Central Kenya Research Articles

Yield Responses of Upland Rice Varieties to Low N Conditions in Central Kenya

Growth, yield, and yield components of five upland rice varieties (MWUR 1, MWUR 4, NERICA 1, NERICA 4, and IRAT109) were evaluated under four different soil N conditions (0, 26, 52, and 78 kg N/ha) to identify the factors contributing to their adaptability to low soil-fertility. The results showed that MWUR 1, MWUR 4, and NERICA 4 had greater adaptability to low N conditions. Specifically, MWUR 1 showed the highest adaptability to low soil fertility. The greater low soil-fertility adaptability of these varieties was attributed to their ability to maintain dry matter production. Furthermore, their greater dry matter production under low N conditions could be attributed to the increased root length, which allowed improved soil nutrient absorption. Our findings suggest that rice grain yield was mainly restricted by sink size, particularly panicle number per plant under low N conditions. The higher grain yield of MWUR 1 under low N conditions could be attributed to greater tillering ability. Thus, MWUR 1 could be a good candidate for cultivation under nutrient-poor soil conditions.

Effectiveness of mHealth in improving medication adherence among hypertensive patients on follow-up in a tertiary hospital in central Kenya: a randomized controlled trial

Background: Non-adherence to medication is documented in the literature as a major barrier to blood pressure control among patients on treatment for hypertension. This study sought to evaluate the potential effectiveness of a mHealth intervention in supporting medication adherence among hypertensive patients on follow up. Methods: We undertook a single blind parallel randomized controlled trial among hypertensive patients undergoing follow up care in Nyeri County Referral Hospital between January and December, 2020. The trial comprised of two arms, with a total of 120 patients randomized on a 1:1 ratio. Patients in the experimental group were put on an educational health intervention comprising of mobile phone delivered SMS messages and interactive voice calls. Patients in the control group were continued on the usual care offered in the hospital’s medical outpatient clinic. The primary endpoint was medication adherence. Data was analyzed through the intention to treat approach at 5% significance level. Results: A total of 112 participants (93.3%) were retained in the study at the end of follow up. The proportion of patients who were adherent to their prescribed medications was higher by 38.3% among participants in the experimental arm compared to those in the control group (p<0.001). The odds of being adherent to medications was 6.1 times higher for patients who had received the study’s intervention compared to those in the control group (95% CI 2.6, 14.3). Conclusions: The mHealth intervention applied in this study was effective in improving medication adherence among patients on treatment for hypertension.

Hustler Populism, Anti-Jubilee Backlash And Economic Injustice In Kenya’s 2022 Elections

Abstract Deputy President William Ruto’s victorious presidential campaign in Kenya’s 2022 elections saw him champion the plight of the ‘hustlers’, young informal economy workers on low, piecemeal incomes. Reconfiguring political identities around notions of economic hardship and struggle, Ruto’s campaign appeared emblematic of what scholars have recently identified as a turn towards ‘populism’ in Africa, transmuting ethno-nationalist identities into class-based ones. However, whilst Ruto’s campaign capitalized on rising prices to devastating political effect, he also channelled discontent with the Jubilee government and its unmet promises of shared prosperity. Drawing on ethnographic data collected in central Kenya’s Kiambu region since 2017, this article understands Ruto’s victory not through the lens of ‘hustler populism’ but rather as an anti-Jubilee ‘backlash’. Ruto’s campaign took advantage of Uhuru Kenyatta’s personal unpopularity as voters increasingly questioned the nature of ‘dynastic’ authority and ‘state capture’, seeking to punish Uhuru personally for his failures to create prosperity in the region whilst enriching himself at their expense. Elaborating on these tensions, the article points towards broken ‘moral economies’ between voters and politicians as a vital field of research.

Prevalence and Correlates of Medication Non-adherence among Hypertensive Patients on Follow-up in Central Kenya

