Voices from the Youth in Kenya Addressing Mental Health Gaps and Recommendations

Memiah, Peter; Wagner, Fernando A.; Kimathi, Robert; Anyango, Naomi Idah; Kiogora, Samuel; Waruinge, Stella; Kiruthi, Faith; Mwavua, Shillah; Kithinji, Celina; Agache, Jeremiah Okuto; Mangwana, Wincolyne; Merci, Niyibeshaho Marie; Ayuma, Leonidah; Muhula, Samuel; Opanga, Yvonne; Nyambura, Maureen; Ikahu, Annrita; Otiso, Lilian

doi:10.3390/ijerph19095366

Cited by 11 publications

(5 citation statements)

References 26 publications

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“…In the context of digital health interventions, HCD is used to create solutions that address the unique challenges and preferences of different populations. Involving vulnerable populations in designing a chatbot that fits their needs is crucial in enhancing service provision and utilization [27,37,48,51]. This could potentially lead to a more extensive population reporting and being linked to GBV response services.…”

Section: Discussionmentioning

confidence: 99%

“…Global pandemics have been documented to increase GBV prevalence among adolescent girls and young women (AGYW) and other vulnerable groups [23,24]. Other factors include stigma and fear associated with GBV affecting reporting and response, low levels of education among AGYW, patriarchal societies that encourage female oppression, limited GBV knowledge and awareness age, and poverty [25][26][27], increasing the risk of this category to GBV. Sexual and gender minorities, including the transgender community, also face disproportionate GBV levels at the hands of intimate partners and strangers and are at an elevated risk of homicide, sexual assault, and sexual harassment due to their sexuality [8,9,28].…”

Section: Introductionmentioning

confidence: 99%

“…Those who experience GBV do not disclose (muted response); if they do, they receive suboptimal services or limited referrals for support and care that are not client-centered care due to institutional system barriers [20,34]. The knowledge gaps limit adolescents' and young people's ability to realize and claim their sexual and reproductive health rights and make informed health decisions [27]. Therefore, there is a need to identify and upscale innovative strategies that can potentially address GBV through awareness creation and providing timely and holistic services [34].…”

Section: Introductionmentioning

confidence: 99%

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Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot

Ngũnjiri,

Memiah,

Kimathi

et al. 2023

IJERPH

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Introduction: Technology advancements have enhanced artificial intelligence, leading to a user shift towards virtual assistants, but a human-centered approach is needed to assess for acceptability and effectiveness. The AGILE chatbot is designed in Kenya with features to redefine the response towards gender-based violence (GBV) among vulnerable populations, including adolescents, young women and men, and sexual and gender minorities, to offer accurate and reliable information among users. Methods: We conducted an exploratory qualitative study through focus group discussions (FGDs) targeting 150 participants sampled from vulnerable categories; adolescent girls and boys, young women, young men, and sexual and gender minorities. The FGDs included multiple inquiries to assess knowledge and prior interaction with intelligent conversational assistants to inform the user-centric development of a decision-supportive chatbot and a pilot of the chatbot prototype. Each focus group comprised 9–10 members, and the discussions lasted about two hours to gain qualitative user insights and experiences. We used thematic analysis and drew on grounded theory to analyze the data. Results: The analysis resulted in 14 salient themes composed of sexual violence, physical violence, emotional violence, intimate partner violence, female genital mutilation, sexual reproductive health, mental health, help-seeking behaviors/where to seek support, who to talk to, and what information they would like, features of the chatbot, access of chatbot, abuse and HIV, family and community conflicts, and information for self-care. Conclusion: Adopting a human-centered approach in designing an effective chatbot with as many human features as possible is crucial in increasing utilization, addressing the gaps presented by marginalized/vulnerable populations, and reducing the current GBV epidemic by moving prevention and response services closer to people in need.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot

Ngũnjiri,

Memiah,

Kimathi

et al. 2023

IJERPH

Self Cite

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“…In Kenya, youth experience a significant burden of mental health problems. Adolescents and young adults ages 10–24 comprise 60% of Kenya’s population with a 10.3% prevalence of mental health disorders (Memiah et al, 2022 ). Based on a 2022 survey, there are around 53 psychiatrists in public facilities for a population of 47 million people in Kenya (Kenya Ministry of Health, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Peer-delivered Problem-solving Therapy for Adolescent Mental Health in Kenya: Adaptation for Context and Training of Peer-counselors

