Effects Of Diarrhoeal Diseases On Farmers' Households In Ewaso Narok Swamp In Laikipia County, Kenya (Thesis Proposal Sample)

EFFECTS OF DIARRHOEAL DISEASES ON FARMERS’ HOUSEHOLDS IN EWASO NAROK SWAMP IN LAIKIPIA COUNTY, KENYA
VINCENT KIPKIRUI NG’ETICH (BSc ENVIRONMENTAL HEALTH)
Q58/29797/2014
DEPARTMENT OF COMMUNITY HEALTH
A RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF PUBLIC HEALTH (EPIDEMIOLOGY AND DISEASE CONTROL) IN THE SCHOOL OF PUBLIC HEALTH OF KENYATTA UNIVERSITY

AUGUST, 2016DECLARATION
This research proposal is my original work and has not been presented for a degree in any other University.
Signature …………………………… …….Date…………………………….
Vincent Kipkirui Ng’etich
Q58/29797/2014
Supervisors:
This research proposal has been submitted for review with our approval as University Supervisors.
1. Signature: ………………… …………….Date ………………………….. .
Dr. Isaac Mwanzo
Department of Community Health
2. Signature:.……………………………………….Date ……………………………..
Dr. Justus Osero
Department of Community Health
3.Signature: …………………………………Date…………………………….
Dipl.-Geogr. Carmen Anthonj
Institute for Hygiene & Public Health, GeoHealth Centre
University of Bonn, Germany

