Browsing by Author "Kiilu, Colleta"
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Item Disparities in Knowledge, Attitude and Practices on Mental Health among Healthcare Workers and Community members in Meru County, Kenya(2022) Kimathi, George; Kiilu, Colleta; Musembi, Jack; Mukami, Diana; Mwenda, Catherine; Opanga, YvonneBackground Mental health (MH) remains a neglected priority in many low and middle-income countries. Currently, there is inadequate data on the prevalence of mental health in Kenya. This is compounded by huge inequity in the distribution of skilled human resources for mental health services. Inadequate knowledge about mental health and negative attitudes towards people with mental health disorders is widespread among the general public. Methods This was a descriptive cross-sectional survey that utilised mixed methods for data collection. A total of 535 community members and 109 healthcare workers (HCWs) were targeted for the study. All cadres of healthcare workers in the selected health facilities who voluntarily consented to participate were recruited through simple random sampling. Data were collected using household surveys, Key Informant Interviews (KIIS) with facility in-charges; Focus Group Discussions (FGD) with community members particularly community Health Volunteers (CHVs) and youth; and In-depth Interviews (IDI) with community gate keepers such as religious leaders, Religious leader, Chiefs/sub-Chiefs, and traditional leaders. Data analysis included simple univariate frequencies of questions chosen to reflect the key concepts on mental health. Descriptive statistics were used to determine frequencies and percentages for the different variables under study. For qualitative data, thematic analysis was applied to generate themes through deductive and inductive methods. Triangulation of qualitative and quantitative data was conducted. Results Approximately 39.1% of respondents reported to have had a family member with mental illness and 68% of HCWs reported to have diagnosed a patient with mental illness. 64% of respondents cited causes of mental disorders as witchcraft; generational curses in some families; genetic factors; drug and substance abuse especially marijuana; social and economic/financial pressures; and injuries from accidents. 93.3% of the HCWs reported to have referred patients to a mental health facility. Only 29.4% of the HCWs reported having counselling services in the facilities for patients with mental health needs. Majority (90.8% HCWs and 62.3% community members) reported that it is convenient for patients with MH needs and illness from the community to access the health care facilities and that MH services were available and mainly offered at the Meru Teaching and Referral Hospital (81.7% HCWs and 53.8% community members). Majority of HCWs (89.9%) reported that MH services were affordable to community members. On the contrary, only 44.4% of community members reported that MH services are affordable. The HCWs reported that the drugs were given for free at the health facilities while community members reported that sometimes stock-outs in drugs for MH existed in which case they would purchase drugs from pharmacies. Majority (96.4% HCWs and 62.5% community members) reported that patients with mental health1 needs and illness2 are treated with respect in the facilities. Aside from health facilities, community members also seek mental health services from: religious leaders; traditional healers including the Religious leader who were approached for cleansing if one believed that the mental health issues were a curse for committing certain offenses. It was also evident that some families did not seek any kind of help for their relatives with mental health illness and needs, with some even detaining them. Conclusion This study adds to the global knowledge on mental health among healthcare workers and community members providing vital data at service delivery level from an African developing country perspective. There is evidence of high burden of MH in the county with very few facilities offering MH services for patients. The existence of myths and misconceptions around the causes of MH is evident and needs to be addressed. There are also evident disparities in the perception of HCWs and Community members in MH with regards to availability and affordability of MH services and access to MH drugs. Communities still seek MH services from traditionalists and some people still neglect MH cases. Sustained poor mental health of individuals, families, the communities including healthcare workers has an enormous contribution towards negative health seeking behavior as well as social capital, an important determinant of health not just in Kenya but in many rural settings across the world. With this therefore, there is need to build the capacity of health care workers and create awareness to the community members as well as strengthen health systems to tackle MH.Item Effectiveness of innovative training models in building capacity of frontline health workers to manage Non-communicable diseases. A crosssectional study in four counties in Kenya(Research Square, 2019-07) Kimeu, Anastasiah; Kosgei, Sarah; Kiilu, Colleta; Jefferys, Sarah; Aiello, Alice; Were, Christopher; Sifuma, Bryson; Kimathi, GeorgeObjectives This research sought to evaluate the effectiveness of innovative learning approaches in training health workers for effective management and control of diabetes and childhood asthma. Setting Assessment was conducted in Kilifi, Nyeri, Nairobi and Kakamega counties in Kenya in selected subcounties in the 4 counties. Participants Health workforce were randomly selected. Selection was stratified by county and model of training then inflated to account for loss to follow up and 382 participated based on availability and saturation. Interventions Based on high burden of non-communicable diseases (NCDs) specifically Diabetes and asthma in Kenya, AMREF and partners implemented a three-year project (June 2015 - May 2018) aimed at building the capacity of health workers to effectively manage and control the NCDs. It was implemented in 4 counties. The trainings were done using face to face, blended, elearning and mlearning. Primary and secondary outcome measures The research measured the effectiveness of the training models in improving the capacity of health workers to effectively manage and control the NCDs. Results The trainings appreciation rate was 95% across the four approaches. Health workers were well equipped with skills to address asthma (85.6%) and diabetes (94.2%). Satisfaction though lower in eLearning (64%) due to reliability of internet and learning platform downtime against mlearning (89%) and face to face (90%), all the training models were found to contribute to improved knowledge. Conclusions The different training models were very effective. The training was successful in increasing knowledge, confidence and commitment to spearhead the preventive and curative aspects of the illnesses. No training model was superior in terms of the degree of satisfaction, improving knowledge, shaping behaviour change and organisational performance. Further research There is need to asses an elearning / mlearning training model that is purely technology based and compare that with the blended approaches of learning.Item Insights of Healthcare Workers and Community Members on Mental Health Perception and Practices in Meru County, Kenya(East African Journal of Health and Science, 2024) Memiah, Peter; Kiilu, Colleta; Opanga, Yvonne; Musembi, Jack; Mukami, Diana; Mwenda, Catherine; Waruinge, Stella; Kimathi, GeorgeMental health is a neglected field in many low and middle-income countries, such as Kenya, where information on the prevalence of mental health conditions is scarce. This problem is aggravated by an uneven distribution of mental health service providers and widespread ignorance and stigma around mental illness in the general population. The study in Meru County, Kenya, aimed to assess the knowledge, attitudes, and practices of healthcare workers and community members regarding mental health. The study, a descriptive cross-sectional survey, involved 535 community members and 109 healthcare workers, employing both qualitative and quantitative methods. Data was collected through household surveys, key informant interviews, and focus group discussions and analysed using univariate frequencies, descriptive statistics, and thematic analysis. The study revealed that 39% of community members had a family member with a mental health condition, while 68% of HCWs had been diagnosed with such conditions. Mental illness was often attributed to supernatural causes, genetics, substance abuse, and socio-economic pressures. A significant gap was found in the availability of counselling services in health facilities, with only 29.4% of HCWs reporting their presence. The perception of the affordability and accessibility of mental health services varied greatly between HCWs and community members. Additionally, while HCWs reported the availability of free medication, community members experienced shortages. The study also noted differing attitudes towards patients with mental illness in terms of respect and dignity and highlighted the use of traditional healers and religious leaders for mental health issues. This study contributes valuable insights into the state of mental health in Kenya, highlighting the high burden of mental illness, limited availability of services, and prevalent myths and misconceptions. It underscores the need for improved healthcare worker training, public awareness, and stronger health systems to address mental health issues effectively in Kenya and similar rural environments