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I send you the articles for retrieved.RESEARCH ARTICLE
Determinants of Primary School NonEnrollment and Absenteeism: Results from a
Retrospective, Convergent Mixed Methods,
Cohort Study in Rural Western Kenya
Nia King1*, Cate Dewey1,2, David Borish1
1 Department of Population Medicine, Ontario Veterinary College, Guelph, Ontario, Canada, 2 Centre for
Public Health and Zoonoses, University of Guelph, Guelph, Ontario, Canada
* nking@mail.uoguelph.ca
Citation: King N, Dewey C, Borish D (2015)
Determinants of Primary School Non-Enrollment and
Absenteeism: Results from a Retrospective,
Convergent Mixed Methods, Cohort Study in Rural
Western Kenya. PLoS ONE 10(9): e0138362.
Editor: Jacobus van Wouwe, TNO, NETHERLANDS
Education is a key element in the socioeconomic development required to improve quality
of life in Kenya. Despite the introduction of free primary education, primary school enrollment and attendance levels remain low. Drawing on qualitative and quantitative data, this
study explores the determinants of non-enrollment and absenteeism in rural western Kenya
and potential mitigation strategies to address these issues.
Received: March 23, 2015
Accepted: August 27, 2015
The study was conducted in Bwaliro village in rural western Kenya. A random sample of 64
students was obtained by blocking the village primary school’s student population according to grade level, gender, and orphan status. Qualitative and quantitative data were collected through interviews with parents, guardians, and key informants, and focus group
discussions with students. Quantitative data were compared using chi-square tests, Student’s T-test, and Poisson regressions. Qualitative data were analyzed using thematic content analysis.
Published: September 15, 2015
Copyright: © 2015 King et al. This is an open access
article distributed under the terms of the Creative
Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
Data Availability Statement: All tabulations of
quantitative data are available freely in the
manuscript, while restrictions contained in the
Research Ethics Board approval render it impossible
to make individual data or transcripts available.
Instead, if requested, a de-identified qualitative
dataset will be made available. Readers are asked to
contact Nia King or Karen Richardson
(krichard@uoguelph.ca) for this data.
Funding: The University of Guelph funded the
project. The funder had no role in study design, data
collection and analysis, decision to publish, or
preparation of the manuscript.
Malaria, menstruation, and lack of money were among the most notable determinants of
primary school dropout and absenteeism, and these factors disproportionately impacted
orphans and female students. Potential mitigation strategies suggested by the community
included provision of malaria treatment or prevention, reduction in education costs, expansion of the established school-feeding program, and provision of sanitary pads.
Despite free primary education, numerous factors continue to prevent children in rural western Kenya from attending primary school. The findings suggest that interventions should
PLOS ONE | DOI:10.1371/journal.pone.0138362 September 15, 2015
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Primary School Non-Enrollment and Absenteeism in Rural Western Kenya
Competing Interests: Nia King and David Borish
have declared that no competing interests exist. Cate
Dewey has read the journal’s policy and has declared
the following competing interest: she initiated the
Children of Bukati project, however, she does not
have any financial ties to the project and she did not
influence the data collection or the interpretation of
the results as presented in this manuscript. This does
not alter the authors’ adherence to PLOS ONE
policies on sharing data and materials.
primarily target orphaned and female students. Prior to implementation, suggested mitigation strategies should be assessed for cost-effectiveness.
Education is a prerequisite to the socioeconomic development needed to alleviate poverty and
improve quality of life. With literacy levels of 90% for men and 83% for women, Kenya is more
literate than Sub-Saharan Africa as a whole, which has average levels of 76% for men and 63%
for women]. However, with a third of the population having incomplete primary education,
Kenya’s labour force lacks the education required to reach its Vision 2030 goals [1–2]. In September 2000, the Kenyan government signed the Millennium Development Goals (MDGs),
aimed to combat the many dimensions of poverty, and subsequently developed the Kenya
Vision 2030, which aims to make Kenya a middle-income country by 2030 [3–4]. School attendance is an important proxy for educational outcomes; by improving access to education,
Kenya would make progress toward achieving both the Vision 2030 Plan and several MDGs
including achieving universal primary education, improving food security, promoting gender
equality, reducing child mortality, improving maternal health, and reducing the levels of HIV/
AIDS and malaria [2–3,5–7].
The Kenyan government views education as the primary means of socioeconomic development and has therefore identified the challenges to achieving universal primary education [4].
These include: limited community participation, inadequate nutrition and health support services, high drop-out rates, imposition of school levies and other fees, cultural prejudice and
negative attitudes towards Orphan and Vulnerable Children (OVCs), and increased numbers
of OVCs [4,8–9]. In 2003, the Kenyan government introduced free primary education to cover
tuition, however families still shoulder the costs of uniforms, activities, exams, and tuition for
the Early Childhood Development (ECD) classes for three to five year old children, which
are substantial expenses for poor families with multiple school-aged children [10–14]. Thus,
despite the government’s 2012 goal of reducing non-enrollment to 5%, it still stands at 9.1%, in
part, due to these costs [15].
