Strengthening Global Mental Health partnerships - #LetsTalk Depression

A new mental health collaborative was inspired to come together after the Health Partnership Symposium, Petty and Randy explain why sharing knowledge and practice across country borders is so crucial in the battle to improve mental health care. 

“Seeing mental health and substance misuse patients suffering, neglected by the community, families and other healthcare workers; motivated me to work with mental health. Working as a health Administrator and a Project Coordinator at a Tanzania National Mental Health Hospital, I found I could help these individuals so that they can be provided with an environment that will allow them to recover from their illnesses, reduce relapses and lead a normal life.”

Perpetua Mwambingu- Tanzania Link Project Coordinator

“In Ghana mental illness is often attributed to spiritual causes and people who suffer from mental illness do not get the help that they need. Stigma and discrimination is high and people who suffer from mental illness lose their dignity, respect and self-worth. My passion for awareness creation and advocacy and my belief that someday Ghana will appreciate the importance of mental health motivates me even during moments of burnout”

Randy Agbodo- Project Lead for Ghana - Zambia - NHS Highlands Partnership

The Story Remains the Same

According to the World Health Organization, for every four people, one will be affected by a mental or neurological disorder in their lifetime. The magnitude of mental health burden is not matched by the size and effectiveness of the response it demands. Currently, more than 33% of countries allocate less than 1% of their total health budget to mental health[1].

Sadly, in Tanzania and Ghana where Randy and I are working, the story remains the same, mental health services are underfunded, and most of the donor funded programs go to communicable diseases. There is inadequate human resource and insufficient supply of medications. Stigma and discrimination towards persons with mental disorders is still prominent and effective mental health prevention and promotion programs are woefully inadequate.

 No Health without Mental Health

Depression is ranked first in the list of top ten leading causes of years lived with disability (YLDs)[2]. Globally, an estimated 350 million people of all ages suffer from depression[3]. At its worst depression can lead to suicide and close to 800,000 people die due to suicide every year[4].

This is why it is so vital that World Health Day this year is addressing depression, bringing it to the fore of global health discussions. It gives health managers and policy advisers the opportunity to appreciate that depression affects productivity and therefore prioritizing and investing heavily in mental health would, in the long run, culminate in populations with healthy outcomes, respect for human rights and stronger economies.

The Health Partnership Symposium ‘effect’

In order to make this a reality, we believe that collaboration and the sharing of approaches is key and at the recent Health Partnership Symposium, organized by THET, we found we were not alone in this thinking.

Our passion for working in mental health was further cemented at the event where a certain chemistry brought colleagues from Ghana, India, Kenya, Nepal, Scotland, Tanzania, Uganda and Zambia together to form the ‘Mental Health group’.

We all wanted to come together to tackle and develop our learning on different mental health issues.  Ultimately we wanted LMIC’s to start collaborating and to share experiences which can strengthen the partnerships we work in. That’s when a luncheon ‘chat’ was called, then a dinner ‘talk’ happened and then we came to form a WhatsApp group, a way for us to easily reach out to each other.

The world is facing many challenges; political unrest, war, economic hardship, unemployment, etc., all are contributing factors to depression. This must be a wake-up call for the global community, the need to re-think, and re-act to this global crises, now is the time to re-set our priorities with regards to mental health and to act together through partnerships and shared learning. After all there is no health without mental health.

Perpetua Mwambingu

Tanzania Link Project Coordinator,

Tanzania

Randy Agbodo

Project Lead for Ghana - Zambia - NHS Highlands Partnership,

Ghana

[1] http://www.who.int/whr/2001/media_centre/press_release/en/

[2] http://www.who.int/mediacentre/factsheets/fs369/en/

[3] Ibid

[4] Ibid

#BeBoldForChange

THET needs to become more conscious about how, if at all, our work is advancing gender equality. 2017 is the year we will achieve this.

