Contemporary power and decolonisation discourses reflect how Eurocentric and Western analysis has shaped our understandings of the world. Decolonisation efforts within Global Health and feminist studies (including what counts as valid forms of women's organising) also requires a reclaiming of praxis developed within historically oppressed countries lost through erasures of knowledgeproduction. Our work contributes to these efforts through an analysis of a form of collective activism for women's health and development in Zimbabwe: the Nhanga. This traditional cultural practice is anchored to intergenerational women only 'safe spaces', a praxis pre-dating second wave feminist theorising on such ideas. Currently, Nhangas are used by the Rozaria Memorial Trust across community, national and global advocacy spaces to promote women's health. Using collaborative autoethnography, each author's personal accounts of engagement in the Nhanga interrogate the processes that promote change in women's lives. Our analysis suggests that the Nhanga fractures systemic, institutional and relational power through leveraging culture, emotions and narrative, in spaces where such dynamics are often overlooked. We conclude that the method offers a valuable form of collective organising: fully engaging with the complex relational, political, social and cultural environments that impact on health, through a quiet activism anchored to emotion, connection and reimagining of culture to promote change at individual, community and global levels.
IntroductionThe launch of the Movement for Global Mental Health brought long-standing calls for improved mental health interventions in low-and middle-income countries (LMICs) to centre stage. Within the movement, the participation of communities and people with lived experience of mental health problems is argued as essential to successful interventions. However, there remains a lack of conceptual clarity around ‘participation’ in mental health interventions with the specific elements of participation rarely articulated. Our review responds to this gap by exploring how ‘participation’ is applied, what it means and what key mechanisms contribute to change in participatory interventions for mental health in LMICs.Methods and analysisA realist review methodology will be used to identify the different contexts that trigger mechanisms of change, and the resulting outcomes related to the development and implementation of participatory mental health interventions, that is: what makes participation work in mental health interventions in LMICs and why? We augment our search with primary data collection in communities who are the targets of global mental health initiatives to inform the production of a programme theory on participation for mental health in LMICs.Ethics and disseminationEthical approval for focus group discussions (FGDs) was obtained in each country involved. FGDs will be conducted in line with WHO safety guidance during the COVID-19 crisis. The full review will be published in an academic journal, with further papers providing an in-depth analysis on community perspectives on participation in mental health. The project findings will also be shared on a website, in webinars and an online workshop.
Despite its inclusion in Sustainable Development Goal 5 (SDG5) to end all harmful gendered practices by 2030, child, early and forced marriage continues to be a pervasive problem globally. While there is consistent evidence on the physical health consequences of child marriage, there is a lack of evidence and inquiry into the mental health consequence. Method: We completed a change-oriented Delphi study to establish consensus on priority areas of research and intervention in relation to the mental health consequences of child, early and forced marriage. Invited experts (n = 11), survivors (n = 27), and professionals (n = 30) participated in our Delphi. Four rounds of data collection included: a blended in-person and online workshops with invited experts, an online mixed-methods questionnaire, focus groups in Zimbabwe with women who are survivors of child marriage and a repeat questionnaire sent to the first round of experts . Quantitative data was analysed using descriptive statistics and ranking methods, consistent with other Delphi studies. Qualitative data was analysed using thematic network analysis. Findings coalesced around three areas: perspectives on the relationship between mental health and child marriage, policy action; and treatment driven solutions. Consensus was reached on 16 items across these areas which included the need to prioritise psychosocial and social interventions to improve mental health outcomes for women and girls in existing marriages. They also called for new approaches to advocacy to drive awareness of this issue in policy circles. Implications for future practice are discussed.
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