Background and Objective: Poor adherence to antihypertensive medications is a major barrier to blood pressure control among patients living with hypertension. In Kenya, a significant number of hypertensive patients have uncontrolled blood pressure, but data on medication adherence among this patient population is scarce. This study sought to determine the prevalence and correlates of medication non-adherence among hypertensive patients on follow-up in two referral hospitals in central Kenya. Methods: We undertook a cross-sectional study comprising of 339 hypertensive patients undergoing follow-up care in two referral hospitals located in Nyeri County between October and December 2019. Medication adherence was assessed using a validated medication adherence questionnaire. Medication adherence was a dichotomous variable (adherent vs non-adherent), with the prevalence of non-adherence being measured as a proportion. Independent predictors of medication non-adherence were identified by fitting a multiple logistic regression model, where adjusted odds ratios (AORs) were computed for various covariates and interpreted at a 5% level of significance and 95% confidence interval (CI). Results: The study sample largely comprised of the female gender (65.2%) and elderly people (mean age, 65 years +/- 12). Nearly half (46.6%) of the hypertensive patients interviewed were non-adherent to their medications. The factors associated with non-adherence were: having poor hypertension knowledge (AOR, 5.6, 95% CI, 3.3, 9.4); being on more than one antihypertensive medication (AOR, 2.8, 95% CI, 1.7, 4.7) and being on two or more daily doses of medications (AOR, 2.3, 95% CI, 1.3, 4.1). Conclusion and Implications for Translation: Non-adherence to prescribed medications is highly prevalent among hypertensive patients in central Kenya, and it should therefore be identified as a public health concern. Strategies aimed at optimizing medication adherence among hypertensive patients in this region may consider focusing on educational interventions to increase hypertension knowledge and also on simplification of treatment regimens. Copyright © 2023 Mutua, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Maintenance of Roads Implemented under the Roads 2000 Strategy in Central Kenya

Road maintenance is an integral component of the low-volume sealed roads provision process, the type and cost of which are influenced significantly by decisions made during the preceding planning, design, and construction phases. Low-volume sealed roads are particularly sensitive to the whims of the physical environment so timely and effective control of their deterioration becomes the key challenge to the management of road maintenance. In Kenya, the Kenya Roads Board (KRB) holds the mandate for funding, oversight, and coordination of road maintenance, rehabilitation, and development through the optimum utilisation of resources for a sustainable road network. Each year, KRB finances the maintenance of the road network through the Kenya Roads Board Fund (KRBF). The Fund is distributed among the road agencies charged with maintenance. KRB reviews, individually, the Annual Road Works Programmes (ARWPs) submitted by Road Agencies and consolidate these ARWPs into an Annual Public Roads Programme (APRP). This study aimed at assessing the level and prioritisation of maintenance of the completed and handed-over projects under the Roads 2000 strategy. The condition of the carriageway was assessed, as well as the resilience and adaptation measures in place to respond to climate change. For climate resilience, data such as erosion, problematic soils, drainage from the road and its near environment as well as from outside the road reserve, instability of embankments and cuttings, construction issues and maintenance problems were collected using a standard form for rating against each data type. The assessment conducted on the performance of the side drainage showed that the majority of the roads have side drainage with inadequate depths and are not free-flowing. The high roughness values obtained, which were deduced to be as a result of distresses such as rutting and potholes, were concluded to be as a result of inadequate and untimely maintenance of the surface of the road. The recommended maintenance strategy should be such that interventions for the defects such as cracks, potholes, and edge breaks, among others are carried out as soon as they are identified. It was observed that all the roads surveyed did not have adequate adaptability measures for climate resilience. It was recommended that the Annual Road Inventory and Conditional Survey (ARICS) incorporates the collection of additional data in the assessment on issues that touch on climate resilience, the assessment of which should inform the implementation of appropriate adaptation techniques to improve the climate resilience of the completed roads, and more so the low volume sealed roads

Towards Attainment of Kenya Certificate for Secondary Education: Role of School Culture in Kenya By

