Projects

We are improving access to quality mental health services in Kenya through mental health legal framework reforms and mental health system strengthening and accountability. We are also strengthening technical and institutional capacity of civil society organizations promoting the rights of people living with mental health conditions and psychosocial disabilities, their families and care givers.

 

Some of the key results that emerged from the Mental Health programme include:

Improvement of legal and policy environment which upholds and protects the rights of users of mental health services, people with mental health conditions, and people with psychosocial disabilities. This was achieved by:
a) Supporting civil society organisations including organisations for persons with lived mental health conditions and health care workers in Nairobi and rural counties of Nyeri, Kilifi and Isiolo to review, critique and contribute their views that informed the Mental Health (Amendment) Act No. 27 of 2022.
b) Provided stakeholders views that informed the amendments of the National Hospital Insurance Fund (Amendment) Act, No. 1 of 2022. One of the suggestions that received favourable considerations was inclusion of severe mental health cases under social protection upon assessment. Hence persons with severe mental health conditions can now receive government stipends, medical cover and preference in government procurement /tendering processes earmarked for persons with disability.
c) HERAF is a part of the campaign that is calling for the repeal of laws and policies that criminalise, stigmatise persons with mental health conditions by conveniently using the phrase ‘persons of unsound mind’. Some of the laws that should be repealed include Children’s Act 2001, Constitution of Kenya, 2010, Local Government Act, Marriage Act No. 14 of 2014 and Criminal Procedure Code and Election laws.
d) Disseminated the Kenya Suicide Prevention Strategy 2021 – 2026 and increased awareness on suicide prevention and early interventions.

Strengthened mental healthcare system at primary health care and referral facilities
a) Enhanced integration of mental health services into routine primary healthcare services through training of 570 healthcare workers, community health volunteers, traditional and faith healers on Quality Rights, Mental Health Gap (MHGap) and Problem Management Plus (PM+) to offer community education on prevention, detection and response including delivery of psychosocial first-aid, monitoring adherence to mental health treatment, reporting and referral for mental health services.
b) Increased resource pool for community level actors contributing to timely interventions, referral and de-stigmatization of mental health conditions. This was enabled by training mental health champions and civic educators on safeguarding, social protection, psychological first aid and key messaging on mental health.
c) Enhanced the capture and reporting of primary health care services delivery data by training and orientating CHVs on mental health services reporting using available tools such as- MOH 513 and MOH 514. The data is used to inform decisions for mental health at community and primary health care facilities.
d) Promoted re-integration and inclusivity of persons with mental health conditions into community life. Reduction of stigma and discrimination associated with mental illness enhanced involvement in family and community life enabling inclusive and informed decision making, access to justice and a rights protection culture for persons with mental health conditions. Persons with mental health conditions representation on court users’ committees (CUCs), access to alternative dispute resolution (ADR) Mechanisms and informed consent promoted access to justice in matters of Succession and Inheritance, Equal work for Equal and progressively ending the culture of violence, abuse & neglect.

Improved mental health care department infrastructures at county referral hospitals through targeted community led advocacy. These actions led to:
a) Repairs and maintenance including new court of painting for mental health units in Nyeri, Kilifi and Isiolo County Referral hospitals. Some of the mental health units received new coat of
paint, expanded dining areas for inpatient while others expanded spaces for offering mental health services including consultations, counselling, social workers rooms and installation of therapeutic aids such as television sets. Other health facilities established and operationalized specialized psychiatric clinics.
b) Increased the number of patients and clients more aware of the available mental health care services at community and facility levels and their entitlements. The 6 targeted health facilities were enabled to develop and disseminate mental health care services charters, codes of conduct and grievance re-address mechanism.

Strengthened governance, planning and budging processes for mental health care programmes at community, facility and county government levels.
a) Supported establishment of multi-sectoral Technical Working Groups (TWGs) in Nyeri, Isiolo and Kilifi counties to champion and coordinate mental health programmes, planning and budgeting.
b) Successfully advocated for inclusion of mental health focal person into County Health Management Team (CHMT) in Isiolo county.
c) Provided technical and logistical support to Kilifi and Nyeri counties to develop and disseminate Costed Mental Health Plans.
d) Inclusion of mental heath in the third generation County Integrated Development Plans (CIDPs). CSOs were mobilised and organized to participate and advocate for inclusion of mental health in CIDPs for Nyeri, Isiolo, Kilifi, Nairobi, Kwale and Machakos counties.

Strengthened rollout and utilization of social accountability reports to inform decision and improve mental health services.
a) Civil society organisations including organisations for persons with lived mental health conditions and care givers were empowered to comprehend and use social accountability tools to measure accessibility, quality of services and government’s commitments to mental health pronouncements.
b) Increased adoption of issues and actions highlighted in community score cards to inform mental health care services, planning and budgeting decisions.

We increase responsiveness and accountability of Public Offices in Service Delivery. To achieve this, we increase citizens and public officer’s knowledge and awareness on constitutionalism and importance of adherence to rule of law in delivery of public services and access to justice. We promote citizens’ rights to services delivery, information, participation in decision making processes, monitoring and oversight of public offices. To ensure marginalized groups (women, youth and persons with disability) are not left behind, we strengthen their capacity to proactively seek for information, public services, participate in decision making processes and give feedback on quality of services, management and utilization of public resources.

We advocate for an improved policy environment for Water Sanitation and Hygiene (WASH) infrastructure in primary health care facilities. This is enabled by improving policy and decision makers’ awareness of WASH policy and requirements in primary HCF. We also advocate to county governments to include costed WASH activities in facility and county budgets. This includes establishing a budget line for WASH in HCF to guarantee infrastructural development, routine maintenance, employment and retention of support staff for WASH services. Citizens are empowered to monitor accountability of the facility management committee and the government in implementation of policies and strategies for WASH in HCF using social accountability tools.

We advocate for and pro-actively engage government and stakeholders in advancing the Universal Health Coverage (UHC) agenda at policy, strategy and service delivery levels. Community members, civil society organizations, health care workers and policy makers are made aware of the core concepts of UHC, their roles and responsibilities in promoting the UHC agenda. These includes engaging with government in development and review of policies, strategies, investment plans and benefit packages. Monitor fulfillment and critique government’s UHC Country progress report, political promises and commitments on UHC at County, national and global levels. We also partner, collaborate and link grassroots civil society organizations to global UHC2030 Civil Society Engagement Mechanism (CSEM) to inform regional and global discussions on UHC.

We increase access and utilization of focused Maternal, Newborn, and Child Health (MNCH) and Family Planning (FP) services in Kenya. This entails conducting advocacy dialogue forums with custodians of cultural practices and beliefs that hinder demand for MNCH/FP services. We mobilize these gatekeepers to become behavior change champions for addressing the negative socio-cultural driven barriers. Expectant mothers are sensitized on importance of Antenatal Clinics (ANC) and Skilled Birth Attendance (SBA) and family planning. We train male champions to reach out to fellow men with information, identify and refer couples for MNCH services while Community Health Volunteers and reformed Traditional Birth Attendants are sensitized to act as birth companions. That is, accompany expectant mothers / new born to health facilities.