Key Indicators

Millennium Development Goals for 2015 Indicator 2014 KDHS Indicator Goal 1: Eradicate extreme poverty and hunger Prevalence of underweight children under 5 years of age Goal 2: Achieve universal primary education Net attendance ratio in primary education Literacy rate of 15-24 year olds Goal 3: Promote gender equality and women’s empowerment Ratio of girls to boys in primary, secondary, and tertiary education Goal 4: Reduce child mortality Under-five mortality rate Infant mortality rate Proportion of 1 year-old children immunised against measles Goal 5: Improve maternal health Adolescent birth rate Contraceptive prevalence rate Antenatal care coverage Births attended by skilled health professional Goal 6: Combat HIV/AIDS, malaria, and other diseases Condom use at last high-risk sex Population age 15-24 with comprehensive knowledge of HIV Ratio of school attendance of orphans to school attendance of non-orphans age 10-14 Goal 7: Ensure environmental sustainability Population using an improved water source Population using an improved sanitation facility Goal 8: Develop a global partnership for development Not applicable to 2014 KDHS

Educational Attainment of Respondents Age 15-49 Percent of women and men age 15-49 7% of women and 3% of men have never attended school. 26% of both women and men attended, but did not complete, primary school. One-quarter of women and 23% of men completed primary school without continuing to secondary education. More than 4 in 10 women and nearly half of men attended secondary school or higher.

Births per woman for the three-year period before the survey Fertility Trends Births per woman for the three-year period before the survey At current fertility levels, a Kenyan woman will have an average of 3.9 children in her lifetime. There is an overall decline in fertility from 6.7 births per woman in 1989 to 3.9 births per woman in 2014. *Data before 2003 exclude North Eastern region and several northern districts in Eastern and Rift Valley regions.

Fertility by County The counties with the lowest TFR are Kirinyaga (2.3) followed by Nyeri, Kiambu, and Nairobi, all with a TFR of 2.7. The counties with the highest TFR are Wajir (7,8), West Pokot (7.2), Turkana (6.9), and Samburu (6.3). Births per woman for the three-year period before the survey

Teenage Childbearing by Education Percent of women age 15-19 who are mothers or pregnant with their first child Overall, 18% of young women age 15-19 have given birth or are pregnant with their first child. Teenage fertility is higher among women with less education: teenage pregnancy prevalence is one-third among women with no education and 36% among women who’ve completed primary school. Teenage fertility is lowest among young women who have secondary or higher education (12%).

Fertility Preferences of Married Women Percent distribution of currently married women age 15-49 by desire for children Half of currently married women want no more children or are sterilised. 13% of women want another child soon (within 2 years) while 32% of women want another child 2 or more years later.

Current Use of Contraception Percent of women age 15-49 The contraceptive prevalence rate (CPR) is defined as the percent of married women using a method of contraception. Currently, the CPR for Kenya is 58% with 53% of married women using modern methods of contraception and 5% using any traditional method of contraception. Among married women, injectables, implants, and the pill are the most popular. 65% of sexually active unmarried women are using a method of contraception, 61% are using a modern method. Male condoms are the most popular method among sexually active unmarried women (21%).

Current Use of Contraception by County 25 counties have a contraceptive prevalence rate above the national average (58%); 6 of which are greater than 75% - Kirinyaga (81%), Makueni (80%), Meru (78%), Machakos (76%), Tharaka-Nithi and Kiambu (74%). Counties with the lowest contraceptive prevalence are Mandera and Wajir (2% each). Percent of currently married women age 15-49 currently using any method of family planning

Trends in Use of Contraception Percent of currently married women age 15-49 Goal 5 Use of any contraception has greatly increased from 27% in 1989 to 58% in 2014. The MDG target for contraceptive prevalence rate is 70%. Kenya has not reached this goal. Modern method contraceptive use has increased from 18% in 1989 to 53% in 2014. *Data before 2003 exclude North Eastern region and several northern districts in Eastern and Rift Valley regions.

Demand for Family Planning Percent of currently married women age 15-49 Overall, 18% of currently married women have an unmet need for family planning. 58% percent of women have a met need for family planning or are using a contraceptive method. If all currently married women who say they want to space or limit their children were to use a family planning method, the CPR would increase to 76%, or total demand. Of the total demand for family planning methods, 77% is met by using any method and 71% is met by using modern methods.

