The Community of Lieta

How was the Lieta community selected?

A research project was undertaken to allow objective selection of the first community for Happy Villages development programs. A number of criteria were articulated before the project commenced and eventually Lieta Location was selected.
At the start of the research project, all locations within the four districts that Happy Villages is registered to work in were in the pool. A shortlist was created using World Bank poverty data and local population data. The shortlist contained ten locations and sub-locations with more than 70% of the population earning less than the Kenya National Poverty Line for rural areas.
Further research revealed that the nearest medical facility is 12 km from Lieta and that there is less food produced in Lieta than most of the other locations on the shortlist. Even among the poorest communities in Nyanza Province, Lieta stood out as one of the worst.
Heavy weight was given to the relatively high number of community groups in Lieta. That the people have come together in a diverse range of groups in an attempt to help themselves bodes well for a productive relationship with Happy Villages. It indicates an attitude of hopefulness and a proactive attitude that is not always easy for impoverished communities to maintain.

Where is Lieta located?

Lieta is a Sub-Location of South Uyoma Location, Madiany Division, Bondo District, Nyanza Province, in Kenya. It is about one hour drive from Kisumu and is on the shore of Lake Victoria.
Lieta sub-location an approximate population of 5,200 people; the sub-location covers nine smaller villages: Kaboung A and B, Malanga A and B, Lweya, Mumbo, Mburu, Agok and Kudho.
See below a hand drawn map kindly made up by one of our Lieta locals.

The population density is 351 persons per square km and the average farm size is approximately 2ha per farming family. The annual rainfall is 1100mm and is received in a bimodal pattern. The long rains occur March-May and the short rains in October-November. Uncultivated areas are covered with natural vegetation of grasses, scattered shrubs and acacias. Black cotton soils dominate, with some alluvial sediment along the lakeshore. Altitude range is about 1140-1200m above sea level.

• Major Roads: 1
• Ndovi to Lwanda Kotieno
• Madiany to Mituri
• Madiany to Ndigwa
• Ndigwa to Nyabera
• Lake Ferry – Lwanda Kotieno to Mbita
• Electricity power line (to the location, but not Lieta sub-location)
• Telephone – cell phones commonly used
• Markets Lwanda Kotieno, Ndigwa (this on the border of Lieta Sub-location) and Madiany

Foods from the farm include maize, sorghum, finger millet, groundnuts, soybeans, green grams, fish, bananas and mangoes. Foods commonly bought from the market are sugar, bread, cooking oil, fish, some vegetables and milk.

The produce obtained from the farm to be used for food is stored in traditional stores or modern stores within the family homesteads. There are no processing facilities / factories. The dominant activities are livestock keeping, crop farming and fishing with small scale business also being practiced.

Statistics and findings

• Life expectancy is between 45-50 years.
• About 2% of people have a disability.
• The age and sex distribution of sampled survey population is provided in Table 1 (see below).
• The average number of people residing in each compound was 4.2.

Table 1. Age and Sex Distribution 

• Children (1-15 yrs) form 43% of Lieta’s population
• 16 – 41 year old adults constitute  40%
• While adults over the age of 41 years form 17% of the population.
• The vast majority of Lieta is of the Luo tribe (99.4 %),
• 0.6% of respondents to Happy Villages’ household survey reported being Luhya                                           (a neighbouring tribe).
• The mother tongue of Luo people is Dhuluo.
• 2.6% of respondents had no allegiance to any religion, 0.6% said they were atheist while the majority 96.5% identified themselves as Christians.

Education in Lieta

Four medical dispensing centres serve Lieta Community.

There is one major district hospital 15 km away serving more than 30,000 people, St. Mary’s Medical Clinic attends to more than 3,000 people and Uzima and Kaswenga are community based chemists.
The common diseases in the community reported by medical staff during the baseline study were malaria, diarrhoea, respiratory tract infections, skin infections and worm infestations.

See Figure 10 below.

Figure 13: Common Reported diseases/Ailments

Community Utilization of Heath services

• In total more than 4,000 visits had been recorded to the clinic, with the district recording the highest number (2,660).
• Women accessed both pre and post natal services at the health centre.
• The district hospital reported 16 births in the 3 previous months and one death, the other centres had no births or deaths reported in the mentioned time span.
• Only the district hospital has an out-reach program for the community.

General Appearance of the Health Facilities

From a general outlook of most of the centres, the buildings were quite old but acceptable, only the district had a kitchen and staff quarters the rest didn’t have either one.

All of the facilities had latrines that were kept relatively clean for the patients, considering the number of patients the district had 8 and the smaller ones had an average of two each.

In Kenya a child should be given 9 essential vaccines by the time they are 5 years of age.

52.2% of the women interviewed produced their children’s vaccination cards, 41.5% had them but did not produce them and only 6.3% had no card.

Incidence of diarrhoea 

16.7% of the children were reported to have had diarrhoea two weeks prior to the survey, of these 48.9% and 46.7% were given some home prepared fluid and a pre-packed ORS fluid respectively.  23% were not given anything.

