Impact statement

Sub-Saharan Africa faces disparities in mental health services and human resources, compounded by fragmented research systems, reliance on externally driven funding and limited cross-country and inter-institutional collaboration. Overall, these challenges hinder the development of contextually relevant and sustainable mental health solutions. This article addresses a critical gap by proposing a scalable model for a regional, South–South collaboration in mental health research and practice, grounded in lessons from the East African Mental Health Collaborative (EAMHC). Drawing on a partnership across Kenya, Rwanda, Tanzania and Uganda, and supported by a mentorship team at Duke University, the model demonstrates how regionally led networks can strengthen research capacity, harmonize methodologies and foster equitable knowledge and skills production. Key components include shared leadership, multilevel mentorship, coordinated research outputs and structured mechanisms for cross-site learning and accountability. By leveraging common health system challenges while respecting contextual differences, the model promotes efficient resource use and reduces duplication of efforts. The significance of this work lies in its practical contribution to advancing sustainable research ecosystems in low-resource settings. It offers a replicable framework for building resilient, locally owned collaborations that can enhance competitiveness for funding, support early-career researchers and generate policy-relevant evidence. Importantly, the model shifts the paradigm from short-term, externally driven projects toward long-term regional ownership and self-sufficiency. This approach has the potential to accelerate the development and implementation of culturally appropriate, evidence-based mental health interventions, ultimately improving service delivery and population mental health outcomes across East Africa and other similar settings.

Background

Across sub-Saharan Africa (SSA), the growing burden of mental disorders has exposed systemic gaps in both mental health research and service provision (Boudreaux et al., Reference Boudreaux, Noble, Coates, Kelley, Abanda, Kintu, McLaughlin, Marx and Bukhman2020; Gupta et al., Reference Gupta, Mocumbi, Arwal, Jain, Haileamlak, Memirie, Larco, Kwan, Amuyunzu-Nyamongo, Gathecha, Amegashie, Rakotoarison, Masiye, Wroe, Koirala, Karmacharya, Condo, Nyemazi, Sesay, Maogenzi, Mayige, Mutungi, Ssinabulya, Akiteng, Mudavanhu, Kapambwe, Watkins, Norheim, Makani, Bukhman and Poverty2021). More than one-third of individuals living in extreme poverty worldwide are in SSA (Alkire et al., Reference Alkire, Roche and Seth2013; Sumner, Reference Sumner2016), which is inextricably linked to poor mental health outcomes (Boudreaux et al., Reference Boudreaux, Noble, Coates, Kelley, Abanda, Kintu, McLaughlin, Marx and Bukhman2020). Yet, SSA has critical gaps in access to and availability of mental health services. Up to 92% of people in need of mental health care in SSA do not receive this care (Docrat et al., Reference Docrat, Besada, Cleary, Daviaud and Lund2019; World Health Organization, 2022).

