Children in Sub-Saharan Africa (SSA) comprise half of the total regional population, yet mental health services are severely under-equipped to meet their needs. A recent systematic review estimated that 1 in 7 children in SSA might struggle with a serious mental health issue. Serious consideration needs to be given to context-specific factors within African countries, such as high levels of stigma associated with mental illness, skepticism of professionalized responses in contrast to community or religious solutions (e.g. mental health advice sought from prayer camps, religious leaders or healers), the large number of youth orphaned by HIV and other health epidemics and the lack of economic opportunities for African youth. However, mental health policy in SSA is at an early stage, and specifically focused on the development of guidelines or identifying workforce shortages. Only 6 percent of African countries have any child and adolescent mental health (CAMH) policy or legislation. Moreover, there are hardly any documented efforts to scale up child and adolescent mental health evidence-based practices (EBPs) across SSA countries.
Thus, the mission of the SMART Africa Center (Strengthening Mental health And Research Training in Sub-Saharan Africa), a regional trans disciplinary collaborative center funded by the National Institute of Mental Health, is to reduce gaps in child and adolescent mental health services and research in SSA through a population approach to child mental health.
SMART Africa Center is one of the very first child mental health implementation research partnerships set in SSA. Housed within Brown School at Washington University in St. Louis, and with initial projects in Ghana, Kenya, and Uganda, SMART Africa advances its mission through:
- Conducting innovative intervention and implementation research focused on child behavioral health: SMART Africa Center currently houses a scale-up study in Uganda, and two pilot studies in Ghana and Kenya respectively, to examine multi-level (State/government, NGOs, families, schools, communities) influences on the uptake, implementation, effectiveness and sustainability of EBPs that address child behavioral challenges.
- Establishing and expanding a trans-disciplinary research consortium: SMART Africa has established a consortium of academic, governmental, NGO, community and cultural stakeholders in Uganda, Ghana, Kenya, and South Africa to focus on addressing child mental health, EBP implementation, scale-up, and service gaps. The Center builds upon the expertise of strong partners across Ghana, Kenya, South Africa, Uganda, and the United States, and continues to expand its network and collaboration with local researchers and stakeholders.
- Strengthening research capacity in SSA: SMART Africa is committed to creating a pipeline of scholars, practitioners, and policy-makers to ensure sustainable progress in child behavioral health in SSA. In addition to its “Global Child Behavioral Health Fellowship” program, SMART Africa provides mentorship and technical assistance to junior faculty and students across all academic levels -both in the United States and SSA- in the conceptualization, design, implementation and evaluation of applied intervention research on child behavioral health. The training also provides mentorship in scientific grant writing, manuscript preparation, and dissemination of key findings intended to inform practice, programming and policy. In addition, SMART Africa provides training opportunities to local stakeholders in evidence-based approaches to strengthening family and community-focused approaches to enhance child health and emotional well-being.
- Informing public policy and programming: SMART Africa acknowledges the importance of engaging local and national-level policy-makers and government officials to create change. Hence, the Center strives to create and sustain policy-NGO-academic research partnerships to disseminate its findings and contribute to knowledge to inform evidence-based policy and programming decisions on child and adolescent behavioral health in SSA.