Improving mental healthcare of the youth of Afghanistan, using mHealth and Telemedicine
Tech4Life Enterprises initiated the project in early 2013 to develop simple and cost effective mHealth and Telemedicine solutions, in partnership with University of Calgary and Aga Khan Health Services, Afghanistan, for improving mental healthcare of the youth of Badakshan province of Afghanistan, which is currently under high prevalence of mental health problems. The project aims to reduce stigma against mental health in the community, build capacity of health providers, ensure standardized care, and improve referral system for advance diagnosis and better treatment.
The project strengthens the existing health system by improving awareness in the community and empowering health workers using simple and low cost mobile technology and telemedicine solutions.
- Reduce stigma amongst the community, emphasizing that the mental health problems are treatable.
- Improving readiness and skills and knowledge of facility as well as community-based healthcare providers, and make information available to them.
- Introducing mHealth and telemedicine facilitated service delivery for remote communities.
The project has performed focused activities using culturally sensitive mHealth and telemedicine interventions delivered to the general community, facility-based and community-based healthcare providers, and young adults. Activities include:
- Raising mental health awareness and Reducing Stigma:
Mental health awareness building was conducted at the community level and specifically for young adults aged 18-25 years.
- Mental Health Awareness for the community:
Town hall sessions and community group gatherings were conducted to highlight and share mental health awareness and knowledge amongst the community. The main purpose was to reduce stigma about mental health problems.
- Mental Health Awareness for young adults:
All young adults age 18-25 years were registered for receiving text messages. Weekly text messages are sent to over 1000 registered adults about mental health problems such as depression, anxiety, PTSD and drug abuse.
Regular awareness sessions at each facility center were conducted in order to improve mental health knowledge and practice of the health providers. This was further supported by face-to-face and blended learning sessions for both community health workers and facility-based providers. The strategy comprises of two models;
- Local capacity building and training sessions with health providers of the districts
- Specific training and teaching modules for providers at all levels respectively, using online learning platform ‘MOODLE’, this was facilitated by local and international mental health experts of the project.
The project include development of Mental Health Mobile Application to perform mental health patients` screenings, diagnosis, triage, and advance referrals of the community.
Online learning and Telemedicine application are assembled within this mobile application for the health providers at all levels respectively, in order to have access remotely. All these health providers used the application through project-provided smart cell phones.
- Screening, Diagnosis, and Triage:
The mental health mobile application included guidelines and protocols; extracted from World Health Organization`s Mental Health Gap Action Program (mh-GAP), for better and quick screening and diagnosis by the community-based providers in field.
- Mobile and web-based Telemedicine:
Mobile Telemedicine application is another critical component of the application; addressing the gaps in health systems and lack of linkages in remote areas. This is designed for use by facility-based providers for virtual teleconsultations creating hub-spoke environment in far flung areas. Whereas, web-based Telemedicine application is also implemented at all intervention centers in each targeted district. This is being facilitated by using Tech4Life`s own developed highly innovative Telemedicine solution, ‘MDConsults’ in either live or store-and-forward mode enabling frontline health workers to use telemedicine consultations for the communities they serve.
The initial results from the evaluation of this low-cost and simple eHealth project have shown to benefit health practitioners and the communities in the remote areas of Afghanistan, and also generated evidence on how eHealth enhanced access to care for remote communities, decreased the stigma, and improved quality of health services by providing opportunities for continuing learning.