.5 Conceptual Framework
Community participation in forest resource management presents various challenges
and opportunities to all stakeholders involved. In most cases, full community
participation in forest resource management is never realised. Consequently, full
ownership and protection by community members is always lacking, leading to
opportunistic exploitation and unsustainable forest resource conservation. This leads
to loss of forest ecosystem goods and services' like clean air, clean water, food, fuel
/
herbal medicine among others. Poverty td human ill being results when the
community cannot access these goods an? services. This enhances unsustainable
forest resource utilisation with little regard to the needs of future generations
(figurel.I).
Inadequate community
participation in forest resource
~ Poverty and increased
Unsustainable forest human ill being
resource utilisation +I Loss of fordst ecosystemI Poor fore~ management I services
Figure 1.1: Conceptual framework for community participation III forest resource
conservation
To reverse this vicious trend would require deliberate investment in participatory
decision-making, hence the need to assess the role of surrounding communities to
pave way for their strategic involvement in nature conservation. On this basis, this
study sought to establish the interrelationships between inadequate community
8participation in forest conservation activities and the resultant negative attitudes
towards the resource, uncontrolled utilisation, loss of the forest ecosystem and the
services it provides. The results were used to suggest policy options towards
sustainable forest resource management.
1.6 Definition of Analytical Concepts
The following definitions apply to the key words as used in this study:
Community: a social system composed of people living in some spatial relationship
with one another and share common history and psychological identification
with the locality and together forms a communication network
Conservation: sustainable use of natural resources; making use of resources in a
manner that does not compromise the ability of future generations to benefit
from the same resources
Environment: totality of nature including land, soil, water, vegetation cover,
livestock, wildlife, minerals, cultural heritage and infrastructure constructed by
humans for settlement and to facilitate social and economic activities.
Participation: a social and political process in which interest groups with often
conflicting interests and bargaining powers interact. It also involves individual
members of a community's guarantee of a fair and equitable share of the benefit
of development; their assurance of the opportunity to contribute to their fullest
capacity and ways most meaningful to them
Resource management: process of decision making whereby resources are allocated
over space and time according to needs, aspirations and desires of man within
the context of his technical innovativeness, political social and institutional
legal and administrative framework
9Forest management: process of decision making whereby critical decisions are made
regarding forest resource use.
Sustainable forest development: means the use of a forest and any of its natural
resources in a manner and to an extent, which does not compromise the capacity
of the forest and its use by future generations, and does not degrade the carrying
capacity of supporting ecosystems
Ecosystem: dynamic complex of plant, animal, micro-organisms communities and
their non-living environment interacting as a functional unit.
Ecosystem services: benefits provided by ecosystems. These include provisioning
services such as food, water, timber, fiber, and genetic resources; regulating
services such as the regulation of climate, floods, disease, and water quality as
well as waste treatment; cultural services such as recreation, aesthetic
enjoyment, and spiritual fulfilment; and supporting services such as soil
formation, pollination, and nutrient cycling.
Household head: person who makes final decisions regarding pertinent issues in a
household
Human well-being: a context and situation dependent state, comprising basic
material for a good life, freedom and choice, health, good social relations and
security
1.7 Organisation of the Thesis
The chapter that follows is a literature review of community participation in forest
management in other parts of the world and Kenya. Chapter 3 presents information
about the research area, the methodology for data collection and materials used.
Chapter 4 presents the findings from the empirical data collected in the field. Chapter
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5 revisits the study objectives followed by a summary of the research findings both
from literature review and primary data. The chapter ends with recommendations for
policy and further research.
11
CHAPTER 2: LITERATURE REVIEW
2.1 Introduction
This chapter provides a review of literature on community participation in forest
management. The first part of the chapter deals with the history and rationale for
community participation in forest management. This is followed by a discussion of
lessons from other parts of the world on community participation in forest
management. The next part of the chapter is devoted to opportunities and constraints
for community-based conservation. This is, again, followed by a discussion of the
historical development of Kenya's forest policy. The fifth part of the chapter gives an
overview of the Kenya forest act. This is followed by a section, in the chapter, that
discusses the economic rationale for community-based forms of forest conservation.
Before concluding the chapter, a discussion is devoted to economic benefits of Mount
Kenya forest as a rationale for community conservation.
2.2 History and Rationale for Community Participation
Over time, indigenous people and local forest dependent communities across the
globe have developed a rich tradition in forest management, as they have been
ancestral custodians of forest ecosystems. For many years, forest policies across the
globe have been based on the notion that local forest users were ignorant and
destructive (World Rainforest Movement, 2002). The state authorities in capital cities
responsible for policymaking looked down on the knowledge and capacities of the
indigenous people and local communities. The fact that the local communities and
indigenous people were the most interested in the forests' conservation as they derive
their livelihood from the forests was ignored. In 1972, the Stockholm Conference
12
recognized forests as the largest, most complex and self-perpetuating of all
ecosystems, and emphasized the need for sound land and forest use policies, ongoing
monitoring of their state and the introduction of forest management planning (UNEP,
2002). In 1978, during the world forestry congress, "forest for the people", a gradual
change of perspective, started to gain acceptance internationally. It was recognized
that those who know more about forests are those who live near them and derive their
livelihoods from them.
According to FAO (2000a), the concept of public participation is defined as the
various forms of direct public involvement where people individually or through
organized groups can exchange information, express opinions and articulate interests
and have potential to influence decisions on the outcome of the specific forestry
issues. Over the last two decades, programmes designed with little reference to
perceptions, and capacities of the local people have often failed (UNCCD fact sheet
2005). Local communities have valuable experience and a special understanding of
their own environment. When the responsibility of natural resource management is
taken away from them their use of forests and other natural resources can become
highly inefficient. The result is often resource degradation. Participatory development
recognizes the rights of the local people over their resources. The local people have
greater stake in improving agricultural productivity while ensuring the long-term
ecological balance of the forest. In addition, local participation in planning and
decision-making is essential for building local capacity.
The unique nature of forest ecosystems has long been acknowledged. Forests are
important both locally and globally as providers of environmental services to human
13
populations for subsistence, commercial purposes, conservation of biodiversity and
for catchment functions. Despite the significant role played by forests, their
conservation status has deteriorated due to unsustainable exploitation. Key threats to
forests are population pressure, uncontrolled logging, encroachment for agricultural
activities, excisions and settlements. Therefore, there is need to reconcile different
local, national and international interests in the forest, particularly, the often
overlooked local interests, and to develop long term and sustainable management
strategies which meet the needs of all sectors of society (Broekhoven and Gathaara,
1995). Sustainable forest management can only be achieved through addressing the
above concerns and active participation of the local communities and co-operation of
the government administration. The forest adjacent communities are the primary users
of forest products and services; hence, their contribution to the resource management
and conservation should not be underestimated.
In Kenya, for a long time, there has been a tendency by the government to see the
state as the key beneficiary of forests. Government forest reserves have been
established and are managed by the government, originally, to supply industrial forest
products and to generate revenue. Forests on government land are managed by local
authorities (district forest reserves or trust land) or by the central government (forest
reserves). Local communities have no formal authority to manage the forest and most
extractive natural forest activities and uses of forestland have been prohibited.
However, deforestation and population growth have continued to exert pressure on
forest resources. Such imbalances of authority and decision-making complicate the
question of rights of different communities. Often, those most dependent on forest
resources have the least power of access and the most limited role in decision making
14
(Ludeki et al., 2006). When the central government took over the control of forest
resources, local forest management arrangements, which had existed under traditional
tribal law, were effectively weakened. Thus, the forests often became access areas for
local people and forest use became based on a free for all situation.
2.3 Lessons on Community Participation in Forest Management
The world summit on sustainable development-held in Bali, Indonesia- focused on
promotion of community-based forest management. The participants committed
themselves to actively promote community forest management as an alternative that is
not only feasible but also socially and environmentally desirable as a solution to the
forest crisis. While there has been extensive documentation of Asian community-
based forest conservation, there is less awareness and documentation of African
experiences. However, while not as well organized or documented, there are growing
and revolving conservation efforts taking place in Africa.
In 1999, an international workshop on community forestry in Africa was held in
Bangui Gambia. Its theme was "Participatory Forestry Management :a strategy for
Forest Management in Africa". The evidence of this workshop suggests that Africa
may well take the global lead in the design of supportive policy and laws in the
implementation of community-based forest resource management. The workshop
revealed that most African countries are yet to put in place an enabling policy and
institutional and legislative framework for community based forest management to
take place (FAO 2000b).
15
According to FAO (2001), government projects, NGOs or the local community have
advocated for community-based forestry in Africa. The principle objectives have been
to arrest forest resource degradation and to enable communities to have secure and
guaranteed access to and ownership of the resources and the benefits through
empowerment and capacity building for forest management at national levels. Other
broader objectives include environmental protection through forest conservation,
enhanced wildlife management, establishment of woodlots and management of
grazing land. Some project-initiated activities have aimed at using community forest
as a livelihood strategy through which income is generated for the participating
communities. Several countries across the African continent have different stories
about the successes and failures of resource management with particular reference to
forest management measures and conservation approaches employed. Where trees do
serve a purpose in terms of household uses, they will often contribute to meeting
environmental concerns as well. However, any broader resource and environmental
benefits that may accrue from stocks emerge as by products of and are subordinate to
farmers' pursuit of their livelihood goals (Arnold and Dewees, 1997).
The main causes of the extensive forest resource degradation in Zaire are increasing
population, shifting cultivation lifestyle of agricultural production and non-
discriminatory collection of firewood (Kankolongo, 2003). The government revisited
and amended its management plan of forest resources to ensure their existence. Two
strategies were adopted in the new management programme for the rational use and
conservation of forest resources, stabilization of agriculture through agro-forestry and
reforestation of denuded and thinning areas. The active involvement of farmers was
secured through local NGOs and community groups selected based on their
16
experience and knowledge of the particular rural settings. The cost of communal
approach to reforestation was less than that incurred in establishing industrial
,
plantations, which require the mobilization of important funds and heavy equipment
(Kankolongo, 2003).
In eastern Africa, the most important factor affecting tree growing appears to be the
existence or absence of rights of exclusion, in particular, exclusion of grazing on
household fallow fields. Where this is discouraged, because livestock management is
important; or where it cannot be enforced, tree growing is unlikely to take place.
Where farmers can exercise this level of control, economic factors are probably more
important than land tenure in determining decisions regarding tree growing. Where
governments intervene to tighten control over forest resources on public land, this can
undermine or eliminate local rights of use and can accelerate the shift towards greater
dependence on privately owned planted resources (Arnold and Dewees, 1997).
Interviews carried out in rural areas of Tanzania, show that people around forestland
understand that these lands belong to the government but they have so far had no hand
in forest management (World Rainforest Movement, 2002). Much attention to reform
the management of natural resources like forests has focused on both increasing
powers and responsibilities of the government on privatization. The attention has
rarely been focused on management of resources by communities or managing them
as common property. Though communities can own land, it remains under the
executive control of the president who can change its ownership status as he deems
necessary. Therefore, chances exist for communities to lose rights over forestland
under this kind of arrangement.
17
According to Kunga (2003), varying success has been achieved where local
communities have been involved. Before 1995, the Mugori forest in Tanzania was
considered to be government land. During the demarcation of the forest, the local
community demanded that the western part be excluded for their use. This was
granted but it was soon realized that neither the forestry division nor the Siginda
district council could manage the reserve. Through 1995-1997, the Tanzanian
government allowed the community to manage the forest through collaborative
management approach. One hundred forest guards were recruited because the district
council was understaffed. Consequently, fire, illegal harvesting and clearing for short-
term millet production ceased and illegal hunting in forests was contained. All this
was achieved by dividing the forest into 5 villages manned by respective
communities. Village bylaws are in place regarding the management of these forest
reserves, thus, the community has protected the reserves well.
In Uganda, there have been similar community efforts to conserve and manage the
forest resources. The efforts have proved to be successful in central Uganda in the
Mpaka forest, which was gazetted in 1932 (Kunga, 2003). Before gazettement, the
forest was under the management and control of the fube clan, who used it as the
burial site. Consequently, due to the traditional beliefs associated with respect for the
dead, the clan did not allow cutting of big trees and controlled the exploitation of
resources within the forest. The local people were denied their rights to the forest
upon gazettement and this resulted in forest destruction as uncontrollable harvesting
of forest resources took place. In search of solutions to this rampant destruction of
forest resources, in 1997, the Ugandan government, through the forest department,
18
introduced collaborative forestry management within the communities around the
reserve. This approach sought to involve all stakeholders in management of the forest
although ownership of the forest still rested on the government. Forest destruction
declined during this time when the initiative was in use as the community now felt
involved in forest management.
2.4 Opportunities and Constraints for Community-based Forest Conservation
Various factors are known to affect community conservation initiatives either
positively (opportunities) or negatively (challenges). Well-defined property rights like
land title deeds giveusers incentives to work on common property (Arnold, 1995).
Property rights also give people an incentive to adopt technologies that increase long-
term benefits. This, in turn, gives resource users an incentive to improve the resource
through management, determining equality in the accessibility to the resources.
Meizen-Dick et al. (1997) state that property rights are based on age, gender, class,
caste and intra-household characteristics. For users to be motivated to participate in
community forestry, they should have a right to extract products from the forest and
exclude specific individuals who do not hold the rights. According to Ostrom (1997),
collective action is affected by the size of the regime, dependency on the forest
resources, and understanding of the value ofthe resource by users. Collective action is
successful if users see high economic potential by the current activities. Users should
have authority to determine harvesting rules and access without external influence.
Baral (1993) states that the ethnic composition, political ideology and culture within
the community could create problems at the user group level. In order to have a
successful common property, every individual should have an equal level of
19
participation in decision-making. Within common property resource management,
participation of different interest groups is important in order to minimize the risk of
excluding poor groups of people from accessing resources (McAllister, 1999).
According to the studies done by Ojha and Bhattarai (2000), poor households do not
benefit from community forests as much as aftluent households and the former are not
very interested in community participation. Poor households also have a high
opportunity cost of participation as the time spent on participation could be used as-
labour for.cash income. Medium class households benefit the most in comparison to
high and lower class households. Upper class households are indifferent as they have
low opportunity cost of participating in the management. However, the research done
by Ojha and Bhattarai (2000) was based only on qualitative data. Their statistical
analysis was general and did not suggest any causal relationship. Members of the
community group need to have equal participation in management in order for the
economically disadvantaged groups to benefit. Equal participation is necessary for
creating effective and equitable management for collective decision-making, which
ensures equal benefits for all user groups.
Demand for forest products also affects participation in community forest
management. Involvement in community forest management practices is necessary to
have access to desired forest products and to bring success to the community forestry
project (Devkota, 1998). It is important to understand the various perspectives
involved in order to identify the successful outcomes. Different groups have different
views about the outcomes and results from the participatory processes. However,
taking account of the primary users of the community forestry is important. In
20
particular, consideration of low-income groups is essential as it ensures an equitable
outcome (McAllister, 1999). Involving minority groups and women in community
forest management can enhance the productivity of the resource. A study done by
Pokharel (2002) found that community forestry has been successful in achieving
sustainable forest and community. However, gender and equity issues are yet another
challenge.
2.5 Historical Development of Kenya's Forest Policy
Kenya's forest cover is less than 2%, way below the internationally recommended
10% (Maathai, 1988). This has been attributed to a number of factors, which include
policy differences, poor regulation, population growth and migration, rural poverty
and economic disincentives for forest conservation at community level. In 1910,
Kenya's colonial administration introduced the shamba system, to provide raw
materials for the expanding timber industry and reduce pressure on natural forests.
Under the shamba system, farmers grow both plantation trees and food crops on small
plots, tending the trees and harvesting the crops until the trees have become
established (Kagombe and Gitonga, 2005). On different occasions, this system has
come under Presidential ban due to widespread abuse and mismanagement leading to
the detriment of sustainable forest sector development. This practice has gone out of
control on many occasions. According to KWS (1999), over 75% of clear-felled forest
plantation areas are not under tree growing. Either replanting was not successful or
not undertaken at all. In addition, 19% of shamba system areas were found to be
encroaching into surrounding natural forests.
21
Rules and subsidiary legislation made under the provisions of the Forests Act of 1942
permitted local communities to use forest resources without licence or fee by virtue of .
customary right and practice. For parts of Mount Kenya Forest, this specified that
local residents could take dead fallen wood for fuel, for personal domestic use, collect
and take wild berries and fruits for consumption, place and visit honey barrels and
collect and take herbal medicine. Community members were also allowed access to
forest for genuine tribal ceremonies like circumcision and handing over of the ruling
age grade. At such times, forest produce as is required by custom was collected by
those taking part in the ceremony. For example, they could cut and take thatching
grass at places approved by a forest officer. Further to this, they were allowed
collection of poles required for erection of schools and medical buildings, collection
of pottery clay and burning of pottery at places prescribed by a forest officer
(Government of Kenya 1942).
Kenya's forest policy of 1957 primarily dealt with the preservation, protection and
sustainable exploitation of forests. It also covered afforestation and conservation of
forests and proper management of privately owned forests. In addition, it recognized
the value of forests for public amenity, recreation and as habitat for wildlife. The
forest policy has undergone a series of changes since then, but mostly retaining the
preservation and protection of the forest estate at the exclusion of local communities.
It was also silent on the role of various stakeholders, especially, local communities,
private sector and NGOs/CBOs in forestry and the linkages with other sectors and
land uses.
22
Sessional paper No. 6 on Environment and Development identifies some
environmental challenges, which include minimal participation by communities in the
management and conservation of forest resources. This is due to the prevailing
attitude that forests belong to the state and that communities have no stake in them.
There is need to involve local communities or to provide legal recognition to
communities involved in forest conservation and management. The Forest
Department and Kenya Wildlife Service have the monopoly of managing forest
reserves. The Forest Department of Kenya now the Kenya Forest Service takes the
lead in forest management and extension services as provided by the forest policy and
legislation. Its main challenge is the ability to respond effectively and promptly to
people's increasing demand for forest product~nd services within the context of a
Heavy commercial exploitation of Mount Kenya Forest under improved transport and
rapidly changing environment. However, there is recognition of the fact that this
would only be effected fully in the long term by revising and putting in place the
forest policy and stakeholder participation in line with other measures. The local
communities are recognized as the resource owners, beneficiaries and they have
indigenous property rights (KWS, 1999).
communication network in central Kenya, accompanied by rising local utilization of
forest resources from a rapidly growing and ,edenterised human population resulted
-:
in severe forest degradation, which worsened during the 1980s (Emerton, 1999). In
response to the rapid loss of forest species and increasing encroachment, the Forest
Act was revised in 1982 and 1992 and a series of bans and prohibitions against natural
forest exploitation were introduced in mid and late 1980s and implemented through
heavy policing of the forest and prosecution of offenders. Forest management was
23
based on an increasingly restrictive and exclusionary system of protection. Forest
utilization continued to be intense despite this legal narrowing of extractive forest
activities, at both commercial and subsistence levels, and rates of forest loss and
degradation escalated. The forest continued to provide a major source of local
subsistence, income and employment and the national and international market for
indigenous hardwoods originating from Mount Kenya Forest remained strong.
It is against this background of local forest dependence, high national and
international demands for indigenous timber and wide scale forest degradation that
recent attempts have been made to initiate community-based forms of forest
conservation in Mount Kenya Forest. Purely exclusionist forms of forest protection
have proved to be difficult to implement successfully, due to the extremely limited
financial and staffing base of the government's Forest Department. Supported by
wider moves to reform national forestry policy and practice, there has been a shift in
forest management methods in Mount Kenya Forest Reserve. Most importantly, new
approaches to forest management recognize the need to involve and benefit local
people in conservation. Already limited forest grazing has been reinstated and efforts
made to control problem animals, which destroy crops and livestock. These moves
have proved popular with the large, poor and land-scarce forest-adjacent rural
population. Various community consultations have been carried out since 1993 under
the guidance of the joint Kenya Wildlife Service and Forest Department
Memorandum of Understanding as a precursor to implementing other planned
community conservation activities. These include the initiation of joint forest
management, sharing of forest revenues with local communities and establishment of
24
a range of on and off-farm development projects aiming to substitute forest sources of
income and subsistence (COMIFOR 1994).
2.6 An Overview of the Kenya Forest Act, 2005
This Act provides for community participation in forest resource management.
Members of the communities may register a community forest association under the
Societies Act. The Act provides for management agreement between the Director of
KFS and the community association which confers all or any of the following user
rights to the association: collection of medicinal herbs; harvesting of honey;
harvesting of timber or fuel wood; grass harvesting and grazing; collection of forest
produce for community based industries; ecotourism and recreational activities.
Others include scientific and education activities; plantation establishment through
non-resident cultivation and development of community wood and non-wood forest
based industries. The new forest legislation, the Forest Act 2005, strips the minister
of the excessive powers to degazette forestland for whatever reason shutting out
arbitrary forest excisions. First, the minister must give notice of his/her intention to
degazette forestland. Kenyans will have to be consulted on the proposed excision.
Unlike in the past, where the state was directly responsible for management of state
forests, the new Act establishes the Kenya Forest Service. This is a semi-autonomous
corporate body charged with the responsibility of formulatin~ policies and guidelines
regarding the management, conservation, and utilisation of all types of forests in
Kenya. A Board of Management runs the Service. The new forest policy is designed
to respond to the changing context, provide directions for the sustainable development
of the forest sector, and enhance sustainable forest conservation by integrating local
25
communities in conservation and management of forest resources (Ludeki et aI.,
2006).
2.7 Rationale for Community-based Forest Conservation
There is increasing concern about the deteriorating state of forests in the country.
Natural forest cover is receding; ecological services are declining; there is increasing
pressure on forestland and increasing demand on forest products, management
capacity is limited and there are institutional constraints in the sector. The current
shift towards a paradigm of community-based conservation is based on a strong
economic rationale that forest-adjacent communities face, binding livelihood
constraints. These include wide scale poverty, land pressure and lack of development
opportunities leading to a high dependence on forest resources for both income and
subsistence. The forest department is severely under-resourced and unable to afford to
effectively police and protect a large and inaccessible forest area. The participation of
local communities is a practical necessity to achieve forest and other natural resource
conservation. It is also desirable, in local development terms, and necessary to justify
forest conservation in the light of national and local demands for forestlands to be
cleared for settlement and agriculture. Unless local communities benefit economically
from forest conservation in the face of these needs and pressures, forests are unlikely
to be conserved in the future.
The government recognizes that a very wide range of people have a stake in the forest
sector; people whose interests are not being fully addressed, and whose roles and
responsibilities need to be defmed and co-coordinated. Involvement of local people in
partnership with other stakeholders in management and conservation of forests
26
resources is the key to sustainable utilization of these resources. For effective
conservation of forest to be achieved communities need to be considered as
contributors to the management system.
In Kenya, government funds are extremely limited and needs for agricultural land,
timber and land for settlement are high in the Mount Kenya region. Mount Kenya
Forest competes for scarce land, money and other resources with other land uses and
investment opportunities at local and national levels (Emerton, 1999). Conservation is
widely viewed by central government as well as by local community as a less
profitable option than converting or developing the forest for other land uses, which
are perceived to give wider and immediate benefits like agriculture to the Kenyan
economy and society. In order to justify conserving Mount Kenya Forest, it is
necessary to demonstrate that not only can conservation compete with other land uses
and investment opportunities, but also that it can simultaneously generate multiple
economic and development benefits at both national and local levels. The basic
economic rationale for conserving Mount Kenya Forest is that it provides a stream of
goods and services, which generate economic benefits and support economic
activities, which accrue to the livelihoods of the local people, the Kenyan economy
and the global community. Mount Kenya Forest and its component resources
constitute far more than a static biological or ecological reserve. They form a stock of
natural capital, which, if managed sustainably, can yield, in perpetuity, a wide range
of direct and indirect economic benefits to human populations. Conserving the forest
will maintain these economic benefits. Forest degradation and loss will constitute a
loss of these goods and services and impose a high cost on the national and local
economy in the medium and long term.
27
In conclusion, the government's controlled forest resource management has largely
failed to contain forest resource degradation. As such, participation of local
communities is crucial towards the achievement of sustainable forest conservation and
management. Failure to this and the consequent top down approaches leads to forest
degradation, since the community develops a negative attitude towards the forest. As
observed, however, community participation comes along with many challenges and
opportunities, which should be investigated with the aim of developing strategies for
full sustainable community participation in forest conservation.
28
CHAPTER 3:METHODOLOGY
3.1 Study Area Characteristics
Naro Moru area forms part of Mt.Kenya forest ecosystem, which lies in Nyeri North
district (Figure 3.1). The main physical features of the district are Mount Kenya
(5199m) to the west and the Aberdare ranges (3999m) to the east. Mount Kenya is the
second highest mountain in Africa. The western part of the district is flat, whereas
further southwards, the topography is characterised by steep ridges and valleys,
occasionally interrupted by hills such as Karima, Nyeri and Tumutumu. The
topography ofNyeri district forms part of Kenya's eastern highlands. It covers an area
of 3,266 Km2 and is situated between longitudes 36° and 38° east and between the
equator and latitude 0° 38 South (GoK, 200 1). Two of the largest rivers in Kenya,
Tana and Ewaso Nyiro have tributaries originating from the slopes ofMt. Kenya.
