Medicine and Health Sciences Commons^™

Strategies For Improving Mental Health And Wellbeing Used By Adults Ageing With Hiv From The Kenyan Coast: A Qualitative Exploration, Peter Mwangala, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing.

Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in …

A Qualitative Inquiry Of Experiences Of Hiv-Related Stigma And Its Effects Among People Living With Hiv On Treatment In Rural Kilifi, Kenya, Stanley Wechuli Wanjala, Moses Nyongesa, Rachael Mapenzi, Stanley Luchters, Amina Abubakar

Institute for Human Development

Background: The pervasiveness of HIV-related stigma and discrimination, and its consequences on HIV prevention and treatment, have been well documented. However, little is known about the lived experiences of HIV-related stigma and its effects among the general adult population living with HIV in rural African settings. This study set out to explore this knowledge gap.

Methods: From April to June 2018, we conducted in-depth interviews with a convenience sample of 40 adults living with HIV aged 18–58 years in Kilifi, Kenya. A semi-structured interview guide was used to explore experiences of HIV-related stigma and its impact on these adults. …

Prevalence And Risk Factors Associated With Depression In Pregnant Adolescents In Nairobi, Kenya, Albert Tele, Joseph Kathono, Shillah Mwaniga, Vincent Nyongesa, Obadia Yator, Onesmus Gachuno, Dalton Wamalwa, Beatrice Amugune, Zul Merali, Manasi Kumar

Brain and Mind Institute

Background: Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolescent mental health. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant adolescents in Nairobi, Kenya.

Methods: We recruited 153 pregnant adolescent (14-18 years) who were accessing maternal health services in one of two Nairobi County primary health care facilities in the cross-sectional survey …

Strategies For Improving Mental Health And Well Being Used By Adults Ageing With Hiv: A Qualitative Exploration, Patrick N. Mwangala, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing.

Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in …

A Systematic Review Of Substance Use And Substance Use Disorder Research In Kenya, Florence Jaguga, Sarah Kanana Kiburi, Eunice Temet, Julius Barasa, Serah Karanja, Lizz Kinyua, Edith Kamaru Kwobah

Anaesthesiology, East Africa

Objectives: The burden of substance use in Kenya is significant. The objective of this study was to systematically summarize existing literature on substance use in Kenya, identify research gaps, and provide directions for future research.

Methods: This systematic review was conducted in line with the PRISMA guidelines. We conducted a search of 5 bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) from inception until 20 August 2020. In addition, we searched all the volumes of the official journal of the National Authority for the Campaign Against Alcohol & Drug Abuse …

Mental Health Disorders Among Post Graduate Residents In Kenya During The Covid-19 Pandemic, Sayed Karar, Jasmit Shah, Katie Du, Nidhi Leekha, Zohray Talib

Internal Medicine, East Africa

Background: Healthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands.

Methods: This cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale–Revised …

Harmful Alcohol Use Among Healthcare Workers At The Beginning Of The Covid-19 Pandemic In Kenya, Florence Jaguga, Edith Kamaru Kwobah, Ann Mwangi, Kirtika Patel, Thomas Mwogi, Robert Kiptoo, Lukoye Atwoli

Internal Medicine, East Africa

Background: Healthcare workers play a key role in responding to pandemics like the on-going COVID-19 one. Harmful alcohol use among them could result in inefficiencies in health service delivery. This is particularly concerning in sub-Saharan Africa where the health workforce is already constrained. The aim of this study is to document the burden and correlates of harmful alcohol use among healthcare workers at the beginning of the COVID-19 pandemic in Kenya with the aim of informing policy and practice.

Methods: This study was a cross-sectional analysis of data obtained from a parent online survey that investigated the burden …

A Four-Component Framework Toward Patient-Centered, Integrated Mental Healthcare In Kenya, Manasi Kumar, Thomas L. Osborn, Cyrus Mugo, Hossein Akbarialiabad, Osman Warfa, Wangui Muthigani Mbuthia, Christine Wambugu, Carol Ngunu, Fatima Gohar, Shillah Mwaniga

Brain and Mind Institute

Background: How can we fast-track the global agenda of integrated mental healthcare in low- and middle-income countries (LMICs) such as Kenya? This is a question that has become increasingly important for individuals with lived experiences, policymakers, mental health advocates and health care providers at the local and international levels.

