PRogramme for Improving Mental health carE (PRIME)

PRIME is a consortium of research institutions, NGOs (among others HealthNet TPO) and Ministries of Health in five countries in Asia and Africa (Ethiopia, India, Nepal, South Africa & Uganda), with partners in the UK and the World Health Organization (WHO). PRIME is supported by the UK government Department for International Development (DFID), and is a six year programme which was launched in May 2011.

PRIME is focusing on mental disorders which contribute to the greatest overall burden of disease. These are alcohol abuse, depression (including maternal depression), psychosis (notably schizophrenia) and epilepsy.

In the Inception phase (Year 1), we will develop an integrated mental health care plan comprising packages of mental health care for delivery in primary health care and maternal health care. In the Implementation phase (Years 2-4), we will evaluate the feasibility, acceptability and impact of the packages of care in primary health care and maternal health care. In the Scaling Up phase (Years 3-6), we will evaluate the scaling up of these packages of care at the level of administrative health units.

The outcomes we anticipate are:

• Increased acknowledgement and uptake of findings to influence policy and practice in the study countries, other low and middle income countries (LMIC) and by international development agencies and donors, to support scaling up of mental health care in LMIC;
• Improved mental health, social and economic outcomes for populations in the Administrative Health Units (AHUs) in which the PRIME research programme will be carried out;
• Sustainable research capacity in the institutions in the participating countries to develop, undertake, and disseminate the research to implement and scale up mental health services;
• Sustainable partnerships for future collaborations between the international partners and, in each country, between academic partners, Ministry of Health and non-governmental organizations (NGOs).

HealthNet TPO and TPO Nepal are responsible for the implementation of the program’s activities in Nepal. The inclusion of Nepal in the consortium is to pilot test the framework in 'fragile' state context. In Nepal, the core framework will be modified to adapt to the challenges that implementation within a fragile state implies, for example a weaker public health system and continuing insecurity. The added value of extending the PRIME methodology to Nepal is that it provides an opportunity to test and inform the approach within fragile states when compared to other LMIC settings.