MIND ME Africa (Mental health INformation aND Monitoring and Evaluation in Africa) is an extension of the Case Studies Project initiated by CBM International and London School of Hygiene and Tropical Medicine (LSHTM) in 2008.5,6 One output of the Case Studies Project was a monitoring and evaluation (M&E) package which was later piloted at two mental health programmes supported by CBM Nigeria (Abuja and Amaudo). This M&E package was designed to generate routine process and outcome data, enabling programmes to evaluate the effectiveness of services in terms of clinical (symptom severity, functioning) and social (quality of life, family attitudes) outcomes.
Key components of the original M&E package include:
- Paper-based M&E tools for data collection
- Enrolment form (administered at first visit)
- Periodic review form (administered at follow-up visits every six months)
- Routine follow-up form (administered at all other follow-up visits)
- Field guide instructing frontline workers on how to complete each M&E form
- Manual of instructions for the general implementation of the M&E system
- Access database where enrolment and periodic review data could be entered and analysed
In 2013, formative research was conducted by LSHTM in collaboration with the Benue State Comprehensive Community Mental Health Programme (CCMHP), the Benue State Ministry of Health and Human Services, and CBM International to further adapt the M&E package along with a newly drafted mental health information system (MHIS) for roll-out across Benue State.7 The focus of this research was on assessing the feasibility, acceptability and appropriateness of the MHIS/M&E package for use by community psychiatric nurses (CPNs) operating mental health clinics in primary care facilities.
Noting significant challenges both in the initial pilots at Abuja and Amaudo and in the early implementation of the adapted M&E package, the MIND ME research project was formalized in 2014 as a partnership between CBM and LSHTM to identify best practices in mental health M&E and MHIS in Nigeria and in sub-Saharan Africa more broadly. Mixed-methods implementation research is currently being carried out over a series of field visits to CCMHP, in which the process of implementation will be documented and outcomes evaluated. The ultimate aim is to identify best practices in the generation of high-quality routine data for mental health M&E and MHIS in low- and middle-income countries.
The integrated MHIS/M&E package that MIND ME is currently evaluating includes:
- Adaptations of the original paper-based M&E tools, designed to reduce the burden of data collection on frontline providers
- Adapted field guide instructing frontline workers on how to complete the new M&E forms
- Two daily MHIS registers (one for new clients, and one for follow-up clients) and a monthly MHIS report, designed to reduce common errors in data processing
- Manualized standard operating procedures which streamline the various record-keeping responsibilities of frontline providers, to reduce the burden of additional MHIS/M&E tasks
- A variety of tools (file logs, appointment cards, receipt templates) designed to improve the efficiency of record-keeping
- Supervision checklists for routine monitoring of data quality
- Revised database specifications (new database to be developed and tested in 2015)
MIND ME has also developed training and advocacy materials to support CCMHP in the implementation and scale-up of this MHIS/M&E system.