Women's health in a marginal area of Kenya.

As eco-demographic pressure on the cultivable areas of tropical Africa increases, women, the main food producers in such areas, are experiencing serious threats to their physical health. Eco-demographic pressure may be defined as the effect of a rapidly-growing population, dependent largely on subsistence production, on the human carrying capacity of an ecological region. Continued subdivision of plots from father to sons, over grazing, and soil erosion lower agricultural productivity and create periodic food shortages, the main burdens falling most heavily upon the poorest people. Migration to cities in search of wage employment, or to lower-potential areas in search of land are common responses. Eco-demographic pressure in the high potential areas of Kenya has been responsible over many years for the migration of agriculturalists into marginal lands. The partial break-up of traditional modes of production and the difficulties of cultivating in a semi-arid environment greatly increase the demands on available labour, whilst levels of health are poor and health care delivery inadequate. It is suggested that women, in particular, are subject to a high degree of stress and evidence of such stress and accompanying ill-health is presented using data from a survey conducted in Kibwezi Division of Machakos District, Kenya. Higher-than-average economic dependence on women is shown in the demographic structure. Water collection patterns show that 70% of all trips are made by women over 15 years over a median distance of 3.5 km and that 87% of women collecting water carry loads without any mechanical assistance compared with 42% of men. Fertility levels remain high and anthropometry revealed that women in the survey were thinner and shorter than a comparable group from a more fertile part of the district. Using functional criteria, the data suggest a higher prevalence of chronic disablement amongst women, compared with men, and the disabilities mentioned tend to reflect the hard lifestyle and high fertility levels of women in Kibwezi.