community mental health practice in somaliland administration of somalia.ppt
TRANSCRIPT
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SSRA-AMOUD PROJECT IN PARTNERSHIP
WITH FORUM SYD IN Sh.Osman
COMMUNITY IN BORAMADr JIBRIl Handuleh,MD
PROJECT COORDINATORAMOUD UNIVERSITY COLLEGE OF
HEALTH SCIENCES
SSRA
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Amoud university Higher education institution with 14 faculties.
Oldest and one of the prestigious university in
the country
PartnersA.Tropical Health and Educational Trust(THET)
B.Global Health Center, Kings College London
C.ForumSyd
D.Kijabe Teaching Hospital, Kenya
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Introduction Project is a partnership implemented by
Amoud University and Somali Swedish
Research Association(SSRA) and funded by
ForumSyd.
Project was proposed in May 2012, grant got
accepted in August that year and became
operational by November 2012.
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Project target population The project serves 20-30,000 people in
Sh.Osman community in Borama
10 female community health care workers
were trained for three months on common
mental health, childhood and maternal health
diseases using appropriate curriculum.
Mobilize community to enhance sanitation,
access to health information and services.
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Primary target groups Primary target group
The Primary benficiaries of the project
include
Children
Reproductive health education and
information
Mentally ill patients
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Goals
Raise health seeking behavior of the
community
Empower women to lead the community
health care worksers
Defend human right value of vulnerable
groups
Increase primary health care access of
community members via awareness and
referrals
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Project success criteria
SSRA-Amoud members committed to assistwith the project implementation
Community base of the community
Involvement of Project coordinationcommittee
Amoud University medical , nursing and
public health faculty helping with personalindirectly
Maternal and Child Centre in close proximity
to project site
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Project relevance and Feasibility
Bridging a Major Gap in Essential Life SavingServices
Creation of a Community Outreach Training
Programme for the University Linking to a Reliable Existing Capacity
community ownership of the project
implementation Recently with NAFIS FGM group extended
mental health counselling to genital
mutilation patients
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3 months training of 10 FCHWs on common
maternal health , maternal and child care
disorders
lialison with MCH and district hospital
Education for community members
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Project aims
To establish a community based HealthProgram in Borama providing a coverage for
20,000 to 30, 000 rural and per-urban
population implemented by FCHWs and
made operational in the later part of the year
2012 with focus on MNCH and Mental Health
To Select 10 females with 8th grade pass
education level, residing in the samecatchment areas in which they will be serving
with the support of their families and local
community leaders
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To develop a three months training curriculum for
the CMHWs and organize their training program at
the Mental Health Center of Borama, run by the
School of Health Sciences of Amoud University To establish a program coordination council
comprising of Amoud University, Community
Leaders, Regional Ministry of Health and Local
Primary Health Care supporting UN and InternationalNGOs to guide and oversee the program
implementation and management
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AND WHAT HAS BEEN SO FAR!Project indicators
R lt I di t f A ti iti
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Project indicators
Results Indicators ofexpected results Activities
i. Mothers, children and
persons with mental
disorders access
essential maternal and
child care and mental
health services througha community based
program at their door
steps
-90% of all persons
with severe mentalhealth disorders in
the project area have
been registered and
linked to the MHC
for diagnosis,treatment and
follow-up
-80% of mothers
with under-six
month old infantswere counseled
about exclusive
breast feeding
-80% of mothers
with children under
one year know how
- Selection of the catchment
areas to be covered
- Social mobilization and
interaction with relevant
authorities and community
leaders- Selection of 10 FCHWs
according to the set criteria
- conducting the FCHWs
intensive training program for
three months followed up by a
problem based learning once
