MEGA | Building capacity by implementing mhGAP mobile intervention in SADC countries https://mega.turkuamk.fi The web site is a communication channel for MEGA project co-funded by the Erasmus+ Programme of the European Union Mon, 18 Oct 2021 11:41:10 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.18 The effects of the COVID-19 pandemic https://mega.turkuamk.fi/the-effects-of-the-covid-19-pandemic/ Fri, 16 Oct 2020 07:00:19 +0000 https://mega.turkuamk.fi/?p=1531 Just like any global project, Erasmus+ KA2 MEGA was heavily affected by COVID-19 and the travelling restrictions caused by the pandemic. At the beginning of the year, MEGA was approaching the last and most important milestones of the project. Based on the initial project timeline, 2020 was going to be the final year to implement the remaining part of the project activities. Many activities that had already begun suddenly reached a critical stage and, stopping them completely, could cause long-term damage for the overall project. Unfortunately, one of the most critical deliverables – “Field testing of the MEGA app” – was also among the activities whose execution risked being put to a halt completely.

After numerous video calls among the project consortium, it was clear that each partner country is sliding into national lockdown. These lockdowns were limiting domestic and international mobility, causing the consortium to make a decision to postpone the planned project meetings in South Africa until the situation stabilizes. Unfortunately, it is still unclear whether the project consortium will be able to implement any of the remaining face-to-face meetings.

What kind of actions has MEGA taken to tackle the damaged caused by COVID-19?

As a consortium that mainly represents the healthcare field, MEGA was in an advantaged position to understand the impending pandemic. Therefore, the MEGA consortium was prepared to implement some rapid changes in order to soften any possible damage caused by COVID-19. The first step was to ensure the safety of project participants and partners. This is why the MEGA consortium decided to cancel all physical meetings in Europe and Africa, transferring all the remaining project meetings to online platforms. Implementation of activities which were intended for the general public (e.g. seminars, trainings) was tackled by establishing tailor-made materials, which would replace the initially planned physical meetings and seminars.

The situation with piloting the MEGA mobile application was a bit more complicated, due to limited interaction with project stakeholders caused by the pandemic. As the MEGA app had to be tested in real-life settings by project stakeholders (nurses, clinical officers, etc.), the consortium could not use any digital tools or online platforms to replace the face-to-face testing period. However, the MEGA consortium strongly believes that the health of the primary healthcare specialist is more important than the overall project results. Fortunately, nurses in several South African and Zambian clinics were able to use the MEGA app while fulfilling their daily duties and, thus, the project was able to collect the necessary data.

What can MEGA and other KA2-projects/EU learn from the pandemic?

The pandemic period has been an excellent learning curve for both the funder and the beneficiaries. Communication during the lockdown period has shown that almost all partners have access to a solid internet connection and online tools. However, we have observed that consortiums (not only MEGA) are not advancing these tools as often as they could. Therefore while planning new projects, e-toolkits should be more commonly used.

As it is still quite difficult to predict when the current pandemic will end, consortiums need to advance the lessons learned and work on implementation strategies that are more reliant on different e-solutions. Fortunately, the MEGA consortium has already taken many necessary steps to become more virtual. Thus, project funder could collect these case studies and develop guidelines on how to develop a virtual working environment and how to shift work online.

The risk assessment will be more closely reviewed while preparing new projects. The future project consortiums have to practice out of the box thinking and be prepared for situations, which might not even happen. Therefore, also the funder should put more emphasis on risk assessment plans and closely review how the future projects are estimating possible risks. Project consortiums have to be ready to tackle unexpected issues.

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Partner meeting in Cape Town https://mega.turkuamk.fi/partner-meeting-in-cape-town/ Fri, 09 Oct 2020 06:22:19 +0000 https://mega.turkuamk.fi/?p=1527

The 6th face to face MEGA partner meeting, organised by the team from Stellenbosch University, took place between 25 and 27 September 2019. The meeting was held at the Protea Hotel by Marriott in the Cape Town suburb of Durbanville. Twenty-seven attendees, representing all nine of the partner universities took part.

