Innovation summary

The SPOT programme is an integrated and consolidated approach to Congolese refugees’  MHPSS needs in the two settlements of Kyaka II and Kyangwali. The target beneficiaries in the two settlements are largely new arrivals who have suffered or witnessed traumatic experiences, got disabilities while running away from the war, have been separated from their families and most of them have embarked on dangerous journeys to get to Uganda. Some of the target beneficiaries have also suffered SGBV while in Congo during the war and so still suffer the psychological distresses and traumatic experiences due to inadequates ervices.

The goal of the intervention is to empower refugees, persons with special needs (PSNs) and vulnerable host communities with demonstratably improved resilience, psychosocial wellbeing and positive coping mechanisms to come to terms with past traumatic experiences and possible future crises.

The project hopes to achieve the above through the following intervention components;

  • Team up activities
  • Detection of stressors, Evaluation of stress, Action towards stressors and Learning from stressors through self-reflection (DEALSmodel)
  • Psychological First Aid (PFA)
  • Home visits and family mediation
  • Basic Psychosocial support
  • Advanced group therapy through CBT-T
  • Individualized therapy and case management
  • Mental health outreaches
  • Physiotherapy services 
  • Providing assistive devices to Persons with Disabilities (PWDs)
  • Occupational therapy services

Impact summary

  • Over the last 11 Months a total of 8,888 (83% of target population)beneficiaries have received MHPSS services
  • 60% of cases reported to have recovered from their presenting distress

“I love the CBT group sessions because they have enabled me to change my negative thoughts to positive thoughts. Before the group sessions I stayed in doors for most of the day. Sometimes people thought I was sleeping but just thinking of things which weren’t even helping me. I grew up with my mother so no one would help me. Now I am thinking, I’ve sat for S.4 what next, who will help me is what is in my mind. Through the peer-to-peer counselling, I am counselling my colleagues and many of them trust me”

Ann Marie Maombi -Kyaka refugee settlement.

Innovation details

Uganda is currently hosting a total of 1.36 million refugees mainly from South-Sudan (985,512 individuals) followed by the DRC (271,967 individuals)1. These new influx refugees led to the rapid expansion of the refugee population in both settlements in Kyaka II and Kyangwali putting a heavy strain on limited existing services1. Most of them have suffered and/or witnessed severe human rights’ abuses and atrocities, suffered traumatic experiences including witnessing of violence of all forms, sexual and gender-based violence, and mass murders. 

Despites these challenges and experiences, majority of these (83%) were unable to receive psychological care. Therefore, the goal of the project is to improve resilience, psychosocial wellbeing and positive coping mechanisms among refugees, persons with special needs (PSNs) and vulnerable host communities in South-Western Uganda. The intervention model is designed to ensure the targeted PSNs of MHPSS services have access to a comprehensive package of services that includes all levels of Mental Health and Psychosocial Support.

  • Non-specialized MHPSS implemented by War Child Holland (WCH) used as preventive measures and platform to identify cases which require support.
  • Specialized MHPSS services implemented by Transcultural Psychosocial Organization (TPO) will be provided to individuals in need and customized to their conditions. This is provided either in groups or individuals following the CBT modal. 
  • Disability and Inclusion response services by Humanity and Inclusion (HI) will be provided to very vulnerable persons with psychosocial distress will receive adapted Psychosocial Support.
  • Coordination, Harmonization and Referral Pathways will be strengthened to improve MHPSS service delivery.

Key drivers

Coordination 

  • The project is being implemented by 3 consortium partners which are specialised in delivering quality MHPSS services at the different levels of the IASC MHPSS pyramid. 
    • The project also strengthened its collaboration with other partners, actors and sectors. This facilitated referrals and linkages for comprehensive case management and response.

Local human resources

  • The project recruits and employs local staff and volunteers who understand the context very well.

Capacity-building

  • The project builds capacity to both internal and external groups to deliver the project. This is to ensure sustainability as some of the trained individuals are from the government and community systems.

Awareness raising

  • This was a key driver in increasing case identification and strengthening positive copying mechanisms. In addition to helping close the information gap on MHPSS issues in the communities.

Close monitoring and follow-up

  • The project also developed a strong M&E protocol which ensured that cases or beneficiaries enrolled in the project were consistently monitored for progress and recovery.

Challenges

Working in silos

  • There are some actors external to the consortium who still want to work in silos. This makes it hard to share information or even support beneficiaries referred to them.

Mobility of some beneficiaries

  • Given the insecurity of accommodation faced by refugees, some beneficiaries keep moving their location which makes follow up and tracking difficult.

Adverse cultural and social beliefs 

  • Some of the refugee cultural and social beliefs and norms can act as barriers for the programme e.g.the belief that psychological distress and mental illness is caused by witchcraft.

Continuation

Lessons and good practices from our work are being profiled and will be used to develop other interventions. Some of these have already been considered in the modification grant by ECHO. Additionally, recommendations will be shared by the different partners through various working groups for knowledge sharing and adaption.

The project is also continuing to engage with relevant actors to streamline MHPSS service provisions. Through the national MHPSS working group, the members (including project staff) are working with the Ministry of Health to develop standard operating procedures for delivering MHPSS services.

Partners

  1. War Child Holland
  2. TPO Uganda
  3. Humanity and Inclusion (HI)

Funders

  1. European Union Civil Protection and Humanitarian Aid (ECHO_

Evaluation methods

The following methods are used to evaluate and monitor programme activities and impact:

  • Project Records: Records on activities conducted on a daily basis are captured into the project monitoring tracker for analysis and monitoring of the project progress.
  • Formal surveys: These are used to provide baseline data against which the performance of the project will be measured against at the end of the project.
  • Interviews with stakeholders
  • Direct observation: Observational record forms are used to report daily on activities being conducted
  • Quarterly Focus Group Discussions
  • Beneficiary Feedback forms 
  • Most Significant Change stories (MSCs)

Impact details

  • Over the last 11 Months a total of 8,888 beneficiaries have received MHPSS services on the various level of MHPSS pyramid (community and family support, targeted non specialised support, and specialised support) following the “IASC guidelines on Mental Health and Psychosocial Support in emergency settings”
    • 83.3% of the targeted population (10,668) both Nationals and Refugees received MHPSS services over the last 11 months of project implementation
  • 17% (1,780) of the beneficiaries to be reached by the end of the project 
  • 60% of cases reported to haver ecovered from their presenting distress. Through our various MHPSS services, beneficiaries realized significant changes and outcomes both at individual and family levels
    • The biggest demonstrable individual outcome among beneficiaries is the improvement in their psychological and emotion wellbeing which was indicated by adopting a positive outlook to life from being depressed, stressed and suicidal.
    • While on the family, it is the improved relationships and social cohesion for the clients with their family members, friends and environment.

References

  1. UNHCR (2019). Uganda Country Refugee Response Plan: The integrated response plan for refugees from South Sudan, Burundi and the Democratic Republic of the Congo. (January 2019 — December 2020).[Link]

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