Prevalence and Socio-demographic Factors of Depression among Secondary School Students in Bungoma County, Kenya
DOI:
https://doi.org/10.51867/ajernet.7.4.88Keywords:
Depression, Prevalence, Socio-Demographic, Adolescents, Secondary School Students, PHQ-9Abstract
Depression is a leading cause of illness and disability among adolescents worldwide, yet evidence on its burden among school-going adolescents in rural Kenyan counties remains limited. This study determined the prevalence and socio-demographic factors of depression among secondary school students in Bungoma County, Kenya, to provide baseline evidence for mental health planning. The study was guided by Hopelessness Theory of Depression and Ecological Systems Theory. An analytical mixed methods cross-sectional study design was adopted. The target population consisted of secondary school students, with a sample size of 400 respondents determined using Taro Yamane formula. The respondents were selected through multistage stratified and systematic sampling from three sub-counties of Bungoma County (Mt. Elgon, Kimilili and Bungoma South). Quantitative data were collected using the Patient Health Questionnaire (PHQ-9) and a structured questionnaire, and analyzed using descriptive statistics and ordinal logistic regression in SPSS version 28. Qualitative data were obtained through ten Focus group discussions with students and twelve in-depth interviews with class teachers, and analyzed thematically. The overall prevalence of depressive symptoms (PHQ-9 score ≥ 5) was 55.5% (n = 222), 41.5% (n = 166) had mild depression, 9.5% (n = 38) moderate depression, 3.5% (n = 14) moderately severe depression and 1.0% (n = 4) severe depression, while 44.5% (n = 178) were not depressed. Female students were found to be almost twice as likely to experience higher levels of depression compared to the males (AOR= 1.71, P= 0.04). On the other hand, students in mixed day and boarding schools were 78% less likely to experience higher level of depression, (AOR = 0.22, P<0.001), compared to those in girls’ boarding and day schools. Further, students who live with extended family were more than twice as likely as those with both parents to experience higher depression levels (AOR = 2.10, P= 0.04). The qualitative data pointed to gender and family structure as possible associations of depression. Depression is highly prevalent among secondary school students in Bungoma County, with one in seven students experiencing moderate to severe depression. Routine school-based mental health screening using validated tools such as the PHQ-9 is recommended to enable early identification, counselling and referral of affected students.
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References
Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96(2), 358-372. https://doi.org/10.1037/0033-295X.96.2.358
Adewuya, A. O., Oladipo, O. E., & Esangbedo, A. (2026). School protective factors and adolescent mental health in Nigeria: An investigation of cumulative effects, buffering mechanisms, and gender differences. BMC Psychology, 14, Article 399.
https://doi.org/10.1186/s40359-026-04150-z
Alharbi, R., Alsuhaibani, K., Almarshad, A., & Alyahya, A. (2019). Depression and anxiety among high school student at Qassim Region. Journal of Family Medicine and Primary Care, 8(2), 504-510. https://doi.org/10.4103/jfmpc.jfmpc_383_18
Antipas, H., Mutisya, S., & Ntaragwe, M. (2022). Prevalence of depression among adolescents in Narok County Kenya. International Journal of Research and Innovation in Social Science, 6(7), 597-601.
https://doi.org/10.47772/IJRISS.2022.6735
Bajaria, S., Yusufu, I., Mboya, I. B., Eyeberu, A., Dessie, Y., Assefa, N., Shinde, S., Patil, R., Tang, K., & Oduola, A. (2025). Prevalence and correlates of anxiety and depressive symptoms among adolescents aged 10-19 years in six sub-Saharan African countries, China and India: A cross-sectional study. PLOS Mental Health, 2(10), Article e0000479.
https://doi.org/10.1371/journal.pmen.0000479
Bakesia, G., Olayo, R., Mengich, G., & Opiyo, R. (2023). Prevalence and sociodemographic predictors of depression among adolescents in secondary schools in Kakamega County, Kenya. East African Medical Journal, 100(8), 6167-6175.
