Background
Methods
Study area
The Rusinga Island Child & Family Programme (RICFP)
Study design
Ethical considerations
Data analysis
Results
Response rate
Socio-demographic characteristics of respondents
Characteristics | Total N | Socio-economic status | ||||
---|---|---|---|---|---|---|
Most poor (%) | Very poor (%) | Poor (%) | Less poor (%) | Least poor (%) | ||
Total households interviewed |
1451
| 19.8 | 20.2 | 19.9 | 20.1 | 30.0 |
CCF-enrolled households |
701
| 22.0 | 20.4 | 20.7 | 21.7 | 15.4 |
Sex of household head (χ
2
= 86.5; d.f. = 4; p < 0.001)
| ||||||
male |
1125
| 16.1 | 18.5 | 19.8 | 21.4 | 24.1 |
female |
326
| 32.2 | 26.1 | 20.2 | 15.6 | 5.8 |
Age of respondent (χ
2
= 26.5; d.f. = 12; p = 0.009)
| ||||||
below 25 |
376
| 19.9 | 20.7 | 17.6 | 20.2 | 21.5 |
25 to 34 |
443
| 23.7 | 23.3 | 17.8 | 17.2 | 18.1 |
35 to 44 |
301
| 15.0 | 16.3 | 23.3 | 20.9 | 24.6 |
above 45 |
322
| 18.6 | 19.3 | 22.4 | 23.3 | 16.5 |
Educational level of respondent (χ
2
= 44.9; d.f. = 12; p < 0.001)
| ||||||
none |
89
| 24.7 | 25.8 | 23.6 | 19.1 | 6.7 |
primary |
1039
| 20.8 | 21.4 | 19.5 | 20.1 | 18.2 |
secondary |
283
| 14.8 | 14.5 | 21.6 | 20.1 | 29.0 |
college |
23
| 8.7 | 17.4 | 4.3 | 26.1 | 43.5 |
Number of household members (χ
2
= 100.0; d.f. = 12; p < 0.001)
| ||||||
2 to 4 |
384
| 27.1 | 26.3 | 21.6 | 14.3 | 10.7 |
5 to 7 |
685
| 21.0 | 20.1 | 18.4 | 18.8 | 21.6 |
8 to 10 |
299
| 10.0 | 15.4 | 22.1 | 29.4 | 23.1 |
more than 10 |
73
| 9.6 | 9.6 | 16.4 | 24.7 | 39.7 |
Number children (χ
2
= 49.7; d.f. = 8; p < 0.001)
| ||||||
1 to 2 |
396
| 24.7 | 24.7 | 20.7 | 15.9 | 13.9 |
3 to 5 |
715
| 20.3 | 21.0 | 18.7 | 19.3 | 20.7 |
more than 5 |
328
| 12.8 | 13.4 | 21.3 | 27.1 | 25.3 |
Number of wives of household head (χ
2
= 37.3; d.f. = 8; p < 0.001)
| ||||||
1 wife |
918
| 22.8 | 21.6 | 19.9 | 19.9 | 15.8 |
2 wives |
286
| 14.3 | 21.0 | 20.3 | 18.9 | 25.5 |
more than 2 wives |
154
| 15.6 | 15.6 | 16.9 | 19.5 | 32.5 |
Main source of household income (χ
2
= 99.1; d.f. = 28; p < 0.001)
| ||||||
unskilled labour |
70
| 28.6 | 24.3 | 30.0 | 11.4 | 5.7 |
skilled labour (craftsperson) |
16
| 25.0 | 25.0 | 18.8 | 18.8 | 12.5 |
farming |
73
| 12.3 | 17.8 | 24.7 | 24.7 | 20.5 |
small scale business* |
426
| 22.8 | 23.9 | 18.3 | 19.2 | 15.7 |
other business |
179
| 17.9 | 21.8 | 18.4 | 19.6 | 22.3 |
fishing |
472
| 17.8 | 17.6 | 21.2 | 22.2 | 21.2 |
Salary/pension for employment |
73
| 4.1 | 12.3 | 16.4 | 19.2 | 47.9 |
support from relative outside Rusinga |
116
| 27.6 | 19.8 | 12.9 | 19.8 | 19.8 |
Monthly expenditure met by households(χ
2
= 89.5; d.f. = 12; p < 0.001)
| ||||||
less than 1500 KShs |
186
| 34.9 | 26.9 | 17.2 | 16.1 | 4.8 |
1500–3000 KShs |
422
| 20.9 | 23.0 | 20.9 | 18.5 | 16.8 |
3000–4500 KShs |
434
| 15.9 | 19.6 | 22.1 | 20.3 | 22.1 |
more than 4500 KShs |
232
| 10.3 | 14.7 | 19.0 | 26.7 | 29.3 |
Sex of respondent | ||
---|---|---|
male
|
female
| |
Education (χ
2
= 76.7; d.f. = 3; p < 0.001)
| ||
Total N | 393 | 1050 |
none | 1.3% | 8.1% |
primary | 64.6% | 75.5% |
