Innovation summary

There is a lack of mental health promotion, prevention and access to care for school-going children in Kenya. The goal of this innovation was to test the efficacy and feasibility for scale-up of a multi-stakeholder model for primary schools that seeks to promote mental well-being, prevent mental illness and reduce the treatment gap for children. The main components of the innovation include:

  • Establishing and running peer clubs
  • Sensitizing parents on mental health issues
  • Increasing interaction between home and school

Impact summary

  • Approximately 6,000 primary school-going children were assessed for mental health issues2
  • The innovation resulted in a reduction of almost 50% in abseentism from school and reduced need of discipline
  • USD $986,000 to implement over 3 years

"This is the best thing that has ever happened to the education sector.  Parents in this community do not understand that they have a role to play in their children’s academic progress and only leave it to the teachers."

 

-Headteacher attending a school entry workshop

This innovation is funded by Grand Challenges Canada.

Innovation details

The innovation is a scale-up of a multi-stakeholder WHO model developed for primary schools that has successfully been piloted in 24 secondary schools in Australia. Africa Mental Health Foundation (AMHF) has piloted the model in one rural school in Kenya. The model takes into account all environmental problems (social and cultural) affecting the child, from school to the community, and identifies and works with all relevant stakeholders.                          

Innovation activities:

  • Establishment of peer clubs, life skills training and screening and case management by lay health workers
  • Training of primary school teachers to run peer clubs (for sustainability)
  • Increase in parent-teacher contact to discuss academic performance 
  • Sensitization of parents to increase involvement and interest in children’s school work through community psychoeducation and awareness
  • Adaptation and adoption of  mhGAP guidelines for training primary health care workers to provide mental health services

Key drivers

Bottom-up approach

  • Giving ownership to the community improves  acceptability and sustainability

Challenges

  • Inadequate attention to children at school and at home
  • School absenteeism due to “sickness” and “helping at home”
  • Mental illness symptoms are not recognised by children, teachers and parents/guardians
  • Parents’ expectation of schools vs. children’s academic performance
  • Proposed life skills for students in an already crowded school curriculum

Continuation

This is a scale-up program from a previously implemented pilot. The pilot itself was replicated in Kenya after WHO successfully implemented a program in 24 secondary schools in Australia. Should the results prove successful, it can be generalized and further replicated in other counties.

Future plans for the innovation:

  • Scale up of innovation to other counties and entire country
  • Inclusion of life skills training and establishment of peer clubs in school curriculum
  • Inclusion of life skills training at teacher training programs
  • Parents’ and teachers’ forum for establishing dialogue

Evaluation methods

A randomized wait-listed control study was undertaken.1 Other evaluation methods will include:

  •  Monitoring of the number of students attending life skills and peer clubs over the period of the project
  • Focus group discussions with parents, teachers and students for qualitative evaluation
  • Monitoring of academic performance over time

Cost of implementation

The scale-up is estimated to cost $1 million USD between 2012 and 2015. A cost analysis to discover the cost-effectiveness of the innovation has yet to be undertaken.

Impact details

  • Community entry with opinion leaders and policy makers to set stage for eventual ownership of project has been completed
  • Formative research (normative and baseline measures) have been conducted
  • Curriculum for providing life skills training and establishing peer clubs in schools under development

References

  1. Kieling C et al. (2011) Children and adolescent mental health worldwide: evidence for action. Lancet, 378(9801):1515-25.
  2. Darr, A (2013)  Screening for mental illness in children: will it lead to better outcomes? Grand Challenges Canada.

Comments

A very inspiring and worthy research project project. I am keen to follow the outcomes.

A very inspiring and worthy research project project. I am keen to follow the outcomes.

A very inspiring and worthy research project project. I am keen to follow the outcomes.

A very inspiring and worthy research project project. I am keen to follow the outcomes.
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Kenya

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