NIHR Global Health Research Group on homelessness and severe mental illness in Africa (HOPE) In HOPE, we will seek to address the needs of people experiencing homelessness and severe mental illness (SMI) in Ethiopia, Ghana and Kenya. People with SMI are over-represented in homeless populations globally, but this is a major concern in low- and lower middle-income countries. However, there is no high-quality evidence to show which interventions are effective in these settings. In HOPE, we will create a new partnership of researchers, policy makers, community members and people with lived experience of SMI and homelessness. We will work in a capital city (Addis Ababa) in Ethiopia, a regional city (Tamale) in Ghana, and a rural county (Makueni) in Kenya to understand the different approaches needed across varied settings. 
In phase 1, we will carry out a number of activities to understand priorities, needs and opportunities for intervention. We will map existing contexts, conduct a survey and ethnographic study with people who are homeless and have SMI, interview stakeholders, synthesise global evidence and experience on interventions for this group, and prioritise potential interventions. 
In phase 2, we will work with stakeholders to select, co-produce and test intervention packages to optimise feasibility and acceptability. We will support and empower people with lived experience of SMI and homelessness to participate. The intervention package will seek to address a range of needs, from basic needs, to mental and physical health, family support, livelihoods and social inclusion. A cornerstone will be peer support. 
In phase 3, we will test the intervention package with 350 people per site who experience homelessness and SMI. We will follow up participants over six months to see whether they benefit in terms of physical and mental health, experience of discrimination and abuse, housing status, family reintegration, functioning and social inclusion. We will identify ways to implement at scale and ensure sustainability. 
By the project end, we will have: (1) developed evidence-supported interventions to improve the lives of people who are homeless and experience SMI; (2) collaborated with the World Health Organization to produce a manual on how to adapt and implement the programme in low-resource settings; (3) developed methods and the capacity of early career researchers and other stakeholders; and (4) built a strong collaboration of multi-sector partners to sustain in-country work and longer-term high-quality future research on this neglected topic. 1) Establish a partnership of researchers, implementers, policymakers and people with lived experience working collectively to improve the lives of people who are homeless and have SMI. 
2) Synthesise global evidence on existing initiatives and obtain global expert consensus on priority actions and approaches.
3) Work in distinctive settings in Ethiopia (capital city), Ghana (regional capital) and Kenya (rural county) to:
a. Identify the priority needs and valued outcomes of those who are homeless and have SMI, and opportunities and challenges for effective intervention. 
b. Integrate global and local evidence to select and co-produce interventions that target priority needs, and pilot test for acceptability and feasibility. 
c. Evaluate the impact of interventions on the human rights and diverse outcomes valued by people who are homeless and experience SMI, and generate evidence on intervention costs, implementation processes and outcomes.
d. Pioneer the development of methods and ethical frameworks for research engaged with people who are homeless and have SMI. 
4) Impact global policy and practice through translation of evidence into a WHO ‘how-to’ guide to adapt and implement programmes for people who are homeless and have SMI in diverse low-resource contexts.
5) Build sustainable capacity across partners that responds to local priorities, enhances existing capabilities, supports south-south and south-north exchange of expertise and develops both individuals and systems.