Mt. Kenya forest spans Embu, Kirinyaga, Meru, Nyeri and Tharaka Nithi districts of
the central highland zone of Kenya, one of the most agriculturally fertile and densely
populated parts ofthe country. More than 200 000 people live within l.5 km from the
edge of the forest, where levels of rural poverty are high and land is extremely scarce
(Emerton, 1996). Rapidly increasing population and thus local and commercial needs
for forest products and agricultural land have placed severe pressure on Mount Kenya
forest, which presents a rich biological diversity not only in terms of ecosystems but
also in terms of species. The diversity in flora is specifically high on Mount Kenya. A
number of studies of the vegetation of Mt. Kenya and the mountain regions of East
Africa have been undertaken since 1885. In the latest and more comprehensive study
undertaken between February 1992 and August 1994; some 882 plant species,
subspecies and varieties belonging to 479 genera of 146 families were identified in
29
Mt. Kenya forest (Bussmann, 1994). Mt. Kenya has 81 endemic plant species (KWS,
1999).
o
MT KENYA FOREST
Legend
30 Kilometer.
8 NAROMORUNYERI DlSTRlCT( NORTH & SOUTH)MT KENYA FOREST
Figure 3.l Map Showing Mount Kenya Forest, Naro Moru Area in Nyeri District
The district experiences equatorial rainfall due to its location and being within the
highland equatorial zone. Annual rainfall ranges from 500mm to 1,500mm. The soils
are mainly red humic clay soils, which are relatively deep, generally well drained and
fertile. The major economic activity in the area is agriculture, and in particular,
farming. The farming systems mainly in use are zero grazing, cash, and food
cropping. The animals in zero grazing are mainly sheep and dairy cattle. Food crops
include late maturing maize varieties, cabbages, potatoes, and carrots among others.
The Kikuyu community dominantly, inhabits Naro Moru area. They migrated to the
foothills of Mount Kenya in the 1500s. The mountain is a sacred place and a central
30
part of their creation myth. The Kikuyu, an agricultural community closely tied to the
land, continued to grow and thrive over the centuries, until the arrival of European
colonists in the late 1800s (Kenyatta, 1965). Traditionally, the forest has been
important to the community as a source of their material needs such as fuel wood,
grazing land, timber, water, food and medicinal herbs. It also acts as an important site
for performing traditional ceremonies. Mount Kenya ecosystem has numerous
community-based projects, which train communities on income generating activities
such as bee keeping, monitoring illegal activities, tree planting, promoting energy-
efficient stoves and reducing garbage dumping. In 2000, there was a public outcry due
to rampant deforestation prompting the government to change the area's status from
Forest Reserve to National Reserve, which allowed for greater forest protection, and
transferred management responsibility from the Forest Department to the Kenya
Wildlife Service (Bongo, 2003)
3.2 Choice of the Site
The choice of the site was informed by the fact that Mount Kenya Forest is one of
Kenya's leading water catchment areas with millions of people depending on it for
livelihood. It is also an important wildlife conservation area. However, the forest is
faced with serious threats such as illegal logging, charcoal making and encroachment
by human settlement, and agriculture. Most interventions aimed at forest management
in the past had a tendency to ignore the participation of local communities who have a
lot to contribute towards the sustainability of forests. More over, indigenous systems
of forest management seem to be on the verge of disappearance in the area. The need
for community participation in conservation of this biodiversity is thus important.
31
However, this cannot be realised without addressing the challenges and opportunities
for community-based forest resource conservation, the focus of this study.
3.3 Target Population and Sampling Procedure
The target population consisted of the communities living at most 2 kilometres from
Mt. Kenya forest in Naromoru area. Households were the basic units of analysis. Four
villages (Kabendera, Gikamba, Kimbo, and Njoguini) neighbouring the forest were
randomly selected for study. Simple random sampling was used to select a sample of
at least 30 respondents from each of the four villages to make a sample size of 120.
Gay 1981, suggests that for correlational research, 30 cases or more are required.
Purposive sampling was used to select key informants based on having stayed in the
area for a long time as well as having in-depth understanding on the issues regarding
community based forest resource conservation. They included agricultural extension
officers, community leaders, forest officers, environmental officers and community
based organization leaders.
Table 3.1 Key informants
Category No Sex Work station
Divisional forest officer 1 Female NaroMoru
Community warden 1 Male NaroMoru
Environmental officer 1 Male Nyeri
Agricultural officer CBO 2 Male NaroMoru
Mt. Kenya conservation groups 2 Male NaroMoru
Local area chief 1 Male NaroMoru
32
3.4 Data Collection Methods and Instruments
To satisfy the study objectives, both quantitative and qualitative data were collected.
Quantitative data was collected by the use of questionnaires for both community
members and key informants with both structured and unstructured questions
(Appendix 1). Structured questions were meant to elicit response while unstructured
questions were meant to acquire in-depth knowledge on the subject matter by giving
respondents freedom to express their opinions without being limited to some set
choices. Questionnaires were, specifically, used to determine the main challenges and
opportunities for community involvement in conservation efforts, their causes and
coping mechanisms.
A set of PRAs was crucial in gathering qualitative data. Village surveys were carried
out through transect walks where the researcher, guided by community
representatives interviewed casually community members encountered along the route
to give meaning and context to issues already identified. These included socio-
economic activities in the area, cropping patterns, trees and vegetation, average farm
sizes, infrastructure, land use practices, community problems and opportunities. Three
field surveys were conducted in September 2006.
Focus group discussions were held at Mwicuiri shopping centre and were attended by
16 individuals who included community members, agricultural extension officers,
community leaders, forest officers, environmental officers, community-based
organization leaders among others. FGDs were used to assess the level of
involvement of the local community in conservation efforts in the area, the specific
group involved, the method and strategies of involvement, and the activities in which
33
the community was involved. Efforts were made to ensure gender equality and
participation of members from diverse economic backgrounds who depend on the
forest ecosystem in different ways and derive diverse benefits.
Key informant interviews were based on checklist questions relating to the
community as a whole. These were mainly used to determine the main hindrances to
community involvement in forest conservation. Elderly individuals were interviewed
about the ethnology and history of the community. The village community leaders
were interviewed about government policies and programmes on community
participation in forest resource conservation and the advantages/disadvantages of
those policies and programmes. Individual household heads were interviewed about
the livelihood, the role of households and community on management of forest and
forestland. Data on the impact of government policies on people's livelihood and the
people's response to these polices as well as the government's attempts to deal with
these responses was also gathered through in-depth interviews.
A historical time line was used to establish the key events, over time, in forest
conservation in the area and how they have influenced the community attitudes and
perceptions regarding forest resource conservation. Changes in the historical
development of forest and forest resources and the history of local community forest
management in Naro Morn area of Mount Kenya forest were recorded. Guided group
discussions were used with a group of key informants and older members of the
community who had wide knowledge ofthe history ofthe area.
34
Since the community benefits from participation in conservation, it is an important
opportunity for community involvement in forest conservation. Village resource flow
map was used to identify basic livelihood resources and their sources either in the
forest or within the farms. The purpose was to learn what the community considers
important as important basic needs and whether they are self-sufficient or heavily
dependent on the forest ecosystem. Resources available strictly within the community
boundary, those partially available in the forest as well as on the farms and those only
available strictly within the forest ecosystem were separately listed.
Ranking exercises were used to assess the impacts of forest products (both timber and
non-timber) on the livelihood ofthe villages. This was done with two different groups
in the village. First, the respondents were asked to list the forest products that they
v,
usually collect. Using a matrix outline, the different forest products were placed down
the left-hand column. Then using a fixed number of local seeds, the respondents were
asked to compare each forest product in terms of its importance to the community. On
the matrix, each item was ranked according to their scores; the item with the highest
score was ranked first. The ranking reflected the impacts of forest products on the
lives of the villagers.
3.5 Data Management and Analysis Method
Quantitative data was analysed using descriptive statistics such as frequency
distribution tables, frequency polygons, charts, and measures of central tendency such
as mean, percentage and mode. All qualitative data was cleaned, coded and discussed
under themes consistent with the objectives of the study. Content analysis and in-
depth probing was also used to make sense of the qualitative data.
35
Inferential statistics involving use of Pearson's correlation coefficient (r) was used to
relate variables such as the level of education and the frequency of involvement in
conservation activities, land sizes and the level of involvement in forest conservation
activities among others. The Statistical Package for Social Sciences (SPSS) was the
main data management spreadsheet used.
36
CHAPTER 4: RESULTS AND DISCUSSION
This chapter is a presentation of the results of the study as per each objective. It starts
with an overview of the socio-economic characteristics of the sampled population
with special regard to the forest and natural resource conservation in the study area.
Discussions based on the information contained in the results are made, and the
implication of the findings cited by linking it to all the sections of the study from the
background, objectives and literature reviewed.
4.1 Socio-economic Characteristics of the Sampled Population
The majority of the respondents (68%) had stayed in the area for over 15 years and,
therefore, had a wide knowledge of issues regarding community participation in forest
management and forest conservation in the area (Table 4.1). About 57% of the
respondents had less than 2 acres of land, which was inherited, bought or hired. This
indicates a high population density and high pressure on agricultural land to meet
livelihood demands. It was noted that a good percentage of the population earned less
than 100 shillings per day. Landlessness was a key characteristic of this group of
people, hence, they relied on offering labour to fellow community members.
Occasionally, they relied on the forest for resources like honey and wild fruits.
Historically, this group of people used to be labourers for the colonial masters.
Most of those interviewed were men (61%). The community in the study area is
largely patriarchal. It was believed that women are supposed to stay at home doing all
the work both at home and in the farm.
37
Table 4.1 Socio-economic characteristics of the sampled population
Variable Category % of sampled population
Age 18-40 years 57%
Over 40 years 43%
Gender Male 61%
Female 39%
Education Primary 42%
Secondary 50%
Post secondary 8%
Income per month Below 1500 75%
1500-4500 16%
Above 4500 9%
Land size <2 Acres 57%
2-5 Acres 40%
Over 5 acres 3%
Length of stay in the area 0-5 Years 11%
6-10 years 8%
11-15 Years 13%
Over 15 Years 68%
How land was acquired Inherited 46%
Bought 46%
Hired 8%
The results obtained from gender daily calendar (Table 4.2) indicates that generally,
men controlled production resources while women were only involved in productive
work at home, usually, with little economic value but taking a lot oftime as evidenced
from the gender daily calendar.
38
Table 4.2 Gender daily calendar of Naro Moru community
Women Men
Time Activity Time Activity
5.30a.m. Wake up and prepare 6.00 a.m. Wake up, milk, take
breakfast milk to dairy
6.30-7.30 a.m. Prepare children 8.00 a.m. Take breakfast
9.00-11.00 a.m. Breakfast and washing 9.00 a.m. Farm activities
utensils
11.00am-12.00 noon Collect fuel wood 2.00 p.m. Lunch and siesta
12.00noon-2.00 p.m. Feed the animals 3-4.00 p.m. Farm activities
2.00pm-4.00 p.m. Lunch preparation 5-8.00 p.m. Leisure
4.00pm-6.00 p.m. Farm activities 9.00 p.m. Take supper
6.00pm-8.00 p.m. Milk the animals 10.00 p.m. Retire to bed
9.00 p.m. Supper preparation
9.30 p.m. Taking supper
11.30 p.m. Retire to bed
This directly affected the time women had to participate in forest conservation
activities, which due to lack of incentives were often regarded as extracurricular
activities. Men were, thus, free to attend forest conservation activities. About 58% of
the respondents had achieved post-primary education. This means that a majority of
community members could participate in conservation activities beyond the basic
level of just planting trees and policing. They could attend management meetings
where their valuable contributions were expected.
Other activities include taking inventories of biodiversity in the forest as well as
various skilled labour opportunities that may arise in forest management and
conservation. Results however showed that more educated respondents were less
likely to be involved in forest conservation (r=-0.22, p=0.05, n=120) because many
were involved in formal employment where skilled labour was involved.
39
Older respondents appeared not to understand the diverse benefits the forest offers to
their community (Table 4.3). These are the custodians of community values and
customs whose support is important in guiding the community towards participation
in forest conservation. The majority of the respondents (57%) were between the ages
of 18-40 years. This means that a good proportion of the community is in the
productive age both economically and demographically. Younger people were likely
to own lesser land sizes (r=0.34, p=0.01, n=120).
Table 4.3 Pearson correlation coefficient (r) values for respondent's age and
awareness of the benefits of Mount Kenya forest
Benefit (r) values where n=120
Climate regulation -0.19*
Soil erosion protection -0.29**
Aesthetics value -0.24**
Air purification -0.26**
**= r values significant at 0.01, *=r values significant 0.05,
This is an indication of a potential higher population density in the area in future due
to land fragmentation. This will come with increased population pressure on the
agricultural land in the area as well as the forest resource in search of livelihood.
There is thus need for proper conservation strategies given the threat to the forest this
would pose. The youthful population can be utilised in a wide range of conservation
activities, which may not be possible with an elderly population.
Historical timelines indicated various issues relating to natural resource conservation
in the area. Generally, the area has experienced famine and occasional droughts,
which have increased the community dependence on the forest for forage and grazing
40
area. Others included increased timber processing, poaching and charcoal burning in
pursuit of income and food security demands. The heavy deforestation of 1994 was
occasioned by government inability to control the shamba system. Instead of
achieving its intended purpose of improving forest cover, the system resulted to
increased clearing of the forest with limited re establishment. Key occurrences in the
history ofthe area are summarised below.
Table 4.4 Historical timeline output
Period Main event Main effect
1963 Kenya's independence and Increased clearing of forest cover and
starting of various schools dependence on the forest for construction
in the area and other materials
development projects
1963 Famine Increased dependence on the forest
resources like grazing, wild fruits and
timber for survival
1970 Kirimara company bought Land subdivision and clearing of
land from a white settler vegetation cover
called Ulman
1973 Mwichuiri farmers company Land subdivision and clearing of
bought the land from vegetation cover
Kirimara Company
1984 Drought Crop failure and increased dependence on
forest resources for survival
1988 Aphid attack on crops Reduced crop yields and increased
dependence on forest resources
1994 Shamba system Heavy deforestation
1998 Good harvest Decreased dependence on the forest
resources for livelihood
1999 Drought Increased dependence on the forest
resources for livelihood
2003 New government New forest policy with increased
government concern on the deteriorating
state of forest resources in Kenya
2004 Drought crop failure No access to forest resources due to
increased government control
41
4.2 Involvement of the local community in conservation of Mount Kenya forest
Up to 87% of the respondents stated that the community has the capacity to manage
the forest resources. It was, however, observed that respondents who thought that the
community has the capacity to manage the forest did not participate in forest
conservation activities (Table 4.5). This indicated community withdrawal from
conservation efforts in the face of increased government control. Community
members argued that as long as the government continue to restrict community access
to the forest resources, the resources would continue to be viewed as government
owned and the community will continue to withdraw from conservation.
Table 4.5 Pearson's correlation coefficient for respondents perception on selected
fo t t tivitires managemen ac IVI res
Activity r values where n=120
Management meetings -0.32**
Afforestation -0.34**
Reafforestation -0.28**
Wildlife protection -0.22*
Forest policing -0.39**
Fire prevention -0.23*
Patrol/ Surveillance -0.40**
**= r values significant at 0.0 I, *=r values significant 0.05
According to the local community and focus group discussions, community
involvement in forest resource conservation has declined over the last five years. The
percentage of community members participating in forest resource conservation was
highest in 2002 at about 27% while the lowest was in 2004 at about 17% (Figure
4.2).This decline was attributed to the ban on the shamba system in 1998 as well as
increased government control over the forest resource from 2002. As a result of
42
reduced benefits from the forest, communities have withdrawn their protection and
care. It is hoped that with the introduction of participatory forest management in the
new Forest Act 2005 and non-resident cultivation, community participation in forest
management will increase. In a multi-stakeholder society, all those who have a stake
in the resource must be represented in any decision-making process concerning the
resource's use at all levels. Although this may be time-consuming in the short term, it
ensures that communications and the common vision are used to resolve differences
and reduce conflicts of interest in the long term, making the use of a resource
sustainable.
2001 2002 2003 2004
30
>. 25~
~ 20=go 15•..
~ 10';!. 5
o
---.. ------- -- -
Year
Figure 4.2 Frequency of community participation in forest conservation from 2001-
2004
In an attempt to negotiate for their role in community-based forest management,
various forest conservation groups operated in the area (Figure 4.3). These were local
common interest groups who, through their own initiative, had come together to assist
in forest conservation and management. The groups with the highest membership
among the sampled population included Muguna (31%) and Karide (28%). Muguna
group is a community forest association, which was formed in 2006 after the
43
provisions for community- based forest conservation groups were made in the new
forest act. Its major activity was to establish nurseries for agro forestry on their its
farms as well as reforestation of areas once with forest cover but depleted through
deforestation. Further to this, the group is involved in bee keeping on its farms using
the Kenya top bar hives. However, honey collection inside the forest is not allowed
because of the risk of fire occurrences, which in the past have contributed to forest
destruction.
Njeki
Upper kimbo-- Gatune::e•...
Q~= Njoguinie:c:eo:
•••• Ngomongo•...
~= Pendoe(J
ti~ Kmicle-r:
Kabuda
Muguna
0 20
PerCent
40
Figure 4.3 Community-based forest conservation groups in Naro Moru area of Mount
Kenya forest and the membership among sampled population
The major activities of the other community-based forest conservation groups
included agro-forestry, raising seedbeds, reforestation and forest policing (Figure 4.4).
Reforestation was both initiated by the farmers on their own in their own land as well
as by various NGOs, who organised local groups for the same purpose. Availability of
44
forest tree seeds was cited as a major challenge affecting both agro-forestry and
reforestation. A few farmers used indigenous knowledge to collect local seeds, but
due to limited resources, this method was not effective. Land sizes were small and
effective tree cover establishment was difficult. There was a general high need for
grafting fruit trees, need for quality seeds and training in agro forestry to improve the
process of tree establishment and management
Others
Merry go round
Forest Management
Grazingt·.••••:c~Fetching firewood for sale.
Bee keeeping
Tree nurseries
Planting tree
o 10 20 30 40
Percent
Figure 4.4 Major activities of community-based forest conservation groups in the
study area
Although community participation in forest management was low, community
members in conservation groups were more likely to be involved in forest
conservation than those not in conservation groups (Table 4.5). This was mainly
because these organised groups acted as important entry points through which the
government departments, non-governmental organisations and development partners
50
45
could utilise in effecting conservation efforts. Community members not in
conservation groups, were therefore, less likely to participate in forest conservation
hence could not access benefits that are derived through participation.
Table 4.6 Pearson correlation coefficient (r) values for respondents belonging to
d i I t i f t ticonservation e:roups an IllVOvemen III ores conserva Ion
Activity (r) values where n=120
Management meetings 0.54**
Afforestation 0.41**
Reafforestation 0.55**
Wildlife protection 0.23*
Forest policing 0.37**
Fire prevention 0.26**
Patrol! Surveillance 0.25**
**= r values significant at 0.01, *=r values significant 0.05
There was a very high expectation that the shamba system will be re-introduced with
its provision in the new forest act 2005. This Act further provides for the formation of
community forest associations whose functions are to protect, conserve and manage
forest as part of the agreement in the designed forest management plan, as well as
assisting in implementation of forests management programmes. This explains the
increase in the number of community-based forest conservation groups in the area.
Other conservation groups in the area included: Gatero Kahuho Greenfield
conservation group, Mwireri group, Murichu Kabati tree nursery group, Genesis
Youth tree nursery group, The Green Avenue group, Wafugaji Self Help group,
Evergreen tree nursery group, Boru tree nursery group, Valleyline conservation
group, Tumaini tree nursery group and Hangi Kahuho conservation group.
46
In the past few years, Kenya government issued a number of policies in order to re-
manage forests and forestry land, such as programmes on agricultural and forestry
extension. These programmes have been effected and implemented in the country,
and there are several difficulties and challenges in the process of socio-economic
development, especially, in local rural communities, implementation and impact of
the Government policies on management and development of forests and forestry
lands. Efforts of the Government to manage Mount Kenya forest have strongly
affected management of forest resources in Naro Moru area through many direct
mechanisms such as enforcing laws and evicting landless squatters from the forest
reserve. These instructions, resolutions and decrees have marked basic change in
orientated socio-economic development, managing and protecting natural resources,
giving temporary land use rights and resources to villagers. However, before 2005,
the influence of central-planned-mechanism, the sole state mechanism, with little
attention to peoples' interest was limited in encouraging villagers to participate in
protection and development of forest resources.
The community members interviewed rated their participation in forest conservation
at various levels along a five point likert scale (Table 4.7). There was, generally, low
level of involvement of the community members in forest management and
conservation activities. About 16% indicated being very frequently involved in
afforestation. Up to 41% of the respondents were never involved in management
meetings. This means that critical decisions regarding forest management and access
to forest benefits and resources are made without community input. The same
scenario manifests itself in wildlife management where 42% of the respondents
reported that they never got involved. This has resulted in lack of good will from the
47
community as far as forest conservation is concerned. The community members had
lost the sense of ownership of the forest, regarding it as a government property, hence
looting the forest at any emerging opportunity.
Table 4.7 Frequency of community participation in various conservation
activities
Rating ( Per Cent)
Activities Very Frequent Sometimes Seldom Never
frequent
Management Meetings 16 10 23 10 41
Afforestation 15 13 16 38 18
Reforestation 19 11 36 21 13
Wildlife protection 10 3 23 22 42
Forest policing 10 12 18 17 43
Shamba system 0 3 2 14 81
Fire prevention 13 2 2 23 60
Patrol/surveillance 18 5 23 12 42
Over 81% of the respondents never involved themselves in forest reestablishment
through the shamba system. This was due to the government's ban on the practice in
1998 due to its failure to meet its objective of forest cover restoration. The system
also exposed indigenous forests to encroachment. However, the community felt that
this system allowed them access to forest resources like firewood and land for
agriculture and needed to be reinstated. The relationship between the community and
government agents that is the Kenya Wildlife Service warden and the divisional
forest officer regarding forest conservation is captured in case study 1 and 2.
48
Case Study 1: Forest warden
We usually involve the community in forestation, reforestation, road construction,
road maintenance, fire control, patrols, tree pruning and other available casual jobs
in the forest. Community members are also allowed to graze their animals at the
periphery of the forest reserve. Though the relationship between KWS and the
community has improved, the community members still feel isolated from the forest
resources since their access to the forest is controlled as opposed to free access
enjoyed in earlier years. Due to lack of an electric fence in some sections, wildlife
sometimes invade the community's farms destroying crops, injuring and killing
people and attacking domestic animals. This has led to negative attitude of the
community to forest conservation. Sometimes, the community members make calls
threatening me on my position regarding their access and use of forest resources.
Case study 2: Divisional forest officer
The forest department is involved in regulation and control of tree felling,
permitting movement of tree products, and giving technical advice on establishment
of tree nurseries, planting and general tree management. The local community sees
the gazetted forest as a government property but there is a change of attitude after
awareness creation and education that they are actually the owners of the forest. The
community is directly involved in tree planting and the forest department promotes
group nurseries through buying their seedlings while the community provides free
labor. There is also community policing/patrols to limit poaching of forest products.
The community has a problem with restricted access to forest resources. In addition
lack of direct benefits from forest conservation tends to discourage the community
from participating in conservation efforts. The ban on forest cultivation through the
shamba system has also affected the community's willingness to conserve the
forest. The ban on tree felling for local industries has rendered many people jobless
and due to lack of alternative sources of income, the community perceives forest
conservation efforts as insensitive to their livelihood needs.
4.3 Benefits Accrued from Mount Kenya Forest
The Naro Moru community perceived the forest as a source of various livelihood
products and services (Figure 4.5). All the respondents interviewed used the forest for
their supplies of heating, cooking and lighting fuel. This was obtained both legally
(through licences) and illegally. Key informant interviews showed that initially,
people moved up to 1 km into the forest to collect their subsistence needs for fuel, but
recently, this distance has increased to more than 2 km. Fuel wood preferences have
also altered over the years, partly in response to diminishing supplies of preferred
species. Many respondents reported that with increased participation in forest
49
conservation, their access to fuel wood would increase. The limitation placed by the
forest department, by the use of paid licences, has led to establishment of agro
forestry trees on the farms as a coping strategy.
Medicinal plant) ~' - ~I
,~ ""~ " ••..
~ .- :1
., 1
-iiOl
Oi ~ "'I••
",;", ,.~I
I!'! ~-~I
- ~ ;::;;- I
I~ ~ -..•~ .. •• m--~- ••-~
150
Grazing/ fodder
Honey
~ Land for cultivationtt
S
~ Timber/Poles
Labour
Timber/Poles
Fire wood
o 50
Per Cent
100
Figure 4.5 Respondents obtaining different benefits from Mount Kenya forest, Naro
Moru
Up to 69 % of the respondents reported that the forest is important as a source of
medicinal plants. Use of medicinal plants from the area was reported to be
increasingly becoming commercialised, with plants now being collected for sale in
herbal clinics in Nairobi and other urban centres. This financial activity encouraged
poaching of medicinal species of plants, hence forest degradation.
50
61% of the respondents reported that the forest was important as a source of timber
for building purposes. These were mostly obtained from the forest through poaching.
Alternatives such as Cypress and Grevillea, which were grown on farm were reported
to be suitable for roofing but not for the waIls since they tended to rot. This
encouraged the local communities to cut poles of the desired species illegally. Further
to this, increased demand and value of poles and timber in urban centres including
Nairobi has increased poaching in the area as the community strive to acquire their
livelihood, resulting in degradation (plate 1). With increased community participation
in conservation, the community felt that sustainable utilisation of these products could
be practised in the area.
Plate 1. Forest degradation on the slopes ofMt Kenya
About 48% of the respondents reported that honey was an important good acquired
from the forest. Some organised community based forest conservation groups also
practised bee-keeping on their farms. Harvesting of honey from the forest was
prohibited because of cases of fire resulting from honey gathering activities. Bee-
keepers user groups have been formed with the aim of convincing the forest
authorities that they can carry out the activities safely. In addition, they should be
allowed to gather honey products from the forest
51
Grazing and fodder are important forest goods to 91% of the respondents (Plate 2).
Fanners, through direct livestock grazing and cutting grass from the forest. With
diminishing land sizes and increasing population pressure, this is important,
especially, during the dry season and it is suggested that dairy fanners could maintain
the forest boundary through harvesting of fodder for their animals.
Plate 2. Livestock grazing inside the forest, a common form of forest resource
utilisation in the study area.
A range of indirect user benefits were also cited (Figure 4.6). Water was identified by
98% of the respondents owing to many rivers and streams that flow from Mt Kenya
ecosystem (plate 3). Tourism was cited by 68% of the respondents as one of the
benefits from the forest. They viewed the unique biodiversity of Mount Kenya forest
as an important asset, which can be used for the development of forest-based eco-
tourism. Eco-tourism has the potential of generating revenue to the community in a
non-destructive way and adds value to the forest resource. It also creates wider
awareness of the ecosystem, its importance, and the need for its conservation.
