Participation and Performance in Education in Sub-Saharan Africa with special reference to Kenya: Improving Policy and Practice

This paper explores aspects of exclusion from education and how patterns of participation have been changing using national data sets. The first part of the analysis uses administrative data from countries in Sub Saharan Africa to chart enrolments by grade over the last decade and explore how enrolment has been changing in terms of grade, gender, and age. After establishing key issues that are raised by the data across eight countries the paper develops a detailed case study of changes in participation and performance in Kenya using data from the Kenya National Examinations Council. The study shows that the aspirations of Education for All remain far from being met in many countries and many of those who enrol in Grade 1 fail to complete primary or lower secondary school. Progress has been patchy and it remains the case that over enrolment in the lower Grades is common (with more enrolled than there are children in the relevant age group as a result of over-aged entry and progression), and less than half the age group progressing through lower secondary school. Gender equity in enrolments is being approached in the eight countries included in the analysis but patterns differ and are contextually located. In all the countries many of those enrolled remain seriously over-age, and urban rural differences persist in enrolment status. The detailed case study of data from Kenya complements the cross national analysis. It shows how uneven growth in participation has been after the announcement of free primary education, and how strongly patterns vary by county. Strikingly it confirms that older children score on average much lower on the Kenya Certificate of Primary Education (KCPE) than younger children, and that this is likely to exclude older candidates from the best secondary schools. This is a source of considerable inequity since over-age status is associated with poverty

Psychosocial Challenges of Alcohol Abuse and Its Effect on the Marital Relationship in Ainamoi Division, Kericho County, Kenya

In Kenya recent community studies indicate (nacada,2012) indicate significant alcohol consumption resulting in many deaths. Despite prevalence of alcohol abuse, few studies have been done on the challenges of alcohol abuse and its effect on the non-drinking spouse. Most past studies on effect on alcohol abuse on spousal relationship have focused on the role of spouse on facilitating or curtailing alcohol abuse of their spouses. The purpose of this study was to investigate the challenges of alcohol abuse and its effect in the marital relationship. The study was carried out in Ainamoi Division, Kericho County. To realize the purpose of the study a descriptive survey design was used and data was collected through questionnaires, interviews and focused group discussion. The target populations were people whose spouses’ abuse alcohol and were selected using stratified and snowballing sampling procedures. The division was stratified into urban and rural so as to ensure comprehensive coverage of the area. Snowballing sampling was used to identify participants who led the researchers to others. A sample population of 144 respondents was used. Descriptive statistics was used to analyze quantitative data with the help of the Statistical Packages for Social Science (SPSS). The qualitative data was summarized into themes in line with the study objectives and thematic analysis done.  The research found out that alcohol abuse causes many challenges for example it causes failure in communication, financial problems, resentments, domestic violence among others which affect the spousal relationship. The research recommends that there is need to sensitize non-drinking spouses on the psychosocial challenges of alcohol abuse on the spousal relationship. There is also need for establishment of counseling centers in more places in order the address the alcohol problem. This would assist non-alcoholic spouses to cope with alcohol abuse in a more effective way. Keywords: Challenges, psychosocial, alcohol abuse, spousal relationship, Keny

Simple, Stigma-free, Scalable, and School-based: A Four-step Approach to Developing Adolescent Mental Health Treatments in Sub Saharan Africa

- Adolescent mental health problems—which are associated with many negative life outcomes—are prevalent in low-income regions such as those in Sub Saharan Africa (SSA) yet many youths suffering from these problems never get treatment. - Existing treatments are inaccessible to SSA youths because they are long, costly, and require expert delivery in a setting where incomes are low, and a paucity of caregivers exist and where social stigma limits help-seeking. - Most of the efforts to develop interventions for youth mental have been led by researchers from Western high-income countries and can be criticized as socio-culturally inappropriate and costly. - To guide intervention development efforts, we propose a four-step approach that encourages researchers to develop mental health interventions that are simple, stigma-free, scalable and school-based. Through this four-step approach, researchers can expand mental healthcare access in SSA by developing interventions that circumvent existing barriers

Shamiri Templeton Comparative Effectiveness Trial

This project page is used to store data, preprints, code, protocols, and other publicly available project materials for the Templeton World Charity Foundation-funded 2021 five-group RCT of Shamiri and its component intervention

Mental Health Interventions in the Juvenile Justice System: A Scoping Review

Background: Adolescents in the juvenile justice system are vulnerable to mental health problems, a challenge that is exacerbated by the rehabilitation methods used in these settings. There is a need to understand adolescent mental health in juvenile detention settings with an emphasis on possible interventions that can improve adolescent mental health while incarcerated. This scoping review aims to identify mental health interventions in the juvenile justice system. Methods: We conducted a scoping review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist used to guide reporting. A search was conducted on the PsycINFO and Google scholar databases for original research articles published between 1990 and 2021. Results: Our search generated 3575 studies; 3506 were excluded after screening. Sixty-nine articles met the inclusion criteria after the first screening. A second review narrowed this to 23 studies. The total sample size for all included studies was 4,798 participants aged 11-20 years. Forty two percent of included studies investigated multisystemic therapy, 26% of studies examined cognitive therapies, 11% harnessed behavioral approaches, and the remaining 21% implemented counseling services, functional family therapy, and trauma affect regulation therapy. Conclusion: Our review identified 18 interventions that were administered to populations in juvenile correctional facilities. Multisystemic therapy and cognitive therapy were the most common, with MST showing more efficacy in improving juvenile mental health problems. Our study reveals the paucity of research on this important topic and identifies the need for more robust trials of character-building interventions in juvenile centers

