GREAT LAKES UNIVERSITY OF KISUMU TICH

SITUATION ANALYSIS REPORT

NYALENDA B,KISUMU EAST DISTRICT
Oyata, E. Mula MCHD/11-M/07
296/2012

The purpose of this Situation Analysis is to serve as a working paper with a view to identifying a way forward and by developing a SWOT analysis and an Action Plan based upon the same within Nyalenda B. In this regard, this report proposes to familiarize with the environmental, demographic, agricultural, social, economic, infrastructure issues in Nyalenda B and to get to know any collaborating partners that may exist in the area. To identify some of the strengths, weaknesses, opportunities and threats in Nyalenda B that touch on the major issues of security of land tenure, improvement of basic infrastructure, housing improvement and access to health and social services. I further propose that a rights based approach will be used to try and address these issues.

TABLE OF CONTENTS Acronyms

Acknowledgements Executive summary

1.0Introduction 1.1 Background information about Nyalenda B 1.2 Purpose of situation analysis 1.3 Broad Objective . 1.4 Specific Goals 2.0 Methodology 2.1Transect Walk 2.1.2 Key Informant Interview.. 2.1.3 Data collection 3.0 Findings of situation analysis 3.1Land tenure and use.. 3.1.2 Population characteristic 3.1.3 Housing 3.1.4 Infrastructure 3.1.5 Education

3.1.6 Health Care 3.1.7 Water and Sanitation 3.1.8 Socio Economic 3.1.9 Administrative Structure. 4.0 Social Assessment. 4.1 Education 4.1.2 Development Group 4.1.3 Gender Issues 4.1.4 Religion 4.1.5 Cultural belief

4.1.6 Health Issues

5.0 SWOT Analysis 6.0 Conclusion. 7.0 Recommendation... 8.0 References . 9.0 Check List ..

ACRONYMS

AIDS: Acquired Immune Deficiency Syndrome CDF: Community Development Fund CHW: Community Health Workers CBO: Community Based Organization FGD : Focused Group Discussion GLUK: Great Lakes University of Kisumu GOK: Government of Kenya HIV: Human Immunodeficiency Virus KIWASCO: Kisumu Water and Sewerage Company Limited KII : Key Informant Interview Kshs: Kenya Shillings MOV: Means of Verifications NGOs : Non- Governmental Organization OVI: Obvious Verifiable Indicators TICH: Tropical Institute of Community Health and Development

ACKNOWLEDEMENT My special thanks goes to the following people for their support and assistance during the entry process, the staff of GLUK/TICH especially the Kisumu East partnership team: The Situation Analysis of the Nyalenda B peri- urban area of Kisumu has been an exciting and all consuming exercise, which has enabled me to unearth salient issues that would need to be addressed if the conditions of those who live in these areas are to be improved. This endeavor would not have been possible without a number of people whose assistance I would like to acknowledge. These include the residents of Nyalenda B area who provided information during community consultations and as key informants, CHWs within Nyalenda B, the local leaders including the Councillor, Chief and Assistant Chiefs, Government Officers (MoPHs), Nyalenda health Center (Joel Omino), the staff of GLUK/TICH especially the Kisumu East partnership team. Special thanks should also go to Careena Flora Otieno of Great Lakes University for the worthwhile supervision and incisive comments which influenced the structure of the final document. Many thanks to the Nyalenda B team and the comprising units for their invaluable support and information provided and for their inputs which made it possible to accomplish this task. I am also indebted to Miss Celestine Okang of GLUK for providing assistance toward acquisition of vital information. And to all those who in any way participated in this worthy endeavor I say many thanks.

