- Hybrid university-industry model with phase-aligned leadership: industry leads rapid iteration and productisation; academia leads validity, measurement, and reporting.
- Implement clear objectives, early assumption testing, proactive ethics planning, and dual dissemination to reduce research waste and support iterative development.
- Embed end-users in living-lab arrangements and establish cross-disciplinary governance to bridge cultural differences and enable scalable, context-sensitive digital mental health solutions.
Mhealth. 2026 Oct 21;12:35. doi: 10.21037/mhealth-2026-0020. eCollection 2026.
ABSTRACT
BACKGROUND: Mental, neurological, and substance use disorders are a leading cause of disability globally. In sub-Saharan Africa (SSA), underinvestment, centralised services, stigma, and workforce shortages create large treatment gaps. Digital delivery can expand access, yet sustainable models remain concentrated in high-income settings. University-industry (U-I) collaboration may bridge capability and scaling gaps, though differing cultures and timelines often impede progress. This study documents a hybrid U-I approach across design, development, and early evaluation of a digital mental health intervention in SSA, and extracts practical lessons.
METHODS: We report a retrospective, multi-country case study of Inuka Coaching, a coach-guided, chat-based problem-solving therapy delivered via mobile/web. Four sequential phases integrated academic and pragmatic processes: (I) needs assessment using literature review, 49 interviews, and 7 focus groups across Kenya, Ghana, and Nigeria; (II) a 20-stakeholder Nairobi hackathon co-creating a minimum viable product (MVP), followed by assumption testing; (III) feasibility and acceptability testing with 13 clients and 5 coaches in Zimbabwe; and (IV) a pilot across 18 Nairobi primary care centres enrolling 80 adults, measuring Self-Reporting Questionnaire-20 (SRQ-20), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder scale-7 (GAD-7) at baseline, 4 weeks, and 3 months.
RESULTS: Phase 1 produced structured design inputs for non-academic stakeholders, synthesized from the needs-assessment activities. Phase 2 delivered an MVP and a preliminary route-to-scale, shaped through iterative testing with stakeholders. Phase 3 produced a refined working prototype through usability testing. Phase 4 delivered a pilot evaluation protocol and dataset; the resulting clinical and feasibility findings are reported separately in an ethically approved publication. This case study focuses on the U-I collaboration process itself and does not present or discuss the results of the underlying research activities. Partnership dynamics were phase-aligned: industry led rapid iteration and productisation (Phases 2-3); academia led validity, measurement, and reporting (Phases 1 and 4). Key challenges included limited end-user involvement due to ethics timelines, divergent publishing and product schedules, and data-access restrictions.
CONCLUSIONS: This is the first documented hybrid U-I partnership for developing and evaluating a digital mental health intervention in SSA. Clear objectives, flexible phase-specific leadership, early assumption testing, proactive ethics planning, and dual dissemination can reduce research waste and support iterative development. Future collaborations may benefit from living-lab arrangements embedding end-users throughout, cross-disciplinary governance to bridge work cultures, and decision frameworks to manage cultural differences in low-resource settings.
PMID:42999577 | PMC:PMC13744049 | DOI:10.21037/mhealth-2026-0020
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