Depression and Anxiety Symptoms Among Kenyan adolescents: Prevalence Rates and Associations with Socio-demographic and Psycho-social Factors During the COVID-19 Pandemic

Background: Research dedicated to youth mental health problems in low – resource countries is an urgent and critical global health priority. Prior to COVID-19, only a handful of studies had estimated the prevalence rates of youth depression and anxiety and identified the associations between these problems with socio-demographic and psychosocial variables. As COVID-19 has emerged as a stressor for youth mental health, new studies on youth mental health during and post COVID-19 may yield important research, policy, and practice implications. Here, we assessed the prevalence of depression and anxiety symptoms and their associations with psychosocial and sociodemographic variables in a large sample of school-going youths in Kenya. Method: Measures of depression (PHQ-8) and anxiety (GAD-7), social support, perseverance, optimism, perceived control, connectedness, happiness, purpose in life, and gratitude were administered to 1,498 Kenyan adolescents (55.47% male) aged 13-to-21 years (M age = 16.33) in mid-2021 when schools re-opened after the COVID–19 school closures. Results: Some 42.46% and 37.56% youths met the clinical cut-off for elevated depression and anxiety symptoms, respectively. Adolescents whose academic performance was not satisfactory endorsed higher depressive and anxiety symptoms. Female adolescents and those who lived with a single parent endorsed higher depressive and anxiety symptoms, respectively. Subjective wellbeing and perceived control were negatively associated with depressive symptoms. Conclusion: The prevalence of depression and anxiety symptoms among Kenyan adolescents has remained steady when compared to pre-pandemic studies. However, symptoms were high when compared to those of adolescents in other countries during COVID-19. This study also identified potential important risk and protective factors

A Mindfulness-Based Intervention for Reducing Adolescent Depression and Anxiety Symptoms: A Study Protocol for a Pilot Randomized Controlled Trial in Kenya

Background: Depressive and anxiety symptoms significantly impact the well-being of African youth. This problem is compounded by limited access to appropriate mental health care services and societal stigma. In addressing this issue in Kenya, we employed the network approach to psychopathology to identity the most significant symptoms of depression and anxiety. These network analyses revealed self-blame and depressed mood in the depression network, as well as too much worry and uncontrollable worry in the anxiety network. Consequently, we identified mindfulness-based interventions, particularly the Learning to Breathe (L2B) program, as effective tools to mitigate these influential symptoms and potentially reduce the prevalence of overall depressive and anxiety symptoms. We adapted and modified the L2B program into the Shamiri Mindfulness Intervention, tailored for the Kenyan context. This pilot aims to assess the impact of the Shamiri Mindfulness Intervention on participants' mindfulness, depressive symptoms, and anxiety symptoms. Methods: We propose a randomized waitlist-controlled study to pilot the Shamiri Mindfulness Intervention among Kenyan Secondary School students. The intervention will consist of lessons, activities, and discussions aimed at enhancing participants' understanding and practice of mindfulness, specifically focusing on their thoughts, emotions, and behaviors. The pilot will involve four 1-hour sessions conducted weekly, with groups of 10-12 students led by local lay-providers trained by our team and supervised by clinical psychologists. Data will be collected at baseline, midpoint, endpoint, and one-month follow-up from all participants. Upon completion of data collection, participants in the waitlist condition will receive the Shamiri Mindfulness Intervention. Discussion: Positive findings from this study can serve as an impetus for conducting additional trials of school-based and lay-provider delivered mindfulness-based interventions in other African and low-to-middle-income settings. By further exploring these interventions, we can adapt and refine them to offer a valuable tool for enhancing youth mental health. This approach presents a low-cost, effective, and culturally appropriate alternative to traditional Western psychotherapy. The potential impact extends beyond the current study, as it contributes to the growing body of evidence supporting the implementation of mindfulness-based interventions in diverse contexts, ultimately benefiting young individuals facing mental health challenges worldwide

Testing the Effects of the Shamiri Intervention and its Components on Anxiety, Depression, Wellbeing, and Academic Functioning in Kenyan Adolescents: Study Protocol for a Five-Arm Randomized Controlled Trial

Background: Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay-providers may help address treatment needs in SSA. One such intervention, the Shamiri Intervention, consisting of three elements (growth mindset, gratitude, and value affirmation) has been tested in randomized controlled trials with school-going Kenyan adolescents. This three-element Shamiri Intervention has been shown to significantly reduce depression and anxiety symptoms and improve social support and academic performance relative to a control group. In this trial, we aim to investigate the effects of each element of the Shamiri Intervention. Methods: In this five-arm randomized controlled trial, we will test each of the intervention components (growth mindset, gratitude, and value affirmation) against the full Shamiri Intervention and against a study-skills control intervention. Students (Nplanned=1288) at participating secondary schools who are interested in participating in this universal intervention will be randomized in equal numbers into the five groups. The students will meet in groups of 8-15 students led by local high school graduate lay-providers. These lay-providers will receive 10 hours of training, plus expert supervision once a week throughout the intervention delivery. Multi-level models will be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes in each intervention group to the control group. Multi-level models will also be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes of those in the single-element interventions compared to the full Shamiri Intervention. Finally, effect sizes (calculated as mean gain scores) will be used to compare all groups on all measures. Discussion: This trial will shed light on the mechanisms and outcomes targeted by each individual intervention, helping prioritize which mental health interventions are most important to disseminate