Population-based socio-demographic household assessment of livelihoods and health among communities in Migori County, Kenya over multiple timepoints (2021, 2024, 2027): A study protocol

Starnes, Joseph R.; Wamae, Jane; Okoth, Vincent; Ressler, Daniele; Were, Vincent; Were, Lawrence; Moon, Troy D.; Wamai, Richard G.

doi:10.1371/journal.pone.0256555

Cited by 5 publications

(10 citation statements)

References 18 publications

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“…The next expansion is planned for Awendo (orange). Two areas in Uriri, Central Kanyamkago and West Kanyamkago, serve as comparison wards (red) ( 44 ).…”

Section: Methodsmentioning

confidence: 99%

“…The details of the sampling methodology and the resulting survey have been previously described in the survey protocol ( 44 ). To summarize, using a power of 80%, sample size was determined by the size required to identify a 10% change over time in each health metric.…”

Section: Methodsmentioning

confidence: 99%

“…The model incorporates traditional birth attendants into professionalized community health worker cadres and is distinguished by its consistent payment, supportive supervision, and proactive community case finding and case management. To better understand community needs and measure the impact of programming, Lwala has conducted longitudinal cross-sectional community household surveys ( 44 ). The surveys include IPV assessment, which allowes for measurement of the prevalence of IPV in the Lwala catchment area.…”

Section: Introductionmentioning

confidence: 99%

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Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey

Schellhammer,

Starnes,

Mudhune

et al. 2024

Front. Glob. Womens Health

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BackgroundInterpersonal violence (IPV) is an issue of major public health concern, with 24% of Kenyan women reporting physical violence perpetrated by a current husband or partner. IPV has profound impacts on physical and mental health outcomes, particularly for pregnant women; it has been found to increase the risk of perinatal mortality, low birth weight, and preterm birth. This study aims to identify variables associated with IPV and assess the effects of IPV experience on prenatal and peripartum maternal healthcare in Migori County, Kenya. Findings build on a previous study that investigated a smaller region of Migori County.MethodsResponses to cross-sectional household surveys conducted in six wards of Migori County, Kenya in 2021 from female respondents aged 18 and older were analyzed. The survey contained validated screening tools for interpersonal violence. Group-wise comparisons, and bivariate and multivariate logistic regression analyses were performed to describe community prevalence, factors associated with IPV against women, and the effect of IPV exposure on prenatal and peripartum health care.ResultsThis study finds that 2,306 (36.7%) of the 6,290 respondents had experienced lifetime IPV. IPV experience was associated with the age group 25–49 (adjusted odds ratio (aOR) 1.208; 95%CI: [1.045–1.397]; p = 0.011), monogamous marriage [aOR 2.152; 95%CI: (1.426–3.248); p < 0.001], polygamous marriage [aOR 2.924; 95%CI: (1.826–4.683); p < 0.001], being widowed/divorced/separated [aOR 1.745; 95%CI: (1.094–2.786); p < 0.001], feeling an attitude of “sometimes okay” toward wife beating [aOR 2.002 95%CI: (1.651, 2.428); p < 0.001], having been exposed to IPV in girlhood [aOR 2.525; 95%CI: (2.202–2.896); p < 0.001] and feeling safe in the current relationship [aOR 0.722; 95%CI: (0.609, 0.855); p < 0.001]. A depression score of mild [aOR 1.482; 95%CI: (1.269, 1.73); p < 0.001] and severe [aOR 2.403; 95%CI: (1.429, 4.039); p = 0.001] was also associated with IPV experience, and women who experienced emotional abuse were much more likely to have experienced IPV [aOR 10.462; 95% CI: (9.037, 12.112); p < 0.001]. Adjusted analyses showed that having experienced IPV was negatively associated with attending at least four antenatal care visits during the most recent pregnancy (OR 0.849, p = 0.044) and with having a skilled birth attendant (OR 0.638, p = 0.007).ConclusionsIPV is prevalent in Migori County, Kenya, with increased prevalence among women aged 25–49, those residing in West Kanyamkago, those in a monogamous or polygamous marriage, those who have been widowed/divorced/separated, and those with severe depressive symptoms. Further, IPV exposure is associated with lower use of maternal care services and may lead to worse maternal health outcomes. There is need for enhanced effort in addressing social and gender norms that perpetuate IPV, and this study can contribute to guiding policy interventions and community responses towards IPV.

