Innovation summary

In many low and middle income countries (LMIC), Traditional and faith healers provide care for the bulk of patients with severe mental disorders in LMIC because of their abundance, the synchrony of their views with their local communities in regard to the causation and treatment of these disorders, and scarcity of mental health specialists. Even though a desire for collaboration between healers and orthodox health providers is commonly expressed, evidence is lacking about the feasibility of collaboration.

COllaborative Shared care to IMprove Psychosis Outcome (COSIMPO) is an innovative program of work in which primary care providers work collaboratively with traditional and faith healers to provide evidence-based care to patients with psychosis. Following training of both groups, structured engagement activities are implemented involving the provision of clinical support by the primary care providers to the healers. Clinical support, mainly provided at the healers’ facilities, includes direct treatment of patients and educational engagement with the healers to reduce harmful and abusive treatment practices. Indices of collaborative engagement as well as patient outcomes are carefully assessed and compared to care as usual in a randomized controlled design.

Through collaboration, the project aims to test the effectiveness of a shared care program between Traditional/Faith Healers (TFH) and Primary Health Care Providers (PHCPs) in improving the outcome of persons with psychosis.

The innovation includes:

  • Development of a manualized collaborative shared care program to improve the management of mental health problems by TFHs, through reduction of harmful practices and abuse of human rights and to facilitate appropriate treatment, consultations and referrals
  • Implementation of a randomized controlled evaluation of the program


Impact summary

  • 80 primary care providers have been trained 
  • 70 traditional and faith healers been trained

Data collection in process.


“It will be good if the faith/traditional healers and the Biomedical practitioners can work together. The CAPs can reveal the root cause of the illness and the doctors can treat. This will shorten the time of admission for a patient” 


29 year old male service user in Kenya

National Institute of Mental Health (NIMH) Hub 

Innovation details

Bringing together service providers, policy makers and researchers with expertise in global mental health to create a sub- Saharan mental health (MH) research Hub. The hub will establish itself as a regional center supporting research capacity-building and innovative MH service development in the region, focusing initially on expanding services from persons suffering from one of the most disabling mental health problems, specifically psychosis.

Pam-D also aims to develop and implement targeted programs of training and mentoring that build mental health research capacity in a broad range of mental health professionals with a view to creating and supporting a critical mass of experts for innovative mental health research to address the region’s mental health needs. 


Key drivers

  • Core Team of Highly-Renowned Researchers
  • Multidisciplinary team of internationally renowned researchers with direct experience about the complex and peculiar mental health situation in Africa  



  • Difficult terrain, especially in rural settings
  • Initial suspicion from Traditional/Faith Healers (TFH) about intention of research
  • Expectation from TFHs of financial compensation from research 



The model of collaboration between Traditional/Faith Healers (TFH) and Primary Health Care Providers (PHCPs) is desirable in all areas of medical care - both mental and physical health conditions. The feasibility of this collaborative-shared care to be tested by PaM-D COSIMPO would be applicable to many areas of healthcare delivery in LMIC. 


Evaluation methods

The research design is a randomized control trial (RCT) in which collaborative-shared care would be compared with care as usual.

Cost of implementation

PaM-D is funded over 5 years with $2,500,000 USD. The cost-effectiveness of the innovation is yet to be determined.


Impact details

Across the two project sites of Kumasi, Ghana and Ibadan, Nigeria:

  • 80 primary care providers have been trained in the recognition and treatment of psychosis
  • 70 traditional and faith healers have received training on how to avoid the use of treatment approaches that are potentially harmful or inhumane

Data collection is currently in process: weekly monitoring visits will be made to the TFH facilities by the PHCP and the research team. Records will be kept of specific collaborative engagements between TFHs and PHCP, the number of consultations and referrals requested and honored, the number of patients benefiting from collaboration, patient symptom and functional outcomes, and the cost of collaboration to the patients.

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Ghana, Kenya, Liberia, Nigeria, South Africa

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