52
However, though eco-tourism is broadly compatible with biodiversity conservation, it
is necessary to identify zones within which it can take place without adverse impacts.
thers 0
[J
I
I
I
I
I
I
I
I
150
Sacred places
Education purposes
Air purification
Tourism
Source of water
Aesthetics
Soil erosion protection
Climate regulation
o 50 100
Per Cent
Plate 3. Naro Moru River, a source of water to the neighbouring community flowing
from Mount Kenya forest
Figure 4.6 Indirect user benefits ofthe forest to the local community
Education was cited by 77% of the respondents as a benefit of Mount Kenya forest. In
addition to formal education in primary and secondary schools, the community
53
members interviewed reported that an education centre could be established. From
here, guides to the forest can be organised through the community members on
payment of a small fee. In addition, equipment such as binoculars can be made
available as well as interpretation displays about the forest and its wildlife. Brochures
from the information and education centre showing routes and features of interest
should also be kept for tourists to ensure that they can confidently find their own way
to the forest.
Climate regulation was cited by 62% of the respondents as an important value of the
forest. These included factors like rainfall, temperature and humidity, which the
community members felt that were it not for the forest, these variables would go to
extremes. Rainfall was cited as the most important climatic factor, which, together
with soil type, determines the type of vegetation in each area. It also determines the
availability of water through the wider hydrological cycle. Rainfall in the area has a
bimodal pattern, with the first period beginning in April and ending in June, and a
second period of rainfall during November and December. January and February are
the driest months.
The general feeling of the community was that destruction and degradation of the
forest implies loss of many of these environmental benefits, although this would
depend on the subsequent alternative land use. Non-use values, which included air
purification and climate regulation, were not appreciated much.
The benefit derived by the local community from the forest was mainly firewood
(100%), grazing/fodder (91%), labour (78%) and medicinal herbs (69%). Forest use is
regulated by the FD which issues a receipt upon payment of a fee, which varies
54
depending on what one wishes to harvest from the forest. Grazing is charged at Kshs
20 per cow, Kshs 16 per sheep and Kshs 20 per donkey per month. Firewood is
charged Kshs 45 per month for a head load twice a week. Goats are not allowed in the
forest because they browse and destroy tree barks, which could lead to drying.
According to local forest department officials, failure to comply with this regulation
attracts a fine of Kshs 500 per month for the livestock or imprisonment of not less
than six months for the livestock owner. The community members, however, felt
these should be revised because the charges are expensive for them and unaffordable.
This leads to the community's failure to utilise these resources hence negative attitude
towards the forest and conservation.
Commercial logging and charcoal burning were banned in 2000. Since then illegal
logging has reduced drastically and the forest department has limited the community
access and benefits from the forest. Though the community supported limitation on
grounds that it had reduced illegal logging, they felt that sustainable utilisation and
not total ban of forest use would help in making the resource useful to the people as
well as reducing poaching of resources from the forest. Illegal exploitation of the
forest has reduced the number of indigenous trees in the area because of the earlier
lucrative timber business.
To cope with the scarcity, the community is now establishing woodlots on their own
farms for firewood and softwood consumption. Alternative sources of energy like
paraffin are getting popular, yet this depends on availability of income. The following
is a case study with Mama Kamau regarding her relationship with the forest.
55
Case study 3
Mama Kamau, a middle aged village woman lives on the edge of Mount Kenya
forest in Naro mom area Nyeri district, She takes care of her four school-age
children. Her son and daughter-in-law work in Nairobi, and come home once or
twice a year, usually, during school holidays. Mama Kamau is responsible for
taking care of the family's day-to-day living expenses since her husband is
unemployed. Mama Kamau cultivates maize, beans and vegetables on her 1.5 acre
shamba because she lacks labour and her farm is small. She also keeps a cow and
four sheep. Her crops are adequate to feed the family, and sometimes, provide a
small surplus for sale in the village market. She also earns income from the
production of viondo, traditional baskets, which are sold in local town centres
through a local women's group. This provides cash to buy tea, sugar, salt, cooking
oil and other purchased goods for the family. Like many households in the area,
Mama Kamau relies on the forest for a range of subsistence items. She enters the
forest twice a week to collect fuel wood with a group of other women from the
village, and supplements this fuel with a few fallen branches from the Grevillea
trees on her farm. Although some of her colleagues do not hold a license for fuel
wood collection, they know that the local forest guards will not arrest them if they
pay them a small bribe. The women remark that it is getting more difficult to find
fuel wood and so they often have to go several kilometers into the forest, or fell
live trees. Because her farm is small, and most of the land is under cultivation,
there is no space for pasture. Mama Kamau's two elder grandsons take the smaller
animals into the forest to graze every day before and after school. At the same
time, they cut grass to be used for zero-grazing. Mama Kamau lives in a mud and
thatch house. Timber frames for the windows and doors were purchased from the
local carpenter, but the poles and thatching grass came from the forest. Her
husband owns six beehives in the forest. Overall, forest use is worth nearly 15,000
a year to Mama Kamau. For her, fuelwood and grazing are the most important
activities, because they support the household.
4.4 Main Hindrances to Community Involvement in Forest Conservation
According to the respondents, various factors hindered their participation in forest
conservation (Figure 4.7). Around 33% of the respondents reported that increased
56
government control over the use of forest resources in the area was a great hindrance
to community participation in forest resource conservation.
Lack ofTime ~
b
"- -~'
1.",."..- I
P
t=:3
-; 1
.•. ~I
1---- '. - -M -I
-0' we ,'" tol
Small Land Sizes
Lack of Tangible Benefits
Human Wildlife Conflicts
'"~l) Illegal Activitiese
iLack of Co-operationfrom Locals
U
Lack of awareness
Poor Management
Poverty
Govenunent Control
20
Percent
30o 10
Figure 4.7 Challenges to community participation in forest conservation
The community recommended that non-residential cultivation or shamba system, as it
is traditionally known, be reintroduced. They argued that the shamba system was an
important strategy for encouraging community participation in forest conservation
(Figure 4.8). Under the Shamba system, the cultivators were incorporated into the
Forest Department through employment. They were also permitted to clear and
cultivate indigenous bush cover in a specified land area, usually between 0.4 - 0.8 ha
per year. This was done with the agreement that tree seedlings are planted on this
land, and subsequently tended through weeding, pruning and safeguarding against
game damage. In return, the Forest Department provided the resident cultivator with
employment, social amenities and land for the cultivation of annual crops such as
maize, potatoes, beans, peas and other vegetables. Cultivation continued until when
40
57
tree seedlings were large enough to shade, thus inhibit the growth of annual plant
crops, usually a period of3-5 years.
Statement
80
70
60
50.•
C<I>U
I. 40<I>~
30
20
10
0
"0 r:: Q) .•..r:: cr:: Q) "0 '" 0 '" 0 .D "0 Q) .-t=ro .D Q) .~ .s .~ .•.. Q) S.s o tl ~ '" 0. 0."0"0 0 § 0 ::l E .2o- S Q) e S S 0.o ::l ~ •.... ~ ~ Q) '"Of) 0 e tEl Q) 0 > .•..'" •.... tEl ,;!:::< 0 §",..s:::: ~ r:: A.._ '" 0. 0 Q) 0 oo "0
o Strongly Agree Agree 0 Neutral 0 Disagree • Strongly Disagree
Figure 4.8 Community perceptions regarding the shamba system as a method of
re-forestation
However, in a bid to remain in allocated land, farmers usually destroyed young trees
to make sure they did not reach the stage where they competed with crops. This
effectively made the Shamba system unworkable as forest establishment became
impossible while other areas remained bare (Plate 4).
58
Plate 4. Tree plantations established through the Shamba system neighbouring a bare
section in Kiambuthia sub-location.
Most farmers (71%) strongly agreed that the shamba system was vital in availing
forest resources like wood and land for agriculture to the community. About 63% felt
that it was important in enhancing forest conservation. The system was devised in the
area by the Forest Department (FD) in 1943 and was meant to facilitate plantation
establishment by means of cheap or free labour. At the same time, this was a strategy
to increase employment among technically low-level workers and to increase
household food production among otherwise landless peasants.
Moreover, this system was to be part of a solution for the increasing demand for
timber. From the early 1980s, however, the scheme was mismanaged leading to the
degradation of the forest. Some of the farmers rented plots to second parties to ensure
continued presence and ownership of allocated plots. Therefore, trees were not re-
planted and the land did not return to the reserve. Many clear-cut plantation areas
were not under tree growing, either replanting was not successful or not undertaken at
all. The shamba system areas encroached into natural forests.
59
were not under tree growing, either replanting was not successful or not undertaken at
all. The shamba system areas encroached into natural forests.
The system was discontinued in 1987 in the area and in the whole country. This was
due to an expanded human population whose demand for forestland allocation
exceeded the initial forest department's objective of plantation establishment. In
addition, illegal activities (e.g. forest clearing, tree poaching, and hunting) from the
resident cultivators and their families jeopardized forest protection and management.
After the Shamba system was stopped, communities living around the forest moved in
and settled in areas that they had cleared.
The Kenya forest act 2005 has introduced the Non-resident Cultivation (NRC) for the
establishment of plantation forests. This is a modification of the Shamba system and
attempts to reduce the risk of cultivators claiming squatter rights on forestland. Little
has been done to understand how such an otherwise justifiable conservation system
resulted in such negative impacts on the forest resource. Unless this is done, there is
still a risk of repeating the mistakes that led to its ban and later reintroduction in the
area.
About 10% of the respondents indicated that lack of tangible benefits from
participating in forest conservation hindered community participation. Though the
local community may not have resources and the technical capacity to participate at
all levels of forest management, they can be helpful in provision of labour, indigenous
knowledge and general good will in conservation of the resources. With increased
funding and capacity building, the local communities can take charge and conserve
forest resources since they would be the first to feel the impact of the forest's
degradation. ",.
60
According to 14% of the respondents, increased poverty in the area tended to increase
the need for income generating activities together with the need for other livelihoods.
Therefore, if these needs can be addressed to some extent through participation in
forest conservation, the neighbouring communities would be encouraged to
participate in such activities. A strategy aimed at addressing the causes of poverty
amongst forest-adjacent communities should be adopted. This would include
interventions seeking to support sustainable livelihoods, with a particular focus on the
poorer members of the community who tend to be most forest-dependent. Particular
attention should be given to supporting and promoting income generation activities,
which either utilise the forest in non-destructive ways, or provide an alternative
source of income or forest products from outside the forest. Either way, it is hoped
that pressure on the forest from unsustainable use will be eased.
About 12% of the respondents cited human-wildlife conflict as a hindrance to
community participation in forest conservation, besides causing poverty. HWC
mitigation was suggested as a strategy to encourage community participation in forest
resource conservation in the area. The area is located along a route to elephants' salt
lick to the south. Community members have a negative attitude towards wildlife
conservation due to destruction of their crops and death/injuries associated with
elephant raids, yet no compensation. In response, the community sometimes killed or
injured the elephants through poisoning, shooting and use of snares. As a possible
solution, the community suggested erection of an electric fence to control elephant
movements.
61
About 5% reported that failure to understand the value of the forest to the community
was the biggest hindrance to community participation in the resource conservation. In
the longer-term, environmental education is the key to ensuring the future of Mount
Kenya forest. With improved understanding and appreciation of its importance,
especially, amongst the local people, there will be less pressure in the future for
excisions and resistance to destructive developments. Education could, therefore, be
crucial in ensuring that there is widespread and continued understanding of the
importance of the forest as well as changing the local community's attitude towards
forest resource conservation. This could address, among others, the importance of the
forest ecosystem to the livelihood of the local community, the rights of the
neighbouring communities as indigenous custodians of the forests plus the
responsibilities that goes with them.
4.5 SWOT Analysis of Community-based Forest Conservation
SWOT analysis was used to generate strategic alternatives of the aspects studied
regarding community participation in forest conservation. Because it concentrates on
the issues that potentially have the most serious impact, SWOT analysis was useful in
addressing the complex strategic situation in an attempt to re-orient community
participation in forest resource conservation towards sustainability. The analysis
classified the internal aspects of the community as strengths or weaknesses and the
external situational factors as opportunities or threats. Strengths were taken as
foundations for building a competitive advantage in forest conservation, and
weaknesses may hinder it. The following diagram shows how a SWOT analysis was
done.
62
Situational analysis
Figure 4.9: SWOT analysis variables for community-based forest conservation
Based on SWOT analysis, the following output can be said to reflect the community's
potential role in forest management.
a) Strengths
There is an emerging culture of conservation, tree planting and agro forestry in the
area due to increased awareness in conservation. This is an excellent entry point for
stakeholders in forest conservation like the government and community-based
organizations since the community is already largely aware of the importance of
forest conservation. There is also increased focus on community conservation as an
integral part of sustainable natural resource conservation since a top down approach
as practised by the government has lacked community good will leading to hostility
from the local community.
The forest is well endowed with a large reservoir of natural capital including water,
biodiversity and grazing land among others. These are powerful incentives, which can
be used by the government to reward positive community contribution towards forest
conservation to enhance community good will. Social capital includes a resilient local
63
community of cultural groups, local elders, sub-area and local government with
developed mechanism in the existing ecosystem, which can also be harnessed. Human
capital include an existing useful indigenous knowledge on the optimum use of
natural resources which has been practised sustainably for as long as the community
has co-existed with the forest even before the colonial era.
b) Weaknesses
Inherent weaknesses within the community include; the weak local governance
institutions, which are incapable of mobilizing and enhancing local community
participation in conservation of forest resources. Traditional governance structures
that used to control exploitation of natural resources are largely ineffective today.
Existing government institutions are also constrained in terms of resources such as
readily available transport. This leads to operational inefficiency.
There is lack of key staff, especially, trained community development experts with
wide knowledge of integrated nature of forest resource conservation. Officers at the
ground tend to be trained on isolated issues such as forest conservation or wildlife
management. Migration of educated labour has resulted to brain drain leaving only
the less literate community members in the rural areas while educated ones go to
urban areas in search of employment. The local communities perceive forests as idle
land that should be used for their daily needs, before they are conserved.
c) Opportunities
)
Under SWOT analysis, an opportunity was seen as the chance to introduce a new
approach in conservation that could generate superior results, usually, arising when
changes occur in the external environment. These included good political will and
recognition of the importance of poverty-environmental linkages and the importance
64
of improving environmental quality as a means of reducing poverty. There is
improved research and emerging technology in forestry, agro-forestry, poverty and
community development with the aim of enhancing sustainable utilisation of natural
resources. International organisations, NGOs and faith-based organizations have
integrated environmental issues as part of their overall development agenda.
The Government is also committed to implementing MDGs and address other global
issues such as climate change as evidenced from the national development plan and
policies, the Forest Act 2005 and Vision 2030 among others. Increased number of
partners and stakeholders has emerged due to increased international concern on the
state of the environment. Social changes and change in consumption patterns such as
use of energy saving technologies for cooking can enhance forest resource
conservation by easing pressure on the forest for fuel wood.
d) Threats
There is insufficient data on biodiversity and environmental degradation and value,
which is important in making key decisions in conservation and community
participation. Poor monitoring systems have, in the past, led to encroachment of
indigenous forests in the practice of shamba system. Since environmental authorities
are under-resourced, there is poor surveillance and consequent poaching of forest
resources. Increasing human-wildlife conflicts over scarce resources have led to
negative community perception of conservation. Rapid population growth has led to
food insecurity and increased demand for land, thus putting pressure on forestland,
usually, perceived as free land. Lack of a system to protect indigenous knowledge and
65
intellectual property rights (e.g., medicinal plants) leading to increased poaching of
vital biodiversity.
SWOT analysis was useful in reducing a large quantity of situational factors into a
more manageable profile. By understanding the four aspects, stakeholders in forest
resource conservation can better control its strengths, correct its weaknesses,
capitalize on excellent opportunities and deter potentially devastating threats.
66
CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS
5.1 Introduction
The study set out to assess the level of involvement of the local community in
conservation of Mount Kenya forest, Naro Moru area and to determine the main
hindrances and opportunities to community involvement in the conservation. These
were determined using questionnaires, focus group discussions, observation surveys
and key informant interviews. From the research findings, the following conclusions
and recommendations were made.
5.2 Conclusions
Several conclusions about the factors affecting participation in common property
management of forests are drawn from this study. Age, gender, and household income
had significant effects on participation in community forest management. Wealthy
households were more likely to be involved in decision making regarding forest
conservation whereas poorer households participated in activities such as surveillance
and tree planting. Individuals with higher landholdings were involved in a higher
level of decision-making whereas individuals with less landholding participated in
lower levels of decision-making. Men were more involved in forestry management
than women were. Increased government control over the use of forest resources in
the area was the greatest hindrance to community participation in forest resource
conservation. A reconnaissance survey of Mount Kenya Forest ecosystem done by
Thuita and Msafiri (2001) found out that roles played by the local communities in
r:
forest conservation and management had been downplayed by the then government
legislation and policies. The government used paramilitary approach in management
67
of the forests. They found that there was a need to involve the communities in
management decisions.
Major activities in which the community was involved included reforestation,
surveillance and patrols. As such, community forestry in this region did not enable
community members to increase their economic level from forest products.
Consequently, the motivation towards conservation was low. A related study by Bett
(2005) found out that respondents suggested that they should be integrated in
management of Mt. Kenya biosphere reserve and be seen as the main stakeholders.
Most respondents suggested that they should be allowed to benefit through non-
resident cultivation, which would enhance their food security as well as their income
base. However, there is an emerging culture of conservation, tree planting and agro-
forestry in the area due to increased awareness in conservation. This is an excellent
entry point for stakeholders in forest conservation like the government and
community-based organisations since the community is already largely aware of the
importance of forest conservation.
5.3 Recommendations
Equal participation is necessary across gender groups and social economic
backgrounds to create effective and equitable management for collective decision-
making, which ensures equal benefits for all user groups. Communities should be
given access to state forests, and local authority forests only to conduct activities with
no adverse impacts on forest ecosystem such as bee keeping, harvesting of medicinal
plants, collection of fuel wood and animal fodder and development of nature trails for
ecotourism.
68
Traditionally, forestry policies have been ineffective in providing rural societies'
basic subsistence needs in Kenya. The government should make a review of the
community participation in forest management with an aim of banning the non-
resident cultivation provided in the new forest act 2005 and provide for activities with
no adverse impacts on forest ecosystem. The regulation on extraction of natural
forests resources should be elaborated so that the local capacities are created for
management of these forests as per the provisions of the law.
The government should encourage communities to plant trees through agro-forestry
programs and to establish private commercial forest plantations to reduce their
dependence on natural forests and supplement their livelihood needs.
5.4 Recommendation for Further Research
This study was conducted at only one area of Mount Kenya forest within a limited
time frame. As such, the results are constrained by the small sample size and lack of
survey data from other forest communities. The small sample size may not reflect the
variability in the other parts of the forest. There is need to conduct similar studies in
other parts of the country to generate more reliable and objective findings to inform
policy decisions.
Gender participation shows that women were participating more but at which level of
participation is yet to be identified. In order to alleviate poverty and achieve success
in economic activities, there must be equitable distribution of access rights to natural
resources among all user groups regardless of their gender and economic profile.
69
This study was carried out during a period of forest sector reforms. A study should be
carried out to investigate the level of community participation in forest conservation
and management after the reforms have taken place.
70
6. REFERENCES
Arnold, J.E. (1995). Managing forests as common property, Community Forestry
Paper 136. FAO, State ofthe World's Forest, 1999.
Arnold, J.E. and Dewees, P.A., eds. (1997). Farms, trees and farmers: responses to
agricultural intensification.London. Earthscan Publications.
Baral, N.R .. (1993). Where is our community forestry? Banko Janaakari, A journal of
forestry information for Nepal, Vol. 4, No.1.
Bett, A. (2005).Role of community in the conservation of Mt.Kenya biosphere reserve.
A report submitted to UNESCO MAB. Kenya Wildlife Service. Nairobi.
Bongo, W. (2003). Mount Kenya National Park: Challenges in Protection and
Management. World Heritage Review.
Brookhaven, G. and Gathaara, G. (1995). Forest conservation in East Africa. East
African Wildlife Society, Nairobi, Kenya.
Bussmann, R. (1994). The Forests of Mt. Kenya: Vegetation, Ecology, Destruction
and Management of Tropical Mountain Forest Ecosystem. University of
Bayreuth, Germany
Bussmann, R.W. (1996). Destruction and management of Mount Kenya's Forests.
Ambio 25 (5): 314-317.
COMIFOR (1994). Conservation and Management of Indigenous Forests Project,
Inception Report, Forest Department, Nairobi
Devkota, G. H. (1998). Women's Participation in Community Forest Management: A
case study of Laxmi Mahila Community Forest User Group at Laxmi Bazar in
Gorkha. Unpublished MA thesis. Tribhuvan University, Kirtipur, Nepal
Emerton, L. (1996). Socio-economic Survey Recommendations for Mount Kenya
Forest, Project Technical Paper No. 10, Forest Department, Nairobi.
Emerton, L. (1999). Mount Kenya: The economics of community conservation. Project
Technical Paper No. 06, Institute for Development Policy and Management.
University of Manchester, United Kingdom.
FAO (2000a). Public Participation in Forestry in Europe and North America.
Geneva: LL.O.
71
FAO (2000b). Participatory forest management; a strategy for sustainable forests
management in Africa.Proceedings of the international workshop on community
forestry in Africa, April 1999, Bangui Gambia. FAO Rome.
FAO (2001). Global Forest Resources Assessment 2000. FAO Forestry Paper 140.
Rome, Food and Agriculture Organization.
Gay, L.R.( 1981). Educational Research: Competencies for analysis and application.
Charcles E .Mairill publishing company A. Bell & Howell Company.
Collumbus, Toronto,London.
Government of Kenya. (1942). The Forests Act, Government Printer, Nairobi.
Government of Kenya.(1994). Kenya Forestry Master Plan. Ministry of Environment
and Natural Resources. Nairobi
Government of Kenya (1999). Sessional Paper No.6 of 1999: Environment and
Development. Government printer, Nairobi.
Government of Kenya (2001). Nyeri District Development Plan 2002-2008, Effective
Management for Sustainable Economic Growth and Poverty Reduction.
Government of Kenya, Nairobi.
Government of Kenya. (2005). The Forests Act, Government Printer, Nairobi.
Kenyatta, J.(1965) Facing Mount Kenya. Vintage Books. Nairobi.
Kagombe, J. and Gitonga, J. (2005). Plantation establishment in Kenya: The shamba
system case study. Kenya Forests Working Group, Nairobi.
Kankolonngo, M.(2003). Promoting community- based reforestation and
agroforestry. Zaire.
Kunga, N. (2003). Forests conservation in East Africa: Is Community Based Forestry
the answer to forests' survival? East African Ecotourism Development and
Conservation Consultants, Nairobi.
KWS (1999). Aerial Survey of the destruction of Mt. Kenya, Imenti and Ngare Ndare
Forest Reserves, Nairobi
Ludeki, J., Wamukoya, G. and Walubengo, D. (2006). Environmental Management In
Kenya: A Framework for Sustainable Forest Management in Kenya-
Understanding the New Forest Policy and Forest Act, 2005 Nairobi: CREEL,
FAN, WWF and Ministry of Environment and Natural Resources .
./
Maathai, W. (1988). The Green Belt Movement: Sharing the Approach and the
experience. Environment Liaison Centre, Nairobi.
72
McAllister, K. (1999). Understanding Participation: Monitoring and Evaluating
process, outputs and outcomes. International Development Research Centre
Meizen-Dick, R.; Brown, L; Feldstein, H. (1997). Gender, Property Rights and
Natural Resources, Food Consumption and Nutrition Division (FCND)
Discussion paper No.29, International Food Policy Research Institute (IFPRI)
Ojha and Bhattarai, (2000). Distributional impact of community forestry, who is
benefiting from Nepal's Community forests? Forest Action Research Series,
00/01. Nepal.
Ostrom, E.; Schroeder, L. and Wynne, S. (1993). Institutional Incentives and
Sustainable Development, Infrastructure Policies in Perspective. Theoretical
Lenses on Public Policy, West view Press.
Pokharel, B. (2002). Contribution of Community Forestry to People's Livelihoods and
Forestry Sustainability: Experience from Nepal. World Rainforest Movement.
Paper presented in the Regional Workshop on Adaptive Collaborative
Management Sept 26-27,2002, Bangkok.
Thenya,T. and Msafiri.F. (2001). Reconnaissance survey of Mount Kenya Forest
Ecosystem. Kenya Forest Working Group. Nairobi.
UNEP (2002). Global Environment Outlook 3: Past, Present and Future Perspective.
Earth Scan, London.
United Nations Conference to Combat Desertification (2005). Fact sheet. UNCCD
secretariat, Bonn.
Wass, P. (1995). Kenya's Indigenous Forests: Status, Management and Conservation.
IUCN-ODA- (UK).
World Rainforest Movement (2002). Contribution of Community Forestry to People's
Livelihoods and forest Sustainability: Experience from Nepal. Regional
Workshop on Adaptive Collaborative Management Sept 26-27,2002, Bangkok.
73
7. APPENDICES
Appendix 1. Questionnaire for the Community
1. General information
Date
Sub-Location
Village
Distance from the forest
Questionnaire No.
