Overview

The overall objective of this project was to build the collaborative team required to develop and submit an NIHR Global Health Research Group funding application (and to respond to other funding opportunities) focussed on designing, implementing and testing a model for integrating mental health (MH) into maternal and child health (MCH) services in Malawi and other Africa settings.

To meet this overall objective we set out to:

• Establish new collaborations within Malawi (e.g. with Department of Health Systems, KUHES), regionally (e.g. University of Cape Town), and in UK (e.g. University of Liverpool).

• Support establishment of a network of organisations and key individual stakeholders to advise/contribute to study design.

• Support the establishment of groups of women (and men) with lived experience of mental health conditions in the perinatal period that will be a key partners in the application, and to introduce them to principles of co-design.

• Have the collaboration established and a research plan in place by end of the grant period developed through consultation with researchers, PWLE and key stakeholders, ready to be finalised and submitted to NIHR in Q3/4 of 2024.

Outcomes

• Collaborative team in place

  • We held a number of face to face and online meetings with potential collaborators who were enthusiastic to work together on the proposed NIHR application.

• A Malawi network of organisations and key individuals in place

  • July 2024 A full day meeting with held in Malawi attended by representatives of Ministry of Health (MOH) reproductive health, MOH mental health, Malawi Epidemiology and Intervention Research Unit (MEIRU), African Alliance for Maternal Mental Health (AAMMH), Kamuzu University of Health Sciences (KUHES) and other teaching institutions. At this meeting the research and practice priorities for integration of MH in MCH services were discussed alongside presentation of the Malawi Maternal Mental Health Manual for review and MOH approval. New relationships were established and joint commitment made to the work.

• Representative groups of women with lived experience established

  • Dr Ngoma led a meeting bringing together a group of 11 women with experience of perinatal mental health conditions who have been in contact with St John of God (SJOG) services, along with Ms Memory Bismark, CEO of Mental Health Users and Carers Association (MEHUCA). Discussion held in which they expressed their views on what would want from integration of maternal mental health in to MCH care. Agreement reached to continue activities of the peer support group and to establish formal link to Mental Health Users and Carers Association (MEHUCA).

• Consultations with the above teams conducted.

  • In each of the activities described above, consultations were held about local priorities for maternal mental health research, all of which fed into the drafting of the application.

• Draft of application

  • Unfortunately, despite the establishment of a stong interdisciplinary and multisectoroal research group, and agreement with them of a research plan for application to NIHR global Helath research level 2 call, we were unable to finalise the application in time for nov 2024 deadline.

  • Although the Nov 2024 submission deadline was not met, we plan to rework the application for the upcoming NIHR Global Health Research, Health Systems and Policy Research call that opens in Feb 2025

  • Although I was not successful in submitting application to the planned call, I learned a huge amount about the process that will put me in a much better place for the next planned submission. I remain confident that this seed funding will eventually result in a successful funding application.

The project has had additional benefits outside of the core objectives in that the meetings held and relationships formed have aided in the successful navigation of approvals for MOH adoption of the Malawi Maternal Mental Health manual as an official Govt of Malawi document.

Future Directions

We plan to rework the application for the upcoming NIHR Global Health Research, Health Systems and Policy Research call that opens in Feb 2025.