The Extent to which the Housing Environment is a Contributor to Child Morbidity in Nairobi and its Policy Implications
Otieno, Raymond O
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Provision of adequate housing is a major challenge in many urban areas of the developing countries. In Kenya, the housing problem in major cities is exacerbated by rapid growth of the urban population without the corresponding expansion in housing provision. Nairobi, the capital city, has been the most affected with a large proportion of the population living in housing conditions characterized by poorly built physical structures, inadequate services and overcrowding. These conditions have health implications on the city residents as morbidity rates stemming out of housing environmental conditions are on the rise. This study examines the extent to which the housing environment is a contributor to child morbidity in Nairobi. It examines relationship between the housing environment and the two morbid conditions that are the leading causes of death in early childhood i.e. Diarrhea and Acute Respiratory Infection (ARI). The study’s main objective is to investigate the relationship between the housing environment and prevalence of child morbidity in Nairobi. In this regard, the study establishes the prevalence rate of diarrhoea and acute respiratory infection, vis-à-vis housing conditions in Nairobi and, secondly, it assesses the relationship between housing conditions and these forms of child morbidity in Nairobi. The analysis in this study is based on a sample of 432 children under the age of five in Nairobi from the 2003 Kenya Demographic and Health Survey (KDHS). This study utilizes descriptive statistics and cross tabulations to compare prevalence rate of these forms of child morbidity vis-à-vis housing conditions. In assessing the nature of the relationship between the housing and the morbid conditions, this study utilizes logistic regression modeling. Results show lower prevalence rates of diarrhoea among children who live in housing which have water piped into dwelling, housing which have flush toilets, and housing having non-earthen floors. Results also show low prevalence rates of ARI among children living in housing that have non-earthen floors. Further analysis using logistic regression modeling at the multivariate level reveal that the type of floor and type of sanitation facility used in a dwelling are significant predictors of diarrhoea among children under the age of five. Children living in housing with non-earth floors are 71 percent less likely to have diarrhoea when compared to those living in housing with earthen floors. Also, children living in housing where sanitation is in the form of flush toilets are 57 percent less likely to have diarrhoea compared to those living in housing environments where the sanitation facilities are pit toilets (traditional pit latrine and ventilated improved pit latrine). In the case of ARI, the type of floor is a significant predictor with children living in dwellings that have non-earth floors being 63 percent less likely to have ARI compared to those residing in dwellings where the floors are earthen. Findings of this study open up an area that has not been explored very much in the developing countries in regard to the mitigation of child morbidity. The overall housing environment plays an important role in health improvement. However, many programs aimed at reducing there prevalence of disease (for instance of diarrhoea) have predominantly targeted only the services in housing (e.g. water and sanitation) to the neglect of other crucial aspects. This study gives a justification to go beyond what is traditionally or universally regarded as “improved” provision of water or sanitation by international agencies and governments. It also highlights the importance of physical attributes of the housing as indicated by the type of floor material which is often ignored in intervention programmes yet these too are significant as clearly shown by this study. Non-earth floors should therefore be viewed as a health measure.
xmlui.dri2xhtml.METS-1.0.item-identifier-citationMSc. Urban Management, University Of Nairobi
Department of Architecture and Buiding Science, College of Architecture and Engineering