Figure 4: Incidence of diarrhoea

Incidence of Pneumonia

32.8% of the children were reported to have had symptoms of pneumonia in the two weeks prior to the survey.  85% of them were given antibiotics for treatment of the suspected pneumonia at the government hospital.

Figure 5: Incidence of pnemonia

Incidence of Malaria

30% of the children had a fever within the two weeks immediately prior to the survey (which is a standard proxy for incidence of malaria in Kenya).   Of the children with fever, 69% of them were taken to a health facility for treatment, 22% were tested for the malaria parasite, 53% were given SP/Fansider and 7% were given Chloroquine.

Figure 6:  Incidence of malaria

Underweight prevalence 

Anthropometric results: children (based on NCHS reference 1977)

Acute malnutrition is defined as <-2 z scores weight-for-height and/or oedema, severe acute malnutrition is defined as <-3z scores weight-for-height and/or oedema

4.7% of the children weighed were severely wasted, 6.1% moderately wasted and 89.2% were normal. The term wasting means that the child’s weight was too little for his her age.

Table 3: Prevalence of acute malnutrition by age based on weight-for-height z-scores 

Figure 7: Incidence of malnutrition

Vitamin A Supplements 

44.8% of children had been given vitamin A and this was observed in the children’s cards.

Low Birth Weight 

26.1 percent of the babies born were weighed at birth, 1.2% had a low birth weight (less than 2500gms).  The average recorded was 2.98kg.

All the children who were born at the health centres were weighed.

Contraception

The most common contraceptive used was the injection by 36.9%, the second most popular was the pill 20.4%, there were no reported incidences of sterilization either male or female, the rest of the women surveyed (45.7%) did not respond to the question.

Unmet Need
All the women who reported wanting to prevent pregnancy had access to a family planning method and therefore there was no unmet need for contraception.

Antenatal Care

• The proportion of women between the ages of 15-49 who were pregnant at the time of the survey was 10.6%.
• 44.5% of the women interviewed (aged 15-49) had given birth to a child who had later died.
• 44.5% had at least one live birth in the last two years.

Figure 10: No of women accessing ante-natal care

• 70% of the women attended an ante-natal clinic, with the numbers decreasing to 53.3% for those who had the urine test, 81% and 77.1 % for those who had the blood test and their blood pressure taken respectively.
• 90% of the women who attended the ante-natal clinic were attended to by a health professional either a nurse or a doctor.

Assistance at Delivery
41.6% of children were delivered in hospital or a health centre. 37.6% in a home not specified (but it is assumed at a traditional birth attendant’s home) and 18.7% within their own homes.

Birth Registration
In Lieta only 37% of the births were registered. The caregivers were asked if they knew how to register a birth.

Early Marriage and Polygamy 

• 7 out of the 21 girls between the ages of 15 and 18 were already married or in union with a man.
• 22% of the women interviewed were in polygamous marriages, 3 of them were girls below 19 years of age.

Table 11 : Women in Polygamous Marriages

• On spousal age difference none of the women aged 15 -24 was currently married or in union with a spouse more than 10 years older, the widest gap among that age group was 7 years.

Domestic Violence

The women were asked what they would consider domestic violence.

45% of the women believed a husband is justified in hitting the wife in all three mentioned occasions:

• if she goes without telling him
• neglects the children
• argues with him and/or refuses sex

Knowledge of HIV Transmission and Condom Use

More than seventy percent of the women could correctly identify two ways of preventing HIV that was either having knowledge that a healthy person could have HIV and have sound knowledge that one reduces his or her chances of getting HIV by using a condom every time one has sex. (Figure 11)

40% of the women correctly identified the misconception about HIV. Only 58% had comprehensive knowledge on HIV.

Knowledge on Mother to child Transmission 

To measure this indicator women aged 15-49 were asked to correctly identify all three means of mother to child transmission (MTCT) of HIV, 56.7% correctly identified transmission during pregnancy, during breastfeeding and during delivery as the common means of MTCT.

HIV Testing 

• 78% of women who had heard of HIV had knowledge of a place to be tested.
• 60% of the women have been tested as part of their pre-natal clinics and know their results.
• Of the young women between 15 and 24 years who have had sexual intercourse in the 12 months preceding the survey, 54% have been tested for the virus and know their results.

Attitude towards people living with HIV 

Acceptance of people living with HIV was low as only 17% had an accepting attitude towards those who are living with the virus.

Though a majority would not mind purchasing or interacting socially with those living with the virus, the same people would not let it be known publicly that they are living with a person with HIV.

Counselling Coverage 

70% of the women aged 15-49 who gave birth 2 years preceding the survey and received antenatal care reported that they received counselling on HIV.

Sexual Behaviour Related to HIV Transmission

The frequency of sexual behaviours that increase the risk of HIV infection among women is presented in the Table 12 Below:

Table 12: Risky sexual behaviors 

• 58.6% of people are drinking surface water.
• 77.9% of people also use surface water for hand washing and cooking.
• 75% of households boil water for drinking and 0.3% add bleach or chlorine.
• 4.7% of the household’s drinking water source is on the premises – they take only 5 minutes or less to fetch the water.

