^{By Tatenda Chimbwanda}

Bulawayo, Zimbabwe – Over 792 million people in Africa live with a Mental Health (MH) conditions. Like many African countries, Zimbabwe has inadequate MH specialists to support the population. The Government of Zimbabwe recognizes MH as a serious public health and development concern. MH is recognized as a priority in the most recent National Health Strategy for Zimbabwe (2021-2025), and the current Ministry of Health and Child Care (MOHCC) MH Strategic Plan. Moreover, there’s is still a significant discrepancy in the number of people with MH conditions who need treatment and those who receive this treatment resulting in high MH treatment gaps.

To close the MH treatment, gap the MoHCC is implementing the FRIENDZ program under Zimbabwe Special Initiative for MH with support from Friendship Bench (FB), UNICEF, WHO and ZimTTECH. The FRIENDZ program aims to scale up assessment and management of priority mental, neurological and substance abuse use disorders from community to, primary and tertiary health care level in Zimbabwe.

MoHCC, MH Department, Deputy Acting Director, Dr Patience Mavunganidze, emphasized on the importance of FRIENDZ program which will strengthen the community and MOHCC Primary Health Care (PHC) MH system in Zimbabwe. “FRIENDZ will also strengthen referral pathways from the community level, through PHC and secondary and tertiary levels and back down, as well as ensure support supervision from higher to lower levels of care, creating a strengthened MH system of care, accessible to the population,” added Dr Mavunganidze.

As part of the FRIENDZ program implementation, MoHCC with support from UNICEF and WHO trained 30 Trainers of Trainers (ToTs) from 10 different provinces between 2-5 August 2020. The ToTs were trained on competency-based psychosocial support, psychological treatments, and foundational helping skills using the WHO MH Action Gap (mhGAP). The ToTs are expected to cascade the training in their various provinces with support from FB and ZimTTECH.

Under the FRIENDZ program, Friendship bench will scale-up Problem-Solving Therapy (PST) services in Zimbabwe. This will be done through training Lay Health Workers (Village or Community Health Workers) on common MH problems, self-care, and how to provide basic PST.  “We also hope to provide our FB and services to 34,480 women, men, girls, and boys aged 16+ years using our PST which evidence has shown significantly reduces symptoms of depression and anxiety,” says FB, Psychiatrist and Clinical Program Manager Rukudzo Mwamuka.

“As Zim-TTECH we will be complementing FB work and ensure we also train more health workers in 20 districts which FB is not present in to ensure we have more health care workers delivering MH in Zimbabwe,” says Zim-TTECH Director Rumbidzayi Dhiliwayo.

To strengthen MH governance and leadership including smooth implementation of the FRIENDZ program. Thanks to USAID generous funding, MoHCC together with FB, WHO and ZimTTECH conducted sensitization workshops with Provincial leaderships in Bulawayo and Gweru. The provincial leadership sensitization workshop conducted between 22 – 26 August. The main goal was to raise awareness with provincial leadership within the country’s ten provinces including discussing integration of mhGAP into existing health programs.

Speaking on the sidelines during the Provincial Health Executive (PHE) sensitization meeting in Gweru, Harare’s Provincial Medical Director, Dr Innocent Hove affirmed his support to implement FRIENDZ in Harare. “As we know, MH human resources are scarce and concentrated in major cities and hospitals leaving 67.8% of Zimbabwe’s total population who are in rural areas, with limited access to MH services care, the FRIENDZ program will go a long way in ensuring that marginalized communities receive MH services,” said Dr Hove.

”The FRIENDZ program seeks to capacitate, Zimbabwe’s MH system with capacity to provide basic mental health coverage to over 3 000 000 women, men, boys, and girls in three years. These people who receive the PST and mhGAP services will experience reduced symptoms and / or improved daily functioning, “said WHO Mental Health Specialist Dr Debra Machando. 

After the training the ToTs are expected to cascade the training to other health cadres across Zimbabwe’s ten province.  The goal is to ensure the knowledge is passed on all the way to the PHC and ensure people in the rural areas also receive quality MH services.