Interviewer
Average Income Per Month
2. Age (years): under 18 [ ] 18-40 [] Over 40 [ ]
3. Gender Male [] Female [ ]
4. Level of education
[ ] Primary Level [ ] Secondary Level [ ] Post Secondary [ ] none [ ]
5. Means of livelihood
Farmer [ ] Casual labourer [ ] Business [ ] Employed [ ] Others specify
6. How long have you stayed in this area (years)?
0-5 [ ] 5-10 [ ] 10-15 [ ] Over 15 [ ]
7. What is the size of your land that is under cultivation?
Less than 2 acres [ ] 2- 5 acres [ ] over 5 acres [ ]
8. How did you access your land?
Inherited [] Bought [] Allocated after subdivision of forest [ ]
Hired [] others (specify) [ ]
9. In your opinion, who owns the Naro Moru forest?
Government [ ] Community [ ] Others (specify) _
THEME ONE
Level of involvement of the local community in conservation of Mount Kenya
forest, Naro Moru area
lOa. Have you ever been. involved in forest conservation. Yes [] No [ ]
b. If yes, when c. How _
d.Ifno,why? _
lla. Do you belong to any forest conservation group? Yes [ ] No [
b. If yes, which one? _
c. Which are the key activities of these groups? --------------
d.Ifno,why? _
12a. Do you believe that the community has the capacity to manage the forest on their
own? Yes [ ] No [ ]
b.lfyes, please explain _
c. Ifno, Why? _
74
13. What do you think are the benefits of Naro-Moru forest to the community and
environment at large?
Benefit Please tick
Climate regulation
Soil erosion protection
Source of food
Aesthetics
Wood fuel
Commercial wood
Source of water
Tourism
Air purification
Pollution mitigation
Medicinal herbs .<
Fodder
Education purposes
Sacred places
Others (specify)
14. How would you rate the frequency of your participation in forest conservation
activities?
Rating
Activities VF F S SL NR
Management Meetings
Afforestation
Reforestation
Wildlife protection
Forest policing
Shamba system
Fire prevention
Patrol/surveillance
Others (specify)
Where V F= Very Frequent F=Frequent Sr=Sometimes SL=Seldom NR= Never
15. In your opinion, what benefits can the community derive from participating in the
forest conservation?
Benefit Please tick
Fire wood
Poles
Labour
Timber
Land for cultivation
Honey
Grazing! fodder
Medicinal plants
Others (specify)
75
THEME THREE
Main hindrances and opportunities to community involvement in forest
conservation
16a. What are the problems/limitations (in order of importance) of participation in
forest conservation, in your opinion?
Rate Problem
1.
2.
3.
4.
5.
b. Why do these problems exist?
17. Please suggest solutions to each ofthe problems listed in 16a above
1.
2.
3.
4.
5.
18a. Have you ever experienced conflicts with forest management authorities?
Yes [ ] No [ ]
b. If yes, which
conflicts? --------------------------------------------------
c. How did you solve the conflicts?
19. In your opinion, what other problems related to the forest does your community
face? Please indicate the level of importance
Rate Aspect Level
importance
4 3 2 I
1.
2.
3.
4 ..
4-extremely Important, 3-Important, 2- not Important, l-Unaware
20. Please indicate, in order of importance, what, in your opinion, can be done to
enhance your participation in forest conservation.
76
I
ii
iii
iv
v
VI
21a. Have you heard ofthe shamba system before? Yes [] No [ ]
b. Have you been involved in it before? Yes [] No [ ]
c. What is your opinion about it on the following items?
Items 1 2 3 4 5
1. It is good and should be promoted
11. It enhances forest conservation
iii. It promotes deforestation
iv. It must be stopped
v. Government cannot stop it
1=strongly agree 2=agree 3=neutral 4=dIsagree 5=strongly disagree
22. Are you willing to support future conservation efforts in Naro Mom forest?
Yes [ ,] No [ ]
Explain. _
77
Appendix 2. Questionnaire for the Key Informants
1. General information
Date
Questionnaire No.
Occupation
Years of stay/work in the area
Age
Gender
Level of education
2. What is the relationship between your organisation and the community?
3. What are the attitudes and perceptions of the local community towards
conservation and protection ofthe forest resources in the area?
THEME ONE
Level of involvement of the local community in conservation of Mount Kenya
forest, Naro Moru area
4a. In your opinion, is the community involved in forest conservation.Yes [ ] No [ ]
b. If yes, when? c. How? _
d. If no, why?
5a. Are there forest conservation groups in the area ?Yes [
b. What role do these groups play in forest conservation?
No [ ]
6a. Do you think the community on its own has the capacity to manage the forest?
Yes [ ] No [ ]
b. Explain
7. In which forest conservation activities is the community involved
8. What benefits, in your opinion, can the community derive from participating in the
forest conservation?
78
THEME TWO
Main hindrances and opportunities to community involvement in forest
conservation
9a. What (in order of importance) hinders the community from participation in forest
conservation?
Rate Problem
1.
2.
3.
4.
b. Why do these problems exist?
10. Please suggest solutions to each ofthe problems listed in 9a above
1.
3.
2.
4.
5.
lla. Are there conflicts between the community and forest management authorities?
Yes[ ] No[ ]
b.Ifyes, which conflicts? _
c. How are these conflicts solved?-------------------
12. Please indicate what, in your opinion, can be done to enhance community
p .. {; .articipation 10 orest conservation
i
II
...
III
iv
v
vi
\\
EFFECT OF WATER, SANITATION AND HEALTH EDUCATION
INTERVENTIONS ON DIARRHOEAL MORBIDITY AMONG
CHILDREN IN MANDERA DISTRICT, KENYA 'i
SHEILLAH N. E. SIMIYU
157/12672/ 5
DEPARTMENT OF PUBLIC HEALTH
A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTERS
IN PUBLIC HEALTH IN THE SCHOOL OF HEALTH SCIENCES OF
KENYA TTA UNIVERSITY
March 2009
Simiyu, Sheillah N.
Effect of water,
sanitation and health
IUIIIIIHI!IIDIIIIIIIUIIII
II
DECLARATION
This thesis is my original work and has not been presented for a degree in any other university
or any other award.
----~ ~, -----------------
She-i~;;~~;miyu
-24:~J1t~t1-ti----2aQ3--
Date
Reg no 157112672/05
Department of Public health
Kenyatta University
SUPERVISORS
We confirm that the work reported in this thesis was carried out by the candidate under our
supervision. bD 1 .:>j
Signature---- - --------------------- Date: ---r,:g------
Dr. Augustine Afullo, PhD
Department of Public health
Kenyatta University
Signature------!!i~------
Dr. Margaret N. Keraka, PhD
Department of Public health
Kenyatta University
111
DEDICATION
To my late beloved mother, who was one of the main reasons for my pursuit of MPH; If only
you had lived longer.
IV
ACKNOWLEDGEMENT
My profound and sincere gratitude to my supervisors, Dr. Afullo Augustine and Dr. Keraka
Margaret, who tirelessly committed their time and knowledge to guiding me in this work from
its inception through its completion.
I would like to appreciate European Commission for Humanitarian Organization (ECHO) for
providing the funds towards this work. To Christophe Galazzar and the Action Against Hunger
staff in Nairobi office for the role they played towards ensuring that all went on well. To the
AAH staff in Mandera, for their guidance and direction in the field and for providing the
required assistance whenever needed.
Appreciation to all the administration officials in Mandera, especially the District
Commissioner, the chiefs of all the locations and their respective assistant chiefs for facilitating
easy entry into the community. Thanks to the key informants such as the chiefs, the AAH staff,
and the Mandera Hospital staff. Appreciation to the research assistants who assisted in the data
collection process and the community members for the warm welcome.
To my friends like Judy Ndungu, Anthony Wanjohi, Morris Gitau, Hannington Sitati, Letema
Sammy, Christine Majale, Onesmus Muinde, Jennifer Maina and many more who I have not
mentioned in name, your acts of kindness steered this work to its completion.
To my father, Mr. Emmanuel Simiyu for believing in me, and for making this endeavor a
success. To my lovely sisters, Rachael and Michelle, thank you for understanding!
Finally, to God, for life, for his all sufficient grace, and without whom this work would not be
complete.
vTABLE OF CONTENTS
DECLARATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENTS v
LIST OF TABLES ix
LIST OF FIGURES x
LIST OF APPENDICES xii
LIST OF ACRONYMS AND ABBREVIATIONS xiii
ABSTRACT xiv
CHAPTER ONE: INTRODUCTION 1
1.1 Background to the study problem 1
1.2 Statement of the problem 3
1.3 Justi fication 4
1.4 Objectives 4
1.5 Research questions 5
1.6 Hypotheses 5
1.7 Significance and anticipated output 5
1.8 Delimitations and limitations 6
1.9 Conceptual framework 6
1.10 Definition of terms 7
CHAPTER TWO: LITERATURE REVIEW 9
VI
2.l. Diarrhoea and its health implication 9
2.2 Access to water and sanitation 10
2.3. Water, sanitation and diarrhea 11
2.4. Water Quality vs. Quantity? 12
2.5 Adequacy in water, sanitation and diarrhea 16
2.6 Knowledge and Practices in diarrhea occurrence and prevention 17
2.7. Children's issues in relation to water and sanitation 19
2.8 The Kenyan situation 21
CHAPTER THREE: METHODOLOGY 25
3.1 Introduction 25
3.2 Study Area characteristics 25
3.3 Research Design 27
3.5 Target population 28
3.6. Sampling techniques and sample size 29
3.6.1 Sampling techniques 29
3.6.2 Sample size 30
3.7 Construction of research instruments 31
3.8 Pilot study 33
3.8.1 Validity 33
3.8.2 Reliability 34
3.9 Data analysis 34
3.10 Logistical and Ethical consideration 34
CHAPTER FOUR: RESUL TS 36
Vll
4.1 Introduction 36
4.2 Socio demographic information 36
4.2.1 Age 36
4.2.2 Gender. 36
4.2.3 Occupation 37
4.2.5 Income 39
4.2.6 Marital status 39
4.2.7 Number of children 40
4.2.8. Size of the household .41
4.3. The relationship between water, sanitation and diarrhoeal morbidity before the
interventions 41
4.3.1 Water 41
4.3.2 Sanitation and hygiene practices .41
4.4 Effects of the interventions on childhood diarrhoeal morbidity .43
4.4.1. The interventions 43
4.4.2. Effects of the interventions on under five diarrhoeal morbidity .44
4.5 Water, sanitation and hygiene risk factors 52
4.5.1. Water risk factors 52
4.5.2. Sanitation and Hygiene risk factors 60
4.5.3 Children's health 68
4.5.4 Influence of the socio economic environment 70
CHAPTER FIVE: DISCUSSION OF RESULTS 71
5.1 Introduction 71
V 111
5.2. The relationship between water, sanitation and diarrhoeal morbidity before the
interventions 71
5.3: Effects of the interventions on childhood diarrhoeal morbidity 72
5.4 Water, sanitation and hygiene Risk factors in the district 75
5.5 SUMMARY OF FINDINGS 81
CHAPTER SIX: CONCLUSION AND RECCOMENDATIONS 85
6.1 Introduction 85
6.2 CONCLUSION 85
6.4 RECOMMENDA TrONS 87
6.4.1 Recommendations for project planning and policy 87
6.4.2 Recommendations for further studies 88
REFERENCES 89
IX
LIST OF TABLES
Table 2.1 Strength of the links between water quality, quantity, hygiene, sanitation and
diarrhea occurrence---------------------------------------------------------------------------------- 15
Table 3.1 Proportionate distribution of households in the divisions-------------------------- 30
Table 3.2 Proportionate distribution of households in the locations-------------------------- 31
Table 4.1: Age distribution of the respondents--------------------------------------------------- 36
Table 4.2: Level of education of respondents---------------------------------------------------- 38
Table 4.3 Number of children below five years among the households---------------------- 40
Table 4.4: Interventions in water, sanitation and Health education in the district----------- 44
Table 4.5: Household heads who had received Health Education Training------------------ 45
Table 4.6: Organization of Health Education training------------------------------------------ 45
Table 4.7 Main water sources in the divisions in Mandera District--------------------------- 48
Table 4.8: Payment for water and description of water price---------------------------------- 50
Table 4.9 Latrine use, type and place of rei ief--------------------------------------------------- 51
Table 4.10 Water availability through the year -------------------------------------------------- 53
Table 4.11 Time taken to water sources----------------------------------------------------------- 54
Table 4.12 Water transportation methods--------------------------------------------------------- 56
Table 4.13 Water treatment and methods--------------------------------------------------------- 57
Table 4.14 Drinking water storage and scooping------------------------------------------------ 59
Table 4.15 Ways of hand cleaning among caregivers with children with diarrhea--------- 64
xLIST OF FIGURES
Figure 1.1 Conceptual Framework----------------------------------------------------------------- 7
Figure 2.1 Risk of human contamination with fecal oral pathogens in relation to water quality,
quanti ty and san itation------------------------------------------------------------------------------- 14
Figure 3.1 Map of Mandera District -------------------------------------------------------------- 26
Fig 4.1 Gender of the respondents----------------------------------------------------------------- 37
Fig 4.2 Occupation types of household heads---------------------------------------------------- 38
Fig 4.3 Income levels of the Household Heads -------------------------------------------------- 39
Fig 4.4 Marital Status of the respondents --------------------------------------------------------- 40
Fig 4.5 Content of Health Education-------------------------------------------------------------- 46
Fig 4.6 Health Education Coverage among those with Diarrhoea----------------------------- 46
Fig 4.7 Main Water Sources in Mandera District------------------------------------------------ 47
Fig 4.8 Diarrhoeal Prevalence among the water sources used by households with Diarrhoea---
----------------------------------------------------------------------------------------------------------- 50
Fig 4.9 Diarrhoeal prevalence among those with latrines-------------------------------------- 52
Fig 4.10 Water Sources used during the dry season--------------------------------------------- 54
Fig 4.11 Time taken to Water sources among those with Diarrhoea-------------------------- 55
Fig 4.12 Water transportation methods among those with Diarrhoea------------------------- 57
Fig 4.13 Water quantity among those with diarrhoea------------------------------------------- 58
Fig 4.14 Number of people sharing latrine among households with Diarrhoea------------- 61
Fig 4.15 Reasons for not using the leaky tin------------------------------------------------------ 62
Fig 4.16 Place of defecation of the chi Idren who had diarrhoea------------------------------- 63
Fig 4.17 Children's Waste disposal methods among those with Diarrhoea------------------- 64
Fig 4.18 Place of Drying kitchen utensi Is -------------------------------------------------------- 66
Xl
Fig 4.19 Storage method of utensils among children with diarrhoea------------------------- 67
Fig 4.20 Causes of Diarrhoea----------------------------------------------------------------------- 69
Fig 4.21 Management of Diarrhoea---------------------------------------------------------------- 70
XII
LIST OF APPENDICES
5.1: HOUSEHOLD'S QUESTIONNAIRE----------------------------- -------------------- 94
5.2: FOCUS GROUP DISCUSSION (FGD) GUIDE-------------------------------------- 100
5.3: OBSERVATION CHECKLIST ------------------------------------- -------------------- 101
5.4: RESEARCH AUTHORISA nON LETTER-------------------------------------------- 102
5.5: LIST OF FGD PARTICIP ANTS-------------------------------------------------------- 103
5.6: LIST OF RESEARCH ASSISTANTS--------------------------------------------------- 106
XIII
AAH
CBS
LIST OF ACRONYMS AND ABBREVIATIONS
Action Against Hunger
Central Bureau of Statistics
DALYs
ECHO
FSAU
GoK
IEA
JMP
KNH
MDG
MoH
MoP&ND
NGO
TFC
SPSS
UNDP
UN-HABITAT
UNICEF
VIP
WHO
WFP
Disability Adjusted Life Years
European Commission Humanitarian Organization
Food Security Analysis Unit
Government of Kenya
Institute of Economic Affairs
Joint Monitoring Programme
Kenyatta National Hospital
Millennium Development Goals
Ministry of Health
Ministry of Planning and National Development.
Non Governmental Organization
Therapeutic Feeding Centre
Statistical Package for Social Science
United Nations Development Programme
United Nations Human Settlements Programme.
United Nations Children's Fund
Ventilated Improved Pit Latrines
World Health Organization
World Food Programme
XIV
ABSTRACT
Globally, more than 125 million children under five years live in households without access to
quality drinking water, while more than 280 million children live in households without
access to improved sanitation facilities. Therefore, more than 1.5 million children die from
diarrhoea every year while many millions more have their development disrupted and their
health undermined by diarrhoeal or water-related diseases. Today diarrhoea is the leading
cause of mortality and morbidity, especially among young children in developing countries.
The Ministry of Health estimates that it contributes to 12.8% of the under five deaths in
Kenya. In Mandera, diarrhea is a problem especially among children under five years. It has
been identified as a major factor contributing to various other health problems such as
malnutrition and mortality. Various organizations have had Water, Sanitation and Health
Education interventions in the district, all aimed at containing diarrhoeal diseases especially
among the under fives. However, it is not known if these interventions have had any effect on
diarrhoeal morbidity among the children. The main objective of this study was to assess the
effects of water, sanitation and health education interventions on diarrhoeal morbidity among
children under five years in Mandera district. This was a descriptive cross sectional study that
mainly targeted the residents of Mandera District. Four divisions in the district were
purposively selected, and the sample size, of 350 caregivers proportionately distributed to
each of these divisions and the locations in each of them. Data was collected through an
interview schedule, focus group discussions and observation. SPSS version 12 was used for
analysis and chi square tests applied. Before the interventions, poor hygiene practices were
identified to be the main factors in the spread of diarrhoeal diseases. The study found that
there had been an increase in the number of people who had received health education. There
had also been an increase in the number of water sources and sanitary facilities, though this
increase did not reduce diarrhoel diseases. Just like before the interventions, the study found
that hygiene practices at the household level were the main factors in the spread of diarrhoea,
including storing drinking and water for other purposes in the same container (x2=8.471;
df=I; p=0.004),scooping of drinking water by pouring from the container (x2=20.981; df=2;
p=O.OOO),washing hands with water only (x2=15.471; df=4; p=0.004) open defecation among
children (x2=34.815; df=4; p=0.047) and poor storage of kitchen utensils (x2=15.859; df=5;
p=0.004). Other risk factors include using the river water in the dry season (x2=16.735; df=7;
p=0.019), water transportation by rolling on the ground (x2=13.329; df=6; p=0.038), and poor
disposal of the children's waste (x2=11.220; df=5; p=0.047). The study thus concludes that the
interventions have led to an increase in water and sanitation facilities, and in health education,
however, diarrhoeal diseases were mainly influenced by water, sanitation and hygiene risk
factors at the household level. This study recommends that the organization in the district
should continue with health education, but target the main household hygiene practices.
Religious leaders should also use religion to promote hygiene and the ministry of Health
should increase coverage of health centres in the district. A further study should be done to
identify factors that hinder the residents from practicing what they have been taught.
CHAPTER ONE: INTRODUCTION
1.1 Background to the study problem
Today, diarrhoea remains a major public health problem directly related to water and
sanitation by being the leading cause of mortality and morbidity, especially among young
children (Clasen et al, 2006). The greater percentage (88%) of diarrhoeal disease is
attributed to unsafe drinking water, inadequate sanitation, and poor hygiene (Bartram et al.,
2005).
United Nations Children's Fund (UNICEF) estimates that more than 2.6 billion people-
forty per cent of the world's population - lack basic sanitation facilities, and over one
billion people still use unsafe drinking water sources (UNICEF, 2006a). Approximately, 1·1
billion people are without access to a protected water source within reasonable walking
distance of their homes (Bartram et al., 2005). Globally, more than 125 million children
under five years live in households without access to an improved drinking-water source,
and more than 280 million children live in households without access to improved sanitation
facilities (UNICEF, 2006a).
Such circumstances, like lack of sanitary facilities and use of unsafe water sources, result to
1.2 billion people suffering annually (Uitto and Biswas, 2000) and 4 million people dieing
annually (ACF, 2005) from water and sanitation related diseases. Of all these illnesses,
diarrhea is the most common (Bartram et al., 2005). Globally, close to 2 million children die
from diarrhoea every year (UNICEF, 2007) while many millions more have their
development disrupted and their health undermined by diarrhoeal or water-related diseases
2(UNICEF,2006a).
In the developing countries, including Africa, 80% of the diseases are related to unsafe
water, poor sanitation, -and lack of hygiene (ACF, 2005); and they are the most common
causes of illness and death. Almost halfhave one or more of the main diseases or infections
associated with inadequate water supply and sanitation (Bartram et al., 2005).
Approximately 2 billion people die each year because of diarrhoeal water and sanitation
related diseases (ACF, 2005). Over 90% of these deaths occur in children under 5 years old
(UNICEF,2006a).
In Kenya some of the major environmental health problems that affect children are
inadequate access to safe water supply and inadequate access to sanitation. Environmental
health issues affecting children also include behavioral aspects related to hygiene and
sanitation, hand washing and food hygiene at the household level, low sanitation coverage
in rural and urban slums, and inadequate school sanitation and hygiene in schools and health
centers. Such factors influence behavior change uptake among children while away from
home (MaR, 2004)
The major causes of morbidity and mortality m Kenya are due to diseases that are
preventable through immunization, proper environmental management or observing basic
hygiene (MOR, 2004). Current environmental problems are related to a low level of safe
drinking water, poor environmental sanitation and refuse disposal, environmental pollution
3and food contamination. As a result, water-borne diseases such as diarrhoeal diseases,
typhoid and cholera have become major threats, especially in children (ibid).
In Mandera, the number of water sources is not sufficient for the population, and thus there
is pressure on the existing resources. Major causes of mortality and morbidity in the district
are conditions related to inadequate water and sanitation such as diarrhoea (Ministry of
Planning and National Development, 200]).
1.2 Statement of the problem
Diarrhoea is a problem in Mandera especially among children under five years. It has been
identified as a major factor contributing to various other health problems such as
malnutrition and mortality (Action Against Hunger, 2007). For instance, in April 2006, 181~
children were admitted to the Therapeutic Feeding Centre (TFC) as compared to the
maximum number of 78 children usually admitted in ope month (ibid). The prevalence at
this time was found to be at 26.8%. Improving wat~ and sanitation conditions is an-.
effective way to reduce vulnerability to diarrhea and other water-related illnesses (ibid) and
hence help children in the district grow to adulthood and play their roles in society.
Various organizations have had water, sanitation and health education interventions in the
district. Activities such as constructing latrines and waste disposal facilities and increasing
awareness about how to keep water clean and safe have been carried out (ibid). These
interventions were largely aimed at containing diarrhoeal morbidity in the district.
4However, it is not known if these interventions have had any effect on the population in
terms of their water, sanitation and hygiene practices and thus on diarrhoeal morbidity
especially among the children less than five years, hence the focus on the effects of these
interventions on diarrhoeal morbidity among the under fives in the district.
1.3 Justification
This study revealed the effects of water, sanitation and health education interventions on
childhood diarrhoeal morbidity in Mandera district. It thus led to an understanding of the
progress done in combating diarrhoeal diseases especially through water, sanitation and
health education interventions. The gaps that need to be filled in future interventions and
factors that still pre-dispose the children to diarrhea and consequently other related diseases
such as malnutrition were identified.
1.4 Objectives
The main objective of this study was to investigate the effects of water, sanitation and health
education interventions on diarrhoeal morbidity among children under five years in
Mandera district.
The specific objectives were:
I. To assess the relationship between water, sanitation and diarrhoeal morbidity before the
interventions.
II. To assess the effects of the interventions on childhood diarrhoeal morbidity
III. To examine the water, sanitation and hygiene risk factors that further pre dispose the
under five children to diarrhoeal morbidity
51.5 Research questions
This study sought to answer the following questions
I. What was the relationship between water, sanitation and diarrhoeal morbidity before the
interventions?
11. What effects have the interventions had on childhood diarrhoeal morbidity?
111. What water, sanitation and hygiene risk factors further pre dispose the under five
children to diarrhoeal morbidity?
1.6 Hypotheses
The hypotheses guiding this study were:
• There is no relationship between health education interventions and diarrhoeal morbidity
among children under the age of five
• There is no relationship between water interventions and diarrhoeal morbidity among
children under the age of five
• There is no relationship between sanitation interventions and diarrhoeal morbidity among
children under the age of five
1.7 Significance and anticipated output
The findings from the study were intended to identify the weaknesses and strengths of the
water, sanitation and health education interventions in the district. Further more, they were
to make suggestions on what directions the activities should take, therefore suggesting
future areas of target. This would be useful in planning for future interventions in the district
to avoid duplication of efforts in the same area.
61.8 Delimitations and limitations
This work begun before Mandera District was split into three districts and thus the study
was delimited to the larger Mandera District. The whole district could not be covered
because of security reasons at the time and thus this study was only limited to four divisions
in Mandera District. Only the households with under five children were selected in the study
area.
1.9 Conceptual framework
Diarrhoea is a result of multiple factors; including water, sanitation, knowledge and
practices. It is estimated that water, sanitation, and hygiene interventions reduce diarrhoeal
disease on average by between one quarter and one third (UNICEF AND WHO, 2006).
However, these sanitary facilities have to be available, and apart from this, they need to be
accessible. As earlier identified, water is an important factor in diarrhoea transmission.
Water should be available in the community, and these water sources should be accessible
to the community members. Accessibility also determines the quantity of water to be used
in a household. Knowledge also plays a role in diarrhoea transmission as it determines the
practices at the household level. It is estimated that educated women (and consequently
knowledgeable women) adapt behaviour change (Cairncross and Shordt, 2004). This
reduces the risky practices in diarrhoea transmission. Such practices include, but are not
limited to; water transportation, treatment of water, hand washing, water storage and
collection and hygiene practices such as handling of children's feacal matter. These are the
main factors that were examined in this study and their relationship in relation to diarrhea as
carried out in this study are shown in figure 1.
7SANITATION
• Availability• Physical access
., ,
WATER HEALTH
• Quantity DIARRHOEAL EDUCATION••••• ......•• Availability ~ MORBIDITY ......•• • knowledge• Physical~---~- A ~
PRACTICES
• Water treatment technologies
• Washing hands after defecating
• Washing hands before handling food
• Water storage practices
• Sharing water sources with domestic
animals
• Water collection practices
• Mode of transportation of water
• Socio-cultural practices
• Disposal of children's feacal matter
Figure 1.1 Conceptual framework
Source: Researcher
1.10 Definition of terms
Agro pastoralists: Persons living along the river and who engaged themselves 111 both
agricultural and livestock keeping activities.
Children Children in this study referred to any person who was below five years of age
Diarrhea: The frequent passage of loose or liquid stools 3-4 times a day (WHO,
2006a).
8Household: was defined as a family unit who ate from the same cooking pot.
