Perspectives of alcohol treatment providers and users on alcohol addiction and its facilitating factors in Uganda and Belgium

Abstract

Background: Although conceptualisation of addiction varies with time and culture, literature on intercultural studies between high and low income countries is scarce. This article uses Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 guidelines on diagnosis of Alcohol Use Disorder (AUD) and the Capability Opportunity Motivation – Behaviour (COM-B) model to explore perspectives on alcohol addiction and its facilitating factors in Uganda and Belgium.

Method: Sixty qualitative interviews (40 with service providers and 20 service users) were administered in four alcohol treatment centres, two in Uganda and two in Belgium. Interviews were transcribed and analysed thematically using Nvivo software.

Result: While addiction was primarily regarded as a disease enabled by capability factors (affordability and the absence of life and social skills) by Belgian respondents, many Ugandans viewed it as a moral or criminal issue; motivated by the varied roles of informal alcohol use amidst weak restrictions. Opportunity-related factors including; acceptability, availability, media influence, cultural/religious beliefs and practices and peer influence were recognised as facilitating factors in both countries, while stigma was equally prevalent.

Conclusion: Interventions in Uganda could explore strengthening legislation and research on utilisation of the well-entrenched religious and cultural institutions to encourage alternatives to alcohol use. In Belgium, promotion of life and social skills, alcohol regulation in educational institutions and other demand reduction strategies seem essential to delay the onset of (mis)use. In both societies; general reduction of opportunities for access, early intervention, programmes for young persons and prevention of stigma through awareness-raising can be explored for mitigation of AUD.

Keywords:

• Addiction
• alcohol abuse
• alcohol policy
• perceptions
• treatment
• recovery and rehabilitation

Acknowledgement

The authors extend gratitude to the management, staff and clients of Butabika Hospital (Alcohol and drug unit) and Hope and Beyond in Uganda and the alcohol units of the St-Camillus and St-Jozef psychiatric hospitals in Belgium for the cooperation and enthusiasm shown in the research. We would like to thank the research assistants O. Nakiboneka, I. Dumarey, T. Southey and V. Brtnikova, who – along with the principal investigator – transcribed the data.

Disclosure statement

David Kalema works with an alcohol and drugs rehabilitation centre in Kampala, Uganda. Others have no interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The research is part of a doctoral programme financed by Ghent University (Belgium) and initial logistical support from the Catholic Scholarship Fund-Uganda.