Clinic outcomes of the Pathway to Care Model: A cross-sectional survey of adolescent depression in Malawi

Background: Depression is one of the leading contributors to the global burden of disease and often has an onset during adolescence. While effective treatments are available, many low-income countries, such as Malawi, lack appropriately trained health providers in community health settings, and this limits access to effective mental healthcare for young people with depression. To address this need, a Canadian-developed youth depression Pathway to Care Model, linking school-based mental health literacy interventions to training of community healthcare providers, was adapted for use in Malawi and successfully applied.Methods: A sample of healthcare providers (N = 25) from community health clinics (N = 9) were trained in the use of comprehensive, systematic clinical interventions, addressing the identification, diagnosis, and treatment of depression in youth who had been referred from schools where mental health literacy interventions had been implemented. Referral outcomes were obtained using a standardised clinical record form.Results: Over 120 clinical outcome forms were available for analysis. Seventy percent of youth referred by their teachers were diagnosed with depression. Most youth diagnosed with depression identified physical symptoms as their primary difficulty. Available standardised outcome measures applied by clinicians indicated that, overall, youth showed positive outcomes as a result of treatment.Conclusions: Community healthcare providers in Malawi were trained in the identification, diagnosis, and treatment of youth depression. When this training was applied in usual clinical care to youth referred from schools, it led to generally favourable clinical outcomes. To our knowledge, this is the first demonstration of a clinically feasible intervention that results in positive outcomes for young people with depression in Malawi, and it may provide a useful model to replicate elsewhere in sub-Saharan Africa

The ICT4scale Initiative: Harnessing ICT to Scale up Agricultural Solutions

This one-page policy brief provides a detailed outline of intervention research and scaling up of a soybean inoculant, using ICT technologies and platforms. The project aims at assessing the effect of a specific combination of ICT interventions and institutional arrangements regarding the number of smallholder farmers who are uptaking the application of a soybean inoculant

Delivering climate services for farmers and pastoralists through interactive radio

A scoping study to assess demand, opportunities and potential for the use of interactive radio to deliver climate services at scale for farmers and pastoralists was conducted by CCAFS in partnership with Farm Radio International in Tanzania, and Farm Radio Trust in Malawi in late 2014. Over 1280 individuals were interviewed in an audience research activity, while a desk survey, key informant interviews and knowledge partner engagement activities were undertaken to validate audience research and assess the wider context. The study reveals that for both Malawi and Tanzania, there is clear demand for climate information services via radio and mobile phone. Both radio and mobile phones are in common use, and are rated by farmers and pastoralists to have great potential as effective and trusted channels where they can access various climate information services. Surveyed farmers and pastoralists noted that radio programs, backed up by ICT services, would serve them best. Rainfall patterns, temperature data and forecasting services – both weekly and daily – were mentioned as particular needs. In general, farmers would trust climate information received via their preferred radio stations, and would use it in decision-making on their farms. Women and men differed in time spent listening to radio, in mobile phone airtime purchased, and in Malawi, phone ownership; but larger location differences masked any gender differences in preferences about information content, delivery channels, or expectations about user and benefit. As a response to farmer articulated demand, Farm Radio International and Farm Radio Trust propose working with key institutions and radio station partners to develop interactive programming for rural climate services as part of their implementation of the GFCS Adaptation Programme in Africa. Interactive climate services radio programming would respond to farmers’ ongoing climate information needs, and will engage them in program design, broadcast, monitoring and evaluation – together with partner radio stations. Interactive climate services radio programming will consist of short weekly radio programs, with the option of daily forecasts or interpretations, and will be complemented with ICT services via mobile phone. Programs will be continuously monitored and assessed by audiences and project staff to ensure relevance, usefulness, level of use and accuracy