The Sendai Framework of 2015-2030, which aims at reducing disaster risks by enhancing resilience of UN member states, and Kenya’s Vision 2030 may not be achieved. A number of facets are at play in Kenya: high national debt, runaway corruption and the threat of top risk health factors. The situation in Luo Nyanza counties is more worrying with specific reference to top risk health factors.
The Kenya Population-based HIV Impact Assessment report 2018 released recently shows that Luo Nyanza has a higher HIV prevalence than the rest of the country. Homa Bay county’s prevalence is the highest at 19.6 per cent, four times the national average of 4.9 per cent. Kisumu is second with 17.5 per cent, Siaya third at 15.3 per cent and Migori fourth at 13 per cent.
Although in aggregate there was reduction in new infections, these statistics on HIV prevalence are significant and worrying, coupled with the fact that the trend has continued for two decades. The socioeconomic impact of HIV-Aids on the region cannot be over-emphasised. Despite remarkable effort by government agencies and NGOs, a lot still needs to be done if answers to these questions are anything to go by:
Could the prevalence partially explain the high dependency ratio among the households in these counties as the Kenya National Bureau of Statistics indicates? Is the upsurge in the number of orphans, widows and widowers as well as children-headed households associated with the scourge? Is this another contributing factor to the enrolment rate imbalance in Kisumu, where more girls than boys registered for the 2019 KCPE exam as boys may be engaged in domestic and economic activities to supplement family income?
Can the misery, hopelessness and weather-beaten faces that greet you on a visit to these lake-side counties’ rural areas be a testimony to this? In my submission as a resident of Homa Bay, the HIV-Aids scourge may be a causal factor to a large extent. No-wonder the statistics from the national census released recently categorised Homa Bay, Siaya and Migori among counties with the most mud-walled and grass-thatched houses.
Mid last year the 26-year longitudinal study on the global burden of diseases, injuries and risk factors painted a grim picture of Homa Bay and Migori. According to the study, Homa Bay and Migori bear the brunt of top risk health factors of unsafe drinking water, poor sanitation, lack of hand-washing, unsafe sex as well as child and maternal malnutrition, which are the leading causes of death across the country.
The report showed that there is a 15-year difference in life expectancy between the county with the highest, Laikipia at 72 years, and the county with the lowest, Homa Bay at 57 years. On child mortality, Nairobi had the lowest at 21 under-five deaths per 1,000 live births compared to Migori’s 81, the highest.
The study found that the likelihood of a child dying below the age of five in Migori is four times compared to Nairobi; at the same time, a resident of Homa Bay is more likely to die from non-communicable diseases than someone in another county.
These statistics call for county governments to allocate substantial financial resources to improve healthcare services, since this is a devolved function. Emphasis must be laid on achieving higher HIV epidemic control as part of universal health coverage goals, while the Health ministry needs to re-examine its policies in the fight against HIV.
There is also need to re-examine the region’s social fabric because individual characteristics may increase vulnerability to some of the top risk health factors. The national and county governments should help the youth accessing middle-level colleges to equip them with technical skills to become self-employed and self-reliant by establishing such institutions in places such as Suba South and North subcounties where none exists.
Finally, residents need to be aggressive and hold their elected leaders to account, especially county government leaderships, on the prudent use of the public resources at their disposal.
Lecturer, Masinde Muliro University of Science and Technology
