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Specific Aims of AFFIRM

1.  Investigate strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa by:

  • Assessing the feasibility and acceptability of low cost task sharing interventions in Ethiopia and South Africa; and
  • Conducting randomised controlled trials (RCTs) of low cost task sharing interventions for severe mental disorders in Ethiopia and maternal depression in South Africa.

2.  Build individual and institutional capacity for intervention research in sub- Saharan Africa by:

  • Providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe to develop capacity for mental health intervention research;
  • Offering short courses in mental health intervention research in sub-Saharan Africa; and
  • Providing supervision to Masters, PhD and post-doctoral students, who wish to base their research in either of the AFFIRM research sites in Ethiopia and South Africa.

3.  Establish a network of collaboration between researchers, NGOs and government agencies that facilitates the   
     translation of research knowledge into policy and practice by:

  • Establishing knowledge exchange with Ministries of Health in all partner countries, regarding steps for evaluating and later scaling up task sharing interventions for mental health disorders; and
  • Producing communication materials, such as policy briefs and annual newsletters, on intervention research for mental health in sub-Saharan Africa, to be disseminated to partner Ministries of Health and NGOs.

4.  Collaborate with other NIMH hubs by:

  • Designing and executing shared research projects related to task sharing and narrowing the treatment gap; and
  • Pooling research knowledge from all hubs to contribute to global advocacy initiatives to narrow the treatment gap for mental disorders in Low and Middle Income Countries (LMIC).


There is growing international consensus that a task sharing approach is required to narrow the treatment gap for mental disorders in low and middle-income countries (LMIC). This means essentially that general health workers need to deliver mental health interventions through routine health care delivery systems, supervised by mental health specialists.

WHO (2008) notes that "by reorganizing the workforce in this way, task sharing presents a viable solution for improving health care coverage by making more efficient use of the human resources already available and by quickly increasing capacity while training and retention programmes are expanded". (See

AFFIRM will be evaluating task sharing through the use of Community Health Workers in South Africa, and Primary Health Care workers in Ethiopia. In South Africa the focus is on pregnant women who are depressed, and in Ethiopia the focus is on people with severe mental disorders.