Contextualization and Pilot testing of the Child and Adolescent Mental and Behavioural disorders (CMH) module of the WHO's Mental Health Gap Action Programme (mhGAP) Intervention Guide in Kenya
Despite the high burden of Child and Adolescent Mental and Behavioural disorders (CMHs) in low and middle-income countries (LMICs), there is a massive gap in mental health care for children and adolescents. Diagnosing and managing these issues in children and adolescents is challenging due to the scarcity of specialized mental health experts, especially in Primary Healthcare (PHC) settings – which are the first healthcare entry point for most. Building healthcare workers' capacity in assessing and managing child and adolescent mental and behavioural disorders including developmental disorders is a critical component of the multi-sectoral integrated care model SPARK aims to develop. Beatrice Mkubwa's PhD project aims to contextualize, adapt, implement, and evaluate the CMH module of the WHO mhGAP-IG version 2 in Nairobi and Kilifi Counties in Kenya.
Phase 1: Scoping Review
The scoping review will examine knowledge, attitudes, and practice gaps in child and adolescent mental health among healthcare workers (HCWs) in sub-Saharan Africa
Phase 2: Situational Analysis
A situational analysis will be conducted to understand the Kilifi and Nairobi counties' mental health systems. Data from the situational analysis on the state of the mental health services, the personnel, their level of competence, the referral networks, and the interventions available will provide a baseline for monitoring the change in the mental health services before and after the implementation of the mhGAP CMH module.
Phase 3: Contextualisation and Adaptation of the CMH Module of the mhGAP-IG
Contextualization and adaptation of the mhGAP-IG version 2 CMH module will follow a step-by-step collaborative process with stakeholders in mental health and mental health experts within Nairobi and Kilifi counties.
Phase 4: Training and Evaluation of impact post-implementation of the CMH module
Training for healthcare workers, nurses, clinicians, and medical officers will be provided in non-specialist settings in Nairobi and Kilifi Counties on the adapted CMH module and training materials. The feasibility and acceptability of the CMH module training and supervision will be examined as well as its use in care delivery in non-specialist healthcare settings in Kenya and the factors influencing its implementation will be explored. Secondly, the research team will evaluate the impact of CMH module training on the knowledge, attitudes, practice, competence, and professional quality of life of HCWs in Kenya. Thirdly, the team aims to assess the psychometric properties of the Professional Quality of Life Scale (ProQOL) when used to assess the quality of life of HCWs after CMH module training. Lastly, client's perspective on CMHs health care provision experiences and service satisfaction offered by the CMH module trained HCWs in Kenya will also be explored.