Barriers and Facilitators to Treatment Seeking for Alcohol Use Among Men in Kenya: A Qualitative Study

Introduction

Substance use disorder accounts for 9.6% of Disability-Adjusted Life Years worldwide. In western Kenya, men between the ages of 25-35 have a 79% alcohol consumption rate (consumption of alcohol in the past 30 days); well over the national average rate of 14.5%. Literature suggests that only 5% of western Kenyan population is seeking treatment for alcohol use. Factors such as stigma, limited service accessibility, and social support have been reported as being the most common barriers and facilitators to treatment for alcoholism in low and middle income countries but little is known of how these factors manifest within diverse cultural contexts. Familial factors, such as wanting a better relationship with the family/spouse, have also been reported as facilitators to treatment but there is a gap in literature on how the family is impacted by father’s treatment seeking behaviors.

Methods

Semi-structured interviews were conducted with 10 families in Eldoret, Kenya. Male with problem drinking, spouse/partner, and one child were recruited from each family. Interview guides were developed to assess factors like stigma, social support, culture, and service accessibility. Father’s self-perception on needing help for drinking and familial factors like family functioning and finances were also considered. Interviews were conducted in Swahili and were audio-reordered. Memos were written, by researcher and interviewer, to help understand and organize the data. Using the thematic content analysis method, the interview transcripts were analyzed using analytical memos and coding.

Results

Perceived benefits of alcohol, limited service availability, and self-perception on needing help were reported as barriers to treatment. Most fathers did not report any initiation of treatment, which might be due to the self-perception of not needing help. Familial factors such as family functioning, couple relationship, finances, and social support were reported as facilitators to treatment; father’s motivation to accept help for alcohol use often stemmed from the desire to be a role model to the family and a better provider. Families reported facing dire financial circumstances related to father not providing or spending funds on alcohol; in such situations, mothers reported being motivated to encourage assistance from other family or community members. Mothers and children reported improved family functioning and finances during periods of reduced alcohol intake by the father.

Conclusion

Future studies and interventions could benefit from focusing more on the role of the family in engaging men in treatment. Effects of alcohol use and father’s treatment seeking on the family may also be a valuable target of alcohol reduction interventions.