Hygiene: Practices related to keeping oneself and the surrounding clean; and included
handling children's waste matter, handling of kitchen utensils, and hand
washing.
Morbidity: Morbidity in this study was used to refer to the number of children under the
age offive who had diarrhoea
referred to the number of children under the age of five who died as a result
of diarrhoea
Nomadic Pastoralists: People who solely had livestock keeping as a means of livelihood.
Mortality:
Prevalence: The percentage number of children who had diarrhoea two weeks before the
time of the study
Sanitation: Sanitation in this context referred to, the collection and disposal of human
waste (excreta) and included facilities/structures used in the disposal of
human waste.
Traditional latrine: Any latrine that did not meet any of the requirements of a VIP
latrine.
VIP latrine- An improved version of a traditional latrine that had at least one of the
following: a vertical vent pipe with a fly screen on top; and a hygienic self
draining floor. (Mathenge et al, 1987).
9CHAPTER TWO: LITERATURE REVIEW
2.1. Diarrhoea and its health implication
Diarrhoea remains the major cause of death of more than 2 million people per year world-
wide (Zamxaka et al., 2004) and the leading cause of mortality and morbidity, among
children in developing countries (Clasen et al., 2006). It is the largest preventable killer of
children under five and is caused by ingesting certain micro organisms spread through food,
utensils, hands and flies (WELL, 2004). Each year there are approximately 4 billion cases of
diarrhoea worldwide (WHO, 2006a).
Every day, 5,000 children under the age of five die in developing countries as a result of
diarrhoeal diseases related to inadequate water supply, sanitation and hygiene (UNICEF,
2006a). Many more are pushed to the very brink of survival (UNICEF and WHO, 2006).
Globally, they bear approximately 84% of the disease burden as a result of diarrhoea (UN-
HABITAT, 2003). These children are very susceptible to environmental health related
diseases such as diarrhoea due to their under developed immune systems and they are the
most affected by poor water supply and sanitation. In the poorest countries, lout of every 5
children fails to reach his or her 5th birthday, mainly due to infectious and environmental
diseases that arise from poor water quality (Uitto and Biswas, 2000).
Diarrhoea is a symptom of gastrointestinal infection and is defined as the passage of loose
or liquid stools more frequently than is normal. This is where a subject experiences three or
more loose, watery or bloody stools in 24 hours (Wright et al., 2006, WHO, 2006a). It may
last a few days, or several weeks and may be life threatening due to fluid loss in watery
10
diarrhoea, particularly in children, the malnourished and people with impaired immunity
(ibidj.It also contributes to malnutrition by causing decreased food intake, impaired
nutrition absorption and direct nutrition losses.
2.2 Access to water and sanitation
Access to safe water is a fundamental human need and therefore a basic human right. It is
the right of each individual to have long-term access to water in sufficient quantity and
quality, and at a distance and a cost that are acceptable (UNFPA, 2001). Basic access to
water is the availability of at least 20 litres per person a day from a source within 30 minutes
round trip (Howard and Bartram, 2003).
In 2000, 2.4 billion people lacked access to improved sanitation and 81% of these were in
rural areas. In the same year, 1.1 billion people lacked access to improved water sources
and 86% of these were in rural areas. Coverage for both improved water supply and
sanitation lags behind in the poorest communities - in rural areas and in urban/peri-urban
slums (WHO, 2004). Estimates by the Joint Monitoring Programme (JMP) for Water
Supply and Sanitation indicate that global coverage for improved water sources increased
from 78% in 1990 to 83% in 2004, Global sanitation coverage increased from 49%in 1990
to 59 % in 2004 (UNICEF, 2006a).
This implies that the world is still far from reaching the set MDG targets by 2015. There are
still huge disparities in the access to improved water and sanitation facilities between the
urban and rural areas. Of the 2.6 billion people globally without proper sanitation facilities,
11
2 billion live in rural areas (ibid). In sub-Saharan Africa, only 36(% of the population has
access to hygienic means of sanitation. This implies that a typical village in Africa with a
population of around 1000 people has less than 400 of its people with access to a latrine
(WHO and UNICEF, 2005).
Sub-Saharan Africa represents about 11 per cent of the world population, but almost a third
of all people without access to safe drinking water live here (Bartram et al., 2005). In South
Asia only 37% of the population uses adequate sanitation facilities, in West/Central Africa
the figure is 36 % and in Eastern/Southern Africa only 38% use adequate sanitation
facilities (UNICEF, 2006a). The urban-rural divide in drinking water is at its widest in sub-
Saharan Africa, where 81% of people in urban areas are served, compared with 41 % in rural
areas (ibid).
2.3. Water, sanitation and diarrhea
The Millennium Project's Task Force on Water and Sanitation identifies that safe drinking
water should be available in sufficient quantities for hygienic purposes (UNICEF AND
WHO, 2006). Such water does not represent any significant risk to health over a lifetime of
consumption, including different sensitivities that may occur between life stages (WHO,
2006a). The task force defines basic sanitation as the lowest-cost option for securing
sustainable access to safe, hygienic and convenient facilities and services for excreta and
sullage disposal that provide privacy and dignity while ensuring a clean and healthful living
environment both at home and in the neighborhood of users (UNICEF AND WHO, 2006).
12
Diarrhoeal diseases are most commonly transmitted through fecal-oral contamination. Most
of the organisms causing diarhoea can be spread by contam inated water. The prevalence in
children is associated with exposures to contaminated water, inadequate waste disposal,
poor domestic sanitation and hygiene in urban and rural households and waterborne
pathogens such as typhoid (MOH, 2004). It is more common when there is a shortage of
clean water for drinking, cooking and cleaning (WHO, 2006a).
Unsafe drinking water, inadequate availability of water for hygiene and lack of access to
sanitation together contribute to about 88% of deaths from diarrhoeal diseases (UNICEF,
2007) and 18% of all under five deaths annually (UNICEF, 2006a). Provision of adequate
sanitation services, safe water supply, and hygiene education represents an effective health
intervention that reduces the mortality caused by diarrhoeal disease by an average of 65%
and the related morbidity by 26% (ibid). Water, sanitation, and hygiene interventions reduce
diarrhoeal disease on average by between one quarter and one third (UNICEF AND WHO,
2006).
2.4. Water Quality vs. Quantity?
Interventions to improve water quality are generally effective in preventing diarrhoea, and
interventions to improve water quality at the household level are more effective than those
at the source (Clasen et al; 2006). However, in the recent decades, a consensus developed
that the key factors for the prevention of diarrhoea are sanitation, personal hygiene,
availability of water and good quality drinking water; and that the quantity of water that
people have available for hygiene is of equal or greater importance for the prevention of
13
diarrhoea as the bacteriological water quality (Jensen, et al., 2004). At the same time, some
studies have shown that only high levels of contamination of water sources (> 1000
Escherichia coli per 100 ml) could be significantly associated with the occurrence of infant
diarrhoea (Jensen, et al; 2004). Other studies suggest that water quality alone reduces
diarrhoea morbidity by 15% (Caincross and Valdamanis; 2007; Kiongo, 2005) while water
quantity reduces diarrhoeal morbidity by 20% (Caincross and Valdamanis; 2007; Kiongo,
2005). Both quantity and quality reduces diarrhoea by 17% (Caincross and Valdamanis;
2007).
UN-HABITAT (2003) shows that the risk of transmission of feacal-oral pathogens
(including diarrhoea) varies according to the quality of provision for water, sanitation and
hygiene as shown in figure 2.1. As illustrated in the figure, the risk of human
contamination with feacal oral pathogens is very high in places without an improved water
supply and with no basic sanitation. This risk is also very high in places where there may
be an improved water supply, but no basic sanitation or in places where there could be
access to basic sanitation but no improved water supply. However, this risk is reduced to
"high" in places where there is an improved water supply and basic sanitation. The risk is
further reduced to "medium" in places with an improved access to quality drinking water
and basic sanitation, combined with improved personal hygiene. However, this drinking
water must be piped to the household and disinfected at the point of use. This risk is
further reduced to "low" when there is continuous, good quality piped water supply into
the house plus hygienic, well maintained toilet in each dwelling unit that is used by all
family members; and safe and convenient disposal of waste water.
/14
No improved water supply (e.g.
reliance on water from rivers or
unprotected wells and no basic
sanitation
(Open defecation common)
Improved water supply (e.g
shared standpipe drawing
from piped supply) and no
basic sanitation
Basic sanitation (e.g pit
latrine in the house) but
no improved water supply
1
Improved water supply (including public standpipes,
boreholes, protected dug wells and rain water) and basic
sanitation (access to a toilet connected to a sewer or septic
tank, a pour flush latrine or a pit latrine.)
Improved access
to drinking water
(piped water
supply to a tap in
each household's
yard as well as
improved water
supply and basic
sanitation)
Improved personal
hygiene (e.g regular
hand washing after
--. defecation) as well as
improved water supply
and basic sanitation
Improved water
quality (e.g
drinking water
+- disinfected at a
point of use) as
well as improved
water supply and
basic sanitation.
Continuous, good quality piped water supply into the house plus
hygienic, well maintained toilet in each dwelling unit that is used by
all family members and safe and convenient disposal of waste water
In addition to the continuous good quality piped water supply into the
house, internal plumbing with hot and cold running water piped to
bathrooms, kitchens and toilets and provision for wastewater removal
from each of these
VERY
LOW
Figure 2.1 Risk of human contamination with fecal oral pathogens in relation to water
quality, quantity and' sanitation
(Source: Adapted from UN-HABITAT; 2003.)
Risk of human
contamination
with feacal-
oral pathogens
VERY HIGH
VERY
HIGH
HIGH
MEDIUM
MEDIUM
TO LOW
15
The risk is finally "very low" when there is continuous good quality piped water supply into
the house, internal plumbing with hot and cold running water piped to bathrooms, kitchens
and toilets and provision for wastewater removal from each of these (UN-HABITAT, 2003)
Further, some water related diseases occur both due to the quality and quantity of water and
sanitation services. The case for diarrhoea diseases is shown in table 2.1. The table
summarizes that if we were to compare between water quality, quantity, hygiene, sanitation,
hygiene and diarrhea occurrence, the link would be high between water quantity and
personal and domestic hygiene and diarhhoea, indicating that if compromised, diarrhea
would be easily spread and thus indicating that they are more crucial to look at when
preventing diarrhea.
Table 2.1 Strength of the links between water quality, quantity, hygiene, sanitation and
diarrhea occurrence
Diarrhoea Strenath of the link
Water Water Personal Wastewater Excreta Food
quality quantity or and disposal or disposal sanitatio
convenience domestic drainage n/hygien
hygiene e
Viral Medium High High Negligible Medium Medium
diarrhoea
Bacterial Medium High High Negligible Medium Medium
diarrhoea
Protozoal Low High High Negligible Medium Medium
diarrhoea
Source: Adapted from UN-HABITAT; 2003
It is therefore clear that water quantity and personal and domestic hygiene are of paramount
importance in the prevention of diarrhea.
16
Further arguments from Caincross and Valdamanis (2007) suggest that food has been found
to be far more heavily contaminated than drinking water, diarrhoea is seasonal especially in
developing countries, control of flies seems to be more effective in diarrhoea control and
that hand washing is more effective than water quality. Therefore suggesting that water
quality may not be of more importance than quantity.
2.5 Adequacy in water, sanitation and diarrhea
Where water supplies and provision for sanitation are inadequate for much of a population,
feacal-oral diseases can be among the most serious health problems (UN-HABITAT, 2003).
The burden of inadequate water, sanitation and hygiene is at least 2.2 million deaths and
82.2 million Disability Adjusted Life Years (DALYs) each year, which is 4% of all deaths
and 5.7% of all DALYs (ibid). Water supplies should be safe, sufficient for the community
needs, regular, convenient and available at a price they can afford. Sanitation facilities
should be convenient for all household members (including women and children),
affordable and should eliminate their contact with human excreta and other waste within the
home and the wider neighborhood. Thus there should be adequate provision for disposing of
excreta, wastewater and storm and surface run off (ibid).
There should be at least 20 litres per person per day from a source within 1 kilometer of the
users' dwelling. For sanitation, there should be access to a private or shared toilet connected
to a public sewer or a septic tank, or access to a private or shared pour-flush latrine, simple
pit latrine or ventilated improved pit latrine (ibid). Diarrhoea morbidity is reduced by 25%
through improved water supply (Fewtrell, et al 2005) and by 37% through improved
17
sanitation (Bartram et al, 2005; Kiongo, 2005)).
2.6 Knowledge and Practices in diarrhea occurrence and prevention
Three key factors in hygiene promotion are a mutual sharing of information and knowledge;
the mobilization of communities; and the provision of essential materials and facilities.
Effective hygiene promotion relies on an exchange of information between the agency and
the affected community in order to identify key hygiene problems and to design, implement
and monitor a programme to promote hygiene practices that will ensure the optimal use of
facilities and the greatest impact on public health.
Improvements in the quality and availability of water, in excreta disposal and in general
hygiene are all important in reducing faecal-oral disease transmission, including diarrhoeal
diseases (WHO, 2006b). Diarrhoeal diseases are transmitted through human excreta, thus
effective barriers should be in place to prevent this major transmission route (WELL, 2004).
Better sanitation alone could reduce diarrhoeal related morbidity by more than a third
(UNICEF, 2007), while improved sanitation combined with hygiene awareness and
behaviors could reduce diarrhoea-related morbidity by two thirds (UNICEF, 2006a). Such
behaviors include consistent use of a toilet or latrine by each person in the household and
hand washing with soap or ash after defecation and before eating (UNICEF, 2006a). Safe
excreta disposal could reduce diarrhoeal diseases by 33% (ACF, 2005). Still other literature
shows that hand washing with water and soap or ashes would reduce 0.5 to 1.4 million
deaths from diarrhea per year (UNICEF, 2007).
18
Hygiene interventions have a significant effect. Hygiene education and promotion of hand
washing with soap leads to a reduction of diarrhoeal cases by 42-47% (Fewtrell et a12005,
Curtis and Caincross, 2000) and cases of hospitalized diarrhoea, cholera and dysentery by
more than 50% (WELL, 2004). When food is prepared or stored in unhygienic conditions it
may be a major cause of diarrhoea (MOH, 2004). Simple techniques for treating water at
home (such as chlorination, solar disinfection and filtration) and storing it in safe containers
could save a huge number of lives each year. Treated water must be stored safely to prevent
re-contamination, for example, using containers with narrow openings and dispensing
devices such as taps (WHO and UNICEF, 2005). Water treatment and adequate domestic
storage, leads to a reduction of diarrhoea episodes by 39 % (Jensen et al., 2004, Fewtrell et
aI2005).
Mothers should dispose of their babies' faeces in a safe way; wash their hands after
defecation, after handling babies' faeces, after cleaning their babies' bottoms and before
preparing food in order to break diarrhoeal disease chain. The full benefits of improved
drinking water and sanitation services will be accrued only with effective and sustainable
behaviour change (WHO and UNICEF, 2005).
Other Studies reveal that
• Better-educated women are more likely to adopt long-term hygiene behaviours,
• Complex .behaviour c a';ges, such as regular hand-washing and consistent use of a
latrine require sustained interventions
19
• Continued access to services is not sufficient to sustain hygienic behaviour; hygiene
promotion and health education are also of fundamental importance (Cairnoross and
/
Shordt, 2004).
/
/
2.7. Children's issues in relation to water and sanitation.
The main water and sanitation issues that are related to childhood diarhoea and which put
children at greater risk are quantity and accessibility to water, storage of water, sanitation,
and the quality of care and hygiene practices; as discussed below.
• Quantity and accessibility vs. quality
In comparing quality and quantity, UN-HABITAT (2003) still maintains that water quantity
is as or even more important than quality, especially for maintaining children's health.
Water quality may be more critical for the health of children under three years of age, while
water quantity becomes a crucial health determinant above the age of three. Contaminated
water contributes to outbreaks of disease, but too little water makes it difficult to maintain
the sanitary conditions that prevent contamination, and that are essential for controlling the
endemic disease that contributes so heavily to death and repeated illness of many children.
It reveals that studies in Bangladesh and Niger found that contamination leading to
diarrhoeal disease is more highly correlated to dirty hands (a good indicator of the
accessibility of water supplies) than it is to the quality of drinking water (UN-HABITAT;
2003).
When water is at a distance and needs to be carried (or when it needs to be purchased from
20
vendors) many households with young children who technically have access to water make
do on far less than they really need. Hands, food, utensils, floors, cooking surfaces and
children are less likely to be kept clean when water must be carried any distance (UN-
HABITA T; 2003).
• Storage
No matter how close a water source is, when water is not piped directly into a house or yard,
it needs to be stored in containers. Even when water is piped to the house, it will have to be
stored if the flow is not regular. It is a particular problem in households with young
children, who may dip dirty hands into a storage bucket, or leave water scoops on the floor
contributing to contamination and disease (UN-HABIT AT; 2003).
• Sanitation
Small children have a drive to play and explore, they are in closer contact with the ground
and they have less appreciation of hygiene. This means that they are more likely to come
into contact wit excreta, as well as other pathogens (UN-HABITAT; 2003). Where children
are concerned the only safe sanitation methods are those that eliminate all forms of
possibility for contact with excreta. Safe stool disposal is far more effective as a safeguard
against diseases than any amount of hand washing (idid).
However, in many cultures, the excreta of young children is considered safe and free from
contamination and therefore not treated with the same hygienic concern as the excreta of
adults. Children are the main victims of feacal oral diseases and consequently remain the
21
major reservoirs of infection. This means that the feaces of children are more infectious than
those of adults as they are more likely to contain the disease causing micro organisms
(WHO; 1996).
• The quality of care and hygienic practices
Poor provision also affects children through the time burden it imposes on their caregivers.
Managing water supplies, keeping children clean and safe, dealing with waste and excreta in
the absence of adequate services, and handling food and utensils hygienically can take very
many hours. These are challenges that are often handled on top of 'real' work. Inadequate
provision takes its toll on the capacity of caregivers to provide care and the capacity of
families to function optimally (UN-HABITAT; 2003).
Improving provision for water can not only increase the amount of water used for child
hygiene but it can also increase the time mothers spend on child care (UN-HABITAT;
2003).
2.8 The Kenyan situation
Globally, a country is categorized as 'water stressed' if its annual renewable freshwater
supplies are between 1,000 and 1,700 cubic meters per capita, and 'water scarce' if
, renewable freshwater supplies are less than 1,000 cubic meters per capita. About 8.3% of
the countries are classified as 'water scarce,' while 9.8% are considered as 'water
stressed'. Kenya is in the category of water scarce countries (lEA, 2007).
22
Environmental problems in Kenya are related to a low level of safe drinking water, poor
environmental sanitation and refuse disposal, environmental pollution and food
contamination. Thus water-borne diseases such as diarrhoeal diseases, typhoid and cholera
have become major threats and causes of morbidity and mortality in children (MOH, 2004)
The national environmental sanitation and hygiene policy stipulates that 50% of the hospital
attendance in Kenya is water, sanitation and hygiene related (MOH; 2007).Water and
sanitation services are the basic necessities of a community, and the two most important
preconditions for development, as they also play an important role in improving health and
quality of life among the Kenyan population and in ensuring children's quality of life (ibid).
Poor water and sanitation aggravate morbidity and mortality. Consumption of contaminated
water and the use of improper sanitation or none at all explain the frequent disease
epidemics which affect the health of vulnerable groups (UNDP, 2002). In 2004, improved
drinking water coverage was at 83% in urban areas and 46% in rural areas. Improved
sanitation was at 46% in the urban areas and 41 % in the rural areas (UNICEF, 2006a). In
2001, Water related diseases accounted for 38% of illness morbidity, while 61 % of cases of
admissions at Kenyatta National Hospital (KNH) were due to diarrhoeal related
complications (MOH, 2002).
As per the WHO statistics of Kenya, between 2000 and 2003 diarrhoea was the second
cause of childhood mortality accounting for 16% after pneumonia (20%). It also contributed
significantly to neonatal deaths and was the third leading cause of death in all ages
accounting for 7% of all deaths (WHO, 2006c).
23
Diarrhoea is the 2nd largest preventable killer of children under five, the fourth leading cause
of death among these children contributing to 12.8% of these deaths and accounts for 40%
of outpatient cases (MOH, 2004). Majority of childhood deaths result from acute respiratory
disease, diarrhea, measles, malaria and malnutrition; or from a combination of these
conditions (GoK, 2005). The annual incidence of diarrhoea is 3.5 to 4.6 episodes per child
per year and dehydration caused by severe diarrhoea is a major cause of morbidity and
mortality (WELL, 2005; Ngaruiya, 2002). Poor Hygiene, which includes poor feacal matter
disposal, contributes to the spread of the disease. Most communities in Kenya believe that
young children's feacal matter is safe, consequently not much effort is made to ensure safe
disposal (CBS, MOH and ORC, 2004).
Surveys done between March and July 2005 showed that 62% of deaths among under-five
children in northwest Turkana resulted from fever and malaria, 28% from cough and
difficult breathing and 10% from diarrhea. Kwale recorded over 28% diarrhoeal disease
incidences (UNICEF, 2005; FSAU, 2005). Studies reveal that frequent illness (such as
diarrhea and acute respiratory infections) among children under five is common in Mandera.
Incidence of diarrheal disease usually increases following the onset of the long rains
(Grobler- Tanner, 2006).
In April 2006, heavy rains caused animal carcasses to be washed into water pans, leading to
contaminated water sources. This resulted in an outbreak of Shigella (a bacteria causing
diarrhea in animal and humans). A large portion of the population also obtains water from
24
unsafe sources (unprotected pans, contaminated nvers, lake) and treatment of water by
boiling or purification is not common (ibid)
In 2006, Diarrhoea was the cause of the sharp increase in malnutrition in Mandera District;
and this was due to use of contaminated water from collapsed latrines and water drainage
systems (WHO, 2006d). Studies reveal that diarrhea is the cause of the increase in
malnutrition in Mandera (AAH, 2006; FSAU, 2005).
25
CHAPTER THREE: METHODOLOGY
3.1 Introduction
This chapter describes how the study was undertaken and describes the methods used in
data collection. It includes sections such as description of the study area, research design,
sample size and sampling techniques, data collection techniques, pilot study and ethical and
logistical considerations.
3.2 Study Area characteristics
The study was carried out in the former Mandera District which was one of the four districts
in North-Eastern Province located at the North-Eastern corner of Kenya until July 2007
when it was split into three districts:-Mandera Central, Mandera West and Mandera East.
(See figure 3.1). It covered an area of 26,474km2 and had a population of281 ,955. (Ministry
of Planning and Development; 2001) with a total of 45,522 households. (GoK, 2001a) It
shared international boundaries with Ethiopia to the north and Somalia to the east. It
bordered Wajir district to the south and southwest. The district had 18 divisions, 86
locations and 116 sub-locations (Ministry of Planning and National Development, 2001).
There are no perennial rivers except the seasonal River Daua that passes over half of the
district's boundary with Ethiopia. There are many dry river beds (Laga), which get filled by
run-off water during the rainy season but dry up as soon as the rain ceases. Rainfall is scanty
and erratic with an annual average of 255mm. The long rains fall in the months of April and
May while the short rains fall in October and November. There is a high rate of evaporation,
which causes withering to most vegetation before maturity (ibid).
26
I 1lW~
$moo~li,E,!!" !ii/Wm5
%}lx$~
VK,Um
lliMtn
NW+E
&
750000
Figure 3.1 Map of Mandera District
27
Water and pasture availability determines population distribution and density. Areas like
Banissa Division, which have more permanent settlements and water sources, have high
population concentrations especially around boreholes and earth pans. In urban and rural
market centers the density is high due to availability of social facilities and security. There
are 104 Ventilated Improved Pit (VIP) latrines and the average distance to the nearest water
point is 20Km. The top five causes of morbidity are malaria, respiratory tract infections,
diarrhoeal diseases, severe malnutrition and anaemia respectively in that order. (ibid) The
main sources of water for the population in the district are wells (29%), dams (19%) and
boreholes (18%) (GoK, 2001a).
3.3 Research Design
This study was a descriptive cross sectional study as it sought to establish associations
between variables such as knowledge, diarrhoeal disease morbidity, water and sanitation. It
was a representation of what was going on at the point in time and no attempt was made to
change the existing conditions on the ground. Childhood diarrhoeal morbidity was the main
dependent variable that was influenced by independent variables such as water, sanitation,
knowledge and practices.
3.4 Location of the study
The study was conducted In different divisions in Mandera District. Due to security,
accessibility and financial challenges, four divisions were selected to represent the district.
These divisions were Khalalio, Central, Malkamari and Hareri.
28
3.5 Target population
The study basically targeted residents of Mandera district. The district has a population of
281,955, with the ratio of men to women being 1:2. The district generally has a sparse
population density, which fall below 35 persons per square kilometre except Central
Division, which has 436 persons / km2. The under five mortality rate is 211000- and the
death rate is 311000 (GoK, 2001b). School dropout rate is at 6.5 per cent because of
migratory nature of the people due to drought, insecurity, lack of school fees and early
marriages (ibid).
The marn livelihood systems in the district are nomadic pastoralists who solely have
livestock keeping as a means of livelihood, Agro Pastoralists who live along the river line
and engage in both agricultural and livestock activities mainly growing maize, sorghum and
millet, there are some few people who are engaged in other means of livelihood such as
businesses, casual labor and water vendoring; while there are others who lost their animals
to the drought and depend on food aid and other alternative means of livelihood. Due to
constant drought lack of market for livestock and unemployment most people are poor and
depend entirely on relief food (maize rations and water) (ibid)
The following criteria were used to select the respondents:
• Residents of Mander a district for at least a year
• Households with children under five years
Those who were excluded from the study were those who were Non residents of Mandera
district and the households without children under five years old
29
3.6. Sampling techniques and sample size
3.6.1 Sampling techniques
Mandera District was selected purposively because of interventions in water, sanitation and
health education. Purposive sampling was also applied to select the four divisions; Central,
Hareri, Malkamari and Khalalio; because they have received water, sanitation and health
education interventions from the organizations. Another reason for the purposive selection
of the divisions was the security situation at the time which therefore implied that some
divisions were not easily accessible. Sampling proportionate to sample size was used to
proportionately distribute the required sample size to each of the divisions as shown in table
3.1.
