Table 1.
Pre-analysis organizing system for Kenya heroin shortage rapid assessment, 2010-2011.
| Thematic foci | Situational considerations | Landscape |
|---|---|---|
| Settings | Heroin market disruption: precipitating factors | • High level policy speeches related to drug trafficking and profiting |
| • Community demonstrations against GoK inaction on arresting “drug barons” and impact in Mombasa | ||
| • Interdiction of heroin | ||
| • Arrests of low level drug dealers | ||
| Initiating events | Heroin market disruption: consequences | • Abrupt and sustained shortage of heroin |
| • Heroin cost increases | ||
| • Heroin quality decreases | ||
| Internal reactions | Public health emergency | • Heroin users experience acute opioid withdrawal |
| • No methadone available, no NSP and some chemists sell syringes | ||
| • Logistics of procuring and using drugs adversely impacted: | ||
| • Traveling long distances in search of heroin | ||
| • Using in different hotspots | ||
| • Pooling of resources | ||
| Actions by heroin users to deal with the situation | Disruption in drug users patterns: desperate and actions taken | • Heroin users seek medical and drug treatment services |
| • Logistics of procuring and using drugs adversely impacted | ||
| • Shift from smoking to injection | ||
| Consequences of heroin users’ actions | HIV risk behaviors | • Syringe sharing |
| • Sick, pooled resources must be divided, cannot access syringes | ||
| • Flashblood | ||
| • Sex for drugs | ||
| Coda/return to the present | Morbidity | • Resurgence of supply leads to relapse and overdosing |