Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-05-26T07:22:44.663Z Has data issue: false hasContentIssue false

Partnership for mental health development in Sub-Saharan Africa (PaM-D): a collaborative initiative for research and capacity building

Published online by Cambridge University Press:  27 November 2018

O. Gureje*
Affiliation:
University of Ibadan, Ibadan, Nigeria
S. Seedat
Affiliation:
Stellenbosch University, Cape Town, South Africa
L. Kola
Affiliation:
University of Ibadan, Ibadan, Nigeria
J. Appiah-Poku
Affiliation:
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
C. Othieno
Affiliation:
University of Nairobi, Nairobi, Kenya
B. Harris
Affiliation:
University of Liberia, Monrovia, Liberia
V. Makanjuola
Affiliation:
University of Ibadan, Ibadan, Nigeria
L. N. Price
Affiliation:
Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
O. O. Ayinde
Affiliation:
University of Ibadan, Ibadan, Nigeria
O. Esan
Affiliation:
University of Ibadan, Ibadan, Nigeria
*
Author for correspondence: Oye Gureje, E-mail: oye_gureje@yahoo.com

Abstract

Aims

In low- and middle-income countries (LMIC) in general and sub-Sahara African (SSA) countries in particular, there is both a large treatment gap for mental disorders and a relative paucity of empirical evidence about how to fill this gap. This is more so for severe mental disorders, such as psychosis, which impose an additional vulnerability for human rights abuse on its sufferers. A major factor for the lack of evidence is the few numbers of active mental health (MH) researchers on the continent and the distance between the little evidence generated and the policy-making process.

Methods

The Partnership for Mental Health Development in Africa (PaM-D) aimed to bring together diverse MH stakeholders in SSA, working collaboratively with colleagues from the global north, to create an infrastructure to develop MH research capacity in SSA, advance global MH science by conducting innovative public health-relevant MH research in the region and work to link research to policy development. Participating SSA countries were Ghana, Kenya, Liberia, Nigeria and South Africa. The research component of PaM-D focused on the development and assessment of a collaborative shared care (CSC) program between traditional and faith healers (T&FHs) and biomedical providers for the treatment of psychotic disorders, as a way of improving the outcome of persons suffering from these conditions. The capacity building component aimed to develop research capacity and appreciation of the value of research in a broad range of stakeholders through bespoke workshops and fellowships targeting specific skill-sets as well as mentoring for early career researchers.

Results

In the research component of PaM-D, a series of formative studies were implemented to inform the development of an intervention package consisting of the essential features of a CSC for psychosis implemented by primary care providers and T&FHs. A cluster randomised controlled trial was next designed to test the effectiveness of this package on the outcome of psychosis. In the capacity-building component, 35 early and mid-career researchers participated in the training workshops and several established mentor-mentee relationships with senior PaM-D members. At the end of the funding period, 60 papers have been published and 21 successful grant applications made.