Our approach is centred on the Key Performance Indicators (KPIs) we have developed for THET this year. Alongside the necessary data we gather to track the performance of our programme, grants-making and policy work, we will ask ourselves one overarching impact question: how is our work accelerating gender equality? 

We will use this question to drive individual and organisational learning across our six offices, commissioning external evaluations, gathering case studies and data and, by the end of the year, publishing our findings publicly. This will be an honest and critical assessment of how well we are faring, and how we can become still more systematic going forward. Collaborating with our partners across the health partnership community will be critical in achieving this.

We already have a certain awareness of how gender influences who delivers health services and who benefits from them. In a recent staff meeting on this theme examples were plentiful and various: from an obstetrician who ran clinical training on reproductive and maternal and neonatal health, to women who needed consent from their male relatives to undergo surgical procedures. 
But this focus is perhaps made even more urgent in 2017 given the position being taken by the US under the leadership of President Trump, and especially his gagging order concerning funding for abortion or post-abortion care. Never has the phrase ‘one step forward, two steps back’ seemed so applicable.

It is also an area highlighted for greater consideration in the recent DFID-commissioned evaluation of the Health Partnerships Scheme and of course, we cannot talk about the Sustainable Development Goals without thinking about gender equality, the phrase ‘No one gets left behind’, alongside health.
This process is being championed across THET by one of our Trustees, Professor Irene Leigh. A Gender Equality Working Group has been established to steer our progress. Written guidance to help us consider gender equality in programme planning and monitoring is being developed by our Monitoring, Evaluation and Learning Team and we have  commissioned two studies into how partnerships’ approach gender equality and an analysis of the populations who use the health services and facilities partnerships work to strengthen. 

This is an exciting and vital area of consideration for THET. If you would like to stay in touch or contribute to this process, please get in touch: info@thet.org

Ben Simms
CEO,
THET

Somaliland: Health After War

In 2000, THET and Kings College Hospital (UK) began working with health training Institutions in Somaliland to improve the skills and knowledge of health care providers. THET works in partnership with health training Institutions, health professional associations and the Ministry of Health by harnessing invaluable experience of UK partners to improve the health care system.

Louise McGrath, Head of Programmes and Development at THET, travelled to Somaliland in January to discuss a new programme to strengthen health worker training in the region. Here follows her account.

I don’t cease to be amazed at what people can achieve,

even when faced with such adversity.

It had been well over a year since I was last in Somaliland, so I was very glad to touch down in Hargeisa at the end of January. I was arriving alongside a number of colleagues from Kings College London and Medicine Africa to hold discussions with national partners; three Somaliland Universities (Hargeisa, Amoud and Edna Adan), to agree the initial plans for the Kings led  Prepared for Practice programme. It is one of the first projects awarded under the DFID funded Strategic Partnerships Higher Education Innovation and Reform (SPHEIR) programme, managed by the British Council.

The project aims to strengthen the training of doctors, nurses and midwives to ensure they are prepared for practice once they qualify. Running over five years it will focus on strengthening undergraduate education and faculties.

THET will support national partners to identify and develop any additional policies and regulations that need to be in place to guide effective oversight of health worker training. We will also be responsible for the security and logistics associated with the trips of the project team and volunteers.

During the course of the meetings, it was brilliant to see how much progress the Somaliland partners had already made and to see the commitment and energy that was invested in achieving the shared goals. I was particularly pleased to see the number of women amongst the faculty and students and hear how dedicated they were to contributing to their countries progress.

One thing the trip also served to highlight is just how far Somaliland has come in the short period since the war ended.  A number of people reminded us of the destruction that the war caused to institutions and to the population. I don’t cease to be amazed at what people can achieve, even when faced with such adversity.

The trip was also a valuable opportunity to spend time with our country team and agree what steps need to be taken in the coming months. All in all a very exciting time for our country team and our partners...

Louise McGrath
Head of Partnerships and Development,
THET, UK

Maximising the potential for further funding in Mozambique.

