scholarly journals Protocol for process evaluation of integration of mental health into primary healthcare in two states in Nigeria: the mhSUN programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Julian Eaton ◽  
Yusuf Akande ◽  
Uchechi Onukogu ◽  
Emeka Nwefoh ◽  
Taiwo Lateef Sheikh ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Process Evaluation ◽  
Scale Up ◽  
Care Staff ◽  
Theory Of Change ◽  
Middle Income ◽  
Middle Income Countries ◽  
Moderating Factors ◽  
Low And Middle Income

Background Current international recommendations to address the large treatment gap for mental healthcare in low- and middle-income countries are to scale up integration of mental health into primary care. There are good outcome studies to support this, but less robust evidence for effectively carrying out integration and scale-up of such services, or for understanding how to address contextual issues that routinely arise. Aims This protocol is for a process evaluation of a programme called Mental Health Scale Up Nigeria. The study aims are to determine the extent to which the intervention was carried out according to the plans developed (fidelity), to examine the effect of postulated moderating factors and local context, and the perception of the programme by primary care staff and implementers. Method We use a theoretical framework for process evaluation based on the Medical Research Council's Guidelines on Process Evaluation. A Theory of Change workshop was carried out in programme development, to highlight relevant factors influencing the process, ensure good adaptation of global normative guidelines and gain buy-in from local stakeholders. We will use mixed methods to examine programme implementation and outcomes, and influence of moderating factors. Results Data sources will include the routine health information system, facility records (for staff, medication and infrastructure), log books of intervention activities, supervision records, patient questionnaires and qualitative interviews. Conclusions Evidence from this process evaluation will help guide implementers aiming to scale up mental health services in primary care in low- and middle-income countries.

scholarly journals Maternal mental health in primary care in five low- and middle-income countries: a situational analysis

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Emily C. Baron ◽  
Charlotte Hanlon ◽  
Sumaya Mall ◽  
Simone Honikman ◽  
Erica Breuer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Maternal Mental Health ◽  
Situational Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Integration of mental health into primary care in low- and middle-income countries: The PRIME mental healthcare plans

2016 ◽  
Vol 208 (s56) ◽  
pp. s1-s3 ◽  
Author(s):  
Crick Lund ◽  
Mark Tomlinson ◽  
Vikram Patel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Healthcare ◽  
Design Evaluation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

SummaryThis supplement outlines the development and piloting of district mental healthcare plans from five low- and middle-income countries, together with the methods for their design, evaluation and costing. In this editorial we consider the challenges that these programmes face, highlight their innovations and draw conclusions.

scholarly journals Barriers and facilitators for scaling up mental health and psychosocial support interventions in low- and middle-income countries for populations affected by humanitarian crises: a systematic review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jordan Troup ◽  
Daniela C. Fuhr ◽  
Aniek Woodward ◽  
Egbert Sondorp ◽  
Bayard Roberts
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Psychosocial Support ◽  
Scale Up ◽  
Scaling Up ◽  
Barriers And Facilitators ◽  
Middle Income ◽  
Middle Income Countries ◽  
Humanitarian Crises ◽  
Low And Middle Income

Abstract Background Humanitarian crises increase the burden of mental disorders due to exposure to traumatic events and ongoing daily stressors. Effective mental health and psychosocial support (MHPSS) interventions exist, but barriers and facilitators for scaling up those interventions are less understood. The study aim was to identify barriers and facilitators for scaling up MHPSS interventions for populations affected by humanitarian crises in low- and middle-income countries. Methods A systematic review following PRISMA guidelines was conducted. Types of scale up were summarised, and barriers and facilitators analysed using the World Health Organization’s Expandnet framework of scaling up. Evidence quality was appraised using the Mixed Methods Appraisal Tool. Results Fourteen eligible studies were identified. Most described horizontal types of scale up, integrating services into primary and community care through staff training, task-sharing, and establishing referral and supervision mechanisms. Barriers were reported in a range of framework elements, but primarily related to those in the health system. The overall quality of studies were limited. Conclusion Few MHPSS interventions in humanitarian crises appear to have been scaled up, and scaling up efforts were largely horizontal which challenges long-term sustainability. Greater focus should be on both horizontal and vertical scaling up, which should be accompanied by higher quality research.

scholarly journals Optimizing treatment cascades for mental healthcare in Mozambique: preliminary effectiveness of the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)

2020 ◽  
Author(s):  
Katrin E Fabian ◽  
Alberto Muanido ◽  
Vasco F J Cumbe ◽  
Nelia Manaca ◽  
Leecreesha Hicks ◽  
...  
Keyword(s):  
Mental Health ◽  
Systems Analysis ◽  
Implementation Strategy ◽  
Scale Up ◽  
Mental Healthcare ◽  
Post Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Substantial investments are being made to scale-up access to mental healthcare in low- and middle-income countries, but less attention has been paid to quality and performance of nascent public-sector mental healthcare systems. This study tested the initial effectiveness of an implementation strategy to optimize routine outpatient mental healthcare cascade performance in Mozambique [the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)]. This study employed a pre–post design from September 2018 to August 2019 across four Ministry of Health clinics among 810 patients and 3234 outpatient mental health visits. Effectiveness outcomes evaluated progression through the care cascade, including: (1) initial diagnosis and medication selection; (2) enrolling in follow-up care; (3) returning after initial consultation within 60 days; (4) returning for follow-up visits on time; (5) returning for follow-up visits adherent to medication and (6) achieving function improvement. Clustered generalized linear models evaluated odds of completing cascade steps pre- vs post-intervention. Facilities prioritized improvements focused on the follow-up cascade, with 62.5% (10 of 16) monthly system modifications targeting medication adherence. At baseline, only 4.2% of patient visits achieved function improvement; during the 6 months of SAIA-MH implementation, this improved to 13.1% of patient visits. Multilevel logistic regression found increased odds of returning on time and adherent [aOR = 1.53, 95% CI (1.21, 1.94), P = 0.0004] and returning on time, adherent and with function improvement [aOR = 3.68, 95% CI (2.57, 5.44), P < 0.0001] after SAIA-MH implementation. No significant differences were observed regarding other cascade steps. The SAIA-MH implementation strategy shows promise for rapidly and significantly improving mental healthcare cascade outcomes, including the ultimate goal of patient function improvement. Given poor baseline mental healthcare cascade performance, there is an urgent need for evidence-based implementation strategies to optimize the performance of mental healthcare cascades in low- and middle-income countries.

scholarly journals Mental health of children with neurodevelopmental disorders during COVID-19: A brief report of family experiences from a low and middle income country

2021 ◽  
pp. 135910452110260
Author(s):  
Sowmyashree M Kaku
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Neurodevelopmental Disorder ◽  
Case Series ◽  
Ground Level ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Difficulties ◽  
Similar Report ◽  
Low And Middle Income

COVID-19 has grossly impacted lives of people across the globe. In particular, children have also been affected due to closure of schools, therapy, and day care centers. Families have been challenged with new circumstances, and mental health professionals are coming up with novel ways to help these families who have children with mental health issues. This article describes experiences of families who have children with a diagnosed neurodevelopmental disorder with comorbid mental health difficulties and their ways of coping with the pandemic challenges. The series will throw light on ground level experiences of families during the pandemic, give insights into their ways of adapting, and brings out problem areas which healthcare professionals must work on, to design novel ways of care. The case series is novel and a similar report has probably not been presented from India or other low and middle income countries.

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