Trends in Childhood Mortality Deaths per 1,000 live births for the five-year period before the survey Goal 4 The current level of infant mortality is 39 deaths per 1,000 live births. The level of under-five mortality is 52 deaths per 1,000 live births. At these current mortality levels, 1 in every 19 children in Kenya dies before their 5th birthday. Childhood mortality has decreased since 1989, when infant mortality was 61 deaths per 1,000 live births and under-five mortality was 90 deaths per 1,000 live births. MDG target for infant mortality is 22 deaths per 1,000 live births. The MDG target for under-5 mortality is 32 deaths per 1,000 live births. *Data before 2003 exclude North Eastern region and several northern districts in Eastern and Rift Valley regions.

Trends in Neonatal Mortality Deaths per 1,000 live births for the five-year period before the survey *Data before 2003 exclude North Eastern region and several northern districts in Eastern and Rift Valley regions.

Summary of child mortality trends

Assistance during Delivery by County All counties in the Central region achieved a level of at least 85% or greater, while the counties in Nyanza region all achieved at least 53%.Less than one-third of births were attended by a skilled provider in Tana River, Wajir, Marsabit, Turkana, West Pokot, and Samburu. Percent of live births in the five-year period before the survey delivered by a skilled provider (doctor, nurse, or midwife)

Delivery in a Health Facility by County All counties in the Central region achieved a level of at least 85% or greater, while the counties in Nyanza region all achieved at least 53%. Less than one-third of births were delivered in a health facility in Tana River, Wajir, Marsabit, Turkana, West Pokot, and Samburu. Percent of live births in the five-year period before the survey delivered in a health facility

Trends in Maternal Health Percent of live births in the five-year period before the survey Goal 5 Since 2003 maternal health indicators have improved. ANC by a skilled provider has increased from 88% in 2003 to 96% in 2014. Skilled assistance during delivery has increased from 42% in 2003 to 62% in 2014. Facility-based deliveries have increased from 40% in 2003 to 61% in 2014. The MDG target for ANC by skilled provider is 100%. Kenya is close to reaching this goal. The MDG target for skilled assistance during delivery is 90%. Kenya has not reached this MDG target. *Skilled provider includes doctor, nurse, or midwife.

Postnatal Care (PNC) Among women age 15-49 who had a live birth in the two years before the survey, percent who had a postnatal checkup in the first two days after birth Half of women received a postnatal checkup within the first two days after birth. Women in urban areas are more likely to have a postnatal checkup than women in rural areas (65% vs. 43%).

Childhood Vaccinations Percent of children age 12-23 months vaccinated 97% of children received the BCG vaccination and 71% are vaccinated against measles. Coverage of the 1st dose of the Pentavalent and polio vaccines is relatively high (98% and 97%, respectively); however, 90% received the 3rd dose of Pentavalent and 81% received the third dose of polio. Overall, 68% of children age 12-23 months have received all basic vaccinations. 2% of children did not receive any vaccination at all. The pneumococcal vaccine was introduced into Kenya’s routine immunisation programme in February 2012. The Kenyan immunization programme considers a child to be fully vaccinated if the child has received all basic vaccinations and 3 doses of pneumococcal vaccination. In Kenya, the 1st dose of pneumococcal vaccination (94%) is higher than the subsequent doses (91% and 85%, respecitively). Overall, 68% of Kenyan children are fully vaccinated. The MDG target for measles vaccination is 90% by 2015. The current level of 87% of one year old with this vaccination does not meet the MDG target. Pentavalent Polio Pneumococcal

Vaccination Coverage by County * At the county level, Mandera (28%), Migori (38%), and Wajir (38%) have low fully vaccinated coverage. Coverage levels are highest in Nandi (94%), Vihiga (91%), and Tharaka-Nithi (91%). Percent of children age 12-23 months fully vaccinated *Kirinyaga county figure based on fewer than 25-49 unweighted cases.

Childhood Illnesses Among children under 5 with symptoms of acute respiratory infection (ARI), fever, or diarrhoea, percent whom advice or treatment was sought from a health facility or provider Among children under 5 with symptoms of ARI, 66% sought treatment or advice from a health facility or provider. Among children under 5 with fever, 63% sought advice or treatment from a health facility or provider. Among children under 5 with diarrhoea, more than half sought treatment of advice from a health facility or provider (58%).

