Context: Neuro-psychiatric disorders are the world's highest cause of incapacity. Mental disease in Africa is taboo and stigmatized, making it a challenge of a silent even hidden epidemy. In Sub-Saharan Africa it is estimated that 20% of patients with mental disorders are treated in primary health care centres and 50-75% are not detected in health facilities. In Mozambique, the prevalence of mental disorders and the frequency with which mental patients are treated at health facilities are not known. Objective: To estimate mental and neurologic disorders burden in Mozambique and evaluate access to mental health care services. Methods: A systematic review of research published in Portuguese, English, French and Spanish during 2017 and 2018 was carried out. We also consulted hospital and outpatient clinical files and yearly reports in the health units of national health system. Quantitative and mixed methods articles were subjected to quantitative meta-analysis and the qualitative and mixed methods articles were submitted to thematic and ethnographic analysis for qualitative meta-synthesis. Results: After selecting 130 articles meeting the search criteria we applied eligibility conditions and reviewed 17 quantitative, 6 mixed-methods and 7 qualitative articles. Population perception about mental illness shows that it is considered a consequence of spiritual problems and patients mainly seek out traditional health practitioners. Epilepsy, a neurologic disorder, is referred in Mozambique as the most prevalent mental disorder. The provision of care for the mentally ill by the national health service is far below the needs. The Mozambican Ministry of Health has a good development program for future mental health services. Discussion: We find scarcity of research in the area of mental health, but progress over time. Studies, though mostly of low quality, show a high burden of mental illness in the Mozambican population, which uses traditional medicine due to lack of conventional health services and cultural adaptation of therapeutic procedures. Conclusion: This study contributes to reveal the beliefs and main mental health problems in the Mozambican population and health system. We propose recommendations for preventive activities and the development of mental health services. This review was registered at www.crd.york.ac.uk/prospero (CRD42018103923).
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