Despite global calls to strengthen mental health systems, many efforts to improve these systems are limited because they are nationally isolated, with minimal cross-regional or cross-institutional collaboration (Chibanda et al., Reference Chibanda, Abas, Musesengwa, Merritt, Sorsdahl, Mangezi, Bandawe, Cowan, Araya, Gomo, Gibson, Weiss, Hanlon and Lund2020) and do not adequately address local challenges to health equity (Boum Ii et al., Reference Boum Ii, Burns, Siedner, Mburu, Bukusi and Haberer2018; Perry et al., Reference Perry, Madundo, Narayanasamy and Knettel2025). Current mental health services in low- and middle-income countries (LMICs) are often replicated from those in high-income countries with limited modification for the context. Considering elusive local funding, institutions in SSA are often supported by external partners with short project timelines and insufficient sustainability planning, and face the threat of reductions or complete loss of funding once grants or contracts expire (Boum Ii et al., Reference Boum Ii, Burns, Siedner, Mburu, Bukusi and Haberer2018; Barasa et al., Reference Barasa, Chuma, Nonvignon and Adeyi2025). Cross-regional and inter-institutional research collaboration is essential to mitigate these challenges. Collaborative approaches linking researchers and practitioners across similar contexts, often referred to as “South–South” partnerships, offer a promising mechanism to share innovations, distribute limited expertise, advance career development and develop regionally relevant, translational solutions to improve evidence-based mental health service delivery (Chibanda et al., Reference Chibanda, Abas, Musesengwa, Merritt, Sorsdahl, Mangezi, Bandawe, Cowan, Araya, Gomo, Gibson, Weiss, Hanlon and Lund2020; Nwaozuru et al., Reference Nwaozuru, Murphy, Richard, Obiezu-Umeh, Shato, Obionu, Gbajabiamila, Oladele, Mason, Takenaka, Blessing, Engelhart, Nkengasong, Chinaemerem, Anikamadu, Adeoti, Patel, Ojo, Olusanya, Shelley, Airhihenbuwa, Ogedegbe, Ezechi and Iwelunmor2025). Transfer of mentorship skills through such partnerships can stimulate the development of research programs and build national and international support to implement and sustain evidence-based interventions (Boum Ii et al., Reference Boum Ii, Burns, Siedner, Mburu, Bukusi and Haberer2018; Akiba et al., Reference Akiba, Go, Mwapasa, Hosseinipour, Gaynes, Amberbir, Udedi and Pence2019).

To advance South–South partnerships, the East African Mental Health Collaborative (EAMHC) was established. Facilitated by the United States’ Duke University Center for Global Mental Health (CGMH), a division of the Duke Global Health Institute (DGHI), the collaborative network is co-led by early-to-mid-career clinical and/or research professionals from institutions in four East African nations: Moi Teaching and Referral Hospital (Eldoret, Kenya), the University of Global Health Equity (Butaro, Rwanda), Kilimanjaro Christian Medical Centre (Moshi, Tanzania) and Makerere University (Kampala, Uganda). The EAMHC promotes regional cross-learning and sharing funding opportunities, mentorship and coproduction of research outputs. This commentary describes a model for establishing a South–South regional mental health collaboration to respond to the realities of resource-limited contexts and support the long-term growth and independence of LMIC health systems.

Drawing on reflections from the EAMHC, we describe this initiative’s (1) impetus, (2) structure, (3) goals and (4) progress, challenges and successes. This commentary presents a model to address a gap identified in the growing literature on pressing needs to strengthen capacity, foster ownership and increase collaboration in African mental health research (Chibanda et al., Reference Chibanda, Abas, Musesengwa, Merritt, Sorsdahl, Mangezi, Bandawe, Cowan, Araya, Gomo, Gibson, Weiss, Hanlon and Lund2020; Nwaozuru et al., Reference Nwaozuru, Murphy, Richard, Obiezu-Umeh, Shato, Obionu, Gbajabiamila, Oladele, Mason, Takenaka, Blessing, Engelhart, Nkengasong, Chinaemerem, Anikamadu, Adeoti, Patel, Ojo, Olusanya, Shelley, Airhihenbuwa, Ogedegbe, Ezechi and Iwelunmor2025). It further adds the perspective of establishing a regional collaborative network grounded in mutual learning and practical deliverables.

The impetus for the collaborative network

DGHI maintains some of its longest-standing partnerships in East Africa and elsewhere throughout the world through educational, clinical and research programs in global health (Duke Global Health Institute, 2025a, 2025b). These partnerships span topical areas related to mental health, infectious diseases, reproductive/maternal health, child/adolescent health noncommunicable diseases and community health (with particular strengths and leading scholarship in mental health in East Africa). DGHI has had individually robust partnerships with each of the four aforementioned institutions in the EAMHC, but, until this collaboration, to our knowledge, no formal efforts had been taken to establish a network of clinical and research mental health leaders from various backgrounds at these institutions to facilitate knowledge sharing and collaboration across sites.

