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Integrating Psychosocial Support for Children in the Education Sector in Zambia: Lessons from the Programme Implementation Process

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Abstract

Literature suggests that psychosocial support programmes can improve wellbeing and mental health among learners. There is however limited documentation on methodologies and factors that shape integration of such programmes within the education sector. This qualitative study aimed to contribute towards addressing this knowledge gap by analysing the implementation process of the Mainstreaming of Psychosocial Support in the Education Sector programme in Zambia. The study showed that the programme contributed to improved school culture and learning involvement. This transformation led to reduction in school dropout, as well as improved students’ wellbeing and performance. These positive results motivated Zambia and other countries to integrate psychosocial support into the education systems. Community engagement, outreach activities, group forums and partnerships were the key programme methodologies that facilitated the integration process. However, limited stakeholder involvement in developing the monitoring process complicated the integration process in the initial stages. In conclusion, effectively facilitating programme integration requires ensuring that the programme is credible, inclusive and has clear implementation guidelines.

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Availability of Data and Materials

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

DEBS:

District Education Board Secretaries

ERES:

Excellence in Research Ethics and Science

MPES:

Mainstreaming Psychosocial Support in the Education Sector

REPSSI:

Regional Psychosocial Support Initiative

SADC:

Technical Southern African Development Community

TAVETA:

Education, Vocational and Entrepreneurship Training Authority

References

  • Atun, R., De Jongh, T., Secci, F., Ohiri, K., & Adeyi, O. (2010). Integration of targeted health interventions into health systems: A conceptual framework for analysis. Health Policy Plan, 25(2), 104–111.

    Article  PubMed  Google Scholar 

  • Birdthistle, I. J., Floyd, S., Machingura, A., Mudziwapasi, N., Gregson, S., & Glynn, J. R. (October 2007). From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. Wolters Kluwer Heal., 2008(22), 759–766.

    Google Scholar 

  • Braun, V., Braun, C. V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Article  Google Scholar 

  • Central Statistical Office (CSO) [Zambia], Ministry of Health (MOH) [Zambia] and II. (2014). Zambia Demographic and Health Survey 2013–2014. Lusaka: CSO.

    Google Scholar 

  • Cluver, L., Boyes, M., Orkin, M., & Poverty, S. L. (2013b). AIDS and child health: Identifying highest-risk children in South Africa. South African Medical Journal, 103(12), 910–915.

    Article  PubMed  Google Scholar 

  • Cluver, L., Orkin, M., Boyes, M. E., Sherr, L., Makasi, D., & Nikelo, J. (2013a). Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model. Social Science & Medicine, 87, 185–193.

    Article  Google Scholar 

  • Collishaw, S., Gardner, F., Lawrence Aber, J., & Cluver, L. (2016). Predictors of mental health resilience in children who have been parentally bereaved by AIDS in Urban South Africa. The Journal of Abnormal Child Psychology, 44(4), 719–730.

    Article  PubMed  Google Scholar 

  • Devries, K. M., Child, J. C., Allen, E., Walakira, E., Parkes, J., & Naker, D. (2014). School violence, mental health, and educational performance in Uganda. Pediatrics [Internet], 133(1):e129–e137. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24298004

  • Ebersöhn, L., Loots, T., Eloff, I., & Ferreira, R. (2015). In-service teacher training to provide psychosocial support and care in high-risk and high-need schools: School-based intervention partnerships. Journal of Education for Teaching [Internet]., 41(3), 267–284. https://doi.org/10.1080/02607476.2015.1044226.

    Article  Google Scholar 

  • Eloff, I., Finestone, M., Makin, J. D., Boeving-Allen, A., Visser, M., & Ebersöhn, L, et al. (2014). A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa. AIDS [Internet], 28(Suppl 3):S347–S357. Retrieved from https://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4160802&tool=pmcentrez&rendertype=abstract

  • Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82(4), 581–629.

    Article  PubMed  Google Scholar 

  • Hong, Y., Li, X., Fang, X., Zhao, G., Lin, X., Zhang, J., et al. (2010). Perceived social support and psychosocial distress among children affected by AIDS in China. Community Mental Health Journal, 46(1), 33–43.

