Abstract
BackgroundThe prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income counties, such as Cambodia, as risk factors in the perinatal period, malnutrition, infections and adverse childhood experiences can be abundant due to poverty and/or conflict. Collaboration between institutions from high-income countries and institutions in resource-poor settings for professional development can improve service providers’ knowledge and skills, which is key to bridging the gap between service needs and the ability to meet those needs.MethodsA Norwegian team comprised of a pediatrician, a child and adolescent psychiatrist and a child psychologist implemented a participatory program for competence building at Centre for Child and Adolescent Mental Health in Cambodia (Caritas-CCAMH) two weeks per year over a 14-year period. Herein, we explore some aspects of this Cambodian-Norwegian collaboration from the perspective of the Caritas-CCAMH staff with a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. Results The multidisciplinary team at Caritas-CCAMH described the learning process with the Norwegian team as a “meeting between experts” characterized by collaboration in planning and implementation, which enhanced the contextual relevance of the project. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the pedagogical process. Learning by observation and supervision from the Norwegian team led to mastering skills and enhancing self-confidence and job satisfaction. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of knowledge exchange despite the difference in socio-economic conditions and learning styles that were unfamiliar to the mental health professionals from high-income countries.ConclusionsBuilding knowledge and skills within a dialogic partnership over a significant period of time contributed to learning across cultures. This model of continuity, low-investment and low-intensity collaborative capacity building may enrich the child and adolescent mental health settings in high-, low- and middle-income countries. Furthermore, the model appears feasible for Western professionals who collaborate with institutions for child and adolescent mental health in low- and middle-income countries.
Social Epidemiology and Global Mental Health: Expanding the Evidence from High-Income to Low- and Middle-Income Countries
