Table 2 Theory of Change log frame

1a.Early Identification

Strengthen the identification and screening of CAMH conditions

Develop CAMH tools (adapt CMED for children) and equip teachers and learner support agents (LSAs) with the skills and knowledge required to use the screening tool

(a) Train teachers and learner support agents on CAMH identification and use of screening tool

(b) Distribute screening tools and guidelines

(a) Equipped teachers and LSAs

(b) Functional tools and guidelines

(a) The number of schools covered

(b) Number of teachers and LSAs trained

(c) Number of tools and guidelines distributed

(a) completed training registers

(b) signed sheets for tools and guidelines received

Teachers and LSAs are equipped to identify CAMH conditions and screen within the school environment

Improved CAMH screening within the school environment

Interviews with principals, teachers, and LSAs

Equip the school health team with the skills and knowledge required to use the screening tool

(a) Train school health team on CAMH identification and use of screening tool

(b) Distribute screening tools and guidelines

(a) Equipped school health team

(b) Functional tools and guidelines

(a) Number of trained school health nurses

(b) Number of tools and guidelines distributed

(a) Completed training registers

(b) Signed sheets for tools and guidelines received

School health team are equipped to identify CAMH conditions and screen within the school environment

Improved CAMH screening within the school environment

Interviews with the school health team

Improve CAMH knowledge and screening practice among PHC workers. Equip (nurses, lay counselors, WBOTs) with the skills required to use the screening tool

(a) Train PHC workers on CAMH identification and use of screening tool

(b) Develop and distribute screening tools and guidelines

(a) Equipped PHC workers

(b) Functional tools and guidelines

(a) Number of trained PHC workers

(b) Number of tools and guidelines distributed

(a) Completed training registers

(b) Signed sheets for tools and guidelines received

PHC workers are equipped to identify CAMH conditions and screen at the PHC clinics and within the community

Improved CAMH screening and management at the community and PHC level

Interviews with PHC operational managers

1b

Routine community awareness and CAMH promotion

Intensify CAMH awareness and mental health promotion to improve CAMH literacy within the community

(a) Train community CAMH volunteers and NPOs to conduct routine awareness/campaign programs within the community

(b) Develop awareness materials

(c) Map out a strategic plan for a routine awareness program

(d) Employ the use of social media platforms to disseminate CAMH information

(e) Partner with media houses such as radio stations to disseminate CAMH information

(a) Equipped CAMH volunteers

(b) Access to campaign materials

(c) Functional strategic plan for a routine awareness program

(d) Active use of social media platforms to disseminate CAMH information

(e) partnership with media houses such as radio stations to disseminate CAMH information

(a) Number of days dedicated to CAMH door-door community awareness

(b) Number of campaigns materials distributed

(c) Number of strategic plan documents distributed

(d) Number of social media platforms developed to disseminate CAMH information

(e) Number of sponsored programs through the partnership

(a) Completed activity log

(b) Signed sheets for campaign materials received

(c) Signed sheets for strategic plan received

(d)Visibility of social media platforms

(e) Number of aired CAMH programs

(a) CAMH volunteers are equipped to conduct routine awareness/campaign programs within the community

(b) Awareness materials are adequately disseminated

(c) Compliance with the strategic plan for a routine awareness program

(d) Consistent update on the CAMH social media platforms

(e) Consistent airing of CAMH programs

(a) Efficient CAMH awareness/campaign programs within the community

(b) Improved CAMH awareness materials

(c) Revised strategic plan for routine

(d) Rebranded CAMH social media platforms

(e) Increased number or airing time for CAMH programs

District mental health coordinator

2. Appropriate referral

Adequately define referral pathways

Design a functional district CAMH referral system (consolidate the referral policies from all sectors DSD, DOH, DBE)

(a) Design a referral guideline involving all the sectors and other possible identification sites

A well-defined referral system

Number of distributed referral guidelines

Schools’, PHC and hospital referral registers

CAMH conditions are appropriately referred to the site of care

Improved referral system

DMHC

Adequately communicate and educate all stakeholders about the referral system

Train stakeholders from all sectors on the appropriate referral pathways

Stakeholders are adequately informed about the appropriate referral pathways

Number and categories of stakeholders trained

Completed training registers

Stakeholders are adequately equipped to refer CAMH cases appropriately

Improved referral system

DMHC

3.CAMH care package

(a) Design a CAMH care package

(1) Empower all care providers through training

(2) Empower parents & families through education and support visits

(3) Clearly define the CAMH care package for each condition

(4) Improve treatment initiation process at the PHC level

Educate all care providers about the CAMH care packages

A well-designed CAMH care package

Number of care providers trained

Completed training registers

Stakeholders are adequately informed about the CAMH care packages

A well-designed CAMH care package

DMHC

(b) Socio-economic support

(1)Create a support group for caregivers

(2)Create a support group for adolescents living with CAMH conditions

(3)Facilitate child support grant

(4)Family Strengthening interventions

(1)Provide resources to facilitate the development of a support group for caregivers

(2)provide resources to facilitate the development of a support group for adolescents living with CAMH conditions

(3)develop a system to facilitate the disbursement of child support grant

(4)Design family strengthening interventions

(1) A functional caregivers support group

(2)A functional adolescent support group

(3)A functional system of child support grant disbursement

(4)Ongoing implementation of family strengthening interventions

(1) Number of support groups developed for caregivers

(2)Number of support groups developed for adolescents

(3)Number of child support grant disbursed

(4)Number of functional interventions implemented

(1)Support group meeting attendance register

(2)Support group meeting attendance register

(3)Evidence of grant disbursed by DSD

(4)Evaluation of the interventions

(1)Adequate and consistent support group meetings

(2) Adequate and consistent support group meetings

(3)Increased number of children on the disability grant

(4)Adequately implemented interventions

(1)Strengthened support group

(2) Strengthened support group

(3)Improved system of grant disbursement

(4)Improved interventions

Caregiver/ DSD/DoH

4a. Role clarification

Strengthen CAMH management system

(a) Clearly define the roles of different stakeholders from the different sectors

(b) Design interventions to expand CAMH workforce through training, task-shifting/sharing, and supervision

(a) Organize intersectoral role clarification training for all stakeholders

(b) Facilitate a task-sharing and supervision system between specialists and non-specialists (psychologists—Lay counselors, LSAs, school counselors, psychiatrist—medical officers and CAMH trained psychiatric nurses—psychiatric nurses, school health nurses)

(a) Stakeholders’ roles are adequately defined

(b) A well developed and functional system of task-sharing and supervision

(a) Number and categories of stakeholders trained

(b) Number of specialists and non-specialists enrolled in the system

(a) Completed training registers

(b) Number of documented task-sharing/supervision activities

a) Stakeholders are adequately informed about their roles

b) Adequate implementation of a task-sharing and supervision system

a) Clearly defined roles

b) Improved supervision and task sharing system

DMHC

4b. Intersectoral governance

Intersectoral collaboration to achieve joint budgeting, design strategic plans, and collaborative services and stewardship

A coordinated system of collaboration

Creation of a CAMH team with representatives from DoH, DSD, DBE and other sectors

A functional intersectoral CAMH board

Number of departments represented in the board

Board meeting register and activity log

Increased number of CAMH intersectoral joint activities

Strengthened CAMH intersectoral activities

DOH, DSD, DBE