Case Study: Discussing Tuberculosis with the Urban Poor In Kenya

A program designed to discuss TB with the urban poor would face many challenges: not only does the target group tend to be resource-poor and poorly educated, but TB does not seem to be a common topic of discussion. Defining the urban poor as urban residents who described their household income as "not having enough money even for food" or as "having enough money for food but not always enough for clothes," 60 respondents from the AudienceScapes 2009 kenya Survey give us a small subsample from which to construct a basic profile of the target group. We see in Table 1 that about half are “working poor,” engaged in sales/retail jobs, agriculture (despite their urban homes), or service industries. Slightly more than average reported their current health as not good or very bad.

Table 1: Profile of Urban Poor

AudienceScapes National Survey of Kenya, July 2009 N = 60 adults (15+) who were identified as Urban Poor.

Table 2 gives an idea of how little information about TB the urban poor currently receive. Although three quarters said they were satisfied with the information available to them, about a third said they had not heard anything about TB in the last month. The most common sources of information about TB were radio and friends and family; medical doctors were only cited by 18 percent of the target group—the same reach as TB information from TV. Although three quarters said they had discussed health issues in the last year, only a third said they had received information about TB from their top word-of-mouth source, friends and family. 

Table 2: Information-Gathering Habits of Urban Poor

AudienceScapes National Survey of Kenya, July 2009 N = 60 adults (15+) who were identified as urban poor.

The detailed data about the target group point to key elements of a tailored strategy:

• Less information about TB than some other health topics is reaching this target group, so it might be useful to incorporate TB messages into successful existing health campaigns.
• Alternatively, since half of this group are actually “working poor” (employed in sales/retail, agriculture, or service industries), workplace education is a possible focus.
• Schools-based programs are less likely to start a discussion about TB, given that few of the urban poor identify themselves as students.
• Urban poor respondents to the survey said they trusted information about health from the radio as much as any other source (including medical doctors), but only 65 percent had received TB information from the radio. This suggests an opportunity for public health workers to bring TB to more people’s attention via radio programs.
• Another opportunity is the majority of urban poor who own mobile phones and could be (but are not yet) receiving information about TB by SMS. The untapped potential of SMS messaging includes not just education about TB but the opportunity for the urban poor to ask questions or receive reminders and tips for adhering to a TB treatment regimen.
  

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