Prolonged grief in African contexts: Scale validation, prevalence rates and risk factors among young adults in Kenya, Namibia and South Africa.

Although grief is a universal part of the human experience, for some, it may become a debilitating mental health disorder. Prolonged grief disorder (PGD) has recently been included in diagnostic guidelines worldwide, but there is little research on global applicability. To our knowledge, this is one of the preliminary studies to examine PGD rates, risk factors and psychometric validity of the International Prolonged Grief Disorder Scale (IPGDS) concurrently across multiple African countries. It is also one of the first studies to examine probable PGD in young adults anywhere, and importantly, in a context where bereavement is often experienced earlier and more often. Psychometric validity and reliability of the IPGDS were confirmed, and exploratory factor analysis supported a one-factor structure. Despite significantly higher exposure to loss and death than in the Western samples, prevalence rates for probable PGD were similar (Kenya 9.63%, South Africa 6.85% and Namibia 5.34%, vs. the global average of 9.8%). Risk factors identified in all three samples include a close relationship to the deceased and a violent death. Gender differences were seen in Kenya and Namibia, with higher rates of probable PGD for women. Financial difficulties increased disorder-level risk in Kenya and South Africa.