Political Leadership in Africa: A Case Study of Ghana\u27s Presidents Kwame Nkrumah and Jerry John Rawlings

The effectiveness of a political leader depends on the leader\u27s ability to formulate a vision, demonstrate genuine concern for the people, and create a constituency or following to translate the vision into concrete actions that produce change. In Ghana, these behavior patterns, which are characteristics of transformational leadership, have been demonstrated by Nkrumah and Rawlings, leading to independence for Ghana and later, the development of more stable and stronger institutions. Nkrumah rallied his colleagues and a majority of the Ghanaian citizens to seek independence. Unfortunately, Nkrumah could not maintain the commitment of his colleagues to remain focused on other aspects (e.g. economic prosperity) of the goal and his government was forcibly removed from office on allegations of corruption. Rawlings had a mission to rid Ghana of corruption and decentralize the process of national decision making. His government established institutions at the level of the grassroots that provided the mechanism for effective democracy. He pursued economic reform through structural adjustment programs that helped to strengthen the Ghanaian economy

The myth of the one-day training: The effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa

Fiona O'May - ORCID: 0000-0003-4417-2819 https://orcid.org/0000-0003-4417-2819Alastair Ager - ORCID: 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Background - In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice. Methods - Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out. Results - Findings indicate that many PFA ToTs were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding of active listening, but responses to a person in distress were less consistent with the guidance in the PFA training or with the principles of effective interventions outlined by Hobfoll et al. Conclusions - There are advantages to training non-specialists to provide psychosocial support during emergencies, and PFA has all the elements of an effective approach. However, the very short training programmes which have been used to train non-specialists in PFA might be appropriate for participants who already bring a set of relevant skills to the training, but for others it is insufficient. Government/NGO standardisation of PFA training and integration in national emergency response structures and systems could strengthen in-country capacity.https://www.cambridge.org/core/journals/global-mental-health6pube5pu

Health system preparedness for integration of mental health services in rural Liberia

Abstract Background There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country’s need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. Methods A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Results Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. Conclusions To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical infrastructure of health facilities at care delivery points; and (3) implementing concurrent interventions designed to improve attitudes towards people with mental illness, their family members and mental health care providers