Evidence map›Paper›PMID 41637477›Full record

ArticlePLoS neglected tropical diseases2026

Social, environmental and policy contexts affecting the feasibility and acceptability of improving household flooring for better health in rural Kenya.

Ulrike Fillinger, Victoria A Ochwal, Hugo Legge, Sharon Muli, Karisa Kazungu, Carlos Mcharo, Jacinta Mwongeli, Charles Mwandawiro, Katherine Halliday, Doris Njomo and 3 more

Abstract read
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Article in PLoS neglected tropical diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Ulrike FillingerInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Victoria A OchwalInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Hugo LeggeDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Sharon MuliInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Karisa KazunguInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Carlos McharoEastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya.
Jacinta MwongeliDepartment of Biomechanical and Environmental Engineering, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Charles MwandawiroEastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya.
Katherine HallidayDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Doris NjomoEastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya.
Rachel PullanDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Lynne ElsonKenya Medical Research Institute- Wellcome Trust Research Programme, Kilifi, Kenya.
Stella KephaEastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya.ORCID https://orcid.org/0000-0003-4035-6485

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHomes with unimproved floors (earth, sand, or clay) are associated with increased risks of soil-transmitted parasites and enteric infections, leading to higher morbidity and reduced quality of life. This study explored the enablers and barriers to adopting improved flooring (sealed, washable, and durable) in three culturally diverse regions of Kenya - Narok, Bungoma, and Kwale - to mitigate disease burdens.

methodsBetween August 2021 and July 2022, we conducted 24 focus group discussions with homeowners, stratified by age, gender, and floor type. Additionally, 28 key informant interviews with local government officials, microfinance representatives, and masonry trainers in Kwale and Bungoma provided contextual insights. Transcribed data underwent thematic analysis.

resultsIn the study areas, most homes were constructed by residents themselves using traditional techniques and locally sourced materials. Despite awareness of the health risks, unimproved floors remained widespread. In Bungoma and Kwale, financial constraints and competing household priorities were primary barriers to flooring improvements, while in Narok, cultural identity contributed strongly to the rejection of changes in traditional houses. Key enablers included perceived health benefits and social status, while feasibility depended on the affordability and availability of materials and skilled labour. Strengthening the role of local artisans and leveraging their social influence were seen as effective strategies to shift perceptions on cost and feasibility. Improved collaboration between health and built-environment sectors could enhance community trust and support environmental disease management.

conclusionCommunities in Kwale and Bungoma were more receptive to improved flooring, while cultural practices and preferences in Narok posed significant adoption challenges. For receptive communities, affordable flooring technologies are critical to overcoming financial barriers, while behaviour change initiatives should address cultural and perceptual concerns. However, clinical evidence on locally generated health benefits is needed to support policy decisions and budget allocations for flooring interventions.

Indexed as

Floors and FloorcoveringsHousingAdultFamily CharacteristicsFemaleFocus GroupsHumansKenyaMaleMiddle AgedRural Population

Identifiers

PMID41637477
PMCPMC12923123

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.