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PROFILE:: THE KILIFI HEALTH AND DEMOGRAPHIC SURVEILLANCE SYSTEM

Wednesday, 26th of September 2012

 

Profile: The Kilifi Health and Demographic Surveillance System (KHDSS)

J Anthony G Scott¹,²,³,^*, Evasius Bauni¹,³, Jennifer C Moisi¹,², John Ojal¹, Hellen Gatakaa¹,  

Christopher Nyundo¹, Catherine S Molyneux¹,², Francis Kombe¹, Benjamin Tsofa¹,

Kevin Marsh¹,², Norbert Peshu¹ and Thomas N Williams¹,²,³

 

+ Author Affiliations

1. 1.       ¹Kenya Medical Research Institute, Wellcome Trust Research Programme, Kilifi, Kenya, ²Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK and ³INDEPTH Network, Accra, Ghana
2. ↵*Corresponding author. KEMRI-Wellcome Trust Research Programme, PO Box 230, Kilifi 80108, Kenya. E-mail: ascott@ikilifi.org

       Accepted March 21, 2012.

 

Abstract below; full text is at http://ije.oxfordjournals.org/content/early/2012/04/27/ije.dys062.full?etoc

 

Summary The Kilifi Health and Demographic Surveillance System (KHDSS), located on the Indian Ocean coast of Kenya, was established in 2000 as a record of births, pregnancies, migration events and deaths and is maintained by 4-monthly household visits. The study area was selected to capture the majority of patients admitted to Kilifi District Hospital. The KHDSS has 260 000 residents and the hospital admits 4400 paediatric patients and 3400 adult patients per year. At the hospital, morbidity events are linked in real time by a computer search of the population register. Linked surveillance was extended to KHDSS vaccine clinics in 2008.

KHDSS data have been used to define the incidence of hospital presentation with childhood infectious diseases (e.g. rotavirus diarrhoea, pneumococcal disease), to test the association between genetic risk factors (e.g. thalassaemia and sickle cell disease) and infectious diseases, to define the community prevalence of chronic diseases (e.g. epilepsy), to evaluate access to health care and to calculate the operational effectiveness of major public health interventions (e.g. conjugate Haemophilus influenzae type b vaccine). Rapport with residents is maintained through an active programme of community engagement. A system of collaborative engagement exists for sharing data on survival, morbidity, socio-economic status and vaccine coverage.

 

• TV, RADIO, AND KNOWLEDGE ON CONTRACEPTION AND HIV/AIDS

‘Television viewing in particular is found to be strongly associated with the use of modern contraception. . .’

 

Full text is at http://www.measuredhs.com/pubs/pdf/AS24/AS24.pdf

 

Executive Summary

This is a study of the association of radio and television exposure with different aspects of reproductive

behavior and with knowledge, attitudes, and behavior in connection with HIV/AIDS. The measures of

mass media are limited to the frequency that women and men report listening to the radio and watching

television, which are standard questions in the Demographic and Health Surveys (DHS). Only the

frequency is assessed; the DHS does not obtain information on programmatic content.

 

The first part of the report focuses on contraceptive behavior, the number of children desired, and the

number of births in the preceding three years. The guiding rationale is that the media open windows to the

outside world, presenting aspects of modern life that can compete with traditional values about marriage

and childbearing. The analysis is based on DHS data from 48 developing countries. Television viewing in

particular is found to be strongly associated with the use of modern contraception and with a smaller

number of children desired and fewer births in the recent past. These associations generally persist after

adjustment for the amount of schooling, wealth, urban residence, and other covariates.

 

The second part of the study focuses on 27 countries in sub-Saharan Africa and explores the implications

of radio and television exposure for HIV/AIDS knowledge, attitudes, and risk behavior. Similar to the

analysis of reproductive behavior, the conclusion is that exposure to television and radio is an important

covariate for knowledge of the causes of HIV/AIDS and how to prevent infection. In this part of the

study, the main assumption is that the media provide valuable information on the sources of infection,

how to avoid it, where to get tested, the importance of condom use, and various other related subjects. In

general, radio exposure appears to be more important than television as a conduit of such information.