Partnership for the implementation of mental health policy in Nigeria: a case study of the Comprehensive Community Mental Health Programme in Benue State

Ryan, Grace; Nwefoh, Emeka; Aguocha, Chinyere Mirian; Ode, P. O.; Okpoju, S. O.; Ocheche, P.; Woyengikuro, A.; Abdulmalik, Jibril; Eaton, Julian

doi:10.1186/s13033-020-00344-z

Cited by 16 publications

(19 citation statements)

References 36 publications

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“…Asimismo, en Nigeria se realizó un estudio en el que se evaluó la transición de un programa local desde el enfoque hospitalario hacia el comunitario mediante el fortalecimiento de la atención en salud mental en la atención primaria, concluyendo que independientemente de la escases de recursos económicos, al capacitar a los profesionales del sistema primario en temáticas básicas de salud mental y realizando operaciones de fortalecimiento y gestión con las redes comunitarias, se podría lograr una transición exitosa hacia este modelo, principalmente en lo relativo del acceso a la atención en salud mental desde el sistema primario( 18 ).…”

Section: Resultados Y Discusiónunclassified

“…Con relación a los determinantes sociales, muchos de los países de ingresos medios y bajos, todavía enfrentan la problemática de la inequidad y la pobreza. Por ejemplo, Chile se mantiene como uno de los países con mayores niveles de desigualdad dentro de los de La Organización para la Cooperación y Desarrollo Económicos (OCDE) con altas brechas entre los deciles más altos y bajos de la población ( 18 ), existiendo todavía un alto índice de pobreza multidimensional (IPM), con una tasa nacional del 20,7% ( 20 ).…”

Section: Resultados Y Discusiónunclassified

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Determinantes sociales de la salud mental: políticas públicas desde el modelo biopsicosocial en países latinoamericanos

Peña

Rubí-González

Vicente-Parada

2021

Revista Panamericana De Salud Pública

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En este artículo se expone la evidencia sobre la implementación de políticas públicas en salud mental, con el objetivo de describir los avances y los desafíos para poner en marcha el modelo biopsicosocial y comunitario principalmente en Latinoamérica. Se realizó una revisión teórica de artículos indexados en Web Of Science, Scopus, PubMed y SciELO. Se incorporaron informes y programas gubernamentales. Los determinantes sociales impactan a la salud mental, la pobreza aumenta significativamente el riesgo de desarrollar una psicopatología. Por ello, la Organización Mundial de la Salud insiste en la necesidad de adoptar un paradigma biopsicosocial para enfrentar los desafíos de salud mental. Alrededor de un tercio de los países, todavía no cuenta con una política nacional de salud mental y existen grandes disparidades de financiamiento y cobertura para la población entre países de ingresos altos y bajos. Particularmente de Latinoamérica, los resultados ilustran un avance en países de ingresos medios y bajos, en elaborar programas de salud mental desde un enfoque comunitario y biopsicosocial. Sin embargo, presentan desafíos en su operacionalización, financiamiento y adaptación a sus realidades socioculturales. La evidencia indica que para avanzar desde un paradigma biomédico hacia uno que incorpore los determinantes sociales de la salud, no se deberían mantener idénticas estrategias en comunidades distintas, puesto que las necesidades de países de ingresos bajos y medios difieren a las de países de ingresos altos. Por ello, resulta fundamental aumentar la investigación local para generar evidencia que refleje las necesidades nacionales en materia de políticas públicas en salud mental.

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Section: Resultados Y Discusiónunclassified

Determinantes sociales de la salud mental: políticas públicas desde el modelo biopsicosocial en países latinoamericanos

Peña

Rubí-González

Vicente-Parada

2021

Revista Panamericana De Salud Pública

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“…Further, it encouraged the use of public-private partnerships to innovate the mental health system. Finally, it recommends adequate training, retraining and continuing professional education on screening, identification, and treatment of MNS conditions at all levels of care for key medical personnel [ 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Chu¹,

Roxas

Aguocha

et al. 2022

BMC Health Serv Res

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Background The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement. Methods Trainees (n = 13) completed a 43-item questionnaire before and after their 5-day training to assess perceptions of mental disorders and attitudes towards people with mental illness. These responses were analyzed using paired-sample t-tests for four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured key informant interviews (n = 11) with trainees, trainers, and local health officials who participated in or supported the HAPPINESS project were thematically analyzed to understand their experiences and perspectives of the project’s barriers, facilitators, and opportunities. Results Trainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. Key informant interviews revealed that the HAPPINESS project enhanced trainees’ diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding, and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Respondents also suggested ways that the HAPPINESS project could be improved and expanded in the future. Conclusions This study adds to the limited evidence on the implementation of mhGAP-IG in Nigeria. Using mixed methods, it evaluates how mhGAP-IG can impact perceptions and knowledge of stigma among primary care trainees. It also highlights barriers, facilitators, and opportunities to consider for project growth. Future efforts should focus on clinical support, supervision, health outcomes, as well as scaling up and assessing the cost-effectiveness of the HAPPINESS project intervention.

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“…Trained in key modules of WHO’s Mental Health Gap Action Programme Intervention Guide (Ryan et al 2020) [ 109 ]…”

Section: Resultsmentioning

confidence: 99%

Strategies to adapt and implement health system guidelines and recommendations: a scoping review

Breneol

Curran

Marten

et al. 2022

Health Res Policy Sys

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Background Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries. Methods We conducted a scoping review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was implemented in MEDLINE (Ovid), Embase, CINAHL, LILACS (VHL Regional Portal), and Web of Science databases in late August 2020. We also searched sources of grey literature and reference lists of potentially relevant reviews. All findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Results A total of 41 studies were included in the final set of papers. Common strategies were identified for adapting and implementing health system guidelines, related barriers and enablers, and indicators of success. The most common types of implementation strategies included education, clinical supervision, training and the formation of advisory groups. A paucity of reported information was also identified related to adaptation initiatives. Barriers to and enablers of implementation and adaptation were reported across studies, including the need for financial sustainability. Common approaches to evaluation were identified and included outcomes of interest at both the patient and health system level. Conclusions The findings from this review suggest several themes in the literature and identify a need for future research to strengthen the evidence base for improving the implementation and adaptation of health system guidelines in low- and middle-income countries. The findings can serve as a future resource for researchers seeking to evaluate implementation and adaptation of health system guidelines. Our findings also suggest that more effort may be required across research, policy and practice sectors to support the adaptation and implementation of health system guidelines to local contexts and health system arrangements in low- and middle-income countries.

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Partnership for the implementation of mental health policy in Nigeria: a case study of the Comprehensive Community Mental Health Programme in Benue State

Abstract: Background

Cited by 16 publications

References 36 publications

Determinantes sociales de la salud mental: políticas públicas desde el modelo biopsicosocial en países latinoamericanos

Determinantes sociales de la salud mental: políticas públicas desde el modelo biopsicosocial en países latinoamericanos

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Strategies to adapt and implement health system guidelines and recommendations: a scoping review

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