Health status and health knowledge of dairy farmers in Nandi district, Kenya

Introduction: Health insurance could increase access to quality health care and prevent people from falling into poverty. Unfortunately few studies of good quality on the impact of health insurance schemes have been done. We started an impact evaluation of the Tanykina Community Health Care Plan of the Health Insurance Fund which was implemented in Kenya in May 2011. A baseline study was performed before implementation of the program. This paper describes the outcomes regarding to health status of the population of that baseline study. Methods: The study population consisted of members of two dairy farmer cooperatives and their households. 1242 households were included. Data were obtained by oral interviews using a questionnaire and by anthropometrics and blood tests. The anthropometrics consisted of measurement of length/height and weight, upper-arm-circumference, waist and hip circumference, blood pressure and heart rate. In the blood hemoglobin, glucose and cholesterol levels were measured, and screening for HIV and malaria was performed. The WHO Anthro Software was used to calculate z-scores. Results: Out of the 7597 individuals 4915 individuals (64.8%) were interviewed. 2606 participants were 12 years or older, and of 1663 of them (63.6%) blood was collected. There was a high prevalence of hypertension, especially in participants of 50 years and older, as well as overweight, obesity, and anemia. The prevalence of malaria, HIV and diabetes was low. The immunization rates were high. Use of antenatal care, home deliveries and health care worker presence at delivery were common. Almost all participants knew how to prevent malaria and HIV. Knowledge on diabetes, hypertension, cholesterol and zoonotic diseases was less common. The majority of the participants had a waist-hip ratio above the cut-off point. Conclusion: Communicable diseases still form a threat for the health of our study population, but the knowledge on how to prevent them is widespread. Cardiovascular diseases could form a new threat, since different cardiovascular risk factors are highly prevalent and there is less knowledge on how to prevent them. Therefore more population based research is necessary to obtain information on the prevalence, treatment, prevention, and the mechanisms behind these cardiovascular risk factors