Support for Addiction and Prevention in Africa
The vision of SAPTA's prevention programme is "healthy individuals, families and communities free of alcohol, drug abuse problems and other associated risks e.g. HIV/AIDS. The mission is to empower communities, individuals and families to adopt healthy behaviours that prevent substance abuse and its associated risks e.g. HIV/AIDS.
The goal of SAPTA's prevention programme is to reduce substance abuse and associated risks especially HIV/AIDS in targeted populations. The programme focuses on the provision of quality substance abuse prevention services and the provision of prevention and harm reduction education targeting the support structures for the targeted populations.
The prevention programme activities are based on two strategic objectives of SAPTA's Strategic Plan
Strategic Objective 1- To provide Quality substance abuse prevention services
The idea of reducing known predictors and enhancing known protective factors to prevent health problems is fundamental to prevention science1. The strategies adopted by SAPTA's prevention programme to reach the target populations are in line with the IOM model. The Institute of Medicine (IOM 1994)2 proposed a new framework for classifying prevention based on the disease model. The prevention category is divided into three classifications of prevention interventions, i.e. universal, selective and indicated.
Universal prevention strategies address the entire population (national, local community, school, neighborhood), with messages and programs aimed at preventing or delaying the abuse of alcohol, tobacco, and other drugs. The mission of universal prevention is to deter the onset of substance abuse by providing all individuals the information and skills necessary to prevent the problem and does not involve prior screening for substance abuse risk.
Through various donor funding, SAPTA prevention programme has carried out sensitization forums, community awareness campaigns & trainings focused on substance abuse/ HIV/AIDS awareness and risk reduction targeting community members, church leaders, muslim leaders, teachers, health facility workers, bar owners, employers, youth leaders, parents, and other community leaders e.g. chiefs & district officers in the Kibera informal settlement, Nairobi and other select districts country wide. Radio has been used as a media to reach a larger audience of community members with messages on substance abuse and risks associated e.g. HIV/AIDS. To reach the youth with the same messages, further innovative forums have been used e.g. Participatory Education Theatre (PET), Soccer Matches and Door to Door Campaigns. IEC materials (brochures and leaflets) have also been produced and disseminated to the general public.
Selective prevention strategies target subsets of the total population that are deemed to be at risk for substance abuse by virtue of their membership in a particular population segment. Risk groups may be identified on the basis of biological, psychological, social, or environmental risk factors known to be associated with substance abuse (IOM 1994), and targeted subgroups may be defined by age, gender, family history, place of residence such as high drug-use or low-income informal settlements, and victimization by physical and/or sexual abuse. Selective prevention targets the entire subgroup regardless of the degree of risk of any individual within the group because the subgroup as a whole is at higher risk for substance abuse than the general population. An individual's personal risk is not specifically assessed or identified and is based solely on a presumption given his or her membership in the at-risk subgroup.
SAPTA has trained and supported 400 peer educators and outreach workers drawn from vulnerable at –risk groups such as bar tenders, female commercial sex workers, MSMs(men who have sex with men), porters, and out of school youth through the Prevention Awareness Groups (PAG). The Prevention Awareness Groups (PAG) is a community based integrated Substance Abuse/HIV/AIDS prevention programme targeting vulnerable populations living in informal settlements in Kenya. The programme is based on the philosophy that each person has the capacity to make the right choices and change required in life, given the relevant information, motivational encouragement and appropriate family and community support. The training and awareness sessions are conducted over a period of 8 weeks consisting two hour sessions run twice a week (16 sessions). The sessions rely on cognitive behavioral approaches, coupled with learning and motivational interviewing strategies for behavior change.
The goal of the PAG is to reduce substance abuse and HIV/AIDS among the target populations
The Objectives of PAG are;
To create awareness on the dangers of consuming alcohol and drugs among at risk vulnerable groups, i.e. bar patrons, commercial sex workers, out of school youth.
Indicated prevention strategies are designed to prevent the onset of substance abuse in individuals e.g. youth who do not meet DSM-IV criteria for addiction. The mission of indicated prevention is to identify individuals who are exhibiting early signs of substance abuse and other problem behaviors associated with substance abuse and to target them with special programs. The individuals may or may not be abusing substances, but exhibit risk factors that increase their chances of developing a drug abuse problem e.g. youth exhibiting conduct disorders, and who are alienated from parents, school, and positive peer groups. The aim of indicated prevention programmes is to delay of onset of substance abuse, and/or reduction in the severity of substance abuse. Individuals can be referred to the indicated prevention programmes by parents, teachers, school counselors, school nurses, youth workers, friends, or the courts. Young people may also volunteer to participate in indicated prevention programmes.
Through the SAPTA AOD (alcohol and drug abuse) youth prevention programme, teachers in selected schools have been trained on SUD/HIV/AIDS risk reduction. SAPTA has facilitated the establishment and running of school based drug clubs, "Tia Drugs Zii Clubs" ("Say No to Drugs Clubs") in Kibera, the largest informal settlement in Africa. The programme is in the process of establishing a prevention education program for indicated secondary school students presenting signs of initial debut into substance abuse in Nairobi, Kenya. In future the SAPTA, AOD (alcohol and drug abuse) youth prevention programme aims to establish and run community based anti drug clubs in informal and formal settlements in Kenya. Through networking and collaboration with other partners and by using technological approaches, SAPTA hope to expand the reach of its prevention services country wide and to the rest of Africa.
SAPTA aims to increase awareness of substance abuse issues in Africa and their impact on HIV/AIDS and other associated health problems, and is looking to using information communication technologies (ICTs) to increase its reach country wide in Kenya and beyond the borders in Africa. SAPTA is advocating to policy makers & stakeholders for the adoption, funding and implementation of evidence based SUD/HIV/AIDS prevention services in Africa. SAPTA believes that substance abuse prevention and interventions should be included and funded in every country's strategic plan in Africa.
1Risk and Protective Focused Prevention: A Science-Based Approach Haggerty, K.P.
2"Drug Abuse Prevention: What Works", National Institute of Drug Abuse, 1997, p. 10-1