Peer- and Mentor-Enhanced Web-Based Training on Substance Use Disorders: A Promising Approach in Low-Resource Settings.

Stigma and insufficient training contribute significantly to the substance use disorder pandemic. This 2014 study assessed the impact in Kenya of online competency-based courses on peer and mentor interactions, using NextGenU.org, the world's only portal to free and accredited higher education. A total of 99 health care workers participated in one of two courses. Completers (50% of those who logged in) reported significant increases in knowledge about substance use disorders and decreases in stigma. Most (92%) stated that they preferred the NextGenU.org courses over classroom courses. All respondents were very confident that they gained useful knowledge and skills and would recommend the courses to peers. Learners' improvements in knowledge, skills, and stigma-related attitudes were comparable to those seen in "gold-standard," contact-intensive, and costly educational models. Free, accredited, easily scalable, clinically interactive, Web-based training courses can teach knowledge and skills while reducing stigma, even in low-resource settings.

Substance Use among a Sample of Healthcare Workers in Kenya: A Cross-Sectional Study.

This study describes reported substance use among Kenyan healthcare workers (HCWs), as it has implications for HCWs' health, productivity, and their ability and likelihood to intervene on substance use. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) was administered to a convenience sample of HCWs (n = 206) in 15 health facilities. Reported lifetime use was 35.8% for alcohol, 23.5% for tobacco, 9.3% for cannabis, 9.3% for sedatives, 8.8% for cocaine, 6.4% for amphetamine-like stimulants, 5.4% for hallucinogens, 3.4% for inhalants, and 3.9% for opioids. Tobacco and alcohol were also the two most commonly used substances in the previous three months. Male gender and other substance use were key predictors of both lifetime and previous three months' use rates. HCWs' substance use rates appear generally higher than those seen in the general population in Kenya, though lower than those reported among many HCWs globally. This pattern of use has implications for both HCWs and their clients.

The prevalence of mental disorders among upper primary school children in Kenya.

PURPOSE: The aim of this study was to estimate the prevalence and correlates of mental disorders among upper primary school children in grades five through seven in Kenya. METHODS: The Youth Self Report (YSR) instrument was adapted for use in Kenyan schools and administered to 2267 school children in grades five through seven from 23 randomly selected schools. We estimated the prevalence of DSM-IV mental disorders, and used logistic regression analyses to examine the socio-demographic factors associated with each disorder. RESULTS: The prevalence of any mental disorder among Kenyan school children was 37.7 % (95 % CI = 35.7-39.7 %). Somatic complaints were the most prevalent (29.6 %, 95 % CI = 27.8-31.5 %), followed by affective disorders (14.1 %, 95 % CI = 12.7-15.6 %) and conduct disorder (12.5 %, 95 % CI = 11.2-13.9). The presence of one or more comorbid mental disorder was seen among 18.2 % (95 % CI = 16.6-19.8 %) of children. Male sex, living in a peri-urban vs. rural area, being held back in school, having divorced or separated parents, and having an employed mother were associated with an increased likelihood of having most of the mental disorders examined, whereas increasing age was associated with a reduced likelihood. CONCLUSIONS: We observed a high prevalence of mental disorders among school children in Kenya. If not detected early, these disorders may interfere with children's psychological, social, and educational development. Our findings highlight the importance of implementing screening measures in schools that can detect single and multiple disorders in order to improve the mental health and well-being of the next generation.