In the district some locations are administratively classified as both locations as well as sub
locations. In central location, such were purposively selected and four locations randomly
selected out of these that were both locations and sub locations. From Malkamari division,
four locations were selected randomly. Three locations were conveniently selected from
Khalalio division and one division left out because of the security situation at the time of
data collection. One location was also randomly selected from Hareri division. The number
of respondents from each location/sub location was proportionately distributed to the
number of respondents per division as shown in table 3.2.
Households were drawn from every zone/village in the selected locations/sub locations with
numbers distributed according to the total number of households in each zone/village. Local
leaders were used to understand boundaries and areal coverage on the ground.
30
3.6.2 Sample size
The sample size was determined using the formula from ACF (2005)
N=t2 (P X Q)
d2
Where,
N= the desired sample size
t= the error risk parameter, related to the 95% confidence interval; thus t=I.96
P= the expected prevalence (p=diarrhoeal disease morbidity; P=0.26 from AAH, 2007)
Q=I-P
d=the degree of accuracy
Thus n= 1.962 x0.26xO.74
0.052
=296 respondents
However to increase representativeness and reduce the error margin, the sample size was
increased to 350 respondents. The increase was also necessitated by the fact that some
locations in the district have very few people and this therefore meant that a representative
figure would not be obtained by using a smaller sample size. This sample size was
proportionately distributed in the four divisions as represented in table 3.1.
T bl 31 P ti t di t ib ti fh h Id . th di ..a e . ropor rona e IS n U IOn 0 ouse 0 sm e ivrsrons
DIVISION H/HOLDS PROPORTION RESP
1. Central 7985 (7985/12869)x350 217
2. Malkamari 2284 (22841l2869)x350 62
3.Khalalio 1497 (1497/12869)x350 41
4. Hareri 1103 (l1031l2869)x350 30
TOTAL 12869 350
(Source: GoK, 200 1b)
The number of respondents from the selected locations in each of these divisions was also
proportionately distributed as shown in table 3.2
31
T bl 32 P d' ib .a e . roportionate istri ution of households in the locations
DIVISION LOC/SUB LOC H/HOLD PROPORTION RESP
1. Malkamari Malkamari 576 (576/2284)x62 16
Guba 825 (825/2284 )x62 22
Hullow 686 (686/2284)x62 19
Malkaruka 197 (197/2284)x62 5
Total 2284 62
2. Hareri Sala 461 (461/461)x30 30
Total 461 30
3. Central Shaf Shaffey 1051 (1051/4314)x217 53
Central 1660 ( 1660/43 14)x21 7 83
Neboi 613 (613/4314)x217 3]
Bulla Mpya 990 (990/4314)x217 50
Total 4314 217
4. Khalalio Khalalio 223 (223/642)x41 14
Bur Abor 248 (248/642)x41 16
Karow ]71 (1711642)x41 11
Total 642 41
(Source: GoK, 2001b)
3.7 Construction of research instruments
Primary Data was collected using several methods, thus:
i. Pre tested interview schedules
These were mainly administered to the household heads. They were objectively designed to
answer questions on water sources, sanitary facilities, hygiene practices at the household
level and childhood diarrhoeal morbidity at the household level. (See appendix 5.1)
ii. Focus Group Discussions (FGDs)
These mainly yielded qualitative data to support the quantitative data obtained from the
Interview schedules and were conducted to the community members in the selected study
areas. For cultural reasons, different discussions were held with the men and women in each
32
of the areas visited. This was important as it gave different views of men and women. Two
focus group discussions were held in each of the locations except in Hullow and Shaf
Shaffey where one discussion was held and in Karow where no discussions were held.
Therefore a total of twenty FGDs were done. These were organized with a minimum of 8
and a maximum of 12 participants. The participants were randomly picked from the
households in which no interview schedules were conducted and which there was at least a
child below the age of five years. (Their names appear in appendix 5.5) Questions were
asked and the responses from the community members recorded. (See appendix 5.2)
iii. Key Informant Interviews
These were held with Local and administrative Leaders and Non Governmental
Organization (NGO) workers in the district. A total of eight interviews were conducted. The
local leaders such as the local administration leaders were selected because of their
knowledge with the community members and thus they were instrumental in providing
information on the community's practices in relation to water, sanitation and hygiene. The
NGO workers were instrumental in providing the information of the state before the
interventions and the specific interventions in water, sanitation and health education that
were implemented. Other interviews were held with the well committee members and local
opinion leaders who also provided information on the community practices in relation to
water and sanitation, especially latrine construction, water source management and other
sources of water used.
33
iv. Observation
This was done using an observation checklist and a sanitary survey checklist as indicated in
appendix 5.3. This method was also used to verify what the caregivers said as they
responded to the interview schedule. It was also used to identify hygiene and sanitation
practices at the household level that were risk factors and potential risks of contamination at
the water sources.
Secondary data
Secondary data was collected through review of related literature to find out the state before
the interventions were introduced and the trend of childhood diarrhoeal morbidity. Some of
the places visited for secondary data collection included Mandera District Hospital, AAH
offices, IR offices, UNICEF Mandera office and the ALRMP office.
3.8 Pilot study
A pilot study was conducted at Border Point 1 (BPI) village in Mandera Central Division.
Fifteen interviews were conducted using the interview schedules and two FGDs conducted
using the FGD guides. This was mainly for testing the research instruments to find out if
they were valid. Various issues that were not clear in the instruments were rectified, while
those that had been omitted from the research instruments were included.
3.8.1 Validity
After the pre testing, the issues that were not clear were rectified. All the questions were
thoroughly scrutinized and those that were not necessary were deleted. Those questions that
34
needed to be rephrased were done so. They were also translated in the local languages
during the pre testing to ensure that they did not lose meaning. To ensure that the
instruments were valid, they were pre tested and the necessary changes made before the
beginning of the study
3.8.2 Reliability
This was ensured through thorough selection and training of research assistants, engaging
them in the pilot study and supervising them during the data collection process. These
assistants were paired to assist each other In the data collection process.
(Their names are listed in Appendix 5.6) Completed interview schedules were
counterchecked daily to identify and correct errors and were shared with the research
assistants to ensure quality of data.
3.9 Data analysis
Data was sorted and entered in an Excel spreadsheet, and later cleaned. It was then
transferred to the Statistical Package for Social Science (SPSS) version 12, where it was
cleaned further by running simple frequencies. The data was then analyzed using descriptive
statistics and further using contingency tables and chi square tests to test the relationship
between the variables. The three hypotheses were tested using the chi square test.
3.10 Logistical and Ethical consideration
Clearance was obtained from Kenyatta University and The Ministry of Science and
Technology who gave an authorization letter to this effect. (Appendix 5.4) Permission to
35
carry out the research was obtained from the relevant authorities in Mandera District
including the District Commissioner and Chiefs. These chiefs were contacted beforehand to
ensure easy entry into the community. The research assistants were carefully selected from
each of the four clans in the district to ensure sensitivity to culture. Informed consent was
sought from all the respondents and confidentiality was maintained on all data collected
36
CHAPTER FOUR: RESULTS
4.1 Introduction
This chapter gives the results of the data collected from the respondents in the study area.
The analysis was done using SPSS version 12 for Windows. Descriptive statistics such as
means and frequencies were calculated for respective characteristics whereas statistical
significance of association was determined by chi square tests. Where appropriate, graphs
and tables have been used to present the findings.
4.2 Socio demographic information
This section represents the socio demographic characteristics of the respondents in the study
area. Thus attributes such as age, occupation, income, level of education, marital status and
household size are presented.
4.2.1 Age
The highest percentage of the respondents was aged between 36-45 years (30.6%) and only
5.7% were aged above 65 years as shown in table 4.1.
a e \..l~e IS n u ion 0 e respon en S
Age categories (in years) Frequency Percent
15-25 35 10.0
26-35 88 25.1
36-45 107 30.6
46-55 73 20.9
56-65 27 7.7
Above 65 20 5.7
Total 350 100.0
T bl 41 A di t ib t fth d t
4.2.2 Gender.
Most of the respondents (7l.4%) were males and 28.6% were females as shown in figure
4.l.
37
Females, 28.60%
Males, 71.40%
Figure 4.1 Gender of the respondents
Men comprised the greater percentage since they were the main breadwinners. However, the
women were the main respondents.
4.2.3 Occupation
There were different occupations in the district. Those who were involved in informal
employment comprised 20.9% of the respondents. These were mainly those who were
casual labourers taking on such jobs as cleaners, tailors, drivers, and other smaller
occupations. Those involved in livelihood occupations comprised 19.4% and these were
mainly the pastoralists, agro pastoralists and farmers. Those who were self employed
comprised 17.4% and these were mainly involved in business. Those who had no defined
occupation comprised 32.3% of the respondents and these were the aged, those who were
school drop outs, housewives or those who had nothing to do for a living. The least group
comprised of those who were formally employed (l 0%) and these were those people
38
employed by the organizations working in the District. These for example consisted of
government employees (figure 4.2).
35 32.3
30
25
10
10
5
-- 1o
None Informal
employment
Farming Self employed Formal
employment
Occupation Types
Figure 4.2 Occupation types of Household heads
4.2.4 Level of education
The greater majority of the respondents had never gone to school (83.1%) and only 0.9%
had attended school to the tertiary level of education as shown in table 4.2.
T bl 42 L I f d f f da e .. eve 0 e uca IOn0 respon ents
Category Frequency Percent
Never gone to school 291 83.1
Lower primary 22 6.3
Upper primary 22 6.3
Secondary 12 3.4
Tertiary 3 .9
Total 350 100.0
39
These results show that the rates of illiteracy are very high in the district.
4.2.5 Income
A greater percentage of the respondents (52%) had an income of less than ksh 5000 with the
least percentage (l.7%) having an income of between ksh 20,000 and ksh 25,000 as shown
in figure 4.3.
Above 25,000
? 20.001-25,000'"~c 15,001-20,000:.=.-
C
0 10001-15,000OIlQ).•..e<:
CJ
Q) 5001-10000S
0CJc 1000-5000•...
less than 1000
0
1-- ---- ------r- --.----,
10 50 6020
Percent
30 40
Fig 4.3 Income Levels of the Household heads
4.2.6 Marital status
Majority of the respondents were married (87.1 %),9.1 % were widowed or widowers and
the rest (3.7%) were divorced as shown in figure 4.4.
40
4%
87%
Fig 4.4 Marital Status ofthe respondents
,---
III Married
13Widowed
151Divorced
4.2.7 Number of children
The least number of children per household was one and a maximum of eight children. The
mean number of children was 4 with a standard deviation of 1.5. for the number of children
below five years, Fourty two percent of the households had one child below the age of five
years while only 0.3% had 5 children below the age of five years as represented in table 4.3.
T bl 43 N b f h'ld b I fi h h h Ida e . urn er 0 c I ren eow rve years among t e ouse 0 s
Number of children Frequency Percent
1 150 42.9
2 123 35.1
3 71 20.3
4 5 1.4
5 I .3
Total 350 100.0
41
4.2.8. Size of the household.
The mean household size was 6 people, with a minimum of 3 people and a maximum of 10
people. The standard deviation was 1.6.
4.3. The relationship between water, sanitation and diarrhoeal morbidity before the
interventions
Information on the situation before the interventions is very scanty. However, the Major
findings from a baseline study done in 2006 were
4.3.1 Water
The common sources of water were the borehole (44%), the river (15%), Ministry of Water
(15%), shallow wells (11 %) and earth pans (5%). This water was transported by donkey
carts (44%), jerry can rolling (29%), and carrying the jerry cans (25%). Transportation of
water through jerry can rolling (on the ground) was associated with the high incidence of
diarrhea. A greater percentage (85.8%) of women did not treat their water. Of those who
treated, 5.8% boiled, 5.8% used the alum stone, 2.5% used chlorine, and 0.4% used
traditional roots (AAH; 2006).
4.3.2 Sanitation and hygiene practices
Sanitation and Hygiene risk factors that were noted for the under five diarrhea incidence
were:
Almost all (9l.7%) of the respondents used the same water container to store water drinking
purposes and water for washing purposes. This meant that the water used for drinking was
likely to be contaminated.
42
Forty three percent of the respondents stored their water in open water storage containers.
Such were metal drums and large plastic tanks. This meant that the water was likely to be
contaminated. This practice was associated with the high incidence of diarrhea. In addition,
63.8% of these containers were dirty.
Slightly more than half (57.9%) of the adults used the family latrine while 56.3% of the
children used the same family latrine. However, this report acknowledges that these
findings were skewed since many of the clusters selected were in an urban area. (AAH;
2006). For those who did not have latrines, 17.9% of adults used the bushes and 22.9% of
the children also used the bushes. The neighbor's latrine was used by 10% of the children
and 18.3% of the adults while the public latrine was used by 2.5% of the children and 6.7%
of the adults.
All the children's waste was swept with rubbish. Thirty two percent disposed these
children's waste in the bushes. Such practices were identified to be routes for diarrhea
transmission since culturally the population believes that children's feces are not harmful to
health. (AAH; 2006). Flies were a major problem and were present in 88.7% of the
households. These were noted to be a complementary in the diarrhea transmission chain
especially in the transfer of pathogens from feaces to food.
The greater percentage (72.8%) of the compounds were not swept. Human feaces were
noted in 26.7% of compounds indicating a poor disposal of human waste. This was also a
reason for the occurrence of flies in the compounds. Apart from human feaces, animal
43
feaces were also observed in 58.3% of compounds. Although all the respondents cited
washing their hands, a washing area with soap was observed in only 6.7% of the
households. There was a high probability that hands were improperly washed or not washed
at all.
In terms of Heath education, only 5.8% of the women interviewed said they had ever
received health education from the various organizations working within the district. This
was noted to be quite a low coverage.
Diarrhea prevalence among children under the age of five at the time (in 2006) was at
26.8%, in addition, 47.9% of the households had diarrhea. Other recommendations from the
baseline were: The need to educate the residents on the importance of storing water in
closed containers; to stress the importance of proper food handling, encourage proper hand
washing (with soap or ash) and use of a tippy tap
4.4 Effects of the interventions on childhood diarrhoeal morbidity
After looking at the situation before the interventions, this section will look at the effects of
the interventions on under five diarrhoeal morbidity.
4.4.1. The interventions
The different interventions in water, sanitation and health education are as summarized in
table 4.4.
44
Table 4.4: Interventions in water, sanitation and Health education in the district
Interventions Specifics
Water • Rehabilitation of earth pans through enlarging, desilting, lining the
bottom of the earth pans with polythene paper, fencing and/or
construction of infiltration wells
• Construction of new earth pans
• Provision of separate water drinking facilities for livestock in the
earth pans
• Rehabilitation of old and worn out underground tanks (birkhads) by
roofing, repairing inlets and enlarging where possible
• Introduction of new water projects
Sanitation • Distribution of tool kits to community health facilitators to aid in
latrine construction
• Construction of communal latrines
• Training of masons to help in construction of the latrines
Health Some topics covered in the health education sessions include:
Education • Latrine usage and maintenance
• Safe water handl ing and treatment
• Diarrhoea control and prevention
• Control and prevention of respiratory infections
• Nutritional health education, benefits of breastfeeding and
immunization
4.4.2. Effects of the interventions on under five diarrhoeal morbidity.
4.4.2.1 Health education
Twenty seven percent of the household heads reported having received health education
while 72% had not received any health education training as shown in table 4.5.
45
T bl 45 H h Id h d h h d . d H I h Eda e .. ouse 0 ea sw 0 a receive ea t ucation Traininz.
Received H.E training Frequency Percent
Yes 96 27.4
No 254 72.6
Total 350 100.0
Of these who had received health education, 84.4% had received from AAH and only 1%
from Arid Lands Resource Management Project as represented in table 4.6.
T bl 46 0 fH I h Eda e .. rganization 0 ea t ucation training
Organization of Health Education Training Frequency Percent
AAH 81 84.4
Islamic Relief 9 9.4
Arid Lands 1 1.0
Ministry of Health 5 5.2
Total 96 100.0
This therefore implies that there had been an increase in the number of people who had
received health education and primarily from AAH. However, the pearson's chi square test
revealed no significant relationship between those who had received health education and
diarrhoeal disease morbidity among the under fives (x2=0.985; df=l ; p~0.321) and thus the
first Null hypothesis was accepted.
Among those who had received health education, the content of the training was as
represented in figure 4.5. As shown in the figure, the greater percentage of respondents
affirmed that the content of the health education was sanitation and hygiene. However,
among those who suffered from diarrhea, 65.8% had not received any health education only
while 34.2% had received health education as represented in figure 4.6.
46
Water 39.6
malaria
~76
~76
~19.8
I
Sanitation-=~= Personal Hygieneo
U
nutrition ~ 35.4)
-,---,--~ ---- r---, --
o 10 20 30 40 50 60 70 80
Percent
Fig 4.5 Content of Health Education
NB: Multiple responses allowed
o received H.E
EiNo H.E.---
Fig 4.6 Health education coverage among those with diarrhoea
This shows that there had been an increase in the number of people who had received health
education; however, the increase had less effect on diarrhoeal morbidity.
47
4.4.2.2 Water
Water is a very sensitive resource in Mandera and thus water sources vary in different
divisions. The graphical representation of the water sources in the district is as shown in
figure 4.7. The figure shows the overall picture of the water sources in the district.
However, there are differentials in the different divisions and the table 4.7 shows the same
;? 15 14.6~
<>bJl.::!=••<J...
'"~
10 9.7
8
6.9
6.3
5
water sources but with the specifics from the divisional levels.
25
23.4
20
o
earth pan borehole piped
water
shallow
well
riverGuba
Water
supply
Water source
birkhad shaff
shaffey
water
supply
Fig 4.7 Main Water Sources in Mandera District
48
Table 4.7 Main water sources in the Divisions in Mandera District
Division Water sources Frequency Percent
Central borehole 63 29.0
piped water 32 14.7
shallow well 34 15.7
nver 34 15.7
birkhad 3 1.4
Shaff shaffey water supply 51 23.5
Total 217 100.0
Hareri river 30 100.0
khalalio piped water 14 34.1
river 18 43.9
birkhad 9 22.0
Total 41 100.0
Malkamari earth pan 24 38.7
Guba Water supply 22 35.5
birkhad 16 25.8
Total 62 100.0
As illustrated in figure 4.7 and table 4.7, the greater percentage of the respondents depended
on the river for their water and the least used the Guba water supply. The Guba water supply
was used by the residents of Guba Location in Malkamari divivison. The river was used by
the residents from all the divisions except Malkamari division who mainly used the earth
pans, Birkhads (underground water storage tanks) and the Guba Water supply. The
Borehole and piped water were used by residents who lived in Central location and Bulla
Mpya location, both of Central Division. The greater percentage of residents using the
borehole can be attributed to the higher number of respondents from Central Division. Some
respondents from Khalalio Location in Khalalio division also depended on piped water
which was piped to their houses through the Khalalio water association. The Shaf Shaffey
water supply was a water project constructed by AAH to enhance access to water among the
residents of Shaf Shaffey Location and other neighbouring locations in central division. It
49
was used by all the respondents of Shaf Shaffey location and others from the neighbouring
locations such as neboi and Bulla Mpya locations.
A cross tabulation of the water sources and diarrhoeal morbidity among the children
indicated that there was an insignificant relationship between the water sources and
diarrhoeal morbidity (x2=7.69; df=7; p=O.361). This shows that diarrhoeal morbidity was
not related to the water sources, and therefore the second null hypothesis was accepted.
However, among the households where diarrhea was present, majority (21.1%) used piped
water and the borehole while the least percentage (2.6%) used the shallow well and the
Guba water supply. This is represented in figure 4.8.
4.4.2.2.1 Payment for water
Seventy five percent paid for water at a mean price of kshs 4.7 for a twenty litre jerrican and
a mean of ksh 229.1 per month for those who used piped water. Slightly less than half
(49.8%) considered this price expensive and 22.4% viewed it as cheap as shown in table
4.8.
50
shaf shaffey water supply
Barkhad
Q) River~
"'"::I Shallow well 2.60ir:
"'" 2.6Q) Guba Water supply.•...
1:':1
~ Piped Water
Borehole
Earth pan
0 5
21 1
21 1
10
Percentage
15 20 25
Figure 4.8 Diarrhoeal prevalence among the water sources used
by households with diarrhoea
T bl 48 P t£ t dd ·f f ta e : avmen orwa er an escrrpnon 0 wa er pnce
Pay for
water Frequency Percent
Description frequency percentage
Fair 73 27.8
Yes 263 75.1 Cheap 59 22.4
Expensive 131 49.8
Total 263 100
No 87 24.9
Total 350 100.0
4.4.2.3 Sanitation
4.4.2.3.1 Latrine use and type
Close to half of the respondents (47.1 %) did not have latrines in the district and only 8.6%
had latrines under construction as at the time of data collection. These latrines comprised
51
mainly of traditional latrines (68.6%) while a majority of those without latrines relieved
themselves in the bush (63.6%). This is represented in table 4.9
Table 4.9Latrine use, type and place of relief
Latrine Frequency Percent
Yes in use 155 44.3% Type frequency Percentage
Yes under Traditional 127 68.6%
construction 30 8.6% latrine
VIP latrine 58 31.4%
Total 185 100%
No 165 47.1% Where relieve oneself
Frequency Percentage
Communal 22 11.3%
latrine
Bush 124 63.6%
Neighbour's 49 25.1%
latrine
Total 195 100%
Total 350 100
The chi square test revealed that there was an insignificant relationship between the
sanitation facilities (latrines) and under five diarrhoeal morbidty (x2=2.478; df=3; p=0.479)
indicating that the sanitary facilities on their own did not playa role in the reduction of
diarrhea and thus the third Null Hypothesis was accepted.
However, it was interesting to note that many of the children who had suffered from
diarrhea were from households that had latrines in use as shown in figure 4.9. This could be
because of poor hygienic practices that led to contamination of hands and therefore transfer
of the disease causing pathogens to food or water.
60
50
,-, 40
~'-'Q,l
Of).s 30=Q,l
CJl.Q,l
Q.. 20
10
o -j---
52
52.6
42.1
5.3
yes in use under construction no
Latrine
Fig 4.9 Diarrhoeal prevalence among those with latrines
4.5 Water, sanitation and hygiene risk factors
4.5.1. Water risk factors
The main water risk factors that formed part of this study were: availability of the water
sources, alternative water sources used, time taken to the water sources and back, water
transportation methods, water treatment, water quantity; and the mode of drinking water
storage and scooping. Each of these is described in detail below
4.5.1.1 Availability of the water sources
Slightly more than half (51.7%) of the water sources were available throughout the year,
and only 0.6% were available for 3-6 months of the year as shown in table 4.10.
53
Table 4.10: Water availability through the year
Water availability through the year Frequency Percentage
Throughout the year 181 51.7
9-11 months 73 20.9
6-9 months 77 22
3-6 months 2 0.6
Less than 3 months 17 4.9
Total 350 100
4.5.1.2 Alternative water sources
The water sources used when the main water sources ran dry were mainly the river (64%),
the birkhad (11.2%), the borehole (10.1 %), piped water (2.4%); and the other sources
(12.3%) as shown in figure 4.10.
Children from households who relied on the river significantly suffered from diarrhoea
compared to children from households that used the other water sources (x2=16.735; df=7;
p=O.O19). This was because during times of drought many of the residents resorted to the
river and therefore the water was most likely contaminated.
4.5.1.3 Time taken to water sources and back
Studies have found that when water is at a distance and needs to be carried mothers are
likely to use little water in order to save time and energy spent in collecting water. (UN-
HABITAT; 2003). Therefore it is recommended that water sources be from a source that is
1 kilometer from the user's dwelling or 30 minutes round trip. (Caincross and Valdamanis;
2007 (UN-HABITAT; 2003). The time taken to water sources was as represented in table
4.11
54
70 64
60
50
,-.,~ 40'-'e;bJ)
('l•..\:Ie; 30()
l-e;Il.
20
10
0
River Birkhad Borehole Piped Others
Water Source water
Fig 4.10 Water Sources used during the dry season
Table 4.11 Time taken to water sources
Time Frequency Percent
less than 10 minutes 134 38.3
10-30 minutes 55 15.7
Above 30 minutes 84 24.0
Brought to my household 77 22.0
Total 350 100.0
The highest percentage of children who suffered form diarrhea were those from households
where the caregivers took less than 10 minutes to the water sources as shown in figure 4.11.
55
60
52.6
50
10
o
less than 10 mins 10-30 mins Time above 30 mins brought to my house
Fig 4.11 Time taken to Water sources among those with
Diarrhoea
There was an insignificant relationship between the length of time taken to the water
sources and diarrhoeal morbidity (x2=4.138; df=3; p=0.247), meaning that the distance to
the water sources did not have an effect to diarrhoeal morbidity. This was because the water
sources were close to the households and thus met the required standards. It is also
supported by the larger number of children suffering from diarrhea being from households
where the water sources were close to the house.
4.5.1.4. Water transportation methods
A higher percentage transported their water by rolling jerricans on the ground and only a
few transported by carrying on the head as shown in the table 4.12.
56
T bl 412 W t t h da e . a er ransportation met o s.
Transport methods Frequency Percent
Donkey carts 93 26.6
Rolling on the ground 107 30.6
Carrying on the back 63 18.0
Carrying on the head 8 2.3
Donkey back 59 16.9
Brought to household 20 5.7
Total 350 100.0
Children from households where water was transported by rolling on the ground and by
donkey carts were more likely to suffer from diarrhoea than those children from households
where water was transported using the other methods. (x2= 13.329; df=6; p=0.038). This
implies that water was contaminated during transportation. In addition, half of the children
who suffered from diarrhea were from households where water was transported by rolling
on the ground, similar to the baseline study. This is shown in figure 4.12.
