The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia

Abstract

BackgroundThe lack of trained mental health professionals has been an important barrier to establishing mental health services in low income countries. The purpose of this paper is to describe the development and implementation of child psychiatry training within a graduate program in mental health for non-physician clinicians in Ethiopia.MethodsThe existing needs for competent practitioners in child psychiatry were identified through discussions with psychiatrists working in Ethiopia as well as with relevant departments within the Federal Ministry of Health Ethiopia (FMOHE). As part of a curriculum for a two year Master of Science (MSC) in Mental Health program for non-physician clinicians, child psychiatry training was designed and implemented by Jimma University with the involvement of experts from Addis Ababa University (AAU), Ethiopia, and Ludwig-Maximillian’s University, (LMU), Germany. Graduates gave feedback after completing the course. The World Health Organization’s (WHO) Mental Health Gap Action Program (mhGAP) intervention guide (IG) adapted for Ethiopian context was used as the main training material.ResultsA two-week child psychiatry course and a four week child psychiatry clinical internship were successfully implemented during the first and the second years of the MSC program respectively. During the two week psychiatry course, trainees learned to observe the behavior and to assess the mental status of children at different ages who had a variety of mental health conditions. Assessment of the trainees’ clinical skills was done by the instructors at the end of the child psychiatry course as well as during the subsequent four week clinical internship. The trainees generally rated the course to be ‘very good’ to ‘excellent’. Many of the graduates have become faculty at the various universities in Ethiopia.ConclusionChild psychiatry training for non-physician mental health specialist trainees was developed and successfully implemented through collaboration with other universities. The model of institutional collaboration in training mental health professionals in the context of limited resources provides a useful guide for other low income countries where there is scarcity of psychiatrists.

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

“…Course durations varied from 3 hours training for teachers about attention deficit hyperactivity disorder, followed by a 1.5-hour booster session,13 to 5 full days ‘base course’ followed by the mhGAP ‘standard course’16 or 40 hours child psychiatry training over 2 weeks 21. Most training lasted 2–3 days, combining didactic lecture teaching with videos, role plays, communication exercises and discussions.…”

The core competencies for mental, neurological, and substance use disorder care in sub-Saharan Africa

“…Opportunities abound for testing the implementation of these core competencies by integrating them into curricular revision activities now in process at African universities that are establishing partnerships for medical and nursing training ( 27 – 30 ). Ministries of health and education play a critical role in implementation of competency-based learning, sometimes stimulating the reform of educational approaches, and by providing the necessary financial resources to carry it out ( 31 ). Implementation also requires working out institutional agreements and collaborations necessary to develop a competency-based training program of study; developing a realistic plan that includes establishing methods for distance learning and supervision, thereby ensuring access to adequate numbers of skilled professionals who can provide ongoing coaching and in vivo training that promotes the delivery of high-quality mental health care; providing credentialing and continuing education for professional development and maintenance of competencies; and establishing plans for monitoring and evaluation.…”

Level of Mental Health Service Integration in Primary Health Care Units in Debre Markos Town, Ethiopia, 2014

“…Jimma University adopted a similar program for non-physician mental health training implemented January 2010 and funded by the Federal Ministry of Education. Additionally, the program has a plan to coordinate with schools and children with community organizations [25]. Health manuals through the carter center are available in conjunction with Toronto University of Canada [26].…”

“…Jimma University changed the graduate program in 2008 to include training for mid level health workers. They were to work in district hospitals and provide supervision and support for primary health clinics to focus on child and adolescent mental health [25].…”