Dimensions of Access Related to Seasonal Malaria Chemoprevention Uptake in Turkana County, Kenya

Abstract

Malaria continues to be a global health problem for 83 countries around the world. Specifically in Kenya, about 70% of the population is at risk. With 13 million people living in endemic areas and another 19 million living in regions that are endemic prone or with seasonal transmission, the burden of disease within the country is high. This study focuses on Turkana County, a region in northwestern Kenya where a majority of the population lives a nomadic lifestyle. Previously thought to be unsuitable for malaria transmission, this community has frequently been left out of malaria control efforts. Recent research now shows that Turkana County has high malaria transmission. The unique lifestyle of the community presents unique challenges for malaria intervention strategies. With many people sleeping outside and living in remote or mobile households, interventions such as indoor residual spraying and bednets have been ineffective. SMC provides an alternative strategy to address the burden of malaria, while reducing the logistical challenges that have come with other prevention methods. To evaluate the effectiveness of SMC in Turkana County, a survey was conducted to ask caregivers about their experience during the SMC campaign. Because access was a problem with other intervention methods, three main dimensions of access were used to assess their role in SMC uptake: SMC Delivery, Community Knowledge and Perception, and Physical Environment. Using multilevel models, each dimension of access had specific variables that were statistically significant on impacting SMC uptake. Socioeconomic status was consistently an important factor across all dimensions of access.