Low and Middle Income Countries

Digital Health: West Africa​

West Africa faces enormous mental health challenges,

including lack of sufficient mental health professionals and

clinical infrastructure, limited access to medication, and

pervasive societal stigma around mental illness. People with

mental illness often go undiagnosed, untreated, or chained

and confined for weeks, months or years at a time in prayer

camps.

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Locally, no one advocates for the continuation of abusive

practices; stakeholders from all sectors including

government, academia, commerce, and healthcare are

concerned about human rights violations. Religious leaders,

traditional healers, and those who operate prayer camps

that engage in these controversial practices have expressed openness and willingness to explore more humane approaches. They need alternative tools.  

 

Our group has deep partnerships with researchers, mental health advocates, clinicians, traditional and faith leaders, and people with lived experience of mental illness in West Africa. Together, we collaborate to develop digital health approaches to combat stigma, support humane care, and improve mental health outcomes using blended interventions (e.g., Evidence-Based Psychosocial AND Spiritual; Technological AND Pharmacological; Mental Health Professional AND Paraprofessional/Caregiver). 

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A Digital Toolkit (M-Healer) to Improve Mental Health Care​​

Working in close collaboration with researchers at the University of Ghana, our team developed a digital toolkit designed to train traditional and faith healers to deliver brief psychosocial interventions to people with mental illness while also discontinuing their use of practices that may constitute human rights violations. Following a series of prayer camp visits and observations, individual interviews, focus groups, and co-design sessions with healers and prayer camp staff, we produced M-Healer.  Once the prototype was developed, a usability study was conducted with faith healers in Ghana who found the tool to be feasible, acceptable, and usable. Read more here.  ​

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​Combining mHealth and Nurse-Delivered Mental Health Care​

In West Africa, most people suffering from serious mental illnesses like schizophrenia and bipolar disorder receive care from traditional and faith healers in “prayer camps.” Specialized mental health providers are scarce in the region, yet the prevalence of traditional healers and clustering of individuals with serious mental illness within the prayer camps offer opportunities to deliver evidence-based treatment to this population. Professors Dror Ben-Zeev at the University of Washington and Angela Ofori-Atta at the University of Ghana are co-leading a multinational team of researchers investigating a two-level intervention package involving a mobile health program which trains healers to deliver high-quality mental health interventions (M-Healer), and visiting mobile nurses who deliver medications directly to patients at prayer camps. With funding support from the National Institute of Mental Health (Grant # R01MH127531-01A1), we are evaluating the effectiveness of this intervention in multiple prayer camps throughout the region. Read more about this study here: study link. ​

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WADMA: Building Capacity for Digital Mental Health Research in West Africa​

Developing and supporting a new generation of digital mental health leaders and innovators in West Africa is vital to improving mental health in the region. Our group at the University of Washington is collaborating with leaders in Ghana and Nigeria to establish the West African Digital Mental Health Alliance (WADMA) – a regional mission-centered network of early-career researchers and trainees with a particular interest in improving mental health through digital interventions. Through WADMA, members will build their network and receive targeted career development in digital mental health research alongside like-minded professionals. WADMA is the first cross-institutional initiative advancing capacity in digital mental health research in the region.

 

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Responding to Adolescent Perinatal Depression with Patient-Centered Mobile Health in West Africa​​

Many factors influence the accessibility of health care facilities by perinatal adolescents. Adolescence has distinct developmental challenges, along with self-stigma (i.e., shame relating to getting pregnant at a young age) and public stigma from health care providers and others in the community that can make accessing these services difficult. Effective, flexible, and convenient-to-access interventions are needed to address the health care needs of pregnant adolescents.

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Led by Dr. Lola Kola, this project will build on previous work to scale up efforts for perinatal depression for adolescents in primary care in Nigeria. Dr. Kola will lead efforts utilizing user-centered design (UCD) principles to develop a mobile phone application to complement a face-to-face intervention for perinatal adolescents within routine care. Elements from the WHO mhGAP Evidenced-based Guidelines for Management of Perinatal Depression will be adapted for this work.