4.5.1.5. Water treatment
Only 28% of the respondents treated their drinking water and the rest did not apply any
treatment to their drinking water. A majority of those who treated their drinking water did
so by boiling (51 %) as shown in the table 4.13. Other methods used for treatment included
filtering, settling and use of alum stones; used by those who used river water. Such methods
however, did not kill the pathogens; they only made the water clearer. More than half
(65.8%) of the children who suffered from diarrhea were from households where water was
not treated.
60
50
40----~e--Q)~~ 30..•..•=Q)u 23.710..
Q)c.
20
o +--1JllllilillllJ:_-,---_
10
57
50
13.2
2.6
_ IlIIIIIIII1IL
donkey carts rolling on the carrymg on donkey back
ground the back
Transportation method
Fig 4.12 Water transportation methods among those with
Diarrhoea
brought to
house
Table 4.13 Water treatment and methods
Treat drinking water Freq 0/0 Method Freq 0/0
Yes 98 28% Boiling 50 51
Adding chlorine 30 30.6
or PUR sachet
Filtering 1 1
Alum stones 12 12
Settling 4 4.1
Liquid solution I I
Total 98 100
No 252 72%
Total 350 100
58
4.5.1.6 Water quantity
The WHO Standards require that every person use at least 20 litres per day for their needs,
and this water should be within 1 kilometer of the user's dwelling (Caincross and
Valdamanis; 2007). The study found out that the mean number of litres used per person per
day was 16.93 litres with a standard deviation of 12.62. This is below the required WHO
standards of twenty litres per person per day.
Seventy one percent of those who suffered from diarrhea were from households where each
member used less than 20 liters per person per day as shown in figure 4.13.
0+----
80
70
60
20
10
71.1
28.9
less than 20 equal or above 20
Amount of water (in iitres)
Fig 4.13 Water quantity among those with diarrhoea
59
4.5.1.7 Mode of drinking water storage and scooping
Almost sixty percent of the respondents stored their drinking water in the same container
that was used for storing water for other uses while 40.3% had separate containers. This
drinking water was stored in closed containers (73.4%) and in open jerricans (18.6%). To
scoop drinking water, 62% poured directly from the container while 11.7% used any
container. This is as summarized in table 4.14.
T bl 414 D . k' t t da e nn 109 wa er s orage an scoopmg
Practices Frequency Percentage
Storage containers Separate containers 141 40.3
Same container 209 59.7
Total 350 100
Mode of storage Open buckets 28 8
Open jerricans 65 18.6
Closed containers 257 73.4
Total 350 100
Scooping Using a special container 92 26.3
Using any container 41 11.7
Pouring from the container 217 62
Total 350 100
There was a significant relationship between water storage containers (x2=8.4 71; df= 1;
p=0.004) and under five diarhoeal morbidity. Children who were from households that used
the same container to store drinking water and water meant for other purposes were more
likely to suffer from diarrhoea than those who were from households that used separate
containers. Children from households where water was stored in closed containers (x2=7.62;
df=2; p=0.022) and scooped by pouring from the container (x2=20.981 ; df=2; p=O.OOO)also
significantly suffered from diarrhoea than those who used the other storage modes and
scooping methods shown in table 4.14. This coupled with the fact that water was transported
by rolling explains that the containers were most likely contaminated during transport and
60
further contaminated at the household level through improper handling. Further analysis
shows that the caregivers who transported water by rolling on the ground scooped drinking
water by pouring from the container (x2=74.374; df=18; p=O.OOOl). In addition, households
who stored drinking water in separate containers treated their drinking water as compared to
those households where water was stored in the same container (x2=34.8l5; df=2;
p=O.OOOl).
4.5.2. Sanitation and Hygiene risk factors
The risk factors considered in this study included time taken to the latrine, sharing of
latrines, adoption of the leaky tin/tippy tap, children's defecation habits, disposal of the
children's waste, hand washing methods; and the drying and storage of kitchen utensils.
Each is described here forth.
4.5.2.1. Time taken to the latrine
If latrines are situated far from a household, then people are less likely to use these latrines
because of the long distance involved in accessing them. Therefore it is recommended that
latrines should be close to the home (UN-HABITAT, 2003). For those people with access to
latrines, 90.3% took less than 5 minutes to the latrine, 5.8% took between 5-10 minutes
while the rest took over 10 minutes. This was mainly because the latrines were household
latrines and the few who took longer than 5 minutes used communal latrines or neighbor's
latrines that were far. Eighty percent of those children who had diarrhea were from
households that took less than 5 minutes to the latrine while the rest were from households
that took 5-10 minutes to the latrine.
61
4.5.2.2. Sharing latrines
Some of the respondents who did not have latrines used the neighbor's latrine or communal
latrines. The study found that 68.6% shared a latrine with less than 20 people, 21.7% shared
a latrine with between 21 and 40 people and the rest had over 40 people sharing the latrine.
A higher percentage of those who suffered from diarrhoea were those from households that
shared a latrine with less than 20 people as represented in figure 4. I4
Il!I!Ilessthan 20 lID21-40 0 more than 401
6.9%
20.7%
Fig 4.14. Number of people sharing latrine among households with
Diarrhoea
4.5.2.3. Adoption of the leaky tin/tippy tap
The leaky tin is a technology that had been adopted to encourage hand washing after
visiting the latrine. This technology requires that a plastic container is filled with water and
a hole is made to allow the flow of water from the container. It is usually required that a
piece of soap is hung just below the container and together with the water container, they
are suspended near a latrine, kitchen or school to encourage hand washing.
62
The study found that the adoption of the leaky tin was still low and only 2.3% were using
the leaky tin. Reasons given for not using the leaky tin are as represented in figure 4.15.
40,-...
~Q'-'~OJ)~ 30.•..=~(J:...~A..
20
60
50.9
50
10
o
Carry water to toilet Don't know it
Reason
Others
Fig.4.15. Reasons for not using the leaky tin
The "others" category was comprised of reasons such as lack of water, children having cut
the rope for hanging the tin, and lack of money to construct the leaky tin.
4.5.2.4. Children's defecation habits
Seventy three percent of the children defecated in the open within the compound, 22.6% in
potties, 2.3% in the bushes, and the rest in traditional latrines and in a fenced place within
the compound. The greatest percentage of the children who suffered from diarrhea were
63
those who defecated in the open and those who defecated in potties as shown in figure 4.16.
These children significantly suffered from diarrhoea than those who defecated in the latrines
(x2=34.815; df=4; p=0.047). This may be due to contamination of hands with feaces.
Pathogens were then transferred to the mouth through feeding.
70
60
50
20
10
0+---
57.9
39.5
2.6
in the open in potties
place of defecation
in a fenced place
Fig 4.16. Place of defecation of the children who had diarrhoea
The caregivers disposed these children's waste by throwing in the bushes (40.9%), throwing
in the traditional latrines (32.3%), throwing in the VIP latrines (16.9%), burying in soil
(5.7%), throwing on the streets (3.4%) and the rest was left where it was in the compound.
The highest percentage of children who suffered from diarrhea were those whose waste was
disposed in the bushes as shown in figure 4.17. Care givers who disposed their children's
waste by throwing in the bushes and those who left the waste where it was had their
children significantly suffering from diarrhoea (x2=11.220; df=5; p=0.047)
45
40
35.-~ 30e'-"
~ 25~-~ 20u
I-
Q) 15e,
10
5
0
39.5
64
31.6
Throw in
traditional
latrines
place of disposal
18.4
5.3
leave where it
is
Throw in
bushes
throw in VIP bury in soil
latrine
Fig 4.17. Children's Waste disposal methods among those with
Diarrhoea
4.5.2.5. Washing of hands
A higher percentage (65.7%) of the caregivers washed their wands with water only before
eating, after latrine use or before feeding a child; 29.1 % washed their hands with water and
soap, 2.9% washed with water and sand, 1.4% with water and leaves and the rest with water
and ash. The greater percentage of children who had diarrhea were from households where
the caregivers washed their hands with water only as represented in table 4.15.
T bl 415 W fh d I ith h'ld ith di ha e . . ays 0 an c eanmg amon g caregivers WI c I ren WI iarr ea
Mode of washing hands Frequency Percentage
With water only 33 86.8%
With water and soap 3 7.9%
With water and leaves 2 5.3%
Total 38 100
65
Caregivers who washed their hands with water only had their children significantly
suffering from diarrhoea (x2=15.471; df=4; p=O.004). There was also a significant
relationship between those children who defecated in the open and the caregivers who
washed their hands with water only (x2=48.871; df=16; p=O.OOOI) implying that the
caregivers did not wash their hands properly after handling children's waste. Further on,
those care givers who scooped water by pouring from the container used water only in
washing their hands (x2=23.697; df=12; p=O.022) implying that their hands were not
properly washed and this facilitated the transfer of disease causing micro organisms
4.5.2.6. Drying of kitchen utensils
Most of the households (46%) used the rack to dry their kitchen utensils and a few used
other areas such as a wire mesh, a carton box, a traditional tray, and the compound fence as
shown in figure 4.18.
66
50 46
45
40
35,-,
~ 30.,'-'•..::: 25~~I. 20~~
15
10
5
0
Rack Fence Bucket Others
Area
Fig. 4.18. Place of drying kitchen utensils
4.5.2.7. Storage of kitchen utensils
Half of the respondents stored their clean utensils on the table, 29% in a bucket, 8% in a
carton box, 5.1 % on a rack, 4.3% in the cupboard and the rest in other areas which included
the fence, a traditional tray and on the floor. The greater percentage of children who
suffered from diarrhea were those from households where kitchen utensils was stored on the
table as shown in figure 4.19 and these children significantly suffered from diarrhoea
(x2=15.859; df=5; p=O.004)
67
Cupboard
5% Bucket
24%
Table
44%
Carton box
24%
~
-- -
~ bucket
EI carton box
I
111I rack
i.table
I EJcupboard
Rack
3%
Fig 4.19.Storage method of utensils among children with diarrhoea
4.5.2.8. Washing hands before eating
Almost all (99.4%) the respondents said they washed their hands before eating while the
same percentage of children also washed their hands before eating. 0.6 % of both the
children and the adults did not wash their hands before eating. All the children who
suffered from diarrhea were those who washed their hands before eating and whose parents
also washed their hands. These hands most likely were washed improperly.
68
4.5.3 Children's health
4.5.3.1 Diarrhoeal disease prevalence
Diarrhoeal disease prevalence among the children under the age of five for the two weeks
preceding the time of data collection was 10.9%. This was lower than the Prevalence
obtained during the baseline of26.8% and that of the KDHS survey of2003 of 12.9%.
4.5.3.2 Number of household members in the household
The more people there are in a house, the less the attention that is likely to be given to the
young ones. Seventy nine percent of the children who suffered from diarrhea were from
households that had six members or more.
4.5.3.3 Causes of diarrhea
The respondents acknowledged that diarrhoea was caused by dirty water, poor hygiene,
dirty food, and dirty environments as shown in figure 4.20. However, from the Focus Group
Discussions, it was clear that the belief in the district is that it was God's will for one to
suffer diarrhoea and that camel milk also led to diarrhoea since it cleans the body's
digestive system.
69
Germs ~'~~' 4
Climate 2.3
Flies :;..:.....:. ": 7.4
Q)'";; Dirty food .... ",. iX·f· .~.~"~::.:••' ••••••••,~.{,:.:,••,,,~."'''t*::*lj. ,', ••"';"::;'. 35.7
~
God's will .·1' •• 1·1,1,1·.1"1"1".1-1'.·1'·1••·1)'.·21.4
Don't know •..•• ~··.. 6.9
Poor hygiene •. . .•..... _~__ " " ,,~.. ,. ',~~', ,', _ , , .•.,.. ",' 47.7
Camel milk _ 4.6
I
Dirty water
o 10 20 30 40 50 60
Percent (%)
Fig. 4.20. Causes of Diarrhoea
NB: Multiple responses allowed.
4.5.3.4 Management of diarrhea
The caregivers gave various measures that they took when their children suffered from
diarrhea. The measures taken were taking the children to hospital and giving them
traditional salt sugar solution as shown in figure 4.21. However, it was evident from the
FGDs that since it was believed that it was God's will to suffer diarrhoea, they first read the
quran verses to the children as a way of treatment of diarrhoea. Hospital attention would
only be sought after the diarrhoea persisted. In areas where hospitals were not easily
accessible like Sala location and Malkamari division, diarhoea was mainly managed at
home.
70
Give sour milk )m 2.9
Give Herbal Medicine ~ 3.1
Givewate~::: I::i:: {:,676
Nothing
Take to hospital
Traditional salt sugar solution
GiveORS ~13.1
o 10 20 30
percent (%)
40 50 60
Fig. 4.21. Management of diarrhoea
NB: Multiple responses allowed.
4.5.4 Influence of the socio economic environment
The study found that those caregivers with low level of education scooped drinking water
using any container (x2=31.43; df=12; p=0.002) and at the same time they used the same
container for storing drinking water and water for other purposes (x2= 11.41; df=4; p=0.02).
The same caregivers who had not received formal education did not have latrines
(x2=23.977; df=12; p=0.02) and therefore they had their children defecating in the open
(x2=31.43; df=16; p=O.OOl). In terms of the economic environment, the households with a
low level of income had their children defecating in the open (x2=87.877; df=24; p=O.OOI)
and this waste was disposed by throwing in the bush or was left it in the open (x2=59.935;
df=30; p=0.002). This confirms that the socio economic environment also had an influence
in the occurrence of diarrhea among the children.
71
CHAPTER FIVE: DISCUSSION OF RESULTS
5.1 Introduction
This section discusses the results obtained and sheds light on the following objectives that
guided this study.
• To assess the relationship between water, sanitation and diarrhoeal morbidity before
the interventions.
• To assess the effects of the interventions on childhood diarrhoeal morbidity
• To examine the water, sanitation and hygiene risk factors that further pre dispose the
under five children to diarrhoeal morbidity
5.2. The relationship between water, sanitation and diarrhoeal morbidity before the
interventions
The baseline study before the interventions was not detailed and therefore gave only a vivid
relationship between water, sanitation and diarrhea. However, the available data points out
that 44% of the residents relied on the borehole, 15% on the river, and 11 % on shallow
wells. Many of the residents transported their water by donkey carts (44%), rolling the jerry
cans on the ground (29%) and by carrying the jerricans (25%). Transportation of water by
rolling the jerricans on the ground was associated with a higher incidence of diarrhea.
Eighty five percent of the respondents did not treat their water and poor water quality was
also associated with a high diarrhea incidence. Water storage containers were left open and
the same containers were used to store drinking water and water for other uses. Such
household practices were also associated with a high incidence of diarrhea.
72
Latrines were used by both adults and children though others also used the bush. Children's
waste was swept with rubbish and at other times, was disposed in the bush. The cleanliness
of most compounds was noted to be poor and this was identified as a reason for the many
flies present in most compounds, which were a transmission route for diarrhea.
Consequently diarrhea prevalence among the under five was at 26.8% and hygiene factors
were major routes of transmission.
This led to the introduction of interventions in water, sanitation and health education. Such
interventions saw the rehabil itation and construction of earth pans and underground tanks all
aimed at increasing the access to water. Latrine use was encouraged through distribution of
tool kits and training of masons. Health education sessions were also carried out and various
subjects were taught in the health education sessions such as latrine use, safe water handling
and diarrhea prevention
5.3: Effects of the interventions on childhood diarrhoeal morbidity
Studies of risk factors in Africa on diarrhoea in children under 5 years have shown that
improvement in water supply and sanitation has the potential of reducing the incidence of
diarrhoea within households (Osumanu; 2007). UNICEF and WHO point out that water,
sanitation, and hygiene interventions reduce diarrhoeal disease on average by between one
quarter and one third (UNICEF AND WHO, 2006).
Findings from the study show that under five diarrhoeal morbidity was at 10.9% for the two
weeks preceding the time of data collection. This figure is almost close, but slightly lower
73
than that obtained by the Kenya Demographic and Health Survey (KDHS) of 12.9% and
also much lower than that of the baseline study done earlier of 26.8%. The study recorded
an increase in the percentage of people who had received health education from the baseline
of only 5.8% to 27.4%, representing a 21.6% increase. According to Caincross and
Valdamanis (2007), Hygiene promotion interventions reduce diarrhoeal disease morbidity
by 33%.
Even with the increase in Health Education, more than half (65.8%) of those who suffered
from diarrhea had not received any health education. These results thus imply that though
there had been an increase in the number of people who had received health education, this
increase had not translated into reducing the diarrhoeal diseases at the household level and
therefore knowledge, as it were, did not directly translate into practice. Kremer and Zwane
(2007) and Trevett and Carter (2008) seem to support these findings by stating that the
literature evaluating health education programs in developing countries suffers from
important methodological weaknesses. The relative effectiveness of education relative to
other interventions remains uncertain and may differ systematically across groups. Trevett
and Carter (2008) further suggest that education should be complemented with other
techniques, such as social marketing, motivational interviewing, and community
mobilization (Trevett and Carter 2008).
Effective water interventions had been introduced in the district and there had been an
increase in the number of people with access to water. This was especially in areas like
Malkamari who solely depended on the earth pans that had either been constructed or
74
rehabilitated. The Shaf Shaffey water supply also increased access to water among the
residents of the location and other neighboring locations.
Fewtrell et al (2005) notes that diarrheal disease morbidity is reduced by 25% through
improved water supply. However, in this study, even with the increase in water supply,
there were children who suffered from diarrhoea who were from households using the
improved water sources. These results imply that the interventions increased the access to
water among the households, but there were other factors leading to diarrhoea occurrence.
These findings seem to concur with Fewtrell and Colford (2004) who suggest that water
source improvements decrease the level of diarrhoeal illness, though this was not
statistically significant. Water supply interventions reduce diarrhoeal illness levels, but this
effect is mainly seen with the provision of household connection and use of the water
without household storage (WHO; 2007). Caincross and Valdamanis (2007) also point out
other studies that show that water improvements have failed to have a significant effect on
diarrhoeal disease incidence. Therefore, providing a public water point appears to have little
effect on health, even where the water provided is of good quality and replaces a traditional
source that was heavily contaminated with fecal material (Caincross and Valdamanis;
2007). As the study found, water source improvements were increased but water still had to
be stored in the house and therefore the likelihood of contaminating the stored water was
still high.
Sanitation facilities had also increased as noted by the percentage of people who had latrines
in construction at the time of data collection. Sanitation and excreta disposal interventions
75
are documented to reduce diarrhoeal disease morbidity by 36% (Caincross and Valdamanis;
2007). The increase in the sanitary facilities did not also translate into reduction of
diarrhoeal morbidity as noted by the highest percentage of children with diarrhea who were
from households that had latrines in use. This further explains that provision of sanitary
facilities on their own did not playa role in the reduction of diarrhea in the district.
As in other arguments, latrines do not provide an adequate solution to the excreta disposal
needs of a community because of the inadequacies in their maintenance and inaccessibility
at night. Thus, some promiscuous defecation continues to be practiced, particularly by
children. Sanitation is likely to have a less effect in rural communities, where all but the
youngest children use communal defecation sites some distance away from their homes
(Caincross and Valdamanis; 2007). This was the same situation in the district as evidenced
by many of the children who defecated in the open environments.
5.4 Water, sanitation and hygiene Risk factors in the district
Osumanu (2007) notes that behavioural changes, even within situations of inadequate water
and sanitation services, can lead to substantial reductions in the incidence of childhood
diarrhoea.
Water risk factors considered in this study included, alternative water sources used, time
taken to water sources, water transportation, water treatment, water quantity, storage of
water containers, and scooping of water for drinking. Among these factors, the study found
a significant relationship between water transportation, alternative water sources during the
76
dry season, how water is stored in the house, how drinking water is scooped and the
containers used for storing drinking water; and under five diarrhoeal morbidity.
This meant that as the containers were rolled on the ground, they most likely came into
contact with pathogens on the ground. These containers were used to store drinking water
and most likely were not cleaned. In addition drinking water was not treated and as the
drinking water was scooped from already dirty containers, it was likely contaminated by
dirty hands or dirty containers. Storing drinking water in the same container also meant that
the containers were likely to be contaminated and therefore contaminating also the drinking
water. During scooping of drinking water, dirty hands may contaminate the water when the
water is poured directly from the container. Such findings agree with HABIT AT who states
that In Cote d'Ivore, 41 % of the stored water samples were more contaminated than those
from the water sources, and in Peru, children in households with water stored in containers
without a tap were twice as likely to have a high incidence of diarrhoea (UN-HABIT AT;
2003)
Storage of drinking water in separate containers ensured that drinking water was treated
well. This is evidenced by the findings in the study which showed that households who had
separate containers for storage of drinking water and water for other uses treated their
drinking water as compared to those households where water was stored in the same
container. Similarly, Trevett and Carter (2008) recommend that water should be stored in
vessels that are covered and regularly cleaned, drinking-water should be stored in a separate
container from other domestic water wherever possible, and that this drinking water should
77
be taken from the storage vessel in such a way that hands, cups, or other objects cannot
contaminate the water.
During drought, many of the households used the river and thus the river was most likely
contaminated since animals, and human beings used the same source of water. Many
children were from households where water was not treated. However, in this study,
methods such as settlement, filtering and using of the alum stones were used to treat water.
However, these methods do not kill any pathogens in the water and where they were used;
the river water was not treated, per se, but was only made clearer. This therefore meant that
if the water was contaminated, the pathogens were still transferred if proper treatment
methods were not applied. As it was in the baseline, poor water quality was associated with
diarrhoeal morbidity (AAH; 2006). It was learnt from the FGDs that people believed that
the water was already treated for those who used sources such as the Shaf shaffey water
supply, the borehole and the shallow well. Others who used the river water preferred it
without treatment because they believed it "tastes better"
Sanitation and hygiene risk factors considered in this study included number of people
sharing a latrine, time taken to a latrine, adoption of the leaky tin technology, disposal of
children's waste and hand washing. Many of the children who suffered from diarrhoea were
from households that took 5-10 minutes to the latrine. More than half (57.9%) of the
children that had diarrhoea defecated in the open within the compound and the rest used
potties. This is similar to India where only 1% of children under 6 years use latrines.
Children rarely use latrines before they are six or eight. The darkness, smelliness and large
78
openings of most pit latrines make their use unpleasant and frightening for young children
because of the risk that they might fall into the pit (UN-HABIT AT; 2003). Children are
more likely than adults to defecate in the open environment and to play in areas where
excreta are dispersed, either by open defecation or by discarding latrine contents (Luby et
al.,2006).
Children mostly defecated in the open and their waste was disposed by throwing in the
bushes and in traditional latrines. Throwing in the bushes increases the likelihood of
contamination. As the children defecate in the open and their wastes thrown in the bush,
there is likelihood that poor handling of the children's waste leads to contamination of the
hands of those who handle this waste. At the same time, as the children play around, they
are likely to come into contact with their wastes, which if contaminated, leads to
contamination of children's hands and the disease causing organisms may be transferred to
the household. This was evident in the study areas where children's waste was seen lying
around in many of the compounds. Children were also seen playing in the same areas where
they defecated.
Proper Hand washing is reported to be almost twice as effective as improvements in water
quality alone (ACF; 2005). Interventions promoting the single hygiene practice of washing
one's hands with soap tend to achieve greater reductions in disease than those that promote
several different behaviors (Caincross and Valdamanis; 2007). A greater percentage of the
children who suffered from diarrhoea had their caregivers mainly washing their hands by
water only. This implies that their hands were not washed well and the disease causing
79
organisms were thus transferred to the house. Caregivers who transported water by rolling
on the ground scooped drinking water by pouring from the container and those who scooped
water by pouring from the container used water only in washing their hands. This means
that as they held the container (which was already contaminated by rolling on the ground;
the ground where the children defecated), they contaminated their hands. Washing these
hands with water only therefore did not kill the pathogens. The adoption of the leaky tin that
was intended to promote hand washing was also very low and therefore, it only proves that
washing of hands with water and soap was not practiced. Cultural and religious practices
seem to have hindered the adoption of the leaky tin since many respondents argued that they
washed their hands after visiting the latrine as a requirement of their faith. However, this
may be done improperly and may not eliminate any organisms that may cause diarrhoea.
Many of the children who suffered from diarrhoea were also from households where kitchen
utensils were stored on the table. This further explains that the utensils may have been
contaminated with dirty hands on the table by the children in their playful habits and since
any container was used to scoop water, the same contaminated containers from the table
may have contaminated drinking water or if they were used to serve food, then they may
have contaminated the food.
As evidenced in this study, Diarrhoeal morbidity is mainly associated with hygiene
practices especially among the caregivers. Hygiene Practices at the household level play the
most significant role in the transmission of the pathogens causing diarrhoea. Therefore
interventions in improving the general hygiene practices seem to be of utmost importance in
the district. These have been documented to have the greatest impact (UNICEF; 2006b)
80
Fewtrell and Colford; (2004) even suggest that focused hand-washing interventions may be
more effective than hygiene education measures. However, these require voluntary behavior
change, but there is little evidence on whether such behavior changes persist in the longer
run (Kremer and Zwane; 2007). This may explain the increase in health education coverage
but the little effect on change of behaviour patterns.
Osumanu (2007) notes that major determinants of childhood diarrhoea outcomes in Sub-
Saharan Africa lie within the socio-cultural and economic environments of households. The
socio-cultural environment, which to a large extent influences behavioural patterns, is made
up of education, hygiene and feeding practices including water and food storage customs.
The economic environment, determined by household wealth, on the other hand, influences
access to water and sanitation services. In reality, there is a complex set of interactions
between multiple risk factors arising from these elements and childhood diarrhoea outcomes
(Osumanu; 2007). This study found that the socio cultural environment had a role to play in
the occurrence of diarrhoea. Low education level infl uenced the behavioural patterns of the
respondents. Those with low level of education scooped drinking water using any container,
used the same container for storing drinking water and water for other purposes, did not
have latrines and had their children defecating in the open. The economic environment also
determined the behavioural patterns of the respondents. Households with a lower income
level had their children defecating in the open and threw their children's waste in the bush
or left it in the open.
