The overall goal is to establish a Hub for research and capacity development to improve the delivery of cost effective interventions for mental disorders in sub-Saharan Africa. There is growing international consensus that a task shifting approach is required in low and middle-income countries (LMIC) in which low cost interventions are delivered by general health workers, supervised by mental health specialists, through routine health care delivery systems. We propose to establish the AFrica Focus on Intervention Research for Mental health (AFFIRM) program, in 5 African countries: South Africa, Ghana, Uganda, Zimbabwe, Malawi and Ethiopia, with the following four specific aims: 1) To investigate strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa;2) To build individual and institutional capacity for intervention research in sub-Saharan Africa;3) To establish a network of collaboration between researchers, NGOs and government agencies that facilitates the translation of research knowledge into policy and practice;4) To collaborate with other regional NIMH hubs. The primary innovation of AFFIRM will be that it will integrate research, capacity building and network development with a shared goal of improving the delivery of cost-effective mental health interventions in sub-Saharan Africa. The Hub will bring together a range of multi-disciplinary researchers, policy makers and NGO practitioners, and build on previous partnerships, such as the MHaPP, with a focus on empirically testing innovative models of task shifting in low resource PHC settings. We will implement the AFFIRM program through three overlapping phases. The inception phase (1st 6 months) will involve establishing the Administrative core at the Centre for Public Mental Health, University of Cape Town;developing a detailed protocol for each of the research sites (Ethiopia and South Africa);conducting a capacity building needs assessment among all AFFIRM partners and making contact with other regional hubs. The implementation phase, carried out in years 1-4, will involve piloting and conducting the research, implementing the capacity-development plan and carrying out the shared projects. The final stage, conducted in years 3-5 will be evaluation and dissemination.

Public Health Relevance

Despite the high burden of mental disorders in Africa, resources for services are limited and inappropriately used, capacity for mental health research is limited and there is a lack of evidence for how task-shifting can be employed in routine clinical settings in Africa, despite its cost-effectiveness. Through carrying out research on task-shifting and simultaneously building research capacity- building, the proposed Hub aims to improve the delivery of cost-effective interventions for mental disorders in sub-Saharan Africa.

Agency
National Institute of Health (NIH)
Type
Research Program--Cooperative Agreements (U19)
Project #
5U19MH095699-04
Application #
8736003
Study Section
Special Emphasis Panel (ZMH1)
Program Officer
Pringle, Beverly
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Cape Town
Department
Type
DUNS #
City
Rondebosch
State
Country
South Africa
Zip Code
7700
Nyatsanza, Memory; Schneider, Marguerite; Davies, Thandi et al. (2016) Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa. BMC Psychiatry 16:164
Mayston, Rosie; Alem, Atalay; Habtamu, Alehegn et al. (2016) Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia. Health Policy Plan 31:367-76
Hanlon, Charlotte; Alem, Atalay; Medhin, Girmay et al. (2016) Task sharing for the care of severe mental disorders in a low-income country (TaSCS): study protocol for a randomised, controlled, non-inferiority trial. Trials 17:76
Habtamu, Kassahun; Alem, Atalay; Medhin, Girmay et al. (2016) Development and validation of a contextual measure of functioning for people living with severe mental disorders in rural Africa. BMC Psychiatry 16:311
Lund, C; Alem, A; Schneider, M et al. (2015) Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM. Epidemiol Psychiatr Sci 24:233-40
Habtamu, Kassahun; Alem, Atalay; Hanlon, Charlotte (2015) Conceptualizing and contextualizing functioning in people with severe mental disorders in rural Ethiopia: a qualitative study. BMC Psychiatry 15:34
Schneider, Marguerite; Baron, Emily; Davies, Thandi et al. (2015) Making assessment locally relevant: measuring functioning for maternal depression in Khayelitsha, Cape Town. Soc Psychiatry Psychiatr Epidemiol 50:797-806
Lund, Crick; Schneider, Marguerite; Davies, Thandi et al. (2014) Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. Trials 15:457
Udedi, Michael; Swartz, Leslie; Stewart, Robert C et al. (2014) Health service utilization by patients with common mental disorder identified by the Self-Reporting Questionnaire in a primary care setting in Zomba, Malawi: a descriptive study. Int J Soc Psychiatry 60:454-61
De Silva, Mary J; Breuer, Erica; Lee, Lucy et al. (2014) Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions. Trials 15:267

Showing the most recent 10 out of 11 publications