The 2014 Kenya Demographic and Health Survey (KDHS) provides information to help monitor and evaluate population and health status in Kenya. The survey, which follows up KDHS surveys conducted in 1989, 1993, 1998, 2003, and 2008-09, is of special importance for several reasons. New indicators not collected in previous KDHS surveys, such as noncommunicable diseases, fistula, and men’s experience of domestic violence, are included. Also, it is the first national survey to provide estimates for demographic and health indicators at the county level. Following adoption of a constitution in Kenya in 2010 and devolution of administrative powers to the counties, the new 2014 KDHS data should be valuable to managers and planners.
The 2014 KDHS has specifically collected data to estimate fertility, to assess childhood, maternal, and adult mortality, to measure changes in fertility and contraceptive prevalence, to examine basic indicators of maternal and child health, to estimate nutritional status of women and children, to describe patterns of knowledge and behaviour related to the transmission of HIV and other sexually transmitted infections, and to ascertain the extent and pattern of domestic violence and female genital cutting. Unlike the 2003 and 2008-09 KDHS surveys, this survey did not include HIV and AIDS testing. HIV prevalence estimates are available from the 2012 Kenya AIDS Indicator Survey (KAIS), completed prior to the 2014 KDHS.
Results from the 2014 KDHS show a continued decline in the total fertility rate (TFR). Fertility decreased from 4.9 births per woman in 2003 to 4.6 in 2008-09 and further to 3.9 in 2014, a one-child decline over the past 10 years and the lowest TFR ever recorded in Kenya. This is corroborated by the marked increase in the contraceptive prevalence rate (CPR) from 46 percent in 2008-09 to 58 percent in the current survey. The decline in fertility accompanies a marked decline in infant and child mortality. All early childhood mortality rates have declined between the 2003 and 2014 KDHS surveys. Total under-5 mortality declined from 115 deaths per 1,000 live births in the 2003 KDHS to 52 deaths per 1,000 live births in the 2014 KDHS. The maternal mortality ratio is 362 maternal deaths per 100,000 live births for the seven-year period preceding the survey; however, this is not statistically different from the ratios reported in the 2003 and 2008-09 KDHS surveys and does not indicate any decline over time.
The proportion of mothers who reported receiving antenatal care from a skilled health provider increased from 88 percent to 96 percent between 2003 and 2014. The percentage of births attended by a skilled provider and the percentage of births occurring in health facilities each increased by about 20 percentage points between 2003 and 2014. The percentage of children age 12-23 months who have received all basic vaccines increased slightly from the 77 percent observed in the 2008-09 KDHS to 79 percent in 2014. Six in ten households (59 percent) own at least one insecticide-treated net, and 48 percent of Kenyans have access to one. In malaria endemic areas, 39 percent of women received the recommended dosage of intermittent preventive treatment for malaria during pregnancy. Awareness of AIDS is universal in Kenya; however, only 56 percent of women and 66 percent of men have comprehensive knowledge about HIV and AIDS prevention and transmission.
The 2014 KDHS was conducted as a joint effort by many organisations. The Kenya National Bureau of Statistics (KNBS) served as the implementing agency by providing guidance in the overall survey planning, development of survey tools, training of personnel, data collection, processing, analysis, and dissemination of the results. The Bureau would like to acknowledge and appreciate the institutions and agencies for roles they played that resulted in the success of this exercise: Ministry of Health (MOH), National AIDS Control Council (NACC), National Council for Population and Development (NCPD), Kenya Medical Research Institute (KEMRI), Ministry of Labour, Social Security and Services, United States Agency for International Development (USAID/Kenya), ICF International, United Nations Fund for Population Activities (UNFPA), the United Kingdom Department for International Development (DfID), World Bank, Danish International Development Agency (DANIDA), United Nations Children’s Fund (UNICEF), German Development Bank (KfW), World Food Programme (WFP), Clinton Health Access Initiative (CHAI), Micronutrient Initiative (MI), US Centers for Disease Control and Prevention (CDC), Japan International Cooperation Agency (JICA), Joint United Nations Programme on HIV/AIDS (UNAIDS), and the World Health Organization (WHO). The management of such a huge undertaking was made possible through the help of a signed memorandum of understanding (MoU) by all the partners and the creation of active Steering and Technical Committees. The Bureau is grateful to all the staff from various institutions and agencies who worked tirelessly to ensure the success of this exercise.