scholarly journals Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps

2018 ◽  
Vol 5 ◽  
Author(s):  
C. Echeverri ◽  
J. Le Roy ◽  
B. Worku ◽  
P. Ventevogel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Capacity Building ◽  
Sub Saharan Africa ◽  
Health Care Settings ◽  
Humanitarian Settings ◽  
Primary Health ◽  
Sub Saharan ◽  
Primary Health Care Settings

Background.In 2015, the United Nations High Commissioner for Refugees started a process of mental health capacity building in refugee primary health care settings in seven countries in Sub-Saharan Africa, ultimately aiming to decrease the treatment gap of mental, neurological and substance use (MNS) conditions in these operations. In 2015 and 2016, a specialized non-governmental organization, the War Trauma Foundation, trained 619 staff with the mental health gap action programme (mhGAP) Humanitarian Intervention Guide (HIG), a tool designed to guide clinical decision making in humanitarian settings.Methods.This paper describes the results of a process evaluation of a real-life implementation project by an external consultant, one and a half years after starting the programme.Results.The mhGAP-HIG capacity building efforts had various effects contributing to the integration of mental health in refugee primary health care. Facility-and community-based staff reported strengthened capacities to deliver mental health and psychosocial support interventions as well as changes in their attitude towards people suffering from MNS conditions. Service delivery and collaboration amongst different intervention levels improved. The scarcity of specialized staff in these settings was a major barrier, hindering the setting-up of supervision mechanisms.Conclusion.Mental health training of non-specialized staff in complex humanitarian settings is feasible and can lead to increased competency of providers. However, capacity building is a ‘process’ and not an ‘event’ and mhGAP trainings are only one element in a spectrum of activities aimed at integrating mental health into general health care. Regular supervision and continuing on-the-job training are in fact critical to ensure sustainability.

scholarly journals Primary Health Worker's Perception on the Need of Integrating Mental Health in Primary Health Care Settings of Kaski District

2019 ◽  
Vol 9 (2) ◽  
pp. 48-52
Author(s):  
Arati Poudel ◽  
Bimala Bhatta
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Workers ◽  
Care Level ◽  
Health Care Settings ◽  
Primary Health ◽  
Mental Health Integration ◽  
Primary Health Care Settings

Introduction: The most effective way to close the treatment gap is to integrate mental health services with primary care to ensure that people receive mental health care they need in their place. Understanding providers' perceptions of evidence-based intervention have an undeniable role in improving their dissemination, implementation, and sustained use. Methods: This study was carried out to assess primary health workers' perception of the need of integrating mental health in primary health care settings in which 200 health workers from all the PHC, HP and UHC of the Kaski district were given a self-administered Likert scale having 5 points to assess the perception of health workers on need of integrating mental health in primary health care settings. The median score of Likert scale of perception of need was calculated then the chi square test was done to find the association which was followed by calculating adjusted odds ratio using binary logistic regression analysis. Results: Health workers who had gained information on mental health from course of study are 2.316 [CI:1.124-4.770] times more likely to perceive need of mental health integration into the primary health care setting and those who have provided mental health service are 2.801 [CI: 1.495-5.249] times more likely to be positive towards need. Conclusions: The majority of the health workers working at the primary health care level at Kaski district are positive towards mental health integration with the high number of health workers interested in receiving mental health training thus they should be provided with basic training in mental health to enhance their knowledge and skills for being able to provide mental health care to patients seeking help at the primary health care level.

scholarly journals Implementing combined WHO mhGAP and adapted group interpersonal psychotherapy to address depression and mental health needs of pregnant adolescents in Kenyan primary health care settings (INSPIRE): a study protocol for pilot feasibility trial of the integrated intervention in LMIC settings

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Manasi Kumar ◽  
Keng-Yen Huang ◽  
Caleb Othieno ◽  
Dalton Wamalwa ◽  
Kimberly Hoagwood ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Training Manual ◽  
Evidence Based ◽  
Depression Care ◽  
Pregnant Adolescents ◽  
Health Care Settings ◽  
Primary Health ◽  
Primary Health Care Settings

Abstract Background Addressing adolescent pregnancies associated health burden demands new ways of organizing maternal and child mental health services to meet multiple needs of this group. There is a need to strengthen integration of sustainable evidence-based mental health interventions in primary health care settings for pregnant adolescents. The proposed study is guided by implementation science frameworks with key objective of implementing a pilot trial testing a full IPT-G version along with IPT-G mini version under the mhGAP/IPT-G service framework and to study feasibility of the integrated mhGAP/IPT-G adolescent peripartum depression care delivery model and estimate if a low cost and compressed version of IPT-G intervention would result in similar size of effect on mental health and family functioning as the Full IPT-G. There are two sub- studies embedded which are: 1) To identify multi-level system implementation barriers and strategies guided by the Consolidated Framework for Implementation Research (CFIR) to enhance perinatal mhGAP-depression care and evidence-based intervention integration (i.e., group interpersonal psychotherapy; IPT-G) for pregnant adolescents in primary care contexts; 2) To use findings from aim 1 and observational data from Maternal and Child Health (MCH) clinics that run within primary health care facilities to develop a mental health implementation workflow plan that has buy-in from key stakeholders, as well as to develop a modified protocol and implementation training manual for building health facility staff’s capacity in implementing the integrated mhGAP/IPT-G depression care. Methods For the primary objective of studying feasibility of the integrated mhGAP/IPT-G depression care in MCH service context for adolescent perinatal depression, we will recruit 90 pregnant adolescents to a three-arm pilot intervention (unmasked) trial study (IPT-G Full, IPT-G Mini, and wait-list control in the context of mhGAP care). Pregnant adolescents ages 13–18, in their 1st-2nd trimester with a depression score of 13 and above on EPDS would be recruited. Proctor’s implementation evaluation model will be used. Feasibility and acceptability of the intervention implementation and size of effects on mental health and family functioning will be estimated using mixed method data collection from caregivers of adolescents, adolescents, and health care providers. In the two sub-studies, stakeholders representing diverse perspectives will be recruited and focus group discussions data will be gathered. For aim 2, to build capacity for mhGAP-approach of adolescent depression care and research, the implementation-capacity training manual will be applied to train 20 providers, 12 IPT-G implementers/health workers and 16 Kenyan researchers. Acceptability and appropriateness of the training approach will be assessed. Additional feedback related to co-located service delivery model, task-shifting and task-sharing approach of IPT-G delivery will be gathered for further manual improvement. Discussion This intervention and service design are in line with policy priority of Government of Kenya, Kenya Vision 2030, World Health Organization, and UN Sustainable Development Goals that focus on improving capacity of mental health service systems to reduce maternal, child, adolescent health and mental health disparities in LMICs. Successfully carrying out this study in Kenya will provide an evidence-based intervention service development and implementation model for adolescents in other Sub-Saharan African (SSA) countries. The study is funded by FIC/NIH under K43 grant.

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