Previous studies in Kenya and other Sub-Saharan countries have found that girls, rural children, and impoverished children are at increased risk of being unenrolled [12,16]. As guardians
pressure girls to marry because of dowry payments and having fewer dependents, early marriage and teenage pregnancy play significant roles in the high female dropout level [6,10,17].
Gender stereotyping, such as the belief that women do not require an education as they belong
in the house supporting the family, can also play a role in the higher dropout level for females
[12]. The added responsibilities that orphans must take on, including financial, food, and childcare responsibilities, increase orphans’ dropout risk [1,18–21].
In addition to low enrollment and high dropout levels, absenteeism must be addressed
given 11.4% of enrolled Kenyan children were absent on any given day in 2012 [15]. Cost of
schooling, parental influence, marriage, pregnancy, menstruation, and household chores are
recognized contributors to absenteeism [12,16,22–23]. Lastly, among the preventable medical
causes of absenteeism, malaria infection accounts for 13% to 50% of school days missed in
Kenya [24].
Various interventions aiming to improve primary school enrollment and attendance have
been tested. Comprehensive school support, including food supplementation, school fees, uniforms, and a school-based helper, for orphans in Kenya and Zimbabwe significantly reduced
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Primary School Non-Enrollment and Absenteeism in Rural Western Kenya
dropout and absence rates [6,10,18]. The provision of free sanitary pads to schoolgirls in
Ghana and Kenya has improved girls’ attendance levels, concentration, and confidence [25–
27]. Halliday et al. (2014) found that school-based intermittent malaria screening and treatment was not effective in improving the health or education of school children, while Aikins
(1995) found that impregnating bed nets with insecticides reduced absenteeism due to illhealth [28–29]. In Chile, Dinkelman and Martinez (2014) found that providing students with
information about the opportunities available to finance higher education effectively improved
primary school attendance [30]. Given the widely recognized positive impacts of school-based
feeding programs on school attendance and learning achievements, such programs are beginning to be implemented in many developing countries [31].
While some programs have successfully reduced absenteeism, to the authors’ knowledge, no
studies have examined the perceived benefits of education within rural Kenyan communities.
There is also little knowledge regarding the determinants of dropouts and absenteeism in rural
western Kenya, without which it is difficult to develop effective community-based strategies to
address these issues. We therefore examined the community’s perceptions of the benefits of
education and the main factors contributing to high non-enrollment and absenteeism levels in
Bwaliro village of rural western Kenya. The community’s input regarding possible mitigation
strategies was also sought. The findings will be useful to policy makers and stakeholders to
develop optimal strategies to improve enrollment and attendance levels in rural western
Study Area and Population
This study was conducted in Bwaliro village, located in Busia County of western Kenya
between May and July 2014. Bwaliro village lies in one of Kenya’s poorest regions: 66.7% of
Busia County’s population lives below the poverty line and 76% is food insecure [32–33]. Subsistence farming is the main economic activity; all families rely on their plot of farming land, or
shamba, as a food and/or income source. Western Kenya has the second highest HIV/AIDS
prevalence (6.6%) in all Kenyan regions, resulting in a large orphan population who is at
increased risk of dropping out of school or being absent [1–2,34]. Malaria was the most common disease treated at the local dispensary in patients over the age of five years.
This study was centered on Bwaliro village’s public primary school: Bwaliro Primary School.
School administrators have identified approximately 35% of the Bwaliro students as OVCs. In
2010, the Children of Bukati Organization partnered with the school to establish a feeding and
agro-forestry program [35]. All students from ECD to grade 3, in addition to OVCs from
grades 4 to 8, are fed a lunch of githeri (boiled maize and beans) on a triweekly basis. Additionally, students in grade 8 bring in their own food to cook a daily communal lunch. Yields from
the agro-forestry program are used to subsidize the feeding program. Many children travel
from neighbouring villages to be involved in these programs.
Recruitment and Participants
We conducted a retrospective, convergent mixed methods, cohort study [36]. Students from
grades 1 to 8 were blocked by grade, OVC status, and gender. Four students from each block
were selected, including two replacements, using simple random sampling as follows. Teachers
provided class lists divided by OVC status and gender. Students were numbered and four random numbers per block were selected. If multiple students who cited the same guardian were
chosen, only one was included, and other randomly chosen students replaced the excluded
ones. The researchers visited the selected students’ households. Upon arrival, the interpreter
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Primary School Non-Enrollment and Absenteeism in Rural Western Kenya
explained the project and asked if the parent or guardian (henceforth referred to as guardians)
was willing to participate. The first two students in each block whose guardian was available
and willing to be interviewed were included, yielding a total of 64 students (32 OVCs and 32
NOVCs). The sample size of 64 guardians was based on an estimate of 0.7 days absent for
NOVCs and of 1.6 days for OVCs. We expected a similar difference between boys and girls,
respectively. Based on a variance of 1.2 days, a power of 80%, and a significance level of 0.05,
approximately 28 participants were required in each category. Female guardians were interviewed, as traditionally females are responsible for childcare. If there was no female adult living
in the household, the adult male was interviewed. OVCs were categorized based on which parent died, and guardians were categorized based on their relationship with the child. All guardians were willing to participate. No compensation was offered.