EXECUTIVE SUMMARY

Nyalenda B is located in west kolwa location, winam division, Kisumu town east district and kisumu town constituency. Winam holds the provincial and the district headquarters and covers an area of (395km2) it is therefore the largest division in Kisumu with the highest population density.Nyalenda stretches from kachok junction on the KisumuNairobi highway to dunga and nanga primary school. The area coverage is 2.696km2 with two sub-locations , Nyalenda A and B (which includes Nyamasaria).in Kisumu, is one major pocket of poverty and it has extended pressure on social amenities such as housing, water and sewerage systems.(UNHABITAT report 2004). Typically housing in Nyalenda is the rooming type, including a courtyard with shared facilities. The main access road is generally wide, with a few narrow feeder roads . Nyalenda B has five sub units namely. Western, Kilo, Got Owak, Nanga and Dunga. There are a lot of health concerns in the area. This is attributed to high level of ignorance and general lack of basic health knowledge. CHWs have however been working to help this problem. The most common disease among adults are HIV and AIDs, which is high due to high level of prostitution in the area and also because of high level of poverty(fish for sex) and this has resulted to a large number of orphaned children. Diseases that commonly affect U5 include malaria, skin diseases, typhoid, diarrhea and measles. This is mainly due to lack proper water treatment practices, ignorance and poor sanitation due to the frequent floods that come with destruction of semi permanent toilets rendering the environment a health hazard. The area mostly affected by floods is kapuothe that is in Nanga sub unit and this forces the inhabitants to migrate to less flood prone areas for safety during rainy season. Overcrowding has often been considered as a defining feature of most of Nyalenda B. Indeed, the upper area is overcrowded with buildings, or buildings overcrowded with people, or both. However, density is not the only defining criterion for Nyalenda B. Neighborhood facilities such as access to water, quality of housing, access to sanitation and healthcare, security of tenure and various aspects of social livelihoods can be just as important.

1.0 INTRODUCTION GLUK is a university that is the centre of excellence in health systems and related fields in teaching, research and service provision, towards empowering communities in the Great Lakes Region of Eastern Africa and beyond, for healthy, peaceful, prosperous and sustainable development.

The institution brings together academicians, professionals and practitioners in community health and development of diverse background to pull skills, expertise and experience in developing concerned leaders, managers and professionals in community health.

GLUK believes that all people and communities have inherent capacities to undertake, sustainable, collective, co-operative and collaborative actions to solve their own problems. In this regard, the principal of partnership lies at the core of academic, professionals and particle institutional values. GLUK thus fully subscribes to a partnership model that recognizes, affirms and builds on strength of every stakeholder and partners engaged in health and development. The following are the vision, mission and the goals of the institution as a center of academic excellence and community health and development

Vision

A healthy, prosperous, and sustainable society in which individuals, families and communities are enabled, empowered and equipped with the necessary practical capacities to cope with the demands in daily life, enjoy essential elements of dignified livelihoods, and experience life in its fullness.

Mission

Building on and strengthening the potentials, actions, strengths and capacities of individuals, families, communities and institutions in order to develop sustainable, concerned and effective leadership and programs in community health and development
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through academic and professional training, research and partnership development at all levels.

Institutional Goal

To develop and sustain TICH as an international centre of academic, professional and technical excellence providing focal support and facilitation in community health and development.

In this light, I therefore carried out a situation analysis exercise in Nyalenda B in Kisumu east between Sept 2011 to Nov 2011. This situation analysis was to enable me get to know the community better for the purpose of health and development in the area and for a future engagement with the community members.

1.1 BACKGROUND INFORMATION TO THE AREA OF STUDY Nyalenda B is located in west kolwa location, winam division, Kisumu town east district and Kisumu town east constituency. Winam holds the provincial and district headquarters and covers an area of (395km2) it is therefore the largest division in Kisumu with a higher population density. It stretches from western junction on the ring road high way to dunga and nanga primary school. The area covers 1.329km2. In Kisumu, Nyalenda B is one major pocket of poverty and it has extended pressure on social amenities such as housing, water and sewerage systems. Typically housing in Nyalenda B is the rooming type including courtyard with shared facilities. The major access road are generally wide, with narrow feeder roads (UN-HABITAT, 2005). Nyalenda B has five sub units namely Kilo, Western B, Got Owak, Dunga and Nanga.

