Public Health and Utilization Level of Health Facilities in the Low Income Settlement: A Case Study Of Kibera

Utilization is an aspect of development in the social and economic field, which always is accompanied by problems of housing, sanitation, and pollution and so are problems resulting from the rising demand for medical and social services. Most towns in Africa are comparatively recent in origin and in a majority of them; there has been an explosive growth of population. Such rapid increase in numbers, with consequent strain on health and social facilities, the dislocation of family life and adjustments called upon by various members of the family to suit new modes of life have created some of the major problems of our age.

Much attention has been given to rapid pace of urbanization in the less developed countries in the recent years and to the possibility of decline in the level of living in the cities as a consequence of this trend. It is considered that unless prompt measures are taken, the large influx of people in the cities of Asia, Africa, and Latin America will greatly those municipal facilities whose functions is to maintain and improve social and health standards. One of the principal areas of concern is the field of health and the possible effects of some aspects of urbanizations particularly, rural-urban migration upon conditions of health and mortality levels in the cities.


Most of the towns in the developing countries lack proper planning. They are characterized by severe in-migration from the rural areas in search of jobs. This has thus brought up emergence of informal settlements that have the poorest infrastructure for health care services in this areas, the spread of diseases is multiplied a thousand times and yet disease can be easily be prevented by simple measures such as vigorous health education and regulations by enlisting public support. Thus health education, environmental sanitation including sewage and garbage disposal, and immunization should be important aspects of health work in the towns.

Just like any other towns of developing countries, Nairobi city has grown both in terms of population and physical expansion.  The rapid increase in population in Nairobi city places a heavy burden on provision of medical services though it has been observed that eight percent of the present are found in urban centers, Nairobi taking the lions share, the services are still not adequate and the services are not performing to capacity.

This research aims at identifying salient issues as regards present and future health planning in Nairobi. This research examines the factors that affect the well-being of residents in the low-income urban settlements and the level of utilization of the health services in the settlements of Kibera.

The study established that majority of the respondents had attained at least primary education (over 60%).The influence of education on health was also reflected on the action taken when one is confronted by a health situation .Majority of residents in Kibera settlements waited for the situation to get out of hand before they visited a doctor. This could be attributed to low education levels and lack of knowledge on dangers of ill health and also to lack of money to pay for treatment. Incomes were low with the majority of the residents earning less than Kshs.2500/=. The study revealed that those who were getting relatively low incomes tended to experience multiplicity of health problems. Since one illness once untreated leads to another. The dwelling units were in a dilapidated state. Densities are high (1500 people per hectare). This accelerated the spread of diseases. Due to high and congestion in the dwelling units (6 persons per room) home accidents were common features in Kibera settlements. The most common disease included water borne disease, AIDS and Sexually Transmitted infections, malnutrition and diarrhea diseases.

Infrastructural services are lacking in the settlement. There is inadequacy, reliability and uncertainty of water supply in the settlement sanitation is crossly inadequate in Kibera. Majority of residents live without their toilets and bathrooms. The few available once are for commercial and a user has to pay one shilling to relieve himself.   This has prompted the residents to relieve themselves in polythene bags, which they refer to as flying toilets.

The study also establishes the low quality residential environments and poor health are closely related. In Kibera settlements insufficient water supply, poor water quality overcrowding inadequate disposal and infestations by rats and flies are commonplace. The study recommends that housing and general environment should be improved. This could be done by provision of basic facilities like standard pipes.  Providing access to small scale credit facilities, upgrading of the existing dilapidated dwelling units, educating the residents on safe and hygienic methods of garbage collection, proper food preparation, and proper practices concerning sickness, maternal care, child care and immunization.

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