Transitioning from dementia‐related stigma to a Community Level Dementia Screening Program in Rural Kenya (DEM‐SKY)

Abstract

AbstractBackgroundPrimary health care providers face the challenge of making timely dementia diagnosis due to limited time available to interact with patients resulting in stigma, neglect and abuse. With training, these providers can collaborate with Community Health Workers (CHWs) to improve dementia detection and articulate the needs of communities whilst mobilizing resources that are salient in decision‐making, care coordination and service delivery processes. In this study, we outline the process that led to integration of a Community Level Dementia Screening Program in Rural Kenya (DEM‐SKY).MethodAs part of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, ten CHWs were trained to deliver a dementia anti‐stigma intervention to 59 members of the general public in rural Kenya, through four bi‐weekly psycho‐education sessions. This led to increased number of people turning up for dementia screening at a county referral hospital. However, due to lack of knowledge and busy waiting lines at the hospital, discussions on how to integrate dementia screening within the hospital began.ResultFindings from the STRiDE project formed the basis of integrating a community‐level dementia screening programme in Makueni County Referral Hospital in Kenya, a program that has seen more than 600 adults aged 60 and above screened for dementia by CHWs in a period of one month. Through partnership and collaboration with the hospital, a recording and reporting system for people living with dementia was established to provide an indication of the number of dementia cases and individuals referred from the community. This was made possible through: (i) training formal and informal providers on importance of dementia screening, (ii) continued awareness in communities to change existing negative dementia perceptions and (iii) motivating CHWs through project visibility materials and recognizing them in community events.ConclusionPublic awareness and stigma reduction using CHWs can be a precursor to strengthening health care systems through routine dementia screening for older people in community settings. This integration process also requires using task‐sharing approaches in order to promote timely detection and improve care coordination at all levels of care, thus forming a basis for formulation, implementation of policy and service planning.