Barrett, S., Muir, C., Burns, S., Adjei, N., Forman, J., Hackett, S., Hirve, R., Kaner, E., Lynch, R., Taylor-Robinson, D., Wolfe, I., & McGovern, R. (2024). Interventions to reduce parental substance use, domestic violence and mental health problems, and their impacts upon children's well-being: A systematic review of reviews and evidence mapping. Trauma, Violence, & Abuse, 25(1), 393-412. https://doi.org/10.1177/15248380231153867
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
https://doi.org/10.4159/9780674028845
DadeMatthews, A., Nzeakah, C., Onofa, L., DadeMatthews, O., & Ogundare, T. (2024). Teenage blues: Predictors of depression among adolescents in Nigeria. PLOS ONE, 19(4), Article e0293995. https://doi.org/10.1371/journal.pone.0293995
Draxler, J. M., Ruppar, T. M., Carbray, J. A., & Delaney, K. R. (2025). Screening for adverse childhood experiences in adolescents using the Bright Futures previsit questionnaire. Journal of Pediatric Health Care, 39(1), 76-82. https://doi.org/10.1016/j.pedhc.2024.06.018
Figueiredo, R. G., Patino, C. M., & Ferreira, J. C. (2025). Cross-sectional studies: Understanding applications, methodological issues, and valuable insights. Jornal Brasileiro de Pneumologia, 51(1), Article e20250047. https://doi.org/10.36416/1806-3756/e20250047
Florence, A., Michelle, K., & Michael, K. (2022). Correlates of parental dysfunctionality and depressive disorder among adolescents in Bungoma County, Kenya. Impact: Journal of Transformation, 5(1), 38-49.
https://doi.org/10.63988/PPAZ3624
Hyde, J. S., & Mezulis, A. H. (2020). Gender differences in depression: Biological, affective, cognitive, and sociocultural factors. Harvard Review of Psychiatry, 28(1), 4-13. https://doi.org/10.1097/HRP.0000000000000230
Johnson, N. E., Musonye, W. M., & Osborn, T. L. (2023). A dataset of the mental health and wellbeing of Kenyan adolescents. Data in Brief, 48, Article 109082. https://doi.org/10.1016/j.dib.2023.109082
Kathuri-Ogola, L., & Kabaria-Muriithi, J. (2024). Family structure, adolescent identities, and the crisis (dilemma) of transition into early adulthood in Kenya. In Y. R. Xia, M. R. T. De Guzman, R. Esteinou, & C. S. Hollist (Eds.), Global perspectives on adolescents and their families (pp. 293-312). Springer International Publishing.
https://doi.org/10.1007/978-3-031-49230-3_14
Kenya Institute of Curriculum Development. (2017). Basic education curriculum framework. https://kicd.ac.ke/curriculum-reform/basic-education-curriculum-framework/
Kenya National Bureau of Statistics, & ICF. (2023). Kenya demographic and health survey 2022. KNBS and ICF.
Khasakhala, L. I., Ndetei, D. M., Mutiso, V., Mbwayo, A. W., & Mathai, M. (2012). The prevalence of depressive symptoms among adolescents in Nairobi public secondary schools: Association with perceived maladaptive parental behaviour. African Journal of Psychiatry, 15(2), 106-113. https://doi.org/10.4314/ajpsy.v15i2.14
Kinyua, S. M. (2022). Relationship between social media use and level of depression among university students in Nairobi County, Kenya [Master's research project, Kenyatta University].
Kisiang'ani, I. B., Sumba, C., Rajah, M., & Kem, P. (2024). Prevalence and sociodemographic correlates of psychotic and mood disorders among the population in Bungoma County, Kenya. African Journal of Empirical Research, 5(1), 36-44. https://doi.org/10.51867/ajernet.5.1.4
Klaufus, L., Verlinden, E., van der Wal, M., Cuijpers, P., Chinapaw, M., & Smit, F. (2022). Adolescent anxiety and depression: Burden of disease study in 53,894 secondary school pupils in the Netherlands. BMC Psychiatry, 22, Article 225. https://doi.org/10.1186/s12888-022-03868-5
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lilly, K. J., Howard, C., Zubielevitch, E., & Sibley, C. G. (2023). Thinking twice: Examining gender differences in repetitive negative thinking across the adult lifespan. Frontiers in Psychology, 14, Article 1239112. https://doi.org/10.3389/fpsyg.2023.1239112
Liu, Z., & Kuai, M. (2025). The global burden of depression in adolescents and young adults, 1990-2021: Systematic analysis of the Global Burden of Disease Study. BMC Psychiatry, 25, Article 767. https://doi.org/10.1186/s12888-025-07201-8
Lund, C., Brooke-Sumner, C., Baingana, F., Baron, E. C., Breuer, E., Chandra, P., Haushofer, J., Herrman, H., Jordans, M., & Kieling, C. (2018). Social determinants of mental disorders and the Sustainable Development Goals: A systematic review of reviews. The Lancet Psychiatry, 5(4), 357-369. https://doi.org/10.1016/S2215-0366(18)30060-9
Luthar, S. S., & Kumar, N. L. (2018). Youth in high-achieving schools: Challenges to mental health and directions for evidence-based interventions. In A. W. Leschied, D. H. Saklofske, & G. L. Flett (Eds.), Handbook of school-based mental health promotion (pp. 441-458). Springer International Publishing.