    Article  PubMed  Google Scholar 

  • Kaljee, L., Zhang, L., Langhaug, L., Munjile, K., Tembo, S., Menon, A., et al. (2016). A randomized control trial for the teachers diploma programme on psychosocial care support and protection in Zambian government primary school. Psychology, Health & Medicine, 22(4), 381–392.

    Article  Google Scholar 

  • King, E., De Silva, M., Stein, A., & Patel, V. (2009). Interventions for improving the psychosocial well-being of children affected by HIV and AIDS. Cochrane Database of Systematic Reviews, 2, 6733.

    Google Scholar 

  • Kirkpatrick, S. M., Rojjanasrirat, W., South, B. J., Sindt, J. A., & Williams, L. A. (2012). Assessment of emotional status of orphans and vulnerable children in Zambia. Journal of Nursing Scholarship, 44(2), 194–201.

    Article  PubMed  Google Scholar 

  • Kunnuji, M. O. N., & Esiet, A. (2015). Prevalence and correlates of sexual abuse among female out-of-school adolescents in Iwaya community, Lagos state, Nigeria. African Journal of Reproductive Health [Internet], 19(1) 82–90. Retrieved from https://www.ajrh.info/home/abstract.php?abstractTitle=Prevalence and Correlates of Sexual abuse among Female Out-of-School Adolescents in Iwaya Community, Lagos State, Nigeria&id=138

  • Kwan, S. Y. L., Peterson, P. E., Pine, C., & Borutta, A. (2005). Health promoting school: An opportunity for oral health promotion. Bulletin of the World Health Organisation, 83(9), 677–685.

    Google Scholar 

  • Lee-Rife, S., Malhotra, A., Warner, A., & Glinski, A. M. (2012). What works to prevent child marriage: A review of the evidence. Studies in Family Planning, 43(4), 287–303.

    Article  PubMed  Google Scholar 

  • Marston, M., Beguy, D., Kabiru, C., & Cleland, J. (2013). Predictors of sexual debut among young adolescents in Nairobi’s informal settlements. International Perspectives on Sexual and Reproductive Health, 39(1), 22–31.

    Article  PubMed  PubMed Central  Google Scholar 

  • Orkin, M., Boyes, M. E., Cluver, L. D., Zhang, Y. (2014). Pathways to poor educational outcomes for HIV/AIDS-affected youth in South Africa. AIDS Care [Internet], 26(3), 343–350. Retrieved https://www.ncbi.nlm.nih.gov/pubmed/23965029

  • Pascoe, S. J. S., Langhaug, L. F., Durawo, J., Woelk, G., Ferrand, R., Jaffar, S., et al. (2010). Increased risk of HIV-infection among school-attending orphans in rural Zimbabwe. AIDS Care., 22(2), 206–220.

    Article  CAS  PubMed  Google Scholar 

  • Pufall, E. L., Gregson, S., Eaton, J. W., Masoka, T., Mpandaguta, E., & Andersen, L. et al. (2014). The contribution of schools to supporting the well being of children affected by HIV in eastern Zimbabwe. AIDS [Internet], 28(Suppl 3):S379–S387. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24991911.

  • Rogers, E. M. (2004). A prospective and retrospective look at the diffusion model. Journal of Health Communications, 9(Suppl 1), 13–19.

    Article  Google Scholar 

  • Rowling, L. (2009). Strengthening “school” in school mental health promotion. Health Education [Internet], 109(4), 357–368. https://doi.org/10.1108/09654280910970929.

    Article  Google Scholar 

  • Scott, S. D., Plotnikoff, R. C., Karunamuni, N., Bize, R., & Rodgers, W. (2008). Factors influencing the adoption of an innovation: An examination of the uptake of the Canadian Heart Health Kit (HHK). Implementation Science, 3(41), 41.

    Article  PubMed  Google Scholar 

  • Skinner, D., Tsheko, N., Mtero-Munyati, S., Segwabe, M., Chibatamoto, P., Mfecane, S., et al. (2006). Towards a definition of orphaned and vulnerable children. AIDS and Behavior, 10(6), 619–626.

