Speaker
Description
Background
In Embakasi West’s informal settlements, baseline screening of 150 widows revealed 78% with moderate-to-severe depression (PHQ-9 ≥10; scale range 0–27) and 65% reporting high social isolation (UCLA Loneliness Scale ≥45). Cultural violence—property seizure and forced “widow cleansing”—combined with economic exclusion, intensifies post-traumatic stress disorder (PTSD) and suicidal ideation (SWISS Strategic Plan, p.10). SWISS’s CARE model—Community Advocacy, Resilience, Empowerment—was designed to reduce depression and isolation by 50% and double counselling uptake over a six-month follow-up period.
Methods
From January to March 2025, four multidisciplinary teams (8 Community Health Promoters, 15 trained paralegals, TB/HIV champions, and CHMT liaisons) implemented:
Advocacy (WORD): Five community justice hubs resolving property and GBV cases
Psychoeducation (WHIP): Grief and SRHR workshops co-designed with AMREF
Economic Action (WISEEP): Table banking circles tracked via KoboToolbox
Assessments at baseline and six months used PHQ-9, GAD-7, UCLA Loneliness Scale, WHO-5 Well-Being Index, and NVivo-coded qualitative data.
Results
Depression prevalence dropped from 78% to 42% (ΔPHQ-9 = –7 points; p<0.001)
Isolation scores decreased by 65% (UCLA)
38% of participants improved from “low” to “moderate” well-being (WHO-5)
Counselling uptake increased from 22% to 85%
92% of WISEEP participants earned ≥KSh 5,000/month
Over 120 property restitution cases were resolved
92% of participants rejected “widow cleansing” practices
ROI: Clinical costs averted / program cost = 3.1×
Conclusions & Next Steps
SWISS CARE demonstrates that training widows as paralegals and peer educators reduces depression, dismantles cultural stigma, and strengthens economic resilience. Embedded in CHMT systems and formalized through the Embakasi West Widow Protection Guidelines (2025), the model is scaling via a real-time digital M&E dashboard.
Next steps include expansion to two additional Nairobi wards and alignment with Kenya’s County Mental Health Strategy.
Keywords
widow mental health · cultural trauma · community paralegals · savings groups · Nairobi