Discussion: This narrative synthesis and perspective piece encompasses an overview of mental health care competencies, best practices and capacity building needed to fast track patient responsive services. In that vein we also review key policy developments like UHC to make a case for fast-tracking our four-step framework.

Results: While there is …

Perinatal Depression And Its Impact On Infant Outcomes And Maternal-Nurse Sms Communication In A Cohort Of Kenyan Women, Alyssa Hummel, Keshet Ronen, Amritha Bhat, Brenda Wandika, Esther M Choo M. Choo, Lusi Osborn, Maneesh Batra, John Kinuthia, Manasi Kumar, Jennifer A. Unger

Brain and Mind Institute

Abstract: Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity/mortality, and compared SMS communication patterns between women with and without perinatal depression. Methods This was a …

Mental Health During Covid-19 Pandemic Among Caregivers Of Young Children In Kenya’S Urban Informal Settlements. A Cross-Sectional Telephone Survey, Vibian Angweny, Margaret Kabue, Esther Chongwo, Adam Mabrouk, Ezra Too, Rachel Odhiambo, Carophine Nasambu, Joyce Marangu, Derrick Ssewanyana, Eunice Njoroge, Eunice Ombech, Mercy Mokaya, Emmanuel Obulemire, Anil Khamis, Amina Abubakar

Institute for Human Development

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition …

Integrating Telepsychiatry Services In A Care Setting In Kenya: A Case Report, Frank Njenga, Linnet Ongeri, Anna Nguithi, Jacqueline Anundo, Maryann Mugane, Zawadi Kimari, Gathoni Mbugua, Cushny Kaigwa, Lukoye Atwoli

Internal Medicine, East Africa

Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa.

Covid-19 And Mental Well-Being Of Nurses In A Tertiary Facility In Kenya, Sayed Karar, Jasmit Shah, Zohray Talib

Internal Medicine, East Africa

Background: The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa.

Methods: A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic …

Mental Health Disorders Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey From Three Major Hospitals In Kenya, Jasmit Shah, Aliza Monroe-Wise, Zohray Talib, Alphonce Nabiswa, Mohammed Said, Abdulaziz Abeid, Sood Mohamed, Mohamed Ali Mohamed, Sayed Karar

Internal Medicine, East Africa

Background: COVID-19 is an international global health emergency and has posed a great challenge to mental well-being and resilience. Little is known about the mental health impact of COVID-19 among healthcare workers (HCWs) in sub-Saharan Africa or other low-resource settings.

Methods: We conducted a cross-sectional study between August and November 2020 among HCWs recruited from three major hospitals in Kenya. The survey questionnaire consisted of six components: demographic and work title characteristics; information regarding care of patients with COVID-19; and symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardised questionnaires. Multivariable logistic regression analysis was performed …

Harnessing Social Media In Mental Health Practice In Kenya: A Community Case Study Report, Linnet Ongeri, Gathoni Mbugua, Frank Njenga, Anna Nguithi, Jacqueline Anundo, Maryann Mugane, Zawadi Kimari, Loice Wanjiru Cushny Kaigwa, Lukoye Atwoli

Internal Medicine, East Africa

The use of social media to increase awareness on mental health is rapidly gaining momentum globally. However, despite evidence of a growing trend in social media use in sub Saharan Africa, little has been reported on tapping the potential of social media within a mental health practice to not only increase awareness but also facilitate linkage to specialist care. We describe one such mental health practice and its process of integration of the different social media platforms to promote mental health and increase linkage to specialist care. We further highlight the challenges and practical implication of social media use in …

Psychological And Physiological Stress And Burnout Among Maternity Providers In A Rural County In Kenya: Individual And Situational Predictors, Patience A. Afulani, Linnet Ongeri, Joyceline Kinyua, Marleen Temmerman, Wendy Berry Mendes, Sandra J. Weiss

Obstetrics and Gynaecology, East Africa

Background: Stress and burnout among healthcare workers has been recognized as a global crisis needing urgent attention. Yet few studies have examined stress and burnout among healthcare providers in sub-Saharan Africa, and even fewer among maternity providers who work under very stressful conditions. To address these gaps, we examined self-reported stress and burnout levels as well as stress-related physiologic measures of these providers, along with their potential predictors.

Methods: Participants included 101 maternity providers (62 nurses/midwives, 16 clinical officers/doctors, and 23 support staff) in western Kenya. Respondents completed Cohen’s Perceived Stress Scale, the Shirom-Melamed Burnout scale, and other …