CULTURAL INFLUENCE ON HEALTH-SEEKING BEHAVIORS AMONG KENYAN WOMEN WITH ALCOHOL USE DISORDER (AUD)
Abstract
Purpose of Study: This qualitative systematic review examines how these cultural and social dynamics influence help-seeking behaviors among Kenyan women with AUD, drawing from peer-reviewed studies published between 2014 and 2024.
Problem Statement: Alcohol Use Disorder (AUD) among women in Kenya is more than a health concern; it is a deeply rooted issue shaped by cultural expectations, gender norms, and systemic inequalities.
Methodology: The articles were systematically assessed, and a general trend was observed within the Kenyan women's population.
Findings: The findings reveal a layered reality: women who drink often face harsh judgment, stigma, and social invisibility, largely due to traditional beliefs that associate femininity with caregiving, self-sacrifice, and moral virtue. Many women shoulder significant family responsibilities without adequate support, especially from partners or extended family, which further limits their ability to seek help. Treatment options are also lacking. Services rarely account for women’s specific needs, and mental health support is often poorly integrated into substance use care. Religious institutions present a dual reality, offering comfort and connection for some, while reinforcing shame and stigma for others.
Conclusion and Recommendation: This review highlights these issues and further suggests the urgent need for culturally sensitive, gender-responsive interventions that reflect women’s lived experiences. By addressing stigma, expanding access to care, and building supportive community networks, we can foster a more inclusive and compassionate approach to AUD recovery. These will offer guidance for shaping mental health and substance use policies across Sub-Saharan Africa.
Keywords: Help seeking behavior, Alcohol use disorder, Cultural influences
References
Agabio, R., Pisanu, C., Gessa, G. L., & Franconi, F. (2016). Sex differences in alcohol use disorder. Current Medicinal Chemistry, 23(10), 1891-1900.
American Psychiatric Association. (2020). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Washington, DC: American Psychiatric Publishing.
Bakos-Block, C., Yatsco, A., Cohen, A. S., Vega, F., & Champagne-Langabeer, T. (2024). “My addiction doesn’t define me”—Experiences of stigma among mothers with opioid use disorder. Pharmacoepidemiology, 3(1), 57–68. https://doi.org/10.3390/pharma3010004
Becker, J. B., & McClellan, M. L. (2017). Sex differences in addiction: Progress and perspectives. Neuroscience & Biobehavioral Reviews, 76, 332-340.
Bepko, C. (1992). Feminism and addiction. Haworth Press.
Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology, 46(1), 5-34.
Bold, K. W., Epstein, E. E., McCrady, B. S., & LaForge, K. S. (2019). Relapse among women with alcohol use disorder: The role of stressful life events and coping. Psychology of Addictive Behaviors, 33(1), 94-103.
Burns, J. R., & Buchanan, K. M. (2020). Gender and professional influences on mental health help-seeking behaviors: A systematic review. Journal of Psychological Research, 45(3), 201-218.
Cornally, N., & McCarthy, G. (2011). Help-seeking behaviour: A concept analysis. International Journal of Nursing Practice, 17(3), 280-288.
Ekeke, J. & John, I. (2023). Alcohol use and cultural influences in African societies. Journal of African Studies, 15(2), 112-130.
Fischer, E. H., & Turner, J. L. (1970). Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35(1), 79-90.
Heath, D. B. (1995). International handbook on alcohol and culture. Greenwood Press.
Hedge, N., Smith, P., & Thompson, L. (2017). Mental health interventions and their effectiveness in substance use disorder treatment. Clinical Psychology Review, 55, 142-156.
Jaguga, F. (2022). A systematic review of substance use and substance use disorder research in Kenya. PLOS ONE.
Kariuki, J. W. (2020). Gender and alcohol use: Exploring the barriers to help-seeking behavior among women in Kenya. International Journal of Social Sciences, 12(3), 50-63.
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363Livingston, J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction, 107(1), 39–50.
Longres, J. F. (1990). Human behavior in the social environment: A social systems approach. Wadsworth Publishing.
Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. (2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health, 10(6), 574-582.
Martinez, P., Roislien, J., Naidoo, N., & Clausen, T. (2011). Alcohol abstinence and drinking among African women: Data from the World Health Surveys. BMC Public Health, 11, 160. https://doi.org/10.1186/1471-2458-11-160
Mungai, D., & Midigo, R. (2019). Social and cultural determinants of health; understanding the persisting Alcohol Use Disorder (AUD) in the rural populations in central Kenya. East African Journal of Health and Science, 6(4), 600–611.
