Family Connectedness and Its Association With Sexual Risk-Taking Among Undergraduate Students at the University of Nairobi.

BACKGROUND: Universities have a student population in the age range of 17 to 25 years, 75 % of whom are sexually active, with the median age of sexual debut at age 18 years. About half of all students are involved in risky sexual behaviour. Many interventions have decreased sexual risk behaviour in the short-term, but there is need for multilevel prevention, including targeting improvements in family relationships for sustained change. Perceived positive family connectedness has been found to be related to reduced sexual risk-taking among adolescents and young adults. METHODS: This cross-sectional study evaluated the family connectedness and sexual behaviour of students aged 18 to 24 years at the University of Nairobi. There were 904 participants, both male and female, who were registered students of the University of Nairobi. After institutional and individual consent were granted, participants completed a self-administered questionnaire within their classes. The family subscale of the Hemingway Measure of Adolescent Connectedness was used to evaluate connectedness, and a sexual behaviour questionnaire was used to evaluate sexual risk-taking behaviour. RESULTS: Six hundred forty (70.8%) of the respondents were sexually active - 372 males and 268 females. High-risk sex was reported by 203 male respondents (54.6%) and 117 females (43.7%). Reportedly abstinent participants had higher family connectedness scores than those who were sexually active (P<.001), and participants who reported less sexual risk-taking had higher mean family connectedness scores than those with higher sexual risk-taking (P<.001). CONCLUSION: Family connectedness had a significant influence on sexual risk-taking, and investment in family relationships could reduce risky sexual behaviour and potentially other risky behaviours among young adult university students.

Quality of life among patients living with epilepsy attending the neurology clinic at Kenyatta National Hospital, Nairobi, Kenya: a comparative study.

BACKGROUND: Most of the studies on epilepsy in Kenya and indeed the sub-Saharan region of Africa mainly focus on prevalence, psychiatric profile, and factors associated with increased seizure burden. This being the first Kenyan and sub-Saharan African study assessing quality of life among people living with epilepsy, it will identify their 'intangible' needs and enable evidence-based intervention that would ultimately lead to a comprehensive management and better outcome. DESIGN: A cross-sectional comparative study, using the World Health Organization Quality of Life questionnaire, a socio-demographic questionnaire, seizure burden and characteristics, drug and treatment profile questionnaires and the Mini-Mental state examination, among PLWE and those accompanying them, herein referred to as the normal healthy controls, attending the neurology clinic at Kenyatta National Hospital, Nairobi. SETTING AND SUBJECTS: Study was carried out between October 2006 and February 2007 at the neurology clinic in the hospital where three hundred consecutive subjects who satisfied the inclusion criteria and gave consent were recruited.Statistical tests used: Descriptive statistics were used to compute means, standard deviations as well as frequencies. Significance of associations was tested using the Chi square test statistic (x2), an independent samples t-test, analysis of variance (ANOVA) and a step-wise (forward) regression analysis. A p < 0.05 was considered statistically significant. RESULTS: The mean quality of life among people living with epilepsy (49.90%) was significantly (p < 0.01) lower than that of the normal controls (77.60%) accompanying them and significantly impaired as compared to the hypothesized mean of 75±2.5%. Factors significantly (p < 0.05) associated with impairment of quality of life in those living with epilepsy were a low level of education, higher seizure burden, low annual income, unemployment, unskilled employment, and living in a rural residence. CONCLUSIONS: The mean quality of life of people living with epilepsy at Kenyatta National Hospital was significantly impaired and lower than that of the normal controls accompanying them. A comprehensive epilepsy management program is recommended to address this problem and its associated risk factors for the people living with epilepsy in Kenya.

Integration of mental health into primary care in Kenya.

Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes.