scholarly journals Research, education and capacity building priorities for violence, abuse and mental health in low- and middle-income countries: an international qualitative survey

2021 ◽  
Author(s):  
Roxanne C. Keynejad ◽  
Abigail Bentley ◽  
Urvita Bhatia ◽  
Oliva Nalwadda ◽  
Fikru Debebe Mekonnen ◽  
...  
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Voluntary Sector ◽  
Sub Saharan Africa ◽  
World Health ◽  
Health Priorities ◽  
Middle Income ◽  
Research Education ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Purpose Despite the World Health Organization and United Nations recognising violence, abuse and mental health as public health priorities, their intersection is under-studied in low- and middle-income countries (LMICs). International violence, abuse and mental health network (iVAMHN) members recognised the need to identify barriers and priorities to develop this field. Methods Informed by collaborative discussion between iVAMHN members, we conducted a pilot study using an online survey to identify research, education and capacity building priorities for violence, abuse and mental health in LMICs. We analysed free-text responses using thematic analysis. Results 35 senior (29%) and junior researchers (29%), non-government or voluntary sector staff (18%), health workers (11%), students (11%) and administrators (3%) completed the survey. Respondents worked in 24 LMICs, with 20% working in more than one country. Seventy-four percent of respondents worked in sub-Saharan Africa, 37% in Asia and smaller proportions in Latin America, Eastern Europe and the Middle East. Respondents described training, human resource, funding and sensitivity-related barriers to researching violence, abuse and mental health in LMICs and recommended a range of actions to build capacity, streamline research pathways, increase efficiency and foster collaborations and co-production. Conclusion The intersection between violence, abuse and mental health in LMICs is a priority for individuals with a range of expertise across health, social care and the voluntary sector. There is interest in and support for building a strong network of parties engaged in research, service evaluation, training and education in this field. Networks like iVAMHN can act as hubs, bringing together diverse stakeholders for collaboration, co-production and mutually beneficial exchange of knowledge and skills.

scholarly journals Stemming the tide: promoting mental health and preventing mental disorders in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Global Mental Health ◽  
Action Plan ◽  
Mental Health Promotion ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The first World Health Organization's global action plan for mental health recognizes the importance of mental health promotion and prevention of mental disorders, through the inclusion of one of four objectives focused on this crucial area of research and practice. This paper aims to provide an ‘aerial view’ of the field of mental health promotion and prevention of mental disorders with a focus on low- and middle-income countries. Starting with reasons why promotion and prevention need to take center stage in global mental health efforts, the paper provides a framework and four general principles to guide such efforts: a socio-ecological perspective (place); an inter-sectoral and interdisciplinary approach (collaboration), a developmental perspective (timing), and a participatory and empowerment approach (strengths), or PaCTS. Evidence-based examples of mental health promotion, universal, selective, and indicated prevention are described.

scholarly journals The potential of low-intensity and online interventions for depression in low- and middle-income countries

2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech
Keyword(s):  
Mental Health ◽  
World Health ◽  
Online Interventions ◽  
Treatment Protocols ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Intensity ◽  
The World ◽  
Health Gap ◽  
Low And Middle Income

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.

scholarly journals Invited commentary on … Mental health research priorities in low- and middle-income countries

2009 ◽  
Vol 195 (4) ◽  
pp. 364-365 ◽  
Author(s):  
Ricardo Araya
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Research Priorities ◽  
Mental Health Research ◽  
Health Priorities ◽  
Middle Income ◽  
Simple Process ◽  
Inequalities In Health ◽  
Middle Income Countries ◽  
Low And Middle Income

SummaryThere are huge inequalities in health research within and between countries. It is argued that this may hinder the process of setting and tackling mental health priorities. If this were true, establishing research priorities would be important. However, this is not a simple process and one must be aware of its limitations. Despite a plethora of declarations, funding for mental health research in low- and middle-income countries remains hard to find. In the absence of funding, establishing research priorities is seen by many as an exercise of lesser importance.

scholarly journals Disability and treatment of specific mental and physical disorders across the world

2008 ◽  
Vol 192 (5) ◽  
pp. 368-375 ◽  
Author(s):  
Johan Ormel ◽  
Maria Petukhova ◽  
Somnath Chatterji ◽  
Sergio Aguilar-Gaxiola ◽  
Jordi Alonso ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
High Income ◽  
World Health ◽  
Role Functioning ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Physical Disorders ◽  
Low And Middle Income

BackgroundAdvocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion.AimsTo establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries.MethodCommunity epidemiological surveys were administered in 15 countries through the World Health Organization World Mental Health (WMH) Survey Initiative.ResultsRespondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders.ConclusionsDespite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.