Overall 35% of the households used an improved excreta disposal method (flush or pour flush to a latrine; ventilated improved pit latrine, pit latrine with slab, or composting toilet),

20% used an open pit or pit latrine without a slab, while 45 % had no defined place for excreta disposal.

30% of the homes practiced safe fecal disposal for children. That is disposing of the stool using a toilet or by rinsing the stool into a toilet or latrine.  Disposal of faeces of children 0-2 years of age is presented in the table below.

Table 5: Safe Disposal of Childs Faeces 

Hygiene practices in schools

Generally the schools had access to hygienic facilities and safe drinking water, that is, using piped water or rain water collection and pit latrines.

The main source of drinking water was piped water (5 schools) and rain water (3 schools) collection.  One used surface water.

Two schools added bleach or chlorine to tap water to make it safe.

Hand-washing 

It was observed that all schools had a place and water available for washing hands. 

Out of the 9 schools only 2 had soap and detergent.

Piped water and rainwater storage were common to all the medical facilities.

The piped water supply was irregular in all but the district hospital.

At time of study – 96.8 % of the households used solid fuel (wood) as the primary source of domestic energy to cook.

3.8% of the total responses had no formal documentation for their residence as the houses they lived in were rented. The majority 95% lived in their own property and had security of tenure.

Main roofing material 

From the table were at least 62.4% of respondents lived under a roof made of finished sheets or wood and 37.2% lived under non-durable roofing material

Table 7: Main wall material 

• Stone with mud was the most common material used for the walls.
• Only 15% had durable wall finishing, that is finished wall with cement, bricks and or blocks and ply wood.

Non-durable wall sheeting is a house either with no wall , natural cane, natural dirt, rudimentary bamboo and or stone.

Field Report

Participatory Rural Appraisal

30th November 2010

My name is Dorothy Adenga. I am a board member and regular volunteer for Happy Villages Organization in Kenya.

After we signed a contract with Annemarie, the consultant we have employed to help us initiate the community participatory planning process, she started working immediately.

I gave her an orientation of our organization and took her to Lieta. With me and the Chairman she came up with a work plan and budget for the three month process.

We then had a joint planning meeting for participatory rural appraisal with the rest of board members. In this meeting we decided that the board members were going to assist Annemarie in some of her meetings with the community members.

She also explained to us what she was going to do for the three months and further impressed upon us the importance of doing the action plan.

I assisted Annemarie to distribute the letters of introduction and invitation to the Lieta community action planning process.

We distributed letters to government departments, local NGOs, women groups, youth groups, self help groups, churches, beach management*, clan elders and the primary and secondary schools.

A number of us joined Annemarie in the field for participatory community spatial mapping and transect work. This was our first meeting with community members.

We met with five community members who came up with the map of Lieta (below). They drew it first on the ground and then transferred it to paper.

After that we conducted a transect walk. We walked in pairs, one Happy Villages board member with each of five community members. We took notes about what we could see in the community.

We later had a meeting with community members who are older to document seasonal diagramming trends and timeline.

Also an important part of the process, the stakeholder analysis was a series of meetings where we met with different groups in the community who are involved in different activities such as farming and fishing.

We also invited 6 people for a stakeholder meeting specifically about gender issues. In gender analysis we meet with men and women who told us about the different roles and duties they do daily.

Child analysis we met with children from the seven primary schools around Lieta. They drew a picture of the Lieta they would like in future.

We also met youths out of school and in school. The school students wrote a composition describing the Lieta they would like in future.

We had a meeting with community members whom we selected from the other meetings which we had. In this meeting we did the economic ranking access and control profiles problem identification and ranking issues and option.

This is the meeting where the community prioritized their problems. The problems were; clean and safe water and sanitation, food insecurity, poor education, inadequate health facilities, poor road and infrastructure, lack of electricity, poor telecommunication, poor housing, climate change, high lake pollution, inadequate income, animal disease outbreak and wildlife.

After they identified the problems in a large group, Annemarie put them into two groups – men and women – to come up with only five problems they think should be addressed.

The groups came up with the same issues to be addressed. These were clean and safe water sanitation, food insecurity, poor education, inadequate health facilities, poor housing and inadequate income.

The last meeting was for action planning. In this meeting we had different stakeholders from the community and even the government. In this meeting the community members were coming up with what should be done to solve the problem, the resources, when the project should be addressed, the organization responsible for assisting the community and the expected outcome.

This was a very good project to be part of and we, here in Kenya, look forward to updating you further in the new year.

Yours sincerely,
Dorothy Adenga
Director
Happy Villages Organization

* as Lieta is on the shores of Lake Victoria (on the western side of Kenya), it has a lake beach, rather than a yellow sand beach as you may have seen photos of from somewhere like Mombasa or Lamu (on the eastern coast of Kenya). Beach management is an informal leadership group from the shore of the lake.

Footnotes
• This information is from a review report and baseline survey carried out by the district agriculture team in the former Bondo District in the year 2006/2007. It is not specific to Lieta Community, but rather relates to South Uyoma Location as a whole.
• This information is from the Lieta Community Baseline Study conducted by Happy Villages Organization in 2009