Access Barriers to Support Services for People Who Use Illicit Drugs in Lamu County, Kenya

Abstract

Background: Despite high rates of substance use among youth and adults in coastal Kenya, access barriers to support services for people who use illicit drugs remain a significant public health challenge in Lamu County. This study aimed to assess access barriers by examining awareness of available support services, evaluating user satisfaction with services received, and identifying socioeconomic factors affecting accessibility. Methods: A cross-sectional mixed-methods design was employed, combining structured questionnaires and key informant interviews. The study involved 207 drug users selected through purposive cluster sampling and snowball sampling across three wards (Mkomani, Hindi, and Faza), along with 48 stakeholders including healthcare professionals, administrative staff, and community representatives. Quantitative data were analyzed using SPSS version 28, while qualitative data underwent content analysis to identify themes related to service access barriers. Results: The study found consistently low outcomes across all focus areas. Awareness of support services was poor, with most participants unaware of existing services or lacking clarity on access procedures. Satisfaction levels were low, with users citing unresponsive service delivery, lack of privacy, and disrespectful provider attitudes. Socioeconomic barriers including low income, unemployment, and poor housing conditions further hindered access. Participants reported significant logistical challenges including geographic isolation, rigid service schedules, and fear of legal repercussions. Correlation analysis revealed strong positive associations between awareness, satisfaction, socioeconomic factors, and access to services. Conclusion: A combination of low awareness, poor service quality, and socioeconomic hardship severely limits access to drug-related support services in Lamu County. The study recommends strengthening community outreach and media-based awareness campaigns, improving service delivery quality, reducing financial and legal access barriers, strategic placement of facilities, flexible service hours, and stigma reduction efforts to increase accessibility and utilization of support services.