Abstract

Contextualization and adaptation of the child and adolescent mental and behavioural disorders module of the mhGAP-IG in Kilifi and Nairobi counties in Kenya

Mkubwa, B. Angwenyi, V. Pacione, L. Nzioka, B. John, M. Kibirige, N. Gichuki, J. Newton, C. R. Sijbrandij, M. Abubakar, A.
Glob Ment Health (Camb). 2025; 12e92

Permanent descriptor

https://doi.org/10.1017/gmh.2025.10049

The Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was developed by the World Health Organization as a key tool for delivering evidence-based mental healthcare in non-specialized settings. The mhGAP-IG requires contextualization and adaptation to ensure local relevance. However, evidence on adapting the Child and Adolescent Mental Disorders (CMH) module of the mhGAP-IG is limited. This study contextualized and adapted the 2016 mhGAP-IG CMH module through two workshops with local mental health experts and stakeholders, preceded by six in-depth interviews exploring the child and adolescent mental health contexts in Nairobi and Kilifi. Data were analysed in NVivo-Lumivero(c) software. Interviews with mental health stakeholders revealed significant challenges in both counties, including a shortage of mental health specialists, frequent medication stockouts, stigma and inadequate resources. Key adaptations to the module included using locally acceptable terms (e.g., replacing 'failure to thrive' with 'suboptimal growth'); expanding training to five days; adding the mhGAP-IG Essential Care and Practice module to address culturally sensitive communication in mental healthcare provision; streamlining referral pathways; and incorporating aspects of self-harm/suicide and substance use linked to the CMH module content. Contextualizing the CMH module is crucial for effective implementation, but sustaining impact will require addressing systemic barriers beyond capacity-building.