Funded by the
Johnson and Johnson Foundation, the research project sought to highlight the state of mental health and resilience of frontline health workers in Kenya. Nearly 4,000 nurses, midwives and Community Health Volunteers (CHVs) were interviewed between January 2021 and June 2022.
Some of the key drivers for mental health challenges include heavy workload, lack of resources, poor work environment, irregular salary payments amongst nurses and midwives and lack of salaries for CHVs.
“There is a need to focus on self-care and peer support in combatting mental health challenges faced by frontline health workers. However, for the frontline health workers to provide self and peer support, they must be able to identify their own psychological needs as well as that of their peers. Further, there is need to train mental health practitioners who can then be deployed in the health system to provide mental support as needed. These require concerted investments by government and partners to ensure that such mental health interventions for frontline healthcare workers are met.” said Dr Eunice Ndirangu-Mugo, Dean, School of Nursing and Midwifery, East Africa, AKU.
The findings indicate the need to establish structures – including policies - that promote the wellbeing of health workers who are crucial in achieving Universal Health Coverage. They also indicate the powerful role mobile health technologies (mHealth) could play in combatting mental health challenges.
“In our analysis of policy documents, we learned that there are various policies that touch on mental health. However, these policies are mainly focused on the patient, with limited focus on the health workers from whom we expect high quality health care. Therefore, we need to develop policies that recognise and address the mental health needs of health workers as well. We also administered a mobile-based SMS intervention that was designed to provide direct psychosocial support to health workers. Preliminary results show that these kinds of mobile health interventions could be feasible, acceptable and used to alleviate mental health challenges faced by health workers,” said Prof Amina Abubakar, Director of the Institute for Human Development, AKU.
Policymakers and stakeholders convened in Nairobi to hear recommendations drawn from the study and map a possible way forward.
Director General Ministry of Health, Dr Patrick Amoth said, “The government of Kenya is keen to support the mental health needs of its citizens as evidenced by the recent assenting of the mental health bill by the President. This was also seen at the height of the COVID-19 pandemic when we developed Mental Health and Psychosocial Support guidelines for our health workers. We are therefore happy to have such kind of evidence that complement the government’s efforts towards generating data on the mental health status of front-line health workers as well as how we might improve their resilience.”
This work is critical in addressing one of the major challenges raised by
The Resilience Collaborative, an initiative spearheaded by the
Johnson & Johnson Center for Health Worker Innovation. Distinct evidence gaps exist in lower resource settings which may lead to limited interventions. This is further compounded by a limited global research base on psychosocial well-being of health workers in relation to prolonged crises as has been seen during the peaks of the COVID pandemic. It is not just conducting this work that is important, sharing and amplifying these insights during this convening event is another step in building the overall knowledge base.