Stigma, Economic Strain, and Mental Health among Single Mothers in Urban Kenya: A Practice-Based Integrative Review

Abstract

Single motherhood is increasingly prevalent in urban Kenya, yet mental health services remain insufficiently responsive to the intersecting challenges of stigma, economic strain, and culturally embedded family norms. This practice-based integrative review synthesizes empirical and policy-oriented literature to examine how structural inequalities and socio-cultural expectations shape the psychological well-being of single mothers, particularly in urban settings such as Nairobi. Drawing on acculturation theory and attachment theory within a non-essentialist, structurally informed framework, the review highlights identity strain, economic vulnerability, and social exclusion as key determinants of distress. The paper identifies a critical clinical gap in culturally responsive assessment, diagnosis, and intervention. Actionable recommendations are proposed across clinical practice and supervision, emphasizing non-pathologizing, context-sensitive approaches. An equity impact analysis considers both the benefits and potential unintended harms of these interventions. This manuscript contributes to the advancement of culturally grounded mental health care in Kenya and similar low- and middle-income contexts.