Advertisement

Global Social Welfare

, Volume 6, Issue 3, pp 177–188 | Cite as

Building Mental Health Research Capacity in Kenya: a South-North Collaboration

  • Muthoni MathaiEmail author
  • Ann Vander Stoep
  • Manasi Kumar
  • Mary Kuria
  • Anne Obondo
  • Violet Kimani
  • Beatrice Amugune
  • Margaret Makanyengo
  • Anne Mbwayo
  • Mara Child
  • Jürgen Unützer
  • James Kiarie
  • Deepa Rao
Article
  • 29 Downloads

Abstract

This paper describes a mental health capacity-building partnership between the University of Nairobi (UON) and the University of Washington (UW) that was built upon a foundational 30-year HIV/AIDS research training collaboration between the two institutions. With funding from the US National Institute of Mental Health Medical Education Program Initiative (MEPI), UW and UON faculty collaborated to develop and offer a series of workshops in research methods, grant writing, and manuscript publication for UON faculty and postgraduate students committed to mental health research. UON and UW scientists provided ongoing mentorship to UON trainees through Skype and email. Three active thematic research groups emerged that focused on maternal and child mental health, gender-based violence, and HIV-related substance abuse. Challenges to conducting mental health research in Kenya included limited resources to support research activities, heavy teaching responsibilities, clinical duties, and administrative demands on senior faculty, and stigmatization of mental health conditions, treatment, and research within Kenyan society. The partnership yielded a number of accomplishments: a body of published papers and presentations at national and international meetings on Kenyan mental health topics, the institution of systematic mental health data collection in rural clinics, funded research proposals, and a mental health research resource center. We highlight lessons learned for future mental health research capacity-building initiatives.

Keywords

Mental Health Medical Education Research Collaboration 

Notes

Funding Information

Funding for this work came from the National Institute of Health/ National Institute of Mental Health (NIMH) through award number R25MH099132 and D43DW010141.

Compliance with Ethical Standards

All research conducted in this project receives approval from the KNH-UON Ethics and Research Committee (http://erc.uonbi.ac.ke).

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the National Institute of Mental Health.

