The Journal of Adolescent Health\u27s current supplement presents the work of a highly active team of researchers who are focusing on developing a strong body of evidence around child and adolescent mental health in Sub-Saharan Africa. The supplement lays out scholarship generated through years of partnership between researchers based in the United States—some of whom are from Sub-Saharan context, specifically Uganda—in connecting applied social work, community mental health for children and adolescents, and family development. The work comprises a series of articles embedded within several National Institutes of Health–funded grants by authors based in the United States in partnership with various academic and nongovernmental organizations in Uganda and Ghana

Kumar, Manasi

English

eCommons@AKU

eCommons@AKU Brain and Mind Institute Centres of Excellence 5-2023 Strengthening the understanding of south partnerships and rigor in addressing social determinants of child and adolescent mental health Manasi Kumar Follow this and additional works at: https://ecommons.aku.edu/bmi  Part of the Psychiatric and Mental Health Commons EditorialStrengthening the Understanding of South Partnerships and Rigorin Addressing Social Determinants of Child and Adolescent MentalHealthThe Journal of Adolescent Health’s current supplement pre-sents the work of a highly active team of researchers who arefocusing on developing a strong body of evidence around childand adolescent mental health in Sub-Saharan Africa. The sup-plement lays out scholarship generated through years of part-nership between researchers based in the United Statesdsomeof whom are from Sub-Saharan context, specifically Ugandadinconnecting applied social work, community mental health forchildren and adolescents, and family development. The workcomprises a series of articles embedded within several NationalInstitutes of Healthefunded grants by authors based in theUnited States in partnership with various academic andnongovernmental organizations in Uganda and Ghana.A rich collection of information and ideas around HIV-associated physical health, psychosocial, and educational chal-lenges across child and adolescent populations are presented.Mental health outcomes and aspects of community and familycohesion, as well as health, are assessed via multimodal in-terventions. The strength of this group’s work is the focus onpoverty and ameliorating adversities through structured eco-nomic and psychosocial empowerment. The article entitled “Thepost-intervention impact of Amaka Amasanyufu on behavioraland mental health functioning of children and adolescents inlow-resource communities in Uganda: analysis of a cluster-randomized trial from the SMART Africa-Uganda study (2016e2022)”, led by Ssewamala et al., presents improvements indepressive symptoms, self-concept, and externalizing behaviorsin a school-based multiple family group (MFG) interventiontested in a three-arm cluster randomized controlled trial deliv-ered by parent, peers, or community health workers versuscontrol condition [1]. Another articles led by Nabayinda et al.explored “The relationship between family cohesion anddepression among school-going children with elevated symp-toms of behavioral challenges in Southern Uganda” and foundthat family cohesion was a protection against depression [2].Both articles were built on the same SMART Africa clusterrandomized controlled trial. Nabunya et al., in the article “Stigmaby Association, Parenting Stress and the Mental Health ofCaregivers of Adolescents Living with HIV in Uganda”, find thatHIV-associated stigma in caregivers of adolescents is associatedwith poor caregiver mental health and parenting stress [3].Byansi et al. extend the focus on adolescents in Uganda in theirarticle “Patterns of and factors associated with mental healthservice utilization among school-going adolescent girls insouthwestern Uganda: A latent class analysis”, reporting onlatent class analysis findings testing MFG on adolescent girls [4].Patterns in attendance of sessions and family demographicfactors were associated with improved mental health serviceutilization. Implications for implementation of intervention aredrawn from the approach taken in the article “Effects of a com-bination economic empowerment and family strengtheningintervention on psychosocial well-being among Ugandanadolescent girls: analysis of a cluster randomized controlled trial(Suubi4Her)” [5]. Filiatreau et al. present findings of another trialtesting youth development account intervention with MFG in athree-arm study, with results suggesting that economicempowerment when augmented with culturally engaged psy-chotherapy is more efficacious [5]. “A Structural Equation Modelof the Impact of a family-based economic intervention on ARTAdherence among adolescents living with HIV in Uganda” re-ports findings of an older trial that tests a variety of financialstrengthening strategies and finds that these improve treatmentadherence and mental health outcomes in young girls [6]. In thearticle “The Impact of Family Economic Empowerment Inter-vention on Psychological Difficulties and Prosocial Behavioramong AIDS-orphaned children in southern Uganda”, deeperinsights are offered around mental health programming infusedwith family-based economic empowerment for youngerorphaned children [7]. It appears from this article that even smallsteps toward strengthening routine care and provision of ser-vices goes a long way in improving child outcomes. The finalarticle focuses on Ghana and uses theWorld Health Organizationschool health survey to identify “Correlates of Suicide AmongMiddle and High School Students in Ghana” [8]. The resultingyounger age of onset of suicide and disaggregation of varioussuicide behaviors provide an impetus toward research thataddresses suicide risk factors, treatment, and mental healthpromotion for children and adolescents.The