scholarly journals Barriers and drivers to capacity-building in global mental health projects

2020 ◽  
Author(s):  
Tarik Endale ◽  
Onaiza Qureshi ◽  
Grace Kathryn Ryan ◽  
Georgina Miguel Esponda ◽  
Ruth Verhey ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Delivery ◽  
Capacity Building ◽  
Stakeholder Engagement ◽  
Global Mental Health ◽  
Middle Income ◽  
Grand Challenges ◽  
Middle Income Countries ◽  
Contextual Understanding ◽  
Low And Middle Income

Abstract BackgroundThe global shortage of mental health workers is a significant barrier to the implementation and scale-up of mental health services. Partially as a result of this shortage, approximately 85% of people with mental, neurological and substance-use disorders in low- and middle-income countries do not receive care. Consequently, developing and implementing scalable solutions for mental health capacity-building has been identified as a priority in global mental health. There remains limited evidence to inform best practices for capacity building in global mental health. As one in a series of four papers on factors affecting the implementation of mental health projects in low- and middle-income countries, this paper reflects on the experiences of Global Mental Health grantees funded by Grand Challenges Canada, focusing on the barriers to and drivers of capacity-building.MethodsBetween June 2014 and May 2017, current or former Grand Challenges Canada Global Mental Health grantees were recruited using purposive sampling. N=29 grantees participated in semi-structured qualitative interviews, representing projects in Central America and the Caribbean (n=4), South America (n=1), West Africa (n=4), East Africa (n=6), South Asia (n=11) and Southeast Asia (n=3). Based on the results of a quantitative analysis of project outcomes using a portfolio-level Theory of Change framework, six key themes were identified as important to implementation success. As part of a larger multi-method study, this paper utilized a framework analysis to explore the themes related to capacity-building.ResultsStudy participants described barriers and facilitators to capacity building within three broad themes: 1) training, 2) supervision, and 3) quality assurance. Running throughout these thematic areas were the crosscutting themes of contextual understanding, human resources, and sustainability. Additionally, participants described approaches and mechanisms for successful capacity building.ConclusionsThis study demonstrates the importance of capacity building to global mental health research and implementation, its relationship to stakeholder engagement and service delivery, and the implications for funders, implementers, and researchers alike. Investment in formative research, contextual understanding, stakeholder engagement, policy influence, and integration into existing systems of education and service delivery is crucial for the success of capacity building efforts.

scholarly journals Barriers and drivers to capacity-building in global mental health projects

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Tarik Endale ◽  
Onaiza Qureshi ◽  
Grace Kathryn Ryan ◽  
Georgina Miguel Esponda ◽  
Ruth Verhey ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Delivery ◽  
Capacity Building ◽  
Stakeholder Engagement ◽  
Global Mental Health ◽  
Middle Income ◽  
Grand Challenges ◽  
Middle Income Countries ◽  
Contextual Understanding ◽  
Low And Middle Income

Abstract Background The global shortage of mental health workers is a significant barrier to the implementation and scale-up of mental health services. Partially as a result of this shortage, approximately 85% of people with mental, neurological and substance-use disorders in low- and middle-income countries do not receive care. Consequently, developing and implementing scalable solutions for mental health capacity-building has been identified as a priority in global mental health. There remains limited evidence to inform best practices for capacity building in global mental health. As one in a series of four papers on factors affecting the implementation of mental health projects in low- and middle-income countries, this paper reflects on the experiences of global mental health grantees funded by Grand Challenges Canada, focusing on the barriers to and drivers of capacity-building. Methods Between June 2014 and May 2017, current or former Grand Challenges Canada Global Mental Health grantees were recruited using purposive sampling. N = 29 grantees participated in semi-structured qualitative interviews, representing projects in Central America and the Caribbean (n = 4), South America (n = 1), West Africa (n = 4), East Africa (n = 6), South Asia (n = 11) and Southeast Asia (n = 3). Based on the results of a quantitative analysis of project outcomes using a portfolio-level Theory of Change framework, six key themes were identified as important to implementation success. As part of a larger multi-method study, this paper utilized a framework analysis to explore the themes related to capacity-building. Results Study participants described barriers and facilitators to capacity building within three broad themes: (1) training, (2) supervision, and (3) quality assurance. Running throughout these thematic areas were the crosscutting themes of contextual understanding, human resources, and sustainability. Additionally, participants described approaches and mechanisms for successful capacity building. Conclusions This study demonstrates the importance of capacity building to global mental health research and implementation, its relationship to stakeholder engagement and service delivery, and the implications for funders, implementers, and researchers alike. Investment in formative research, contextual understanding, stakeholder engagement, policy influence, and integration into existing systems of education and service delivery is crucial for the success of capacity building efforts.