Simultaneously, the DGHI’s partners in Kenya, Rwanda, Tanzania and Uganda reported strikingly parallel challenges in mental health service provision and in research: critical human-resource shortages (Muhia et al., Reference Muhia, Jaguga, Wamukhoma, Aloo and Njuguna2021; Knippler et al., Reference Knippler, Martinez, Amiri, Madundo, Mmbaga, Goldston, Relf and Knettel2024); limited integration of mental health services in nonmental health settings, primary care and community settings (Knettel et al., Reference Knettel, Rugira and Tesha2018, Reference Knettel, Luke, Kiweewa, Nsubuga, Darkis, Afriyie and Ojiambo2020; Puffer and Ayuku, Reference Puffer and Ayuku2022; Knippler et al., Reference Knippler, Martinez, Amiri, Madundo, Mmbaga, Goldston, Relf and Knettel2024); persistent stigma associated with mental illness and other chronic health challenges (Watt et al., Reference Watt, Knippler, Minja, Kisigo, Knettel, Ngocho, Renju, Osaki, Mwamba, Rogathi and Mmbaga2019; Chakraborty et al., Reference Chakraborty, Sanchez, Kaddumukasa, Kajumba, Kakooza-Mwesige, Van Noord, Kaddumukasa, Nakasujja, Haglund and Koltai2021; Venturo-Conerly et al., Reference Venturo-Conerly, Wasil, Osborn, Puffer, Weisz and Wasanga2022); and relative strengths and weaknesses in providing condition-specific mental health services (Madundo et al., Reference Madundo, Knettel, Knippler and Mbwambo2023; Mwobobia et al., Reference Mwobobia, Knettel, Headley, Msoka, Tarimo, Katiti, Juhlin and Osazuwa-Peters2024; Staton et al., Reference Staton, Minja, De Souza, Gallis, Santos, Buono, Sakita, Ngowi, Boshe, Phillips, Vissoci and Mmbaga2025). In response, East Africa site leads and DGHI faculty had explored and codeveloped innovative mechanisms and locally adapted strategies to address these constraints (Puffer and Ayuku, Reference Puffer and Ayuku2022; Knettel et al., Reference Knettel, Knippler, Amiri, Joel, Madundo, Msoka, Boshe, Tarimo, Katiti, Rwakilomba, Turner, Minja, Staton, Vissoci, Mmbaga, Relf and Goldston2023; Kawonga et al., Reference Kawonga, Livingstone, Ndaimani, Sibomana, Waka, Mhlanga and Mclellan2025). The realization that similar challenges were being solved with similar mechanisms, and separately across the region, inspired the concept of developing a unified collaborative approach to more efficiently address shared challenges. Figure 1 displays the conceptual framework for the EAMHC, with key collaborative factors, goals and deliverables described in the following sections.

Figure 1.

Conceptual framework for the research collaborative network.

Figure 1. Long description

The flowchart is organized into three vertical columns.

Column 1: Collaborative factors (blue).

- Interactivity with peers: Arrows point to Collaborative learning, Shared opportunities, and Joint research output.

- Interactivity with mentors: Arrows point to Collaborative learning, Shared opportunities, and Joint research output.

- Shared leadership and work resources: Arrows point to Joint research output and Self-sustaining research network.

Column 2: Goals (green).

- Collaborative learning: Arrow points to Strengthened capacity.

- Shared opportunities: Arrows point to Influence visibility and networking, and Co-written manuscripts and grants.

- Joint research output: Arrows point to Influence visibility and networking, and Co-written manuscripts and grants.

- Self-sustaining research network: Arrow points to Influence and growth at local sites.

Column 3: Deliverables (yellow).

- Strengthened capacity.

- Influence visibility and networking.

- Co-written manuscripts and grants.

- Influence and growth at local sites.

The development of the EAMHC

Initial funding for EAMHC was obtained through an internal pilot grant from DGHI in 2023. The total direct cost of setting up the EAMHC was ~$25,000, which was largely used to fund Duke CGMH and East African colleagues’ travel and lodging at each other’s institutions.