81
The community's cultural and religious beliefs may also have a role to play since it was
aired from the Focus Group Discussions that many of the residents believed that it was
God's will for one to suffer diarrhoea and that diarrhoea was caused by camel milk. This
therefore influences their response in times of a diarrhoea episode. Many are less likely to
seek medical attention and as discovered in the FGDs they resort to reading the quran verses
or to traditional healers. This therefore implies that religion has a strong effect on the
hygiene practices of the residents of the district and it should thus be used in the promotion
of proper hygiene practices.
At the same time, the residents of the district have developed a dependency syndrome and
consequently only want to participate in receiving the benefits of the interventions. This
may explain why there has not been any change in their practices. Diarrhoeal disease
morbidity from Mandera District Hospital showed an increase in diarrhoea morbidity from
5,177 cases in 2005 to 7661 cases in 2006 (Mandera District Hospital Records).
Since the results found that the interventions did not have a significant relationship with
diarrhoeal morbidity, the three null hypotheses were accepted.
5.5 SUMMARY OF FINDINGS
5.5.1 The relationship between water, sanitation and diarrhoeal morbidity before the
interventions:
The study found out that diarrhoeal morbidity before the interventions was mainly
associated with poor hygiene and sanitation practices at the household level. These included
82
factors such as water transportation and poor water storage at the household level. The
general hygiene of most of the households was also found to be poor. Consequently
diarrhoea transmission was mainly associated with the poor hygiene and sanitary practices
at the household level. This then led to interventions in increasing access to water and
sanitary facilities.
5.5.2 Effects of the interventions in the district
As discussed earlier in the chapter, the interventions had had a general effect of increasing
access to water supplies and the sanitary facilities, although singly, there had not been a
significant effect on diarrhoeal diseases. This was also evidenced by the hospital records
which showed that diarrhoeal diseases in the district had been on the increase in 2005 and
2006. Interventions in water had led to increased water access and had largely met the
required standards of having water supplies within a source of 1km from the user's
dwellings; evidenced by the short time taken to get to the water supplies. However, as
evidence suggests, this increase in water supplies does not have a direct effect on diarrhoeal
diseases if water is not piped to the houses. Since this water still had to be stored,
contamination is likely to occur between transportation, storage and at the point of use.
Sanitation interventions had also seen an increase in the number of excreta disposal
facilities and many households were involved in the construction of the latrines. However,
many of the children were from households that used latrines. Other studies suggest that
increasing sanitation facilities may not have a significant impact in rural areas since the
young children rarely use the latrines. The study found out that the children did not use the
83
latrines and instead defected in the open environments thus increasing the likelihood of
contamination of hands and therefore transfer of pathogens to the house.
Health education sessions also did not have much effect on diarrhoeal diseases, though there
was an increase in the people that had received health education. However, this health
education did not translate into change of behaviour.
5.5.3 Water sanitation and hygiene risk factors
In the district, the river was used by majority of the respondents during times of drought. It
was therefore most likely contaminated and was in itself a factor for the spread of diarrhoea.
The study found significant relationships between hygiene practices and diarrhoeal
morbidity. Such practices included water transportation by rolling on the ground, storing
drinking water in the same container with water for other purposes, water scooping, and
storage of kitchen utensils. Thus the study therefore found out that the transfer of pathogens
causing diarrhoea mainly occurred at the household level. This also underscores other
literature that suggests that hygiene interventions may be of greatest benefit in reducing
diarrhoea. The residents were direct beneficiaries of increased access to water, sanitation
and health education, but they did not practice good hygiene behaviour at the household
level. Water transport for instance was mainly through rolling on the ground and at the same
time, sputum was carelessly thrown on the ground. All the respondents reported washing
their hands before eating and after leaving the latrine. However, this washing was mainly
with water only.
)
84
Washing after latrine use is a general practice by the Muslims, and all the respondents
reported carrying water to the latrines. However, it needs to be stressed to the respondents
that washing after latrine use should be done with water and soap and not water only. At the
same time, hand washing should be seen as a hygiene practice and not as a requirement of
the Muslim religion. Other hygiene risk factors included poor defecation habits, improper
disposal of these children's waste, combined with improper hand washing and low income
and education levels.
The hypotheses therefore were tested and no since no significant relationships were found
with diarrhoeal morbidity, they were accepted.
85
CHAPTER SIX: CONCLUSION AND RECCOMENDATIONS
6.1 Introduction
This chapter gives the main conclusions from the study and recommendations made.
6.2 CONCLUSION
The study therefore concludes that
• Diarhhoeal disease transmission before the interventions was mainly associated with
poor household hygiene practices, water transportation and storage.
• The modal ities of diarrhoeal disease transmission in the district are not related to the
interventions; these interventions have played a role in increasing water supplies and
sanitary facilities to the WHO standards. Health Education coverage was also
increased.
• Diarrhoeal disease transmission mainly occurs due to using contaminated water in
the dry season, unhygienic water transportation methods such as rolling jerricans on
the ground, poor storage and scooping of drinking water at the household level. It is
also influenced by poor hygiene practices including poor children's defecation habits,
poor handling of the children's waste, inappropriate storage of kitchen utensils and
poor hand washing. Other risk factors are low income and education levels.
The main pathways of disease transmission and therefore the main risk factors are:
• Alternative water sources used during the dry season. The residents relied on the
river for all their needs and thus the river became contaminated. This coupled with
lack of water treatment further put the children at greater risk.
86
• Water transportation through rolling on the ground. The ground is contaminated with
children's feacal matter and sputum and therefore the container gets contaminated
and the pathogens transferred to the hands.
• Water storage containers that were used to store water for drinking and for other
purposes. This meant that the likelihood of contaminating drinking water was high.
This also meant that the storage containers were less likely to be cleansed
appropriately. As evidenced, drinking water was not treated.
• Since the hands of the caregivers may have been contaminated at the point of water
transportation, the likelihood of contaminating drinking water at the point of
scooping was high.
• Kitchen utensils were mainly stored on the table and therefore were prone to
contamination especially when children played around. Water scooping using any
container also meant that children's hands may have been contaminated from the
environment and the pathogens transferred to the kitchen utensils that were stored on
the table. When these utensils were used to draw drinking water, the pathogens were
transferred to the drinking water.
• Poor hand washing with water only. Caregivers washed their hands after using the
latrine as part of the requirement of the Muslim faith. Hands are therefore less likely
to be washed clean without soap. The poor adoption of the leaky tin because of the
belief that hands were washed in the latrine also explains this.
• Open defecation by the children put the children at greater risk of contaminating their
hands from these waste. At the same time, the caregivers disposed their ch iIdren' s
waste by throwing in the bushes; and this coupled with washing hands with water
87
only meant that the pathogens not eliminated. Children were also likely to come into
contact their waste as they played around .
• The dependency syndrome-the residents were more willing to get benefits of the
interventions but this did not translate into good hygiene practices. This therefore
meant that upon withdrawal of these interventions, the practices are not likely to be
sustained .
• The study however noted a decrease in the prevalence of diarrhoea from 26.8% in
2006 to 10.9% for the two weeks preceding the time of data collection.
6.4 RECOMMENDATIONS
6.4.1 Recommendations for project planning and policy
• The stakeholders working in the district should shift their focus to addressing the
household hygiene practices especially in the health education sessions.
• These organizations should continue with health education, but in the sessions, the
key hygiene practices should be taught using simple messages such as encouraging
covering of all water containers, storing drinking water in separate containers,
encourage drawing water by pouring directly from the storage containers without the
hands touching the water; and proper hand washing.
• The Ministry of Education should enhance the implementation of free primary
education to increase the levels of knowledge of the people in the district.
• The Ministry of Health should increase the coverage of the health centres especially
in the remote parts of the district where people have to walk for long distances to
88
access a health centre. In these health centres, health education sessions should also
be promoted.
• The religious leaders in the district should play a role in the health education
awareness to enlighten the community of the importance of proper hygiene
practices. The importance of using water in cleaning should also be used in religious
education to promote hygiene.
6.4.2 Recommendations for further studies
• In as much as there seems to be an increase in health education especially in contents
of hygiene, there seems to be a mismatch between what is learnt during the health
education sessions and what is practiced at the household level. Therefore a further
study should be done to identify reasons why the residents do not practice what they
have been taught.
• A further study to find out the applicability of locally available materials in hand
washing, such as washing with sand and leaves.
89
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94
APPENDICES
5.1: HOUSEHOLD'S QUESTIONNAIRE
Dear respondent,
My name is Sheillah Simiyu, a Masters in Public Health student from Kenyatta University. I
am carrying out a research on the effect of water, sanitation and health education
interventions on diarrhoeal morbidity among children under five and would appreciate to
have you as one of my respondents. Your response will be purely for academic and project
planning purposes and you are assured of utmost confidentiality. This will take a few
minutes.
Questionnaire number Date of interview .
Interviewer's name Village .
Sub location Location .
Division District , .
Checked and verified by Date .
PART A: SOCIO DEMOGRAPHIC DATA
1. Household characteristics. Tick whichever is applicable
HH member Age Gender Occupation
I-Housewife 5. Farmer
2-Pastoralist 6. Agro pastoralist
3- Business 7. Employed
4. Student; 8. Other (specify)
M F
Household
head
Spouse
Child 1
Child 2
Child 3
Child 4
Child 5
Grandfather
Grandmother
Other
Total
2. Level of Education
1. Lower primary
3. Secondary
5. Never gone to school
2. Upper primary
4. Tertiary
6.0ther (specify)
3. Religion
l. Muslim 2. Catholic 3. Protestant
95
4. None
4. Income per month (Ksh)
1. Less than 1,000
4. 10,000-14,999
5. Others (specify)
2. 1,000-4,999
5. 15,000-19,999
3. 5,000-9,999
6.20,000-24,999 7. above 25,000
5. Marital status
1. Single
4. Widowed/widower
2. Married
5. Other (specify)
3. Divorced
PART B: HEALTH EDUCATION
1. Have you received any training on health education in the last one year?
1. Yes 2. No
2. If YES, from which organization have you received this heath education training?
1. AAH 2. Islamic relief
3. Arid lands 4. Ministry of Health
5. Red cross 6. Other
3. What was the content?
1. Nutrition
3. Personal hygiene
5. Water
2.Malaria
4.Sanitation
6. Other (specify)
4. Was the training useful to you?
1. Yes 2. No
PART C: HOUSEHOLD HYGIENE PRACTICES
1. How do you dry the-washed kitchen equipment?
1. On the floor 2.ln a bucket
4. On grass 5. On traditional tray
7. On the fence SWire Mesh
10. Hang on sticks 11. Metallic bed
2. How do you store clean kitchen equipment?
1. On the floor 2.In a bucket /basin
4. On grass 5. On traditional tray
7. Fence 8. Table
10. In a sack
3. Do you wash your hands before eating? (Adults)
1. Yes 2. No
4. Do your children clean their hands before eating?
1. Yes 2. No
3. In carton box
6. In a rack
9. On the table
3. In carton box/box
6. In a rack
9. In a Cupboard
96
PART D: WATER SOURCES AND PRACTICES
1. What is your main source of water for cooking and drinking
1. Earth Pan 2. Borehole 3. Piped water
4. Guba Water Supply 5. Shallow well 6. River
7. Birkhad 8. Shaf Shaffey water supply
2. Do you pay for water?
1. Yes 2. No
3. How much do you pay for a twenty litre jerican? State amount.. .
4. I f you have piped water, how much do you pay per month?
5. In your opinion how would you describe the price of water?
1. Fair 2. Cheap
3. Expensive
6. How long does it take you to and from this drinking and cooking water source?
1. Less than 10 minutes 2. 10-30 minutes
3. Above 30 minutes 4. Brought to my household.
7. How long in a year is the drinking and cooking water resource available to you?
1. The whole year 2. 9-11 months
3. 6-9 months 4. 3 to 6 months
5. Less than 3 months
8. What water source do you use when this drinking and cooking water source dries up?
1. Earth pan 2. Borehole 3. Piped water
4. Rain water (roof catchment) 5. River 6. Barkhad
7. Wells within dried river 8. Other (Specify)
9. How do you transport water from the drinking and cooking source to the house?
1. By donkey carts 2.By rolling on the ground
3. Carrying on the back 4.Carrying on the head.
5. Donkey back 6.N/A
7. Brought by boozer
10. Do you treat your household drinking water?
1. Yes 2.No 3. Sometimes
11. If YES, How?
1. Boiling
4. Traditional leaves
7. Liquid Solution
2. Adding chlorine or PUR sachet
5. Alum stones
3. Filtering
6. Settling
97
12. How much water do you use for household consumption per day? In terms of twenty
liter Jerricans? .
13. Are there separate containers for drinking water and for general use?
1. Yes 2. No
14. Do you consider the water you have as sufficient for your household?
1. Yes 2. No
15. How do you store drinking water in the house? RA can also observe
1. In open Buckets 2. In open jerricans
3. In closed containers 4. Other (Specify)-------------------------------
16. How do you scoop the water from the household containers for drinking?
1. Using a special container 2. Using any container
3. With hands 4. Pouring from the container
5. Other: speci fy----------------------------
PART E: SANITATION FACILITIES, KNOWLEDGE AND PRACTICES
1. Do you have a latrine?
1. Yes in use 2. Yes under construction 3. Yes communal 4. No
2. If yes, what type ofa latrine? (Observe if within the compound)
1. Buckets 2.VIP Latrines
3. Traditional latrine 3.0ther (specify)
3. If no latrine where do you relieve yourself?
1. Communal latrine 2. Bush 3. Neighbor's latrine
4. How long do you take to a latrine from your house?
1. Less than 5 minutes 2.5-10 minutes
3. Above 10 minutes
5. How many people share the latrine?
1. Less than 20 2.21-40 3. More than 40
6. Do you have a leaky tin / Tippy tap? (Water container outside the latrine for washing
hands as one leaves the latrine)
1. Yes 2. No 3. Don't Know it
7. If yes, do you use it?
1. Yes 2.No
8. If you don't use the leaky tin/tippy tap why?
1. Carry own water to the toi let 2. Lack of water
98
3. Lack of soap
5. Don't know how to use
7. No money to construct one
4. Lack of a place to hang it
6. children cut the rope for hanging
8. don't know it
9. Where do the young children who are under five years defecate?
1. In the open (within the compound) 2. In the bushes
3. In the traditional latrines 4. In the VIP Latrines
5. In Buckets 6. In potties
7. No Children 8. In a fence place (within the compound)
8. Other
10. If the children defecate within the compound, how do you dispose the children's stool?
I. Leave it where it is in the compound 2. Throw it in the bushes
3. Throw it in the traditional latrines 4. Throw it in the VIP Latrines
5. Leave it in potties 6. Throw it anywhere since it is harmless
7. Bury in soil 8. Throw on the streets
9. In Neighbor's latrine
II. How do you mainly wash your hands before eating or feeding a young child?
1. with water only 2. With water and soap
3. with water and ash 4. With water and sand
5. With water and leaves 6. Other (specify)
12. According to you what causes diarrhea?
1. Dirty water 2. Dirty environments
3. Camel milk 4.Poor personal hygiene
5. Lack of latrines 6. Dirty food
7. God's will 8. Don't know
9. Flies 10. Climate
II Germs
13. Has any of your household suffered from diarrhea in the last two weeks?
1. Yes 2. No
14. If yes, who?
1. Below 5 years 2. Above 5 years
15. What do you do when a member of the household suffers from diarrhea?
1. Give ORS 2.Give traditional salt sugar solution
3. Taken to hospital 4. Nothing
5. Give water and fluids 6. Taken to mobile clinics
7. Taken to traditional healer 8. Give Sour Milk
9. Give lemon 10. Give Camel milk
II. Give Herbal Medicine
99
16. How do you dispose your household sol id waste?
1. Burning 2. Burying
3. Household pits 4. Garbage pit
5. Communal pit 6. Given to livestock
7. Transfer station 8. Laga
9. Throwaway 10. Open Dumping
100
5.2: FOCUS GROUP DISCUSSION (FGD) GUIDE
1. WATER SUPPLY
a. What water source do you use in your area?
b. When was this water source constructed and by who?
c. Is the water supply reliable? How long will it last?
d. Is there any restriction in use of the current water sources for some members of the
community?
e. Is water treatment being practiced? If yes, which methods are used in water
treatment? If No, why? .
f. Are you happy with the supply? Explain.
g. If not, how should the state of water be improved?
2. HYGIENE AND EXCRETA DISPOSAL
a. What facilities are there for excreta disposal?
b. What facilities do you have for disposal of rubbish?
c. Are the sanitary facilities safe and effective?
d. How many people or families share one toilet?
e. Do people wash their hands after defecation and before food preparation and
eating? How?
f. Is soap, water or other cleansing materials available?
g. Do you and children under five years wash hands after defecating and before
handling food?
3. HEALTH EDUCATION:
a. Have you received any health education? What was the content of the health
education? c. Has the health education been of help to you?
4. OTHERS:
Since last year, how do you rate the support you get?
Water supply: Poor Moderate
Sanitation: Poor Moderate
Health education: Poor Moderate
Children health Not improved Moderate
Cases of Diarrhoea in
families among children Low Moderate
Good
Good
Good
Improved
High
5. What do you consider the most significant effects of Water, Sanitation and Health
Education interventions in your area?
6. What causes diarhoea in children and how do you manage cases of diarrhoea in your
area?
101
5.3: OBSERVATION CHECKLIST
Tick where appropriate
I. Main water sources for the community (indicate)
2. Water contamination activities at the water source
• Animals drinking water [ ]
• Personal hygiene e.g. bathing [ ]
laundry activities
relieving oneself
[ ]
[ ]
3. Presence offeacal matter around water sources
Present [ ] not present [ ]
4. Mode of water transportation to the household
Rolling on the ground [ ] carrying on the head []
Donkey carts [ ] other
5. Types of water containers used for water storage
Closed [ ] open [ ]
6. How water is scooped from the containers
Pouring [] scooping with a special container [ ]
Scooping with any container [ ]
7. Presence offlies present [ ] Not present [ ]
8. Food covered [ ] food not covered [ ]
9. Availability of latrines and type: Present [ ] Not present [ ]
Type
10. Presence of tippy taps or leaky tins: Present [ ] Not present ] and
washing area with soap present [ ] not present
11. Garbage Pit Present [ ] Not present
12. Waste thrown around the compound Yes [ ] No
13. Presence offeaces around the compound: Yes [ ] No
14. Drying rack Present [] Not present [ ]
[ ]
[ ]
[ ]
[ ]
15. Are there any of the following in the latrines?
(i) Blockages/ Filled up I. Yes
(i i) Odour? 1 . Yes
(iii) Flies in your toilet? I. Yes
2. No
2. No
2. No
102
5.4 RESEARCH AUTHORISATION LETTER
REPUBLIC OF ICENYA
MINISTRY OF SCIENCE & TECHNOLOGY
Telegrams: "SCIENCE, 'rEC", 'Nairobi
Telephone: 02-318581
E-·Mail:psC@scienceandtechnology.go.ke
JOC:;OO IIOUSE, "13"
IIARAMI3EE AVENUE,
r.o. Box 9583-00200
NAIROS]
Wb eri Replying please quote
Ref, IVlOST 13/0011 38C 2212 lSthFebruary 2008
Sheillah Simiyu
Kenyatta University
P.O. Box 43844
NAIROBI
RE: RESEARCH AUTHORIZATION
Following your application for authority to carry out research on,
'Assessl11ent of' Effects of' Water. Sanitation and Health Education -
Interventions on Diarrhoeal Morbidity Among Children Under Five in
Mandera District'
I am pleased to inform you that you have been authorized to carry out
research in Mandera for a period ending so= April, 2008.
You are advised to report to the District Commissioner and the Public
Health Officer, Mandera District before embarking on your research
project.
On completion of your research, you are expected to submit two copies of
your research report to this office .
.t\"'"A~,~:\C2;~~)
M. O. ONDIEKI
FOR: PERMANENT SECRETARY
Copy to:
The District Commissioner
Mandera District
Mandera
The Public Health Officer
Mandera District
Mandera
103
5.5. LIST OF FGD PARTICIP ANTS
Women Men
BPI BP I
1. AbdiaDiis 1. Adan Osman
2. Abdia Abdi 2. Abdi Mohammed
3. Amina Garori 3. Awale Abey
4. Habiba Kerat 4. Madnur Mohammed
5. Fatuma Noor 5. Okash Abey
6. MuslimaAli 6. Hussein Ali
7. Shankara Yussuf 7. Mohammed Abdi
8. Timira Sheikh 8. Abdullahi Abdi
9. Noor Mohammed Omar
Bulla Mpya Bulla Mpya
1. Daran Yussuf 1. Osman Maal im
2. Khadija Ali 2. Suleiman Muktar
3. Khadija Mohammed 3. Muktar Birik
4. Amina Mohammed 4. Mude Bilow Mohammed
5. AminaAdan 5. Okash Ali Adan
6. Rukia AbdiRahman 6. Ahmed Alasow Ali
7. Hadija Hassan 7. Daud Hussein Ali
8. Halima Abdow 8. Mohammed Abikar Farah
9. Gamana Ahbdow 9. Suleiman lsaack Biriq
10. Abdia Bulle 10. Adan Daud Abdi
11. Haretha Isaak II. Sabriye Biriq Hussein
12. Hawa Ibrahim 12. Idle Dakane Ali
Bulla Jamhuria Bulla Jamhuria1. Seinab Mohammed Hassan 1. Ibrahim Mohamud
2. Habiba Osman 2. Mohammed Ibrahim
3. Halima Noor " Mohammed Gulia-'.
4. Gureisha Mohammed 4. Noor Ibrahim
5. Abdia Ali Liba 5. Malele Mohammed
6. Fatuma Abdullahi 6. Sheikh Ibrahim mohammed
7. Nuria Adan 7. Khalif Abdi Noor
8. Bishara Bulle 8. Abdikadir Hassan
9. Jowhara Sheikh 9. Ibrahim Sambul
10. Arfou Dahi 10. Mohammed Ibrahim
II. Halima Ibrahim
104
Bur Abor
I. Quresha Ali Hassan
2. Halima Yunis Adan
3. Hawa Mohammed Noor
4. Nuria Mohamud Ahmed
5. Habiba Abdi
6. Habiba Olad
7. Aden Ibrahim
8. Binta Daud
9. Abshira Abey Hassan
10. Dahira Ali Hassan
Guba
I. Amina Abdullahi Sheikh
2. Abdia Ahmed
3. Zeinab Yussuf
4. Fatuma Mohammed
5. Shariffa Adan Shheikh
6. Suban Mohammed
7. Abdia Omar
8. Adey Maalim Noor
9. Habiba Maalim Abdullahi
Malkaruka
I. Habiba Hassan
2. Halima Hassan
3. Habiba Abdi
4. Halima Mohammed
5. Abdia Sharrif
6. Khadija Isaak
7. Diqo Guyo
Sala 2
1. Fatuma Dubane
2. Gaba Abdullahi
3. Dahaba Hussein
4. Batula Shaaban
5. Halima Hassan
6. Fatuma Noor
7. Geley Ahmed
8. Ibada Billow
9. Mumina Ahmed
10. Alasa Buul
11. Gulay Abdullahi
Bur Abor
1. Mursal Said Mohammed
2. Farah Ahmed Ali
3. Abdi Elmi Omar
4. Mohammed Abdullahi Sheikh
5. Mohammed Hussein Shaaban
6. Adan Abdi Bulle
7. Jabril Hussein Omar
8. Ali Hassan Hussen
9. Ali Gayle Noor
10. Adan Kulow
Guba
I. Mohammed Adan Yussuf
2. Bishar Duale Hassan
3. Ali Mohammed Abdule
4. Abdule Mohammed Hassan
5. Ismail Sheikh Salah
6. Hassan Abdile Hassan
7. Idow Garade Mohammed
8. Abdi Shaaban Abdi
9. Jimale YussufNoor
10. Kullow Sabdow Ganway
11. If ye Garad
12. Bishar Shaaban
Malkaruka
1. Hussein Maalim Adan
2. Mohammed Abdi Shakur
3. Abdi Adow Alio
4. Maalim Adan Ibrahim
5. Abdirahman Maalim
6. Nurow Mohammed
7. Adan Mohammed Abdi
8. Ahmed Abdi Dadai
Hullow
1. Dakane Sany
2. Mohammed Abdi Farh
3. Noor Mohammed Ali
4. Mohammed Slat Hassan
5. Guliya Jamaa Abdi
6. Mhammed Ismail
7. Bashir Abikar Farah
8. Isaack Diqis Amin
105
Khalalio
1. Jamita Yusuf
2. Nathira Mohammed
3. Fatuma Birik
4. Bishara Siraq
5. Ambia Haji
6. Rukia Haji Ahmed
7. Marwa Sheikh Abdi karim
Shaff Shaffey
1. Magala Muktar
2. Abshira Hussein
3. Haretha Ali
4. Duba Muktar
5. Abdia Mohammed
6. Zeinab Dugaw
7. Ebia Amin
8. Habiba Adan
9. Halima Guleya
10. Amina Esmail
11. Amina Hillowle
9. Shakur S.Abdi
10. Mohammed Ahmed Muse
11. Omar Shaaban Adan
12. Sheikh Mohammed Sheikh Abdi
Sala 2 Men
1. Bisha Derow
2. Abdi Noor Omar
3. Hassan Ibrahim
4. Hassan Salat
5. Ahmed Mohamud
6. Billow Sheikh
7. Ibrahim Mohammed
Khalalio Men
1. Mohammed Osman
2. Salah Ibrahim
3. Mohammed Ali
4. Hassan Isaack
5. Mohammed Abdullahi Bulle
6. Sheikh Mahat Maalim
7. Ahmed Mohammed Kaley
8. Mohammed Abdi
9. Abdullahi Shakut Gorow
10. Mohammed R. Ali
11. KhalifYussuf Abdi
106
5.6 LIST OF RESEARCH ASSISTANTS
1. Mohammed Sheikh Takoy
2. Mohamud Ali Adan
3. Ahmed Hussein Sheikh
4. Amin Sheikh Adam
5. Mohammed Abdi Huessein
6. Abdullahi Abdirahman
7. YusufShaban Ahmed
8. Fatuma Daud Hussein
9. Ali Abdullahi Ahmed
10. Abdi Gedi Ali