Increasingly, civil society organisations are recognising the link between good maternal mental health and improved outcomes for existing programmes addressing human immunodeficiency virus (HIV), tuberculosis (TB), orphans and vulnerable children (OVC) as well as other social and developmental programmes.
Further, maternal mental health interventions are now recognised as an important aspect of First 1000 Days initiatives which seek to address the determinants of child development and health outcomes in this critical period.
SPF is an NGO based in East London, Eastern Cape (EC), who for 28 years, has implemented a wide range of community-based capacity building programmes, focusing on strengthening primary health systems.
We were invited to develop a training package to embed an understanding of maternal mental health and empathic engagement skills into the work being done by SPF’s community health care workers.
The project was implemented in three phases.
Phase 1: all SPF managers, trainers and CW coordinators completed the Bettercare distance learning programme before attending a three-day skills training workshop in Mthatha. After the Mthatha training, we worked with senior SPF staff to develop a strategic plan for integrating maternal mental health services within their routine operations.
Phase 2: the clinics, other government and non-government partners and role players in the Ngqeleni area (Nyandeni municipality, OR Tambo district, EC), were invited to attend a 3-day workshop where they were informed of the project and maternal mental health.
Phase 3: CW in Ngqeleni were trained in basic concepts of maternal mental health and recognition and referrals of vulnerable mothers. The workshop was conducted in isiXhosa, with our trainer present to provide support.
This collaboration is ongoing. The next phase is the introduction of Nyamekala4Care, to ensure ongoing support for CW and to monitor that the work is sustained.
Ithemba Lobomi a non-profit organisation based in the community of Thembalethu, outside George in the Eden District of the Western Cape. The organisation works to addresses issues related to HIV/AIDS, TB and chronic diseases and mitigate their negative impacts.
IL requested that the we consult towards the development of a mental health programme embedded within IL’s existing operations.
Prior to developing a strategy, we conducted an on-site situation analysis at IL and surrounds. A staff member (a social worker) from IL was identified to lead the service coordination process going forward. This staff member visited the PMHP for a week to gain first-hand knowledge of all aspects of our mental health services.
In addition, a diverse group of IL staff and local stakeholders were recruited to participate in a team-based, distance-learning programme for six weeks, using our “Maternal Mental Health” Bettercare book. Thereafter, we conducted a two-day training workshop on empathic engagement skills.
We then facilitated a strategic planning workshop with key IL staff to assist with the phased design of a maternal mental health service embedded within their home-based programmes. Four key objectives were identified for careful strategy development; the development of a comprehensive, relevant, evidence-based and feasible intervention; the training of providers to deliver the intervention; the raising of community awareness about mental health in order to decrease stigma and increase support for mothers and finally, the integration of mental health care in to all IL programme areas.
The work is on-going, with consultation and support being provided by the PMHP.
The PMHP has partnered with Philani to develop and test a staff support programme. This was initially called Skills2Care, but later evolved into Nyamekela4Care (N4C). In February 2017 we successfully introduced the project coordinators and senior mentor mothers to our N4C Launch and Sustain package.
One of our volunteers, Trisha Lord, took over facilitating the Retreat MOU staff support group from Beulah Marks in April 2015. The aim of the group is to provide a supportive space and thinking environment for the staff once a month. Trisha also has links with the Compassionate Birth Project.
In addition Dr Simone Honikman, our director, is on the Scientific Advisory Board of the project.