Nutritional Status of Children Percent of children under 5 26 4 The nutritional status of young children is a comprehensive index that reflects the level and pace of household, community, and national development. Malnutrition is a direct result of insufficient food intake or repeated infectious diseases or a combination of both. It can result in increased risk to illness and death and can also result in a lower level of cognitive development. Children who are stunted are considered too short for their age. 26% of children are stunted. Children who are wasted are too thin for their height. 4% of children are wasted. Children who are underweight are too thin for their age. 11% of children are underweight. The MDG target for underweight is 15%. This goal has been achieved. 11 *Based on the 2006 WHO Child Growth Standards

Stunting by County At the county level, West Pokot and Kitui counties have the highest levels of stunting (46%). Nyeri, Garissa, and Kiambu counties have the lowest percentage of stunted children, each less than 16%. Percent of children under 5 who are stunted, or too short for age

Trends in Nutritional Status of Children Percent of children under 5 Overall, nutritional status of children has slightly improved since 2003 with declines in stunting, wasting, and underweight. *Based on the 2006 WHO Child Growth Standards

Breastfeeding Status Under 6 Months Percent distribution of youngest children under 6 months who are living with their mother by breastfeeding status Supplementing breast milk with other liquids or foods starts at an early age in Kenya. 61% of children under 6 months were exclusively breastfed. Contrary to the recommendation of exclusive breastfeeding, 23% of children under 6 months were given plain water, other milk, or other non-milk liquids while 15% were fed complementary foods in addition to breast milk. 1% of children are not breastfed.

ITN Ownership by County In Kenya, an ITN is defined as either 1) factory-treated net that doesn’t require additional treatment, or 2) a net that has been soaked with insecticide within the past 6 months. ITN ownership is highest in Kisumu (88%), Kisii (86%), and Nyamira (85%). ITN ownership is lowest in Nyandarua (13%), Laikipia (18%), and Samburu (19%). Percent of households with at least one insecticide-treated net (ITN)

Ownership of and Access to ITNs Percent of household population Percent of households While 59% of households own at least one ITN, only 34% of households have enough ITNs to cover each hsouehld member, assuming one ITN is used by two people. Among the household population, nearly half has access to an ITN – could sleep under an ITN if each ITN in the household were used by up to 2 people. In Kenya, an ITN is defined as either 1)factory-treated net that doesn’t require additional treatment, or 2) a net that has been soaked with insecticide within the past 6 months. *Assuming one ITN covers 2 people

Use of ITNs Percent who slept under an ITN the night before the survey among all households Percent who slept under an ITN the night before the survey among households with at least one ITN More than half of children under 5 and pregnant women slept under an ITN the night before the survey.—the groups most at risk from malaria. Owning a net does not automatically mean families use it. 77% of children under 5 and 77% of pregnant women in households with an ITN slept under an ITN the night before the survey. In Kenya, an ITN is defined as either 1)factory-treated net that doesn’t require additional treatment, or 2) a net that has been soaked with insecticide within the past 6 months.

Intermittent Preventive Treatment during Pregnancy (IPTp) Percent of women age 15-49 with a live birth in the two years before the survey who: Malaria during pregnancy contributes to low birth weight, infant mortality, and other complications. To prevent malaria, pregnant women should receive two or more doses of SP/Fansidar during an ANC visit. 30% of women received any SP/Fanisdar during an ANC visit. Only 17% of women received 2 or more doses of SP/Fansidar and received at least one during an ANC visit. 1 in 10 women received 3 or more doses of SP/Fansidar and received at least one during an ANC visit.

Fever in Children In the 2 weeks before the survey, 24% of children under 5 had a fever. 72% were taken to a health facility or provider for advice or treatment. 35% had blood taken from a finger or heel for testing. 27% took antimalarial drugs. 23% took ACT. Nearly one-quarter of children had fever within the 2 weeks before the survey. Of these children, 72% were taken to a health facility, provider, or pharmacy for treatment or advice. More than one-third had there blood taken from finger or heel for testing. More than one-quarter were given antimalarials. 23% were given ACT.

Knowledge of HIV Prevention Methods Percent of women and men age 15-49 who know that HIV can be prevented by: Men generally have higher knowledge of HIV prevention methods than women. 80% of women and 88% men know that the risk of getting HIV can be reduced by using condom. 92% of women and 94% of men know that HIV can be prevented by limiting sex to one faithful, uninfected partner. Overall, 77% of women and 85% of men know that HIV can be prevented by both methods.

