"Addressing depression in young people is a health-care policy need in sub-Saharan Africa. There exists poor mental health literacy, high levels of stigma, and weak capacity at the community level to address this health-care need. These challenges are significant barriers to accessing mental health
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care for depression, soon to be the largest single contributor to the global burden of disease. We here describe an innovative approach that addresses these issues simultaneously while concurrently strengthening key mental health components in existing education and health-care systems as successfully applied in Malawi and replicated in Tanzania. Improving the pathway to care for young people with depression requires the following: improving mental health literacy (MHL) of communities, youth, and teachers; enhancing case identification and linking schools to community health clinics; improving the capacity of community health-care providers to identify, diagnose, and effectively treat depression in youth. Funded by Grand Challenges Canada, we developed and applied a program called “An Integrated Approach to Addressing the Challenge of Depression Among the Youth in Malawi and Tanzania” (IACD). This was an example of, a horizontally integrated pathway to care model designed to be applied in low-resource settings. The model is designed to 1) improve awareness/knowledge of mental health and mental disorders (especially depression) in communities; 2) enhance mental health literacy among youth and teachers within schools; 3) enhance capacity for teachers to identify students with possible depression; 4) create linkages between schools and community health clinics for improved access to mental health care for youth identified with possible depression; and 5) enhance the capacity of community-based health-care providers to identify, diagnose, and effectively treat youth with depression. With the use of interactive, youth-informed weekly radio programs, mental health curriculum training for teachers and peer educators in secondary schools, and a clinical competency training program for community-based health workers, the innovation created a “hub and spoke” model for improving mental health care for young people. Positive results obtained in Malawi and replicated in Tanzania suggest that this approach may provide an effective and potentially sustainable framework for enhancing youth mental health care, thus providing a policy ready framework that can be considered for application in sub-Saharan Africa." (Abstract)
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"The African Farm Radio Research Initiative (AFRRI) was a 42-month action research project implemented by Farm Radio International (FRI) in partnership with World University Service of Canada (WUSC), and with the support of the Bill & Melinda Gates Foundation. An estimated 40 million farmers in five
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different countries were served by the AFRRI partnership with 25 radio stations. Farmers engaged in the design and development of farm radio programming were almost 50 per cent more likely to take up agricultural practices deemed to improve their food security than passive listeners. Those in what AFRRI deemed "active listening communities" (ALCs) were 10 times more likely to adopt the practice than those farmers who had no access to the farm radio programs. Farmers demonstrated increased knowledge of agriculture innovations as a result of listening to AFRRI radio programs, with up to 96% of some radio listeners scoring at least 60% on a follow-up knowledge quiz about the promoted farm practices [.] Farmers participate in selecting the focus – or topic – of the radio campaign, choose the time of broadcast, and are intimately engaged in the ongoing development of the farm radio programming over a set number of weeks; including as central agents of the knowledge-sharing process. Lively and entertaining formats are designed to attract listeners. [.] This report presents and discusses the key findings from an in-depth evaluation of 15 round-two Participatory Radio Campaigns (PRCs) – three PRCs in each of the five countries involved in AFRRI. AFRRI examined a mix of radio stations – community, associative, commercial, and state. Tools used for this evaluation included 4,500 household surveys (300 per radio station) in 90 communities, farm visits and field measurements, key informant interviews, and collection of secondary data (from other sources, such as national agricultural extension services)." (Executive summary, page 5)
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