Background Substance use disorders are a major problem in Uasin Gishu County, Kenya. The objective of this study was to describe the existing resources within substance use treatment facilities in the County, with the aim of guiding policy and interventions. Methods This was a cross-sectional study. We collected data from six substance use treatment facilities within Uasin Gishu County between August and November 2021. We used a researcher-designed questionnaire to collect information on: availability of in-patient and out-patient services; facility ownership (private-for-profit vs government-run); bed capacity; mode of payment for services; cost of services; availability of medicines for substance use treatment; and staffing characteristics. Descriptive statistics were used to summarize the data. Results One facility was run by the National government and the rest were private-for-profit. Uasin Gishu County government had no substance use treatment facility of its own. The total number of beds available within the six facilities was 174 against a population of 1.1 million. All six facilities had stocked at least one medication for substance use disorder treatment. None of the facilities had buprenorphine, buprenorphine naloxone, or methadone. Out-of pocket was the most common mode of payment for services with patients paying using this mode in all the six facilities. Only one facility was accredited by the National Hospital Insurance Fund (NHIF). All facilities had at least one certified addiction counselor and at least one psychologist. Half of the facilities did not have a nurse and two did not have a doctor. The qualification held by most staff was addiction counseling with 41.3% of them having achieved this qualification. Conclusion The facilities were well staffed with psychologists and addiction counselors. Gaps were found as regards bed capacity, use of pharmacotherapy, insurance coverage and availability of nursing staff and doctors. We recommend that the County government in collaboration with key stakeholders invests in substance use treatment in order to address the high burden of substance use disorders in Uasin Gishu County.

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 (the African Journal of Alcohol and Drug Abuse). The results of eligible studies have been summarized descriptively and organized by three broad categories including: studies evaluating the epidemiology of substance use, studies evaluating interventions and programs, and qualitative studies exploring various themes on substance use other than interventions. The quality of the included studies was assessed with the Quality Assessment Tool for Studies with Diverse Designs. Results Of the 185 studies that were eligible for inclusion, 144 investigated the epidemiology of substance use, 23 qualitatively explored various substance use related themes, and 18 evaluated substance use interventions and programs. Key evidence gaps emerged. Few studies had explored the epidemiology of hallucinogen, prescription medication, ecstasy, injecting drug use, and emerging substance use. Vulnerable populations such as pregnant women, and persons with physical disability had been under-represented within the epidemiological and qualitative work. No intervention study had been conducted among children and adolescents. Most interventions had focused on alcohol to the exclusion of other prevalent substances such as tobacco and cannabis. Little had been done to evaluate digital and population-level interventions. Conclusion The results of this systematic review provide important directions for future substance use research in Kenya. Systematic review registration PROSPERO: CRD42020203717.

Background: 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) 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 (the African Journal of Alcohol and Drug Abuse). The results of eligible studies have been summarized descriptively and organized by the three broad categories: (1) Studies evaluating the epidemiology of substance use, (2) studies evaluating interventions and programs, and (3) qualitative studies exploring various themes on substance use. The quality of the included studies was assessed with the Quality Assessment Tool for Studies with Diverse Designs.Results: Of the 185 studies that were eligible for inclusion, 144 investigated the epidemiology of substance use, 23 qualitatively explored various substance use related themes, and 18 evaluated substance use interventions and programs. Key evidence gaps emerged. Firstly, vulnerable populations such as police officers, pregnant women, health care workers and persons with physical disability had been under-represented within the epidemiological and qualitative work. Secondly, no intervention study had been conducted among children and adolescents. Thirdly, most interventions had focused on alcohol to the exclusion of other prevalent substances such as tobacco and cannabis. Finally, little had been done to evaluate digital and population-level interventions. Conclusions: The results of this systematic review provide important directions for future substance use research in Kenya. Systematic review registration: PROSPERO: CRD42020203717

Background and Objective:In Kenya, youth needing mental health (MH) treatment vastly outnumber licensed mental health professionals. Task-sharing MH treatment to non-professionals has potential to reduce the treatment gap. For youth, non-professional peer counselors have the benefit of increasing engagement and reducing stigma. Problem-solving therapy (PST) is one treatment shown to alleviate MH symptoms even when delivered by non-professionals. Here we (1) evaluate the implementation of a PST training and (2) codify adaptations for PST implementation at a youth drop-in center at Family Health Options Kenya. Experimental Design or Project Methods:A 2-week training for peer mentors was conducted. Curriculum included core counseling skills, overview of MH, and PST introduction and application.Peer Outcomes: Mean scores from pre- and post-written exams were compared using paired t-tests. Standard role plays were evaluated using the Working with children – Assessment of Competencies Tool (WeACT). Consensus WeACT scores from pre- and post-role plays were compared using paired t-tests.Adaptations: Feedback on cultural acceptability, language comprehensibility, and intervention flow was collected. Proposed intervention changes were coded within the Ecological Validity Model framework. Results:Based on a written exam, mentors’ knowledge of MH conditions and core counseling skills improved after training (Pre: 10.88±4.36; Post: 15.38±2.88; p=.026). Competence in application of counseling skills evaluated with WeACT improved after training (Pre: 20.63±6.61; Post: 28±1.69). Examples of adaptations to PST include: changes to address stigma for MH treatment in Kenya and redistribution of content between sessions. Conclusion and Potential Impact:A 2-week PST training improved peers' counseling skills and ability to deliver a manualized PST treatment. Training allowed contextual, conceptual, and methodological adaptations to PST for use in a Kenyan context. Implementing and improving lay-counselor trainings for MH interventions in Kenya has the potential to increase access to preliminary MH treatment.

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