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Levels of mental health awareness in rural Kenya remain very low with higher levels of stigma and discrimination towards people with psychosocial disabilities, especially for women. This study aimed to describe the levels and correlates of mental health knowledge, discrimination and social functioning among rural women with psychosocial disabilities in Kenya. We randomly recruited 25 women living with psychosocial disabilities in a rural county. Mental health knowledge was measured by Mental Health Knowledge Schedule (MAKS), anticipated discrimination was measured by Questionnaire on Anticipated Discrimination while social functioning was measured using the Social Functioning questionnaire. The mean age of study participants was 36.6 ± 3.0 and the mean score of MAKS was 21.9 ± 30. The most endorsed item was referring a friend with mental illness to a professional to seek help. The prevalence of low social functioning was 64%. In terms of identification of mental illness, majority (88%) identified depression as a mental illness. Higher mental health knowledge was associated with a higher level of education (p= 0.012), being self-employed as opposed to unemployed (p= 0.018) and earning monthly income (p= 0.023). The most frequent reason for anticipated discrimination was friends and neighbors knowing about their mental health problems (24.0%). Anticipated discrimination was associated with participants who had ever been treated for a mental health problem (p= 0.05). Poor social functioning was significantly correlated with the number of years lived with disability (p< 0.001). Poor mental health awareness and discrimination against people with psychosocial disabilities limit their functioning, health-seeking and recovery in Kenya. There is need for prioritization of mental health services and increased mental health awareness to improve health-seeking behavior, social participation and recovery for persons with psychosocial disabilities.

Objective: Substance use disorder (SUD) is a global concern. Evidence from high-income countries suggests that SUD training for psychiatry residents is less than optimal but it is unknown whether the situation is different in low-/middle-income settings. This study assessed psychiatry residents’ perception of their SUD training. Methods: A cross-sectional survey was conducted among general psychiatry residents in Nigeria from November 2018 to May 2019. Data were collected through self-completion of an English-language questionnaire with multiple-choice and open-ended questions administered face-to-face and online. Results: A total of 51 participants completed the questionnaire, mean age 33.6 years and 76.5% men. Most participants (70.6%) expressed interest in addiction psychiatry, and 47.1% perceived their SUD training as inadequate. When asked to rate satisfaction with the SUD training they have received so far, 52.9% were unsatisfied, and the absence of in-house SUD training (29.4%) was the leading cause of dissatisfaction. For those who were satisfied, the most common reasons were availability of SUD training and treatment-related factors (31.4%). The most frequent suggestions for making addiction psychiatry subspecialty attractive to psychiatry residents were provision of SUD treatment units, structured SUD training, and continuity of such training. Equipping existing SUD treatment units and creating more treatment units were the most common suggestions for improving current SUD training. Conclusion: This study demonstrated a high level of interest in addiction psychiatry, but satisfaction with SUD training was mixed. Addressing causes of dissatisfaction and areas suggested for improvement would be necessary to sustain interest.

Media reports show that methamphetamine use is growing in Nigeria, but there is a paucity of empirical research that examines the motivations for, and consequences of, using the drug. In this study, we explored motivations or reasons for methamphetamine use and implications among 18 users and service providers. We analysed the data thematically to generate themes. The findings show that while most users initiated methamphetamine use in friendship networks, drug dealing also facilitated the initiation. Some participants were motivated to use methamphetamine to stay awake at night and engage in online businesses, while others used the drug to enhance their energy for manual work to improve productivity and enhance sexual drive, performance and pleasure. Although participants believed that methamphetamine use performed some functions, they reported its adverse effects on them and their friends, including irritation, hostility, extreme violent behaviour, delusion, psychiatric disorders, and inability to urinate or defecate for seven days. Additional findings showed that stigma is a prominent barrier to accessing treatment. Therefore, individuals do not use treatment facilities until their condition deteriorates. The findings suggest the need for the urgent provision of information to deter people from methamphetamine uptake and to provide interventions and pathways to treatment that will protect people who use methamphetamine from stigmatisation and other forms of discrimination.

ABSTRACTAssistive technologies are critical to supporting the participation and engagement of persons with disabilities and others who experience functional difficulties in daily life. Assistive products have been demonstrated to be related to the achievement of the Sustainable Development Goals (SDGs); however, no previous research has explored the relationship between assistive technology (AT) and the SDGs from the perspective of stakeholder organisations working in the field of AT provision. In this study, we evaluated the relevance of AT and the SDGs to achieving the organisational missions of key stakeholders in AT ecosystem in Malawi. Key stakeholders (n = 36) in the AT field in Malawi were asked to rate the relevance of AT to achieving their organisational missions, and the relevance of AT to each of the 17 SDGs on a 5-point Likert scale. Stakeholders who participated were engaged in consultative meetings with the government and an action research team as part of a larger policy development project, and represented ministries and government agencies, organisations of persons with disabilities, and local and international non-governmental organisations. AT was rated as being relevant to all of the SDGs, albeit to varying degrees, and not surprisingly to achieving AT stakeholders’ organisational missions. The cross-cutting nature of the relevance of AT underscores the importance of cross-ministerial cooperation and shared leadership in provision AT.

ABSTRACTBackgroundAssistive technologies promote participation and quality of life for people with disabilities and other functional limitations. There is a global call to develop and implement policies to improve access to assistive technologies. In response, a stakeholder led initiative in Malawi is working towards the development of such a policy.ObjectiveThe objective of this study was to assess the existing network of stakeholders, and the strength of relationship between organizations who deliver assistive products and related services.MethodWe conducted a survey-based network analysis of assistive technology stakeholder organizations in Malawi.ResultsStakeholders (n = 19) reported a range of connections, from no awareness to collaboration with organizations within the assistive technology network. No single organization or government ministry was most central to the network. International NGOs were less central to the network than local organizations for disabled people, service providers, and ministries.ConclusionThe assistive technology stakeholder network in Malawi is distributed, with a range of responsibility across a variety of stakeholders, including three government ministries. An effective assistive technology policy must engage all stakeholders and may benefit from a collective leadership approach that spans the inter-sectoral need for a cohesive assistive technology system.