Defaulting Rate Among Patients Attending Methadone Maintenance Clinics in Nairobi City County, Kenya
| dc.contributor.author | Owuor, Sharon Akoth | |
| dc.date.accessioned | 2026-03-13T12:27:12Z | |
| dc.date.available | 2026-03-13T12:27:12Z | |
| dc.date.issued | 2025-11 | |
| dc.description | A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, November, 2025 Supervisor: 1.Isaac Mwanzo 2.Alloys Orago | |
| dc.description.abstract | Defaulting from MMT clinics is a major public health problem affecting people globally resulting into high transmission of HIV, hepatitis B and C, increased crime rate and reduced productivity of an individual. There is a global increase in the use of opioids with a prevalence of 1.2 % and in Kenya the prevalence stands at 0.3 %. The objective of this study was to investigate the defaulting rate and its associated factors, and the strategies that can be put in place to improve retention. This study was done at Ngara MMT clinic and Mathari MMT in Nairobi City County, Kenya. A cross-sectional analytical study design was employed, and the study population was the patient’s currently taking methadone in both clinics. There was use of simple random sampling with a sample size of 369 being recruited in both facilities. Stratified Sampling was used to select 8 members of the FGD and purposive sampling done for the key informants in both facilities. A researcher-administered questionnaire, a key informant guide, and a focus group discussion guide were used to collect data. Quantitative data analysis was done using SPSS version 24.0. Chi-Square and regression analysis were used for descriptive and inferential statistics for the quantitative data, and the qualitative data was analysed thematically. All study participants signed informed consent. Sociodemographic data was collected and the mean age of the patients was 33.91. The defaulting rate of patients attending MMT clinics was 53% with no significant association between defaulting and type of MMT clinic (χ2 = 2.731, df = 1, p = .098). The study found significant associations between MMT defaulting and marital status (χ2 = 44.592, df = 3, p < .001), religion (χ2 = 47.653, df = 2, p < .001), education level (χ2 = 72.125, df = 3, p < .001), and income source (χ2 = 44.784, df = 2, p < .001). Age and MMT benefits awareness had no association with defaulting. Social support from friends and family was also significantly associated with MAT defaulting (χ 2 =34.453, df=1, p<0.001). The institutional factors such as affordability of transportation, HCW friendliness, clinic hour’s convenience, and waiting time for attendance were also significantly associated with defaulting. This study identified several strategies to improve the retention rate among MMT clients including extension of clinic hours, expanding mobile van clinic, staff training on dealing with patients, fare provision, reduced stigmatization, defaulter tracing, family and community support, and avoiding peer influence. Additionally, frequent patient counselling and education were suggested as ways to improve retention. To improve patient retention and improve methadone effectiveness, this study recommends the implementation of the suggested measures. The Ministry of Health should ensure the implementation of the retention measure within the MMT clinics to improve methadone effectiveness | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/32742 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Defaulting Rate Among Patients Attending Methadone Maintenance Clinics in Nairobi City County, Kenya | |
| dc.type | Thesis |