title: The challenge of promoting interventions to prevent disease in impoverished populations in rural western Kenya.
abstract: Poverty is a critical social determinant of health. A particular approach toward mitigating inequitable access to health services in Kenya has been through a community-based distribution program implemented by the Safe Water and AIDS Project (SWAP) that has achieved modest uptake of public health interventions. To explore reasons for modest uptake, we asked program participants about child health problems, daily tasks, household expenditures, and services needed by their communities. Respondents identified child health problems consistent with health data and reported daily tasks, expenses, and needed services that were more related to basic needs of life other than health. These findings highlight the challenges of implementing potentially self-sustaining preventive interventions at scale in poor populations in the developing world.
authors.affiliation: Katharine Schilling and Rob Quick are with the Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA. Bobbie Person is with the Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention. Sitnah H. Faith and Ronald Otieno are with the Safe Water and AIDS Project, Kisumu, Kenya.
authors.forename: Katharine
authors.initials: K
authors.lastname: Schilling
authors.forename: Bobbie
authors.initials: B
authors.lastname: Person
authors.forename: Sitnah H
authors.initials: SH
authors.lastname: Faith
authors.forename: Ronald
authors.initials: R
authors.lastname: Otieno
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
mesh_terms: D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D019058:Community Networks; D006293:Health Promotion; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007630:Kenya; D008137:Longitudinal Studies; D011204:Poverty Areas; D011322:Primary Prevention / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D012424:Rural Population; D011795:Surveys and Questionnaires