Challenges and Strategies for Improving Training of Mid-Level Research Personnel in Nigeria

et al. 2020

BMC Health Serv Res

Self Cite

Background In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria. Method Attendees at the Nigeria Implementation Science Alliance (NISA)‘s 2019 conference participated in nominal group technique (NGT) exercise informed by the “Exploration, Preparation, Implementation, and Sustainment (EPIS)” framework. The NGT process was conducted among the nominal groups in two major sessions of 30-min phases followed by a 30-min plenary session. Data analysis proceeded in four steps: transcription, collation, theming and content analysis. Results The two major theoretical themes from the study were – opportunities and challenges of integrating mental health treatment into HIV services. Three sub-themes emerged on opportunities: building on health care facilities for HIV services (screening, counseling, task-sharing monitoring and evaluation frameworks), utilizing existing human resources or workforce in HIV programs (in-service training and including mental health in education curriculum) and the role of social and cultural structures (leveraging existing community, traditional and faith-based infrastructures). Four sub-themes emerged for challenges: double burden of stigma and the problems of early detection (HIV and mental health stigma, lack of awareness), existing policy gaps and structural challenges (fragmented health system), limited human resources for mental health care in Nigeria (knowledge gap and burnout) and dearth of data/evidence for planning and action (research gaps). Conclusions Potential for integrating treatments for mental disorders into HIV programs and services exist in Nigeria. These include opportunities for clinicians’ training and capacity building as well as community partnerships. Multiple barriers and challenges such as stigma, policy and research gaps would need to be addressed to leverage these opportunities. Our findings serve as a useful guide for government agencies, policy makers and research organizations to address co-morbid mental disorders among PLHIV in Nigeria.

Section: Discussionmentioning

confidence: 99%

Section: Processmentioning

confidence: 99%

Opportunities and challenges to integrating mental health into HIV programs in a low- and middle-income country: insights from the Nigeria implementation science Alliance

et al. 2020

BMC Health Serv Res

Self Cite

“…NGT is a structured approach for group "brainstorming", and it is useful for gathering sets of ideas, information, or recommendations and their relative importance from relevant stakeholders (29,30). The duration of the NGT process was 90 minutes and it was facilitated by ve resource persons experienced in NGT (26,28) Before commencing the process, the lead facilitator introduced the topic to the participants and highlighted why it was an important public health issue. He stated the purpose of the research and also explained the modi ed NGT process that was adopted.…”

Section: Processmentioning

confidence: 99%

“…NISA is aimed at facilitating collaboration among partners, bridging research-to-practice gaps through application of implementation science approaches and implementation research in Nigeria and other countries in Sub-Saharan Africa, and identifying feasible and culturally appropriate strategies for improving public health through research (26,27). Yearly, NISA conferences have focused on "Prevention of mother to child HIV transmission(PMTCT)" (2015), "HIV/AIDS and related infections, adolescents health, STI & Hepatitis B" (2016), "Improving Health through Implementation Science & Research" (2017) and "Evidence-based approaches to enhance quality of care" (2018) (26)(27)(28). The fth NISA conference in September 2019 focused on achieving impact through implementation research.…”

Section: Introductionmentioning

confidence: 99%

Opportunities and challenges to Integrating mental health into HIV programs in a Low- and Middle-Income Country: Insights from the Nigeria Implementation Science Alliance

et al. 2020

Preprint

Self Cite

Background: In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria.Method: Attendees at the Nigeria Implementation Science Alliance (NISA)’s 2019 conference participated in nominal group technique (NGT) exercise informed by the “Exploration, Preparation, Implementation, and Sustainment (EPIS)” framework. The NGT process was conducted among the nominal groups in two major sessions of 30-minutes phases followed by a 30-minute plenary session. Data analysis proceeded in four steps: transcription, collation, theming and content analysis.Results: The two major theoretical themes from the study were – opportunities and challenges of integrating mental health treatment into HIV services. Three sub-themes emerged on opportunities: building on health care facilities for HIV services (screening, counseling, task-sharing monitoring and evaluation frameworks) , utilizing existing human resources or workforce in HIV programs (in-service training and including mental health in education curriculum) and the role of social and cultural structures (leveraging existing community, traditional and faith-based infrastructures). Four sub-themes emerged for challenges: double burden of stigma and the problems of early detection (HIV and mental health stigma, lack of awareness) , existing policy gaps and structural challenges (fragmented health system) , limited human resources for mental health care in Nigeria (knowledge gap and burnout) and dearth of data/evidence for planning and action (research gaps) .Conclusions: Potential for integrating treatments for mental disorders into HIV services exist in Nigeria. These include opportunities for clinicians’ training and capacity building as well as community partnerships. Multiple barriers and challenges such as stigma, policy and research gaps would need to be addressed to leverage these opportunities. Our findings serve as a useful guide for government agencies, policy makers and research organizations to address co-morbid mental disorders among PLHIV in Nigeria.

“…In this study, the process of ranking responses helped NISA to identify the priority areas regarding the opportunities and challenges of integrating mental health care into HIV treatment in Nigeria. The duration of the NGT process for this study was 90 minutes and it was facilitated by ve resource persons experienced in NGT (26,28) Before commencing the process, the lead facilitator introduced the topic to the participants and highlighted why it was an important public health issue. He stated the purpose of the research and also explained the modi ed NGT process that was adopted.…”

Section: Processmentioning

confidence: 99%

Opportunities and challenges to Integrating mental health into HIV programs in a Low- and Middle-Income Country: Insights from the Nigeria Implementation Science Alliance

et al. 2020

Preprint

Self Cite

Background: In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria. Method: Attendees at the Nigeria Implementation Science Alliance (NISA)’s 2019 conference participated in nominal group technique (NGT) exercise informed by the “Exploration, Preparation, Implementation, and Sustainment (EPIS)” framework. The NGT process was conducted among the nominal groups in two major sessions of 30-minutes phases followed by a 30-minute plenary session. Data analysis proceeded in four steps: transcription, collation, theming and content analysis. Results: The two major theoretical themes from the study were – opportunities and challenges of integrating mental health treatment into HIV services. Three sub-themes emerged on opportunities: building on health care facilities for HIV services (screening, counseling, task-sharing monitoring and evaluation frameworks) , utilizing existing human resources or workforce in HIV programs (in-service training and including mental health in education curriculum) and the role of social and cultural structures (leveraging existing community, traditional and faith-based infrastructures). Four sub-themes emerged for challenges: double burden of stigma and the problems of early detection (HIV and mental health stigma, lack of awareness) , existing policy gaps and structural challenges (fragmented health system) , limited human resources for mental health care in Nigeria (knowledge gap and burnout) and dearth of data/evidence for planning and action (research gaps) . Conclusions: Potential for integrating treatments for mental disorders into HIV services exist in Nigeria. These include opportunities for clinicians’ training and capacity building as well as community partnerships. Multiple barriers and challenges such as stigma, policy and research gaps would need to be addressed to leverage these opportunities. Our findings serve as a useful guide for government agencies, policy makers and research organizations to address co-morbid mental disorders among PLHIV in Nigeria.