Quality Indicators for Epilepsy Care in Zambia: Roadwork for the WHO Mental Health Gap Action Programme (mhGAP) Guidelines (P07.116)

Kvalsund, Michelle; Mbewe, Edward; Mulenga, Julius; Atadzhanov, Marsharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

doi:10.1212/wnl.78.1_meetingabstracts.p07.116

Cited by 2 publications

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“…As in more medically developed countries [30], low-income countries need valid quality indicators for epilepsy care that can adequately assess the effects of guideline implementation. It may be possible to develop such quality indicators even with basic health records in some LAMIC institutions [31]. Before initial implementation, plans should be discussed for updating guidelines as needed and revising them based upon the findings of the impact assessment.…”

Section: Reviewmentioning

confidence: 99%

Epilepsy care guidelines for low- and middle- income countries: From WHO mental health GAP to national programs

Katchanov

Birbeck

2012

BMC Med

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In 2011, the World Health Organization's (WHO) mental health Gap Action Programme (mhGAP) released evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.

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Section: Reviewmentioning

confidence: 99%

Epilepsy care guidelines for low- and middle- income countries: From WHO mental health GAP to national programs

Katchanov

Birbeck

2012

BMC Med

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“…As in more medically developed countries [31], low-income countries need valid quality indicators for epilepsy care that can adequately assess the effects of guideline implementation. It may be possible to develop such quality indicators even with basic health records in some LAMIC institutions [32].The clinical care algorithms provided in the mhGAP were developed for use in a wide range of possible low-income and middle-income settings, and therefore must be adapted to local resources and needs, especially if the guidelines are to be used for childhood epilepsy in resource-constrained settings.…”

Section: Discussionmentioning

confidence: 99%

Health Care Delivery Model of Childhood Epilepsy to Reduce Treatment Gap in an Outreach- Financially-Constrained District in Pakistan

2019

ARC Journal of Neuroscience

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Background: In order to tackle the considerable treatment gap for childhood epilepsy in many low-and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services in outreach financially constrained districts. However, there are limited data on implementation and impact of such services in poor settings. Our study aimed to explore the perspectives of service users on the clinical-effectiveness and cost-effectiveness of childhood epilepsy treatment received in a task-shared model in an outreach-financially constrained district Bhakhar-Pakistan. Methods: A qualitative interventional case control study was carried out using the center records and interviews with 240 children with epilepsy (160 being followed at the community childhood epilepsy center and 80 (control) receiving care as usual). Most of the care received was focused on medication provision with limited information provided on how to manage their illness and its effects. Results: Among the children getting free AEDs and monthly pediatric neurology consultations, AEDs adherence of 85% and treatment gap of 20% was documented. In comparison among the children receiving epilepsy treatment care as usual (control), AEDs adherence was 38% and childhood treatment gap, according to ILAE, was 82.5%. Childhood epilepsy treatment from local community center was 202 times cost-effective as compared to such treatment from Lahore. By integration and implementation of childhood epilepsy center in primary health financial constraints and issue of sustainability could be easily sorted out. Conclusion: Task-sharing improved the overall care of childhood epilepsy. Nonetheless, promotion of community involvement and family engagement were highlighted as areas requiring further improvement. Future work on implementing childhood epilepsy care models in LMIC contexts is warranted.

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Quality Indicators for Epilepsy Care in Zambia: Roadwork for the WHO Mental Health Gap Action Programme (mhGAP) Guidelines (P07.116)

Cited by 2 publications

References 0 publications

Epilepsy care guidelines for low- and middle- income countries: From WHO mental health GAP to national programs

Epilepsy care guidelines for low- and middle- income countries: From WHO mental health GAP to national programs

Health Care Delivery Model of Childhood Epilepsy to Reduce Treatment Gap in an Outreach- Financially-Constrained District in Pakistan

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