Baseline situational analysis in Bangladesh, Jordan, Paraguay, the Philippines, Ukraine, and Zimbabwe for the WHO Special Initiative for Mental Health: Universal Health Coverage for Mental Health

Abstract

Introduction Mental, neurological and substance use conditions lead to tremendous suffering, yet globally access to effective care is limited. In line with the 13th General Programme of Work (GPW 13), in 2019 the World Health Organization (WHO) launched the WHO Special Initiative for Mental Health: Universal Health Coverage for Mental Health to advance mental health policies, advocacy, and human rights and to scale up access to quality and affordable care for people living with mental health conditions. Six countries were selected as ‘early-adopter’ countries for the WHO Special Initiative for Mental Health in the initial phase. Our objective was to rapidly and comprehensively assess the strength of mental health systems in each country with the goal of informing national priority-setting at the outset of the Initiative. Methods We used a modified version of the Program for Improving Mental Health Care (PRIME) situational analysis tool. We used a participatory process to document national demographic and population health characteristics; environmental, sociopolitical, and health-related threats; the status of mental health policies and plans; the prevalence of mental disorders and treatment coverage; and the availability of resources for mental health. Results Each country had distinct needs, though several common themes emerged. Most were dealing with crises with serious implications for population mental health. None had sufficient mental health services to meet their needs. All aimed to decentralize and deinstitutionalize mental health services, to integrate mental health care into primary health care, and to devote more financial and human resources to mental health systems. All cited insufficient and inequitably distributed specialist human resources for mental health as a major impediment. Conclusions This rapid assessment facilitated priority-setting for mental health system strengthening by national stakeholders. Next steps include convening design workshops in each country and initiating monitoring and evaluation procedures.

Exploring the potential of delivering mental health care services using digital technologies in Bangladesh: A qualitative analysis

“…In Bangladesh, there are limited psychiatrists and psychologists for a population of 163 million people, which highlights the potential role of an integrated digitally-based mental health services ( Sakib, 2021 ; Alam et al, 2020 ; Islam and Biswas, 2015 ; Kemp et al, 2022 ). Currently, various digital media-based solutions are provided by NGOs: Kaan Pete Roi, for example, acts as a suicide prevention helpline ( Khan et al, 2021 ), while the mobile app MAYA provides countrywide health and mental healthcare services through doctors and psychologists via SMS and telecommunication ( MAYA, 2022 ).…”

Understanding the nature of substance use in Zimbabwe: State of the art and ways forward: A scoping review protocol

“…2 Shona term for cannabis. 3 Shona term for crystal meth. 4 Illegally imported and banned brand of cough syrup containing codeine used locally.…”

“…The situation is further compounded by the treatment gap for mental, neurological and substance use disorders, with sub-Saharan Africa having the largest gap globally [16]. This is largely linked to the 'brain drain' due to mass emigration of mental health professionals [17], and significant underfunding for mental health services due to resource constraints [3]. For example, there is a paucity of drug and alcohol specialist treatment facilities in Zimbabwe [3].…”

“…This renewed call to address substance use disorders comes following the global focus on mental health and the desire to achieve equitable access to mental health services for mental, neurological and substance use disorders. This is the key aim of the World Health Organisation's (WHO) Special Initiative for Mental Health: Universal Health Coverage for Mental Health, which was launched in 2019 [3]. One of the early adopters of this initiative from the sub-Saharan Africa region is Zimbabwe, a low to middle income country (LMIC) that has experienced significant economic, social and political challenges over the past few decades [4].…”

“…This is largely linked to the ‘brain drain’ due to mass emigration of mental health professionals [17], and significant underfunding for mental health services due to resource constraints [3]. For example, there is a paucity of drug and alcohol specialist treatment facilities in Zimbabwe [3]. The situation for managing SUDs is also likely to be worsened by the emerging reports of the country becoming a hub for drug trafficking, whereby drug runners are reportedly compensated for their services using drugs, increasing availability of drugs in local communities [18, 9].…”