Voices from the Ground: Ethnographic Perspectives on Strengthening the Ugandan National Mental Health System: An Ethnographic Needs Assessment

Abstract

Background Mental health capacity building is a critical need and a growing priority in Ugandan health and education systems. Despite increased governmental attention to community mental health and mental healthcare needs, no published assessments garner qualitative perspectives directly from stakeholders in the Ugandan mental health system. Addressing this gap, the goal of the current needs assessment study was to systematically explore stakeholders’ perceptions of strengths, challenges, and recommendations for enhancing capacity in the national mental health system in Uganda. Methods Using qualitative ethnographic methods, data was collected from key informants through interviews and focus groups. A total of 44 stakeholders, who were engaged in the mental health system, were included in our final sample. Results Thematic analyses of data yielded several themes in each category, including system strengths related to existing policy and action plan, free medications, private sector, partnerships and collaborations; system challenges including socioeconomic constraints, stigma, and limited family engagement; and recommendations for improvement including enhanced education and training, integrating systemic approaches, and policy advocacy. Conclusion The results of this study have clinical, research, and policy implications that may inform mental health capacity, not only in Uganda, but in other global settings, advancing capacity to respond to pressing community mental health needs.