Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis

 

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dc.contributor.author Mugisha, James
dc.contributor.author Abdulmalik, Jibril
dc.contributor.author Hanlon, Charlotte
dc.contributor.author Petersen, Inge
dc.contributor.author Lund, Crick
dc.contributor.author Upadhaya, Nawaraj
dc.contributor.author Ahuja, Shalini
dc.contributor.author Shidhaye, Rahul
dc.contributor.author Mntambo, Ntokozo
dc.contributor.author Alem, Atalay
dc.contributor.author Gureje, Oye
dc.contributor.author Kigozi, Fred
dc.date.accessioned 2017-03-24T12:02:23Z
dc.date.available 2017-03-24T12:02:23Z
dc.date.issued 2017-01-05
dc.identifier.citation Mugisha, J., Abdulmalik, J., Hanlon, C., Petersen, I., Lund, C., Upadhaya, N., ... & Gureje, O. (2017). Health systems context (s) for integrating mental health into primary health care in six Emerald countries: a situation analysis. International Journal of Mental Health Systems, 11(1), 7.
dc.identifier.uri http://dx.doi.org/10.1186/s13033-016-0114-2
dc.identifier.uri http://hdl.handle.net/11427/24087
dc.description.abstract Background: Mental, neurological and substance use disorders contribute to a significant proportion of the world’s disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. Methods: A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analyzed using thematic content analysis. Results: Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilization for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be in adequate in all the study countries. Monitoring and evaluation systems to support the integration of mental health into PHC in all the study countries were also inadequate. Conclusion: Integration of mental health into PHC will require addressing the resource limitations that have been identified in this study. There is a need for up to date mental health legislation and policies to engender commitment in allocating resources to mental health services.
dc.language.iso en
dc.publisher BioMed Central
dc.source Internatinal Journal of Mental Health Systems
dc.source.uri http://ijmhs.biomedcentral.com/
dc.title Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis
dc.type Journal Article
dc.date.updated 2017-01-05T19:03:12Z
dc.rights.holder The Author(s)
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Mugisha, J., Abdulmalik, J., Hanlon, C., Petersen, I., Lund, C., Upadhaya, N., ... Kigozi, F. (2017). Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis. <i>Internatinal Journal of Mental Health Systems</i>, http://hdl.handle.net/11427/24087 en_ZA
dc.identifier.chicagocitation Mugisha, James, Jibril Abdulmalik, Charlotte Hanlon, Inge Petersen, Crick Lund, Nawaraj Upadhaya, Shalini Ahuja, et al "Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis." <i>Internatinal Journal of Mental Health Systems</i> (2017) http://hdl.handle.net/11427/24087 en_ZA
dc.identifier.vancouvercitation Mugisha J, Abdulmalik J, Hanlon C, Petersen I, Lund C, Upadhaya N, et al. Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis. Internatinal Journal of Mental Health Systems. 2017; http://hdl.handle.net/11427/24087. en_ZA
dc.identifier.ris TY - Journal Article AU - Mugisha, James AU - Abdulmalik, Jibril AU - Hanlon, Charlotte AU - Petersen, Inge AU - Lund, Crick AU - Upadhaya, Nawaraj AU - Ahuja, Shalini AU - Shidhaye, Rahul AU - Mntambo, Ntokozo AU - Alem, Atalay AU - Gureje, Oye AU - Kigozi, Fred AB - Background: Mental, neurological and substance use disorders contribute to a significant proportion of the world’s disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. Methods: A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analyzed using thematic content analysis. Results: Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilization for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be in adequate in all the study countries. Monitoring and evaluation systems to support the integration of mental health into PHC in all the study countries were also inadequate. Conclusion: Integration of mental health into PHC will require addressing the resource limitations that have been identified in this study. There is a need for up to date mental health legislation and policies to engender commitment in allocating resources to mental health services. DA - 2017-01-05 DB - OpenUCT DO - 10.1186/s13033-016-0114-2 DP - University of Cape Town J1 - Internatinal Journal of Mental Health Systems LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis TI - Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis UR - http://hdl.handle.net/11427/24087 ER - en_ZA


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