secondary | 30.0% | 15.7% |
college | 4.1% | 0.7% |
Occupation (χ
2
= 800.3; d.f. = 7; p < 0.001)
| ||
Total N | 391 | 1053 |
farmer | 9.0% | 4.6% |
labourer | 4.6% | 2.1% |
craftsperson | 2.6% | 1.1% |
fisherfolk | 61.6% | 2.2% |
small-scale business | 4.9% | 48.0% |
business | 5.4% | 7.8% |
formal employment | 5.1% | 2.1% |
none | 6.9% | 32.2% |
Knowledge and beliefs
Education* | Odds Ratio | 95% C.I. for Odds Ratio |
P
| |
---|---|---|---|---|
Lower
|
Upper
| |||
none | 1.000 | |||
primary | 1.248 | 0.491 | 3.175 | 0.641 |
secondary | 2.707 | 1.033 | 7.096 | 0.043 |
college | 10.800 | 3.154 | 36.984 | <0.001 |
Causes of malaria | n | % |
---|---|---|
Total N = 1378
| ||
Mosquito bites | 1250 | 90.7 |
Weather conditions | 423 | 30.7 |
Lack of hygiene | 250 | 18.1 |
Bushy compound | 156 | 11.3 |
Food | 69 | 4.8 |
Body exhaustion | 31 | 2.1 |
Variables* | Odds Ratio | 95% C.I. for Odds Ratio |
p
| |
---|---|---|---|---|
Lower
|
Upper
| |||
Factors associated with knowledge of mosquito bites as sole cause of malaria
| ||||
Education*
| ||||
none | 1.000 | |||
primary | 1.473 | 0.910 | 2.385 | 0.115 |
secondary | 2.837 | 1.681 | 4.787 | <0.001 |
college | 4.400 | 1.615 | 11.990 | 0.004 |
Factors associated with belief that unfavourable weather causes malaria
| ||||
Non-CCF*
| 1.488 | 1.172 | 1.890 | 0.001 |
Education*
| ||||
none | 1.000 | |||
primary | 0.871 | 0.536 | 1.416 | 0.578 |
secondary | 0.287 | 0.162 | 0.510 | <0.001 |
college | 0.204 | 0.055 | 0.756 | 0.017 |
Factors associated with belief that lack of hygiene causes malaria
| ||||
Age*
| ||||
below 25 | 1.000 | |||
25 to 34 | 0.985 | 0.666 | 1.457 | 0.939 |
35 to 44 | 1.175 | 0.775 | 1.783 | 0.448 |
above 45 | 1.926 | 1.309 | 2.834 | 0.001 |
Factors associated with not mentioning mosquito bites as cause of malaria
| ||||
Non-CCF*
| 2.309 | 1.483 | 4.209 | <0.001 |
Age*
| ||||
below 25 | 1.000 | |||
25 to 34 | 1.113 | 0.659 | 1.880 | 0.690 |
35 to 44 | 1.250 | 0.703 | 2.222 | 0.448 |
above 45 | 2.694 | 1.578 | 4.600 | <0.001 |
Ways of parasite entry | n | % |
---|---|---|
Total N = 1439
| ||
Mosquito bites | 999 | 69.4 |
Dirty water or food | 138 | 9.6 |
Body openings & cuts | 125 | 8.7 |
Don't know | 291 | 20.2 |
Methods | Methods known | Methods used | χ2 |
p*
| ||
---|---|---|---|---|---|---|
N
|
%
|
N
|
%
| |||
Total N = 1451
| ||||||
Bednets | 1274 | 87.8 | 692 | 47.7 | 528.0 | <0.001 |
Bush clearing | 633 | 43.6 | 492 | 33.9 | 28.4 | <0.001 |
Destruction of burrow pits that can collect water | 492 | 33.9 | 0 | 0.0 | 592.4 | <0.001 |
Burning/spraying insecticide or mosquito repellents | 233 | 16.1 | 236 | 16.3 | 0.1 |
ns
|
Boiling/treating water | 186 | 12.8 | 109 | 7.5 | 22.4 | <0.001 |
Taking anti-malarial drugs | 183 | 12.6 | 170 | 11.7 | 0.5 |
ns
|
Keeping body/food warm and clean | 170 | 11.7 | 0 | 0.0 | 180.6 | <0.001 |
Proper disposal of empty tins that can hold water | 122 | 8.4 | 309 | 21.3 | 95.3 | <0.001 |
Keeping utensils, house and compound clean | 117 | 8.1 | 38 | 2.6 | 42.5 | <0.001 |