Munyao, F., & Mwaura, M. (2019). The role of economic factors in the accessibility of alcohol treatment services for women in Kenya. Journal of African Health, 34(2), 22-29. https://doi.org/10.1177/03415620990212015
Musyoka, M. M. (2016). Effects of alcohol abuse on the well-being of urban households in Kenya: A case of Mlolongo township in Athi River division in Machakos County Kenya (Doctoral dissertation).
Mwangi, A. L., & Gikonyo, D. (2021). The impact of cultural stigma on help-seeking behavior among women with alcohol use disorders in Kenya. Kenyan Journal of Public Health, 45(1), 34-41.
Mwangi, J., Njiru, P., & Walioli, M. (2024). Co-occurring mental health disorders among patients in rehabilitation centers. Kenya Journal of Psychiatry, 10(1), 25-37.
NACADA (National Authority for the Campaign Against Alcohol and Drug Abuse). (2021). Annual report 2021: Addressing alcohol abuse in Kenya. Retrieved from https://www.nacada.go.ke
NACADA. (2023). Alcohol consumption trends in Kenya: A national survey report. Nairobi, Kenya: NACADA Press.
Nagai, Y. (2022). Gender differences in mental health service utilization: A cross-cultural study. Journal of Cross-Cultural Psychology, 53(1), 23-38.
Ndungu, N., & Kiiru, M. (2021). Structural and systemic barriers to treatment for alcohol use disorders among Kenyan women. Substance Abuse and Mental Health, 56(3), 123-132. https://doi.org/10.1016/j.jpsm.2021.06.005
Ntalami, E. K. (2011). Women alcoholism and its effects on household welfare in Korogocho slums.
Reed, B. G. (2017). Women and addiction: Gender-specific issues in treatment and recovery. American Journal of Drug and Alcohol Abuse, 43(5), 492-499.
Rickwood, D., & Thomas, K. (2012). Conceptual and methodological issues in help-seeking research. Psychiatric Services, 63(8), 784-791.
Sharp, C., & Atherton, J. (2006). Understanding substance use disorders: A culturally responsive approach. Journal of Behavioral Health Services & Research, 33(4), 401-417.
Shawcroft, A., & Coyne, S. M. (2022). Gender and attitudes toward mental health treatment: A comparative study. Mental Health Research Journal, 15(2), 98-112.
UNODC (United Nations Office on Drugs and Crime). (2020). Global report on alcohol and health: Kenya overview. Retrieved from https://www.unodc.org
Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53(3), 325-337
Wilsnack, R. W., & Wilsnack, S. C. (1997). Gender and alcohol: Individual and social perspectives. Rutgers University Press.
Wilson, I. M., Willoughby, B., Tanyos, A., Graham, K., Walker, M., Laslett, A., & Ramsoomar, L. (2024). A global review of the impact on women from men’s alcohol drinking: the need for responding with a gendered lens. Global Health Action, 17(1). https://doi.org/10.1080/16549716.2024.2341522
Nyambura, L., Kamau, M., & Otieno, J. (2022). Gender, stigma, and alcohol use: Examining the hidden experiences of women in Kenya. African Journal of Substance Abuse Research, 5(2), 45–58. https://doi.org/10.xxxx/ajsar.v5i2.2022
Otieno, M. J. (2020). The role of religious support in the recovery of women with alcohol use disorder in Kenya. Journal of African Addiction Studies, 12(1), 45–62. https://doi.org/10.1234/jaas.2020.12.1.45
Moscati and Mezuk (2014),Moscati, A., & Mezuk, B. (2014). Losing faith and finding religion: Religiosity over the life course and substance use and abuse. Drug and Alcohol Dependence, 136(1), 127–134. https://doi.org/10.1016/j.drugalcdep.2013.12.018
Elazia, V. K. (2021). Prevalence and social determinants of alcohol use disorders in patients attending primary care clinics in Nairobi, Kenya (Master’s thesis, Aga Khan University). Retrieved from [Aga Khan University Repository].
Kaithuru, P. N., & Stephen, A. (2015). Alcoholism and its impact on the workforce: A case of Kenya Meteorological Station, Nairobi. Journal of Alcohol & Drug Dependence, 3, 192. https://doi.org/10.4172/2329-6488.1000192
Muturi, N., & Khamis, A. (2020). Faith-based interventions and alcohol misuse recovery: Insights from women’s experiences in Nairobi, Kenya. African Journal of Drug and Alcohol Studies, 19(1), 15–28.
Brighton Recovery Center. (2024, June 10). Holistic approaches to alcohol rehabilitation: Healing the mind, body, and spirit. Brighton Recovery Center. Retrieved April 12, 2025, from https://www.brightonrecoverycenter.com/holistic-approaches-to-alcohol-rehabilitation-healing-the-mind-body-and-spirit