References

  1. Ambale, C. A., Sinei, K. A., Amugune, B. K., & Oluka, M. N. (2017). Accessibility of medicines used in the management of substance use disorders in selected hospitals in Nairobi. African Journal of Pharmacology and Therapeutics, 6(2), 102–108.Google Scholar
  2. Bass, J., Neugebauer, R., Clougherty, K. F., Verdeli, H., Wickramaratne, P., Ndogoni, L., & Bolton, P. (2006). Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes: randomised controlled trial. The British Journal of Psychiatry : The Journal of Mental Science, 188(6), 567–573.  https://doi.org/10.1192/bjp.188.6.567.CrossRefGoogle Scholar
  3. Bolton, P., Bass, J., Betancourt, T., Speelman, L., Onyango, G., Clougherty, K. F., & Verdeli, H. (2007). Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA, 298(5), 519–527.  https://doi.org/10.1001/jama.298.5.519.CrossRefGoogle Scholar
  4. Child, M. J., Kiarie, J. N., Allen, S. M., Nduati, R., Wasserheit, J. N., Kibore, M. W., et al. (2014). Expanding clinical medical training opportunities at the University of Nairobi: adapting a regional medical education model from the WWAMI program at the University of Washington. Academic Medicine: Journal of the Association of American Medical Colleges, 89(8 Suppl), S35–S39.  https://doi.org/10.1097/ACM.0000000000000350.
  5. Collins, P. (2013). Research priorities, capacity, and networks in global mental health. In V. Patel, H. Minas, A. Cohen, & M. J. Prince (Eds.), Global mental health principles and practice (1st ed., pp. 425–449). New York: Oxford University Press.Google Scholar
  6. Fryers, T., Melzer, D., & Jenkins, R. (2003). Social inequalities and the common mental disorders. Social Psychiatry and Psychiatric Epidemiology, 38(5), 229–237.  https://doi.org/10.1007/s00127-003-0627-2.CrossRefGoogle Scholar
  7. Global Burden of Disease Study 2013 Collaborators. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England), 386(9995), 743–800.  https://doi.org/10.1016/S0140-6736(15)60692-4.CrossRefGoogle Scholar
  8. Horton, R. (2013). Offline: is global health neocolonialist? The Lancet, 382(9906), 1690.  https://doi.org/10.1016/S0140-6736(13)62379-X.CrossRefGoogle Scholar
  9. Jomo, S., Amugune, B., Sinei, K., & Oluka, M. (2016). Assessing the prevalence and severity of potential drug-drug interactions among mentally ill inpatients. Indian Research Journal of Pharmacy and Science, 8(8), 331–343.Google Scholar
  10. Katon, W., Russo, J., Lin, E. H. B., Schmittdiel, J., Ciechanowski, P., Ludman, E., & Von Korff, M. (2012). Cost-effectiveness of a multicondition collaborative care intervention. Archives of General Psychiatry, 69(5), 506–514.  https://doi.org/10.1001/archgenpsychiatry.2011.1548.CrossRefGoogle Scholar
  11. Lansang, M. A., and Dennis, R. (2004). Building capacity in health research in the developing world. Bulletin of the World Health Organization, 82(10), 764–70. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15643798.
  12. Machayo, J., & Keraro, V. (2013). Brain drain among health professionals in Kenya: a case of poor working conditions? - a critical review of the causes and effects. Prime Journal of Business Administration and Management, 3(6), 1047–1063.Google Scholar
  13. Madeghe, B. A., Kimani, V. N., Vander Stoep, A., Nicodimos, S., & Kumar, M. (2016). Postpartum depression and infant feeding practices in a low income urban settlement in Nairobi-Kenya. BMC Research Notes, 9(1), 506.  https://doi.org/10.1186/s13104-016-2307-9.CrossRefGoogle Scholar
  14. Maina, R., Obondo, A. A., Kuria, M. W., & Donovan, D. M. (2015). Substance use literacy: implications for HIV medication adherence and addiction severity among substance users. African Journal of Drug and Alcohol Studies, 14(2), 137–151 Retrieved from https://www.ajol.info/index.php/ajdas/article/view/133134.Google Scholar
  15. Manasi, K., Linnet, O., Ongeri, L., Mathai, M., & Mbwayo, A. (2015). Translation of EPDS questionnaire into Kiswahili: understanding the cross-cultural and translation issues in mental health research. Journal of Pregnancy and Child Health, 2(1).  https://doi.org/10.4172/2376-127X.1000134.
  16. Mbwayo, A. W., & Mathai, M. (2016). Association between hopelessness and conduct problem among school going adolescents in a rural and urban setting in Kenya. Journal of Child and Adolescent Behaviour, 4(291).  https://doi.org/10.4172/2375-4494.1000291.
  17. Musyoka, C. M., Obwenyi, A. M., Mathai, M., & Ndetei, D. M. (2016). Models and approaches to alcohol and drug addiction rehabilitation in Kenya. International Journal of Health and Psychology Research, 44(44), 1–12 Retrieved from http://www.eajournals.org/wp-content/uploads/Models-and-Approaches-to-Alcohol-and-Drug-Addiction-Rehabilitation-in-Kenya.pdf.Google Scholar
  18. Mutavi, T., Obondo, A., Nganga, P., Kumar, M., & Mathai, M. (2016). Psychosocial outcomes among children following defilement and the caregivers responses to the children’s trauma: a qualitative study from Nairobi Suburbs, Kenya. African Journal of Traumatic Stress, 5(1), 29–32.Google Scholar
  19. Mutavi, T., Mathai, M., & Obondo, A. (2017). Post-traumatic stress disorder (PTSD) in sexually abused children and educational status in Kenya: a longitudinal study. Journal of Child and Adolescent Behavior, 5(5), 1–8.  https://doi.org/10.4172/2375-4494.1000357.Google Scholar
  20. NIH. (2011). Multiple Principal Investigators - general information. Retrieved from https://grants.nih.gov/grants/multi_pi/overview.htm
  21. Osanjo, G. O., Oyugi, J. O., Kibwage, I. O., Mwanda, W. O., Ngugi, E. N., Otieno, F. C., & Kiarie, J. N. (2015). Building capacity in implementation science research training at the University of Nairobi. Implementation Science, 11(1), 30.  https://doi.org/10.1186/s13012-016-0395-5.CrossRefGoogle Scholar
