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Lay People's Lived Experience in Rigoma Division, Nyamira

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Lay People's Lived Experience in Rigoma Division, Nyamira MALARIA: LAY PEOPLE’S LIVED EXPERIENCE IN RIGOMA DIVISION, NYAMIRA DISTRICT, KENYA ^ BY A THESIS SUBMITTED TO THE INSTITUTE OF AFRICAN STUDIES IN PARTIAL FULFILLMENT FOR THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF ARTS IN ANTHROPOLOGY OF THE ^UNIVERSITY OF NAIROBI 7 2003 University ol NAIROBI Library 0444702 5 DECLARATION This thesis is my original work and has not been presented for a degree in any other university . Jared Maaka Siso Date V=l-c>\ • o<-f This thesis has been submitted for Examination with my approval as a university supervisor. Dr. Isaac Keango Nyaniongir^trr^rr^?^ ..................Date..3A'.™V^.%. i DEDICATION To my beloved late sister Bonareri My grandma Baba Mosaisi And my loving mother Tabitha I can do all things through Christ who strengthenth me. Philippians.4: 13. ii ACKNOWLEDGEMENTS I am deeply indebted to many people and institutions for the successful completion of this thesis. However, due to limited space. I shall only mention a few. First, my sincere thanks are due to my supervisor. Dr. Isaac K. Nyamongo (Director Institute of African Studies), for not only being part and parcel of my decision to join Graduate school, but also for his invaluable advice, guidance and support throughout the study. I am also profoundly grateful to Prof. Collette Suda and Prof. Simiyu Wandibba for their comments and suggestions during the discussions of the proposal. To Dr. R. Kibiti, Dr. S. M. Nangendo. Dr. L. A. Muruli. Dr. D. M. London. DR. W. Subbo, and Mr Muyekho - I will forever treasure the memories of your intellectual insights, the time and assistance you readily accorded me. My uttermost appreciation too. is extended to the residents of Rigoma division especially my respondents for their hospitality and co-operation during my Fieldwork. Many thanks go to Mr. Bundi Nyakeri (my research assistant) and the local provincial administration for facilitating the development of rapport during my fieldwork. Jared Obiria and Justus Maroko deserve my special mention for not only sparinu their time to show me the quickest village routes to my respondents but also trekking with me for long distances. My unreserved appreciation goes to Henry. Leonard. Osebe. and Evans who in various and special ways have been of great support and strength. In particular I need to note that our moments together, have helped me to shape and enrich my vision, aspiration and character. To my wife Mercylyn and my son Siso Jnr.. thanks for being there for me always. You are the real forces behind my motivation. Special mention goes to Bosire. Rotich and Ichwara for enabling me type and print this work. Last but not least, may I extend my hqartfelt gratitude to all my friends and relatives, who in one way or another gave me a shoulder to lean on. thus making certain situations bearable. To you all I say. God bless. Above all. I salute my dear lord for being the good master of my intellectual journey and life- mbuyci mono (Thanks). iii TABLE OF CONTENTS PAGE DECLARATION......................................................................................................... DEDICATION.............................................................................................................. ACKNOWLEDGEMENT.......................................................................................... TABLE OF CONTENTS............................................................................................ LIST OF FIGURES AND TABLES ABBREVIATION....................................................................................................... ABSTRACT................................................................................................................. CHAPTER ONE 1.0 INTRODUCTION.............................................................................................1 1.1 Background Information.....................................................................................2 1.2 Statement of the Problem....................................................................................4 1.3 Study Objectives..................................................................................................5 1.3.1 General Objective................................................................................................5 1.3.2 Specific Objective...............................................................................................5 1.4.0 Rationale for the Study........................................................................................ 6 CHAPTER TWO: LITERATURE REVIEW 2.0 Literature Review..................................................................... .......... 8 2 1 Introduction................................................................ ....8 2.1.1 Nature of disease.............................................................. ......... 8 2.1.2 Malaria Epidemiolouv and Endemicitv....................... ....... 10 2.1.3 Effects of Malaria.................................................. .....13 2.1.4 Economic Impact of Malaria................................... .....14 2.1.5 Malaria Prevention and Control............................. ........ 16 2.1.6 Folk knowledge and perceptions of Malaria...... .....18 2.1.7 Health Seeking Behavior..................................... .21 2.2.0 Theoretical Framework................................. 23 2.2.1 Explanatory models................................... 23 2.2.2 Relevance of the model to the studv 2.3.0 Assumptions............................. 2S IV 2.3.1 Definition of Key Terms 26 CHAPTER THREE: METHODOLOGY 3.0 Introduction............................................................... 27 1 Site Location............................................................. 27 1.2 Topography............................................................... 28 .1.3 Climate....................................................................... 28 .1.4 Population size and Composition............................ 32 .1.5 Land use and Soils.................................................... 32 . 1.6 Infrastractural development...................................... JJ .1.7 Health Facilities........................................................ 34 .1.8 Disease Incidence...................................................... 35 .2 Population Universe................................................. 35 .2.1 Study Population....................................................... 37 .2.2 Sampling Procedure................................................. .37 .2.3 Entry into the Study Area......................................... .38 O J .3.0U-> L»J MethodsOJ O J L»J O J of L»-> L»J DataO J L*J collection...................................... <-*J O J .39 3.3.1 Case Histories.'........................................................... .40 3.3.2 Focus Group Discussions........................................ .41 3.3.3 Direct Observation.................................................. .41 3.3.4 Free listing................................................................ .42 3.4 Unity of Analysis...................................................... .42 3.5 Ethical Issues............................................................ .43 3.6 Methods of Data collection..................................... .43 3.7 Problems and challenges encountered in the study .44 CHAPTER FOUR: RESEARCH FINDINGS 4.1 Introduction......................................................................................................... 47 4.2.1 Age, Gender and Marital Status.........................................................................47 4.2.2 Family Size..........................................................................................................49 4.2.3 Religious Affiliation...........................................................................................49 4.2.4 Level of Education............................................................................................. 50 4.2.5 Flousing and other Ecological Factors...............................................................^ 4.2.6 Occupation and Land Use.................................................................................52 4.3.0 Folk knowledge of Malaria............................................................................... 53 4.3.1 Health problems as perceived by lay people in Rigoma division.................. 53 4.3.2 Lay peoples recognition of malaria signs and symptoms................................55 4.3.3 Lay perceptions about malaria causation......................................................... 59 4.3.4 Perceived malaria transmission period............................................................. 60 4.3.5 Prevention and control of Malaria.....................................................................62 4.3.6 Treatment Options and there Utilization.......................................................... 65 4.3.7 Treatment time seeking......................................................................................69 4.3.8 Determinants of Health Seeking Behavior....................................................... 70 4.3.9 Effects of malaria............................................................................................... 74 CHAPTER FIVE: DISCUSSION AND CONCLUSIONS 5.0 Introduction.........................................................................................................75 5.1 Summary............................................................................................................. 75 5.2 Conclusion..........................................................................................................91
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