Kenya

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Rain is abundant along the coast; normally about 890 to 1,270 mm fall each year depending on location. Similar amounts fall throughout the highlands, although several of the higher areas and the shores of Lake Victoria receive considerably more. Northern Kenya and the interior areas of the East are quite dry. Parts of the North receive less than 250 mm a year. 1.1.3 Economy Agriculture and tourism are the main drivers of Kenya’s economy. In 2014, the agricultural sector recorded mixed performance, mainly attributable to erratic rains with some regions experiencing depressed rainfall. The low levels of rainfall resulted in a decrease in production of some crops as well as pasture regeneration for livestock. The tourism sector performance decreased in 2014 on account of a number of factors. These include insecurity, negative travel advisories, and fear of continued spread of Ebola in West African countries. According to the 2015 Economic Survey, Kenya’s economy expanded by 5.3 percent in 2014, compared to a growth of 5.7 percent in 2013. From the demand side, growth was driven mainly by an increase in private consumption and a rapid growth in capital investment. From the supply side, the major drivers of the economy were agriculture, forestry, and fishing; construction; wholesale and retail trade; education; and finance and insurance (KNBS 2015). 1.2 BASIC DEMOGRAPHIC INDICATORS In the 2009 Population and Housing Census, Kenya’s population stood at 38.6 million. Previous census results indicated an annual population growth rate of nearly 3 percent each year during the 1999-2009 period. Kenya’s population is characterised as “very young.” The 2009 population census reports that 43 percent of the population is under age 15 and only 4 percent is age 65 or older (KNBS 2012). This is attributed to high fertility and declining mortality. Table 1.1 presents trends in basic demographic indicators for Kenya from 1969 to 2014. The population grew from 10.9 million people in 1969 to 38.6 million people in 2009. At the same time, the population density increased from 19.0 persons per sq km to 66.4 persons per sq km. The percentage of the population living in urban areas increased from 9.9 percent to 32.3 percent. The Kenya National Bureau of Statistics estimated the population to be 43.0 million in 2014, the density to be 73.9 persons per sq km, and the proportion urban to have remained unchanged. Table 1.1 Basic demographic indicators Selected demographic indicators for Kenya, 1969, 1979, 1989, 1999, 2009, and 2014 Indicator 1969 1979 1989 1999 2009 2014 Population (millions) 10.9 16.2 23.2 28.7 38.6 43.0 a Density (pop./km 2 ) 19.0 27.0 37.0 49.0 66.4 73.9 a Percent urban 9.9 15.1 18.1 19.4 32.3 32.3 Crude birth rate 50.0 54.0 48.0 41.3 34.8 30.5 b Crude death rate 17.0 14.0 11.0 11.7 10.4 10.4 b Inter-censal growth rate 3.3 3.8 3.4 2.9 2.9 2.9 b Total fertility rate 7.6 7.8 6.7 5.0 4.8 3.9 Infant mortality rate (per 1,000 births) 119 88 66 77 54 39 Life expectancy at birth 50.0 54.0 60.0 56.6 58.0 58.0 b a Projected figures b Assumed to remain constant over the inter-censal period Source: CBS 1970; CBS 1981; CBS 1994; CBS 2002; KNBS & ICF Macro 2010; KNBS 2012; KNBS and ICF International 2015 Several indicators also show improvement in development between 1969 and 2014. For instance, the total fertility rate declined from 7.6 to 3.9. Infant mortality declined from 119 deaths per 1,000 live births to 39. Life expectancy at birth increased from 50 to 58 years. The inter-censal growth 4 • Introduction
ate declined from 3.3 to 2.9 percent per annum. The crude death rate (i.e., the number of deaths occurring among the population in Kenya during a given year, per 1,000 mid-year total population) also declined from 17.0 to 10.4. Finally, the crude birth rate (i.e., the number of live births occurring during the year, per 1,000 population estimated at mid-year) dropped from 50.0 to 30.5. 1.3 HEALTH PRIORITIES AND STRATEGIES FOR MALARIA PREVENTION Kenya’s development agenda is articulated in the Vision 2030, which aims to make Kenya a ‘globally competitive and prosperous country with a high quality of life by 2030 (Government of Kenya 2007). The Vision’s agenda is anchored on three pillars: social, political, and economic. Health issues are categorised in the social pillar and are further articulated in the Kenya Health Sector Strategic Plan (KHSSP) 2014-2018. The strategies and goals laid out in these documents focus on the need to improve the number of available health services, scale up coverage of required health services, and reduce the financial burden associated with using health services. The plan emphasises prevention and investment in maternal and newborn health. Specific targets include the following: 1. Reduce, by at least 50 percent, infant, neonatal, and maternal deaths 2. Reduce, by at least 25 percent, time spent by persons in ill health 3. Improve, by at least 50 percent, levels of client satisfaction with services 4. Reduce, by 30 percent, catastrophic health expenditures (MOH 2013) 1.3.1 Kenya Malaria Strategy 2009-2018 (Revised 2014) The Kenya Malaria Strategy 2009-2018 (revised 2014), is a revision of the National Malaria Strategy 2009-2017 following a mid-term review in 2013-2014. The timing of the review was informed by emerging issues such as the devolution of health service