Examining Wealth Trends in Kombewa, Kenya

This study examined wealth trends in a rural Kenyan community between 2011 and 2018. Understanding wealth trends is important for understanding health outcomes and overall well-being of vulnerable communities, and for informing economic and health policy that can improve specific wealth challenges. Information regarding household materials, assets, education, and mortality from 20,370 households in the Kombewa Health and Demographic Surveillance System was used. Three indices were developed and compared to quantify wealth: a principal component analysis of assets, a multiple correspondence analysis of assets, and the multidimensional poverty index. Wealth quintiles and levels of deprivation relating to socioeconomic status were then created and analyzed over time. Wealth measured by the asset-based indices, suggested an increase in wealth during the assessment period with the percentage of households in the wealthiest quintile increasing from 19 to 23%. The multidimensional poverty index, however, suggests no change in socioeconomic status over time. Among other factors, a lack of access to sanitation and improved water seems to be the main justification. Our results indicate that households are accumulating assets, but their increased accumulation is not translating to changes in living conditions known to improve health. Hence, while houses may be getting wealthier, they may not necessarily be getting healthier.