Knowledge, Attitudes and Practices towards Problem Management Plus among Health Care Professionals in Burera District, Rwanda: A cross – sectional study

Abstract

Introduction: Globally mental health disorders have become the leading cause of disability adjusted life where 183.9% millions of people are affected by mental health disorders and substance use. In Rwanda mental health disorder has increased and been classified among the top 10 causes of YLDs. To cope with it, since 2012 Partners In Health (PIH) in collaboration with Rwandan Ministry of Health implemented mentorship initiative namely MESH at Health Centers level in Burera District. The intervention started with pharmacotherapy and completed with Problem Management Plus in 2017 as all patients did not respond to it. However, there is no study done and published on knowledge, attitude and practice of PM+ since its implementation despite the increasing number of mental health disorders.Methods A cross-sectional study design with mixed approach was conducted in July 2022. The sample was 205 participants (HCPs) from Burera District health facilities. The interviews were conducted and structured questionnaires were filled for quantitative and an interview guide for qualitative approach to collect data before entering and analyzing data into SPSS. Descriptive statistics analysis was used to determine percentages and frequencies while multivariate seconded the bivariate regression analysis to determine the factors associated with PM + practices.Results the majority of respondents 118(60.5%) were females and their age is between 19 and 50, 136 (69.7%). Majority of them have bachelor’s degree 98(50.3%). (57.4%) of HCPs have low level of knowledge on PM + intervention, (48.2%) of them have negative attitudes and (82.1%) of HCPs have poor practices towards PM+. The male respondents were three times more likely to have good practice of PM + intervention compared to females (AOR = 3.277; 95% CI: [1.358–7.665], p = 0.008). The odds of practicing PM + intervention among respondents who did not know it than those who knew it were 1.771 times (AOR = 1.771; 95%CI: [0.534–5.872], p = 0.041). The odds of applying PM + were 12.749 times (AOR = 12.749; 95%CI: 0.751-216.377, p = 0.028) among HCPs who did not know how to use the screening tool compared to those who said that they knew how to use it.Conclusion The knowledge, attitudes and practices among HCPs have great impact on mental health project implementation and training of health care providers on PM + will be crucial.