LOGICAL FRAMEWORK FOR THE PROJECT

Sources and means of verification

Objectively verifiable indicators SUBMITTED UPDATED

Intervention logic of achievement

Local authorities, medical and

social professionals promote News of conferences, training, News of conferences, training,
mental health care in Greater seminars on this subject seminars on this subject
Cairo

Stigma attitudes around mental Local press articles, NGOs Local press articles, NGOs
health are reduced reports reports; MdM supervision
visits;eveluation forms in the
project training; reports from
staff support groups with
Improvement of access to mental Banaty and Basmat Amal
Overall objective health services among most at risk
populations in Greater Cairo

Community, medical and social Local press articles, NGOs Local press articles, NGOs
professionals play a very active reports, national councils reports, national councils
role in rehabilitating at risk activities reports activities reports
populations.

SPECIFIC OBJECTIVES
Mental health care services are Health centres registries Health centres registries; MoH
available and efficient in 7 PHC monthly reports; PHCs
centres after 2 years of project; casemanagement books ;
Mental Health services are available
Objective one training evaluations and
and effective in 7 PHC centers in Cairo
attendance list

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 Laws, or policies or methods National, local press
regarding mental health care
access have been agreed upon,
or adapted, or reinforced, at the
Capacities of the civil society to work end of the second year.
Objective two
with vulnerable population are improved

At risk populations are well Interviewes with patients; NGOs Interviewes with psychosocial
integrated in the community and reports; Observations staff (revised monthly
supported by families network, monitoring form in 2016); NGOs
civil society organizations, and reports; Observations
community actors at the end of the
second year.

Effective and sustainable resources are

Objective three allocated to implement efficient Mental
Health policies

RESULTS

One contact list for referral system Word or excel document

is present and accessible to all regularly updated every six
month

Participation of PHC and mental Attendance sheets; Reports of Attendance sheets; Reports of
hospitals staff coordination the meetings the meetings
meetings/visits per year: 6
sessions per year.

Result 1 : The system is organized to

introduce mental health services inside One Mental Health folder is Hard and soft copy of the MH Registers, psychiatric
the 7 PHC centres. integrated in the Family health mental health folder sheet, referral sheets
folder of 7 PHC centres. End of
First year

Mental health consultations in 7 PHC registry reports; monthly PHC registry reports; monthly
PHC centres are regularly reports reports
provided: 70
Results
consultations/month
(objective1)

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 Results
(objective1)
Number of PHC medical staff who On-the-job training reports; PHC monitoring form, on-the-
provide mental health care written test twice a year job training reports; written quiz
according to training material and
updated MH guidelines. 15
medical staff per year

Number of PHC social staff who On-the-job training reports; PHC monitoring form, on-the-
Result 2: Health professionals, Health provide mental health care written test twice a year job training reports; written quiz
workers, Social workers, and according to training material and
community visitors of 7 HCC in Cairo updated MH guidelines. 15 social
improved their skills and knowledge on staff per year
mental health and apply it

Number of PHC social staff who ToT attendance sheet; training ToT attendance sheet; training
provide training sessions to other sessions reports sessions reports
staff, according to training material
and updated MH guidelines. 15
social staff at the end of the
second year

NGOs staff provides mental health On-the-job training reports; monthly supervision visits
support to vulnerable populations written test twice a year reports; NGOs monthly
according to material training reports; ; training evaluations;
provided. 20 social workers per IEC activities reports
year
Result 1: Capacities of local NGOs to
respond to mental disorders are
strengthened Health education sessions in 7 PHC reports; IEC officer reports PHC monthly supervision visits
PHC centres are regularly held reports; training evaluations;
every two months, 70 persons IEC activities reports; IEC flyers
attending every two months

A Family Network exists, between Meetings reports; Family support group reports
10 and 20 members

Organization of Anti-stigma Registration of radio Registration of radio

community activities, 2 radio programmes; reports and programmes; reports and
Results (Objective programmes and 2 theatre record of tehatre actvities record of tehatre actvities
2) workshops and 1 final theatre
performance in two years

Result2: Vulnerable people suffering of

mental distress are supported by the
communties and the health system in Participation in discussion groups NGOs reports; activities reports NGOs reports; activities reports
Cairo in NGOs: 40 participants/month

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 mental distress are supported by the
communties and the health system in
Cairo