  22. Patel, V. (2007). Mental health in low- and middle-income countries. British Medical Bulletin, 81–82(1), 81–96.  https://doi.org/10.1093/bmb/ldm010.CrossRefGoogle Scholar
  23. Polkovnikova-Wamoto, A., Mathai, M., Vander Stoep, A., & Kumar, M. (2016). “Haven of safety” and “secure base”: a qualitative inquiry into factors affecting child attachment security in Nairobi, Kenya. Vulnerable Children and Youth Studies, 11(4), 286–296.  https://doi.org/10.1080/17450128.2016.1201237.CrossRefGoogle Scholar
  24. Pratap, S., Itzhak, L., Sylvie, O., Francisco, A. de, and Shekhar, S. (Eds.). (2007). Research capacity for mental health in low-and middle-income countries: results of a mapping project. Global Forum for Health Research and World Health Organization. Geneva: Geneva, World Health Organization & Global Forum for Health Research. Retrieved from http://www.who.int/mental_health/MHRC_FullText.pdf
  25. Røttingen, J-A., Regmi, S., Eide, M., Young, A. J., Viergever, R. F., Årdal, C., Guzman, J., Edwards, D., Matlin, S. A., Terry, R. F. (2013) Mapping of available health research and development data: what's there, what's missing, and what role is there for a global observatory? The Lancet, 382(9900), 1286–1307Google Scholar
  26. Rao, D., Feldman, B. J., Fredericksen, R. J., Crane, P. K., Simoni, J. M., Kitahata, M. M., & Crane, H. M. (2012). A structural equation model of HIV-related stigma, depressive symptoms, and medication adherence. AIDS and Behavior, 16(3), 711–716.  https://doi.org/10.1007/s10461-011-9915-0.CrossRefGoogle Scholar
  27. Rüsch, N., Müller, M., Ajdacic-Gross, V., Rodgers, S., Corrigan, P. W., & Rössler, W. (2014). Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking. Epidemiology and Psychiatric Sciences, 23(2), 177–187.  https://doi.org/10.1017/S204579601300036X.CrossRefGoogle Scholar
  28. Saxena, S., Paraje, G., Sharan, P., Karam, G., & Sadana, R. (2006). The 10/90 divide in mental health research: trends over a 10-year period. The British Journal of Psychiatry, 188(1), 81–82.  https://doi.org/10.1192/bjp.bp.105.011221.CrossRefGoogle Scholar
  29. Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007). Resources for mental health: scarcity, inequity, and inefficiency. The Lancet, 370(9590), 878–889.  https://doi.org/10.1016/S0140-6736(07)61239-2.CrossRefGoogle Scholar
  30. Vasquez, E. E., Hirsch, J. S., Giang, L. M., & Parker, R. G. (2013). Rethinking health research capacity strengthening. Global Public Health, 8 Suppl, 1(sup1), S104–S124.  https://doi.org/10.1080/17441692.2013.786117.CrossRefGoogle Scholar
  31. Verdeli, H., Clougherty, K., Onyango, G., Lewandowski, E., Speelman, L., Betancourt, T. S., & Bolton, P. (2008). Group interpersonal psychotherapy for depressed youth in IDP camps in northern Uganda: adaptation and training. Child and Adolescent Psychiatric Clinics of North America, 17(3), 605–624, ix.  https://doi.org/10.1016/j.chc.2008.03.002.CrossRefGoogle Scholar
  32. Waititu, A. I., Mwangangi, E. M., Amugune, B., Bosire, K. O., and Makanyengo, M. (2016). Impact of depression on adherence to antiretroviral therapy among HIV/AIDS patients at a Kenyan referral hospital. Retrieved from http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/95964
  33. Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., & Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 1575–1586.  https://doi.org/10.1016/S0140-6736(13)61611-6.CrossRefGoogle Scholar
  34. World Health Organization (2012). Report of the Consultative Expert Working Group on Research and Development: financing and coordination. http://www.who.int/phi/CEWG_Report_5_April_2012.pdf
  35. World Health Organization. (2016). mhGAP Intervention guide - version 2.0 for mental, neurological and substance use disorders in non-specialized health settings. Geneva.Google Scholar
  36. Yator, O., Mathai, M., Vander Stoep, A., Rao, D., & Kumar, M. (2016). Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi. AIDS Care, 28(7), 884–889.  https://doi.org/10.1080/09540121.2016.1160026.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Muthoni Mathai
    • 1
    Email author
  • Ann Vander Stoep
    • 2
    • 3
  • Manasi Kumar
    • 1
  • Mary Kuria
    • 1
  • Anne Obondo
    • 1
  • Violet Kimani
    • 4
  • Beatrice Amugune
    • 5
  • Margaret Makanyengo
    • 6
  • Anne Mbwayo
    • 1
  • Mara Child
    • 7
  • Jürgen Unützer
    • 7
  • James Kiarie
    • 8
    • 9
  • Deepa Rao
    • 10
    • 11
  1. 1.Department of Psychiatry, College of Health Sciences, Kenyatta National HospitalUniversity of NairobiNairobiKenya
  2. 2.Department of Psychiatry and Behavioural SciencesEpidemiology University of WashingtonSeattleUSA
  3. 3.Child Health InstituteSeattleUSA
  4. 4.School of Public Health, Kenyatta National HospitalUniversity of NairobiNairobiKenya
  5. 5.School of Pharmacy, Kenyatta National HospitalUniversity of NairobiNairobiKenya
  6. 6.Kenyatta National HospitalUniversity of NairobiNairobiKenya
  7. 7.Psychiatry and Behavioural Sciences, School of Public Health and Department of Global HealthUniversity of WashingtonSeattleUSA
  8. 8.Department of Obstetrics and GynaecologyUniversity of NairobiNairobiKenya
  9. 9.World Health Organization, Human Reproduction TeamKenyatta National HospitalNairobiKenya
  10. 10.Department of Global Mental Health, Psychiatry and Behavioural SciencesUniversity of WashingtonSeattleUSA
  11. 11.Department of Global HealthHarborview Medical CenterSeattleUSA

Personalised recommendations