Stakeholder perspectives on suicidal behavior and suicide prevention opportunities in rural Uganda: A qualitative study

Abstract

Worldwide, suicide remains a major public health challenge, with a disproportionate burden in low- and middle-income countries. Despite growing evidence on suicidal behavior in Uganda, little is known about how community stakeholders perceive its burden, drivers and opportunities for prevention in rural settings. We aimed to explore stakeholders’ perspectives on suicidal behavior, its perceived drivers and opportunities for suicide prevention in Ntungamo District, southwestern Uganda. We conducted a qualitative study involving 19 face-to-face in-depth interviews and three focus group discussions with purposively selected stakeholders. Interviews were audio-recorded, transcribed verbatim and analyzed using rapid qualitative thematic analysis. Three themes emerged: (1) suicidal behavior was perceived as an increasingly visible community and public health concern; (2) participants identified interacting drivers of suicidal behavior, including access to lethal means, socioeconomic adversity, demographic vulnerabilities, and harmful alcohol and substance use; (3) participants identified community-informed opportunities for suicide prevention and to promote awareness, reduce stigma and encourage early help-seeking. Stakeholders perceived suicidal behavior as a significant community concern driven by interacting social, economic, demographic and environmental influences. Community-informed suicide prevention strategies that strengthen existing community structures and trusted local actors could inform policy and practice in Uganda and similar rural settings across sub-Saharan Africa.