Conclusion

The success of PaM-D in energising young researchers and implementing a cutting-edge research program attests to the importance of partnership among researchers in the global south working with those from the north in developing MH research and service in LMIC.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdulmalik, J, Kola, L, Fadahunsi, W, Adebayo, K, Yasamy, MT, Musa, E and Gureje, O (2013) Country contextualization of the mental health gap action programme intervention guide: a case study from Nigeria. PLOS Medicine 10, e1001501.Google Scholar
Abdulmalik, J, Fadahunsi, W, Kola, L, Nwefoh, E, Minas, H, Eaton, J and Gureje, O (2014) The Mental Health Leadership and Advocacy Program (mhLAP): a pioneering response to the neglect of mental health in Anglophone West Africa. International Journal of Mental Health Systems 8, 5.Google Scholar
Adewuya, AO and Makanjuola, ROA (2008) Lay beliefs regarding causes of mental illness in Nigeria: pattern and correlates. Social Psychiatry and Psychiatric Epidemiology 43, 336341.Google Scholar
Adewuya, AO and Oguntade, AA (2007) Doctors' attitude towards people with mental illness in Western Nigeria. Social Psychiatry and Psychiatric Epidemiology 42, 931936.Google Scholar
Chisholm, D, Flisher, AJ, Lund, C, Patel, V, Saxena, S, Thornicroft, G and Tomlinson, M (2007) Scale up services for mental disorders: a call for action. The Lancet 370, 12411252.Google Scholar
Chisholm, D, Gureje, O, Saldivia, S, Villalón Calderón, M, Wickremasinghe, R, Mendis, N, Ayuso-Mateos, J-L and Saxena, S (2008) Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis. Bulletin of the World Health Organization 86, 542551.Google Scholar
Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, JP, Angermeyer, MC, Bernert, S, de Girolamo, G, Morosini, P, Polidori, G, Kikkawa, T, Kawakami, N, Ono, Y, Takeshima, T, Uda, H, Karam, EG, Fayyad, JA, Karam, AN, Mneimneh, ZN, Medina-Mora, ME, Borges, G, Lara, C, de Graaf, R, Ormel, J, Gureje, O, Shen, Y, Huang, Y, Zhang, M, Alonso, J, Haro, JM, Vilagut, G, Bromet, EJ, Gluzman, S, Webb, C, Kessler, RC, Merikangas, KR, Anthony, JC, Von Korff, MR, Wang, PS, Brugha, TS, Aguilar-Gaxiola, S, Lee, S, Heeringa, S, Pennell, B-E, Zaslavsky, AM, Ustun, TB, Chatterji, S and WHO World Mental Health Survey Consortium (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291, 25812590.Google Scholar
Gibbons, M (2000) Mode 2 society and the emergence of context-sensitive science. Science and Public Policy 27, 159163.Google Scholar
Global Forum for Health Research (2000) The 10/90 Report on Health Research. Global forum for health Research.Google Scholar
Grimshaw, JM, Eccles, MP, Lavis, JN, Hill, SJ and Squires, JE (2012) Knowledge translation of research findings. Implementation Science 7, 50.Google Scholar
Gureje, O and Alem, A (2000) Mental health policy development in Africa. Bulletin of the World Health Organization 78, 475482.Google Scholar
Gureje, O and Jenkins, R (2007) Mental health in development: re-emphasising the link. The Lancet 369, 447449.Google Scholar
Gureje, O and Lasebikan, V (2006) Use of mental health services in a developing country. Social Psychiatry & Psychiatric Epidemiology 41, 4449.Google Scholar
Gureje, O, Lasebikan, VO, Ephraim-Oluwanuga, O, Olley, BO and Kola, L (2005) Community study of knowledge of and attitude to mental illness in Nigeria. The British Journal of Psychiatry: the Journal of Mental Science 186, 436441.Google Scholar
Gureje, O, Olley, BO, Ephraim-Oluwanuga, O and Kola, L (2006) Do beliefs about causation influence attitudes to mental illness? World Psychiatry 5, 104.Google Scholar
Gureje, O, Hollins, S, Botbol, M, Javed, A, Jorge, M, Okech, V, Riba, M, Trivedi, J, Sartorius, N and Jenkins, R (2009) Report of the WPA task force on brain drain. World Psychiatry 8, 115118.Google Scholar
Gureje, O, Olowosegun, O, Adebayo, K and Stein, DJ (2010) The prevalence and profile of non-affective psychosis in the Nigerian Survey of Mental Health and Wellbeing. World Psychiatry 9, 5055.Google Scholar
Gureje, O, Nortje, G, Makanjuola, V, Oladeji, BD, Seedat, S and Jenkins, R (2015) The role of global traditional and complementary systems of medicine in the treatment of mental health disorders. The Lancet Psychiatry 2, 168177.Google Scholar
Gureje, O, Makanjuola, V, Kola, L, Yusuf, B, Price, L, Esan, O, Oladeji, BD, Appiah-Poku, J, Haris, B and Othieno, C (2017) COllaborative shared care to IMprove Psychosis Outcome (COSIMPO): study protocol for a randomized controlled trial. Trials 18, 462.Google Scholar
