Childhood Mental Disorders in Primary Health Care: Results of Observations in Four Developing Countries

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 677-683
Author(s):  
R. Giel ◽  
M. V. de Arango ◽  
C. E. Climent ◽  
T. W. Harding ◽  
H. H. A. Ibrahim ◽  
...  

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Colombia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to that encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The results have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

2015 ◽  
Vol 31 (2) ◽  
pp. 250-258 ◽  
Author(s):  
Mary-Anne Ahiabu ◽  
Britt P Tersbøl ◽  
Richard Biritwum ◽  
Ib C Bygbjerg ◽  
Pascal Magnussen

Author(s):  
Alexandro Pinto ◽  
Luciana Sepúlveda Köpcke ◽  
Renata David ◽  
Hannah Kuper

Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.


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