Burning rubbish in the compound | 77 | 5.3 | 42 | 2.9 | 10.7 | 0.010 |
Use traditional herbs | 48 | 3.3 | 61 | 4.2 | 1.6 |
ns
|
None | 52 | 3.6 | 184 | 12.7 | 64.5 | <0.001 |
Variables* | Odds Ratio | 95% C.I. for Odds Ratio |
p
| |
---|---|---|---|---|
Lower
|
Upper
| |||
Factors associated with knowledge of bednets
| ||||
Non-CCF*
| 0.438 | 0.306 | 0.627 | <0.001 |
Age*
| ||||
below 25 | 1.000 | |||
25 to 34 | 1.393 | 0.882 | 2.200 | 0.155 |
35 to 44 | 1.164 | 0.703 | 1.926 | 0.555 |
above 45 | 0.525 | 0.327 | 0.844 | 0.008 |
Education*
| ||||
none | 1.000 | |||
primary | 2.071 | 1.179 | 3.638 | 0.011 |
secondary | 3.928 | 1.935 | 7.975 | <0.001 |
college | 542.724 | 0.000 | 1.43E+09 | 0.404 |
Factors associated with knowledge of source reduction (filling burrow pits)
| ||||
Non-CCF*
| 0.712 | 0.566 | 0.894 | 0.004 |
Women*
| 0.745 | 0.579 | 0.959 | 0.022 |
Education*
| ||||
none | 1.000 | |||
primary | 1.032 | 0.637 | 1.672 | 0.899 |
secondary | 2.660 | 1.569 | 4.510 | <0.001 |
college | 7.446 | 2.570 | 21.573 | <0.001 |
Factors associated with knowledge of insecticides and repellents
| ||||
Non-CCF*
| 0.514 | 0.381 | 0.693 | <0.001 |
Age*
| ||||
below 25 | 1.000 | |||
25 to 34 | 0.937 | 0.653 | 1.343 | 0.723 |
35 to 44 | 0.542 | 0.349 | 0.842 | 0.006 |
above 45 | 0.576 | 0.376 | 0.883 | 0.011 |
Factors associated with belief in bush clearing
| ||||
Non-CCF*
| 0.552 | 0.445 | 0.685 | <0.001 |
Women*
| 0.736 | 0.578 | 0.938 | 0.013 |
Education*
| ||||
none | 1.000 | |||
primary | 1.602 | 1.007 | 2.551 | 0.047 |
secondary | 2.431 | 1.454 | 4.067 | 0.001 |
college | 3.312 | 1.263 | 8.689 | 0.015 |
Factors associated with belief in increased hygiene and keeping warm
| ||||
Non-CCF*
| 1.419 | 1.107 | 1.818 | 0.006 |
Age*
| ||||
below 25 | 1.000 | |||
25 to 34 | 1.279 | 0.929 | 1.762 | 0.132 |
35 to 44 | 1.335 | 0.937 | 1.903 | 0.110 |
above 45 | 1.639 | 1.132 | 2.371 | 0.009 |
Education*
| ||||
none | 1.000 | |||
primary | 0.639 | 0.394 | 1.037 | 0.070 |
secondary | 0.544 | 0.316 | 0.937 | 0.028 |
college | 0.205 | 0.056 | 0.758 | 0.018 |
Malaria prevention behaviour
Variables* | Odds Ratio | 95% C.I. for Odds Ratio |
P
| |
---|---|---|---|---|
Lower
|
Upper
| |||
Factors associated with ownership and usage of bednets
| ||||
Socio-economic status*
| ||||
most poor | 1.000 | |||
very poor | 1.918 | 1.186 | 3.101 | 0.008 |
poor | 3.816 | 2.241 | 6.498 | <0.001 |
less poor | 3.640 | 2.205 | 6.008 | <0.001 |
least poor | 6.849 | 3.885 | 12.076 | <0.001 |
Factors associated with use of insecticides and repellents
| ||||
Women-headed*
| 1.470 | 1.073 | 2.014 | 0.017 |
Factors associated with proper disposal of tins and rubbish
| ||||
Women-headed*
| 0.708 | 0.514 | 0.974 | 0.034 |
Factors associated with bush clearing
| ||||
Non-CCF*
| 0.687 | 0.547 | 0.864 | 0.001 |
Women-headed*
| 0.564 | 0.424 | 0.751 | <0.001 |
Factors associated with boiling/treating drinking water
| ||||
Women-headed*
| 1.929 | 1.240 | 3.000 | 0.004 |
Socio-economic status*
| ||||
most poor | 1.000 | |||
very poor | 1.807 | 0.889 | 3.673 | 0.102 |
