Appendix 1


Methodology and acknowledgements

Interviews were undertaken with people with mental health issues, their family members, representatives of local communities and local authorities, traditional healers, representatives of traditional healers’ associations, mental healthcare staff, and representatives of various governmental ministries.

MDAC and MHUNZA researchers carried out 57 semi-structured interviews that usually lasted one hour. These were recorded, transcribed and typically sent to the interviewee for amendment and approval. All interviewees were assured of anonymity to promote frank reporting. Out of the 57 interviews, 20 were conducted with people with mental health issues (half were female, half male). Another ten were carried out with their family members, and again there was a gender balance.183 Five family members interviewed were spouses, three were parents, and two were extended family members. Three interviews were conducted with refugees. Interviews with people with mental health issues and their families were selected on the basis of a wide geographic and ethnic spread.184 In addition, over 50 unstructured interviews were conducted in January and February 2014 with people with particular experiences and an interest in discussing their experiences with traditional healers and psychiatric services.

Meetings were conducted with:

  1. Representatives of disabled people’s organisations, including people with mental health issues and from the Zambia Federation of Disability Organizations (ZAFOD).
  2. Representatives of the relevant government ministries (the Health Promotion Focal Point Person for Traditional Healers and the Chief Mental Health Officer, at the Ministry of Health; Chief Cultural Affairs Officer at the Ministry of Chiefs and Traditional Affairs - now under the Ministry of Tourism; the Head of Human Rights and International Treaties Section at the Ministry of Justice; two Access to Justice Programme Specialists at the Ministry of Justice, the Prison Secretary at the Ministry of Home Affairs, two Senior Social Welfare Officers and the Focal Point Person for Mental Health at the Ministry of Community Development, Mother and the Child, and the Administration Secretary at the Ministry of Local Government).
  3. Representatives of other relevant state agencies: the Executive Director and the Information Officer of the Zambian Agency for Persons with Disabilities, the Executive Director of the Zambia Institute of Natural Medicine and Research and the Executive Director of the Legal Aid Board.
  4. Representatives of regulatory bodies, including the Director General and an Inspector of the Pharmaceutical Regulatory Body, now called Zambia Medicines Regulatory Authority.
  5. Representatives of traditional healing associations (two representatives of the Traditional Health Practitioners’ Association of Zambia) and two traditional healers.
  6. Mental health professionals including two psychiatrists, the Head of Clinical Care and a Consultant Psychiatrist at Chainama Hills Hospital.
  7. Human rights professionals, including the former Director, the current Chairperson, a Legal Officer and an Information Officer at the Human Rights Commission.
  8. Representatives of local community organisations, including three representatives of the Ward Development Committee.
  9. Representatives of other NGOs, including the Executive Director of the Non-Governmental Organisations Co-ordinating Council, the Executive Director of the Legal Resource Foundation, the Executive Director of the Paralegal Alliance Network, and the Executive Director of the Prisons Care and Counselling Association.
  10. Representatives of faith communities, including the President and Senior Pastor of the Life of Christ Church.
  11. Representatives of the international organisations such as the Health Information Promotion Officer, and the Traditional Medicine Focal Person at the World Health Organization office in Zambia.

Permission to visit psychiatric facilities was sought and granted by the Permanent Secretary of the Ministry of Health. Five facilities were visited in five provinces: Central, Copperbelt, Eastern, Southern and Lusaka.185 Monitors visited Chainama Hills Hospital which is the only tertiary care psychiatric hospital in the country. The “Nsadzu mental health settlement centre” was also visited.186

Traditional healing facilities providing services to people with mental health issues were identified based on interviews. Monitors visited five traditional healing centres, including a faith healer’s centre.187 None had anyone staying there who had mental health issues, reflecting the tendency for treatments to be given on an outpatient basis.

Visits to psychiatric facilities and traditional healers were guided by a checklist developed by MDAC and adapted from a toolkit for monitoring human rights in mental health and social care institutions.188 Information was gathered through observation and unstructured interviews with patients, staff and visiting family members. Literature searches were carried out to find available reports on the facilities. Data was analysed using manual analysis methods for qualitative data. Interview guides, checklists, protocols and consent forms are available from MDAC upon request.

In-country research was coordinated by Eyong Mbuen (MDAC Project Manager) and included Paul Chungu (Mental Health Association of Zambia), Sylvester Katontoka (MHUNZA National Coordinator) and Hannah Roberts (independent mental health writer and MDAC Consultant). Om Shanti (MDAC intern) did desk research on traditional healing literature. Reima Ana Maglajlić (former MDAC Research and Monitoring Director) provided input into previous drafts of the report. Eyong Mbuen and Hannah Roberts wrote the final report, which was edited by Steven Allen (MDAC Advocacy and Communications Director) and Oliver Lewis (MDAC Executive Director).

Ádám Szklenár (MDAC Digital Media and Communications Assistant) provided assistance in the design and production of the report.

183 The age range of interviewees with mental health issues was 18 to 67, with the average age being 41. The age range for interviewees who were family members of people with mental health issues was 37 to 86.

184 Five interviews were conducted in Lusaka (Lusaka Province), four in Kitwe (Copperbelt Province), and six in Chipata (Eastern Province). In total, interviews were conducted at six sites, three of which were rural (Chipata, Solwezi/Meheba Refugee Camp and Chongwe) and three were urban (Lusaka, Kitwe and Livingstone). Interviews were conducted with native Bemba, English and Nyanja speakers.

185 Chainama Hills Hospital, Lusaka (the only tertiary care referral hospital in the country); Chipata Psychiatric Unit, Chipata General Hospital, Eastern Province; Ndola Psychiatric Unit, Ndola General Hospital, Copperbelt Province; Kabwe Psychiatric Unit, Kabwe General Hospital, Central Province; and Livingstone Psychiatric Unit, Livingstone General Hospital, Southern Province.

186 Nsadzu mental health settlement centre, Chadiza District, Eastern Province (the only functioning of the three officially listed mental health rehabilitation centres in the country).

187 Traditional healer Lagabisolomi, commonly known as Kwa Mbomba compound located in Kitwe. The healer specialised in providing in-patient treatment to people with psycho-social disabilities, but stopped in 2009 due to ill-health. Traditional healer Jeremiah Arunk, Chizanga Township, Lusaka Province. Traditional healer Mizyu, located at Kayama Township in Lusaka Province. Traditional healer Maut, in N’yombe, Garden Township in Lusaka Province Spiritual healer George Kagoda, Paradise Spiritual Church in Mumbwa district, Central Province.

188 The Institutional Treatment, Human Rights and Care Assessment (ITHACA Project Group, ITHACA Toolkit for Monitoring Human Rights and General Healthcare in Mental Health and Social Care Institutions, (Health Service and Population Research Department, Institute for Psychiatry, King’s College London, London: 2010), available online at

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