Africa Mental Health Foundation

HighlightsWhat are the main findings?Non-communicable diseases (NCDs) impact 2.1 billion children worldwide and cause nearly 1 million deaths annually, with poor nutritional status further in-creasing mortality and treatment-related complications.Integrating nutrition care into childhood NCD management improves survival, reduces treatment-related complications, influences disease progression, and lowers healthcare costs.What is the implication of the main finding?Nutrition services should be embedded as a standard component of NCD care for children, yet underfunding, workforce shortages, inadequate training, and limited access to nutrition products continue to hinder progress.Multi-sectoral collaboration is essential to expand the nutrition workforce, strengthen training and professional standards, establish effective monitoring frameworks, and leverage technology to deliver sustainable solutions.Non-communicable diseases (NCDs) affect over 2.1 billion children globally, accounting for 15.9% of deaths in children under 20 and contributing 174 million years lived with disability. Integrating nutrition care into NCD management within health systems can save lives, reduce costs, and improve quality of life. Nutrition interventions have been found to improve survival rates in children with cancer by 30%. Incorporating early nutrition interventions in hospitals is associated with a 36% reduction in per-patient costs. Despite these clear benefits, nutrition care is often not readily accessible as part of NCD management in children. Access to trained nutrition professionals is limited, and nutrition training for healthcare workers is often inadequate. There are cost-effective and scalable models for delivering high-quality nutrition care, but scaling these models will require commitment to capacity building, training, technological innovation, and monitoring frameworks. Coordinated, multisectoral responses are needed urgently to incorporate nutrition sustainably into healthcare systems to confront the growing burden of childhood NCDs.

Suicide is a significant global public health concern, particularly among adolescents, with substantial implications for economies, societies and individuals’ mental well-being. Understanding its patterns and intention and psychosocial determinants in a given context can suggest potential intervention points. This population-based cross-sectional study aimed to document suicidal ideas, behaviors and intensity among youths aged 14 to 25 in the Nairobi metropolitan area and associated socio-economic position, demographic indicators and potential intervention points. A diverse sample of 1,972 participants was recruited from urban and peri-urban settings within the Nairobi metropolitan area. Data analysis included descriptive statistics, chi-square tests and logistic regression. Our findings confirm a high prevalence of suicidal ideas and behavior in the youth (19.9% and 3.6%, respectively), with very few significant differences between the urban and peri-urban areas. The severity of suicidal ideation and behavior reported methods and reasons, and the socio-demographic profile of participants, point to multiple potential intervention targets. These findings ought to be used to design, manage and evaluate suicide prevention programs.

As the fourth high level meeting of the United Nations General Assembly on non-communicable diseases (NCDs) approaches, <b>Bai Li and colleagues</b> warn that failing to tackle obesity will set back progress on NCDs

Suicide is a significant global public health concern, particularly among adolescents, with substantial implications for economies, societies and individuals’ mental well-being. Understanding its patterns and intention and psychosocial determinants in a given context can suggest potential intervention points. This population-based cross-sectional study aimed to document suicidal ideas, behaviors and intensity among youths aged 14 to 25 in the Nairobi metropolitan area and associated socio-economic position, demographic indicators and potential intervention points. A diverse sample of 1,972 participants was recruited from urban and peri-urban settings within the Nairobi metropolitan area. Data analysis included descriptive statistics, chi-square tests and logistic regression. Our findings confirm a high prevalence of suicidal ideas and behavior in the youth (19.9% and 3.6%, respectively), with very few significant differences between the urban and peri-urban areas. The severity of suicidal ideation and behavior reported methods and reasons, and the socio-demographic profile of participants, point to multiple potential intervention targets. These findings ought to be used to design, manage and evaluate suicide prevention programs.

