Mobile-based blended learning for capacity building of health providers in rural Afghanistan.

BACKGROUND: Mobile-based blended learning initiative was launched in November 2014 in Badakshan province of Afghanistan by Tech4Life Enterprises, Aga Khan Health Service, Afghanistan (AKHS, A), and the University of Calgary, Canada. The goal of this initiative was to improve knowledge of health providers related to four major mental health problems, namely depression, psychosis, post-traumatic stress disorder (PTSD) and drug abuse. METHODS: This paper presents the results of quasi-experimental study conducted in 4 intervention districts in Badakshan for improvement in the knowledge among health providers about depression. The results were compared with three control districts for the change in knowledge scores. RESULTS: Sixty-two health providers completed pre and post module questionnaires from case district, while 31 health providers did so from the control sites. Significant change was noticed in the case districts, where overall knowledge scores changed from 45% in pre-intervention test to 63% in post-intervention test. Overall background knowledge of pre to post module test scores changed from 30% to 40%, knowledge of symptoms showed correct responses raised from 25% to 44%, knowledge related to causes of depression from overall districts showed change from 22% to 51%, and treatment knowledge of depression improved from 29% to 35%. Average gain in scores among cases was 16.06, compared to 6.8 in controls. CONCLUSIONS: The study confirms that a blended Learning approach with multiple learning techniques for health providers in Badakshan, Afghanistan, enhanced their knowledge and offers an effective solution to overcome challenges in continuing education. Further research is needed to confirm that the gains in knowledge reported here translate into better practice and improved mental health.

Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care.

Improving Mental Health Care for Young Adults in Badakshan Province of Afghanistan Using eHealth.

Decades of war, social problems and poverty, have led large number of Afghan youth aged between 18-25 years suffering from mental health problems. Other important contributing factors include extreme poverty, insecurity, and violence and gender disparities, contributing to worsening mental and emotional health conditions in the country. The reported project is designed to strengthen the health system for improving mental health services in the province of Badakshan by improving awareness in the community and empowering frontline health workers. The project uses technological innovations, in combination with traditional approaches, to reduce stigma, enhance capacity of health providers and improve access to the specialist. The project also focuses on skills development of health providers, and empowering them to provide quality mental health services through access to interactive protocols, Management Information system and telemedicine.