Greater Eldoret Health and Development Survey (Round 2) 2005 - Kenya

Analysis unit
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Household, Individual

Kind of data
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Sample survey data [ssd]

Sampling procedure
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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
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Face-to-face [f2f]

Research instrument
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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
· Time and risk preferences
· Food consumption and other 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)
· Family background, such as personal/parental characteristics, fosterage and inheritances
· Mortality of previous household members and children living away
· Discussions about diseases such as malaria and HIV/AIDS

分析单元

家庭，个人

数据类型

样本调查数据 [ssd]

抽样程序

调查区域。本次家庭调查在肯尼亚西部纳迪北区的科西赖分区进行，该区域为农村地区。科西赖分区面积达195平方公里（76平方英里），人口为35,383人，其中6,643户家庭（中央统计局，1999年）。调查家庭散布在超过100个村庄中，动物和农作物养殖是主要的经济活动。调查的随机样本由512户家庭组成（如下所述），旨在代表科西赖分区的家庭。这些家庭的资料因此为理解莫索里奥特卫生中心服务人群的健康和社会经济特征提供了机会。

样本选择。在设计调查家庭的样本时，考虑了多种因素。在科西赖分区创建了一个家庭的随机样本，以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。为进一步探讨与艾滋病/艾滋病病毒（如疾病影响和治疗）相关的问题，选择了AMPATH艾滋病诊所中HIV阳性患者的单独样本。最后，选择了一小部分自愿咨询检测（VCT）客户（HIV检测呈阳性或阴性）的样本，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。

调查家庭的样本因此由三个不同的群体组成：(a) 从科西赖分区的家庭普查中随机选择的512户家庭（随机样本），(b) 至少有一名HIV阳性个体在莫索里奥特卫生中心HIV诊所接受医疗护理的250户家庭（HIV样本，或“HIV家庭”），以及(c) 有个体最近访问过MRHTC的VCT诊所的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阳性个体正在莫索里奥特HIV诊所接受抗逆转录病毒（ARV）治疗。在随机样本中，受访者的HIV状态通常未知，除非受访者报告已进行HIV检测并检测出HIV阳性或阴性。最后，在VCT样本中，大多数受访者HIV检测结果为阴性。

莫索里奥特农村卫生培训中心。该卫生中心位于埃尔多雷特镇以南约25公里处，是科西赖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莫索里奥特建立了一个电子病历系统（MMRS），其中包含所有访问卫生中心患者的各种临床信息（汉南等，2000年）。2001年，相同的合作还创建了预防与治疗艾滋病/艾滋病病毒（AMPATH）的学术模型。AMPATH的第一个农村HIV诊所于2001年11月在莫索里奥特开业（科恩，2004年）。从2003年底开始，莫索里奥特的HIV诊所经历了巨大的增长，患者数量从2003年的不到100人增加到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，每个问卷都专注于不同的问题，如健康、教育、农业和收入/就业。每次采访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

· 时间和风险偏好

· 食品消费和其他支出

· 从受访者那里向其他人和机构以及从其他人和机构向受访者进行的财务和非财务转移

· 关于疟疾和艾滋病/艾滋病病毒等疾病的知识

· 与健康相关的行为实践（包括性行为和HIV检测）

· 家庭背景，如个人/父母的特征、收养和继承

· 前家庭成员和在外居住的儿童的死亡率

· 关于疟疾和艾滋病/艾滋病病毒等疾病的讨论