The sessions were interactive and stimulating and resulted in the successful finalisation of the content for the data collection application and work packages four and five. Potential future collaborations were also discussed. On the last day of the meeting, a ‘Train the Trainers’ session was held. The participating primary healthcare practitioners found this to be informative and enjoyable and appreciated being consulted on the training content. They also expressed appreciation for the need for the training. We too are grateful for their willingness to be a part of the MEGA project.

A meeting dinner was arranged at the Radisson Blu Hotel at the Waterfront, where participants got to enjoy the sun and sea while experiencing some of the local cuisines. Fortunately, the unpredictable Cape Town weather played along, making this an enjoyable experience. We hope that after this little taste of Cape Town attendees will come back for more!

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Meet the team – University of Pretoria https://mega.turkuamk.fi/meet-the-team-university-of-pretoria/ Fri, 02 Oct 2020 07:00:17 +0000 https://mega.turkuamk.fi/?p=1522 The University of Pretoria (UP) is a multi-faculty research-intensive university that has remained among the top South African universities in research output and impact. UP is also the top producer of graduates in the country. UP currently has more than 50 000 students and has become one of the leading higher education institutions on the continent. Its nine faculties and business school offer a diverse range of degrees, diplomas and certificates, over 1 000 of which are postgraduate programmes.

Students in the Faculty of Health Sciences are trained by 600 academic staff members located in four schools, namely Dentistry, Healthcare Sciences, Health Systems and Public Health and Medicine. Training is in partnership with the Gauteng Health Department in Steve Biko, Kalafong and Weskoppies Hospitals and Mpumalanga’s Witbank Hospital and its community.


From left to right:

Dr Gerhard P Grobler, the principal psychiatrist and head of the clinical unit Psychiatry at Steve Biko Academic Hospital, in partnership with the Department of Psychiatry. He is the co-investigator and national lead in South Africa, as well as a lead researcher & project manager for the MEGA project.

Tumisang Chiloane is a research assistant at the University of Pretoria and has also been involved in the MEGA project as a trainer for participating clinics at the UP site.


In the MEGA project, the UP team is responsible for the implementation and evaluation of the mobile application, which involves establishing contact with the relevant political and health care authorities at the selected health care districts in South Africa and Zambia.

The healthcare workers at participating sites in Pretoria have been trained and are equipped to initiate the implementation of the MEGA mobile application. The post-evaluation of the training suggests that the primary healthcare workers are comfortable with incorporating the MEGA app into their daily practice. They will require some technical support and regular visits to troubleshoot any issues pertaining to the use of the app.

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Mobile application pilot in the Free State https://mega.turkuamk.fi/mobile-application-pilot-in-the-free-state/ Fri, 25 Sep 2020 06:57:04 +0000 https://mega.turkuamk.fi/?p=1516 South Africans are in dire straits as a vast part of the economy shut down and the country went into lockdown for months. As a result of job losses and businesses closing down, millions of people are going hungry every day. Worldwide, mental illness has been on the rise, and anecdotally, the pandemic is further compounding the situation.

Against all the odds, Free State continued with the implementation of the mobile application screening tool throughout the lockdown. Even though patient numbers declined drastically, hope springs eternal. All our trained nurses are positive about the new tool and problems with the use thereof have been few and far between. Nurses report finding the mobile application especially useful as it raised new awareness of mental health problems in their teenage patients, and because it made them realise that mental health screening has been neglected.

It has further been reported by one of the Free State MEGA nurses that she believes that her use of the mobile tool already saved more than one life as she detected severe mental health problems and suicidal tendencies in some of her young patients. Another reported that she now realises that mental health problems often stem from the difficult circumstances teenagers are faced with every day, including poverty, violence and substance use, and that they themselves often employ substance abuse to numb emotional pain and despair.

Importantly, the use of the mobile tool called attention to a myriad of gaps in the functioning of the mental health care system, to the degree that, at times, it seems to be ill-equipped to meet demands for particularly secondary and tertiary mental health care. The Free State will continue to implement the mobile tool still for some months and the team is looking forward to conducting focus group discussions at the end of the pilot.