Empirical research revealed that Kenya is experiencing poor performance in the Kenya Certificate for Secondary Education (KCSE) within the context of subsidized secondary education adopted in 2008. School culture has been considered a central concept that changes how schools operate, improve educational results and is heavily influenced by its institutional norms and history which could be an obstacle to over all performances. The purpose of the study therefore was to determine school culture and its influence on KCSE attainment in Nandi Central Sub County Kenya. The study was guided by the following objectives: To establish form(s) of culture(s) that is/are practiced. To determine the relationship between school motto, vision, mission statement, to determine the relationship between school rules, regulations and the attainment of KCSE in public secondary schools in Kenya and to establish the relationship between Internal assessment exams and attainment of KCSE in public secondary schools in Kenya. This study adopted convergent triangulation mixed method research design; Pragmatic philosophical paradigm was employed. This study was guided by dual factor theory by Fredrick Herzberg 1957. The study was conducted in Nandi Central Sub-County, Nandi County involving 20 secondary schools. There were 352 respondents comprising of 20 principals, 81 form four class teachers and 251 form four students selected using simple random, stratified sampling and purposive technique.. The data from the study was collected using questionnaires, interview, document analysis and direct observation. Data generated from this study was both quantitative and qualitative. Analysis of quantitative data involved, use of inferential statistical analysis where data was coded and entered into a Statistical Package for Social Sciences (SPSS) version 26. In qualitative approach, data was analyzed thematically by organizing themes corresponding to the study objectives. The study revealed that, there was a statistically significant relationship between forms of cultures practiced and attainment of KCSE in Kenya (p=0.019<0.05). School motto, vision and mission statement is statistically significantly associated with attainment of KCSE in Kenya (X2=93.572, p=0.000<0.05). School rules, regulations, policies are statistically significantly associated with attainment of KCSE in Kenya (X2=16.083, p=0.003<0.05). Regular internal assessment exams are statistically significantly associated with attainment of KCSE in Kenya (X2=14.821, p=0.005<0.05). The study concluded that forms of culture practiced in schools include; equal distribution of educational resources and learning opportunities, made students and staff feel emotionally and physically safe, high concern for staff/students combined with strong performance expectations and being centered on performance with little regard for staff and students. School motto, vision, mission statement should spell out the purpose of the school, create a new and deeper relationship among students and staff and consist of a new-defined ideology of the school, for example fundamental values and beliefs. Set rules and regulations direct student’s social and academic discipline that translates into performance by guiding student’s behaviors. The study recommends that schools should ensure that their school motto, vision, mission statement spell out the purpose of the school and this would create a new and deeper relationship among students and staff.

The occurrence and status of black-and-white Puffinus shearwaters on the Kenyan and Tanzanian coasts, with the first specimen records of Persian Shearwater P. persicus persicus

We review specimens and sight records of small black-and-white Puffinus shearwaters in Kenya and Tanzania. An early specimen of an Audubon's Shearwater P. lherminieri sensu lato found inland at Limuru, Kenya in October 1963, long held to represent taxon bailloni (now treated as Tropical Shearwater P. bailloni), is reassigned here to P. b. nicolae. We refer three other specimens and two well-documented sight records to Persian Shearwater P. persicus persicus and a third sight record in northern Tanzania to P. persicus. We suggest that nominate persicus is a regular visitor to the central Kenya coast in December–March, probably as far south as the Pangani region of north-east Tanzania at least, concurrent with a seasonal upwelling event on the Kenya Banks associated with the north-east monsoon. Tropical Shearwater, however, is no more than a rare visitor to East African shores based on current evidence. Our data clarify the status of these shearwaters in the region, provide additional biometric data to complement published sources, and extend the western Indian Ocean non-breeding range of the nominate subspecies of Persian Shearwater approximately 2,000 km south from northern Somalia.

The deep origin of ground fissures in the Kenya Rift Valley

Intense volcanic and geothermal activities characterize the Great Rift Valley of East Africa. Ground fissure disasters of the Great Rift Valley have garnered increasing attention in recent years. Through field investigations, trenching, geophysical exploration, gas sampling and analysis, we determined the distribution and origin of 22 ground fissures within the Kedong Basin of the Central Kenya Rift. These ground fissures caused varying degrees of damage to roads, culverts, railways, and communities. Trenching and geophysical exploration have shown that ground fissures in sediments are connected to rock fractures with gas escaping. The gases expelled from the rock fractures contained methane and SO2, which were absent in the normal atmosphere, and 3He/4He ratios in gases measured further indicated that the volatiles were derived from the mantle, suggesting that these rock fractures extended deep into the underlying bedrock. Spatial correlations with rock fractures demonstrate the deep origin of these ground fissures, which are associated with active rifting, plate separation, and volcanism. The ground fissures are formed due to movement on the deeper rock fractures, and then the gas escapes through the fissures. Determining the unusual origin of these ground fissures can not only guide infrastructure development and urban planning but also contribute to the safety of local communities.

