Kenya mental health country profile

Njenga, Frank; Okonji, Max; Kigamwa, Pius

doi:10.1080/09540260310001635096

Cited by 38 publications

(37 citation statements)

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“…There are few mental health providers in Kenya 17 . Nevertheless, depression can be effectively treated in low-income countries 39,100,101 .…”

Section: Discussionmentioning

confidence: 99%

“…The social, economic and health impact of depression in sub-Saharan Africa is also great, where depression is associated with mortality 2-5 , work disability 4-7 , lower quality of life 5,[8][9][10][11][12] , risk of heart disease 13 and high-risk behaviors for contracting HIV infection 14 . With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .…”

mentioning

confidence: 82%

“…The PHQ-9 scoring algorithm for DSM-IV diagnoses of MDD and ODD is described elsewhere (p. 607) 57 . The PHQ-9 total score ranges from 0 to 27 with five severity categories: minimal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27). General health perception rating was administered 85 : "In general how would you rate your overall health right now?"…”

Section: Methodsmentioning

confidence: 99%

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Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

et al. 2008

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BACKGROUND: Depression greatly burdens subSaharan Africa, especially populations living with HIV/ AIDS, for whom few validated depression scales exist. Patient Health Questionnaire-9 (PHQ-9), a brief dualpurpose instrument yielding DSM-IV diagnoses and severity, and PHQ-2, an ultra-brief screening tool, offer advantages in resource-constrained settings. OBJECTIVE:To assess the validity/reliability of PHQ-9 and PHQ-2. DESIGN: Observational, two occasions 7 days apart.PARTICIPANTS: A total of 347 patients attending psychosocial support groups.MEASUREMENTS: Demographics, PHQ-9, PHQ-2, general health perception rating and CD4 count. RESULTS:Rates for PHQ-9 DSM-IV major depressive disorder (MDD), other depressive disorder (ODD) and any depressive disorder were 13%, 21% and 34%. Depression was associated with female gender, but not CD4. Construct validity was supported by: (1) a strong association between PHQ-9 and general health rating, (2) a single major factor with loadings exceeding 0.50, (3) item-total correlations exceeding 0.37 and (4) a pattern of item means similar to US validation studies. Four focus groups indicated culturally relevant content validity and minor modifications to the PHQ-9 instructions. Coefficient alpha was 0.78. Test-retest reliability was acceptable: (1) intraclass correlation 0.59 for PHQ-9 total score, (2) kappas 0.24, 0.25 and 0.38 for PHQ-9 MDD, ODD and any depressive disorder and (3) weighted kappa 0.53 for PHQ-9 depression severity categories. PHQ-2 ≥3 demonstrated high sensitivity (85%) and specificity (95%) for diagnosing any PHQ-9 depressive disorder (AUC, 0.97), and 91% and 77%, respectively, for diagnosing PHQ-9 MDD (AUC, 0.91). Psychometrics were also good within four gender/age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) subgroups.CONCLUSIONS: PHQ-9 and PHQ-2 appear valid/ reliable for assessing DSM-IV depressive disorders and depression severity among adults living with HIV/AIDS in western Kenya. INTRODUCTIONMore than 70% of all deaths attributable to HIV/AIDS are in sub-Saharan Africa, with approximately 6.1% of adults living with HIV in Kenya in 2005 1 . The social, economic and health impact of depression in sub-Saharan Africa is also great, where depression is associated with mortality 2-5 , work disability 4-7 , lower quality of life 5,[8][9][10][11][12] , risk of heart disease 13 and high-risk behaviors for contracting HIV infection 14 . With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .Depression in sub-Saharan Africa presents in forms (culturespecific idioms, somatic, based on interpersonal relationships or spiritual in nature) that may o...

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“…There are few mental health providers in Kenya 17 . Nevertheless, depression can be effectively treated in low-income countries 39,100,101 .…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

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Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

et al. 2008

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“…Other Kenyan psychiatrists are active in research collaboration with international partners (Jenkins et al, 2002;Kiima et al, 2004). One area into which research is currently being undertaken is drug and alcohol misuse.…”

Section: Researchmentioning

confidence: 99%

Mental health policy and programmes in Kenya

Njenga¹,

Kigamwa

2005

Int. psychiatry

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Following a 10-year war of liberation (fought by the Mau Mau against the British), Kenya attained full independence from colonial rule in 1963. For 10 years the country enjoyed rapid economic growth (6–7% per annum) but this slowed steadily to near stagnation in the 1990s. Poor governance, abuse of human rights, internal displacements of citizens, large numbers of refugees from neighbouring countries and the AIDS pandemic conspired to reduce Kenyans’ life expectancy to 47 years (in the UK it is presently 77 years). Some 42% of the population now live below the poverty line, and 26% of Kenyans exist on less than US$1 per day. The annual per capita income in Kenya is US$360 (in the UK it is $24 000) (World Bank, 2002). AIDS currently has an estimated prevalence rate of 12%. In large parts of rural Kenya many sexually active adults are unable to work, and elderly grandparents are left to look after orphaned children (some already infected with HIV), as they struggle to deal with their own grief for the loss of many of their own children. In December 2002 a new government was elected, which gives some grounds for optimism in an otherwise bleak situation.

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“…Of Kenya's approximately 31,500,000 people (WHO, 2004), 2 20% are now urban, with the rate of urbanization increasing rapidly (Kiima et al, 2004, p. 58). 3 In the process, vocational choice and economic migration are now two commonplace examples of decision-making which have become subject to greater individual autonomy and less to familial influence over the past two decades. Career opportunities for educated women have increased even more rapidly than for men.…”

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confidence: 99%

MTV, Technology, the Secular Trend, and HIV/AIDS: Why Kenyan Parents Need to Learn about Adolescent Development

Ginsberg

Gekonge

2004

Dialect Anthropol

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As technological innovation increases the pace of communication and trade, traditional patterns of family interaction, education for adult social and vocational roles, belief systems, health and dietary practices also change. This is so because it is generally the young who are most heavily exposed to imported ideas and practices. They become the early adopters not only of technology, but also of trivial fashion fads and of profound, life-changing behavior, values, and ideology. At no stage in life is this more apparent and of greater concern to their elders than when it occurs concurrent with the physical changes marking puberty.Traditionally, the biological changes of puberty were both themselves predictable and predictably associated with changes in social role, often marked by rites of passage and always marked by change of status within the community. In recent times, however, the timing of puberty itself has changed. It is now earlier, most markedly so among urban dwellers, and catches children and families unaware. This, more than the annoyingly rapidly turnover in fads related to popular culture that are readily accessible even in remote areas through communications technology, is likely to be a source of family conflict.Consider the case of the individual going through puberty at 12 to 13 years of age when his or her parents' and grandparents' cohort was one, two, or more years older. The community is faced with girls and boys who are physically mature, but who have neither learned to do the tasks traditionally expected of women and men nor had adequate life experience to take on the responsibilities of young adulthood. This disturbing situation is rendered even more discordant when the individuals concerned are challenging elders' authority, behaving like children at one moment and claiming adult privilege the next. In societies without the concept of adolescence as a life stage, the appearance of what are, to Europeans and North Americans, familiar adolescent behaviors brings confusion and, in cultures with high HIV transmission rates, also threatens the continued existence of the community itself.

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Kenya mental health country profile

Cited by 38 publications

References 0 publications

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

Mental health policy and programmes in Kenya

MTV, Technology, the Secular Trend, and HIV/AIDS: Why Kenyan Parents Need to Learn about Adolescent Development

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