Challenges To Family Behaviour Therapy and Universal Health Coverage among Refugee LGBTIQQ: A study of Three Urban Settings in Kenya, 2019

There are challenges to Family Behaviour Therapy and Universal Health Coverage among Refugee LGBTIQQ. This was revealed in a  study of three urban settings in Kenya, done between August to November 2019 by Dr. Tom Muyunga-Mukasa.

An LGBTIQQ identity, mixed with non-citizen status, mobility and financial hardships provide problem contexts affect how refugee LGBTIQQ each can access, afford and enjoy quality health services. This study analysed variables affecting health seeking practices and how leaders of Mutual Aid Groups could ensure inclusion, equality and quality life.

All five mutual Aid Groups in the study, owned houses, pay rent, utilities and food, have all 48 members fully documented.

But, 12 have drug or alcohol use disorders. These factors directly impact health. In the last 10 months 2 of the Mutual Aid Groups had to caution 8 as well as suspend 3 members for drug-related violent acts; in another, 2 members missed taking ARVs regularly after a relapse into alcohol abuse. None received professional care. 

A dramatic rivalry among the groups and outing to Police authorities which has quality life threatening consequences. Family Based Therapy (FBT) combined methods and HCT services are apparent.

It is obvious that , LGBTIQQ benefiting from support structures promoting inclusion, equality, parity, self-determination and not suffering hardships (financial, political, religious, social, cultural and legal) are healthy.

Future research will be done into how access to trained service providers, qualifications for gainful employment, integration skills, interpersonal/intrapersonal skills, contribute to the common good of their communities and good rapport.

Universal Health Care is an often made statement. However, on scrutiny, one finds that it applies to people whose identity is heterosexual, who is married officially and status is a well-documented citizen and financially sound. The 2010 Constitution, guarantees the right to healthcare, including reproductive health. However, violations of the right to sexual and reproductive health continue to be experienced throughout Kenya. Stigma and discrimination towards MSM and other members of LGBTIQQ communities, are barriers against seeking the quality health services they need with over half of HIV infections and drug use disorders going undiagnosed.

An LGBTIQQ identity, mixed with non-citizen status, drug or alcohol user, mobility and financial hardships, affect how refugee LGBTIQQ each can access, afford and enjoy quality health services.

The implications for public health practice

Identity and status play an important role on agency, autonomy, self-determination and confidence. Remediation should be focused on ensuring access to Prevention services in order to address HIV infections and drug use disorders. As well, improving access to health care, rehabilitation, political and legal dispensation entrenching and enforcing upholding dignity of persons.