Tuko Pamoja

Tuko Pamoja Family is the group-based prevention component. Many families come together, with all of their family members, in community settings, such as religious congregations, schools, or community centers. Local facilitators lead highly interactive sessions centered on communication and teaching skills for problem-solving, conflict resolution, coping, emotional support, parenting and strong couples’ relationships. Skits, role plays, discussion, and shared activities let families practice new skills in the moment, in sessions that are both fun and challenging.

The program was originally developed and tested under the name READY, Resilience Education And skills Development for Youth, using community-based participatory methods in Muhuru Bay, in Kenya’s Nyanza Province. In a stepped wedge cluster randomized trial, families receiving the intervention reported improvements in family communication and in male caregivers’ involvement, along with higher self-efficacy for risk-reduction skills and fewer risk behaviors among sexually active youth. While READY included HIV prevention content, the current version is flexible to include content on different topics that match the priorities of each community.

Tuko Pamoja Home is the in-home family therapy component, developed for families experiencing high levels of conflict, including those who have a child or adolescent with emotional or behavioral concerns. It grew out of a qualitative study of family functioning and mental health in Eldoret, Kenya, and takes a family systems approach. Sessions draw on solution-focused family therapy, behavioral skills training in communication and parenting, and cognitive behavioral therapies. Six modules address domains of family functioning and families receive the modules that match their specific needs. A digital tool guides counselors and allows for playing role-play videos of families applying the Tuko Pamoja skills. A pre-post pilot documented improvements in family functioning and mental health, and a subsequent small randomized controlled trial showed improvements in family functioning and in coping, hope, and couples’ relationships.

When delivered together, the two components follow our community-embedded implementation model, which describes how community-level prevention, modular household-level treatment, and effective referrals can reinforce one another. The package spans prevention and treatment needs within the same community, reaching families across different levels of need. Offering Tuko Pamoja as an integrated package, and evaluating its combined effects, is a direction we are moving towards with community partners.

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Puffer, E. S., Friis Healy, E., Green, E. P., Giusto, A. M., Kaiser, B. N., Patel, P., & Ayuku, D. (2020). Family functioning and mental health changes following a family therapy intervention in Kenya: A pilot trial. Journal of Child and Family Studies, 29(12), 3493–3508.

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