In May 2024, the first in-person workshop of the EAMHC was held at Moi University in Eldoret, Kenya, and this workshop was used to facilitate the codesign process that resulted in the hybrid mentorship meeting model for the EAMHC. The first in-person workshop included introductions of core team members from Duke CGMH and the four East African mentees. The East African mentees were invited to share research priority areas at their respective institutions, including past capacity-building efforts, areas of strength and areas of perceived need. Brainstorming sessions followed throughout the 3-day meeting to discuss emerging synergies across the four sites, task-sharing approaches within research and clinical care, prioritization and ranking of research topics for EAMHC according to need and feasibility, and a final discussion on opportunities and preferred format for collaboration.

Considerable overlaps in current research efforts and needs were identified across the four sites, including epidemiological studies on common mental health challenges and the development, evaluation and implementation of task-sharing and task-shifting models, drawing on similar implementation science frameworks. Task-sharing approaches were common within clinical care across all four sites, and the subsequent implementation science research projects accounted for this in the study design, data collection and dissemination stages. Similar to previous literature, and endorsed by the four mentees, a common gap across the four East African institutions was the lack of clear succession plans and mentorship models to support emerging researchers within their institutions. Notably, while the mentees are early-career in terms of research experience, the majority have extensive clinical and teaching experience and carry substantial clinical responsibilities; thus, the four mentees all reported a lack of protected time for research and difficulty in securing this protection unless one is pursuing additional degree qualifications (Kumwenda et al., Reference Kumwenda, Niang, Orondo, William, Oyinlola, Bongo and Chiwona2017; Conradie et al., Reference Conradie, Duys, Forget and Biccard2018). The mentees, at their own institutions, also act as mentors to several junior staff and trainees, with reported minimal structured guidance on how to maintain these relationships.

Unique research strengths were also identified across the four East African institutions. At Moi Teaching and Referral Hospital in Kenya, innovative community-engaged and family-grounded research models focused on (1) raising mental health awareness and problem-solving among youth, (2) strengthening community-based substance use support groups, (3) improving rehabilitation of patients with severe mental illness at transitional homes via skills-based empowerment and (4) task-sharing pilot projects to increase access to mental health services at primary care settings and among youth groups (Giusto et al., Reference Giusto, Ayuku and Puffer2022; Jaguga et al., Reference Jaguga, Kwobah, Giusto, Apondi, Barasa, Korir, Rono, Kosgei, Puffer and Ott2023, Reference Jaguga, Aalsma, Enane, Turissini, Kwobah, Apondi, Barasa, Kosgei, Olando and Ott2025; Turissini et al., Reference Turissini, Rollins, Kimaina, Jaguga, Barasa, Okeyo, Kimaiyo, Matundura, Kosgei, Kipkorir, Patel and Kwobah2025). At the University of Global Health Equity in Rwanda, areas of focus included pilot-training primary care health workers using the World Health Organization’s Mental Health Gap Action Programme (mhGAP) (Smith et al., Reference Smith, Franke, Rusangwa, Mukasakindi, Nyirandagijimana, Bienvenu, Uwimana, Uwamaliya, Ndikubwimana, Dorcas, Mpunga, Misago, Iyamuremye, Dusabeyezu, Mohand, Atwood, Osrow, Aldis, Daimyo, Rose, Coleman, Manzi, Kayiteshonga and Raviola2020; World Health Organization, 2023) and studies on intergenerational trauma through the Butaro Human Development and Demographic Surveillance System (HD2SS) (Amberbir et al., Reference Amberbir, Boah, Semakula, Rwagasore, Uwinkindi, Cyuzuzo, Cibwe Kunda, Kateera, VanderZanden, Akiiki Bitalabeho, Deifu, Tobi Alayande, Henley, Yohannes Waka, Maria Pesando, Sudharsanan and Bekele2025). At Kilimanjaro Christian Medical Centre (KCMC) in Tanzania, studies included an innovative telehealth-based counseling intervention to address depression and suicidality (Knettel et al., Reference Knettel, Madundo, Amiri, Msoka, Pan, Khofi, Ngangula, Turner, Joel, Rwakilomba, Tarimo, Katiti, Knippler, Mmbaga, Relf and Goldston2025), group counseling for youth living with HIV (Mollel et al., Reference Mollel, Ketang’enyi, Komba, Mmbaga, Shayo, Boshe, Knettel, Gallis, Turner, O’Donnell, Baumgartner, Ogbuoji and Dow2024) and a brief intervention for harmful alcohol use in an emergency care setting (Staton et al., Reference Staton, Minja, De Souza, Gallis, Santos, Buono, Sakita, Ngowi, Boshe, Phillips, Vissoci and Mmbaga2025). At Makerere University in Uganda, studies included the investigation of stigma surrounding epilepsy and understanding ideal and culturally relevant interventions for epilepsy (Kakooza-Mwesige et al., Reference Kakooza-Mwesige, Kaddumukasa, Koltai, Kaddumukasa, Nakasujja, Kajumba, Nakku, Kolls, Fuller, Teuwen and Haglund2021; Kajumba et al., Reference Kajumba, Njeru, Prose, Mason, Ramasubramanian, Tebulwa, Kakooza-Mwesige, Andrews, Johnson, Nshemerirwe, Kalubi and Koltai2025). Additionally, exploring the causality of neuropsychiatric conditions such as epilepsy and depression (Smith et al., Reference Smith, Kajumba, Bobholz, Smith, Kaddumukasa, Kakooza-Mwesige, Chakraborty, Sinha, Kaddumukasa, Gualtieri, Nakasujja, Onuoha, Nakku, Muhumuza, Sanchez, Fuller, Haglund and Koltai2021; Kajumba et al., Reference Kajumba, Kakooza-Mwesige, Nakasujja, Koltai and Canli2024).

