Community Sensitization in N. Malawi to Promote Good Mental Health in School Children
We are a team of professors from the Division of Child and Adolescent Psychiatry at the University of
Washington who conducted a needs assessment of school children’s mental health needs in August
2013 in villages in the Mzimba District in Northern Malawi. Malawian educators and health
professionals participated in this project as an outgrowth of a school health survey conducted by The
Principal of the University of Livingstonia College of Health Sciences, Flemmings Nkhandwe, BSNurs,
MPH,, in 2005. Mr. Nkhandwe served as our co-investigator for our project.
The urgent need to call attention to the mental health of school children is predicated on specific
features of the Malawi context. Malawi is one of the poorest nations in the world. Without a strong
economy or high-value natural resources, education is a critical lynchpin for the future welfare of the
population. Many obstacles impede children’s success in school, chief among them being low resources
invested in the educational sector, poor nutrition, and inadequate nurturing of social and emotional
development and school readiness. Among Malawi parents and teachers there is negligible appreciation
of the important role of secure attachments, brain (emotional, cognitive) development, and schoolreadiness in academic success.
In August 2013 the UW team that included clinical psychologists, Laura Kastner, Ph.D., Elizabeth
McCauley, Ph.D. and child psychiatric epidemiologist, Ann Vander Stoep, Ph.D., traveled to N. Malawi to
learn about the emotional health status of school-aged children. Principal Nkandwe arranged for the
team to conduct 10 semi-structured interviews with groups of school and health sector representatives
and villagers to learn about prominent emotional health problems and how they were being addressed
in primary and secondary schools and health clinics.
After completing the interviewing and data summary phase, the team convened a one-day school
mental health workshop with 41 Malawian participants to convey what they had learned. They reported
their findings, demonstrated U.S. best practices for dealing with prominent emotional health problems
seen in Malawi school children, and implemented a nominal group process activity where participants
came to consensus about the way forward to address emotional health needs of school children.
Participants unanimously endorsed carrying out Community Sensitization as the next step forward. Five
strong leaders from health and education sectors volunteered to participate on an Advisory Group to
plan and implement a School Mental Health Promotion Community Sensitization project.
Community sensitization is a process of raising public awareness about an issue of importance - in this
case, promoting optimal mental health in children, enabling children to come to school prepared to
learn. To ensure the full participation of stakeholders, a strategy for public sensitization and awarenessraising is designed so that communities will clearly understand the issue and how to address it. A key
priority in such efforts includes developing a sense of ownership in the project and involving community
members, leaders and mentors for the implementation of a mental health promotion program.
The Seattle and Malawi-based team is seeking funds to plan, implement, and evaluate a pilot
Community Sensitization project in two villages in Northern Malawi.
Our goals are to:
Develop a pilot community sensitization program with input from local service providers, teachers and
other community leaders.
Raise awareness at the community level about practices that nurture the mental health and optimal
well-being of school children so that they can arrive at school ready to learn and able to engage in their
education.
Increase outreach to communities with a focus on parents, guardians of orphans and vulnerable
children, and community leaders who can advocate for school children.
Engage community leaders to expand the reach of psychological support to families who may lack
knowledge about the basic mental health needs of developing children (e.g. secure attachment, positive
discipline, physical safety, mediational learning).
We are currently carrying out preliminary planning with the Advisory Group via email and Skype. Seattle
team members hope to return to N. Malawi for 4-5 weeks soon after the start of the next school year
(September 2014) to finalize planning both sensitization (scripting skits and role plays, creating posters,
and composing songs/dances, media announcements) and evaluation activities (pre-post assessments of
knowledge, attitudes, and practice of key community members) for the pilot project.