Difu Simo Mental Health Awareness Campaign

Innovation summary

Difu Simo is a Mental Health Awareness Campaign in Kilifi County located on the Kenya Coast of the Indian ocean. Difu Simo is a Kigiriama phrase which means “Breaking Free”. The aim of the program is to tackle the myths and misconceptions about mental, neurological and substance use disorders by creating platforms for dialogue between the community and mental health stakeholders, especially biomedical practitioners and traditional healers. The program uses participatory art as a tool to tackle stigma. This includes poetry, songs, dance and audio-visual arts such as participatory videos which are created and disseminated by people with lived experience in mental and neurological illnesses

Impact summary

Since its establishment in 2019, Difu Simo has reached over 3,000,000 in Kenya through multiple dialogue platforms. Preliminary data on effectiveness in reducing stigma indicates that in the short term, the program has reduced public stigma by increasing knowledge about mental illness, improving attitudes towards people with mental illness and improving intended behaviour.

Innovation details

The innovation addressed stigma against people with mental, neurological and substance use disorders coastal Kenya. The goal of the innovation is to reduce stigma against mental and neurological disorders to enable people with these disorders to seek care and ultimately improve their health and quality of life. The project uses various approaches to tackle stigma such as mass campaigns and targeted campaigns for stakeholders of community wellness such as community leaders and community health volunteers. The core mode of delivery of the interventions is through art such as songs, poems and dance. The content of the part is created using participatory approaches that involve people with lived experience and representatives from the target populations.

Key drivers

Use of participatory approaches

Involving stakeholders in mental health such as community health volunteers, community leaders, representatives of the general population, biomedical practitioners, traditional and faith healers contributed to acceptability of the campaign in the community. Additionally, the intervention delivered during the campaign were contextually relevant and were relatable to the target audience as they addressed the mental health literacy gaps relevant to the community.

Use of art

In addition to providing entertainment to the target audience, the use of art ensured that messages were preserved and could be widely shared through various platforms such as social media and mainstream media. Art was also viewed as a neutral way of addressing controversial concepts about mental health such as whether mental illness is caused by witchcraft.

Involvement of people with lived experience

Qualitative interviews with participants from the various campaigns indicated that involving people with lived experiences made the messages believable and relatable. This was especially the case when the people with lived experience had recovered from their illnesses or were in remission from episodes of severe mental illness.

Challenges

Disruption of implementation plan due to the COVID-19 pandemic

Between 2020 and 2021, the project had periods of no activity because of the public health restrictions imposed to control the spread of COVID-19.

Funding constraint

Related to the disruptions due to the COVID-19 pandemic, the project faced funding challenges as staff continued to be paid even though they were unable to work and hence this reduced the funding available to run field activities.

Continuation

Plans for scale-up are ongoing

Partners

KEMRI Wellcome Trust Research Programme

County Government of Kilifi

Malindi District Cultural Association

Documentary Institute for Eastern Africa

Funders

Wellcome Trust

National Institute for Health and Care Research

Novartis

Evaluation methods

Before and after research designs to measure the effectiveness of interventions

The effectiveness of some of the project’s methods such as participatory videos has been quantitatively evaluated using before and after designs. Stigma, which was conceptualised using knowledge, attitudes and behaviour, was measured using validated tools at baseline and at two follow-up time points following the delivery of the intervention to a target audience of community leaders. The quantitative results of this evaluation are currently under peer review in a scientific journal.

Validation of the stigma tools was also done as part of the project and the process and results of this validation can be obtained in this article Validating measures of stigma against those with mental illness among a community sample in Kilifi Kenya

Cost of implementation

Cost effectiveness analysis on going

Impact details

In summary, to date, the project has been able to reach over 3,000,000 residents of coastal Kenya. Data from the psychiatric and neurological outpatient facilities which cover the catchment areas of the campaign indicate that there has been an increase in the number of referrals of people with mental and neurological disorders from the community. The precise impact of the campaign on the number of cases

References

Research

Multimedia

Reports

Difu Simo press kit

Associates

Mary Bitta Principal Investigator

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Country

Kenya

Affiliated organizations

KEMRI Wellcome Trust Research Program - CGMRC