every month
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I
Results
i. Mothers, children and
persons with severe
mental illness in theproject catchment areas
received appropriate
treatment and personal
and family counseling
support
Indicators of
results
-At least 50% of thechained persons with
severe mental illness
became chain-free with
the help of case
management and
family counseling-At least 80% of the
families caring for
persons with severe
mental disorders have
received education and
counseling
Activities
-Regular home visits
conducted by theFCHWs
-Family education and
counseling carried out
by FCHWs-Patient referral and
case management and
follow up at the MHC
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Project objectives continuediii. A programcoordination council
(PCC) established
comprising of Amoud
University, Community
Leaders, Regional
Ministry of Health and
Local Primary Health
Care supporting UN and
International NGOs to
guide and oversee the
program
implementation and
management
-At least threestakeholders have
membership in the
PCC that include
community leaders,
local health
authorities and the
university-Two consecutive
council meeting
minutes are recorded
-Community awareness building,social mobilization and project
presentation workshop organized
by the Amoud University in
Borama with the participation of
all relevant stakeholders that
would be involved in the PCC
-Conducting a consultation
meeting to nominate the
members of the PCC and definetheir terms of reference
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December 2012- February 2013 10 FCHWS were recruited, trained and became
operational
Project steering committee formed
Field work started
Catchment area identified
Three project activities teached, relevant parties
engaged A. Mental health
B. Maternal health
C. Child health
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March-June 2013 Home to Home visits fully started
Patients and families received counselling and
health related teaching on sanitation,
common illnesses and early referral to
patients
Some chained patients are chain free , work
in the community and support their families
Community mobilized to help clean
environment
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March-May 2013 cases seen in the
communityCommon conditionsNumber of patients seenconditions
Anemia, vaginal bleeding ,
obstructed labor , prolongedlabor, and referral for normal
antenatal follow up
490Maternal health
Educated mothers and
pregnant women about
exclusive breastfeeding toreduce childhood illness and
suffering to empower them
meet their responsibilities
340Breastfeeding
Respiratory infections,
diarrhea, malnutrition and
vaccination taking the life ofchildren in developing
countries
647Childhood illnesses
Psychosis, depression etc.606Mental health
1604Total
ormer pro ect
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ormer pro ectTHET and Amoud University Partnership 2011-
2013
Introduced mental health service in Borama
both in the community and in patient unit in
Borama hospital.
Started mental health courses for pharmacy
students in addition to the KTSP PROGRAM
covering med students and nurses
Assisted training 2 nurses and 2 doctors
working in mental health
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Academic and research collaboration with
Kings College london and Maudsley NHS
psychiatrists.
worked with one Elaj center in Borama
Established student counseling center at
Amoud medical school campus.
Amoud University worked with local and
diaspora NGO to empower mental health care
in Awdal region.
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Publications
Handuleh, J: Establishment of community
mental health services in Borama, Somaliland,
Somaliland medical association journal,
Version 1, Issue 1, 21-22, 2012
Handuleh, J : Experience of establishing
mental health services in Somaliland,
Intervention, 2012,volume 3, number 3, page
274-278
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Handuleh, J, Whitwell S, Fekadu, D, School Mental health
project in Somalia, The Arab Journal of Psychiatry (2013) Vol.
24 No. 1 Page (46 - 51) (doi: 10.12816/0000098)
Roxanne Keynejad, M.B.B.S., Faisal R. Ali, M.R.C.P.Alexander E.
T. Finlayson, M.R.C.P., Jibriil Handuleh,
M.D.GudonAdam,M.D.,JordanS.T.Bowen,M.R.C.P., Andrew
Leather, F.R.C.S.Simon J. Little, M.R.C.P., Susannah Whitwell,
M.R.C.Psych. Telemedicine for Peer-to-Peer
PsychiatryLearning Between U.K. and SomalilandMedicalStudents, Academic Psychiatry 2013; 37:182186
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Handuleh , J. Transforming a hospital dumping
site into psychiatric inpatient unit in Somalia,
American Journal of Psychiatry(in press).
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THANKS FOR LISTENING
Mahadsanid