    Article  PubMed  Google Scholar 

  • Ssewamala, F. M., Karimli, L., Torsten, N., Wang, J. S. H., Han, C. K., Ilic, V., et al. (2016). Applying a family-level economic strengthening intervention to improve education and health-related outcomes of school-going AIDS-orphaned children: Lessons from a randomized experiment in Southern Uganda. Prevention Science, 17(1), 134–143.

    Article  PubMed  PubMed Central  Google Scholar 

  • Svanemyr, J., Amin, A., Robles, O. J., & Greene, M. E. (2015). Creating an enabling environment for adolescent sexual and reproductive health: A framework and promising approaches. Journal of Adolescent Health, 56(1 Suppl), S7–S14.

    Article  PubMed  Google Scholar 

  • Wang, B., Li, X., Barnett, D., Zhao, G., Zhao, J., & Stanton, B. (2012). Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: A structural equation modeling analysis. Social Science & Medicine, 74(9), 1435–1443.

    Article  Google Scholar 

  • Zulu, J. M., Hurtig, A.-K., Kinsman, J., & Michelo, C. (2015). Innovation in health service delivery: Integrating community health assistants into the health system at district level in Zambia. BMC Health Services Research, 15(1), 38.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zulu, J., Kinsman, J., Michelo, C., Hurtig, A.-K. (2014). Integrating national community-based health worker programmes into health systems: A systematic review identifying lessons learned from low-and middle-income countries. BMC Public Health [Internet], 14(1):987. Retrieved September 22, 2014, from https://www.biomedcentral.com/1471-2458/14/987.

  • Zulu, J. M., Kinsman, J., Michelo, C., & Hurtig, A.-K. (2014). Hope and despair: Community health assistants’ experiences of working in a rural district in Zambia. Human Resources for Health, 12(1), 30.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We are also grateful to the Ministry of Education for permitting and supporting the data collection process. We also appreciate the valuable insights that were provided by the respondents: teachers, community workers, lectures at Mongu and Chipata Colleges of Education, REPSSI Programme Coordinators at Chalimbana University and Mindolo Ecumenical Foundation, DEBS office, Principal Education Officer-Guidance at the Ministry of Education, Curriculum Specialist at TEVETA, the Head of Education at the William Pitcher Teacher Training college in Swaziland and the Deputy Director of NAMCOL (the Namibia College of Open and Distance learning).

Funding

The study programme was funded by COMIC Relief.

Author information

Authors and Affiliations

  1. School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia

    Joseph M. Zulu

  2. School of Education, University of Zambia, P.O. Box 32379, Lusaka, Zambia

    Ecloss Munsaka

  3. Regional Psychosocial Support Initiative, Regional Office, Randburg, South Africa

    Emeka Okonji, Carmel Gaillard & Lynette Mudekunye

  4. Regional Psychosocial Support Initiative, Lusaka, Zambia

    Kelvin Ngoma & Mukuka Mwamba

Authors
  1. Joseph M. Zulu
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  2. Ecloss Munsaka
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  3. Emeka Okonji
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  4. Carmel Gaillard
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  5. Kelvin Ngoma
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  6. Mukuka Mwamba
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  7. Lynette Mudekunye
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Contributions

All the authors contributed towards the study design. JMZ and EM collected the data and conducted the analysis and interpretation. JMZ draft the first draft of the article and all authors critically revised the paper and contributed towards the revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Joseph M. Zulu.

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Conflict of interest

The authors declare that there are no competing interests.

Ethical Approval

Ethical clearance was sought and granted by the Excellence in Research Ethics and Science (ERES). Informed consent and parental/ assent to participate in the study was obtained from study participants.

Informed Consent

Informed consent and assent for the publication were obtained from the participants.

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Zulu, J.M., Munsaka, E., Okonji, E. et al. Integrating Psychosocial Support for Children in the Education Sector in Zambia: Lessons from the Programme Implementation Process. Community Ment Health J 56, 1215–1224 (2020). https://doi.org/10.1007/s10597-020-00682-9

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  • DOI: https://doi.org/10.1007/s10597-020-00682-9

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