The Recruitment and Retention of Alzheimer's Disease Diversity Genetic Cohorts in the Alzheimer's Disease Sequencing Project (READD-ADSP) was established to bridge thegap inAlzheimer's disease and related dementias (ADRD) research in Africa. We examined the role of Community Advisory Boards (CABs) in improving participant recruitment and retention in ADRD research in Africa, by exploring how culturally sensitive engagement, community trust-building, and stakeholder involvement influence research participation. Amulti-site, multi-phased qualitative study approachthat involved establishment of CABs, initial planning meetings and community engagement cum recruitment activities. Twenty-one CABs (141 members) were established across 14 study sites in 9 African Dementia Consortium (AfDC)member countries. Co-creation planning meetings, culturally sensitive outreaches for brain health, dementia awareness creation, and recruitment were held. Establishing CABs within the READD-ADSP project has proven instrumental in co-creating culturally appropriate and community-centered strategies for recruitment and retention in ADRD research in Africa. The Recruitment and Retention of Alzheimer's Disease Diversity Genetic Cohorts in the Alzheimer's Disease Sequencing Project (READD-ADSP) project utilizes a community-engaged research (CER) framework to develop a community engagement program and establish Community Advisory Boards (CABs) to enhance participant recruitment and retention. There is a need to standardize CER practices and promote context-sensitive and culturally appropriate CE activities across African Dementia Consortium (AfDC) sites to ensure cultural sensitivity and enhance recruitment and retention. The project seeks to empower CABs to promote national dementia policies by collaborating with policy-makers and advancing equitable dementia scienced and care in Africa.

BackgroundAlthough 90% of the global adolescent population resides in low and middle-income countries (LMICs), cross-national mental health research has primarily focused on high-income countries. This systematic review aims to examine cross-national studies, including LMICs, focusing on adolescent mental health and psychosocial problems.MethodsPeer-reviewed articles comparing adolescent mental health or psychosocial issues across countries were included if published in English and based on observational study designs. Six databases were searched from inception to January 2024. Risk of bias was assessed using the JBI tool and additional cross-national quality criteria. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines.ResultsThe search identified 172 studies including data from over 12 million adolescents across 166 countries. The most used international survey was the Health Behaviour in School-aged Children study, and most studies employed cross-sectional designs with school-based, self-reported questionnaires. Adolescent mental health research involved 166 countries, while 52 countries were not represented in any of the studies. The inclusion of LMICs in cross-national research increased over time. Internalising problems and bullying were well-researched topics, but studies on externalising behaviours were limited. The number of publications increased over time, particularly after 2020. Variations by income level were observed, with traditional bullying more prevalent in LMICs.DiscussionThis review provides important insights into global patterns and gaps in adolescent mental health research. It highlights the need to address methodological heterogeneity, including the use of validated and culturally adapted measures, comprehensive reporting of sampling procedures, sample sizes, response rates and greater attention to generalisability. In addition, the targeted inclusion of under-represented regions is essential to addressing global disparities and informing effective interventions.PROSPERO registration numberCRD42024505077.

INTRODUCTIONThis study describes the implementation outcomes and evaluation of DEM‐SKY, a community‐based dementia screening program developed in rural Kenya with the support of community health care workers (CHWs).METHODSDEM‐SKY was delivered to 3546 older adults in Makueni County, Kenya, over a 6‐month period. Using a mixed‐methods design, we explored implementation outcomes with stakeholders through surveys and interviews.RESULTSThe program demonstrated good acceptability, adoption, and fidelity and was effective in instigating behavior change. Individuals who screened positive for dementia were 28.7 times more likely to intend to speak to a doctor. Qualitative data showed that participants valued the program but indicated scope for improvement, particularly further down the diagnostic pathway.DISCUSSIONDEM‐SKY was successful across several implementation metrics. Although the program demonstrates that community‐based screening can be conducted effectively with minimal resources, future research needs to explore the long‐term benefits of dementia screening in Kenya.HighlightsCommunity‐based dementia screening is feasible in rural Africa.Involving community health workers strengthens trust in health care systems.Empowering community health workers enhances the community capacity to address dementiaScreening promotes proactive health seeking among older adults.