1.2 Purpose of situation analysis

To work together with residents towards strengthening the existing health and development in Nyalenda B.

1.3 Broad objective

To familiarize myself with the area and be able to carry out a situation analysis of the community.

1.4 Specific objectives To familiarize with the environmental, demographic, agricultural, social, economic, infrastructure issues in Nyalenda B and to get to know any collaborating partners that may exist in the area. To identify some of the strengths, weaknesses, opportunities and threats in Nyalenda B

2.0 METHODOLOGY

The following methodology were used Desk review of the relevant literature Transect walk Key informant interviews Focus group discussion Direct observation Group discussion

2.1 Transect walk This was carried out in order to familiarize with the environment and area. Together with women and CHWs. Information gathered during this process were : health issues, cultural beliefs, food
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security in the area and the attitude of the community towards health and their health seeking behavior.

2.1.2Key informant interview

We interviewed the chief, assistant chief, CHWs women group leaders and the youth groups. The information gathered were: development issues, health issues and social and economic issues.

2.1.3 Data collection KII and FGD guides, check lists and weekly meeting schedule were used.

3.0 FINDINGS OF THE SITUATION ANALYSIS 3.1 Land Land in Nyalenda B is on freehold tenure and most families inherited the land from their parents as is typical in rural setups. Therefore, the area can be characterized as a rural settlement caught up in urban expansion. The result is a massive concentration of people in a rural-like environment with Luo style rural housing in the urban fringes. Cultural land use practices persist in Nyalenda B despite its location and proximity to the up market Milimani residential area, resulting in periodic conflicts with Municipal authorities as grazers invade parks and other amenities in pursuit of pasture. Nyalenda "A" (Pandpieri) has similarities to Nyalenda B however; the difference arises in its ability to attract new developers. Pandpieri grew as an extension to Nyalenda B but has been more advantageous because of the internal accessibility roads, the proximity to swamps and the distance from the major areas of economic activity. The settlement has had a lower population density for a long time and therefore has fewer graves and is more amenable to the land market. Title deeds are available except for the Kisumu prisons farm, which is un-surveyed. The process of getting documentation after land subdivision as enshrined within CAP 300 Laws of Kenya is very lengthy and some informal subdivisions remain unregistered.

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3.1.2 Population Characteristics According to the 1999 government of Kenya (GOK) census, Nyalenda B slum has a total male population of 25,669 and female population of 23,706. A survey in 2005 revealed that Nyalenda B had 12,507 male and 11,224 female whereas Nyalenda "B" had 13,162 male and 12,482 female (UN-HABITAT, 2005). Nyalenda B comprises of different ethnic groups some of them include, the Luo, Luhya, Abagusii, Kamba, Kuria, Kalenjin, Kikuyu among others. They either use their ethnic languages, Kiswahili and English as common languages of communication. Unemployment is rampant in Nyalenda B. 3.1.3 Housing Housing in Nyalenda B areis mud walled with iron sheet roofs and plastered or mud floors. These types of houses are referred to as semi-permanent. Landlords who are also landowners put up rental houses on their residential plots thus sharing one compound with tenants. Most of the buildings have had no council approval because the landlords are unable to put up standard houses as required by the council, therefore most houses lack basic amenities such as toilets, power, water and security. There are quite a number of very modern housing structures in the periphery of Nyalenda B near the Milimani area. Housing rents in Nyalenda B vary between Kshs 500 and 2000 per month for a one room house close to water supply and a toilet facility. With power connection, the rent goes up to Kshs 3000, which is unaffordable to most would-be tenants.

3.1.4 Infrastructure The only access network road that has been completed is Ring Road. This has led to an increase in value of the properties adjacent. The Ring Road runs on the outer edges of Nyalenda and is the only public transport vehicle (matatu and TukTuk) route in the area. Beyond this point, access into the slum is only possible by foot or bicycle however an access road was made from Ring Road to Nanga and Dunga passing through Got Owak. Those wishing to use a matatu must walk to the Ring Road. Most roads in Nyalenda B are narrow tracks eroded by runoff water, with homes constructed close to the road or road reserves. These roads lack drainage which compounds the erosion.

