A Gamified Digital Mental Health Intervention Across Six Sub-Saharan African Countries: A Cross-Sectional Evaluation of a Large-Scale Implementation

Christopher K. Barkley (), Charmaine N. Nyakonda, Kondwani Kuthyola, Polite Ndlovu, Devyn Lee, Andrew Dallos, Danny Kofi-Armah, Priscilla Obeng and Katherine G. Merrill
Additional contact information
Christopher K. Barkley: Grassroot Soccer, Hanover, NH 03755, USA
Charmaine N. Nyakonda: Grassroot Soccer, Hanover, NH 03755, USA
Kondwani Kuthyola: Grassroot Soccer, Hanover, NH 03755, USA
Polite Ndlovu: Grassroot Soccer, Hanover, NH 03755, USA
Devyn Lee: Grassroot Soccer, Hanover, NH 03755, USA
Andrew Dallos: Grassroot Soccer, Hanover, NH 03755, USA
Danny Kofi-Armah: Viamo, Villa 21, Five Star Paradise, Runda, Nairobi 00619, Kenya
Priscilla Obeng: Viamo, Villa 21, Five Star Paradise, Runda, Nairobi 00619, Kenya
Katherine G. Merrill: Center for Dissemination and Implementation Science, University of Illinois Chicago, 818 S. Wolcott Avenue, Chicago, IL 60612, USA

IJERPH, 2025, vol. 22, issue 8, 1-19

Abstract: Mental health conditions affect many young people in sub-Saharan Africa (SSA), where stigma is high and access to care is limited. Digital tools accessible on basic mobile phones offer a scalable way to promote mental health, but evidence on their effectiveness in SSA is limited. This study evaluated the reach, feasibility, acceptability, and knowledge outcomes of Digital MindSKILLZ, an interactive voice response (IVR) mental health intervention implemented in the Democratic Republic of Congo, Ghana, Nigeria, Rwanda, Uganda, and Zambia. Over seven months, 700,138 people called the platform, and 425,395 (61%) listened to at least one message. Of these users, 63.6% were under 25 and 68.3% were from rural areas. The three content branches—mental health information, mental health skills, and soccer quizzes—were accessed by 36.5%, 46.4%, and 50.9% of users, respectively. Among users who accessed the mental health branch of the intervention, the mean number of messages completed was 7.6 out of 18 messages. In a follow-up survey, 91% of users understood the content, 85% would recommend the intervention, and 38% found the mental health content most helpful. Average knowledge scores were 62%, with lower scores on common disorders and stigma. The intervention showed strong reach and acceptability, but content and implementation improvements are needed to boost engagement and retention.

Keywords: mental health literacy; sub-Saharan Africa; adolescents; digital health; interactive voice response (IVR); gamification; mobile health (mHealth); low-resource settings; implementation science; mental health promotion (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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