The peace that I wanted, I got: Qualitative insights from patient experiences of SMART DAPPER interventions for major depression and traumatic stress disorders in Kenya.

SMART DAPPER is an implementation science study responding to mental health treatment gaps for depression and trauma-related disorders in Sub-Saharan Africa (SSA). We report on patient experiences in a study using a Sequential, Multiple Assignment Randomized Trial (SMART) design to test first and second line non-specialist treatment using psychotherapy (Interpersonal Psychotherapy [IPT] or medication (fluoxetine [FLX]), integrated within public sector primary care in western Kenya. An embedded qualitative study conducted in-depth interviews (n = 17) and three (n = 3) focus group discussions with participants (May to October 2021). Audio-recorded interviews were transcribed and translated into English; we deductively and inductively analyzed transcripts guided by grounded theoretical approaches and content analysis. We drew on the health belief model and socio-ecological framework to present findings, including perceived severity (motivations for taking part in the intervention), impacts of the intervention at the individual, interpersonal, and community and health systems levels as well as barriers and facilitators. Participants discussed family and marital conflict, loss of a child, loss of income or a job, and traumatic events such as a death or illness. Impacts at the individual level included reduced headaches, improved appetite and weight management, increased energy, improved sleep, better self-efficacy, and improved concentration, which was reported to lead to increased economic opportunities. At the interpersonal level, participants noted a reduction in conflict, better conflict management and resolution, increased harmony with family and community members, and improved relationships with their partners and children. Perceived challenges included balancing the intervention with livelihoods, preference for traditional medicines, actual or anticipated side effects with medication (FLX), mental health stigma, major life events, and perceived inadequate counseling and challenges with providers. The findings demonstrate the potential of the SMART DAPPER intervention for depression and trauma-related disorder treatments and underscore the challenges and barriers that must be addressed when scaling similar interventions. Trial registration: ClinicalTrials.gov identifier: NCT03466346

No longer green: Female characters of African descent as sex workers in Chika Unigwe’s On Black Sisters’ Street (2009) and Amma Darko’s Beyond the Horizon (1995)

This article explores the potentialities of diaspora as conveniently structured to demonstrate the emancipatory potential of migration for women in Chika Unigwe’s On Black Sisters’ Street (2009) and Amma Darko’s Beyond the Horizon (1995). Sex and sexual intercourse between men and women in the African societies that are fictionalised in these texts are not only an issue about morality, but also about how morality is governed and policed within these societies. While the societies in these texts hope to derive their integrity through women’s sexual purity, conflict arises when such communal integrity fails to recognise the individual circumstances of the female individuals upon whom such notions of purity rest. The question of what role sex and sexual practices play in upholding the honour of communities is a vexed one. While the societies that the texts explore here show less scrutiny on marital sex, regardless of whether it is consensual or forced, these societies occupy a judgmental pedestal on pre-marital and extra-marital sex. Harsher judgement, however, is reserved for individuals who engage in these practices for monetary gain. This textual analysis is informed by the postcolonial theory, as articulated by Homi Bhabha and his postulations on identity and ‘othering’

Beautiful dreams: Deconstructing discourses of redemption in Darko’s Beyond the Horizon (1995), Unigwe’s On Black Sisters’ Street (2009), Adichie’s Americanah (2013) and Mbue’s Behold the Dreamers (2016)

This paper entails an analysis of how in their different particularities, Amma Darko’s Beyond the Horizon, Chika Unigwe’s On Black Sisters’ Street; Chimamanda Adichie’s Americanah and Imbolo Mbue’s Behold the Dreamers explore the underbelly of notions informing the discourse of a redemptive West for Africans located at the margins of globalisation. The analysis locates Chimamanda’s Americanah and Mbue’s Behold the Dreamers within the racialised polity in the USA, in the midst of either a global economic meltdown or individual inability to access the fruits of globalisation because of the fact of race or immigration status.  It also explores how choicelessness in the job market in Europe informs the radical choice of persisting at the social and economic margins of Europe despite the harsh realities and outcomes in this choice. This paper demonstrates that the questions of place at particular moments in history force a revision of initial fantasy about the notions of the redemptive West.  This textual analysis is informed by the postcolonial theory, as articulated by Robert Nichols and Homi Bhabha and their postulations on identity, ‘othering’ and ‘in-between spaces’

Empowering women groups in Kenya through ICT, education and alternative livelihood

Paper presented at ICT conference of 2008. Theme : ICT's Role towards a Knowledge Economy.Paper presented at ICT conference of 2008. Theme : ICT's Role towards a Knowledge Economy