https://doi.org/10.1007/978-3-319-89842-1_23
Madara, M., & Chang'orok, J. (2024). Marketing and communication strategies deployed by betting companies to foster addiction among Kenyan youths. Journal of African Interdisciplinary Studies, 8(4), 37-53.
Marangu, E., Mansouri, F., Sands, N., Ndetei, D., Muriithi, P., Wynter, K., & Rawson, H. (2021). Assessing mental health literacy of primary health care workers in Kenya: A cross-sectional survey. International Journal of Mental Health Systems, 15, Article 55. https://doi.org/10.1186/s13033-021-00481-z
Mbithi, G., Mabrouk, A., Sarki, A., Odhiambo, R., Namuguzi, O., Dzombo, J. T., Atukwatse, J., Kabue, M., Mwangi, P., & Abubakar, A. (2023). Mental health and psychological well-being of Kenyan adolescents from Nairobi and the Coast regions in the context of COVID-19. Child and Adolescent Psychiatry and Mental Health, 17, Article 63. https://doi.org/10.1186/s13034-023-00613-y
Minelli, R., Meoli, A., Tiri, A., Fanelli, U., Iannarella, R., Gismondi, P., & Esposito, S. (2020). An atypical presentation of primary hyperparathyroidism in an adolescent: A case report of hypercalcaemia and neuropsychiatric symptoms due to a mediastinal parathyroid adenoma. Frontiers in Endocrinology, 11, Article 581765. https://doi.org/10.3389/fendo.2020.581765
Misigo, J. I. (2021). Relationship between selected forms of bullying and psychosocial adjustment among secondary school students in Bungoma County, Kenya [Doctoral dissertation, Kabarak University].
Mokaya, A. G., Kikuvi, G., Mutai, J., & Memiah, P. (2025). A descriptive phenomenological study of school-related gender-based violence: Lived experiences of symbolic violence, harassment, and systemic complicity in a mixed secondary school in Nairobi, Kenya. BMC Public Health, 25, Article 3926.
https://doi.org/10.1186/s12889-025-25341-0
Moreira, P., Pedras, S., Silva, M., Moreira, M., & Oliveira, J. (2021). Personality, attachment, and well-being in adolescents: The independent effect of attachment after controlling for personality. Journal of Happiness Studies, 22(4), 1855-1888.
https://doi.org/10.1007/s10902-020-00299-5
Muteti, J., & Kamenderi, M. (2019). Status of drugs and substance abuse among secondary school students in Kenya. African Journal of Alcohol and Drug Abuse, 1, 1-6.
Nalugya-Sserunjogi, J., Rukundo, G. Z., Ovuga, E., Kiwuwa, S. M., Musisi, S., & Nakimuli-Mpungu, E. (2016). Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child and Adolescent Psychiatry and Mental Health, 10, Article 39. https://doi.org/10.1186/s13034-016-0133-4
Nuna, R. M. (2025). Relationship between prevalence of cyberbullying and psychological wellbeing of adolescents' in selected public secondary schools in Nairobi County, Kenya. Journal of Popular Education in Africa, 9(10), 59-73.
Nyayieka, M. A., Nyagwencha, S. K., & Nzyuko, S. (2020). Prevalence of clinical depression and anxiety among adolescents in selected secondary schools in Homabay County, Kenya. African Journal of Clinical Psychology, 3(1), 1-13.
