AFFIRM is one of four collaborative Hubs funded by the US National Institute of Mental Health (NIMH), focused on global research in mental health. The Hub includes research institutions and Ministries of Health from sub-Saharan Africa (Ethiopia, Ghana, Malawi, South Africa, Uganda and Zambia), and academic centers in the US (Columbia University and Johns Hopkins School of Public Health) and the UK (King’s College London). The Hub is coordinated through the University of Cape Town, South Africa. There are 4 components to the project:
Randomised Controlled Trials (RCT) of task-sharing interventions are being carried out in South Africa and Ethiopia. Both sites have completed successful formative research, retrieving qualitative information on task sharing and local understandings of mental illness. This has also contributed to the development of locally valid Functional Assessment Tools in Butajira, Ethiopia and Khayelitsha, Cape Town.
Khayelitsha, Cape Town, South Africa: The objective of this randomised controlled trial (RCT) is to determine the effectiveness and cost-effectiveness of a task sharing counseling intervention for maternal depression in South Africa. We wish to determine whether such care can be delivered by non-specialist health workers more cost-effectively than enhanced usual care in South Africa.
Butajira, Gurage Zone, Southern Nations Nationalities and People’s Region (SNNPR), Ethiopia: The main aim of the proposed RCT is to determine the effectiveness and cost-effectiveness of task sharing care of persons with severe mental disorders (SMD) with Primary Health Care Workers, compared to a model of specialist mental health care in Ethiopia.
2. Shared Project
As part of the group of four NIMH Hubs involving task sharing for mental health, AFFIRM is conducting a mixed-methods evaluation of the barriers and facilitators to task-sharing, from the perspectives of health and community workers, mental health professionals, clients, and other relevant persons in the health care system. This is based in Ethiopia.
3. Capacity Building
AFFIRM has a capacity building component that aims to build individual and institutional capacity for intervention research in mental health, in sub-Saharan Africa. This is addressed through:
- MPhil programme on Public Mental Health at UCT and Stellenbosch University
- Support for PhD students linked to the trials or shared project
- Provision of short courses covering topics such as Randomised Controlled Trials and policy making and planning for mental health
AFFIRM collaborates with researchers, NGOs, government agencies, and other NIMH Hubs, to facilitate the translation of research knowledge into policy and practice. This is addressed through on-going discussions and meetings and through sharing experiences in the capacity building and research components.