scholarly journals Stemming the tide: promoting mental health and preventing mental disorders in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Global Mental Health ◽  
Action Plan ◽  
Mental Health Promotion ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The first World Health Organization's global action plan for mental health recognizes the importance of mental health promotion and prevention of mental disorders, through the inclusion of one of four objectives focused on this crucial area of research and practice. This paper aims to provide an ‘aerial view’ of the field of mental health promotion and prevention of mental disorders with a focus on low- and middle-income countries. Starting with reasons why promotion and prevention need to take center stage in global mental health efforts, the paper provides a framework and four general principles to guide such efforts: a socio-ecological perspective (place); an inter-sectoral and interdisciplinary approach (collaboration), a developmental perspective (timing), and a participatory and empowerment approach (strengths), or PaCTS. Evidence-based examples of mental health promotion, universal, selective, and indicated prevention are described.

scholarly journals Mental Health in low-and middle income countries (LMICs): Going beyond the need for funding

2018 ◽  
Vol 17 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Folashade T Alloh ◽  
Pramod Regmi ◽  
Igoche Onche ◽  
Edwin Van Teijlingen ◽  
Steven Trenoweth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Global Mental Health ◽  
Poor Mental Health ◽  
Health Issues ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Issues ◽  
The Impact ◽  
Low And Middle Income

Despite being globally recognised as an important public health issue, mental health is still less prioritised as a disease burden in many Low-and Middle-Income Countries (LMICs). More than 70% of the global mental health burden occurs in these countries. We discussed mental health issues in LMICs under themes such as abuse and mental illness, cultural influence on mental health, need for dignity in care, meeting financial and workforce gaps and the need for national health policy for the mental health sector. We highlighted that although mental health education and health care services in most LMICs are poorly resourced; there is an urgent need to address issues beyond funding that contribute to poor mental health. In order to meet the increasing challenge of mental health illness in LMICs, there is a need for effort to address cultural and professional challenges that contribute to poor mental health among individuals. We have a notion that mental health should be integrated into primary health care in LMICs. Creating awareness on the impact of some cultural attitudes/practices will encourage better uptake of mental health services and increase the ease when discussing mental health issues in these countries which can contribute to reducing the poor mental health in LMICs.

scholarly journals Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers

2017 ◽  
Vol 27 (1) ◽  
pp. 11-21 ◽  
Author(s):  
M. Semrau ◽  
A. Alem ◽  
J. Abdulmalik ◽  
S. Docrat ◽  
S. Evans-Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Capacity Building ◽  
Mental Health System ◽  
Health System Strengthening ◽  
Target Groups ◽  
Middle Income ◽  
Middle Income Countries ◽  
Building Activities ◽  
Low And Middle Income

There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the ‘Emerging mental health systems in low- and middle-income countries’ (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.

scholarly journals Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers

2017 ◽  
Vol 27 (1) ◽  
pp. 3-10 ◽  
Author(s):  
C. Hanlon ◽  
M. Semrau ◽  
A. Alem ◽  
S. Abayneh ◽  
J. Abdulmalik ◽  
...  
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Evidence Base ◽  
Health System Strengthening ◽  
Service Users ◽  
Target Groups ◽  
Middle Income ◽  
Middle Income Countries ◽  
Building Activities ◽  
Low And Middle Income

Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.

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