Greater Eldoret Health and Development Survey (Round 1) 2004 - Kenya

Analysis unit
---------------------------

Household, Individual

Kind of data
---------------------------

Sample survey data [ssd]

Sampling procedure
---------------------------

Survey area. The household survey was conducted in Kosirai Division, a rural area located in the Nandi North District of western Kenya. Kosirai division has an area of 195 square kilometers (76 square miles) and a population of 35,383 individuals and 6,643 households (Central Bureau of Statistics, 1999). The survey households are scattered across more than 100 villages where animal and crop farming is the primary economic activity. The survey's random sample of 512 households (described below) is intended to be representative of households in Kosirai Division. Information from these households thus presents an opportunity to understand the health and socio-economic characteristics of the population served by the Mosoriot health centre.

Sample Selection. A range of factors were considered when designing the sample of households in the survey. A random sample of households in Kosirai Division was created to provide representative information on the disease burden and socio-economic issues in the survey area. To further examine specific issues relating to HIV/AIDS (such as impacts of the disease and treatment), a separate sample of HIV-positive patients in AMPATH's HIV clinic was chosen. Finally, a small sample of VCT clients (who tested HIV-positive or HIV-negative) was chosen to examine issues relating to HIV testing. It should be noted that the random sample also serves as a comparison group to the HIV and VCT samples.

The sample of survey households is thus comprised of three different groups: (a) 512 households chosen randomly from a household census of Kosirai Division (the random sample), (b) 250 households with at least one HIV-positive individual who receives medical care at the HIV clinic in the Mosoriot health centre (the HIV sample, or “HIV households”), and (c) 61 households with an individual who has recently visited the VCT clinic in MRHTC (the VCT sample). Of the 250 households in the HIV sample, 167 are households in which the HIV-positive individual is receiving antiretroviral (ARV) treatment at the Mosoriot HIV clinic. In the random sample, the HIV status of respondents is usually unknown, unless the respondent reported having gone for an HIV test and testing HIV-positive or negative. Finally, in the VCT sample, most respondents have tested HIV-negative.

Mosoriot Rural Health Training Centre. The health centre is located approximately 25 kilometers south of Eldoret town and is the main health care provider in Kosirai Division. The health centre provides primary care services and is mainly an outpatient facility. In addition, a collaboration between Indiana University and the Moi University Faculty of Health Sciences has established an electronic medical record system (MMRS) at Mosoriot which contains a range of clinical information on all patients who visit the health centre (Hannan, et al. 2000). In 2001, this same collaboration also created the Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH). AMPATH's first rural HIV clinic was opened in Mosoriot in November 2001 (Cohen, 2004). Beginning in late-2003, the HIV clinic at Mosoriot has experienced tremendous growth, with the number of patients rising from less than 100 in 2003 to over 800 as of October 2004 (AMPATH data).

Mode of data collection
---------------------------

Face-to-face [f2f]

Research instrument
---------------------------

Multiple questionnaires were used in the survey, each one focusing on different issues such as health, education, agriculture, and income/employment. Each interview began with a listing of all household members. Information on characteristics of each member was collected - age, sex, relationship to household head, education, health status, and participation in income-earning activities. For children under the age of 5 years, height and weight measurements were also taken. In addition, the household and individual questionnaires also addressed the following additional topics:

· Ownership and purchases/sales of assets such as land, livestock, and durable goods
· Agricultural production and investment
· Allocation of time to income-earning and other activities
· Food consumption and expenditures
· Financial and non-financial transfers to and from the respondent
· Knowledge about diseases such as malaria and HIV/AIDS
· Health-related behavioral practices (including sexual behavior and HIV testing)

分析单元

---------------------------

家庭，个人

数据类型
---------------------------

抽样调查数据 [ssd]

抽样程序
---------------------------

调查区域。此次家庭调查在肯尼亚西北部Nandi北区的Kosirai分区进行，该分区位于一个农村地区。Kosirai分区占地面积为195平方公里（76平方英里），人口为35,383人，其中家庭6,643户（中央统计局，1999年）。调查家庭分布在该地区超过100个村庄，动物和农作物养殖是主要的经济活动。调查的随机样本包括512户家庭（以下将详细描述），旨在代表Kosirai分区的家庭。这些家庭的资料提供了了解由Mosoriot卫生中心服务的群体健康状况和社会经济特征的机遇。

样本选择。在设计调查中的家庭样本时，考虑了多种因素。Kosirai分区的家庭随机样本旨在提供关于调查区域疾病负担和社会经济问题的代表性信息。为进一步研究与艾滋病（如疾病影响和治疗）相关的问题，选择了一个单独的样本，即AMPATH艾滋病诊所中的HIV阳性患者样本。最后，选择了一小部分VCT客户样本（测试结果为HIV阳性或阴性），以研究与HIV检测相关的问题。值得注意的是，随机样本还作为HIV和VCT样本的比较组。

因此，调查家庭的样本由三个不同的群体组成：（a）从Kosirai分区的家庭普查中随机选择的512户家庭（随机样本），（b）在Mosoriot卫生中心艾滋病诊所接受医疗护理的至少有一名HIV阳性个体的250户家庭（HIV样本，或“HIV家庭”），以及（c）在MRHTC的VCT诊所最近就诊的个体所属的61户家庭（VCT样本）。在HIV样本中的250户家庭中，有167户家庭中的HIV阳性个体正在Mosoriot艾滋病诊所接受抗逆转录病毒（ARV）治疗。在随机样本中，受访者的HIV状况通常未知，除非受访者报告已接受HIV检测并呈阳性或阴性。最后，在VCT样本中，大多数受访者已检测为HIV阴性。

Mosoriot农村卫生培训中心。该卫生中心位于Eldoret镇以南约25公里处，是Kosirai分区的主要医疗服务提供者。卫生中心提供初级保健服务，主要是一个门诊设施。此外，印第安纳大学与莫伊大学健康科学学院之间的合作在Mosoriot建立了电子病历系统（MMRS），该系统包含所有访问卫生中心的患者的大量临床信息（Hannan等人，2000年）。2001年，相同的合作还创建了预防与治疗艾滋病的学术模型（AMPATH）。AMPATH的第一个农村艾滋病诊所于2001年11月在Mosoriot开业（Cohen，2004年）。从2003年底开始，Mosoriot的艾滋病诊所经历了巨大的增长，患者数量从2003年的不到100人增长到2004年10月超过800人（AMPATH数据）。

数据收集方式
---------------------------

面对面 [f2f]

研究工具
---------------------------

调查中使用了多种问卷，每份问卷都针对不同的问题，如健康、教育、农业和收入/就业。每次访谈都以列出所有家庭成员开始。收集了每个成员的特征信息——年龄、性别、与户主的关系、教育、健康状况和收入赚取活动的参与情况。对于5岁以下儿童，还进行了身高和体重测量。此外，家庭和个人问卷还涉及以下附加主题：

· 土地、牲畜和耐用消费品等资产的所有权和购买/销售

· 农业生产和投资

· 收入赚取和其他活动的用时分配

· 食品消费和支出

· 从受访者那里流向和来自的金融和非金融转移

· 对疟疾和艾滋病等疾病的了解

· 健康相关的行为实践（包括性行为和HIV检测）