Awareness sessions on right to sessions reports; plus Awareness material

mental health care are organized, attendance sheet
4 sessions, 30
participants/session
One anthropological research on Soft copy of the research Social Research Report
communtiy patterns in health
access
Result 1: An action plan is developed Community mental health services Local press articles; reports
for advocacy and decentralization thematic
conferences, are organized, three
conferences during the project
Mental health cases are recorded Health care centres registers Health care centres registers,
within the PHC data collection psychiatric sheet, referral
system sheets
Result 2: Reinforcement of the existing
Results (Objective
data collection system
3)
Four advocacy workshops have Meetings and advocacy Meetings and advocacy
been organized; an action plan initiatives reports; documents of initiatives reports; documents of
developed policies or agreements; press policies or agreements; press
articles articles
Result 3: Promotion of a deeper
integration of community mental health
care in the health system
SOURCES OF INFORMATION
ACTIVITIES MEANS
Result 1

Objective 1 Activity 1: Organization of a referral logistics; personnel; facilities and Progress: monthly reports;
system supplies attendance sheets; presence of
the contact list update/6 months

Activity 2: Introduction of Mental Health logistics; personnel; facilities and Progress: presence of the MH
as part of Family Health model in HCC supplies folder; register of consultations
Activity 3 Equipment of rooms and/or logisics, admin and support team in PHC. reports and photos;
progress:
renovation of existing consultations
rooms in PHC centers.

Result 2

Activity 1: Training of Health technical personnell; supplies; Progress: Training content

Professionals of 7 PHC centers on facilities material; follow-up plan report;
Mental Health diseases, psychotherapy attendance sheets.
techniques and psychiatric drugs
Activity 2: therapeutic
(including Training of Social workers
education) technical personnell; supplies; Progress: Training content
and Health visitors on social aspects of facilities; training; transportations material; follow-up plan report;
psychiatric diseases (screening, attendance sheets.
awareness, follow-up of patients,
communication skills, therapeutic
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 Activity 3: Participation in updating and supplies, logistic personnell; Progress: presence and report
distributing the existing Mental Health about the medical guidelines
guidelines udpatred and disseminated.
Costs:

Result 1

Objective 2
Activity 1: Training for the staff of the training; technical and supportive Progress: Training content
partner NGOs on mental health staff; supplies; material; follow-up plan report;
disorders,
Activity counseling; referral
2: Coordination system;
meetings with logistic personnell; facilities attendancemonthly
Progress: sheets.reports;
Costs:
in providing
the awareness
PHC center’s team, sessions
and MH on MH attendane sheets
to the community leaders; training in
hospitals.
animating focus groups
Activity 3: Participation in Health technical and supportive Progress: reports of the
Education sessions and in the social personnell; facilities; sessions; participants
activities of the PHC centers. attednance sheets
Result 2
Activity 1: Creation or strengthening of facilities; supplies Progress: monthly reports;
a network of patients families. attendane sheets

Activity 2: Awareness of the external consultants; personnell; Progress: Record of the

communities on Mental Health distress logistics; facilities; supplies initiatives, in articles, and in
and solutions (NGOs, community and monthly reports
Activity technical personnell; supplies;
religious3:leaders,
Discussion groups
schools, for the
youth clubs) Progress: Reports and
patients in PHC centers and NGOs. attendance sheets
through radio programs and/or theater
activities and/or seminars
Activity 4: Production and distribution of publication costs; support Progress: hard and soft copy of
information documents. personnell; supplies; translation the document
costs
Activity 5: Awareness sessions (for facilities; supplies;personnell Progress: Reports and
mental health hospitals staff, PHC attendance sheets
centre staff, NGOs, community leaders,
families and patients) on the rights to
health care access.
Activity 6: Social research on the
obstacles of mental health care access

Result 1
Objective 3 Activity 1: Definition of an advocacy conferences costs, services; per Progress: reports of
plan diems, technical and support conference, press articles
personnell; supplies

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 Result 2

Activity 3.2: Data collection about technical personnell; Progress: register in PHC and
mental health in Primary Health Care monthly reports
centers, integrated in the existing data
collection system.
Result 3
Activity 3.3: Advocacy actions technical personnell; logistics; Progress: reports of workshops
facilities, supplies and action plan

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LOGICAL FRAMEWORK FOR THE PROJECT

Sources and means of verification

Assumptions
OBSERVATIONS (2016)

3 conferences took place on the theme of mental health in 2015 in Egypt; a peer to peer
supersion group was formed; most of international actors are still working on mental health for
refugees, while few international actors (MdM, Italian cooperation in Beheira) are working on
mental health for general population. Apart, from our project, the GSMH is working with
WHO to improve community referral to secondary and tertiary, few information are available
and coordination between GSMH and MoH primary health actors is proving difficult

