Health information for district level planning: a cross-sectional household survey in rural Kenya

Health care planning and management in sub-Saharan Africa is being decentralised, and health information systems need to meet new needs. This study in rural Kenya explored the feasibility of a cross-sectional household health interview survey to help district-level health planning. Heads of 390 households were interviewed about health-related factors like housing standard, water supply, sanitation, recent illness, and health care use. Half of all households lived on farming. Access to water sources was poor, but latrine coverage was high. Of all disease episodes 26% were respiratory, 18% gastrointestinal and 10.5% malaria. Rates of illness episodes were low (1.0 day of illness/person/30 days), and 40% of episodes were taken to a modern service provider like a dispensary, health centre or hospital. The survey generated much information on household characteristics, illness episodes and action taken, data that was not available through the routine health information system. Survey costs were estimated at 15 US cents per resident in the project area, a large proportion of which was absorbed by computerized data processing, but may be reduced to about half. If conducted once every three or four years, a survey of this kind would be affordable within the ordinary recurrent district health budget and would provide useful planning and management information.