Non Hospital Services of Mental Health in Rwanda: Analysis of their Functioning and Challenges

Introduction: After the Genocide of 1994, NGOs and other public services supplemented hospitals in the care of mental patients. However, there is little research examining their functioning and challenges. Aims: (1) to present the contribution of nonhospital services in terms of patients treated; (2) to report activities performed by these services; and (3) to assess challenges and remedial solutions. Materials and Methods: A quantitative and qualitative study of 25 staff representing on hospital services of mental health. A questionnaire with open-ended and closed-ended items was used. Percentages and thematic analysis were used for data analysis. Results: Nonhospital services of mental health are mainly local NGOs staffed by psychologists. Genocide Survivors and victims of rape are consulting population. Counselling, sensitization for mental health awareness and advocacy are the main activities organised. Not knowing the importance of mental health and ignorance of mental disorders are the main challenges. Increasing number of staff, and providing incentives and transportation fees are remedial solutions. Discussion: Nonhospital services of mental health play a key role in increasing access and funds for mental health services. Their achievements in Rwanda can serve other countries or regions with similar situation

Mental Health Care in Hospitals in Rwanda

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A randomized controlled trial evaluating the effectiveness of narrative therapy on resilience of orphaned and abandoned children fostered in SOS children’s village

Background: Narrative Therapy is an efficacious treatment approach widely practiced for various psychological conditions. However, few studies have examined its effectiveness on resilience, a robust determinant of one’s mental health, and there has been no randomized controlled trial in sub-Saharan Africa. Objective: This study sought to evaluate the efficacy of narrative therapy for the resilience of orphaned and abandoned children in Rwanda. Method: This study was a ‘parallel randomized controlled trial’ in which participants (n = 72) were recruited from SOS Children’s Village. Half of the participants (n = 36) were randomly allocated to the intervention group and the rest to the delayed narrative therapy group. For the intervention group, children attended ten sessions (55 min each) over 2.5 months. Data were collected using the Child and Youth Resilience Measure (CYRM) and analyzed using mixed ANOVA within SPSS version 28. Result: The results from ANOVA indicated a significant main effect of time and group for resilience total scores. Of interest, there was a significant time by group interaction effect for resilience. Pairwise comparison analyses within-group showed a significant increase in resilience in the intervention group, and the effect size was relatively large in this group. Conclusion: Our findings highlight the notable efficacy of narrative therapy for children’s resilience in the intervention group. Therefore, health professionals and organizations working with orphaned and abandoned children will apply narrative therapy to strengthen their resilience and improve mental health. Trial registration: Pan African Clinical Trial Registry identifier: PACTR202107499406828.