3.1.5 Education The community generally values education considering the high enrollment to schools in
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lower classes. There are two government secondary schools and two government primary schools. However, there are many private schools. The percentage of the girl child in lower classes is usually higher than that of the boy child hut this scenario reverses when they reach class four due to higher dropout rate for the girls (Odundo and Owino, 2004). This is because people have access to free primary education but due to poverty there is low enrolment in secondary schools. The youth who drop out of school are easily misled and may start abusing drugs. In higher classes the population of boys usually exceeds that of girls and this has been associated with high pregnancy rates, early marriage, HIV and AIDS (Odundo and Owino, 2004). The consequences are that girls are involved in child labour as house helps or bar attendants.

3.1.6. Health care The only government health facility in Nyalenda B is Nyalenda Health center commonly referred to as Joel Omino Health Center. However, the private sector provides services to those who can afford it at a basic cost of about Kshs. 500 per visit, which often includes cost of medicines along with service. For residents to access other hospitals like the district, provincial and Lumumba health centre they are forced to walk long distances and therefore many people turn to alternative medicine to satisfy their healthcare needs. H1V/AIDS is rampant in Nyalenda B, due to traditional beliefs, poverty, early school drop-out, idleness and drug abuse and mere ignorance. A number of civil service organizations provide home-based care but resource availability constrains activities and many patients have lost opportunities for care and support through denial.

3.1.7 Water and Sanitation Solid waste disposal is a major problem in Nyalenda B since it has minimal coverage. However the municipality has placed some garbage collection tanks. Some areas are not covered for several reasons, including poor access, lack of transport and dustbins, and residents' attitude to waste disposal. A few of the slum dwellers have taken to composting or burning, but a majority resort to dumping on any empty spaces. Sources of domestic water include piped water and wells, with municipal pipe water being sold from water kiosks. Nyalenda B is positioned next to a main water delivery pipe of 200mm diameter, which provides water whenever Kisumu Water and Sewerage Company (KIWASCO) make it available. However, the temporary nature of a majority of housing structures makes the option of individual household connections unattractive and
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unacceptable.. The cost of water supplied by vendors is three times higher than that accessed in households connected to the water system. A twenty litre container sells for twenty shillings. Ground water is highly contaminated because sewage leakages, resulting in high morbidity levels. This is attributed to the fact that Nyalenda B is not properly cleaned and water table is high. Water from streams is used for washing and for watering livestock.

3.1.8 Socio economic Most residents work as petty traders in Nyalenda B and beyond and many others work in the Jua Kali sector. Domestic work in the nearby Milimani area is a widespread means of sustenance. A small number of Nyalenda B residents are in formal employment. Petty trading like selling food on the road side, repairing shoes, bicycle riding, watchmen, house helpers are the predominant sources of income, followed by Jua Kali artisanship, salaried employment and farming. Farming takes place in Nam Thowe, a prime area for developing productive urban agriculture. However, in almost all sectors, income levels are low and availability of serviced plots continues to be a major challenge in establishing small-scale enterprises in the area (UN-HABITAT, 2005). Fishing in Lake Victoria provides a significant source of income, with jobs either as fishermen or fishmongers. Housing represents another major source, with further potential both in terms of construction labour and rents (UN-HABITAT, 2005).

3.9.9 Administrative Structures The units as referred to in the area are headed by village elders. These elders report to the sub-chief who report to the chief. The chief holds a baraza, (meetings) every Monday where the sub-chief gives a feedback of matters arising during the week.

4.0 Social Assessment 4.1Education There are two secondary schools in Nyalenda B and several primary schools both Government and private. These have mostly permanent structures with stone walls, iron sheets and cemented floors. They also use wooden furniture and glass windows although some are made of plain iron sheets. The community generally values education considering the high enrollment to schools in lower classes. The percentage of the girl child in lower classes is usually higher than that
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of the boy child but this scenario reverses when they reach class four due to higher dropout rate for the girls. In secondary schools more boys than girls are enrolled. Girls drop out mainly due to pregnancy. Joel Omino Primary school has a fence built recently using CDF.

