A look back, a path forward: Revisiting the mental health and well-being research and practice models and priorities in sub-Saharan Africa

A bibliometric review of positive psychology and well-being research in Africa

Positive Psychology rapidly developed into an influential field of study and intervention, initially situated in Psychology, and later becoming multidisciplinary. Research interest in the study of (psychological) well-being has gained global popularity, with increasing salience in Africa. Although the global trends of these developments are relatively well-known, a bibliometric analysis of positive psychology research in Africa was necessary to shed light on the present hotspots and trends and future trajectories in this region of the world. The data source of the present bibliometric analysis study was Scopus, from which Positive Psychology and well-being research literature from Africa between 1983 and 2023 were searched. Using biblioshiny and VOSviewer, the 622 extracted articles were analysed, from which findings about the current condition, research hotspots, and thematic developmental patterns could be made. Africa experienced an initial slow growth period from 1983 until 2005, after which a rapid growth in research productivity, relevance and impact was experienced. In this regard, the results show that the focal point of scientific productivity is South Africa, with the dominance of South African institutions, particularly the North-West University, from where most positive psychology research is produced and cited. Even with potential access to international journal, African researchers seem to prefer to place their publications in the regional journals such as Journal of Psychology in Africa and South African Journal of Psychology. The research reviewed tends to be characterised by more dominant thematic clusters of positive psychology, psychological well-being, and subjective well-being, with a focus on human individuals. An increasing concern for contextual factors and potential antecedents and dynamics of well-being is also observed. The findings provide a good map from which identification of future research priorities can be deduced. As such, we speculate that future positive psychology research in Africa ought to be concerned with the following: greater distribution and intercountry collaborations across the continent, questions of conceptual clarity of terms, better understanding of contextual factors which influence well-being, and well-being research embracing the complexity of bio-psycho-social-ecological well-being, and science concerned with health-promotion interventions.

Facilitating change processes in group-based behaviour change interventions in rural African contexts: practical lessons from Ghana

Evidence from implementation research suggests that group-based behaviour change interventions (GBCIs) can encourage the development of peer support, promote psychosocial skills, and facilitate collaborative therapeutic relationships. However, although the mechanisms of action that mediate the behaviour change process have been extensively described in other settings, less is known about the implementation strategies and contextual factors that actuate the reported behaviour changes among programme participants in Ghana and sub-Saharan Africa, more generally. We draw on insights from the literature and field experiences from designing, implementing, and evaluating GBCIs across several rural and peri-urban communities in Ghana to discuss a range of theoretical, methodological, and contextual factors that facilitate the behaviour change process in programme participants. We offer suggestions to guide researchers to envision and manage potential challenges with the programme development and implementation processes. We propose that intervention programmes designed to facilitate health behaviour change in the defined context should (i) have a context-relevant focus, (ii) be coherent and well-structured, (iii) have explicit techniques to facilitate inter-personal and intra-personal change processes, (iv) include appropriate mechanisms to monitor and assess the progress of the interventional sessions; and (v) be implemented by trained facilitators with a deep knowledge of the sociocultural values and norms of the target group and of the principles and theories underlying the intervention programme. We envisage that these insights could serve to guide the design, implementation, and evaluation of contextually-tailored and potentially effective GBCIs that align with the needs, capacities, and circumstances of the local population.

Context matters: Sociocultural considerations in the design and implementation of community-based positive psychology interventions in sub-Saharan Africa

Scholars conducting cross-cultural research in mental health often import intervention programs found to be efficacious in one social context (e.g., Western) and directly implement them in other contexts (e.g., African and Asian) without recourse to the sociocultural disparities between the target populations and the theoretical foundations of the constructs and principles underpinning the intervention programs. Such efforts mistakenly assume that positive psychology interventions (PPIs), most of which were developed from Western perspectives and assumed individualistic cultural orientation and value systems, operate equally across all contexts. Drawing on the extant literature and on insights from designing, implementing, and evaluating group-based (mental) health behavior change intervention programs across several communities in Ghana, we discuss some sociocultural, theoretical, and methodological issues that can significantly constrain the design, uptake, and effectiveness of PPIs in the rural, low literate, socioeconomically disadvantaged, highly collectivistic context of Ghana, and sub-Saharan Africa more generally. In all illustrations, we offer suggestions to guide the design and implementation processes to ensure culturally appropriate, highly acceptable, and potentially effective intervention programs. We argue that PPIs can be potentially fructuous in the sub-region when adapted to, or embedded in, the cultural values of the target population and tailored to the needs, capacities, and circumstances of participants.

Measuring Positive Mental Health and Depression in Africa: A Variable-Based and Person-Centred Analysis of the Dual-Continua Model

The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalising mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis such as confirmatory factor analysis (CFA), or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting data from an African sample to both CFA and latent class analysis (LCA) to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum—Short Form (MHC-SF) and Patient Health Questionnaire—9 (PHQ-9); and LCA on combined item responses. College students (N = 892; average age = 22.74, SD = 4.92; female = 58%) from Ghana (n = 309), Kenya (n = 262), Mozambique (n = 232), and South Africa (n = 89) completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF, and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms (25.9%), flourishing with low endorsement of depressive symptoms (63.7%), and moderate mental health with high endorsement of depressive symptoms (10.4%). These findings further contribute to affirming the evidence for the dual-continua model of mental health, with implications for the assessment of mental health, to inform policy, practise, and future research in community and clinical settings in Africa.