Jenkins, R, Baingana, F, Belkin, G, Borowitz, M, Daly, A, Francis, P, Friedman, J, Garrison, P, Kauye, F and Kiima, D (2010 a) Mental health and the development agenda in Sub-Saharan Africa. Psychiatric Services 61, 229234.Google Scholar
Jenkins, R, Heshmat, A, Loza, N, Siekkonen, I and Sorour, E (2010 b) Mental health policy and development in Egypt-integrating mental health into health sector reforms 2001–9. International Journal of Mental Health Systems 4, 17.Google Scholar
Jenkins, R, Kiima, D, Okonji, M, Njenga, F, Kingora, J and Lock, S (2010 c) Integration of mental health into primary care and community health working in Kenya: context, rationale, coverage and sustainability. Mental Health in Family Medicine 7, 3747.Google Scholar
Jenkins, R, Kydd, R, Mullen, P, Thomson, K, Sculley, J, Kuper, S, Carroll, J, Gureje, O, Hatcher, S and Brownie, S (2010 d) International migration of doctors, and its impact on availability of psychiatrists in low and middle income countries. PloS ONE 5, e9049.Google Scholar
Kola, L, Fadahunsi, W and Gureje, O (2009) Mental health research in Africa: reports from 26 countries. Nigerian Journal of Psychiatry 7, 913.Google Scholar
Kurihara, T, Kato, M, Reverger, R and Tirta, IGR (2006) Pathway to psychiatric care in Bali. Psychiatry and Clinical Neurosciences 60, 204210.Google Scholar
Lund, C, Alem, A, Schneider, M, Hanlon, C, Ahrens, J, Bandawe, C, Bass, J, Bhana, A, Burns, J, Chibanda, D, Cowan, F, Davies, T, Dewey, M, Fekadu, A, Freeman, M, Honikman, S, Joska, J, Kagee, A, Mayston, R, Medhin, G, Musisi, S, Myer, L, Ntulo, T, Nyatsanza, M, Ofori-Atta, A, Petersen, I, Phakathi, S, Prince, M, Shibre, T, Stein, DJ, Swartz, L, Thornicroft, G, Tomlinson, M, Wissow, L and Susser, E (2015) Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM. Epidemiology and Psychiatric Sciences 24, 233240.Google Scholar
Luyckx, VA, Steenkamp, V, Rubel, JR and Stewart, MJ (2004) Adverse effects associated with the use of South African traditional folk remedies. The Central African Journal of Medicine 50, 4651.Google Scholar
Makanjuola, V, Esan, Y, Oladeji, B, Kola, L, Appiah-Poku, J, Harris, B, Othieno, C, Price, L, Seedat, S and Gureje, O (2016) Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities. Social Psychiatry and Psychiatric Epidemiology 51, 16451654.Google Scholar
Mental Health Research Mapping Group (2007) Research Capacity for Mental Health in low-and Middle-Income Countries: Results of A Mapping Project. Geneva, Switzerland: Global Forum for Health Research and World Health Organization.Google Scholar
Mullan, F (2005) The metrics of the physician brain drain. The New England Journal of Medicine 353, 18101818.Google Scholar
Mullan, F, Politzer, RM and Davis, CH (1995) Medical migration and the physician workforce. International medical graduates and American medicine. JAMA 273, 15211527.Google Scholar
Nortje, G, Oladeji, B, Gureje, O and Seedat, S (2016) Effectiveness of traditional healers in treating mental disorders: a systematic review. The Lancet Psychiatry 3, 154170.Google Scholar
Nyström, ME, Karltun, J, Keller, C and Andersson Gäre, B (2018) Collaborative and partnership research for improvement of health and social services: researcher's experiences from 20 projects. Health Research Policy and Systems 16, 46.Google Scholar
Ormel, J, Petukhova, M, Chatterji, S, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Bromet, EJ, Burger, H, Demyttenaere, K, de Girolamo, G, Haro, JM, Hwang, I, Karam, E, Kawakami, N, Lépine, JP, Medina-Mora, ME, Posada-Villa, J, Sampson, N, Scott, K, Ustün, TB, Von Korff, M, Williams, DR, Zhang, M and Kessler, RC (2008) Disability and treatment of specific mental and physical disorders across the world. The British Journal of Psychiatry: The Journal of Mental Science 192, 368375.Google Scholar
Patel, V and Kim, Y-R (2007) Contribution of low-and middle-income countries to research published in leading general psychiatry journals, 2002–2004. The British Journal of Psychiatry 190, 7778.Google Scholar
Patel, V and Sumathipala, A (2001) International representation in psychiatric literature. The British Journal of Psychiatry 178, 406409.Google Scholar
Pilowsky, DJ, Rojas, G, Price, LN, Appiah-Poku, J, Razzaque, B, Sharma, M, Schneider, M, Seedat, S, Bonini, BB and Gureje, O (2016) Building research capacity across and within low-and middle-income countries: the collaborative hubs for international research on mental health. Academic Psychiatry 40, 686691.Google Scholar