Analysis of Effect of Long Term Financing on Profitability of Supermarkets in Central Business District Nairobi City Kenya

Analysis of Effect of Long Term Financing on Profitability of Supermarkets in Central Business District Nairobi City Kenya

African Indigenous knowledge versus Western science in the Mbeere Mission of Kenya

This article sets out to explore the way in which Western science and technology was received in the Mbeere Mission of central Kenya since August 1912 when a medical missionary, Dr T.W.W. Crawford, visited the area. In his dalliance with ecclesiastical matters, Crawford, a highly trained Canadian medical doctor, was sent by the Church Missionary Society (CMS) at Kigari-Embu, in 1910, to pioneer the Anglican mission in the vast area that included Mbeereland, where Mbeere Mission is situated. Contending with the African indigenous knowledge in medicine, environmental conservation, agriculture and other forms of indigenous science, the introduction of Western science and technology, 1912 to 1952, the article argues, did not erase the former; rather, it complimented it. Pockets of general resistance were evident, though Mbeereland, unlike its neighbouring Mutira Mission of 1912, did not offer elaborate opposition to the Western science and technology, partly because the locals could have learnt about it from their neighbours who had experienced it much earlier. Through a historico-narrative design, the research article endeavours to primarily review the coming of Western medicine in Mbeereland: Did it conflict with the African medicine? Methodologically, the data have been collected via archival sources, oral interviews and by reviewing applicable literature.Contribution: The input of this research article to the HTS Journal’s vision and scope is seen by appreciating its focus on the interface between African indigenous knowledge and the European science and technology. Although the main focus is

"You'll Be Chased Away": Sources, Experiences, and Effects of Violence and Stigma among Gay and Bisexual Men in Kenya.

Gay and bisexual men in Kenya face extreme socio-political stigma which manifests in widespread violence and discrimination across socio-ecological levels. We conducted individual in-depth interviews with 60 gay and bisexual men in western and central Kenya. Interview transcripts were thematically analyzed using an inductive, phenomenological approach to qualitatively examine experiences of stigma and violence at the interpersonal and institutional levels. A total of seven primary themes and four sub-themes emerged from the data. At the interpersonal level, participants described stigma and violence from family, friends, and romantic/sexual partners with sub-themes for gay-baiting violence, blackmail, intimate partner violence, and commitment phobia. At the institutional level, participants described stigma and violence from religious, employment, educational, and healthcare institutions. This stigma and violence severely impacted the lives of participants including their mental health, physical health, sexual health, socioeconomic status, and ability to access health-promoting services. These data identify sources of stigma and describe how this stigma manifests in the everyday lives of gay and bisexual men in Kenya. Study findings and quotes from participants highlight the severity of violence, stigma, and discrimination faced by this community and emphasize the need for decriminalization of same-sex sexualities as well as interventions to support health and wellbeing.

Nutrient content and biochemical analysis of papaya (Carica papaya L.) hybrids grown in central Kenya

Papaya (Carica papaya L.) is a known powerhouse of nutrients and biochemicals which have health benefits necessary in a human diet. Mineral and vitamin deficiencies, like stunting, wasting and underweight in children, are common in Kenya yet available fruits like papaya can provide those nutrients. This study evaluated the nutritional and biochemical compositions, sugars and the 2,2-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging activities of 2 newly developed papaya hybrids (JKUAT 7 and JKUAT 8) grown in Kenya and Solo variety, as control; in a completely randomised design which were subjected to one way ANOVA at p?0.05. Results from this study showed significant differences for JKUAT 8 with zinc, iron, potassium and vitamin C contents at 3.28, 3.62, 1145.10 and 448.30 mg/100 g respectively. Solo variety had significantly higher ?-carotene (68.75 mg/100 g), lycopene (25.47 mg/100 g) and flavonoid (0.0178 g/100 g) contents. JKUAT 7 had more phenolic and tannins contents at 0.4434 g/100 g and 81.65 mg/100 g respectively. The DPPH activities ranged from 20 to 80 mg/mL with JKUAT 7 having the highest activity at 20 mg/mL and the least, Solo at 80 mg/mL. JKUAT 7 also exhibited higher total sugar contents in a range of 4.86 to 11.57%: with glucose and fructose at 5.74 and 5.83 % respectively. Our results suggested high nutritional and biochemical profiles of the newly developed JKUAT 7 and JKUAT 8 compared to Solo, the commercial variety. The high nutritional and biochemical contents recorded in the study papayas can be utilised in enhancing human nutrition and health thereby reducing metabolic disorders.