We asked Sarah Cavanagh, Pharmacist and Peter Donaldson, Consultant Surgeon, to reflect on what they did to increase the chances of their project lasting beyond Health Partnership Scheme funding; by forging links with the Rotary Club they have secured potential funding for the future. Their project aims to develop patient safety programmes at the Central Hospital of Beira, Mozambique.

Tell us more about how you started to engage with the Rotary Club and where you are at now.

We began to engage with the Rotary club fairly early on in our partnership. We attended the 2014 THET conference which provided inspiration in the form of a workshop that covered fundraising strategies, as well as local stakeholder engagement. 

What was the issue?

The main issue was that our partnership did not have a very high profile locally, either within our hospital or in our local community. We also had no certainty that we would secure funding after the project end which is set for February 2017.

Who said or did what, and when?
We presented to Ipswich-Orwell Rotary Club in December 2014, October 2015, July and September 2016. In October 2015 we also presented to Woodbridge Rotary Club. In March 2016 we were invited to attend a drinks reception with local business leaders and our local MP and former Health Secretary, Ben Gummer, who has over many years been very supportive of both Ipswich Hospital and The Rotary Club. We also met with MP Ben Gummer separately, in his constituency office.

Ipswich-Orwell Rotary Club greet Health Professionals from Mozambique

Photograph taken by Eleanor Bull in Ipswich Hospital, April 2016.

What were the immediate reactions and results? What challenges did you face?

Immediately our profile was raised because we had spoken to these influential people. We also had increased press coverage, specifically in The East Anglian Daily Times and the Ipswich Star, through a Rotary-Orwell contact.

We did face some challenges however, as the vision to involve the Rotary Club and seek wider support, as well as additional funding was not universally shared within the team. This led to some debate and delay, but eventually it was seen to be a good idea for the future of the partnership.

What were the longer-term results?

After presenting twice, and without asking for any money, Rotary-Orwell asked whether they could support us financially. They organised a fundraising event in July 2016 and prior to that held a raffle; the two events raised over £700 for the project! As the July fundraising event (Rotary Mastermind Competition) was held in collaboration with the other three Ipswich Rotary Clubs, it has led to friendly contact with these clubs as well as Ipswich-Orwell. The partnership’s involvement has also helped raise awareness of the great work of the Rotary Club and Rotary International.

Sarah Cavanagh presenting the Rotary Ipswich-Orwell banner to Dr Wingi Olivier in Beira 2016

Photograph taken by Eleanor Bull in Ipswich Hospital, April 2016.

Have you solved the problem of sustainability? What will you do next?

We feel that we have to a certain extent solved this problem. There is a much greater understanding and awareness of our partnership both within our hospital and our community, and we have established good links with five of the local Rotary Clubs. After our next visit, in November 2016, we will have a clearer idea of the next steps with the partnership. We will be maintaining our established links with Rotary, with a view to maintaining or even increasing their involvement in the future.

What have you learnt, and what advice could you give to other partnerships?

One of the most important lessons we learned was that asking for money straight away is not necessarily the best way to maximise fundraising, neither is it the best way to forge longer term relationships with potential funders and local opinion leaders. These things take time and it is important to nurture the relationships.

Orwell Rotary Club presenting a cheque for £703 to our partnership in September 2016 for medical and maintenance equipment for Beira Hospital.

Photograph taken by David Vincent, 2016.

Rotary Club and Rotary International consist of 1.2 million neighbours, friends, and community leaders who come together to create positive, lasting change in local communities and around the world. Differing occupations, cultures, and countries give Rotary a unique perspective. Rotary support a variety of causes both at home and abroad. They are specifically identified and targeted to maximize local and global impact. Rotary uses its network of resources and partners to focus service efforts in promoting peace, fighting disease, providing clean water, saving mothers and children, supporting education, and growing local economies. As such this ethos ties in very nicely with Health Partnerships.

If you would like more information on the work of the Rotary Club and  Rotary International, please visit https://www.rotary.org/en/about-rotary