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Strengthening Systems

Gender-based violence (GBV)

Gender-based violence (GBV), especially threats directed at women such as sexual and domestic violence, remain a serious regional and global human security concern. South Africa (SA) has one of the highest rates of violence against women in the world. SA, during the Coronavirus pandemic, has reported increased incidents of GBV including cases perpetrated within and around campuses of higher education institutions. The causal factors of GBV are complex and intertwined with social and patriarchal constructions that places maleness in the center of society, with men dominating the most visible roles and an expectation that women will occupy subordinate positions. This view is prevalent in SA society and in most academic settings and effects power relations in society. From a power relationship perspective GBV is a display of power with culture often negating the concept that women need to provide consent for sexual intercourse with their partners.

FPD Mental Health System Strengthening Projects

Our Projects in South Africa

- FPD, has since 2019, in partnership with NDoH and all Provincial DoHs with sponsorship from Sanofi been implementing a limited MH system strengthening project focusing on building MH treatment and referral capacity at PHC level. FPD has trained 1120 PHC nurses and doctors in diagnosing and managing non-complex MH issues to improve referrals for complex MH issues to regional and tertiary psychiatric centres. This initial project has continued in 2021 with the additional training of 500 Mental Health practitioners, all the training being conducted virtually in view of the COVID restrictions. The focus in this training was on compliance with the Mental Healthcare Act and the roles and responsibilities of all in the quality care chain to ensure that mental health users are receiving the care they need.

- The initial MH project has culminated in a journal publication in the African Primary Healthcare Family Medicine Journal (PHCFM) available at the Digital Object Identifier: https://doi.org/10.4102/phcfm.v13i1.2909

- During the COVID-19 pandemic FPD soon realised the effect of the lockdown restrictions and concomitant demands on patient care, in the wake of high morbidity and mortality rates on the mental health and well-being of healthcare workers and the general public. Two online courses to build mental resilience were developed within a short period of time; the first focussed on the general public with content embracing the importance of healthy lifestyles, exercise, creative activities and the role of routines during lockdown to keep mentally sane. In the second course the focus was on healthcare workers and how to support them in staying mentally strong and stable – the course provided insights into anxiety and depression and how to overcome them with available helplines and support structures and gave direction should depression and Post-traumatic stress become a reality. Many organisations have supported their employees and healthcare workers by making this course available through sponsorships – this amounted to more than 6000 participants accessing this course.

- From 1 January 2022 a FPD lead consortium started implementing a CDC funded 5-year grant designed to: i) improve access, mental health care for people living with HIV (PLHIV) and vulnerable and at-risk individuals and ii) decrease Health Care Workers (HCW) stress, anxiety, and burnout.

Our Projects in Africa

- FPD in partnership with Columbia University: FPD has been partnering with Columbia University since May 2017 to implement an NIH/NIMH funded program titled PRIDE SSA - Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence Based Practices in sub-Saharan Africa. This program has established a collaborative network of mental health (MH) stakeholders (researchers, teaching faculty, service providers, and policy makers) in five Sub-Saharan countries (Botswana, Malawi, Mozambique, South Africa, Zambia). The project builds capacity through implementation research focused on scaling up community mental health care integrated within public health services based on the mhGAP Intervention Guide developed by WHO. PRIDE SSA has to date achieved the following: i) conducted rigorous scale-up research in partnership with policy makers to identify and implement the best task-sharing delivery pathway for sustainable trans-diagnostic community MH services, integrated into the public health system in Mozambique, including deployment of MH screening and treatment applications; ii) trained and supervised over 200 clinic-based mental health care providers to offer Screening, Brief Intervention, and Referral to Treatment (SBIRT-MI) and Safety Planning Interventions ; iii) established a multidisciplinary MH research network in all five countries comprising researchers, faculty, policy makers, and trainers of trainers; iv) provided Policy TA on the use of MH research to inform policy and program development and v) implemented a Trainer of Trainers program in Mozambique to develop MTs.

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