“She gives it to her child who doesn’t even talk”: a qualitative exploration of alcohol and drug use among primary school-age children in Uganda

Abstract

Background There is little research on alcohol and other drugs (AOD) use by school-age children in low-resource settings like Uganda. Including the voices of children in research can inform prevention and early intervention efforts for those at risk of AOD use. The aim of this study was to understand the perspectives of children aged 6 to 13 years regarding AOD in Uganda. Methods This qualitative study was conducted in Mbale district, Uganda from February to March 2020. Eight focus group discussions (FGDs) were conducted with 56 primary school-age children, stratified by age (6–9 and 10–13 years), sex (male and female), and school status (in school and out of school). All FGDs were conducted in either Lumasaaba or Luganda. The FGDs were audio-recorded, transcribed verbatim, and translated into English. Data were coded, and overarching themes were identified using thematic framework analysis. Results Two themes identified were (1) Children’s perceptions and experiences with AODs. The participants understood alcohol by its consistency, colour, odour, and by brand/logo. They described the types and quantities of AOD consumed by school-age children, brewing processes for homemade alcoholic drinks, and short and long-term consequences of the use of alcohol. (2) Contributing factors to childhood drinking included: Stress relief for children who experienced multiple adversities (orphaned, poverty-stricken, and hailing from broken homes), fitting in with friends, influence from families, and media exposure that made alcohol look cool. Children would start drinking at an early age) or were given alcohol by their parents, sometimes before they could start talking. In the community, alcohol and other drugs were cheap and available and children could drink from anywhere, including in the classroom. Conclusions Children eligible for primary education in Uganda can easily access and use AOD. Several factors were identified as contributing to alcohol and other drug use among children, including availability and accessibility, advertising, lack of parental awareness and supervision, peer influence, adverse childhood experiences, socioeconomic factors, and cultural norms. There is a need for multi-sectoral action for awareness of childhood AOD use and deliberate consideration of children in the planning, design, and implementation of research, policies, and programs for prevention and early intervention.

Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda

“…While the study focused on a specific region in Uganda, it is crucial to acknowledge the need for caution in generalizing the results to the entire country. However, on the whole, alcohol consumption in Uganda is quite worrying [ 5 , 6 , 57 ]. As such, use of a simple tool like the one we have adapted would be a great resource and strength in the identification of affected children.…”

“…With about half of its population (49.3%) under the age of 15 years [ 3 ], Uganda is home to one of the world’s largest populations of children. Studies have detected alcohol consumption by children in Uganda, with some starting as young as 5 to 8 years old [ 4 – 6 ]. In addition, we found that primary school-age children in Mbale district, Uganda, reported easy access to alcohol, consuming it in various settings, including their homes, schools, and even classrooms during instructional sessions [ 6 ].…”

“…Studies have detected alcohol consumption by children in Uganda, with some starting as young as 5 to 8 years old [ 4 – 6 ]. In addition, we found that primary school-age children in Mbale district, Uganda, reported easy access to alcohol, consuming it in various settings, including their homes, schools, and even classrooms during instructional sessions [ 6 ]. Low family socioeconomic status has been linked to health inadequacies and behavioral risks, including the harmful consumption of alcohol [ 7 ], which is a concern given Uganda’s classification as a low-income country [ 8 ].…”

“…While initially developed for adolescents aged 12–18 years, we acknowledge the evolving landscape of substance use among children under 10 in Uganda [ 6 ], and the associated challenges in healthcare worker perceptions and age-appropriate screening methods. It is important to note that, at the time of our study, routine screening for substance use among primary school-age children, particularly those below 10 years, was not a standard practice in Uganda, yet there was evidence that children in this age group were engaging in alcohol consumption and other substance use.…”