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      Evaluation of Government Programs in Mitigating Drug and Substance Abuse in Kilifi and Mombasa Counties, Kenya

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      African Journal of Empirical Research
      AJER Publishing

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          Abstract

          The issue of drug and substance abuse has become a major concern in Kenya, particularly in the coastal region. In response, the government has implemented various programs to mitigate the problem. The objective of this paper was to evaluate the government's programs for mitigating drug and substance abuse in the Kilifi and Mombasa counties of the coastal region of Kenya. Social learning theory and functionalism theory served as the study's guiding principles. The study was further underpinned by the interpretivism approach. The study used descriptive and evaluative research designs, with data collected through interviews and focus group discussions. The study was conducted in Kilifi and Mombasa Counties. Data was collected from 552 respondents, who included 384 household heads, 20 victims, 2 county education officers, 2 county commissioners, 2 county health officers, 70 administrative chiefs, 102 village elders, 9 senior NACADA officers, and 8 religious leaders. The data collected included the existing programs that are directly or indirectly implemented by the government, as well as their impacts on the residents of the study area. Government programs in the study region focused on prevention, treatment, law enforcement, and harm reduction, proving effective to varying degrees. The study revealed that law enforcement programs were more effective than the others. The study recommended the re-evaluation of these programs, including reinforcing their weaknesses and conducting constant evaluations to maximize the strengths of the organizations.

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          Most cited references16

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          School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis

          Findings from systematic reviews and meta-analyses about the effectiveness of school-based programmes to prevent or reduce substance abuse are inconclusive. We hypothesise that in order to be effective, programmes have to be aligned with the developmental stages of the intended target group (childhood, early, middle, or late adolescence). The present study provides an overview of universal and targeted programmes, while distinguishing four age groups and examining which intervention characteristics are the effective components for the respective groups.
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            Prevalence, intensity and associated risk factors of soil-transmitted helminth and schistosome infections in Kenya: Impact assessment after five rounds of mass drug administration in Kenya

            Background In Kenya, over five million school age children (SAC) are estimated to be at risk of parasitic worms causing soil-transmitted helminthiasis (STH) and schistosomiasis. As such, the Government of Kenya launched a National School Based Deworming (NSBD) program in 2012 targeting the at-risk SAC living in endemic regions, with the aim of reducing infections prevalence to a level where they no longer constitute a public health problem. The impact of the program has been consistently monitored from 2012 to 2017 through a robust and extensive monitoring and evaluation (M&E) program. The aim of the current study was to evaluate the parasitological outcomes and additionally investigate water, sanitation and hygiene (WASH) related factors associated with infection prevalence after five rounds of mass drug administration (MDA), to inform the program’s next steps. Materials and methods We utilized a cross-sectional design in a representative, stratified, two-stage sample of school children across six regions in Kenya. A sample size of 100 schools with approximately 108 children per school was purposively selected based on the Year 5 STH infection endemicity prior to the survey. Stool samples were examined for the presence of STH and Schistosoma mansoni eggs using double-slide Kato-Katz technique, urine samples were processed using urine filtration technique for the presence of S. haematobium eggs. Survey questionnaires were administered to all the participating children to collect information on their demographic and individual, household and school level WASH characteristics. Principal findings Overall, STH prevalence was 12.9% (95%CI: 10.4–16.1) with species prevalence of 9.7% (95%CI: 7.5–12.6) for Ascaris lumbricoides, 3.6% (95%CI: 2.2–5.8) for Trichuris trichiura and 1.0% (95%CI: 0.6–1.5) for hookworm. S. mansoni prevalence was 2.2% (95%CI: 1.2–4.3) and S. haematobium prevalence was 0.3% (95%CI: 0.1–1.0). All the infections showed significant prevalence reductions when compared with the baseline prevalence, except S. mansoni. From multivariable analysis, increased odds of any STH infections were associated with not wearing shoes, adjusted odds ratio (aOR) = 1.36 (95%CI: 1.09–1.69); p = 0.007; high number of household members, aOR = 1.21 (95%CI: 1.04–1.41); p = 0.015; and school absenteeism of more than two days, aOR = 1.33 (95%CI: 1.01–1.80); p = 0.045. Further, children below five years had up to four times higher odds of getting STH infections, aOR = 4.68 (95%CI: 1.49–14.73); p = 0.008. However, no significant factors were identified for schistosomiasis, probably due to low prevalence levels affecting performance of statistical analysis. Conclusions After five rounds of MDA, the program shows low prevalence of STH and schistosomiasis, however, not to a level where the infections are not a public health problem. With considerable inter-county infection prevalence heterogeneity, the program should adopt future MDA frequencies based on the county’s infection prevalence status. Further, the program should encourage interventions aimed at improving coverage among preschool age children and improving WASH practices as long-term infection control strategies.
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              Socio-ecological determinants of alcohol, tobacco, and drug use behavior of adolescents in Kilifi County at the Kenyan coast

              Alcohol, tobacco, and other drug use form a risk factor for health and social problems during adolescence. From a socio-ecological model, perceptions of 85 young people and 10 stakeholders on the types of alcohol, tobacco, and other drugs used and the predisposing and protective factors were explored; among adolescents at the Kenyan Coast in the Kilifi County. We found that the consumption of home-brewed alcohol, tobacco and marijuana smoking, and khat chewing was common and requires multi-component and community-centered intervention. Countering alcohol, tobacco, and other drug use needs enforcement of strong measures to regulate access to alcohol, tobacco, and other drugs for minors; addressing social and cultural norms; strategies for poverty alleviation; and community empowerment.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                African Journal of Empirical Research
                AJERNET
                AJER Publishing
                2709-2607
                July 05 2023
                August 07 2023
                : 4
                : 2
                : 119-134
                Article
                10.51867/ajernet.4.2.15
                68fabf4f-8259-4a40-a605-d06581f67b21
                © 2023

                https://creativecommons.org/licenses/by-nc/4.0

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