Abstract:
Abstract: In Kenya, there is a treatment gap for depression and alcohol use that is especially large
for fathers, which has consequences for families. While treatments exist, there are challenges to
implementation. This study aimed to understand barriers and facilitators to implementing a treatment
for fathers’ depression and alcohol use in Eldoret, Kenya. Guided by the Consolidated Framework
for Implementation Research and the Integrated Sustainability Framework, we conducted 18 key
informant interviews and 7 focus group discussions (31 total participants) with stakeholders in
Eldoret (hospital leaders, policy makers, mental health providers, community leaders, fathers, lay
providers, and patients previously engaged in treatment). Interviews were analyzed using the
framework method; themes were matrixed by framework domains. Participants identified barriers
and facilitators, and opportunities for implementation, in the following domains: innovation, outer
setting, inner setting, individual, sustainability, and characteristics of systems. Barriers included a
lack of resources, stigma, masculine norms, cost of services, and alcohol dependence. Facilitators
included community buy-in, family support, providers with lived experience, government support,
and relevant treatment content. Findings will inform implementation strategy development for an
intervention for fathers with depression and alcohol use, and family problems with local relevance
and scalable potential.