Screening a young mother

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Free State MEGA team trains professional nurses on mental health and the use of a mobile app https://mega.turkuamk.fi/free-state-mega-team-trains-professional-nurses-on-mental-health-and-the-use-of-a-mobile-app/ Tue, 18 Feb 2020 09:40:41 +0000 https://mega.turkuamk.fi/?p=1351 Training of Free State nurses commenced on a beautiful sunny Friday in January 2020. The Free State MEGA team conducted two training workshops, one on 31 January 2020 and another on 7 February, at the School of Nursing, University of the Free State.

The six-hour workshops covered two main topics, firstly training on a variety of mental health-related themes as contained in the MEGA training handbook developed by Hamburg and Turku Universities of Applied Science partners; and secondly how to use the MEGA mobile application (app), developed by our partners at the Riga Technical University, for the purpose of assessing for mental health problem onset in youth. Collectively, the eight Free State nurses trained, work in a variety of primary health care (PHC) facility departments, including HIV&AIDS/antiretroviral treatment (ART); tuberculosis (TB); integrated management of childhood illnesses (IMCI); maternal and child health; antenatal care; family planning;  and the chronic and the acute conditions departments. Ten to 19-year olds visiting facilities for a wide variety of purposes will, therefore, be screened with the app. Our nurses expressed excitement to be part of the research. The Free State team experienced difficulty recruiting participants to implement the app in PHC facilities, due to severe understaffing. As a result, the pilot group in the Free State is quite small. However, despite these challenges, the MEGA team here is determined to make a great success of the pilot project over the next six months.

Free State MEGA team training of nurses, 31 January 2020

 

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Training of trainers workshop in Cape Town https://mega.turkuamk.fi/training-of-trainers-workshop-in-cape-town/ Wed, 18 Dec 2019 14:02:05 +0000 https://mega.turkuamk.fi/?p=907 On the 27th of September 2019, the highly anticipated MEGA “Training the Trainer” workshop was held in Cape Town. In the months leading up, we had worked hard to incorporate all the valuable feedback from primary health care workers and students from Zambia, South Africa and Germany who had taken part in the piloting phase. Participants of the training course in Cape Town consisted of designated future trainers from within each of our partner universities in South Africa and Zambia and (to much of our delight!) a number of local primary mental health care workers. The HAW team conducted the training course and was met with a highly motivated and engaged group of trainees and a lot of expertise already at hand.

Throughout the lengthy preparation phase for the training, there was a growing awareness that the MEGA training needs to offer learning opportunities for a heterogeneous group of trainees with diverse educational and cultural backgrounds. We, therefore, tried to produce compact learning material consisting of sound information about youth mental health issues in a way that opens up a space for discussion and reflection, Most of all we want to equip practitioners with a new skill – how to use the MEGA app.  The MEGA curriculum is split up in modules and trainers follow a manual in the form of a powerpoint presentation, which guides them step-by-step through a 6-hour training course. In order to guarantee a level of standardization, trainers should orientate towards the notes and follow the curriculum as much as possible. However, if there is a lack of time, the principle “less is more” applies. If the group of trainees is fairly advanced, the (online) material offers a variety of further readings.

The results of a short evaluation questionnaire all participants filled out after the training day show that the MEGA “Training the Trainer” course in Cape Town proved to be a success. Trainees enjoyed the mix of presentation, large and small group discussion and the hands-on practice session using the app in a role-play setting. They gave valuable feedback for the final revision of the MEGA app, which was appreciated by our partners from Riga who are launching the final version of the app. The MEGA trainers are ready to rumble and the MEGA team is excited to roll out the MEGA training in February 2020!

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Meet the team – University of Cape Town https://mega.turkuamk.fi/meet-the-team-university-of-cape-town/ Tue, 05 Nov 2019 07:41:36 +0000 https://mega.turkuamk.fi/?p=876 UCT aspires to be a world-class African institution, and in line with that vision our Department endeavours to be a leading Department of academic excellence that produces transformative and integrative teaching, research, healthcare and public service relevant to mental illness and well-being in local, African and global contexts.

