Worldwide, the majority of people who need mental health care do not have access to quality mental health services. The social stigma of mental illness, a lack of trained and qualified healthcare workers, and fragmented services all contribute to the treatment gap. Those who live in lower and middle-income countries are especially vulnerable. Up to 85% of people living with mental illnesses are without treatment, according to the World Health Organization.

In Rwanda, 93 percent of nearly 60,000 Community Health Workers (CHWs) completed four mental health training courses through tech social enterprise Viamo’s mobile platform, a Frontiers in Public Health study concluded August 24. 

Although Rwanda has seen impressive economic growth and is committed to mental healthcare, it still faces significant challenges in getting this care to the people who need it. 

The Rwandan Ministry of Health and Johnson & Johnson approached Viamo to address this gap via mobile training in 2018. The first point of contact in Rwanda for accessing healthcare are the Community Health Workers (CHWs). Ideally, all CHWs should be trained in mental healthcare, but rolling out conventional training to workers across the country was expensive and time-consuming.

“With the mobile phone platform, the Rwandan government has been able to educate almost 60,000 community healthcare workers in just a few months — compared to the approximately 25,000 workers they’d been able to train by traveling from village to village for several years.”

— Ginger Smith-Swintosky, Mental Health Global Program Leader, Global Public Health, Johnson & Johnson

Through their mobile phones, CHWs listened to a four week curriculum consisting of key messages and quizzes to better understand mental health symptoms, causes, and treatments. The course subjects included identifying mental health symptoms, learning the causes, and what treatment is available for common mental disorders, PTSD, depression, drug abuse, and epilepsy.

The initiative only required basic mobile phones with no need for internet access. Calls were kept short so that CHWs could easily fit them into their day. The comprehensive Viamo Remote Training program was only $2.50 per CHW. 

At program end, a survey of CHWs showed:

This partnership resulted in community health workers receiving vital training not only regardless of location but also at a vastly increased rate, allowing those who needed help to receive it more quickly. 

This allowed the Ministry of Health, Rwanda, to fulfill the aim stated in its National Community Health Strategic Plan 2013–2018 for CHWs to receive training on mental illness

“The effectiveness of the remote training was very positive as we noticed the improvement of community awareness on mental health issues,” commented The Ministry of Health. “It is obvious that the promotion of mental health for the Rwandan population will be improved.”

Viamo’s Remote Training product has since reached over 250,000 people in 10 countries in the last 12 months alone, with trainees having listened to over one million minutes of training. Read more from the published journal article. 

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