Speaker
Description
Background: Child and adolescent mental health (CAMH) disorders contribute substantially to morbidity and disability globally, with an estimated prevalence of 10–14% in sub-Saharan Africa. In Kenya, 46% of the population (~21.9 million) are under the age of 18, yet little is known about CAMH services and systems (CAMHSS) in the country. This study set out to perform the first situational analysis of CAMHSS in Kenya as a baseline for future CAMHSS strengthening initiatives.
Methods: A desktop situational analysis was conducted using an adapted brief version of the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS 2.2), modified to include CAMH-specific variables. Data were obtained from publicly available policy documents, legislation, routine health information systems (KHIS/DHIS2), regulatory bodies, academic publications (2016–2025) and grey literature, with the support of key CAMHSS stakeholders. A narrative synthesis was performed across the six WHO-AIMS domains. The study was approved by the University of Cape Town HREC.
Results: Under Domain 1 (Policy and Legislative Framework), Kenya had no dedicated CAMH policy, plan, budget or coordinating authority. Instead, CAMH was embedded within broader mental health and child protection frameworks, with limited documented implementation. In Domain 2 (CAMH Services), outpatient services were concentrated in a small number of urban referral hospitals, with no dedicated public inpatient CAMH units. Services were largely delivered by general psychiatrists, and availability of medication in public facilities was inconsistent. For Domain 3 (CAMH in Primary Healthcare), integration occurred mainly through mhGAP training; structured CAMH-specific supervision and monitoring was limited. Domain 4 (Human Resources) revealed limited specialist CAMH training across professional groups and identified only three specialist child & adolescent psychiatrists nationally. Domain 5 (Public Education and Intersectoral Collaboration) identified a handful of project-based and fragmented initiatives. Domain 6 (Monitoring and Research) identified 172 CAMHSS publications from Kenya, but routine data systems inadequately captured CAMH indicators.
Conclusions: Despite existing policy and legislative foundations and a growing research base, substantial gaps remain in governance, service delivery, workforce capacity, primary care integration, and monitoring of CAMHSS in Kenya. Coordinated national and county-level investment and explicit CAMH-focused strategies are required to translate policy intent into equitable, developmentally-appropriate CAMH care in Kenya.
Keywords: Situational analysis, WHO-AIMS, Child, Adolescent, Mental health, Services, Kenya, Low- and middle- income countries, LMIC