From right to left:

Prof. Dan Stein, Professor and Head of the Department of Psychiatry & Mental Health. He is a clinician-scientist, educator-mentor, and advocate-leader in the fields of neuroscience and mental health.  His specific focus for more than two decades has been on anxiety disorders, obsessive-compulsive and related disorders, and trauma- and stress-related disorders (i.e., anxiety and related conditions). He has contributed to the field via collaboration, mentorship, and publication.

Dr. Adele Pretorius, Senior Programme Manager in the Department of Psychiatry and Mental Health. She is a Clinical Psychologist and holds a PhD in Biosystems Engineering. She has been managing large multi-site research studies in the Department since 2014. Previously, she has managed multi-national projects related to human performance and safety in the private sector in South Africa.

Deborah Jonker, Project Manager and PhD student in the Department of Psychiatry and Mental Health. She is a research psychologist with an interest in integrative transdisciplinary approaches to neuroscience and public mental health. Her PhD focuses on the complications arising from prenatal substance exposure and maternal mental health risk factors on children in early life.

Weslin Charles, Research Assistant in the Department of Psychiatry & Mental Health. She has been involved in various mental health research projects for the past 10 years with a specific focus on the impacts of substance use on children in the South African context.

The UCT team is enthusiastic to be a collaborator in this partnership that will aim to integrate both good practice and science to design a mobile health application to screen for common child and adolescent mental health problems in primary health care (PHC) settings.

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Meet the team – UNZA https://mega.turkuamk.fi/meet-the-team-unza/ Mon, 07 Oct 2019 07:44:20 +0000 https://mega.turkuamk.fi/?p=869 The University of Zambia (UNZA) is a public Higher Education Institution located in Lusaka, Zambia. The University offers both undergraduate and postgraduate education in different fields in 13 different schools.

The University has a student population of about 26,000 students at both undergraduate and postgraduate levels with approximately 300 academic staff members and support staff. The University offers more than 157 programmes at both undergraduate and postgraduate levels. The school of Nursing Sciences is one of the 13 Schools of the University of Zambia. The School offers both undergraduate and postgraduate degrees in Clinical Nursing, Maternal and Child Health, Community and Global Health, and Psychiatry and Mental Health Nursing. The School runs both onsite and distance programmes for undergraduates. The Erasmus+ MEGA Project is hosted within the Mental Health Department of the School. The Project is run by a team of five staff members who are responsible for the dissemination related activities which is Work Package 8 of the MEGA Project. In addition, team members participate and contribute to all the other work packages of the project.

The Profile for each team Members is given below:

  1. Mwape Lonia is a Senior Lecturer at the University of Zambia. She is the Vice-President of the General Nursing Council of Zambia and is a Vice-Chair of the National Research Ethics Board. She leads the MEGA project for UNZA.
  2. Katowa-Mukwato is a Senior Lecturer at the University. She has specialized in teaching and learning of clinical skills, simulation & knowledge translation. She is a project manager and controller in the MEGA project.
  3. Ms Wahila Ruth is a Head of Department of Basic and Clinical Nursing Sciences at the University. She is also a lecturer and PhD Candidate. She fulfils the role of the researcher in the project.
  4. Chapima Fabian is a lecturer at the University of Zambia and a PhD fellow. He is a Researcher role in the MEGA project.
  5. Mumbuluma Peterson is a member of the Zambia Institute of Chartered Accountants and a fellow of ACCA. His role in the MEGA project is to ensure that accounting and financing issues in the project at UNZA goes smoothly and within the approved budget.
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Pilot training: University of the Free State https://mega.turkuamk.fi/pilot-of-training-university-of-the-free-state/ Wed, 25 Sep 2019 11:14:42 +0000 https://mega.turkuamk.fi/?p=872 As the MEGA app is continuing development, the training materials for nurses on mental health and health care are ready for testing and implementation. The pilot test was carried out by the UFS team in actual settings. The training was conducted in a boardroom of the Heidedal Community Health Centre (CHC) at the Pelonomi Hospital in the Free State province. Despite the clinics being busy with their daily work, the training was prioritised, and one nurse and one social worker of the clinic were released for the pilot training for one full day.