articles make a compelling case around strengtheningeconomic empowerment by directly providing economic in-centives to support vulnerable populations and high-riskConflicts of interest: The author has no conflicts of interest to declare.Disclaimer: This article was published as part of a supplement supported by theNational Institute of Mental Health. The opinions or views expressed in thisarticle are those of the authors and do not necessarily represent the officialposition of the funder.www.jahonline.org1054-139X/ 2023 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).https://doi.org/10.1016/j.jadohealth.2023.02.005Journal of Adolescent Health 72 (2023) S1eS2children and youth. The themes that require more attentionwithtime include addressing more contextualized mental healthconstructs such as triggers and idioms of distress, understandingchild and adolescent development from African culturalperspective, disentangling intersectional stigma and its impacton caregiver and child mental health, and grasping the signifi-cance of the adversities these communities and children face byreflecting on economic vulnerabilities and stressorsmore closely.A system-level appraisal of how these economic strengtheningapproaches are independently evaluated and evaluation bypartners from economic and social development sectors of theUgandan government or civil society would be important nextsteps. There is room to report on implementation outcomes thatfocus on the process of developing these integrated interventionsand whether mental health and economic empowermentapproaches need a different strategy, community, or youthengagement framework.As a guest editor, my commentary here is to buttress theimportance of such well-funded, well-aligned scholarship inAfrica and also to highlight that South-to-South partnerships arenot only about US-funded research from largely northern part-ners. It should also become a venture where Southern countries(often “sites of intervention and need”) deliberate and build jointpriorities, co-create solutions that are relevant to them, andframe research articles in a manner that reflects how multi-stakeholder priorities were identified and addressed. The title ofSouth-to-South partnerships could be a misnomer when most ofthe key authors are from limited northern institutions. Southernresearchers working within the global north is not the onlymodel for south-south partnerships. Most of these articles areled by individuals based in global North, including senior, first,and second authors. That is where a sea-change is needed.Building capacity to publish more articles within research teamsand for improved representation would also serve accomplishedteams that are generating enormous evidence-based research inthese constrained geographies. How young people will respondto such complex interventions, and if these are designed, vetted,and improved by their feedback, has become a big theme inglobal health. While developing strong, outcome-informed evi-dence, we need process indicators. Multilevel community, eco-nomic, and family-level analyses that speak to multidimensionaland interconnected social determinants would be other oppor-tunities to consider. My hope would be to see more attention tothese areas of framing and partnerships. It will be important forfunders, publishers, and global health consortiums to ask for ascore card on inclusivity, equity, representativeness, and afocused direction toward addressing social determinants of childand adolescent mental health.Manasi Kumar, Ph.D.Brain and Mind InstituteAga Khan UniversityNairobi, KenyaReferences[1] Ssewamala FM, Brathwaite R, Bahar OS, et al. The post-intervention impactof Amaka Amasanyufu on behavioral and mental health functioning ofchildren and adolescents in low-resource communities in Uganda: Analysisof a cluster-randomized trial from the SMART Africa-Uganda study (2016-2022). J Adolesc Health 2023:S3e10.[2] Nabayinda J, Kizito S, Ssentumbwe V, et al. The relationship between familycohesion and depression among school-going children with elevatedsymptoms of behavioral challenges in Southern Uganda. J Adolesc Health2023:S11e7.[3] Nabunya P, Namuwonge F, Bahar OS, et al. Stigma by association, parentingstress and the mental health of caregivers of adolescents living with HIV inUganda. J Adolesc Health 2023:S18e23.[4] Byansi W, Ssewamala FM, Neilands TB, et al. Patterns of and factors asso-ciated with mental health service utilization among school-going adolescentgirls in southwestern Uganda: A latent class analysis. J Adolesc Health2023:S24e32.[5] Filiatreau LM, Tutlam NT, Brathwaite R, et al. Effects of a combinationeconomic empowerment and family strengthening intervention on psy-chosocial well-being among Ugandan adolescent girls: Analysis of acluster randomized controlled trial (Suubi4Her). J Adolesc Health2023:S33e40.[6] Kizito S, Nabayinda J, Neilands TB, et al. A Structural Equation Model ofthe Impact of a family-based economic intervention on ART Adherenceamong adolescents living with HIV in Uganda. J Adolesc Health2023:S41e50.[7] Tutlam NT, Filiatreau LM, Byansi W, et al. The impact of family economicempowerment intervention on psychological Difficulties and prosocialbehavior among AIDS-orphaned children in southern Uganda. J AdolescHealth 2023:S51e8.[8] Azasu EK, Joe S. Correlates of suicide among Middle and high school Stu-dents in Ghana. J Adolesc Health 2023:S59e63.Editorial / Journal of Adolescent Health 72 (2023) S1eS2S2

Strengthening the understanding of south partnerships and rigor in addressing social determinants of child and adolescent mental health

https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1396&context=bmi

Strengthening the understanding of south partnerships and rigor in addressing social determinants of child and adolescent mental health

Abstract

Similar works

Full text

Available Versions

eCommons@AKU