Hervet Randriamady, PhD student, on his study of how food insecurity affects mental health in Ranobe Bay

From May 2022 to August 2022, Hervet Randriamady, a Ph.D. student in Population Health Sciences at Harvard TH Chan School of Public Health (HSPH), conducted qualitative assessments in 7 communities across the Bay of Ranobe to better understand the mental health challenges in the southwestern region of Madagascar. His overall hope is to evaluate the potential mental health impacts of climate change-driven food insecurity.

Hervet is co-advised by Dr. Christopher Golden (Department of Nutrition) and Dr. Karestan Koenen (Department of Epidemiology) during his Ph.D. program and works closely with Dr. Kimberly Hook and Rocky Stroud II from HSPH. In addition, the study is in collaboration with the Ministry of Public Health’s Mental Health Department, represented by Dr. Hanitra Randriatsara.

Hervet wants to understand how environmental and climate change affect anxiety and depression in the Ranobe Bay communities once the longitudinal research is implemented in 2023. The anxiety and depression measurement tools will be simultaneously administered with dietary intake and socioeconomic surveys every four months for three years. To choose the anxiety and depression measurement tools that are culturally appropriate for the  Bay of Ranobe communities, the qualitative study conducted from May to August 2022 was crucial:

• To identify significant mental health and psychosocial issues among adult people in the Bay of Ranobe.
• To identify commonalities and differences in the experiences and needs of mental health problems in adults in the Bay of Ranobe.
• To describe local conceptions of mental and psychosocial health and illness and define the terminology used to describe these experiences.
• To describe critical elements of healthy functioning and resiliency in the local context and in the local language.
• To understand the experience of mentally ill people and the process of seeking care (or not) both in formal government clinics and with traditional healers in the Bay of Ranobe area. 

Hervet was supported by several local students: Romario (IHSM), Madeleine (Univesity of Toliara), and Aro Faliniariana (IHSM) to conduct research in the field.

The team conducted six focus groups and 32 free-listing exercises in the Ranobe area from both Vezo (fishing communities) and Masikoro (agriculturalist communities). The most frequent themes that cause anxiety are:

1. Worrying about providing food to their children.
2. Unsustainable livelihoods due to drought.
3. The scarcity of seafood products.

Thanks to Dr. Hanitra Randriatsara, Dr. Nivohanitra Razafindrasoa, Dr. Vola Nirina Andrianavalona, and Nadège Verson Volasoa from the Ministry of Public Health team, who conducted the focus groups.