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26.10.2021

Promoting mental health - especially in times of Covid-19

In 2019, SolidarMed began supporting the rollout of the Friendship Bench Initiative in Masvingo Province, Zimbabwe, which aims to strengthen the mental health of rural populations. The initiative evaluates clients concerns to explore potential gender inequities and the impact of COVID-19 on abuse and violence.

Village health worker providing psychological counseling in one of the hospitals in Zaka district.

In Zimbabwe, mental health services are very poor, with only 13 psychiatrists for 15 million people and about 126 clinical psychologists. Services are concentrated in urban areas, even though 60% of the population lives in rural areas.

The Friendship Bench initiative is a low-cost intervention in which trained and supervised lay health workers:in villages treat common mental disorders in Zimbabwe's primary care system. These lay health workers are taught a structured approach to identify mild to moderate mental disorders such as anxiety and depression, find workable solutions, and identify and treat more severe cases in greater depth.

After individual talk therapy, clients are invited to a peer-led support group known as Circle Kubatana Tose (CKT), which means "holding hands together." This safe space contributes to clients' sense of belonging, reduces mental health stigma, and allows for sharing of personal issues.

Lay health workers in a village providing mental health services at a rural clinic in Zaka district, Zimbabwe.

The COVID-19 pandemic thrives on inequalities and injustices and has led to a significant increase in gender-based violence [UN Women Africa]. Therefore, it is important to understand the link between any form of abuse and the COVID-19 pandemic in order to provide rural women in particular with the primary mental health services they need and to build critical support systems.

To this end, we reviewed problem lists submitted by clients during lay counseling and examined the prevalence of emotional, socioeconomic, physical, and sexual abuse.

Comparing the problem list between 2019 and 2020, there was an overall increase in problems falling into the abuse category. In 2019, approximately 30% of the problems presented could be categorized as abuse, while in 2020 this percentage increased to 35.6%.

During COVID-19, there was a significant decrease in access to (mental) health care, while the proportion of problems listed in the abuse category increased from 30% overall to 36%.

The full article can be found here.