Comprehensive Knowledge of HIV among Youth by Residence Percent of women and men age 15-24 with comprehensive knowledge* of HIV Comprehensive knowledge is an indicator that measures how much young people know about transmission and prevention of HIV. Comprehensive knowledge includes knowing that condoms and monogamy prevent HIV transmission, that a healthy looking person can have HIV infection, and rejects the two most common local misconceptions about HIV transmission. This slide shows that young men are somewhat more informed than young women; and urban women and men are more informed than their rural counterparts. The MDG target for comprehensive knowledge among all youth is 85%. *Comprehensive knowledge means knowing that the risk of getting HIV can be reduced by using condoms and limiting sex to one uninfected partner, knowing that a healthy looking person can have HIV, and rejecting the two most common local misconceptions about HIV prevention and transmission.

Multiple Sexual Partners Among women and men age 15-49 who had 2+ sexual partners in past 12 months, percent who: Among women and men age 15-49 who have ever had sexual intercourse: Percent of women and men age 15-49 who had: Men are more likely than women to report having multiple partners in the past 12 months. 13% men have had 2 or more partners compared to only 1% of women. Among both men and women with multiple partners in the past year, 4 in 10 women and 44% of men say they used a condom at last intercourse. Men report having more lifetime sexual partners than women, more than 3 times as many partners (2.1 for women versus 6.8 for men).

Percent of women and men age 15-49 HIV Testing Percent of women and men age 15-49 83% of women nationwide and 71% of men have been tested at some time and received the results. In the 12 months before the survey, more than half of women and 46% of men have been tested and received the results.

Recent HIV Testing by County: Women Recent HIV testing among women is highest in Kisumu county at 71% and lowest in Mandera county at 8%. Percent of women age 15-49 who were tested for HIV in the past 12 months and received their results

Recent HIV Testing by County: Men Recent HIV testing among men is highest in Siaya county at 68% and lowest in Mandera county at 3%. Percent of men age 15-49 who were tested for HIV in the past 12 months and received their results

Trends in Recent HIV Testing Percent of women and men age 15-49 who were tested for HIV in the past 12 months and received their results HIV testing has improved dramatically since 2003 when only 7% of women and 8% of men had been tested and received their results within the 12 months before the survey.

Experience of Domestic Violence Percent of ever-married women and men age 15-49 who have ever experienced physical or sexual violence committed by their spouse/partner 38% of ever-married women have ever experienced physical violence compared to 9% of ever-married men. In this context, physical violence means any type of physical violence, whether it is experienced at home or in another location, such as the workplace or school. 14% of ever-married women have ever experienced sexual violence compared to 4% of ever-married men. 41% of ever-married women have ever experienced physical or sexual violence, while 11% of ever-married men have ever experience either form of violence from a partner.

Percent of women age 15-49 who: Female Circumcision Percent of women age 15-49 who: Knowledge of female circumcision is nearly universal. Overall, 21% of women in Kenya have been circumcised. Female circumcision is nearly universal in North Eastern region (98%) compared with Eastern region (26%).

Female Circumcision by Age Percent of women age 15-49 circumcised Female circumcision is less common among younger women and is perhaps on the decline: 11% of women age 15-19 are circumcised compared with more than 20% among women over age 30. More than 40% of women age 45-49 are circumcised.

1% of Kenyan women have ever experienced fistula. The 2014 KDHS included a series of questions on fistula, a condition that develops when the blood supply to the tissues of the vagina, bladder, and/or rectum is cut off during prolonged obstructed labour, resulting in the formation of an opening between the bladder or rectum and the vagina through which urine and/or faeces pass uncontrollably. Women who develop fistula are often socially rejected. Only 1% of women report ever experiencing fistula symptoms.

Key Findings Women have an average of 3.9 children. The contraceptive prevalence rate of any contraceptive method among married women is 58%. Infant mortality rate is 39 deaths per 1,000 live births and under-five mortality rate is 52 deaths per 1,000 live births. 61% of births were delivered in a health facility. 68% of children received are fully vaccinated. 26% of children under 5 are stunted (too short for age). 48% of Kenyan household population has access to an ITN. 53% of women and 46% of men were tested for HIV in past 12 months and received the results of the test. 21% of women in Kenya are circumcised.