Abstract
BackgroundDeveloping evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority.AimsTo outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia.MethodA mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation).ResultsThe community packages were community case detection, community reintegration and community inclusion. The facility packages included capacity building, decision support and staff well-being. Organisational packages were programme management, supervision and sustainability.ConclusionsThe MHCP focused on improving demand and access at the community level, inclusive care at the facility level and sustainability at the organisation level. The MHCP represented an essential framework for the provision of integrated care and may be a useful template for similar LMIC.
Highlights
Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority
The main gap in knowledge is on how best to meet these needs. Prompted by his first-hand experience of working in Ethiopia, the late Professor Robert Giel made the argument over four decades ago, well before the Alma Ata declaration, that if mental health services are to be expanded to address the mental health needs in LMIC, two things have to happen: (a) certain disorders have to be prioritised as targets of intervention given the resource constraints in LMIC; and (b) mental healthcare has to be provided by non-specialists through task-sharing and integration into primary care.[6]
What kind of organisational support is needed and what interventions are required to gain this organisational support? What kind of capacity strengthening support is required to enable primary care staff to provide safe, effective and inclusive care? What are the best approaches to improve accessibility of care in a traditional rural population that live in difficult to access terrains? This paper aims to answer these questions by describing a mental healthcare plan (MHCP), which defines the key intervention packages to be implemented in one rural district in Ethiopia
Summary
Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority. Aims To outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia. Method A mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation).
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