poor | 2.315 | 1.157 | 4.632 | 0.018 |
less poor | 2.384 | 1.187 | 4.791 | 0.015 |
least poor | 2.185 | 1.053 | 4.534 | 0.036 |
Factors associated with not practicing any malaria prevention behaviour
| ||||
Non-CCF*
| 1.400 | 1.001 | 1.958 | 0.049 |
Women-headed*
| 1.461 | 1.000 | 2.134 | 0.050 |
Socio-economic status*
| ||||
most poor | 1.000 | |||
very poor | 0.607 | 0.383 | 0.961 | 0.033 |
poor | 0.699 | 0.444 | 1.099 | 0.121 |
less poor | 0.430 | 0.258 | 0.717 | 0.001 |
least poor | 0.469 | 0.282 | 0.781 | 0.004 |
Malaria treatment seeking behaviour and associated expenses
The role of the community in malaria control
Reasons | n | % |
---|---|---|
Total N = 491
| ||
Malaria is a God given fact of life | 141 | 28.7 |
Impossible to kill all the mosquitoes | 125 | 25.5 |
People can not afford prevention and treatment | 60 | 12.2 |
People do not take preventive measures | 53 | 10.8 |
We are surrounded by the lake (believed breeding habitat) | 48 | 9.8 |
Malaria multiplies fast and can't be stopped | 23 | 4.7 |
It is a virus which can not be stopped | 9 | 1.8 |
There is a lot of dust on Rusinga causing respiratory illness and malaria | 4 | 0.8 |
No reason | 28 | 5.7 |
Education* | Odds Ratio | 95% C.I. for Odds Ratio |
P
| |
---|---|---|---|---|
Lower
|
Upper
| |||
none | 1.000 | |||
primary | 1.619 | 1.048 | 2.499 | 0.037 |
secondary | 2.878 | 1.754 | 4.722 | <0.001 |
college | 4.644 | 1.463 | 14.749 | 0.010 |
Reasons | n | % |
---|---|---|
Total N = 939
| ||
Everybody needs to sleep under a bednet | 482 | 51.3 |
Everybody needs to clear vegetation for compound to be open | 346 | 36.8 |
Stagnant water needs to be drained or treated to kill larvae | 258 | 27.5 |
Government to provide control (including free bednets, larvicide and clearing vegetation) | 91 | 9.7 |
Everybody to keep compound clean and built latrines | 84 | 8.9 |
Free and proper diagnosis and treatment in hospitals | 79 | 8.4 |
Everybody to take anti-malarial drugs | 57 | 6.1 |
Provision of training on malaria control | 52 | 5.5 |
Provision of access to safe water | 33 | 3.5 |
Everybody to use preventive measures in the house | 27 | 2.9 |
Malaria vaccine needs to be introduced | 12 | 1.3 |
Living standards need to be improved | 3 | 0.3 |
Contributions | n | % |
---|---|---|
Total N = 939
| ||
Personal oriented protection (bednet, insecticides, repellents) | 243 | 25.9 |
If I would be trained I could teach people | 170 | 18.1 |
I can clear vegetation around my house | 166 | 17.7 |
I can advise people to clear vegetation | 153 | 16.3 |
I can teach people to boil water | 72 | 7.7 |
I can participate in removal of empty containers | 68 | 7.2 |
I would actively participate in a program that tells me what to do | 53 | 5.7 |
I can spay paraffin on waterholes | 5 | 0.5 |
I can buy medicines and bednets for people | 4 | 0.4 |
I can help constructing latrines | 3 | 0.3 |
I can only contribute if I am given money | 3 | 0.3 |
I can not contribute | 113 | 12.0 |
I do not know how I could contribute | 45 | 4.8 |