Mortality Trends and Causes of Death in Nairobi, Nyeri and Bungoma Districts

Abstract

A study on mortality is very important, since mortality it is one of the major components of population dynamics. Mortality is responsible for the depletion of human population through death. It is important to study different causes of death in an attempt to shed new light while at the same time putting proper policies in place to bring down the number of deaths to reasonable figures. This is because many causes of death are preventable especially when proper actions are taken in good time. Therefore, this study set out to establish the major causes of death in Nyeri, Bungoma and Nairobi districts. The objectives of the study were to generate mortality trends based on both census and KDHS data and establish major causes of death in Nyeri, Bungoma and Nairobi districts, using vital registration data. Mortality trends have been reversed in the recent past with all indicators pointing to upward trends. Infant and child mortality started rising in the mid-1980s while life expectancy dropped drastically. There was, therefore, a need to establish the major causes of death, which were responsible for the observed trends. Covering the period between 1999 and 2002, the study examined the causes of death in the three districts based on the number of registered deaths in each district for each year. During this period, the average coverage rate for Nyeri was 83%, 63% in Bungoma and 75% in Nairobi. The methods of data analysis were simple descriptive statistics like frequency tables and cross tabulation to establish differentials in death by some selected study variables. From the findings, five major causes of death were established in each district during the four years. The causes of death in all the districts were similar in nature and it is only the magnitude that differed considerably. The

major causes of death were pneumonia, malaria and HIV/AIDS. Malaria, pneumonia, tuberculosis and HIV/AIDS were common in all the districts while anaemia was peculiar to Bungoma, sudden death to Nyeri and gastroenteritis to Nairobi. Malaria was the greatest single killer in all the districts with the greatest impact being felt in Bungoma district. Pneumonia was the main killer in Nyeri and Nairobi while HIV/AIDS contributed significantly to the total deaths in the two districts. HIV/AIDS was prevalent in the age group 25-49 years and afflicted more females than males in all the districts. Major childhood diseases were similar to those afflicting the general population although the highest casualties from the leading causes (i.e. pneumonia and malaria) were those below zero and under five. Other diseases peculiar to children were dehydration, malnutrition, septicaemia and respiratory failure. One Major causes of death among certain selected occupations were HIV/AIDS, which had the greatest impact on housewives, drivers, armed forces and business professionals. The occupations, which were hardest, hit by deaths in Nyeri and Bungoma districts were farm workers and agricultural subsistence probably because majority of the people are engaged in agricultural activities. In Nairobi, majority of deaths occurred among housewives, unemployed and business professionals. From the findings, HIV/AIDS is the major killer of housewives and this study recommends that further research be carried out to find the underlying factors. This study also recommends further research as to whether there is any association between region of residence and pre-maturity as a cause of death in Nyeri and Nairobi districts. This study recommends that proper intervention programmes be put in place to address the morbidity situation

in Kenya while at the same time engaging in aggressive programmes to tackle childhood diseases. Vital registration data is still wanting in terms of quality and coverage. From the findings, it was clear that quite a number of variables had missing cases. This study, therefore recommends that proper training on data collection and capture be paramount to ensure data is of high quality. The forms, which are used for data collection, should be revised so as to allow inclusion of more information like background characteristics of the deceased.