Giusto,

Vander Missen,

Kosgei

et al. 2023

Res Child Adolesc Psychopathol

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Peer-delivered interventions for adolescent mental health can help address poor access to mental health interventions. Questions remain about how interventions can be adapted for peer delivery and whether peers can be trained. In this study, we adapted problem solving therapy (PST) for peer-delivery with adolescents in Kenya and explored whether peer counselors can be trained in PST. We adapted treatment prior to and during training using the Cultural Adaptation and Contextualization for Implementation framework. Nine peer counselors (Ages 20–24) were selected and trained over 10 days. Peer competencies and knowledge were measured pre-post using a written exam, a written case study, and role plays rated using a standardized competency measure. We chose a version of PST used in India with secondary school adolescents originally delivered by teachers. All materials were translated into Kiswahili. Language and format were adapted to Kenyan adolescents as well as for delivery by peers with a focus on understandability and relevance (e.g., noting shared experience). Metaphors, examples, and visual materials were adapted for the context to reflect the culture and vernacular of Kenyan youth. Peer counselors were able to be trained in PST. Pre-post competencies and understanding of content showed improvements with peers minimally meeting patient needs (pre) on average to moderate/fully meeting patient needs (post). Post-training written exam score showed an average 90% correct. There is an adapted version of PST for Kenyan adolescents and peer delivery. Peer counselors can be trained to deliver a 5-session PST in a community context.

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“…being the most widely used illicit drug [ 1 ]. The peak age for drug use is between 18 and 25 years old, with the youth in sub-Saharan Africa being the most affected [ 1 , 2 ]. Kenya has not been spared by this crisis, as reported by the National Authority for the Campaign against Alcohol and Drug Abuse (NACADA).…”

Section: Introductionmentioning

confidence: 99%

Polydrug Use among Students in a Public University in a Lower Middle‐Income Country

Jelagat,

Budambula,

Ngari

et al. 2023

BioMed Research International

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Recreational drug use among students in tertiary institutions remains a public health concern. Despite documentation of drug use in Kenyan universities, most of the studies are based on self-reported history which is prone to social desirability bias. It is in this context that we sought to establish lifetime and current drug use among university students. The study investigated self-reported and confirmed drug use. Using proportionate to size and snowball sampling methods, 380 respondents were enrolled from three university campuses. Actual drug use was confirmed qualitatively using a 6 panel plus alcohol saliva test kit. The study participants’ median (IQR) age was 22 (20–23) years, and 262 (69%) were male; 328 (86%) were degree-level students, while 127 (33%) were in their fourth year and above. A total of 221 (58%) students reported a lifetime ever use of drugs, while 193 (51%) tested positive for at least one drug. Alcohol, tobacco products (cotinine), marijuana, and amphetamine or khat were the most preferred drugs. The usage was either solely, concurrently, or simultaneously. Having multiple sexual partners compared to students with no sexual partner (adjusted risk ratio (aRR) of 2.33 (95% CI 1.45, 3.76)) and residing in Mishomoroni and Kisauni (aRR 1.50 (95% CI 1.08, 2.09)) were associated with risk of testing positive for any drug. Having one (aRR of 1.54 (95% CI 1.05, 2.26)) and multiple sexual partners (aRR 2.03 (95% CI 1.27, 3.25) and residing in Mishomoroni and Kisauni (aRR 1.48 (95% CI 1.05, 2.08)) were associated with self-reported drug use. One out of two students was currently using drugs. Irrespective of the method used to record data, alcohol, tobacco products, marijuana, and amphetamine or khat were the most preferred drugs. The usage was solely, concurrently, or simultaneously. Future interventions should focus on continuing students, students’ residences, and those who are sexually active.

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Voices from the Youth in Kenya Addressing Mental Health Gaps and Recommendations

Cited by 11 publications

References 26 publications

Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot

Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot

Peer-delivered Problem-solving Therapy for Adolescent Mental Health in Kenya: Adaptation for Context and Training of Peer-counselors

Polydrug Use among Students in a Public University in a Lower Middle‐Income Country

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