3 August 2017
In the rural Upper West Region of Ghana, levels of harmful alcohol use are on the rise. Alcohol dependency affects the young and the old, both men and women, and can drive families and generations into health decline and poverty. Specialist services available in Accra are not easily accessible to families who live far away in rural areas and whose family member dependent on alcohol has driven the family into economic hardship. Before the partnership, the only support provided in the area had been from one volunteer ex-nurse who ran a support group founded on the principles of Alcoholics Anonymous (AA).
The partnership between NHS Highland and the Ghana Health Service in the Upper West Region of Ghana aims to support local mental health and primary care health personnel by training them in techniques to support and encourage patients’ recovery from addiction. The partnership also hopes to reduce hazardous alcohol use in particular groups of people who make contact with the health service, particularly in pregnant women.
The partner teams have put together a training program for treatment of alcohol dependency. Training on acute alcohol detoxification and on theories of dependence, relapse, and high risk situations have been given to community psychiatric nurses (CPNs), midwives, nurses, and practitioners. In addition, there has been training in alcohol brief intervention (ABI) and ABI in ante-natal settings with a motivational interviewing (MI) approach.
Several local champions (various CPNs, nurses, midwives, users, nurse tutors, clinical officers) have been identified and have then received additional training. With these champions, the partnership has also been able to engage with the community through alcohol awareness events. For example, the team of volunteers were invited to talk to a large church congregation and to Sunday school children. Furthermore, champions deliver periodic health talks to the Out Patient Department on maintaining a minimal drinking habit, post educational posters in clinical areas, educate clients and families who have a link in their condition to alcoholism, and address questions asked from the public on a weekly radio talk show on mental health. These champions play an important role in the sustainability of the program by continuing the work once volunteers have left.
One UK team member highlights the self-confidence gained from working in Ghana:
Gaining a greater awareness of the challenges and the opportunities to apply training into practice. This facilitated personal development on returning to Scotland generating courage, confidence, self-belief and drive
A Ghana team member reflects on the knowledge gained through the training:
Training has imparted a lot professionally, taking that we have received a new level of education which hither to was not available to participants. Furthermore, individuals can now accurately calculate the unit of alcohol in the volume they take and help others reduce within 15-35% after performing Alcohol Brief Interventions
The programme has faced logistical challenges in communication and management of volunteers who have time-sensitive schedules. However, with effective planning, they have been able to ensure that at least two volunteer trainers are able to travel together at a time, for both safety and responsibility sharing. Additionally, many of the CPNs have travelled to the rural areas to work and do not know the indigenous language; therefore, it has become a priority to train volunteers who are well spoken in the language of the people.
Despite the challenges, the team is very optimistic about the great benefits to both the local community in the Upper West Region by improving and expanding these specific mental health services and support as well as to the NHS in Scotland, which has already requested the programme leaders to share their process of adapting ABI materials in a wider setting.