In preparation, the trainer of the UFS team put together a book with the relevant training materials and supplements supplied by the MEGA project as well as an additionally sourced video on depression, a contextually appropriate article on depression conducted among Sesotho speaking respondents in the Mangaung Metro area, where the UFS team focuses their MEGA project activities. The Free State team further included a cultural competency test in the materials.

Despite meticulous planning and preparation, the UFS team faced some challenges. An unannounced taxi strike occurred on the day the training was scheduled for. As a result, several nurses working in the facility were absent, and the nurse who was earmarked to be trained could not be spared because the clinic was severely short-staffed. Only the social worker was released for the training.

The training commenced at 09:00. After an hour of training, the trainee informed the team that she is unable to stay much longer as she must attend to patients at a special clinic on a Wednesday (which was the training day). The team was not informed about this situation beforehand. The team requested the trainee to at least complete the Personal Reflection checkbox sheet and to go through the app questions and get her impressions on that and the training she was able to undergo. Completing the checkbox sheet took up 10 minutes and going through the evaluation took up 30 minutes.

The trainee expressed her gratitude for the training and the book with training materials and supplementary information on mental health and mental health care, and expressed that she would like to be part of the rest of the training, provided it is spread over two-hour sessions and several days – on days and times that suit all the trainees identified for the training.

It is clear from the pilot experience that it may prove challenging to recruit nurses for the eventual formal training, and to get their buy-in. Furthermore, the UFS MEGA team will have to customize the training per the needs of clinics. The team will have to work very hard to get buy-in from the Free State Department of Health, facility managers and the identified trainees for the training to take place successfully.

It should also be noted that mental health care is a lower priority part of the public health care system in the Free State, and presumably elsewhere in South Africa. In general,  mental healthcare receives less time, attention and resources in comparison to other health care programmes. For this reason, it may be difficult to recruit nurses for training.

A short evaluation of the training that did take place on the day was conducted. The trainee was asked to name mental health/illness topics she would like to see included in the eight-hour training course on mental health and mental health care. She indicated that she would like to see information on depression and stress and the differences between the two. These two concepts are contextually not often separated by the patients and some nurses. The same is true for PTSD and anxiety. It is important to include clear guidelines for nurses to distinguish between stress, depression, PTSD and anxiety.”

She also suggested information for nurses and social workers pertaining to referral to a psychiatric unit or a psychologist/ psychiatrist. Clear guidelines should be provided about when a patient can be treated in a clinic and when a patient should be referred for a higher level of care.

The trainee was also asked her opinion about the scheduling of the training. She indicated that a whole day is too long to take personnel out of their duty, as clinics are short-staffed. It will, therefore, be better to break up the training into two hours over several days.

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Meet the team – Stellenbosch University (SU) https://mega.turkuamk.fi/meet-the-team-stellenbosch-university-su/ Wed, 11 Sep 2019 04:30:02 +0000 https://mega.turkuamk.fi/?p=860 Stellenbosch University (SU) is home to an academic community of 29 000 students as well as 3 000 permanent staff members on five campuses. The University is amongst South Africa’s leading tertiary institutions based on research output, student pass rates and rated scientists, and is recognised internationally as an academic institution of excellence.

From left to right:

Prof Soraya Seedat is Distinguished Professor and Executive Head of Department of Psychiatry at Stellenbosch University. She is the Principal Investigator for the Stellenbosch site.

Dr Sharain Suliman is a research psychologist and postdoctoral researcher in psychiatry. She is the project co-ordinator.

Dr Leigh van den Heuvel is a psychiatrist and PhD student who is acting as project manager for the Stellenbosch team.

Sr Irene Mbanga is a Mental Health Nurse with a Nursing Admin Diploma. She has been involved in various mental health research projects for the past 20 years and is the trainer for SU site.

We are hopeful that the project will lead to improved access to mental health services and enhanced mental health care for youth in South Africa and Zambia.

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