Health-seeking behaviour among residents of the informal settlement of Kibera, Nairobi

Abstract

This study investigates factors influencing health-seeking behaviour among the informal settlers of Kibera, Nairobi. It specifically addresses the following: whether beliefs on the cause of diseases influence the types of therapy used, whether the perceptions about the cost of treatment influence choice of sources of therapy and whether education influence therapy choice. A total of 140 respondents (35 from each of the four villages: Lindi, Gwatekera, Laini Saba and Makina) were systematically sampled and interviewed using a standard questionnaire. In-depth interviews of 20 key informants (five from each village) were undertaken and two Focus Group Discussions (one comprising of health service providers and the other women with children under-five years) were conducted. Two case histories of people who had chronic illnesses were carried out as well. The study found that beliefs 'about cause of diseases influence types of therapy used during the first stages of an illness. However, switching of therapies is common during follow-up stages and in episodes of chronic illnesses. Secondly, the study reveals that in the initial stage~ of illness, the respondents utilise health-care sources they consider affordable such as Government clinics and hospitals or indigenous healers. However, when an illness persists for a longer period or does not respond to treatment, the respondents usually change the source of therapy from cheaper to expensive ones. ix Thirdly, the findings show that there is no association between level of education and therapy used. Qualitative data reveal that the choice of therapy depends on affordability, the seriousness of the illness, as well as the prospects of recovering. It is concluded that health-care outcome is determined by perceptions about disease causation and the cost of treatment. It is recommended that improving hygienic levels of Kibera, and creating awareness through public health education on causes and management of common ailments, as well as enhancing the residents' incomes through skills training and involvement in income-generation activities to enable them access health care services should be emphasized. These measures will enable residents to make informed health care choices. Recommendations for future research are also identified.