Abstract BackgroundThe burden of Alzheimer’s disease and related dementias is growing fast in Africa. The Recruitment and Retention for Alzheimer’s Disease Diversity Genetic Cohorts in the Alzheimer’s Disease Sequencing Project (READD‐ADSP) has commenced recruitment of 5000 African participants (AD and cognitively unimpaired individuals) to generate genomic and biomarker data to better characterize AD genetic architecture in Africa. Participating countries, part of the African Dementia Consortium (AfDC) include Nigeria, Ghana, Benin, Cameroon, Uganda, Kenya, Ethiopia, Tanzania, and Mozambique. This abstract focuses on the biobanking activities, including the challenges and lessons learnt in LMIC locales.MethodA Standard Operating Procedure (SOP) was developed for all biobanking activities, supplemented with monthly Zoom meetings to discuss efforts across all sites. Blood samples were collected and transported to the African Coordinating Centre (ACC: Ibadan, Nigeria) where DNA extraction, plasma isolation, and long‐term biospecimen storage occurred (Figure 1). Small aliquots of DNA and plasma were sent to the Hussman Institute at the University of Miami (HIHG‐UM) (Figure 2) for whole genome sequencing and biomarker analysis. The biobanking activities were guided by the International Society for Biological and Environmental Repositories (ISBER) benchmarks for internationally accepted best practices in biorepository science.ResultSample collection kits and extraction materials were centrally procured at UM, shipped to the ACC, then distributed. Standardized blood sample collection and processing (e.g., use of sample kiosk software, short‐term (&lt;12 weeks) biospecimen storage at ‐20oC and long‐term storage at ‐80oC, and shipment from African sites to ACC) were achieved. DNA was extracted at ACC and shipped together with plasma to HIHG‐UM. The duration of intercontinental shipment (USA to‐and‐from Nigeria) was 18.5+/‐2 days while shipment within Africa was 5+/‐3.5 days. Challenges encountered included delays with institutional ethics approval, custom clearance at borders, high shipping costs between African countries, and occasional breakage of stored blood tubes. Innovative solutions were devised to mitigate these challenges (Table 1). Initial shipment of samples to the HIHG‐UM included &gt;200 DNA samples of excellent quality.ConclusionOur biobanking experience in a LMIC setting demonstrates the feasibility of establishing a successful African biobanking network, an important infrastructure to support AD/ADRD research in Africa.

Intimate partner violence (IPV) within heterosexual relationships affects both men and women, yet an in-depth description of IPV against men in developing countries is still limited. This study explored community perceptions of male IPV victimization in an informal settlement in Nairobi, Kenya. We conducted 12 focus group discussions (FGDs) with 118 ever-married participants (59 men and 59 women), divided into 6 FGDs for each gender. We performed thematic analysis using NVivo software. This article presents three main themes that emerged during data analysis: (a) triggers, (b) manifestations, and (c) consequences/effects of IPV against men. Both male and female participants perceived male IPV victimization as a significant concern in the community. The poor living conditions, coupled with alcohol use, seemed to be major underlying factors, often forming the basis of spousal conflict. Emotional abuse, including denial of basic needs, acts of humiliation, and coercive control, were the most frequently cited forms of violence. The consequences of what was considered IPV against men affected victims and their families including the violent female spouses, children, and the society at large. These effects upset the health, economic, and social spheres of life with some retriggering male IPV, thus creating a vicious cycle of abuse. Notably and of concern, IPV against women was highlighted as a consequence of male victimization. Although we set out to explore community perceptions, study participants openly shared their experiences of male IPV perpetration and victimization. These findings underscore the importance of recognizing men as potential victims of IPV and contextualizing IPV prevention strategies targeting the urban poor with the goal of designing and implementing policies and interventions that address IPV holistically.