Radio podcasts on Egyptian radio about protection of mh patients (MoH) ; mental health
expecially addictions became a subject of TV shows; a documentary about Abbasseya mh
hospital ( message: addiction can be part of human experience; moving from criminal image
of addiction to a behaviour linked to environmental factors and coping mechanisms) has been
released in 2016 and the next Ramdan series will be set in Abbasseya;
The reports from the NGOs in the project confirms that a significant change occurred in the
attitude of psychosocial workers (expecially with regard to the attitude towards other staff
dealing with target groups). Reporting on suicide in the press has increased; several articles
have been published about mental health and its relation with the political environemt
however these can mainly be found mainly in Egyptian press in English (Mada Masr, Daily
News). In the mainstream press in Arabic still lot of emphasis is given to the dangerousness
stigma attached to mental health. Misconception about mental health linked to spiritual/
religious dimension is still present in the community and in some press

Basmal Amal, El Shehab and Banaty partners NGOs, f are now applying CBT therapy on their
clients and manage cases more sistematically. Cewla s shortcoming are mainly linked to the
discontinuity of psycosocial staff. Regarding other actors, children in street situations remain
the category where the biggest efforts to provide MHPSS is carried out. EU funded a project
on street children and other donors like Drosos foundation have allocated funds to street
children, adults with HIV and women victims of violence. a However, the majority of
international funds for most at risk populations goes to refugees projects.

SPECIFIC OBJECTIVES
The project trained 118 PHCs staff (FATMA please add number of ow mnay doctors, nurses Conditions: all the staff has received new
etc) in 9 PHC Centers. The training was completed in January 2016 and the service is being skills and knwoledge; the local authorities
organized in February-March 2016. The monthly reports of MoH focal points confirm that will to follow-up and supervise the actities
before the training there were 0 mh consultations provided in the target PHCs. In eac of the 9 in the centres; Risks: huge changes in the
PHC there is one assigned staff for CBT and one assigned staff as Casemanager. MoHP affect the support and follow-up of
the activities; social and political instability
that threatens security.

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 As far as methods are concerned: 3 partner ngos (Basmat Amal, El Shehab and Banaty) Conditions: availability of strong and
choose cognitive behavioural therapy for their protocols. Following the projects IEC trainings, efficient communication strategy among
all of them have organized antistigma activities for their target group (FATMA: from the local authorities, professionals, families
beginning of the project how many IEC, you can take it directly from NGOs but also from the and patients; availability of an harmonized
interim reports). No change in law occurred; the regulation of involuntary admission is and collective action plan; sharing of clear
currently under revision; a list of 5 psychotropic drugs to be provided to PHCs is currenyl common goals. Risks: instability of the
under discussion within the MoH (the GSMH is one of the opponents to this development, this political situation; political vacuum.
suggesting a persistent tension between Tertiary/Secondary level and Primary Level)

Interviews administered directly to taget groups have been limited in number since the target Conditions: civil society and families
groups of the partner NGOs are not easily accessible for confidentiality reasons. (update received capacity building and support
based on social research). Fatma: add something about stories emerged during theater and their role is strongly empowered and
workshop with Cewla. One family support groups have been activated at the beginning 2016 reinforced; Risks: social, economical and
with Basmat Amal with 25 family members of children with disabilities. In addition to the political instability create insecurity inside
monthly NGOs report and the NGOs coordination meeting we are introducing a new form the communities.
where thorugh interviews to the NGOs focal points we can better capture the impact of our
training on the target group. (FATMA: from the beginning of the project how many IEC, you
can take it directly from NGOs but also from the interim reports. In particular the IEC activities
that NGOs implemented alone). Political climate prevented however any form of direct activity
of MdM in the community (assumption) so the startegy was adapted so that we intervene
thorugh our partner by training the psychosocial workers on how implement activities for target
group (and in minor part the community since partner NGOs, for the same assumption above
have been limited events opened to the general public)

RESULTS

A list of all the ngos providing psychosocial support withing the catchment area of the PHCs Key staff of PHC centres need to work in
the list of target PHCs has been prepared and will be distributed in March; and the avilable the centres for at least on year;
tertirary services.

Ministry of Health has regularly attened the coordination meetings starting June 2015 (when Key staff of PHC centres need to work in
the MoU was signed) for a total of 8 coordination meetings. The strategy was revised as far as the centres for at least on year;
mental health hospitals are concerned because the GSMH has never been responsive supervision of PHC department; stable
despite them being benefiting the most of an integration of mh at primary health care level so political and security situation in the
it was not possible to include mental health hospitals in the project. country.

