Ethiopia - Kersa HDSS INDEPTH Core Dataset 2007-2012 Release 2015

CMD2012.v2

2015-06-09

v1: Original version

The Kersa Demographic Surveillance and Health Research Center (KDS-HRC) conducts demographic and health surveillance within the Kersa district of the Eastern Harerage zone of Oromiya region in Eastern Ethiopia. The Kersa district was selected out of 14 considered districts in the zone due to its convenience for surveillance and its representativeness of the zone- especially the presence of highland areas within the district. The center was established in February 2007 to monitor population and demographic change in a previously minimally studied area in Ethiopia. The first census was carried out in 2007 and in 2008 the center expanded its surveillance to include health data- such as reproductive, environmental and nutritional health and health behavior patterns and utilization. In the face of large rural populations with poor utilization of health and other services and a lack of a vital record system, longitudinal demographic and health surveillance is an efficient, cost effective and reliable way to collect population and health data in a country such as Ethiopia. Traditional data collected from health clinics, small sample surveys and vital registries miss large segments of the population who do not access these services and are not representative of the population as a whole. Demographic and health surveillance includes these individuals by conducting community based surveys that are representative of the entire population. This provides essential data for health and developmental planning and activities.

Surveillance takes place in 12 of the district's 38 Kabeles. These 12 Kabeles are representative of the entire district as a whole. There are 2 semi-urban- the towns of Kersa Town and Weter Town- and 10 rural Kabeles within the surveillance site, which almost exactly mirrors the urban- rural population distribution of the Kersa district. Each Kabele contains roughly 1000 households with populations of 4000 to 5000 people. The average household size is 5.2 individuals. The Kabeles selected for surveillance are also proportionately distributed according to the highland, midland and lowland distribution of all the Kabeles in the district. Two of the surveillance Kabeles are located in highland areas, 8 in midland areas and 2 in low land areas. Kabeles range, in altitude, from 3200 meters above sea level in the highland areas to 1400 meters above sea level in the low land areas.

In both the rural and semi-urban areas seasonal farming is the main economic activity. Farmers generally produce crops once or twice for the year during the rainy season, while farmers in Handhura Kossum- one of the 12 surveillance Kabeles-produce 3 times a year due to irrigation practices there. In the semi-urban areas, however, people also work as petty traders, government workers, laborers and other service workers. The primary income generating crops in the mid and low land areas are khat, coffee and to a lesser extent sorghum. Khat and coffee are not as present in the high land areas due to the wetness of the land, but maize and vegetables are. Potatoes, oats, barley and wheat are also grown in most Kabeles. These crops are used primarily for personal consumption and only excess is sold. They are not as profitable as the cash crops mentioned previously. Therefore, Kabeles, which grow more cash crops, tend to be slightly wealthier than other Kabeles. Households also keep a number of animals- cows, donkeys, hens and goats- as a source of food and as work animals.

As with many rural areas in the continent, housing is rudimentary. Almost all (99.3%)(Kersa Demographic Surveillance and Health Research Center, 2008) houses in Kersa, especially the rural Kabeles, are made of mud and wood. They generally consist of a single living space partitioned into sleeping quarters and space for animals to be kept. Some larger houses have completely separate rooms for animals, storage and sleeping. However, the majority, (67.8%) share sleeping/living rooms with domestic animals (Kersa Demographic Surveillance and Health Research Center, 2008). Kitchen facilities tend to be outside of the main living quarters in separate huts (54.2% are separate (Kersa Demographic Surveillance and Health Research Center, 2008)), but some houses have space set aside for cooking. In-house bathroom facilities are very rare (only 1.7% of households have them) (Kersa Demographic Surveillance and Health Research Center, 2008). About a third of households (36.4%) have access to a latrine facility and 6.9% have on-site solid waste disposal means (Kersa Demographic Surveillance and Health Research Center, 2008). Otherwise, sanitation facilities in the district are generally unimproved; i.e. they consist of the use of pit latrines or no facilities/bush or field disposal (Haramaya University, b). Houses generally do not have windows (82.3% (Kersa Demographic Surveillance and Health Research Center, 2008)), making ventilation poor. Roofs vary from traditional grass roofs, to plastic coverings and the more expensive, but increasingly common, corrugated iron (76.7%(Kersa Demographic Surveillance and Health Research Center, 2008)).In the semi-urban Kabeles houses may be made of wood or concrete, in addition to the traditional mud.

All of the Kabeles are accessible by road (typically unpaved), have cell phone service, which many individuals use, and have landline telephone access through the Kabele administration office. During the rainy season access to the highland areas becomes difficult due to muddy and difficult to navigate road conditions. Most (67.5%) have access to an improved water source and 10.3% of those who don't, treat water in their homes (Kersa Demographic Surveillance and Health Research Center, 2008). Water sources in the district include tap water, protected and unprotected springs and wells and ponds. Those accessing from wells, fetch water from central pumps within the Kabeles. The 2 semi-urban Kabeles also have electricity available to all or most households for a small price. Some wealthier households in certain Kabeles- such as Handhura Kossum- also have electricity but generally, it is not found in the rural areas.61.5% of houses are poorly illuminated (Kersa Demographic Surveillance and Health Research Center, 2008).

Other services and facilities available in the district include schools (from elementary to preparatory), churches and mosques and government funded farmer training centers (FTC). In total, there are 18 elementary, 2 secondary, 1 preparatory and 2 religious schools in the surveillance site. Access to educational facilities is equal in both the urban and rural areas. However, the types of schools available and the length of schooling for children are different between the rural and urban areas. In rural areas, schools are more likely to be religiously affiliated and run, while government schools are more prevalent in the urban areas. Also, individuals leave school earlier in the rural areas in order to support their families or start families of their own. While Islam is the dominant religion and there are 138 mosques in the area, there are also 8 churches in the site. There are also 6 FTCs in the study site. FTCs are buildings and programs set up by the government in rural farming areas, to train farmers in new and improved agricultural methods and skills.

Event history data

Individual