Provider perspectives on service delivery modifications to maintain access to HIV pre‐exposure prophylaxis during the COVID‐19 pandemic: qualitative results from a PrEP implementation project in Kenya

HIV pre-exposure prophylaxis (PrEP) is an essential prevention strategy being scaled up for priority populations in Kenya, including for HIV serodiscordant couples. The COVID-19 pandemic posed challenges to PrEP rollout. We conducted a qualitative study of PrEP providers to understand how clinics adjusted PrEP delivery during the COVID-19 pandemic. Since 2017, the Partners Scale-Up Project has integrated PrEP into 25 HIV clinics in Central and Western Kenya. We conducted qualitative interviews with 40 purposively sampled clinic personnel. We interviewed personnel once during the first pandemic wave (May-Aug 2020) and again after some decline in COVID-19 rates (Nov-Jan 2021). We analysed data using inductive memo-writing and summarized data by themes along the PrEP delivery cascade, guided by the Framework for Reporting Adaptation and Modifications (FRAME). We interviewed 27 clinical officers, five nurses, four health records and information officers, and four counsellors from Central (n=20) and Western (n=20) Kenya. About half (n=19) were female, with a median age of 32 (IQR: 29-34) and 2.3 years of experience delivering PrEP (IQR: 2-3). All participants reported clinic changes in PrEP demand creation and service delivery during the pandemic. Modifications occurred during PrEP implementation and sustainment phases, were partly reactive to the pandemic and also facilitated by interim Ministry of Health guidance on PrEP delivery during COVID, and were made by PrEP delivery teams, clients and clinic managers. Commonly reported modifications included dispensing multiple-month PrEP refills, intensifying phone-based client engagement and collaborating with other HIV clinics to ensure that clients with prolonged stays in other regions could continue to access PrEP. Some clinics also adopted practices to streamline visits, such as within clinical-room PrEP dispensing, pre-packing PrEP and task-shifting. Most providers liked these changes and hoped they would continue after the pandemic subsides. COVID-19 served as a catalyst for PrEP delivery innovations in Kenya. HIV clinics successfully and rapidly adapted their PrEP demand creation, refill and retention strategies to promote PrEP uptake and effective use. These modified implementation strategies highlight opportunities to streamline the delivery of PrEP, as well as other HIV and chronic care services, and strengthen engagement with populations post-pandemic.

Evaluation of Soil Mineral Nitrogen under Different Organic and Inorganic Fertilization in Central Kenya

Evaluation of Soil Mineral Nitrogen under Different Organic and Inorganic Fertilization in Central Kenya

Diversity of Insect Flower Visitors on Macadamia within a Monoculture Orchard in Murang’a County, Central Kenya

Diversity of Insect Flower Visitors on Macadamia within a Monoculture Orchard in Murang’a County, Central Kenya

Pregnancy trends and associated factors among Kenyan adolescent girls and young women pre- and post-COVID-19 lockdown

Globally, COVID-19 has had a negative impact on health systems and health outcomes, with evidence of differential gender impacts emerging. The COVID-19 timeline of events spanning from closures and restrictions to phased reopenings is well-documented in Kenya. This unique COVID-19 situation offered us the opportunity to study a natural experiment on pregnancy trends and outcomes in a cohort of Kenyan adolescent girls and young women (AGYW), enrolled in the KENya Single-dose HPV-vaccine Efficacy (KEN SHE) Study. The KEN SHE Study enrolled sexually active AGYW aged 15–20 years from central and western Kenya. Pregnancy testing was performed at enrollment and every 3 months. We determined pregnancy incidence trends pre- and post-COVID-19 lockdown, pregnancy outcomes (delivery, spontaneous, or induced abortion), and postabortion and postpartum contraceptive uptake. Kaplan–Meier survival estimates of incidence rates were used to estimate the cumulative probability of pregnancy during the study period. Cox regression was used to investigate factors associated with pregnancy incidence. Of the 2,223 AGYW included in the analysis, median age was 18.6 IQR (17.6–20.3), >90% had at least secondary school education, 95% were single at the time of enrollment, and 82% had a steady/primary sexual partner. Pregnancy incidence peaked at 2.27 (95% CI [1.84, 2.81])/100 women-years of observation at the end of the first quarter of 2020, a period coinciding with the government-imposed lockdown. AGYW had 60% increased risk of being pregnant during the lockdown when compared to prelockdown period (HR = 1.60, 95% CI [1.25, 2.05]). Among the 514 pregnancies reported, 127 (25%) ended in abortion, of which 66 (52%) were induced abortions. Our findings demonstrate the adverse sexual and reproductive health (SRH) consequences of the COVID-19 pandemic and the lockdown measures among AGYW. As services continue to be disrupted by the pandemic, there is an urgent need to strengthen and prioritize AGYW-centered SRH services, including contraception and safe abortion.

