Utilization of traditional, complementary and alternative medicine and mental health among patients with chronic diseases in primary health care settings in Cambodia

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.

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

Global Mental Health ◽

10.1017/gmh.2018.19 ◽

2018 ◽

Vol 5 ◽

Cited By ~ 12

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.

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