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“…The next expansion is planned for Awendo (orange). Two areas in Uriri, Central Kanyamkago and West Kanyamkago, serve as comparison wards (red) ( 44 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey

Schellhammer,

Starnes,

Mudhune

et al. 2024

Front. Glob. Womens Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The survey and sampling methodology have been described in detail elsewhere 14. Briefly, the survey was powered to detect a 10% change in health metrics over time with 80% power.…”

Section: Methodsmentioning

confidence: 99%

“…Programming includes an innovative community-led health programme that activates community governance structures, professionalises the community health worker (CHW) role, incorporates traditional birth attendants into the healthcare system and supports public health facilities to improve the quality of care. To monitor impact and allow for improvement, a repeated cross-sectional household survey was designed to assess a wide variety of health metrics in both programming and control areas 14–18. This study aims to use the most recent iteration of this survey to expand our prior mortality work.…”

Section: Introductionmentioning

confidence: 99%

Childhood mortality and associated factors in Migori County, Kenya: evidence from a cross-sectional survey

Starnes,

Rogers,

Wamae

et al. 2023

BMJ Open

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ObjectivesThe under-five mortality (U5M) rate in Kenya (41 per 1000 live births) remains significantly above international goals (25 per 1000 live births). This is further exacerbated by regional inequalities in mortality. We aimed to describe U5M in Migori County, Kenya, and identify associated factors that can serve as programming targets.DesignCross-sectional observational survey.SettingAreas served by the Lwala Community Alliance and control areas in Migori County, Kenya.ParticipantsThis study included 15 199 children born to respondents during the 18 years preceding the survey.Primary and secondary outcome measuresThe primary outcome was mortality in the first 5 years of life. The survey was powered to detect a 10% change in various health metrics over time with 80% power.ResultsA total of 15 199 children were included in the primary analyses, and 230 (1.5%) were deceased before the fifth birthday. The U5M rate from 2016 to 2021 was 32.2 per 1000 live births. Factors associated with U5M included year of birth (HR 0.926, p<0.001), female sex (HR 0.702, p=0.01), parental marriage (HR 0.642, p=0.036), multiple gestation pregnancy (HR 2.776, p<0.001), birth spacing less than 18 months (HR 1.894, p=0.005), indoor smoke exposure (HR 1.916, p=0.027) and previous familial contribution to the National Hospital Insurance Fund (HR 0.553, p=0.009). The most common cause of death was malaria.ConclusionsWe describe factors associated with childhood mortality in a Kenyan community using survival analyses of complete birth histories. Mortality rates will serve as the baseline for future programme evaluation as a part of a 10-year study design. This provides both the hyperlocal information needed to improve programming and generalisable conclusions for other organisations working in similar environments.

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Predictors of under-five healthcare utilization in Rongo sub-county of Migori County, Kenya: results of a population-based cross-sectional survey

Rogers¹,

Lee²,

Joseph³

et al. 2022

Pan Afr Med J

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Population-based socio-demographic household assessment of livelihoods and health among communities in Migori County, Kenya over multiple timepoints (2021, 2024, 2027): A study protocol

Cited by 5 publications

References 18 publications

Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey

Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey

Childhood mortality and associated factors in Migori County, Kenya: evidence from a cross-sectional survey

Predictors of under-five healthcare utilization in Rongo sub-county of Migori County, Kenya: results of a population-based cross-sectional survey

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