1. 8/29/20151 POPULATION STUDIES AND RESEARCH INSTITUTE (PSRI) UNIVERSITY OF NAIROBI, KENYA RUSINGA DSS ON THURSDAY 12 TH MARCH 2015

2. PRESENTATION OUTLINE  Background to the Rusinga DSS  Objectives  Design  Activities  Potential uses  Next steps 8/29/20152

3. Background  The Island covers an area of 44 sq km stretching 10km East-West and 4 km North-South  The site is divided into: Two locations, six sub locations and 42 EAs (Clusters) 8/29/20153

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6. Rationale and Establishment Area had adverse health outcomes based on previous data sets such as censuses Examples- high mortality and fertility - high HIV prevalence The site was established in 2001 baseline household survey which provided the baseline data for the DSS 8/29/20156

7. Objectives  Provide training to PSRI students on research methodology  Provide data for an institutional based research program  Provide insights into demographic processes for interventions, development planning and evaluation  Provide a unique data set for understanding socio-economic and demographic phenomenon  To help community address their own problems 8/29/20157

8. Design  The site is designed to update the baseline household population on a continuous basis by undertaking regular registration of births, deaths, movements and marriages  Link the household data with GIS locations for each household  Conduct studies to explain the observed changes  The site is community based meaning that there is community involvement in data collection 8/29/20158

9. Data Collection  Routine longitudinal data collection - Collection is undertaken by 13 Research Assistants who are drawn from the clusters they are assigned  Continuous registration data is collected using six forms each for a particular event on a monthly basis followed by  Verbal Autopsy to capture causes of death at end of every round 8/29/20159

10. Dissemination  Community  County  National 8/29/201510

11. Training of Students 8/29/201511 Field trips

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13. Data collection 8/29/201513 Research Assistants conducting household interviews in a household

14. Data collection 8/29/201514 Research Assistants conducting household interviews in a household

15. Updates  21 rounds undertaken since 2001  21 st Round - November 2014 8/29/201515

16. Some Results  Population and household changes  rate of occurrence of events- births, deaths, migration  family formation – occurrence of marriages,  Rate of formation and dissolution of households  8/29/201516

17. Household and Population Trends July 2001 (Baseline) March 2006Feb 2009 Oct 2014 No of Households4,1614,8625,0616567 Population17,55120,40722,54837308 Household growth rate 3 %1.3 %5 % Population growth rate 3 % 8 % 8/29/201517

18. Key Characteristics Population in early stages of demographic transition: high fertility, mortality and youthful  HH conditions are reflective of majority of population being of low socio-economic status  High school drop out rates particularly for girls in the initial stages  Prevalence of early marriage  High orphan hood rates  Unsafe drinking water  Deaths concentrated in only a few households 8/29/201518

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20. Major Causes of Death  TB  HIV/AIDS  Malaria  Pneumonia 8/29/201520

21. Potential Uses Trends on population growth and household growth rates are useful for planning – Such as future school going population, heath facility needs, provision of services such as safe water, electricity etc 8/29/201521

22. Potential Uses  Interventions – for example the high mortality in the region and fact that most deaths occur in only a few households calls for targeted interventions  testing extent to which services are utilized – school age population not attending school, health personnel per population  Determination of Proportion of children without birth certificates 8/29/201522

23. Next steps – Proposed survey  After baseline in 2001, what has changed in the Community in terms of:  household living conditions (amenities) – what is the impact of development activities in the lives of people in the region?  8/29/201523

24. Next steps – Proposed survey  Involvement of GOK (8 th Country programme) –  Rusinga is part of Homabay county which is designated as having high burden of maternal mortality – what is the level of mortality and extent of utilization of services in the region? 8/29/201524

25. Next steps – Proposed survey  PSRI plans to monitor use of MNCH to inform interventions on MNCH and identify potential interventions.  To monitor extent of birth death registration and track why low levels of registration still occur 8/29/201525