title: Determinants of Primary School Non-Enrollment and Absenteeism: Results from a Retrospective, Convergent Mixed Methods, Cohort Study in Rural Western Kenya.
abstract: BACKGROUND
  Education is a key element in the socioeconomic development required to improve quality of life in Kenya. Despite the introduction of free primary education, primary school enrollment and attendance levels remain low. Drawing on qualitative and quantitative data, this study explores the determinants of non-enrollment and absenteeism in rural western Kenya and potential mitigation strategies to address these issues.
  
  
  METHODS
  The study was conducted in Bwaliro village in rural western Kenya. A random sample of 64 students was obtained by blocking the village primary school's student population according to grade level, gender, and orphan status. Qualitative and quantitative data were collected through interviews with parents, guardians, and key informants, and focus group discussions with students. Quantitative data were compared using chi-square tests, Student's T-test, and Poisson regressions. Qualitative data were analyzed using thematic content analysis.
  
  
  RESULTS
  Malaria, menstruation, and lack of money were among the most notable determinants of primary school dropout and absenteeism, and these factors disproportionately impacted orphans and female students. Potential mitigation strategies suggested by the community included provision of malaria treatment or prevention, reduction in education costs, expansion of the established school-feeding program, and provision of sanitary pads.
  
  
  CONCLUSIONS
  Despite free primary education, numerous factors continue to prevent children in rural western Kenya from attending primary school. The findings suggest that interventions should primarily target orphaned and female students. Prior to implementation, suggested mitigation strategies should be assessed for cost-effectiveness.
authors.affiliation: Department of Population Medicine, Ontario Veterinary College, Guelph, Ontario, Canada.
authors.forename: Nia
authors.initials: N
authors.lastname: King
authors.affiliation: Department of Population Medicine, Ontario Veterinary College, Guelph, Ontario, Canada; Centre for Public Health and Zoonoses, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Cate
authors.initials: C
authors.lastname: Dewey
authors.affiliation: Department of Population Medicine, Ontario Veterinary College, Guelph, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Borish
mesh_terms: D000041:Absenteeism; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D007630:Kenya; D008297:Male; D062407:Meals; D010465:Perception; D012189:Retrospective Studies; D012574:Schools / Q000706:statistics & numerical data*; D013223:Statistics as Topic / Q000379:methods*; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*