scholarly journals COVID-19 preparedness—a survey among neonatal care providers in low- and middle-income countries

2021 ◽  
Author(s):  
Claus Klingenberg ◽  
◽  
Sahil K. Tembulkar ◽  
Anna Lavizzari ◽  
Charles C. Roehr ◽  
...  
Keyword(s):  
Low Income ◽  
Care Delivery ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
World Health ◽  
Care Providers ◽  
Clinical Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Objective To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. Study design Cross-sectional, web-based survey administered between May and June, 2020. Results Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. Conclusions Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

scholarly journals Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers

2017 ◽  
Vol 27 (1) ◽  
pp. 11-21 ◽  
Author(s):  
M. Semrau ◽  
A. Alem ◽  
J. Abdulmalik ◽  
S. Docrat ◽  
S. Evans-Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Capacity Building ◽  
Mental Health System ◽  
Health System Strengthening ◽  
Target Groups ◽  
Middle Income ◽  
Middle Income Countries ◽  
Building Activities ◽  
Low And Middle Income

There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the ‘Emerging mental health systems in low- and middle-income countries’ (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.

scholarly journals Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers

2017 ◽  
Vol 27 (1) ◽  
pp. 3-10 ◽  
Author(s):  
C. Hanlon ◽  
M. Semrau ◽  
A. Alem ◽  
S. Abayneh ◽  
J. Abdulmalik ◽  
...  
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Evidence Base ◽  
Health System Strengthening ◽  
Service Users ◽  
Target Groups ◽  
Middle Income ◽  
Middle Income Countries ◽  
Building Activities ◽  
Low And Middle Income

Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.

Physical injury and psychotic experiences in 48 low- and middle-income countries

2019 ◽  
pp. 1-8 ◽  
Author(s):  
A. Stickley ◽  
T. Sumiyoshi ◽  
Z. Narita ◽  
H. Oh ◽  
J. E. DeVylder ◽  
...  
Keyword(s):  
Mental Health ◽  
Meta Analysis ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Psychotic Experiences ◽  
Mental Health Systems ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractBackgroundPsychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- and middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs.MethodCross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002–2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression.ResultsIn fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85–2.31], traffic injury (OR 1.84, 95% CI 1.53–2.21) and other injury (OR 2.09, 95% CI 1.84–2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22–2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle).ConclusionsDifferent types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.

scholarly journals Lay-delivered talk therapies for adults affected by humanitarian crises in low- and middle-income countries

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Grace K. Ryan ◽  
Andreas Bauer ◽  
Tarik Endale ◽  
Onaiza Qureshi ◽  
Asmae Doukani ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Evidence Synthesis ◽  
World Health ◽  
Cochrane Library ◽  
Middle Income ◽  
Middle Income Countries ◽  
Link Type ◽  
Humanitarian Crises ◽  
Low And Middle Income

Abstract Background Published by the World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) in 2015, the mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) recommends brief versions of structured psychological interventions for people experiencing symptoms of common mental disorders (CMDs). mhGAP-HIG acknowledges a growing body of evidence suggesting these interventions can be delivered by lay workers to people affected by humanitarian crises in low- and middle-income countries (LMICs). However, there has not yet been a systematic review and synthesis of this evidence. This paper reports the results of a systematic review of qualitative, quantitative, and mixed-methods studies assessing the implementation and/or effectiveness of talk therapies for CMDs when provided by lay workers in LMICs to adults who have survived or are currently living in humanitarian situations. Methods Seven electronic databases were searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library, and ClinicalTrials.gov. We also hand-searched the contents pages of three academic journals, reference lists of 30 systematic reviews, and online resource directories of two mental health networks. A preliminary list of included studies was circulated to topical experts for review, and all included studies were backward and forward searched. All titles, abstracts, and full-texts were independently double-screened. Quality appraisal and data extraction were carried out by a single reviewer and checked by a second reviewer, using standardised tools. Any disagreements were discussed and referred to a third reviewer as needed. Results We identified 23 unique studies and carried out a narrative synthesis of patient and implementation outcome data. Every evaluation of the effectiveness of lay-delivered talk therapies for adults affected by humanitarian crises in LMICs showed some treatment effect for at least one CMD, and often multiple CMDs. Implementation research generally found these interventions to be acceptable, appropriate and feasible to implement, with good fidelity to manualised therapies. Conclusion Although results are promising, particularly for individually-delivered talk therapies based on cognitive behavioural therapy techniques, there is a high degree of heterogeneity in this literature. We make several recommendations on how to improve the quality and generalisability of research on this topic, to facilitate further evidence synthesis. Trial registration PROSPERO registration number: CRD42017058287.

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