The workshop concluded with a plan to combine annual in-person and monthly virtual follow-up meetings to discuss individual progress on collaborative goals.

Structure of the collaborative network

The proposed structure was to engage one early- to mid-career researcher from each East African site, who were selected based on having varied but complementary interests, capacity and preexisting collaborative work with the teams at DGHI. The small number of mentees was selected to maximize direct mentor–mentee interaction at this inaugural stage of the collaborative network (Welch, Reference Welch2016), and considering budgetary limitations. The mentees worked alongside senior and mid-career faculty mentors with extensive experience in mental health research and/or service delivery in the East African sites.

The EAMHC has a multilayered mentorship model: two senior faculty mentors at DGHI (United States) who colead the Duke CGMH (BK – Associate Professor of Nursing and Global Health, EP – Associate Professor of Psychology and Neuroscience) and one senior faculty member at Moi Teaching and Referral Hospital, Kenya (FJ – Consultant Psychiatrist). The senior faculty at Duke guided administrative and logistical tasks, such as oversight of project timelines, milestones and research output, monitoring expenditure from each EAMHC in-person meeting and supporting the preparation of reports from these meetings. FJ emphasized autonomy and leadership of the mentees by encouraging independent decision-making, discussing the reasoning behind those decisions and identifying opportunities to develop skills in grant-writing, manuscript drafting and revision and oral presentation. Two mid-career faculty, EC (Assistant Professor in Psychiatry and Behavioural Sciences, with expertise in clinical psychology and health behavior) and EM (Postdoctoral Associate, with expertise in psychiatric epidemiology), were both based in the United States. The mid-career faculty served as peer mentors, bringing topical and writing expertise by conducting first-draft reviews of manuscripts and grant submissions, supporting logistical and administrative tasks such as the preparation of in-person meeting agendas and reports, and co-reflection of the mentees’ individual and collaborative priorities. While the peer mentors’ roles were more hands-on and offered collegial support on day-to-day tasks, the senior mentors provided direction, oversight and leadership development opportunities. Additional research logistics support was provided by a Master’s level project coordinator (MS) based at DGHI, sharing meeting reminders and summaries and organizing action items for the mentors and mentees. Overall, mentors contributed to the execution of mentoring and capacity-building through complementary tasks in strategic guidance, practical skills development, accountability and progressive leadership opportunities for mentees within the network.

