Innovation summary

Although several landmark international movements and publications have recently served to improve the knowledge base on how to address the escalating burden of mental disorders, information is still scarce on how to translate this knowledge into practice at the health system level.

The EMERALD project aims to improve mental health outcomes in low- and middle-income countries by generating the evidence and capacity to enhance health system performance, thereby providing more and better care in these countries. It aims to do so by:

  • Identifying key barriers to effective service delivery within health systems
  • Offering solutions for better service delivery in the future

EMERALD is structured as six work packages:

  • Management and co-ordination tasks
  • Capacity-building in mental health systems research
  • Adequate, fair and sustainable resourcing for mental health (health system inputs)
  • Integrated provision of mental health services (health system processes)
  • Improved coverage and goal attainment in mental health (health system outputs)
  • Dissemination

Impact summary

  • Consortium of 12 partners across six countries
  • $7,955,860 USD funding over five years

Although several landmark international movements and publications have recently served to improve the knowledge base on how to address the escalating burden of mental disorders, information is still scarce on how to translate this knowledge into practice at the health system level.

-The EMERALD Project

Innovation details

The key issues that EMERALD addresses focus on health system inputs, processes, and outputs:

Objective 1: Adequate, fair and sustainable resourcing

To identify health system resources, financing mechanisms and information needed to scale-up (i.e. expand) mental health services and move towards universal coverage.

Objective 2: Integrated physical and mental health service provision

To evaluate the context, process, experience and health system implications of mental health service implementation.

Objective 3: Improved coverage of care and goal attainment

To develop, use and monitor indicators of mental health service coverage and system performance.

These objectives are being pursued by taking a systems approach, strengthening the ability of in-country researchers and mental health experts to communicate their messages, as well as the capacity of policy-makers and planners to make use of the information, but also involving service users and their caregivers in health system policy and planning actions alongside the necessary capacity-building processes.

Key drivers

EMERALD is innovative in that it brings together a large and diverse group of stakeholders with expertise in global mental health and health systems research (including researchers, clinicians, policy-makers, service users and caregivers), who will together work towards improving mental health systems in low- and middle-income countries.

Challenges

There are challenges around coordinating the research across a range of different country settings, each with different resources, capacities and requirements. However, this is also a strength of the project, as this should increase the relevance of EMERALD’s findings to a broader set of contexts.

Continuation

EMERALD intends to widely disseminate findings so that these can be used to inform the development and strengthening of health systems in the partner countries and in other low- and middle-income countries. EMERALD has strong links with policy-makers and service user organizations throughout all participating countries, and works closely with stakeholder groups to ensure that the dissemination of findings reaches a broad audience and to facilitate implementation of research findings.

Partners

EMERALD is funded through the European Union Seventh Framework Program (Grant Agreement Nr. 305968).

EMERALD includes a consortium of 12 partners, of which five are in Europe and seven are in African and Asian low- and middle-income countries. Partner institutions include the following:

Evaluation methods

To achieve its objectives, a mixed-method approach will be employed across a range of sub-studies within the EMERALD project. These include, for example:

  • Survey with household members of people attending health care facilities to assess the economic impact of people living with a mental disorder
  • Key informant interviews and focus groups with policy-makers and planners, health facility managers, as well as service users and their caregivers
  • Delphi consensus study on suitable indicators

Cost of implementation

The total grant awarded by the European Union is $7,955,860 USD dispersed over five years (November 2012-2017).

Impact details

The EMERALD project is still in its early stages. However, the consortium intends to identify the key health system barriers to, and the solutions for, the scaled-up delivery of mental health services in low- and middle-income countries, and by doing so may improve mental health outcomes in a fair and efficient way, and ultimately help reduce some of the mental health treatment gap.

Research

Multimedia

Reports
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Country

Ethiopia, India, Nepal, Nigeria, South Africa, Uganda

Gallery

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