delivery from national to county governments as well as updated technical guidance on malaria control from the World Health Organization (WHO). The main recommendation of the review was to consolidate the delivery of current malaria prevention and control interventions. The development of the revised malaria strategy was a multi-stakeholder and multi-sectoral participatory process led by the national and county governments in collaboration with civil society, development partners, and programs of the Ministry of Health. Furthermore, the revision has been informed by the KHSSP 2014-2018, the Kenya Health Policy 2012-2030, the Global Technical Strategy for Malaria 2016-2030 and the Roll Back Malaria Partnership’s Action and Investment plan to defeat malaria 2016-2030 (MOH 2014). The strategy is a concerted effort to achieve a malaria-free Kenya, and its mission is to direct and coordinate efforts against malaria though effective partnerships. The goal of the strategy is to reduce morbidity and mortality caused by malaria by two-thirds of the 2007-08 level by 2017. The strategic objectives are: 1. To have at least 80 percent of people in malaria risk areas using appropriate malaria preventive interventions by 2018. 2. To have all suspected malaria cases that present to a health provider managed in accord with National Malaria Treatment Guidelines by 2018. 3. To ensure that all sub-counties in the malaria epidemic and seasonal transmission zones have the capacity to detect and respond in a timely manner to malaria epidemics by 2018. Introduction • 5
Page 1: REPUBLIC OF KENYA MINISTRY OF HEALT
Page 4 and 5: The 2015 Kenya Malaria Indicator Su
Page 6 and 7: 3.2 Use of Mosquito Nets ..........
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Page 11: Acknowledgements • ix
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Page 19: 1 INTRODUCTION 1.1 HISTORY, GEOGRAP
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5 CASE MANAGEMENT Key Findings •
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Figure 5.1 highlights the actions t
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Table 5.2 Source of advice or treat
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extremely or very important was low
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While health facilities are providi
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6 MALARIA AND ANAEMIA IN CHILDREN K
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Table 6.2 Prevalence of malaria in
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As Figure 6.3 shows, the decline in
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Table 6.4 Prevalence of anaemia Per
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Although malaria prevalence in the
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MEASURE Evaluation, Roll Back Malar
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Table A.1 Enumeration areas and hou
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A.4 SAMPLE PROBABILITIES AND SAMPLE
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APPENDIX B ESTIMATES OF SAMPLING ER
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Table B.1 List of selected variable
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Table B.7 Sampling errors: Coast en
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Table C.2 Age distribution of eligi
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Table D.2 Prevalence of malaria in
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Table D.4 Prevalence of anaemia in
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Table D.6 Comparison of malaria and
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APPENDIX E SURVEY PERSONNEL NATIONA
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LOGISTICIAN Robert Mwaura FIELD TEA
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ICF INTERNATIONAL Sara K. Head Joy
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MALARIA CONTROL UNIT KENYA NATIONAL
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INTRODUCTION AND CONSENT ADMINISTER
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HOUSEHOLD SCHEDULE LINE NO. USUAL R
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HOUSEHOLD CHARACTERISTICS NO. QUEST
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MOSQUITO NET ROSTER NET #1 NET #2 N
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SOURCE AND USES OF MOSQUITO NETS NO
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SOURCE AND USES OF MOSQUITO NETS NO
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INTERVIEWER'S OBSERVATIONS TO BE FI
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SECTION 1. RESPONDENT'S BACKGROUND
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SECTION 2. REPRODUCTION 212 Now I'd
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SECTION 3. PREGNANCY AND INTERMITTE
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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SECTION 4A. KNOWLEDGE AND ATTITUDES
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CHILD 1 CHILD 2 CHILD 3 NAME NAME N
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HEMOGLOBIN MEASUREMENT AND MALARIA
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CHILD 4 CHILD 5 CHILD 6 121 122 123
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Kenya

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