4.1.2 Development groups Several youth groups exist. One is the pand pieri youth group. Their objective is to provide self employment to the youth, poverty reduction, empower out of school youths, support for the OVC, awareness & Advocacy on HIV and AIDS and Preservation of environment. They do so by offering group trainings and distribution of brochures provided by NGOs working in the area. Women groups and church groups do exist with different aims and objectives.

4.1.3 Gender issues Women are seen as the weaker sex and have no say in households. Though there are limited cases of forced marriages, few girls generally are married at a very young age. They are not allowed to inherit property and can only own property once their husbands die. The husband is responsible for the use of income in the household. Hence, when women struggle invest through property so that they can raise funds when need be, their efforts are shattered because culturally once the property is in the homestead it becomes the man's property and therefore the woman has to seek permission to sell it. The economic empowerment of woman is negatively impacted. They are therefore discouraged to carry out any kind of investment and end up leaving in poverty.

4.1.4 Religion This community is generally religious. There are several churches. All kinds of denominations are found here including, Catholic, ACK, Pentecostal Churches, Gospel Church, SDA and many indigenous churches. There are some indigenous churches including Roho manyien that prohibit going to the hospital and rely on faith healing.

4.1.5 Cultural beliefs Wife inheritance is still practiced and has led to the high prevalence of HIV and AIDS cases. This practice is slowly losing ground due to awareness. However there are cases
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of ignorance among a few families. This particular culture negatively affects the health of the unborn. Old women do not eat chicken and children given very little and inadequate food thereby pointing to the high rate of malnutrition incidences in the area while men are free to eat all that they desire.

4.1.6 HEALTH ISSUES The most prevalent diseases in Nyalenda B are malaria, HIV and AIDS, Pneumonia, Measles, Anemia, Meningitis, ear measles, Diarrheal diseases , TB and ARI. HIV and AIDS counselors are few. But many NGOs are in Nyalenda and they contribute towards raising awareness. The ratio is 1: 200. The gap is quite big and more need to be trained. Nyalenda B has only one Government health center, Joel Omino Health center. Most members of households do not seek health care until the situation of the patient detiorates. This is mainly due to ignorance. A large proportion prefers traditional doctors, witch doctors while others resort to herbs. Health care services at the hospital are generally satisfactory to those who seek the service. In most cases they buy pain killers from the shops which are basically Paracetamol and aspirin. The most common ailments affecting children under five are malaria which is reported to be the most common and fatal due to non use of bed nets, presence of shrubs which harbor mosquitoes and during rainy season when they breed and ignorance, followed by diarrhea, skin diseases, pneumonia, tuberculosis, HIV/AIDS and typhoid.

Originally most mothers did not regard child immunization as important but presently this has been a commendable change as a result of CHWs getting involved in educating them. There has been a lot of awareness on family planning although women do it secretly for fear of being reproached by their husbands. In some families however both parents have shown interest in family planning.

5.0 SWOT ANALYSIS Strengths: 1. Presence of Katuoro water project. 2. Availability of farming land e.g. Kapuothe 3. Presence of community health workers who offered defaulter training 4. Presence of counselors who offer guiding and counseling to the community.
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5. Presence of River Wigwa 6. Presence of health facility. 7. Presence of capacity of new agricultural techniques.

Weaknesses: 1. Men are not ready to go for counseling due to stigma. 2. Cultural belief e.g. wife inheritance. 3. Ignorance towards health issues. 4. Lack of capacity on new agricultural techniques and extension workers. 5. Idleness of male youth. 6. Presence of alcohol in the area e.g. changaa 7. Lack of ownership of development projects like of the health facility at Nyalenda B. 8. Malnutrition of under five. 9. Male involvement (men are not involved) In health related issues.

