Children in Sub-Saharan Africa (SSA) comprise half of the total regional population, yet mental health services are severely under-equipped to meet their needs. Although child mental health evidence-based practices (EBPs) exist, attempts to take them to scale have been plagued by serious challenges related to uptake, implementation, integration and sustainability in the U.S. and have rarely been undertaken in SSA. This application, in response to RFA-MH-16-350, seeks funding for an African Center for Collaborative Child mental health implementation Research (ACCCR), an African Regional Trans-disciplinary Collaborative Center, aimed at reducing child mental health service and research gaps in Uganda, Ghana, and Kenya through a population approach to child mental health. The proposed ACCCR is guided by the following Specific Aims: 1) To establish and engage a trans-disciplinary research consortium of academic, government, NGO, community and cultural stakeholders in Uganda, Ghana, Kenya, and South Africa to focus on addressing child mental health burden, evidence-based intervention implementation, scale-up, service gaps; 2) To build child mental health implementation research capacity (including developing monitoring systems, conducting small-scale implementation studies) in two countries, Ghana and Kenya; 3) To conduct an EBP scale-up research study in Uganda, which will examine multi-level (State/government, NGOs, families, schools, communities) influences on the uptake, implementation, effectiveness and sustainability of EBPs that address serious child disruptive behavioral challenges; 4) To disseminate timely and pragmatic findings to government officials (Ministries of Health and Education) and consortium partners to optimize roll-outs of EBPs and scale-up process via an African Policy Research Advisory Board, consisting of an expanded network of scientists, NGOs and government officials. The US-based team consists of scientific leaders in child mental health services and implementation science, as well as investigators with current NIH-funded studies and capacity building programs set across Africa, Drs. McKay, Ogedegbe, Hoagwood, Huang, Ssewamala. SSA investigators are drawn from leading academic institutions, including Makerere University, Rakai Health Sciences Program (Uganda), University of Ghana and University of Nairobi (Kenya). NGOs with multi-country presence have expressed strong commitment to supporting the goals of the ACCCR. The ACCCR leadership team will work closely with five Subcontract PIs to develop strategies to engage collaborating institutions, as well as relevant community stakeholders. This trans-disciplinary partnership within and across countries will lay foundation work for subsequent scale up studies in Uganda, Ghana and Kenya and ultimately sustainment of efforts. The work of the ACCCR targets the core goal of the Grand Challenges in Global Mental Health initiative to expand access to effective mental health care worldwide, and NIMH's priority of strengthening the public health impact of research by improving knowledge on transporting evidence-based interventions into practice.
This project, which aims at reducing child mental health service and research gaps in Uganda, Ghana, and Kenya, addresses critical implementation policy, research and service gaps by applying a comprehensive regional capacity building approach to scale up child behavioral health services in diverse community settings.
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