Measuring the prevalence of mental disorders in western Kenya
20th Anniversary of Global Health Fellows and Scholars
There is no such thing as a typical work week for Dr. Edith Kamaru Kwobah, a psychiatrist and head of mental health at Moi Teaching and Referral Hospital in Eldoret, Kenya. Her every day looks different; she is a clinician, teacher, and administrator, heads seven different departments, and in her "free time," she works on her research and checks in on the small groups she helps manage.
"It is not an eight-to-five job with a clear structure," said Kwobah. "Working on many different things at the same time requires strict time management skills." Skills that her Fogarty fellowship helped her develop, she added.
Kwobah connected with Fogarty through Duke University and the AMPATH consortium, which stands for Academic Model Providing Access to Healthcare. TThe partnership includes Moi University, Moi Teaching and Referral Hospital, the Kenyan government, and the AMPATH consortium of North American universities led by Indiana University. Initially, the consortium focused its research and training on HIV and other chronic diseases, such as diabetes and hypertension, while conducting scant research on mental health.
"When I joined the hospital in 2013, I realized that we did not even have baseline data on how common mental health problems are in our region. My goal was to find that baseline data so we could develop interventions for patients," said Kwobah. With this in mind, for her Fogarty research project, which was part of her fellowship training, she decided to study the prevalence of common mental disorders across a sample population in western Kenya.
For her study, she and her team interviewed 420 adults from western Kenya. Researchers found that, just like in& the rest of the world, the most common mental health disorders in the region were depression, anxiety, and substance use disorder. Their most interesting and concerning finding was that at least 45% of their study participants had symptoms of a mental health disorder at some point in their lifetime. This number is high, considering that the World Health Organization reports the worldwide average as roughly 25%. Another important finding: at least 16% of the people they interacted with had attempted suicide at least once in their lifetime. Again, this is significantly higher than the WHO average. Lastly, they found a significant treatment gap—more than 75% of participants had never sought care for mental illness.
Her Fogarty project provided a baseline for a new mental health care delivery program at Moi University that integrates therapy into a system initially created to manage chronic diseases like HIV, hypertension, and diabetes. As a part of this program, Kwobah and her team train primary care workers at the hospital and community workers to screen for mental disorders and link community members to care. They also provide community education for village elders, chiefs, teachers, religious leaders, and police officers to increase mental health awareness and reduce the stigma around seeking treatment. Going forward, Kwobah hopes to continue this research using the data from her Fogarty year to evaluate how they can increase mental health interventions used in Kenyan health care settings.
Kwobah knew early on that serving those with mental illness would be her calling. "Of all the rotations after medical school, psychiatry was my favorite. When I returned for a master's degree to specialize two years later, my love for mental health was cemented." Because of her passion for this field, she continues her work even after she leaves the hospital. In addition to her professional roles, Kwobah is a mother and a voice for those affected by mental illness in western Kenya. She spends time outside work talking to the media and hosting Zoom webinars whenever asked to ensure the conversation on mental health continues.
Her advice to those pursuing the Fogarty program is to "identify an area that you are truly interested in and would like to be associated with 20 years from now."
Updated September 27, 2023
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