PROF. WANGOMBE JOSEPH K.

Rotavirus infection is the single most common cause of acute gastroenteritis in children under five years of age. Rotavirus gastroenteritis has a high morbidity and mortality in children in Kenya. To determine the short term clinical outcome for children admitted to Kenyatta National Hospital with rotavirus gastroenteritis and the correlates of poor outcome. Short longitudinal survey. Kenyatta National Hospital from February to May 2008. Five hundred children were screened using a rapid antigen detection kit and ELISA. Of the 191 children who tested positive for rotavirus in stool; 172 children were recruited into the study. Eighty eight per cent of the patients were discharged within one week, 8.1% stayed for more than seven days while 4.1% died. Children who had co-morbidities such as malnutrition, rickets and pneumonia had worse outcomes. Rotavirus gastroenteritis has a long hospital stay and a high mortality. Children in shock on admission and those with co-morbid conditions should get priority for they have a poor outcome

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

PIP: A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were–or were suspected to be–HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

OBJECTIVE: To assess the relationship between maternal factors and child nutritional status among children aged 6-36 months. DESIGN: Cross sectional descriptive survey. SETTING: Urban slum settlement in Nairobi, Kenya. SUBJECTS: This study included a random sample of 369 households of mothers with children aged 6-36 months at the time of the study. RESULTS: Maternal factors which showed a positive significant association with at least one of the three child nutritional status indicators (height for age, weight for age and weight for height) were birth spacing, parity, maternal education level and mothers marital status. Child spacing and parity emerged as the most important predictors of stunting among study children. Maternal nutritional status was also shown to be positively associated with child nutritional status. Maternal ill health had a negative effect on child nutritional status. CONCLUSION: Maternal factors are an underlying cause of childhood malnutrition.

During the decade and a half after Alma Ata hundreds of projects were started in developing countries to implement the principles of PHC and start community based health care programs in the rural areas of developing countries. Until the past five years urban health was not seen as a special health problem. Population pressure in the rural areas has created shortages of land, food and employment opportunities. These forces have generated major population movements to the urban centres. The population movements have encouraged unprecedented expansion of urban centres. This sudden concentration of large populations in small geographical areas has resulted in the urban health crises of the developing world. The poor who live in the slum areas have no access to adequate health services, they experience frequent epidemics of communicable diseases like cholera, they live within a heavily polluted environment, and their children have very poor health because they are not immunized and are malnourished. The paper agrees with approaches which have been championed by development agencies to address the urban health crises. These approaches propose the reorientation of urban health systems to include adoption of PHC for urban health programs, intersectoral collaboration and extra budgetary support. The paper argues for further strengthening of the reorientation approach by adjusting the development planning model. It is proposed that the urban plan be integrated into the national development plan so that emerging urban health crises can receive special attention in resource allocation.

PIP: A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were–or were suspected to be–HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company.

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

Two thousand, seven hundred and ninety one normal and handicapped children aged 5-15 years were examined for traumatic dental injuries. Twelve percent had traumatised teeth while three percent had soft tissue injuries. More handicapped children (18%) than normal children (11%) had injuries. This study indicates that children need to be educated on preventive measures regarding traumatic dental injuries.

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

Essential drug schemes in the Third World countries face many problems. These include dependency on imported drugs in the face of chronic shortages of foreign exchange, inadequate manpower and technical capability for selection and procurement of drugs, competition between generic and brand drugs, weak local drug procurement and distribution systems and inability to commence local manufacturing even in situations where there may exist comparative advantage. Many of these problems relate to each other and are compounded by the domination of the pharmaceutical industry by multinational firms. Third World countries are in a very weak position in the international pharmaceutical industry. It is suggested that the essential drug situation would improve in Third World countries if certain strategies and policies were adopted. These include: intensification of personnel training in pharmaceuticals, deliberate use of generic drugs rather than brand name drugs, the involvement of the public sector in the procurement and distribution of drugs, buying drugs in bulk, changing drug prescription and consumption practices through continuous education, changing or instituting regulations to guard against unfavourable patents and commencing domestic production of essential drugs where this is not in conflict with the principle of comparative advantage.

Essential drug schemes in the Third World countries face many problems. These include dependency on imported drugs in the face of chronic shortages of foreign exchange, inadequate manpower and technical capability for selection and procurement of drugs, competition between generic and brand drugs, weak local drug procurement and distribution systems and inability to commence local manufacturing even in situations where there may exist comparative advantage. Many of these problems relate to each other and are compounded by the domination of the pharmaceutical industry by multinational firms. Third World countries are in a very weak position in the international pharmaceutical industry. It is suggested that the essential drug situation would improve in Third World countries if certain strategies and policies were adopted. These include: intensification of personnel training in pharmaceuticals, deliberate use of generic drugs rather than brand name drugs, the involvement of the public sector in the procurement and distribution of drugs, buying drugs in bulk, changing drug prescription and consumption practices through continuous education, changing or instituting regulations to guard against unfavourable patents and commencing domestic production of essential drugs where this is not in conflict with the principle of comparative advantage.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

Essential drug schemes in the Third World countries face many problems. These include dependency on imported drugs in the face of chronic shortages of foreign exchange, inadequate manpower and technical capability for selection and procurement of drugs, competition between generic and brand drugs, weak local drug procurement and distribution systems and inability to commence local manufacturing even in situations where there may exist comparative advantage. Many of these problems relate to each other and are compounded by the domination of the pharmaceutical industry by multinational firms. Third World countries are in a very weak position in the international pharmaceutical industry. It is suggested that the essential drug situation would improve in Third World countries if certain strategies and policies were adopted. These include: intensification of personnel training in pharmaceuticals, deliberate use of generic drugs rather than brand name drugs, the involvement of the public sector in the procurement and distribution of drugs, buying drugs in bulk, changing drug prescription and consumption practices through continuous education, changing or instituting regulations to guard against unfavourable patents and commencing domestic production of essential drugs where this is not in conflict with the principle of comparative advantage.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.