In addition to capacity development for the mentees, the collaborative network was intended to support bidirectional exchange of knowledge, experience and skills between the East African and Duke partners. Table 1 summarizes the mentees’ background and expertise. Shared areas of interest across the mentee and mentor groups include the intersection of mental health and medical illness and holistic and multidisciplinary approaches to understanding and addressing mental health challenges.

Table 1.

East African collaborators’ professional backgrounds and areas of research expertise

Table 1. Long description

The table consists of four columns: East African early-career researchers, Country, Professional background, and Research expertise.

* Row 1: Researcher A N from Rwanda. Professional background is P h D in Nursing. Research expertise includes Mental health and H I V care engagement and treatment retention, and Mental health nursing.

* Row 2: Researcher K M from Tanzania. Professional background is Master’s level Psychiatrist. Research expertise includes Intervention codesign, Telehealth-based counseling intervention, and Trauma, depression and suicide prevention.

* Row 3: Researcher M K from Uganda. Professional background is P h D in Clinical Health Psychology and Neuroscience. Research expertise includes Biopsychosocial explanatory models and treatment modalities for physical and mental illnesses.

* Row 4: Researcher R M from Kenya. Professional background is Master’s level Psychiatrist. Research expertise includes Community and school mental health, Intersection of mental health and medical illness, and Substance use and related interventions.

The vision was to hold four in-person rotational country meetings, first in Kenya in 2024, followed by Tanzania in 2025, Rwanda in 2026 and Uganda in 2027. Monthly virtual meetings were proposed for sharing progress updates on manuscripts and grants, problem-solving writing, literature searches and revision processes, as well as joint manuscript and grant planning. The annual in-person convenings were suggested to workshop a specific skill gap – for example, grant writing – and strengthen cross-country relationships and capacity for a post-grant virtual East African regional mental health research network.

The Duke CMGH team shared access to digital workspaces (e.g., shared folders, training materials, statistical support and access to digital library services) and coordinated the virtual and in-person meetings. The East African mentees had rotating co-leadership roles in organizing the in-country meetings, with intended equitable participation, sustained collaboration despite geographic and resource constraints and opportunity for leadership development. Online polls were filled out to reach consensus on the most convenient meeting time, considering the mentees’ preexisting and competing clinical, academic and administrative commitments. This was determined to be a 1-hour meeting immediately after working hours, East African Time.

None of the mentees was able to secure protected time for research within their regular work schedules. Consequently, they either conducted research outside of working hours or attempted to allocate dedicated time each day according to their schedules.

Goals of the collaborative network

The overarching aim is to build a sustainable, regionally connected community of mental-health researchers and practitioners across four East African countries. The multilevel approach to achieve this is through active and supported research collaboration, individual professional development and career advancement. The collaborative network set three operational objectives, building upon the identified synergies, shared constraints and complementary strengths across the four institutions: joint output, mentorship and sustainability. See Table 2 for an overview of the collaborative goals.

Table 2.

Goals and target deliverables for the EAMHC

Table 2. Long description

The table consists of three columns: Goal, Approach, and Target deliverable. It is organized into four rows.

Row 1:

- Goal: Collaborative learning.

- Approach: Multilevel mentorship including (1) Peer-to-peer cross-learning, feedback, guidance, mutual support, sharing opportunities, and exchanging context-specific knowledge; and (2) Mentorship by senior faculty from Duke and Moi.

- Target deliverable: Strengthened individual capacity through individual development plans. Strengthened collaborative capacity through four shared manuscripts and increased grant competitiveness.

Row 2:

- Goal: Shared professional opportunities.

- Approach: Mentors share and guide on opportunities for scientific conferences, workshops, and professional development resources.

