Developing mental health research in sub-Saharan Africa: capacity building in the AFFIRM project.

M Schneider,S Musisi,M Prince,A Alem,J Ahrens,S Holzer,A Fekadu,E Susser,D Chibanda,C Hanlon,K Sorsdahl,A Ofori-Atta,G Thornicroft,C Lund,R Mayston

doi:10.1017/gmh.2016.28

Abstract

There remains a large disparity in the quantity, quality and impact of mental health research carried out in sub-Saharan Africa, relative to both the burden and the amount of research carried out in other regions. We lack evidence on the capacity-building activities that are effective in achieving desired aims and appropriate methodologies for evaluating success. AFFIRM was an NIMH-funded hub project including a capacity-building program with three components open to participants across six countries: (a) fellowships for an M.Phil. program; (b) funding for Ph.D. students conducting research nested within AFFIRM trials; (c) short courses in specialist research skills. We present findings on progression and outputs from the M.Phil. and Ph.D. programs, self-perceived impact of short courses, qualitative data on student experience, and reflections on experiences and lessons learnt from AFFIRM consortium members. AFFIRM delivered funded research training opportunities to 25 mental health professionals, 90 researchers and five Ph.D. students across 6 countries over a period of 5 years. A number of challenges were identified and suggestions for improving the capacity-building activities explored. Having protected time for research is a barrier to carrying out research activities for busy clinicians. Funders could support sustainability of capacity-building initiatives through funds for travel and study leave. Adoption of a train-the-trainers model for specialist skills training and strategies for improving the rigor of evaluation of capacity-building activities should be considered.

Highlights

There remains a large disparity in the quantity, quality and impact of mental health research carried out in subSaharan Africa, relative to both the burden and the amount of research carried out in other regions
Recent investments in mental health services research in low- and middle-income countries (LMICs), such as those made by National Institute of Mental Health (NIMH), are set to make a significant contribution to the evidence base relating to task-shifting, scale-up and integration of mental health treatment and care (Collins et al 2013), there remains a large disparity in the quantity, quality and impact of mental health research carried out in LMICs, relative to both the burden and the amount of research carried out in other regions (Thornicroft et al 2012)
While 40% (10) of the AFFIRM fellows had graduated by June 2016, of the 14 self-funded students, four (28%) had graduated

Summary

Introduction

There remains a large disparity in the quantity, quality and impact of mental health research carried out in subSaharan Africa, relative to both the burden and the amount of research carried out in other regions. Recent investments in mental health services research in LMICs, such as those made by National Institute of Mental Health (NIMH), are set to make a significant contribution to the evidence base relating to task-shifting, scale-up and integration of mental health treatment and care (Collins et al 2013), there remains a large disparity in the quantity, quality and impact of mental health research carried out in LMICs, relative to both the burden and the amount of research carried out in other regions (Thornicroft et al 2012) Underlying this deficit are gaps in capacity and inadequate, unevenly distributed resources for research.

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