Problematic alcohol use among fathers in Kenya: Poverty, people, and practices as barriers and facilitators to help acceptance

Puja Patel; Bonnie N Kaiser; Christina S Meade; Ali Giusto; David Ayuku; Eve Puffer

doi:10.1016/j.drugpo.2019.10.003

Problematic alcohol use among fathers in Kenya: Poverty, people, and practices as barriers and facilitators to help acceptance

Int J Drug Policy. 2020 Jan:75:102576. doi: 10.1016/j.drugpo.2019.10.003. Epub 2019 Nov 16.

Authors

Puja Patel¹, Bonnie N Kaiser², Christina S Meade³, Ali Giusto⁴, David Ayuku⁵, Eve Puffer⁴

Affiliations

¹ Duke Global Health Institute, Duke University, Durham, NC, USA; Psychology, University of North Carolina Greensboro, Greensboro, NC, USA. Electronic address: pppatel2@uncg.edu.
² Duke Global Health Institute, Duke University, Durham, NC, USA; Anthropology, University of California San Diego, La Jolla, CA, USA.
³ Duke Global Health Institute, Duke University, Durham, NC, USA; Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
⁴ Duke Global Health Institute, Duke University, Durham, NC, USA; Psychology and Neuroscience, Duke University, Durham, NC, USA.
⁵ Behavioral Sciences, Moi University, Eldoret, Kenya.

Abstract

Background: In Kenya, the prevalence of alcohol use disorder (AUD) is close to 6%, but a notable treatment gap persists. AUD is especially pronounced among men, leading to negative consequences at both individual and family levels. This study examines the experiences of problem-drinking fathers in Kenya regarding previous treatment-seeking related to alcohol use. Experiences and dynamics of the family are also explored as they pertain to treatment-seeking experiences.

Methods: In Eldoret, Kenya, semi-structured qualitative interviews were conducted with 11 families with a male exhibiting problem drinking, his spouse, and one child. Thematic content analysis was used to examine themes related to barriers and facilitators to treatment.

Results: Participants only reported informal help received from family and community members; they exhibited little awareness of available formal treatments. Families were both deeply affected by alcohol use and actively involved in help-seeking. Indeed, fathers' experiences are described as help-accepting rather than help-seeking. Three overarching themes emerged from the results: poverty, people, and practices. Poverty could be a motivator to accept help to support one's family financially, but stress from lack of work also drove drinking behaviours. People were also crucial as both barriers and facilitators of help-accepting. Negative help strategies or peer influence deterred fathers from accepting help to quit. Positive motivation, social support, and stigma against drinking were motivators. Practices that were culturally salient, such as religiosity and gender roles, facilitated help acceptance. Overall, most help efforts were short-term and only lead to very short-term behaviour change.

Conclusion: Families and communities are active in help provision for problem-drinking men in Kenya, though results confirm remaining need for effective interventions. Future interventions could benefit from recognizing the role of family to aid in treatment-engagement and attending to the importance of poverty, people, and practices in designing treatment strategies.

Keywords: Barriers; Facilitators; Family; Fathers; Problem drinking.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alcohol Drinking / epidemiology*
Alcoholism / epidemiology*
Child
Family Health
Fathers / psychology
Fathers / statistics & numerical data*
Female
Humans
Interviews as Topic
Kenya / epidemiology
Male
Motivation
Patient Acceptance of Health Care / psychology*
Poverty
Social Stigma
Social Support

Abstract

Publication types

MeSH terms

Grants and funding