Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

Laurah Odima Ating’ah; Antony Odek; Duncan Ochieng

doi:10.51867/ajernet.5.4.20

Authors

Laurah Odima Ating’ah
odimating@gmail.com
St. Paul’s University, Kenya https://orcid.org/0009-0003-1275-7596
Antony Odek St. Paul’s University, Kenya
Duncan Ochieng St. Paul’s University, Kenya https://orcid.org/0009-0009-9496-8533

Keywords:

Health Information, HIV/AIDS Healthcare, Household Access, Literacy Levels, Low-Income Communities, Socio-Economic Determinants

Abstract

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Dimensions

REFERENCES

Adebisi, Y. A., Alaran, A., Badmos, A., Bamisaiye, A. O., Emmanuella, N., Etukakpan, A. U., Oladunjoye, I. O., Oluwaseyifunmi, O., Musa, S. K., Akinmuleya, T., Olaoye, O. C., Olarewaju, O. A., & Lucero-Prisno, D. E. III. (2021). How West African countries prioritize health. Health Economics Review, 49, 87. https://doi.org/10.1186/s41182-021-00380-6 DOI: https://doi.org/10.1186/s41182-021-00380-6

Aljassim, N., & Ostini, R. (2020). Health literacy in rural and urban populations: A systematic review. Patient Education and Counseling, 103(10), 2142-2154. https://doi.org/10.1016/j.pec.2020.06.006 DOI: https://doi.org/10.1016/j.pec.2020.06.007

Andersen, R. M. (1968). A behavioral model of families' use of health services (Research Series No. 25). University of Chicago, Center for Health Administration Studies.

Azevedo, M. J. (2017). The state of health system(s) in Africa: Challenges and opportunities. In Historical perspectives on the state of health and health systems in Africa (Vol. II, pp. 1-73). Springer. https://doi.org/10.1007/978-3-319-32564-4_1 DOI: https://doi.org/10.1007/978-3-319-32564-4_1

Barak, A., & Grohol, J. M. (2017). How online therapy works: A systematic review of the effectiveness of internet therapy. American Journal of Psychotherapy, 70(1), 1-20.

Brunson, J. (2013). The impact of parental education on children's healthcare decisions. Journal of Family Health, 9(2), 123-135.

Campbell, J., Kelsey, K., & Paley, S. (2019). Evaluating the National Health Service Guidelines app: A usability study. Journal of Health Communication, 24(6), 614-621.

Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM - Population Health, 15, 100847. DOI: https://doi.org/10.1016/j.ssmph.2021.100847

Crowley, R., Atiq, O., & Hilden, D. (2021). Financial profit in medicine: A position paper from the American College of Physicians. Annals of Internal Medicine, 174(10), 1447-1449. https://doi.org/10.7326/M21-1178 DOI: https://doi.org/10.7326/M21-1178

Dahab, R., & Sakellariou, D. (2020). Barriers to accessing maternal care in low-income countries in Africa: A systematic review. International Journal of Environmental Research and Public Health, 17(12), 4292. https://doi.org/10.3390/ijerph17124292 DOI: https://doi.org/10.3390/ijerph17124292

Heestermans, T., Browne, J. L., Aitken, S. C., Vervoort, S. C., & Klipstein-Grobusch, K. (2016). Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: A systematic review. BMJ Global Health, 1(4), e000125. DOI: https://doi.org/10.1136/bmjgh-2016-000125

Kenya Ministry of Health. (2022). Kenya primary health care strategic framework. Government of Kenya.

Kenya National Bureau of Statistics. (2019). 2019 Kenya population and housing census volume I: Population by county and sub-county. Government of Kenya.

Kioko, M. T., & Pertet, A. M. (2017). Factors contributing to antiretroviral drug adherence among adults living with HIV or AIDS in a Kenyan rural community. African Journal of Primary Health Care & Family Medicine, 9(1), a1343. https://doi.org/10.4102/phcfm.v9i1.1343 DOI: https://doi.org/10.4102/phcfm.v9i1.1343

Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30(3), 607-610. https://doi.org/10.1177/001316447003000308 DOI: https://doi.org/10.1177/001316447003000308

Lansford, J. E. (2021). Cross-cultural similarities and differences in parenting. Journal of Child Psychology and Psychiatry, 63(4), 466-479.

https://doi.org/10.1111/jcpp.13539 DOI: https://doi.org/10.1111/jcpp.13539

Madise, N. J., Ziraba, A. K., Inungu, J., Khamadi, S. A., Ezeh, A., Zulu, E. M., Kebaso, J., Okoth, V., & Mwau, M. (2012). Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya. Health & Place, 18(5), 1144-1152. https://doi.org/10.1016/j.healthplace.2012.04.003 DOI: https://doi.org/10.1016/j.healthplace.2012.04.003

Maher, K., Bui, V., & Wong, L. (2018). The role of mobile health apps in providing healthcare information to young people. Health Informatics Journal, 24(3), 248-257.

