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Project Record

Objectives:

The research programme consortium aims to provide new knowledge regarding comprehensive multi-sectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme will undertake an analysis of existing mental health policies in African countries, provide interventions to assist in the development and implementation of mental health policies in those countries, and evaluate the policy implementation over a 5-year period.

Progress and Impact:

1. Conducted the first large-scale situation analysis of mental health systems in 4 African countries: Ghana, South Africa, Uganda and Zambia. These studies highlighted the neglect of mental health in current policies, the meagre resources available for mental health, lack of data for mental health service provision and widespread stigma against the mentally ill.

2. Established partnerships between research teams and Ministries of Health in all four countries and built capacity for mental health research and policy development through training workshops, exchanges and supervision.

3. Currently conducting and evaluating interventions that are having a significant impact on policy and practice in the four countries, including:

• Ghana: reform of mental health legislation and establishment of mental health information systems for routine service monitoring.
• South Africa: development of a strategic plan for mental health in the Northern Cape and development of mental health information systems in Northern Cape and KwaZulu-Natal.
• Uganda: development of a national mental health policy, national strategic plan and reform of mental health legislation.
• Zambia: reform of the mental health legislation.

4. Establishing models of best practice for the integration of mental health into primary health care, through demonstration projects in all 4 countries.

5. Conducted the first systematic literature review of the relationship between mental health and poverty in low and middle income countries. From this process and our engagement in the four African countries we have identified a range of interventions that have the potential to address the vicious cycle of poverty and mental ill-health.

General Notes:

In addition to the consortium partners, we have received support for the proposal and indication of willingness to participate from the relevant government departments in the study countries:

- Ministry of Health (MOH), Accra, Ghana: Director of Mental Health (Dr Samuel Allotey)

- Department of Health (DoH), Pretoria, South Africa: Director of Mental Health and Substance Abuse (Mr Sifiso Phakathi)

- MOH, Kampala, Uganda: Mental Health Coordinator (Dr Sheila Zaramba Ndyanabangi)

- Central Board of Health (CBOH), Lusaka, Zambia: Mental Health Specialist (Mr John Mayeya)