StrongMinds

The development problem.

Depression is a critical development problem to solve. First, the negative impact of depression includes lower education and literacy levels, greater food insecurity, substantial economic insecurity with decreased income, lost productivity and absenteeism from work, and poorer health outcomes for women and their children. Second, depression is a problem world over. There are over 300 million cases of depression globally, of which at least 30 million are in Africa. Third, it is especially relevant for women. Depression is more common among females (5.1%) than males (3.6%). In Sub-Sahara Africa depression among women is 5.9%. African women suffering from depression are classified as both a vulnerable and disabled population by the World Health Organization (WHO). Despite one in four women suffering from depression, the services to treat these women is not in place; over 85% of these sufferers having no access to treatment, according to the WHO.

Finally, depression is consistently overlooked in the global development sphere. Receiving just 0.3% of all global development assistance for healthcare, mental illness is deprioritized by western funding sources as a second-order issue. This view further stigmatizes those who suffer from depression and fails to acknowledge the multiple negative effects depression has on all aspects of a woman’s life. Because of how debilitating depression can be, sufferers are less likely to respond to outreach and services offered by international non-governmental organizations (INGOs) and governments, such as livelihood training or outreach promoting safe sex.

The innovation.

StrongMinds’ has modified IPT-G (group interpersonal therapy) with role-playing activities, interactive charts and visual aids, adapted to the cultures and literacy levels of their participants. Each talk therapy group lasts 12 weeks, with 12-15 women coming together each week for approximately 90 minutes. StrongMinds runs facilitator-led sessions (STG), peer-led sessions (PTG), which according to StrongMinds’ own data, have average healing rates of 75%, and 65% respectively.

GIF's investment.

StrongMinds will use GIF investment to:
- Refine the StrongMind's low-intensity, democratized, replicable and scalable IPT-G model, and test its effectiveness in healing depression and reducing depression rates and improving well-being metrics.
- Set up StrongMinds for a successful scale up by refining the toolkit to support partners implement its program through the social franchising model and gain traction with the government to scale with them in the future.
- Deepen understanding of relationship between mental health and gender equality.

Investment objective(s).

Refine StrongMind’s low-intensity, replicable and scalable IPT-G (interpersonal group therapy) model, and continue testing its effectiveness in healing depression and reducing depression rates and improving well-being metrics by conducting two pilots with iNGOs and/or MoH in Uganda, Zambia with different levels of engagement. Create the toolkits for replication of the IPT-G model and build a strong pipeline for partnerships with iNGOs and MoH in Uganda, Zambia. Capture learnings related to each model to determine the model for scale, and define a clear path to scale with one or more partners to scale to 20,000or more women by 2023.

Why we invested

Depression is a barrier for women: It affects women more than men, especially after puberty (Weller et al., 2006) and prevents them from accessing and retaining economic opportunities and therefore is a serious constraint on their agency.
StrongMinds’ model is evidence-based, and more importantly, scalable: This evidence-based model is in line with WHO guidance and based on an RCT done in 2002 on a similar intervention in rural Uganda. This is a relatively low-intensity operational model compared to current approaches of providing mental health care through mental health professionals, which is often scarcely available and when available, is inaccessible to the poor. This intervention is designed to help poor depressed women in Africa (with less than $2 per day to spend on their families).
High additionality of funding for a neglected development problem: One, there is now a lack of funding for evidence generation on accessible delivery models on mental health interventions focusing on women. GIF can provide potentially catalytic funding for mental health treatment of women in developing country contexts as there is limited funding for mental health issues around the world (less than $130M a year). Second, in addition to the funding, GIF can play an important role in helping StrongMinds build the right model for scale, and connect StrongMinds to gender equality thought partners. Third, GIF also envisions part of this grant to be used for gender lens capacity building within the StrongMinds team.
Learning agenda for intersectionality of mental health and gender equality: This investment will help StrongMinds apply a gender lens to their work and improve programming and partnership and generate evidence which will contribute to the wider development ecosystem. This investment will be an opportunity for GIF to learn from and improve how it internalizes gender in its work.

Click here to read StrongMinds’ Impact Brief.

Apply for funding