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Building mental health & psychosocial support capacity for orphans and vulnerable children in Nigeria
Mental health has increasingly gained recognition as a global health priority due to its significant impact on people’s wellbeing. In Nigeria, poverty, cost of living, unemployment, lack of infrastructure, working conditions, insecurity, deteriorating health care and the burden of chronic diseases such as HIV are among the major drivers of mental illness. According to the Africa Polling Institute, it is estimated that 20-30% of Nigeria’s population suffers from mental health challenges.
The Pact-led, USAID-funded Adolescent and Children HIV Incidence-reduction, Empowerment and Virus Elimination (ACHIEVE) project has played a pivotal role in Nigeria by providing technical and organizational capacities to USAID-funded Integrated Child Health and Social Services Award (ICHSSA) prime implementers so that they can lead orphans and vulnerable children (OVC) programming for children aged 6-20 and their caregivers. A key activity of the project has included developing a package of mental health and psychosocial support (MHPSS) resources for frontline case workers implementing OVC programs. The package equips the case workers with the skills, knowledge and resources to identify and respond appropriately to mental health issues among OVC and their families.
Mental health landscape analysis
To develop a training curriculum that is HIV-sensitive, and which appropriately addresses the mental health and psychosocial needs of OVC program participants, ACHIEVE conducted a MHPSS landscape analysis. The landscape analysis gathered information, assessed and detailed the current situation in Nigeria vis-a-vis OVC programming. The findings revealed the absence of community mental health screening and identification tools suitable for community OVC programs.
Co-creation workshop
To address the gaps identified through the analysis, ACHIEVE conducted a three-day co-creation workshop in Abuja to address the MHPSS needs of people living with HIV and OVC program participants. During the workshop, ACHIEVE and ICHSSA partners, in partnership with Reconnect Health Development Initiative (RHDI), developed the first OVC MHPSS Screening and Identification Checklist in Nigeria. The checklist was adapted from multiple standard mental health diagnostic tools used by mental health clinicians and psychologists. It aims to help community case workers (CCWs) detect signs of mental health conditions among OVC program participants and provide immediate first-line support appropriate for the screening outcome. The support may include psychological first aid, psychosocial support and referral for professional care.
ACHIEVE pre-tested the checklist in four states: Akwa Ibom, Bauchi, Lagos and Kano States. The team then integrated the feedback collected during the pre-test to improve the relevance, validity, simplicity, accuracy and useability of the checklist.
Mental health & psychosocial support training
Following these activities, ACHIEVE led a five-day mental health and psychosocial support training for key staff of the organizations implementing ICHSSA interventions, including the Government of Nigeria and civil society organizations.
The training focused on increasing the knowledge and skills of CCWs in detecting mental health disorders specifically identification and screening processes among OVC program participants in their care and referral. The knowledge gained has better prepared CCWs to create awareness on mental health in their immediate communities, which will ultimately reduce stigma and help individuals manage their mental health. Additionally, key outcomes of the training included the development of a Mental Health and Psychosocial Support Screening and Identification Standard Operating Procedure, a Training Facilitators Guide and a Mental Health Discussion Guide for case workers.
Doreen Magaji, Agreement Officer Representative at USAID, expressed that the ICHSSA partners can start integrating learnings from the training to facilitate a change in people's mental health. Felix Iwuala, Chief of Party for ICHSSA 2, added that the ACHIEVE-supported mental health resources provide an important part of the continuum of care to those in need of mental health support services.
Outcomes
Identifying program participants who demonstrate signs of mental health conditions is a critical step in ensuring that they are linked to and access appropriate mental health services, and ultimately improve their stability, treatment adherence and viral suppression while enhancing other social parameters for the households. The outcomes of ACHIEVE’s interventions indicate that evidence-based, data-driven tools and customized trainings serve as an important means to ensure that OVC program participants receive the support and care they need to improve their health and maintain their overall well-being.