Social determinants of health and health inequities in Nakuru (Kenya).
BACKGROUND
Dramatic inequalities dominate global health today. The rapid urban growth sustained by Kenya in the last decades has created many difficulties that also led to worsening inequalities in health care. The continuous decline in its Human Development Index since the 1990s highlights the hardship that continues to worsen in the country, against the general trend of Sub-Saharan Africa. This paper examines the health status of residents in a major urban centre in Kenya and reviews the effects of selected social determinants on local health.


METHODS
Through field surveys, focus group discussions and a literature review, this study canvasses past and current initiatives and recommends priority actions.


RESULTS
Areas identified which unevenly affect the health of the most vulnerable segments of the population were: water supply, sanitation, solid waste management, food environments, housing, the organization of health care services and transportation.


CONCLUSIONS
The use of a participatory method proved to be a useful approach that could benefit other urban centres in their analysis of social determinants of health.
WHO Centre for Health Development, Kobe, Japan. grenierf@who.int.
Esther
E
Muchukuri
Francis R
FR
Grenier