An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia

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dc.contributor.authorFaydi, Edwigeen_ZA
dc.contributor.authorFunk, Michelleen_ZA
dc.contributor.authorKleintjes, Sharonen_ZA
dc.contributor.authorOfori-Atta, Angelaen_ZA
dc.contributor.authorSsbunnya, Joshuaen_ZA
dc.contributor.authorMwanza, Jasonen_ZA
dc.contributor.authorKim, Carolineen_ZA
dc.contributor.authorFlisher, Alanen_ZA
dc.date.accessioned2015-11-11T12:03:30Z
dc.date.available2015-11-11T12:03:30Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND: Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. METHODS: The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached. RESULTS: All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. CONCLUSIONS: Six gaps which could impact on the policies' effect on countries' mental health systems were: lack of internal consistency of structure and content of policies, superficiality of key international concepts, lack of evidence on which to base policy directions, inadequate political support, poor integration of mental health policies within the overall national policy and legislative framework, and lack of financial specificity. Three strategies to address these concerns emerged, namely strengthening capacity of key stakeholders in public (mental) health and policy development, creation of a culture of inclusive and dynamic policy development, and coordinated action to optimize use of available resources.en_ZA
dc.identifier.apacitationFaydi, E., Funk, M., Kleintjes, S., Ofori-Atta, A., Ssbunnya, J., Mwanza, J., ... Flisher, A. (2011). An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia. <i>Health Research Policy and Systems</i>, http://hdl.handle.net/11427/14902en_ZA
dc.identifier.chicagocitationFaydi, Edwige, Michelle Funk, Sharon Kleintjes, Angela Ofori-Atta, Joshua Ssbunnya, Jason Mwanza, Caroline Kim, and Alan Flisher "An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia." <i>Health Research Policy and Systems</i> (2011) http://hdl.handle.net/11427/14902en_ZA
dc.identifier.citationFaydi, E., Funk, M., Kleintjes, S., Ofori-Atta, A., Ssbunnya, J., Mwanza, J., ... & Flisher, A. (2011). An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia. Health Res Policy Syst, 9(1), 17.en_ZA
dc.identifier.ris TY - Journal Article AU - Faydi, Edwige AU - Funk, Michelle AU - Kleintjes, Sharon AU - Ofori-Atta, Angela AU - Ssbunnya, Joshua AU - Mwanza, Jason AU - Kim, Caroline AU - Flisher, Alan AB - BACKGROUND: Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. METHODS: The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached. RESULTS: All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. CONCLUSIONS: Six gaps which could impact on the policies' effect on countries' mental health systems were: lack of internal consistency of structure and content of policies, superficiality of key international concepts, lack of evidence on which to base policy directions, inadequate political support, poor integration of mental health policies within the overall national policy and legislative framework, and lack of financial specificity. Three strategies to address these concerns emerged, namely strengthening capacity of key stakeholders in public (mental) health and policy development, creation of a culture of inclusive and dynamic policy development, and coordinated action to optimize use of available resources. DA - 2011 DB - OpenUCT DO - 10.1186/1478-4505-9-17 DP - University of Cape Town J1 - Health Research Policy and Systems LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia TI - An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia UR - http://hdl.handle.net/11427/14902 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14902
dc.identifier.urihttp://dx.doi.org/10.1186/1478-4505-9-17
dc.identifier.vancouvercitationFaydi E, Funk M, Kleintjes S, Ofori-Atta A, Ssbunnya J, Mwanza J, et al. An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia. Health Research Policy and Systems. 2011; http://hdl.handle.net/11427/14902.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Faydi et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceHealth Research Policy and Systemsen_ZA
dc.source.urihttp://www.health-policy-systems.com/en_ZA
dc.subject.otherMental health policiesen_ZA
dc.subject.otherGhanaen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherUgandaen_ZA
dc.subject.otherZambiaen_ZA
dc.subject.otherAfricaen_ZA
dc.subject.otherWHO Mental Health Policy Checklisten_ZA
dc.titleAn assessment of mental health policy in Ghana, South Africa, Uganda and Zambiaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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