Mental health care in resource poor settings
In 2005, we funded the WHO Collaborating Centre, the Kenyan Ministry of Health and the Kenyan Psychiatric Association to develop and implement a training programme to enable primary care workers to provide mental healthcare in Kenya. The work was led by Professor Rachel Jenkins.
The project was a response to an appraisal of mental health problems and treatment undertaken by the Kenyan Ministry of Health and the WHO Collaborating Centre. Funded by the Department for International Development (DFID), the appraisal led to developments in mental healthcare policy, including a strategic plan to integrate mental health into primary care.
Professional training and support
Between 2005 and 2010, 1,677 primary care workers received training, as well as 195 medical supervisory staff. A randomised control trial funded jointly with DFID showed a shift in knowledge in those trained and further surveys have demonstrated the positive impact of the training on the treatment of patients.
The training was delievered through the Kenya Medical Training College (KMTC), and the curriculum has been embedded into both its pre-service training for primary care workers and its in-service course. The course has been approved for continuing professional development by both the Nursing Council and the Clinical Officer’s Council, and its content incorporated into the initial training of both psychiatric and general nurses.
The Minster for Health has recognised the importance of the project in implementing Kenya’s mental health policy and has funded additional training courses in the north and north east of the country.
The project's success has led to interest from other countries interested in implementing a similar approach to mental healthcare provision. Professor Jenkins has responded to requests to train health trainers in Nigeria, Malawi, Zanzibar, Sri Lanka, Iraq, Yemen, Pakistan, Egypt and Oman.
DFID has commissioned Professor Jenkins to carry out a community survey on malaria and depression and to conduct another randomised control trial on the effects of the training programme on maternal and child health.
Kiima, D. and Jenkins, R (2010) Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations. International Journal of Mental Health Systems, 4(1)19.
Jenkins R, Kiima D, Njenga F, Okonji M, Kingora J, Kathuku D, Lock S. Integration of mental health into primary care in Kenya. World Psychiatry. 2010;9:118–120.
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