OBJECTIVES: The purpose of this study is to compare the prevalence and correlates of suicidal ideation youth in Botswana, Kenya, Tanzania, Uganda and Zambia, all sub-Saharan African countries. This study also addressed differences in prevalence and correlates of suicidal ideation between boys and girls in each country in an attempt to identify how these risk behaviors vary by gender across country settings. Findings from this study are important for prevention efforts that seek to reduce suicidal behavior among youth in sub-Saharan African countries and to promote research and prevention efforts in the mental health area in these under-resourced countries.

METHODS: Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Botswana (N=2197; 2005), Kenya (N=3691; 2003), Tanzania (N=2176; 2006), Uganda (N=3215; 2003) and Zambia (N=2257; 2004) of students primarily 13 to 16 years of age. Logistic regression analyses were computed to determine the associations between 13 risk factors (i.e., hunger, current alcohol use, problem drinking, bullying victimization, sadness, loneliness, worrying, having no close friends, missed school, illicit drug use, physical fights, physical attacks and early sexual initiation) and suicidal ideation for all students and between boys and girls.

RESULTS: The results showed variability in the prevalence of suicidal ideation across these African countries. Zambia had the highest prevalence of suicidal ideation (31.9%) among all students, followed by Kenya (27.9%), Botswana (23.1%), Uganda (19.6%) and Tanzania (11.2%). Sadness and feeling lonely was the most commonly associated correlate of suicidal ideation among students across these sub-Saharan countries. Sadness was significantly associated with suicidal ideation in Kenya, Tanzania and Uganda. Sadness remained significantly associated among boys and girls in Kenya, Tanzania and Uganda. All risk factors, except for having no close friends, were found to be predictors of suicidal ideation in certain countries or gender groups.

CONCLUSION: The associations between the risk factors examined and suicidal ideation have helped to increase the understanding of an ignored, but critical issue in Sub-Saharan Africa. There is an urgent need for additional research in this area in addition to greater suicide prevention efforts in sub-Saharan African countries.