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An Integrated Approach to Addressing the Problem of Youth Depression in
Malawi and Tanzania
I.
FORMATIVE RESEARCH GUIDELINES
Aim
The major aim of this activity is to ensure that the campaign messages and formats address the
information needs and preferences of the target audiences so that they can succeed in meeting
their own objectives with respect to identifying and mitigating the effects of Depression amongst
the youth.
The formative research will allow us to understand the current knowledge, attitudes and healthseeking practices (in selected communities or listening groups) regarding mental health, mental
illness and Depression. By gaining this information, it enables us to return to the same
communities after broadcast, and see to what extent KAP have changed – and whether we have
achieved our project objectives.
The results from the formative research, along with the baseline survey results will provide radio
stations with a good understanding of the topic and the community’s information needs on the
topic. Formative research reports, coupled with a short training on the topic, will give
broadcasters enough information for them to design and produce an effective radio program,
with campaign messages that are best able to target youth, and understand what Depression is
and how to get help if needed.
Research methods and tools used in formative research include:
Mobenzi: The mobile-based survey system is sometimes used to conduct a baseline survey as
part of the formative research plan, and captures quantitative data about KAP, as well as
listening preferences. For this project, Mobenzi was used to assess gaps in knowledge, and
identify stigmatizing attitudes and stereotypes about mental illness and Depression.
Focus Group Discussions: Small groups of 8-10 people are asked a set of questions requiring
short answers and that are more related to attitudes and opinions, and provide in-depth feedback.
Questions often address aspects of the baseline survey that require further clarification. For this
project, we will work with 4 groups of 10 in each of the 3 impact districts for a total of 12 focus
groups, and 120 youth. Focus groups should last 60-90 minutes, and have a facilitator, a
recorder/note-taker and a content specialist. The groups will be made up of the following:
1. In-school youth—females: Secondary school females aged under 25 years
2. In-school youth—males: Secondary school males aged under 25 years
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3. Out of school youth club females: This group includes women under 25 years who are
not in school and belong to a youth club. They may have finished secondary school or
have dropped out.
4. Out of school youth club males: This group includes women under 25 years who are
not in school and belong to a youth club. They may have finished secondary school or
have dropped out.
Key Informant Interviews: A total of 18 20-30 minute interviews with people who can provide
general information on the demographics, mental health perceptions, challenges and services.
For this project, these could include:
Suggestions:
1. Community health centre/hospital employees in each district, preferably those trained in
mental health
2. District level education employee – demographics, and information about mental health
awareness and promotion campaigns
3. National Ministry of Health representatives in the ministry of health—integration of
mental health into national framework, challenges and services for youth
4. Mental Health experts/psychologists in the Malawi College of Medicine Department of
Psychiatry and the College of Nursing about stigmas, misperceptions, availability of
services and medications, challenges with identification and diagnosis of Depression, and
the capacity of health providers to deal with Depression
5. Scottish team at the Malawi College of Medicine about psychiatric services in Malawi,
the prevalence of Depressions, and challenges to reducing the burden of Depression
amongst the youth
6. Head Teachers- learn more about school-based mental health programs, and determine if
they address Depression and how
Documentation Review: This involves conducting a scan of available and relevant documents
that are available around mental health literacy, Depression, and mental health communication
strategies. This will give us an idea of the kinds of information available on youth mental health
literacy as it relates to youth Depression.
Suggestion: select 3-5 pieces to review and summarize
Websites – in2mentalhealth, teenmentalhealth.org, WHO
Project documents—Proposal, MH curriculum
Articles from medical journals
Education and Health documents about school-based mental health programs and mental health
literacy
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Articles and websites about mental health literacy and stigma
Resource availability, primary health care assessment, and mapping: This involves getting a
clear sense of the availability of the necessary resources/services (including pharmaceuticals)
required to address mental health issues, and to treat youth who may be suffering from a mental
illness.
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Visiting 2-3 district hospitals to see if they have mental health experts on staff,
and to ask if they have SSRIs available to treat Depression
 Interviewing district level health professionals to ask about diagnostic tools and
referral services for Depression
 Scanning schools and interviewing teachers to determine if they have ever used
mental health curriculum in their classes, or had any training about adolescent
mental health
I. QUESTIONS FOR MH FOCUS GROUP DISCUSSIONS WITH YOUTH
MENTAL HEALTH INFORMATION (requires input from Stan)
This section will be used to gain a further understanding of what youth understand, don’t
understand, are curious about, and would like to know about mental health, mental illness and
Depression.
1. Sometimes people get an illness where they fail to adapt appropriately to life stresses and
traumas. Their reaction may last very long and be very severe, leading them to withdraw
from friends and family, to lose their appetite, to lose interest in school and activities and
to cry a lot. Some people experience these feelings even if nothing negative has happened
in their life. Have you ever heard of this? Has anyone you’ve ever known experienced
this?
2. When you have difficult stresses in your life, who do you trust to talk to about them?
3. Would you ever go to a teacher to talk about your life stresses? Why or why not?
4. We all experience very difficult circumstances in life—such as the break-up of a
relationship, the death of a loved one, or failing an exam at school— that may make us
feel very sad or worried. What would be some good strategies to cope with these
stresses? What would be the signs of someone who is not able to cope and who may need
help?
5. Most people think that mentally ill people are all psychotic, and dangerous and violent.
But there are many kinds of mental illness where this is not true. What is your perception
of mental illness?
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6. Is there anything you would like to know more about with regard to mental health, and in
particular an illness called Depression?
RADIO LISTENING INFORMATION (requires input from Marvin)
This section will be used to gain insights about the types of radio programs youth would prefer,
including information about the type of mini-drama they would like to listen to, and the youth
issues they would like to hear more about.
1. What kinds of youth issues would you like to hear addressed on a youth radio program?
2. Who are your favourite male and female radio personalities
3. Would you want a youth radio program to include music? If Yes, what kind of
Music? Local or international. Which international artists would you want included
in the program? Which local artists would you want included? If no, can you take
out what you wouldn’t want to see in a youth program among the following:
discussion, drama, phone in, sms in?
4. If drama was to be included, what would be the best setting? School? Township?
Youth Club? Church Choir? Any other?
5. What broadcast time would be appropriate for you?
6. Who are your role models? Heroes?
7. What kind of thoughts dominates your mind on a daily basis?
8. What do you think of your relationship with your parents? Guardians? Teachers?
Fellow youth? Males? Females?
9. What do you think about religion and praying?
10. Are you interested in politics and how you are governed?
11. What makes you happy?
12. What makes you sad?
13. What do you think of alcohol? Chamba (Cannabis)? Sex? Material things? Money?
14. What do you think of love relationships among the youth?
15. Do you ever think about your future?
16. What do you find challenging in your day to day life?
17. I would like you to think of the most depressing event in your life and tell me about
it in youthful language. Language like but not limited to: Bobo, yina yake, umadziwa,
fanzi, mafana, masteni, pa deni.......... (This would have to be recorded by an audio
recorder)
18. Where do you get advice on your day to day challenges in life from?
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II. REPORTING
Reporting template:
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3.
4.
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6.
Research team, dates and locations
Objectives
Results from Documentation review
Results from Informant interviews including transcriptions
Results from focus group discussions including transcriptions
Results from mobenzi—report for MH Literacy and Audience Preferences
7. Conclusions