TABLE OF CONTENTS
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DECLARATION  PAGEREF _Toc459295724 \h
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LIST OF ABBREVIATIONS AND ACRONYMS  PAGEREF _Toc459295725 \h
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DEFINITION OF OPERATIONAL TERMS  PAGEREF _Toc459295726 \h
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ABSTRACT  PAGEREF _Toc459295727 \h
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CHAPTER ONE: INTRODUCTION  PAGEREF _Toc459295728 \h
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1.1 Background to the study  PAGEREF _Toc459295729 \h
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1.2 Problem Statement  PAGEREF _Toc459295730 \h
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1.3 Justification  PAGEREF _Toc459295731 \h
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1.4 Research Questions  PAGEREF _Toc459295732 \h
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1.5 Hypothesis  PAGEREF _Toc459295733 \h
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1.6 Objectives  PAGEREF _Toc459295734 \h
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1.6.1 Broad Objectives  PAGEREF _Toc459295735 \h
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1.6.2 Specific Objectives  PAGEREF _Toc459295736 \h
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1.7 Significance of the Study  PAGEREF _Toc459295737 \h
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1.8 Delimitation and Limitation  PAGEREF _Toc459295738 \h
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1.8.1 Delimitations  PAGEREF _Toc459295739 \h
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1.8.2 Limitations  PAGEREF _Toc459295740 \h
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CHAPTER TWO: LITERATURE REVIEW  PAGEREF _Toc459295741 \h
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2.1 Overview of the effects of diarrhoeal diseases  PAGEREF _Toc459295742 \h
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2.2 Common diarrhoeal diseases in wetlands  PAGEREF _Toc459295743 \h
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2.3 Access and utilization of health services  PAGEREF _Toc459295744 \h
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2.4 Household coping strategies  PAGEREF _Toc459295745 \h
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CHAPTER THREE: MATERIALS AND METHODS  PAGEREF _Toc459295746 \h
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3.1 Study Design  PAGEREF _Toc459295747 \h
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3.2 Variables  PAGEREF _Toc459295748 \h
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3.3 Location of the Study  PAGEREF _Toc459295749 \h
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3.4 Study Population  PAGEREF _Toc459295750 \h
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3.5 Sampling Technique  PAGEREF _Toc459295751 \h
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3.6 Sampling Size Determination  PAGEREF _Toc459295752 \h
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3.7 Construction and Research Instruments  PAGEREF _Toc459295753 \h
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3.8 Pre Testing  PAGEREF _Toc459295754 \h
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3.9 Validity  PAGEREF _Toc459295755 \h
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3.10 Reliability  PAGEREF _Toc459295756 \h
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3.11 Data Collection Techniques  PAGEREF _Toc459295757 \h
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3.12 Data Analysis  PAGEREF _Toc459295758 \h
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3.13 Ethical Considerations  PAGEREF _Toc459295759 \h
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REFERENCES  PAGEREF _Toc459295760 \h
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APPENDICES  PAGEREF _Toc459295761 \h
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Appendix 1: Workplan  PAGEREF _Toc459295762 \h
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Appendix 2: Budget  PAGEREF _Toc459295763 \h
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Appendix 3: Distribution of Responsibilities  PAGEREF _Toc459295764 \h
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Appendix 4: Map of the Study Location  PAGEREF _Toc459295765 \h
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Appendix 5: Informed Consent  PAGEREF _Toc459295766 \h
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Appendix 6: Questionnaire  PAGEREF _Toc459295767 \h
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Appendix 7: Key Informant Interviews  PAGEREF _Toc459295768 \h
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Appendix 8: Focus Group Discussion Guide  PAGEREF _Toc459295769 \h
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LIST OF ABBREVIATIONS AND ACRONYMS
DALYs: Disability Adjusted Life Years
FGD: Focus Group Discussion
IDI: In-Depth Interviews
IEC: Information Education and Communication
IHPH: Institute for Hygiene and Public Health, University of Bonn
ILRI: International Livestock Research Institute
KDHS: Kenya Demographic Health Survey
KII: Key Informant Interviews
Kms: Kilometres
KPHC: Kenya Population and Housing Census
KUERC: Kenyatta University Ethics Review Committee
Ksh: Kenya shillings
LMICs: Low and Middle Income Countries
MOH: Ministry Of Health
NGOs: Non Governmental Organizations
SDG: Sustainable Development Goals
SPSS: Statistical Package of Social Sciences
UNEP: United Nations Environment Program
UNICEF: United Nations Children’s Emergency Fund
WHO: World Health Organization
DEFINITION OF OPERATIONAL TERMS
capacity to pay: It signifies reasonable income remaining after essential achievement of subsistence necessity. Reasonable income refers to the overall household consumption expenditure.
COPING STRATEGY: - It denotes a particular effort, both psychological and behavioural that household apply to master, endure or lower stressful events.
DISEASE: - Refers to a period of sickness affecting the body or mind.
Health economics: Refers to sub-branch of economics concerned with effectiveness, efficiency, worth and behaviour in healthcare production and consumption.
HOUSEHOLD: Refers to group of people, often family, who live together.
ONEROUS: Refers to something involving an amount of effort and difficulty that is oppressively burdensome.
OUT OF POCKET EXPENDITURE: It signifies the point at which payments to receiving health services are met. It entails all cost related to consultation fees, purchases of drugs, hospital bills and net of insurance reimbursement.
subsistence spending: Refers to the lowest requirements to sustain basic life in a society.
ABSTRACT
The growing food insecurity in East Africa has led to an expansion of cultivation to wetland sites. As individuals use them for farming, they may expose themselves to the risk of contracting diseases. Disease can have wide-ranging implications on households, which shall be addressed by this study. The main research focus will be to investigate medical and productivity effects of the major diarrhoeal disease for farmers and their families on a household level. The effects of different diarrhoeal diseases shall be measured as well as the coping strategies of households. A descriptive cross-sectional study design which employs mixed methods will be used. For the quantitative part of the study, household questionnaires will be administered in the two stratified zones in Ewaso Narok Swamp. As for qualitative data collection, household members will be selected for participation in Focus Group Discussions. Also, Key Informant Interviews will be conducted with Community Health Volunteers, village heads, religious leaders and farmers’ association members. The pertinent issues addressed will entail family income reduction due to absenteeism; the patient special time-intensive and costly cares from the family and health services of the farmers’ households. The research will be conducted in Ewaso Narok Swamp, Kenya, which is characterized by year-round water availability within a semi arid area, high resource base quality and hence potential hotspot for food production. Effective health policy decision making requires a concise picture of diarrhoeal disease burden inorder to prioritise allocation of resources. Thus, this r...