Prince, M, Patel, V, Saxena, S, Maj, M, Maselko, J, Phillips, MR and Rahman, A (2007) No health without mental health. The Lancet 370, 859877.Google Scholar
Razzouk, D, Sharan, P, Gallo, C, Gureje, O, Lamberte, EE, de Jesus Mari, J, Mazzotti, G, Patel, V, Swartz, L and Olifson, S (2010) Scarcity and inequity of mental health research resources in low-and-middle income countries: a global survey. Health Policy 94, 211220.Google Scholar
Saraceno, B, Ommeren, MV, Batniji, R, Cohen, A, Gureje, O, Mahoney, J, Sridhar, D and Underhill, C (2007) Barriers to improvement of mental health services in low-income and middle-income countries. The Lancet 370, 11641174.Google Scholar
Saxena, S, Maulik, PK, Sharan, P, Levav, I and Saraceno, B (2004) Mental health research on low-and middle-income countries in indexed journals: a preliminary assessment. Journal of Mental Health Policy and Economics 7, 127132.Google Scholar
Saxena, S, Paraje, G, Sharan, P, Karam, G and Sadana, R (2006) The 10/90 divide in mental health research: trends over a 10-year period. The British Journal of Psychiatry 188, 8182.Google Scholar
Saxena, S, Thornicroft, G, Knapp, M and Whiteford, H (2007) Resources for mental health: scarcity, inequity, and inefficiency. The Lancet 370, 878889.Google Scholar
Schneider, M, van de Water, T, Araya, R, Bonini, B, Pilowsky, D, Pratt, C, Price, L, Rojas, G, Seedat, S and Sharma, M (2016) Monitoring and evaluating capacity building activities in low and middle income countries: challenges and opportunities. Global Mental Health 3, E29.Google Scholar
Semrau, M, Alem, A, Abdulmalik, J, Docrat, S, Evans-Lacko, S, Gureje, O, Kigozi, F, Lempp, H, Lund, C, Petersen, I, Shidhaye, R, Thornicroft, G and Hanlon, C (2018) Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers. Epidemiology and Psychiatric Sciences 27, 1121.Google Scholar
Sharan, P, Gallo, C, Gureje, O, Lamberte, E, Mari, JJ, Mazzotti, G, Patel, V, Swartz, L, Olifson, S and Levav, I (2009) Mental health research priorities in low-and middle-income countries of Africa, Asia, Latin America and the Caribbean. The British Journal of Psychiatry 195, 354363.Google Scholar
Thornicroft, G, Chatterji, S, Evans-Lacko, S, Gruber, M, Sampson, N, Aguilar-Gaxiola, S, Al-Hamzawi, A, Alonso, J, Andrade, L, Borges, G, Bruffaerts, R, Bunting, B, de Almeida, JMC, Florescu, S, de Girolamo, G, Gureje, O, Haro, JM, He, Y, Hinkov, H, Karam, E, Kawakami, N, Lee, S, Navarro-Mateu, F, Piazza, M, Posada-Villa, J, de Galvis, YT and Kessler, RC (2017) Undertreatment of people with major depressive disorder in 21 countries. The British Journal of Psychiatry 210, 119124.Google Scholar
van der Watt, AS, Nortje, G, Kola, L, Appiah-Poku, J, Othieno, C, Harris, B, Oladeji, BD, Esan, O, Makanjuola, V and Price, LN (2017) Collaboration between biomedical and complementary and alternative care providers: barriers and pathways. Qualitative Health Research 27, 21772188.Google Scholar
van der Watt, A, van de Water, T, Nortje, G, Oladeji, B, Seedat, S, Gureje, O and Price (2018) The perceived effectiveness of traditional and faith healing in the treatment of mental illness: a systematic review of qualitative studies. Social Psychiatry and Psychiatric Epidemiology 53, 555566.Google Scholar
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Karam, EG, Kessler, RC, Kovess, V, Lane, MC, Lee, S, Levinson, D, Ono, Y, Petukhova, M, Posada-Villa, J, Seedat, S and Wells, JE (2007) Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet (London, England) 370, 841850.Google Scholar
Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, Charlson, FJ, Norman, RE, Flaxman, AD, Johns, N, Burstein, R, Murray, CJL and Vos, T (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382, 15751586.Google Scholar
World Health Organization (2007) Task Shifting: Rational Redistribution of Tasks Among Health Workforce Teams: Global Recommendations and Guidelines.Google Scholar
World Health Organization (2010) mhGAP Intervention Guide for Mental, Neurological and Substance use Disorders in non-Specialized Health Settings: Mental Health Gap Action Programme (mhGAP). WHO: Geneva.Google Scholar
World Health Organization (2018) Mental Health Atlas 2017. Geneva: World Health Organization.Google Scholar
World Psychiatric Association (2016) A WHO-WPA Policy Roundtable during The World Psychiatric Association Regional Meeting in Abuja, Nigeria, 2224 October, 2009. http://www.wpanet.org/detail.php?section_id=19&content_id=340. (accessed 15 November 2018).Google Scholar