Mapping the Health and Mental Health Needs Among a Rural Fishing Community in Zambia

Background and Purpose

An estimated 300,000 people in Zambia rely on the fishing industry for their livelihood. Being one of the major employment sectors in Zambia, which is largely informal and unregulated, it is disproportionately represented by marginalized populations, such as female migrant labor. Within small-scale fishing communities in Zambia, the phenomenon of “fish for sex” has been established as a widespread occurrence. In addition to the risk of HIV and gender-based violence through “fish for sex” deals, female fish traders in Zambia are exposed to other potentially traumatic events and ongoing daily stressors with the risk of subsequent adverse mental health outcomes.

The aim of the current qualitative study is to (1) document and map health services (health, mental health, and psychosocial support) available to the Sinazongwe fisherfolk community and (2) understand the needs and challenges of the female fish traders and surrounding communities in accessing health services.

Method

The current study used qualitative methods to examine the local understanding and relevance of health and mental health needs specific to fisherfolk in Sinazongwe. The study relied heavily on community engagement and local partner HIV/AIDS Technical Support Foundation (HATSFO) to 1) establish trust with the fisherfolk and community members, 2) ensure cultural relevance, and 3) begin the formation of relationships for the sustainability of future potential Mental Health and Psychosocial Support Services (MHPSS) programming. The study employed purposive sampling to recruit female fish traders, community members, community leaders, and health workers. Semi-structured interviews were used to interview 30 (n) participants, including 10 female fish traders. Data analysis for the study was informed by the template analysis approach (Braun & Clarke, 2006; Crabtree & Miller, 1999).

Results

Results were disaggregated into two groups (a) health workers, community members, and community leaders and (b) fisherfolk. Themes such as available services, demands of services from fisherfolk, how services are offered to the community, and barriers and challenges related to MHPSS were highlighted through the health workers' and community members’ narratives. Fish traders reported on their general understanding of mental health, with one participant noting,“...health is basically the well-being of an individual whereas mental health is well being or an individual’s memory/mind wise..” Their narratives underscored the themes of accessibility of MHPSS and other health services and the community needs where a participant shared, “I think the people in the community need a clinic ...They also need more community caregivers.....the clinic should be built nearby.”

Conclusion

Findings from the qualitative analysis demonstrate the critical need for MHPSS services in the fisherfolk community in Zambia.

Practice: Local and international social work practitioners should effectively converge and coordinate stakeholders to translate fish traders' community voices to effective action that improves the availability and quality of health, mental health, and psychosocial support services.

Policy: This study provides and lays a unique opportunity to build on the momentum of the Zambian Mental Health Act of 2019 by assessing the current status of mental health and psychosocial support delivery systems among an at-risk migrant population.