ABSTRACT
This study intended to investigate the relationship between jigger infestation and participation at school by pre-primary school and lower primary school children. The objectives of the study were to find out the relationship between jigger infestation and children‟s rate of school attendance, performance in outdoor activities, academic performance and dropping out of school. The study was carried out in Gatundu District because it is one of the highly jigger infested districts in Kiambu County, Kenya. The study utilized the Ecological systems theory and it employed the descriptive survey design. The population of the study comprised of pre-primary, lower primary school children and their class teachers from all the public schools in Gatundu District. The sample size was eleven schools. Purposive sampling technique was applied to sample 44 jigger infested children in these schools. An equal number of pupils not infested were randomly sampled to be compared with those who were infested. The teachers handling pre-primary school and lower primary classes were also purposively sampled. Data was collected through the use of questionnaires for teachers, observations and document analysis. Qualitative and quantitative methods of data analysis were applied. The Statistical Package for Social Sciences (SPSS) was used to prepare and organize data for analysis. Pearson‟s correlation coefficient test was used to compute the relationship between the variables. Frequency distribution tables, percentages, and descriptions were utilized for data presentations. The study concluded that jiggers were a major threat to the realization of children‟s educational goals. The Pearson correlation coefficient indicated that jiggers significantly affected children‟s play in outdoor activities at r =0.306, and significantly lead to high dropout rates at r = 0.311. They also reduced school attendance at r = -0.123 and lead to slightly poor academic performance at r = -0.005.The study recommends that the school managers liaises with other stakeholders to seek for strategies of curing those infested, carry out routine checkups on children and sensitize communities on the causes, dangers and preventive measures of the jigger parasite in order to help all children realize their full educational potential in life.
CHAPTER ONE
INTRODUCTION AND CONTEXT OF THE STUDY
Introduction
This chapter summarizes the background of the study, statement of the problem, the purpose of the study and the objectives. It further presents the research questions, the significance, limitations and delimitations. Other sub topics in this chapter include assumptions, theoretical framework, conceptual framework and operational definition of terms.
Background to the Study
Health educators and health professionals worldwide have been calling for total commitment to good health as a way of life. Health is the physical, mental and social wellness of a person. According to Kelly and Lewis (1987) an individual cannot be active and productive in his/her day to day activities if they are unhealthy. UNICEF (2005) also observes that the health of children is important as it determines their physical growth and development, academic performance and participation in life activities. This is necessary because as Creswell (1993) observes, healthcare makes its greatest impact during the formative years of a child and that the possible causes of ill health among children are known to include malnutrition, childhood diseases and parasitic infections (Obade, 2007; Creswell, 1993; Oluoch, 2001).
The United Nations Convention on the Rights of Children (UNCRC) (1989), Article 24, also stipulates that every child has a right to the highest standard of health and medical
care attainable and that states shall place special emphasis on the provision of primary and preventive healthcare, public health education and the reduction of child mortality. Moreover, several countries including Kenya agreed that every child should be provided with a nurturing, caring and safe environment in order to survive, be physically healthy, mentally alert, emotionally secure and socially competent to be able to learn (Obade, 2007). The Kenya Government has also demonstrated concern for improving the well- being of young children by putting in place initiatives such as the Kenya Educational Support Program (KESSP) whose aim is to improve the learning facilities of Kenyan Schools and by extension help school going children in realizing their full potential in life. This is in line with the National Early Childhood Development Policy Framework (KIE, 2006) which stipulates that for children to realize their full potential in life, they require quality healthcare, nutrition, protection, early stimulation and training services.
According to the Kenya Health Policy (2012-2030), the New Constitution of Kenya is a major milestone towards the improvement of health standards, alleviating poverty and addressing inequalities in health and education among other issues. According to the policy, every Kenyan citizen has a right to the highest attainable standard of health including reasonable standards of sanitation and the right to a clean heath environment but many segments of the population have minimal access to high-quality healthcare and social services.
Studies on health have mainly focused on malnutrition and childhood diseases. The underlying causes of malnutrition and in turn ill-health, in the sub-Saharan Africa have been said to be mainly extreme poverty, inadequate caring practices, low levels of education of parents and poor access to health services (UNICEF, 2005). Studies indicate
that malnutrition and childhood diseases adversely affect the growth and development of children by contributing to infant and children morbidity, mortality and stunted growth especially in the developing countries (Chesire, 2007; Kameta 2005; Waswa 2005; Obade 2007; Odanga 2003). Mburia (1999) did a study on the ecology of human development in Machakos and found that poor health in pre-primary school and lower primary school children is the main cause of poor school enrolment, absenteeism, early school dropout, repetition of classes and poor academic achievement.
Another threat to children‟s health in Africa is parasitic infections (Oluoch, 2001). Malaria, for example, is an infection caused by a parasite known as the anopheles mosquito. The mosquito bites children, invades their red blood cells making them feel weak, develop fever, have headaches and fatigue. Studies on malaria (Oluoch 2001; Othoro 1996; Karah & Rahim 1995) have established that it mostly affects children below the age of five and that it can cause disability and death among the children. The studies were carried out on children who had either mild or severe malaria in order to establish the most effective way of controlling or curing the infections. These studies did not establish whether poor health is a determinant of pre-school entry since children start attending pre-school education by the age of three years. These studies did not also focus on jiggers or the effects of parasites on children‟s rate of school attendance, participation and drop out.
Studies on intestinal infections caused by worms revealed that they cause malnutrition anemia and retarded growth in children depending on the severity of the infection (Echoka, 2007; Otula, 2005; Muchiri 2001; Mburia, 1999 & Magambo 1998). Furthermore, chronic attack by these parasites leads to physical and mental illness and
increased susceptibility to other infections (Mburia, 1999). The consequence of this state of intestinal infestation makes the child experience fever, abdominal pains, diarrhea, vomiting and sometimes convulsions. This condition of poor health may interfere with the children‟s involvement in school activities and hence poor academic performance.
Jigger is a parasite that has not been confirmed to have adverse effects on children‟s health. Jigger is the common name for Tungiasis, also known as Chigoe flea, bicho de pie, sad flea, bug of the foot and Tunga Penetrans (Akwe, 2008). According to Heukelbach, Frank & Feildmeier (2004), jiggers are found among communities with limited resources in several countries within America, Asia and Africa. In some of these communities, jiggers attack a substantial number of children. Mutahi (2009) for example, quoted a journal known as `e-medicine‟ which reported that 51% of children from Trinidad and 42% from Nigeria were jigger infested. Mutahi also reported that infection rates among native inhabitants of developing countries are much higher than those of developed countries and that some regions often seem to be more prone to jigger infestations than others. The report however, did not give the effects of the infestation on children‟s school attendance or performance in their evaluation tests. It did not also reveal any challenges faced by the infested children in participating in school activities.
In addition, a cross sectional study carried out in Cameroon found out that jigger prevalence was highest among school-going children and then it decreased in adults and increased again among the elderly (Collins, 2009). The reason given for the prevalence
in children was that the culture and the traditions of the people placed children at a higher risk. For example, they wore sandals or damaged shoes and played in dry and dusty areas.
The study aimed at ascertaining the prevalence of Tungiasis (jiggers) among the inhabitants, assessing the impact of the infestation and identifying preventive measures in a number of rural settings in the North West county of Cameroon. The study concluded that the infestation was an important health problem which seemed to have been neglected. It suggested that the problem be addressed by medical health officers, community, educationists and sufferers themselves since it is a serious threat to health.