Majeed-Ariss, R., Rowe, J., & Edirippulige, S. (2015). Digital health apps: Addressing the needs of young people. BMC Public Health, 15(1), 28.

Maniatopoulos, G., Hunter, D. J., Erskine, J., & Hudson, B. (2020). Large-scale health system transformation in the United Kingdom: Implementing the new care models in the NHS. Journal of Health Organization and Management, 34(3), 325-344. https://doi.org/10.1108/JHOM-05-2019-0144 DOI: https://doi.org/10.1108/JHOM-05-2019-0144

McKee, M., Dunnell, K., Anderson, M., Brayne, C., Charlesworth, A., Johnston-Webber, C., Knapp, M., McGuire, A., Newton, J. N., Taylor, D., & Watt, R. G. (2021). The changing health needs of the UK population. The Lancet, 397(10288), 1979-1991. https://doi.org/10.1016/S0140-6736(21)00229-4 DOI: https://doi.org/10.1016/S0140-6736(21)00229-4

Meyer, S. B., Luong, T. C. N., Mamerow, L., & Ward, P. R. (2013). Inequities in access to healthcare: Analysis of national survey data across six Asia-Pacific countries. BMC Health Services Research, 13, 238. https://doi.org/10.1186/1472-6963-13-238 DOI: https://doi.org/10.1186/1472-6963-13-238

Moyo, E., Moyo, P., Murewanhema, G., Mhango, M., Chitungo, I., & Dzinamarira, T. (2023). Key populations and Sub-Saharan Africa's HIV response. Frontiers in Public Health, 11, 1079990. https://doi.org/10.3389/fpubh.2023.1079990 DOI: https://doi.org/10.3389/fpubh.2023.1079990

Muhula, S., Opanga, Y., Oramisi, V., Ngugi, C., Ngunu, C., Carter, J., Marita, E., Osur, J., & Memiah, P. (2021). Impact of the first wave of the COVID-19 pandemic on HIV/AIDS programming in Kenya: Evidence from Kibera informal settlement and COVID-19 hotspot counties. International Journal of Environmental Research and Public Health, 18(11), 6009. https://doi.org/10.3390/ijerph18116009 DOI: https://doi.org/10.3390/ijerph18116009

Muinga, N., Magare, S., Monda, J., English, M., Fraser, H., Powell, J., & Paton, C. (2020). Digital health systems in Kenyan public hospitals: A mixed-methods survey. BMC Medical Informatics and Decision Making, 20(2), 2. https://doi.org/10.1186/s12911-019-1005-7 DOI: https://doi.org/10.1186/s12911-019-1005-7

Mutua, F. M., Karonjo, J., Nyaberi, J. M., & Kamau, P. (2020). Socio-demographic and economic factors influencing utilization of youth-friendly reproductive health services among youths in selected universities in Nairobi County, Kenya. International Journal of Community Medicine and Public Health, 7(7), 2437-2442. https://doi.org/10.18203/2394-6040.ijcmph20202962 DOI: https://doi.org/10.18203/2394-6040.ijcmph20202962

Mwinga, M., & Sen, A. (2020). Challenges in accessing healthcare information in informal settlements: A case study of Kibra Sub County, Kenya. Journal of Public Health in Africa, 11(1), 45-52.

Sun, S., Li, Z., Zhang, H., Jiang, H., & Hu, X. (2020). Analysis of HIV/AIDS epidemic and socioeconomic factors in Sub-Saharan Africa. Entropy, 22(11), 1230. https://doi.org/10.3390/e22111230 DOI: https://doi.org/10.3390/e22111230

Wasti, S. P., van Teijlingen, E., Rushton, S., Subedi, M., Simkhada, P., & Balen, J. (2023). Overcoming the challenges facing Nepal's health system during federalisation: An analysis of health system building blocks. BMC Health Services Research, 21(1), 117.

https://doi.org/10.1186/s12961-023-01033-2 DOI: https://doi.org/10.1186/s12961-023-01033-2

Williams, D. R., & Cooper, L. A. (2020). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 17(14), 5186.

Zajacova, A., & Lawrence, E. M. (2018). The relationship between education and health: Reducing disparities through a contextual approach. Annual Review of Public Health, 39, 273-289. https://doi.org/10.1146/annurev-publhealth-031816-044628 DOI: https://doi.org/10.1146/annurev-publhealth-031816-044628