A specific mental health register and a psychiatric sheet , referral sheet, scales for social Stability inside the local authorities
workers and a specific person has been assigned in 9 PHCs as casemanager. The integration departments
of the mental health folder in the family health folder will be possible only at national level.
MdM recommendation to MoH is to digitalize casemanagement system of PHCs and, even
more urgent, introduce only one coding system to all services provided by PHCs. NOTE: This
should have been included in tha assumption)

The training was completed in January 2016 and the service is being organized in February- Social and political stability allows
March 2016. The monthly reports of MoH focal points confirm that before the training there movement;
were 0 mh consultations provided in the target PHCs (baseline). In eac of the 9 PHC there is
one assigned staff for CBT and one assigned staff as Casemanager.

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 The training was completed in January 2016 and the service is being organized in February- High turn over of medical staff does not
March 2016. The monthly reports of MoH focal points confirm that before the training there allow to train the same staff all over the
were 0 mh consultations provided in the target PHCs (baseline). In eac of the 9 PHC there is project period.
one assigned staff for CBT and one assigned staff as Casemanager. It was decided to
administer a written quiz during the months of March and April during the visits to PHCs.

The training was completed in January 2016 and the service is being organized in February- High turn over of social staff does not
March 2016. The monthly reports of MoH focal points confirm that before the training there allow to train the same staff all over the
were 0 mh consultations provided in the target PHCs (baseline). In eac of the 9 PHC there is project period.
one assigned staff for CBT and one assigned staff as Casemanager. It was decided to
administer a written quiz during the months of March and April during the visits to PHCs.

ToT has been requested by the MoH as final activity of the project (scheduled for 2017), High turn over of social staff does not
however one refresher training will be provided in September 2016 allow to train the same staff all over the
project period.

54 Psychosocial workers received training from the beginning of the project. 3 partner ngos High turn over is addressed by the NGO
(Basmat Amal, El Shehab and Banaty) choose cognitive behavioural therapy for their management;
protocols. Following the projects IEC trainings, all of them have organized antistigma activities
for their target group. (FATMA: from the beginning of the project how many IEC, you can take
it directly from NGOs but also from the interim reports).

118 staff of 9 PHCs have received 2 sessions each during the training of December and Social and political stability allows
January 2016. Flyers have been developed about most common MH diseases and will be movement; High turn over is addressed
tested and distributed in March. Every flyer includes an antistigma message. 2 Health by the NGO management;
sessions with PHCs are planned for April on the issue of violence (in particular GBV)

A family support group with 25 members has been established within Basmat Amal. Social and political stability allows
movement

A total of 4 drama therapy workshops have been organized for Banaty, El Shehab and Cewla. Social and political stability allows
Two theater events have been organized for Basmat Amal. 3 theater performances have been movement
organized. A radio campaign is scheduled to take place for Ramadan. Given the political
climate MdM decided to deliver IEC activities only thorugh the partner NGOs and not directly
to the community. FATMA: number of IEC activities organized by the NGO alone

Two peer to peer supervision meetings have been organized for 54 pyschosocial workers in Social and political stability allows
2016 for 4 partner NGOs. 2 peer to peer supervision meetings took place in Basmat Amal and movement and field activities
1 in Banaty starting January 2016.

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 Flyers about 6 mental health diseases and one awareness poster have been developed since Social and political stability allows
it was decided not to deliver direct activities with the community movement and field activities

A social research report has been finalized in 2015 and the Report has been finalized in Security issues allow for movement in the
March 2016 field

Referral has been identified has the key area for Advocacy based on field observations and Security issues allow travels, meeting in
the social research. An advocacy position paper is being developed in March 2016. The only public premises
confernece on the theme of decentralization of Mh services has been organized by MdM in
May 2015; the MoH has developed in 2015 a training curriculum for primary healthcare
9 PHCs have been trained on how to register MH cases, registers have been provided to 9 Staff turn-over is addressed by the PHC
doctors to be applied at national level. The topic of decentralization of mental Health services
PHCs; a psychiatric
is largely absent fromsheet has been
the media provided to 9 PHCs and a referral sheet
discourse department

One conference has been Organized in May 2015 and a second one is scheduled to take security situation is stable
place in April 2016.

ASSUMPTIONS

security allows movement in the target

areas

security allows movement in the target

areas
security allows movement in the target
areas

possibility of movement of staff outside

their centres

possibility of movement of staff outside

their centres

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 strong coordination and agreement
among all the actors invovled

security allows movement in the target

areas
security allows movement in the target
areas

security allows movement in the target

areas

social situation is calm and stable

political and social situation is stable

social situation is calm and stable

previous agreement among all the actors

involved

social situation is calm and stable

political and social situation is stable

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 availability of effective data collection
system

political and social situation is stable

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