Nyongesa, M. K. (2019, October 20). Depression in Kenya. Globally Minded. https://www.globallyminded.org/home/depression-in-kenya/
Nzangi, A., Munene, A., Chang'orok, S., & Mucherah, W. (2022). Prevalence of depression among adolescents in selected public secondary schools in Makueni County, Kenya. African Journal of Clinical Psychology, 4(3).
Obeng-Okon, N. A. S., Opoku, D. A., Ayisi-Boateng, N. K., Osarfo, J., Amponsah, O. K. O., Ashilevi, J., Agyemang, S., Bernard, F., Addai-Manu, H., & Mohammed, A. (2024). Prevalence and correlates of depression among students in a senior high school in Ghana: A school-based cross-sectional study. SAGE Open Medicine, 12, Article 20503121241229841. https://doi.org/10.1177/20503121241229841
Osborn, T. L., Venturo-Conerly, K. E., Gan, J. Y., Rodriguez, M., Alemu, R. G., Roe, E., Arango, S. G., Wasil, A. R., Campbell, S., & Weisz, J. R. (2022). Depression and anxiety symptoms amongst Kenyan adolescents: Psychometric properties, prevalence rates and associations with psychosocial wellbeing and sociodemographic factors. Research on Child and Adolescent Psychopathology, 50(11), 1471-1485.
https://doi.org/10.1007/s10802-022-00940-2
Patel, U., Chauhan, D., Patel, M., Rahul, K., & Yadav, V. (2023). Determinants of depression among higher secondary students of private schools of science stream in an urban area of western India. Indian Journal of Community Medicine, 48(2), 334-339. https://doi.org/10.4103/ijcm.ijcm_374_22
Pozuelo, J. R., Desborough, L., Stein, A., & Cipriani, A. (2022). Systematic review and meta-analysis: Depressive symptoms and risky behaviors among adolescents in low- and middle-income countries. Journal of the American Academy of Child & Adolescent Psychiatry, 61(2), 255-276. https://doi.org/10.1016/j.jaac.2021.05.005
Saleem, N., Young, P., & Yousuf, S. (2024). Exploring the relationship between social media use and symptoms of depression and anxiety among children and adolescents: A systematic narrative review. Cyberpsychology, Behavior, and Social Networking, 27(11), 771-797. https://doi.org/10.1089/cyber.2023.0456
Smith, O. A., Nelson, J. A., & Adelson, M. J. (2019). Interparental and parent-child conflict predicting adolescent depressive symptoms. Journal of Child and Family Studies, 28(7), 1965-1976.
https://doi.org/10.1007/s10826-019-01424-6
United Nations. (2026). SDG indicators. https://unstats.un.org/sdgs/report/2026/
Vidal, C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social media use and depression in adolescents: A scoping review. International Review of Psychiatry, 32(3), 235-253. https://doi.org/10.1080/09540261.2020.1720623
Waiganjo, M. M., & Waiganjo, M. M. (2018). Relevance of life skills education in preparing Kenyan youth for national development. Journal of African Studies in Educational Management and Leadership, 10, 85-103.
World Health Organization. (2025). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
World Health Organization. (2026). Depression. https://www.who.int/health-topics/depression
Yabunga, P. M., Koyiet, P. N., Simiyu, K., Kitur, S., Koskei, P., Evangelidou, S., & Manyara, A. M. (2025). Prevalence and correlates of common mental health disorders, functioning and resilience among youth in Western Kenya: A cross-sectional study. East African Medical Journal, 102(2), 412-424.
https://doi.org/10.21203/rs.3.rs-6933736/v1
Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper & Row.
Yang, C., Lv, J., Kong, X., Chu, F., Li, Z., Lu, W., & Li, X. (2024). Global, regional and national burdens of depression in adolescents and young adults aged 10-24 years, from 1990 to 2019: Findings from the 2019 Global Burden of Disease Study. The British Journal of Psychiatry, 225(2), 311-320. https://doi.org/10.1192/bjp.2024.69
Zakar, R., & Iqbal, S. (2024). Editorial: Social determinants of women's health in low and middle income countries. Frontiers in Global Women's Health, 5, Article 1482047. https://doi.org/10.3389/fgwh.2024.1482047
Zhao, J., Sun, X., & Wang, Q. (2021). Emotional neglect and depressive symptoms of left-behind adolescents: The role of friendship quality and gender. Journal of Affective Disorders, 295, 377-383. https://doi.org/10.1016/j.jad.2021.08.073
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