Barriers to Utilization of Harm Reduction and Drug Rehabilitation Services among Female Drug Users in Kenya

Abstract

There are an estimated 3.2 million women who inject drugs (WUD) globally, constituting 20% of all people who inject  drugs. Notwithstanding the significant proportion of female drug users (FDUs) in Kenya, anecdotal reports from harm  reduction and drug rehabilitation facilities have continued to record low utilization rates of the existing support services.  Despite these alarming reports, there is limited data attempting to understand the barriers facing FDUs in  need of harm reduction and drug rehabilitation services (HRDRS) in Kenya. The study therefore endeavored to  investigate the barriers hindering access to HRDRS among FDUs in Kenya. A cross-sectional study was conducted using  triangulation of multiple data collection methods. Findings showed that FDUs were primarily exposed to systemic barriers; socio-economic barriers; cultural and societal barriers. The most commonly reported systemic barriers were  inadequate female friendly facilities; unavailability of baby friendly needs; recruitment challenges; and access challenges  by pregnant or breastfeeding FDUs. The key socio-economic barriers were parenting responsibilities; challenges of physical access; lack of opportunities for income generation; and high cost of drug rehabilitation. The  cultural and societal barriers were manifested through stigma associated with the family, community, religion as well as  the healthcare personnel. The study therefore concluded that the complex interplay of the systemic barriers; social  economic barriers; and cultural and societal barriers were the main underlying risk factors impeding utilization of   HRDRS in Kenya.