Opportunities: 1. Availability of willing partners in health and development e.g. NGOs an 2. Presence of safe water provided by KIWASCO to the community through water projects. 3. Availability of CDFs. 4. Presence of health facility in the area. 5. Good administrative structure. 6. Regular training in the community on positive living and prevention of mother to child transmission. 7. Presence of urban agriculture.

Threats: 1. Presence of alcohol in the area. 2. Presence of River Wigwa which floods during rainy seasons. 3. Insecurity in the area. 4. Discrimination of Jodak (settlers mainly people who bought land from the natives). 5. Invading of farms by people and animals (Hippos) e.g. Kapuothe.
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6. Floods which become health hazards and contribute to malaria infection and flooded toilets. 7. Poor sanitation and drainage systems. 8. Overdependency of orphan children on Child Rights and protection. Many opharned children remain vulnerable. 9. Selling of land to private developers as the communities migrate to Kapuothe 10. Floods. 11. Vandalism of water pipes.

6.0 CONCLUSION From the findings of the situation analysis and subsequent SWOT analysis, it becomes clear that the community is experiencing certain problems . This report gives a fairly clear picture of the current situation in Nyalenda. It is evident that the community members need a lot of trainings on socio-economic and development issues. The floods cause a health hazard to the community especially when semi permanent toilets are destroyed and the waist is left scattered all over the village. The level of ignorance among the community on HIV and AIDS infections, and wife inheritances encompassed with polygamy poses great concern. Top of this is the under utilization of the Health facility thus poor health outcomes in the location.Uptake of services at the facility is poor due to the perception that services at the facility are expensive and that the staff stationed there are not quite friendly . CHWs are also not well motivated a fact that they concede but are ready to try out new ways of rewarding themselves.

7.0 Recommendation The following should be considered during participatory planning as they come out clearly as adoable actions to foster health and development of the community.

1. More awareness to households regarding HIV and AIDS and other health related issues is vital.
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2. Community awareness on resource mobilization using the available Government resources like the youth fund, women fund, CDF need to be addressed. 3. Capacity building in terms of training given to CHWs. 4. Formation of a CBO by the CHWs in which they could drive the motivation agenda through innovations ,business startups among others. 5. CHWs to scale up their household visits and surveillance among other duties assigned to them.

8.0 References 1. The CHWs and other members of Nyalenda B community. 2. The Assistant chief. 3. The women and youth group leaders

9.0 CHECKLIST

9.1 THE ASSISTANT CHIEF Geographical description Total area Direction Topography Environment What is the total population of the area of study? How many villages are found in the area What is the location? What type of community development group exist What activities are their engaged in the community?

9.1.2HEALTH ISSUES What are the most common diseases in the area affecting children under 5 years How many health facilities are in the area? Are the health facilities accessible by the community? Are their any health providers beside government in the area When do the community seek medical care and where do they seek treatment and
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why? Are there CHWs and TBAs in the sub location? How many are trained and what were they trained on What the community attitude towards health Do the children get immunized as stipulatd Are they educated on water and sanitation 9.1.3 FDGs WITH CHWs Are there any women groups? Any support group for PLWAs? CBIs, how are births and death reported? Are services at the health facility satisfactory? Why do you think mothera do not value about the health of their children?

9.1.4 TRANSECT WALK Environmental issues Observe shelter(roofing material, floors, walls) Observation availability of: Number of toilet and latrines Use of latrines Rubbish pits. General hygiene. Major source of water in the community How does the community make their water safe What are their source of energy

Infrastructure Whats the status of roads Are their schools and other health facilities Are there means of transport like matatus CBIS chief, schools, CHWs, churches

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Education How many primary , secondary, nurseries schools and other institution are in the area How are the schools distributed in the area What is the enrolment rate considering gender Are their any drop outs What are the status of these schools( floors, walls, windows and furniture)

Gender issues Are there cases of forced marriage Are women allowed or forced to inherit land and property

Cultural beliefs What are the cultural belief in the area How do they affect development in the community

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