Geographical variation in the Bar-tailed Trogon Apaloderma vittatum

Distributed in four areas of Africa (‘Eastern’—east of the Gregory Rift Valley from central Kenya south to Malawi; ‘Central’—west of the Gregory Rift from western Kenya and western Uganda south to Burundi and eastern Democratic Republic of Congo; ‘Western’—Nigeria and Cameroon plus Bioko; and Angola), Bar-tailed Trogon Apaloderma vittatum is at present widely judged to be monotypic. However, photographic evidence reveals three different facial patterns in these populations, with a bare ear spot and whitish-green bill in Eastern and Angolan birds, a bare ear spot, golden-yellow bill and bare gape line in Central birds, and these same features plus a distinct bare crescent above the eye in Western birds. Central and Western birds also have broader, more distinct barring on the wing panel. Moreover, there is a stepped cline in sizes in these three distinct populations, from Eastern plus Angola (largest) through Central to Western (smallest), with Bioko birds having notably short tails; and songs also decelerate from east to west, but with too much overlap to be diagnosable. Nevertheless, under the Tobias criteria the morphological differences of Central and Western birds vs. Eastern and Angolan populations accord the former species rank, for which the name camerunense is available. This latter species itself breaks into three subspecies, with the nominate in Nigeria and Cameroon, francisci on Bioko, and a new name for the hitherto taxonomically unrecognised Central populations.

Drivers of species richness and beta diversity of fishes in an Afrotropical intermittent river system.

Tropical freshwater ecosystems are some of the most threatened systems yet remain understudied relative to temperate systems. Here, we look at the drivers of community structure of fishes in a tropical and intermittent system in central Kenya. We conducted monthly sampleswithin the upper Northern Ewaso Ng'iro to assess variation in community composition and abiotic characteristics. We analyzed species richness along the longitudinal gradient, computed beta diversity within the system, relative contributions of each site, and partitioned beta diversity metrics into nestedness and turnover components. We found that, similar to temperate intermittent systems, species richness varied along the longitudinal gradient, nestedness contributions to beta diversity exceeded those of turnover, and environmental and spatial variables determined patterns of beta diversity. Sites at the highest and lowest ends of the species richness gradient showed the highest contributions to beta diversity, suggesting sites important for preservation or restoration initiatives, respectively. With ongoing water extraction and conflict over resources throughout the region, this study highlights the need for further investigations of the effects of multiple stressors on biodiversity patterns and ecosystem functioning in tropical stream communities.

Smallholders’ livelihoods in the presence of commercial farms in central Kenya

We study smallholder households livelihood profiles in central Kenya in an area characterized by the presence of many large commercial farms. We surveyed 375 smallholder households, compared them according to three categories (employed, contract farmers, households non-engaged with commercial farms), and constructed a livelihood index. The results show that contract farmers and households employed on farms are only a small fraction of all smallholders. Employed and non-employed households show little difference in overall livelihood profiles. Results suggest that employment on large commercial farms is mainly a coping strategy for younger households or in times of need. Contract farmers were found only in a specific location and had better access to irrigation water and higher livestock holdings. Comparison with earlier data shows the persistence of precarious livelihood levels and household strategies aiming at diversification of activities, with little evolution over the last 20 years despite the presence of commercial farms. Overall, there is little evidence that the proximity to the commercial farms offers a way out of poverty for nearby smallholder farmers.

Effects of changes in short-term human cognition on reported healthcare utilisation.

Growing empirical evidence indicates that financial anxiety causes reductions in short-term cognitive capacity. Results from urban communities in Delhi, India show sizable differences in the number of health events recalled between the poor and non-poor respondents over experimentally controlled recall periods. One explanation for this recall difference is 'poor memory'. Such results provide additional reasons for healthy skepticism of the accuracy of self-reported health survey data. The present research identifies which forms of cognitive capacity are related to health event recall and assesses the roles of poverty and illiteracy as mediating variables. Results indicate that underreporting of health events among the poor in rural Kenya is not solely due to 'poor memory'. Data used comes from a repeated cross-sectional study conducted in Samburu county, Kenya over 10-months between 2017-2018. This period coincided with the ending of a protracted and severe drought in East Africa. The results presented in the current study confirm the poor and non-poor distinction, but provide a more detailed cognitive explanation for such results. Reflective throught, as measured by fluid intelligence and heuristic use, is shown to be good predictors of fever recall among relatively poor rura communities in central Kenya.