Abstract:
Background: Substance use is an unhealthy behavior that predisposes healthcare
workers to health, social and work-related problems. Few studies conducted in Lowand
Middle-Income Countries have investigated the burden of substance use among
healthcare workers, and particularly among hospital employees. Knowledge on the
extent of the problem and its associated factors is important in establishing
interventions especially in Low- and Middle-Income countries where human
resource for health is scarce. This study therefore intends to bridge an existing gap in
knowledge.
Broad objective: To determine the prevalence and factors associated with substance
use among employees of Moi Teaching and Referral Hospital.
Methods: This was a cross-sectional study in which multistage stratified sampling
technique was used to stratify the sampling frame into cadre, work station and
sex, and proportionate random sampling technique was used to identify the
respondents. The World Health Organization‘s Alcohol, Smoking and Substance
Involvement Screening Test (ASSIST) questionnaire was administered to 374
employees of Moi Teaching and Referral Hospital (MTRH), in Eldoret, Kenya,
between January and June 2020. A total of 330 employees responded. Descriptive
statistics were used to summarize the data, while inferential statistical methods were
used to assess for associations.
Results: The mean age of the respondents was 37 years (SD +/-7.8). Majority were
female (62.4%). 44.8% were in the age category of 30-39 years. The prevalence of
lifetime use was 42.42% for alcohol, 7.88% for tobacco, 5.15% for cannabis, 3.94%
for sedatives, 3.33% for Cocaine, 2.12% for hallucinogens, 1.82% for Opioids,
0.91% for Amphetamines, and 0.3% for inhalants. Alcohol (29.05%) and tobacco
(6.73%) were the most commonly used substances in the past three months. Only
two participants (0.61%) reported lifetime use of injection drugs. Majority of the
respondents fell in the low and moderate risk categories of current substance users.
Lifetime use of alcohol was significantly associated with being male (p=<0.001),
Being unmarried (p=0.024), Use of substances by co-workers (p=<0.001) and ease
in availability of substances at the workplace (p=0.039). Lifetime use of tobacco was
significantly associated with being male (p=<0.001), years of work experience
(p=0.004) and use of substances by coworkers (p=0.042).
Conclusion: The prevalence of lifetime and current use of substances among
hospital employees was high especially for alcohol and tobacco. Being male and
having a co- worker who was using substances were common predictors of
substance use.
Recommendations: Based on the findings, we recommend regular screening of
MTRH employees for alcohol, tobacco and other substance use. We further
recommend that, interventions targeting groups at risk be implemented and strict
surveillance be done to ensure that substances are not easily accessible within the
workplace at MTRH.