Addressing determinants of health through intersectoral collaboration: fish farming project in South Imenti constituency in Meru County, Kenya
Globally, the fisheries industry plays an important role in economic, social and health development. In Kenya, this industry contributes to local incomes, subsistence and nutrition, which are all important determinants of health. Addressing determinants of health will have positive consequences for population health outcomes, health equity and yield greater and sustainable returns, including accelerating achievement of the Millennium Development Goals (MDGs). The fisheries industry supports over one million people and provides livelihoods to many other Kenyans. The Government of Kenya in its governance role is committed to the policy of sustainable development and its citizens' well-being, as demonstrated in the Poverty Reduction Strategies (PSR), the Economic Recovery Strategy (ERS) for Wealth and Employment Creation, as well as the social pillar of the Kenya Vision 2030 and the Economic Stimulus Programme policies.
In particular, the intersectoral Economic Stimulus Programme (ESP) was launched to address food insecurity and mitigate the effects of the 2007 post-elections violence and the global economic and financial crisis. Therefore, cross-government action was required to tackle determinants of health and action on health equity.
The ESP was allocated KES 22 billion, which were committed to numerous projects per constituency, in order to bring benefits to other sectors. The sectors that benefited from the funds allocated were education, health and sanitation, environment, local government, industrialization, food production and fisheries. The projects in these sectors were intended to address several social and economic determinants of health by providing basic services to its citizen. These services included water, food, health, and education, creation of business and job opportunities and security.
Among the numerous intersectoral programmes introduced was fish farming or aquaculture. The focus of fish farming (aquaculture) was to improve food and nutrition and create over 120 000 employment and income opportunities. Hence, this case study explores the extent to which fish farming has improved food security (impact on nutrition of household members) and impacted on household employment and income levels.
The findings of the study showed increased food security and improved nutrition. The fish farming project also created employment and generated income for participating households. Of the study participants, 42.4% reported an increase in food availability, 57.6% reported improved household nutrition, 56.1% reported employment opportunities, while 43.9% received income from the fish farming project. The ESP programme has had a positive impact on the underlying determinants of health. Other findings include strengthened intersectoral collaboration as a result of the Economic Stimulus Programme in Kenya, which also enhanced public private partnership in food security initiatives. The study has demonstrated how intersectoral collaboration can have positive consequences, particularly when supported by a political willingness.