- Target deliverable: Increased visibility and exposure via attendance at one annual scientific conference or workshop. Submission of four joint manuscripts and four cowritten grants.

Row 3:

- Goal: Joint research output.

- Approach: Collaborative leadership and writing tasks.

- Target deliverable: Four coauthored manuscripts and four submitted cowritten grants, each led by one of the four East African mentees.

Row 4:

- Goal: Sustainable South-South research network.

- Approach: Adaptive co-leadership across four East African sites. Shared digital work resources. Preparing early-career mentees for mentoring and succession planning.

- Target deliverable: Replication of implementation science models. Mentees capable of pursuing diverse funding. Increased motivation and participation in site-specific and collaborative activities.

The team set targets for research output across the 4-year study period: four shared manuscripts and four grants, with the writing led by each of the mentees. Considering the collaborative network’s values in supporting equitable participation, the shared writing processes can precipitate high-quality research products that reflect both regional priorities and cross-country learning. Through coordinated study designs, shared evidence and methodological approaches, as well as open exchange of implementation strategies, the EAMHC aims to leverage similarities in health-system constraints while acknowledging contextual differences, and to harmonize data collection tools and analytic frameworks that allow meaningful replication across sites without duplication of effort.

Recognizing the widespread need for structured mentorship and protected research time, the collaborative network seeks to establish a supportive, multilevel mentorship model. This includes peer-to-peer learning across the East African institutions and with US-based peer mentors, with an emphasis on practical skill-building in research design, grant writing, data analysis and dissemination. Both virtual and in-person meetings offer opportunities for peers to exchange experiences and support each other. Similarly, the peers are developing an adaptable mentorship framework that each individual and their institution can integrate into long-term capacity-building efforts. RM, AN, KM and MK have each presented a summary of their individual professional development plans, what they wish to gain from mentorship and how this plan is informed by relationships with their own mentees. The EAMHC is intentionally structured to evolve into a self-sustaining regional network that can persist beyond the initial 4-year grant period. Key sustainability strategies are discussed later.

To mitigate an anticipated funding bias, priorities for the research output are set by the East African mentees based on local needs and insights, rather than the Duke-based mentors’ preferences. Equitable decision-making responsibilities are central to the collaborative network, with a nonhierarchical governance structure.

Progress, challenges and successes

To date, the EAMHC has met 10 times virtually and 3 times in person, with a fourth and final in-person meeting planned for 2027, to be co-led by MK in Uganda. The most recent in-person meeting, held in Rwanda and co-led by AN, included updates from each mentee on personal initiatives, individual career development, departmental priorities, identification of new opportunities for collaboration and an intensive grant-writing workshop. The workshop was added to the 2026 annual meeting in response to an identified gap in grant-writing skills among the East African mentees. MK was unable to attend because of Ebola-related travel restrictions affecting travel from Uganda.

As the collaborative network progressed, competing professional responsibilities and high workloads occasionally affected attendance at monthly virtual meetings and the time available for research activities. These challenges were addressed through a flexible and supportive approach to mentoring rather than expecting uniform progress across mentees. The group regularly reviewed milestones, timelines and priorities for the travel grant, as well as individual and collaborative outstanding deliverables. These discussions, alongside monthly meeting summaries, allowed goals and timelines to be revisited according to each mentee’s circumstances. The team started using a free online messaging and work platform to facilitate rapid communication, sharing questions and advertisements for conferences and follow-up between meetings. Additional learning resources were identified throughout the EAMHC meetings and shared with mentees, including successful examples of previously submitted grants and adaptable workflow strategies used by the senior and peer mentors.