Key informant interviews were conducted with the principal, four teachers, the village chief,
the District Education Officer, a church official, and two local nurses. The 24 grade 6 to 8 students whose guardians had been interviewed were invited to participate in focus group discussions (FGDs). All of these students participated.
Interview Approach
The data were collected using a household questionnaire through a local interpreter who spoke
either Kimarachi (the local vernacular language) or Kiswahili, depending on the guardian’s
preference. The questionnaire was written by the authors in English. Questions were translated
into both Kimarachi and Kiswahili by one interpreter and were then back translated by another
interpreter to ensure that the meaning of the question was maintained. The questionnaire was
piloted in 20 randomly selected village households; appropriate changes were made thereafter.
The opening questions addressed independent variables. Household-level variables were: selfreported household income and number of days the randomly chosen child was absent from
school within the previous two weeks. Guardian level variables were: age, gender, and level of
education. Next, the questionnaire asked open-ended questions regarding perceived level of
community support for education, perceived benefits of education, determinants of dropout
and absenteeism, potential mitigation strategies, and the impacts of pre-established programs
on students’ education.
During the interview process, the interpreter would ask the question, listen to the answer,
and then translate the response for the first author who transcribed the answers. Interviews
were conducted within the guardian’s compound and typically lasted between 30 and 40
Key informant interviews were conducted in English, since all respondents were fluent in
English. Key informants were asked about the level of community support for education, perceived benefits of education, determinants of dropout and absenteeism, potential mitigation
strategies, and observed impacts of pre-established school programs. These interviews were
conducted in the informant’s office, classroom, or home, depending on the interviewee.
No repeat interviews were conducted. A review of the notes showed that after these interviews, data saturation had been reached. All interviews were audio recorded and recordings
were referenced to ensure accurate transcription. The first and third authors, who had been
trained by the second author in interview methodology, conducted all interviews. Transcripts
were not returned to participants; however, results were sent to the interpreters to confirm
accuracy. Initial findings were shared with the community at a community gathering to
obtain feedback. School enrollment and exam results were also obtained from the school’s
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Primary School Non-Enrollment and Absenteeism in Rural Western Kenya
Focus-Group Approach
The first author conducted the FGDs and was trained in facilitation using The Focus Group
Kit [37]. The first author had been integrated into the school community for over a month
prior to starting FGDs. To ensure open discussion, FGDs were conducted according to gender,
grade, and OVC status, yielding a total of six FGDs. The FGDs took place in a private setting at
school, intentionally not within a classroom, to foster an open dialogue. At the outset of the
FGD, the researcher explained the purpose of the study, and all participants gave verbal assent.
The participants were instructed that the discussion could be held in any language and typically
English, with intermittent Kiswahili, was used. Participants were informed that all information
was confidential and that if they felt uncomfortable at any time they could choose to skip the
question or leave the discussion. All FGDs were audio recorded with permission.
Local high school graduates acted as moderators; a female moderator was used for the
female FGDs and a male for the male groups. Both moderators were fluent in Kimarachi, Kiswahili, and English and were given moderation training by the first author. The first author
acted as a note taker to capture the key issues raised. Each discussion lasted for 45 to 60 minutes. In order to standardize the FGDs, a broad open-ended question guide was formulated.
Topics included: benefits of education, reasons for dropout and absenteeism, family and community support of education, and feeding program impacts. For the female groups, menstruation was also included as a topic.
At the conclusion of the FGDs, the moderator and researcher debriefed the FGD to ensure
that the notes were comprehensive and accurate. A review of the notes showed that after these
six FGDs, data saturation had been reached. Transcripts were not returned to participants.
Key informant interview and student FGD qualitative data were independently analyzed using
inductive thematic content analysis [38]. The first and third authors coded the data using
semantic themes and sub-themes to ensure consistency and accuracy [38]. Open-ended question responses from guardians were not blocked during analysis, as most guardians were caring
for both OVCs and NOVCs, and girls and boys. As such, it was impossible to separate these
responses according to OVC status or gender. Given FGDs were conducted according to OVC
status and gender, these data were already blocked as necessary.
Household and guardian level quantitative data were blocked by OVC status and gender,
and results from these groups were compared to investigate differences in the number of days
absent. Chi-square tests were used to compare OVC versus NOVC status and girls versus boys
for proportional data including guardian category. Student’s T-tests were used to compare
OVC and NOVC status and guardian education attained for normally distributed data including self-reported household income. Poisson regressions were used to compare OVC versus
NOVC status, girls versus boys, and guardian category for count data including number of
school days absent and number of school days absent for particular reasons. Significance level
was set at α
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