Kenya is set to strengthen access to drug and substance abuse treatment at the community level following the validation of new guidelines aimed at bringing rehabilitation services closer to people in need.
The National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) has endorsed the Community-Based Rehabilitation (CBR) Guidelines, which seek to decentralise care and integrate addiction treatment into primary healthcare and existing community support structures.
The guidelines were validated during a board meeting chaired by NACADA chairman Stephen Mairori, paving the way for the next phase of implementation in collaboration with county governments and community organisations.
The initiative comes amid concerns over the limited capacity of formal rehabilitation facilities, the high cost of treatment and the stigma associated with seeking help for substance use disorders.
According to NACADA, Kenya has 135 accredited treatment and rehabilitation facilities with a combined capacity of 3,790 beds, highlighting the need for alternative approaches that can reach more people, particularly in underserved areas.
The authority's national survey estimates that about 1.36 million Kenyans aged between 15 and 65 have severe alcohol use disorder, while 887,627 have severe tobacco use disorder.
Communities to play greater role in addiction treatment
Under the proposed framework, communities will play a greater role in identifying people struggling with addiction, linking them to appropriate care and supporting their recovery.
Community Health Promoters will be involved in screening, early identification and referrals, while Community Coordination Committees will bring together health workers, social workers, psychologists, families, local administrators, faith-based organisations and people with lived experience of addiction.
The guidelines outline a range of interventions, including outpatient treatment, medication-assisted therapy, peer support, mobile treatment units, harm reduction services, sober living arrangements and faith-based rehabilitation programmes.
They also establish a comprehensive approach to recovery, covering prevention, early intervention, treatment, aftercare, relapse prevention and reintegration into society.
Guidelines prioritise vulnerable groups
NACADA's framework places particular emphasis on vulnerable groups who may face additional barriers to accessing treatment. These include persons with disabilities, out-of-school children and young people, street-connected persons, refugees, older people and individuals in contact with the criminal justice system.
Gender-responsive services and trauma-informed care are also incorporated into the guidelines, alongside provisions for involving families and caregivers throughout the recovery process.
Beyond medical treatment, the framework recognises the importance of helping recovering individuals rebuild their lives through education, vocational training, employment opportunities, housing assistance and family support.
Framework strengthens accountability and recovery support
To improve accountability and service delivery, the guidelines provide for standardised training of community-based rehabilitation personnel, supervision and mentorship, as well as monitoring systems to assess programme performance and client outcomes.
Data collection will be aligned with national health information systems, including the Electronic Community Health Information System (eCHIS), to support coordination and monitoring.
The framework also outlines safeguards on informed consent, confidentiality, data protection and protection against abuse and exploitation. It further prohibits partnerships with alcohol, tobacco and other harmful substance industries through conflict-of-interest provisions.
With validation complete, NACADA is expected to work with county governments and community organisations to begin implementing the guidelines, in a move that could make rehabilitation more accessible to individuals and families affected by substance abuse.
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