Progress toward independence was assessed through mentees’ increasing ownership of manuscript and grant preparation, presentations and collaborative leadership. Rather than relying solely on attendance or meeting deadlines, mentors also assessed whether mentees could independently apply skills acquired through the collaborative network. When progress slowed, senior mentors discussed with mentees, either during monthly meetings or separately, to identify barriers and problem-solve by breaking larger tasks into more manageable ones. The peer mentors communicated more frequently with the East African mentees in between monthly meetings to respond to differences in pace without creating a perception that all mentees were expected to progress identically. Both senior and peer mentors provided individualized technical feedback and goal-setting support, such as offering ways to conceptualize research questions, creating realistic timelines and brainstorming how to incorporate research into the often-unpredictable work schedules, while encouraging mentees to take increasing responsibility for their own research activities. To model good research practice, senior mentors facilitated several teachable moments, including appropriate authorship, handling of sensitive data and how to avoid selective citation and confirmation bias in research writing.

Mentees themselves developed strategies to remain engaged despite limited protected research time. These included online check-ins and brief virtual meetings between the monthly meetings, and working on research before or after regular working hours where necessary. The mentees recognized a growing need to delegate and task-shift clinical and administrative tasks to junior team members, thereby creating additional time for research activities. For mentees in leadership positions, displaying the Eisenhower matrix in their workspaces was identified as a useful tool to guide delegation and prioritize tasks (Columbia University School of Professional Studies, n.d.). Other strategies included setting regular reminders, planning 30 min a day to write and organizing competing responsibilities according to urgency and priority. Following existing templates for writing abstracts, manuscripts and reports was identified as a time-saving strategy.

These approaches have contributed to tangible outputs, often emerging from brainstorming sessions and structured exercises to prioritize and rank EAMHC research topics, according to identified needs and feasibility. Three manuscripts have been submitted for publication: a scoping review, a commentary piece and a call to action. Two additional manuscripts, led by senior mentors, have also been submitted. All four mentees contributed to the study methodology, writing and review of these papers. Two grants have been submitted and funded, including a Fogarty International Center Global Health Training Fellowship and a pilot grant to support mhGAP intervention development in Rwanda. Two career development grant applications and two intervention development grants have also been reviewed by the mentees and submitted.

Although competing demands and limited protected time remain significant challenges, the EAMHC seeks to maintain progress through flexible goal setting, regular and rapid communication, peer and mentor accountability, targeted support when progress slows and increasing mentee ownership of research activities. These mechanisms have helped accommodate differences in individual circumstances while maintaining momentum toward research independence across the network.

Next steps

The initial phase of establishing the EAMHC has demonstrated a demand for cross-country partnership in a region where mental health systems face shared constraints but possess complementary strengths. The next steps must continue to prioritize operationalizing the collaborative network’s vision through structured, evidence-informed strategies that enhance sustainability, capacity-building and regional relevance (Chibanda et al., Reference Chibanda, Abas, Musesengwa, Merritt, Sorsdahl, Mangezi, Bandawe, Cowan, Araya, Gomo, Gibson, Weiss, Hanlon and Lund2020; Wondimagegn et al., Reference Wondimagegn, Pain, Seifu, Cartmill, Alemu and Whitehead2023; Nwaozuru et al., Reference Nwaozuru, Murphy, Richard, Obiezu-Umeh, Shato, Obionu, Gbajabiamila, Oladele, Mason, Takenaka, Blessing, Engelhart, Nkengasong, Chinaemerem, Anikamadu, Adeoti, Patel, Ojo, Olusanya, Shelley, Airhihenbuwa, Ogedegbe, Ezechi and Iwelunmor2025). Initiatives in East Africa have further highlighted the lack of regional collaborations, advocating for harmonization of policy and equitable mental health services (Atewologun et al., Reference Atewologun, Adigun, Okesanya, Hassan, Olabode, Micheal, Ahmed, Ukoaka, Idris, Oso and Lucero-Prisno2025; EACMHN, 2025; East African Community, 2025).

The collaborative network is documenting an implementation plan that includes mentor and mentee roles, the total planned learning experience, goals, methods, materials and assessments and costing of the regional network establishment. A compiled living document will be updated toward the end of the original funding period and as new members join the EAMHC. In the current study and an intended future publication, we summarize key considerations for collaborative research networks and further evaluation outcomes, respectively. Next, we discuss the EAMHC’s plans for sustainability.