Interviews also indicate PTSD symptoms are common
In a nationwide study in Kenya, one in four nurses, midwives and community health volunteers interviewed by AKU researchers exhibited signs of depression. An even higher proportion showed symptoms of post-traumatic stress disorder. The findings were based on phone interviews with nearly 4,000 individuals conducted between January 2021 and June 2022. Health care workers from all 47 counties participated. The study was conducted by faculty from the Institute for Human Development and the School of Nursing and Midwifery, East Africa, and funded by the Johnson and Johnson Foundation.
Twenty-three percent of nurses and midwives and 25 percent of community health volunteers (CHVs) showed signs of depression. Forty percent of nurses and midwives and 38 percent of CHVs showed symptoms of post-traumatic stress disorder.
Sources of stress identified by participants included heavy workloads, lack of resources, poor work environments, irregular salary payments amongst nurses and midwives and lack of salaries for CHVs. Opportunities to receive psychosocial support were found to be lacking, with managers having little or no relevant training. Resources necessary for providing psychosocial support – such as space, trained staff and funding – were also found to be limited or nonexistent.
“We need to develop policies that recognise and address the mental health needs of health workers,” said Professor Amina Abubakar, Director of the Institute for Human Development. “In our analysis of policy documents, we learnt that available policies focus on patients and their needs. There is limited direction on how to address health workers’ psychosocial needs, yet we expect quality health care from them.”
The study implemented a text message-based intervention to provide psychosocial support to health workers. Participants received automated text messages offering advice on managing work-related stress and on resilience-building measures. Preliminary results indicated that such interventions could help health workers to manage mental health challenges.
As the study was conducted during the pandemic, it included funding for masks, sanitizers and gowns, which were distributed to health care workers who were having difficulty obtaining such items. Approximately $7,000 worth of such resources were distributed in northeastern Kenya through the Frontier Counties Developmental Council and in the Dagoretti area of Nairobi.
The Nursing Council of Kenya assisted in identifying participating nurses and midwives, while the CHVs were recruited through the County Departments of Health. The National Nurses Association of Kenya provided counselling services for those in distress. Study results were disseminated at a high-level meeting with policymakers from the Ministry of Health, representatives of nursing associations and other stakeholders.