Experience of Trained Primary Health Care Workers in Mental Health Service Delivery across Ogun State Nigeria

Adebowale Timothy,Olaitan Funmilayo,Ighoroje Maroh,Olarinde Samuel,Richard Gater,Onofa Lucky Umukoro,Ogunyomi Karmodeen,Olopade Modupe,Okewole Niran,Ogundele Adefolakemi,Ogunwale Adegboyega

doi:10.21767/2471-9854.100035

Abstract

Background: In developing countries with shortage of mental health professionals, paramedics are trained in the delivery of mental health services. Knowledge of the experience of the trained health workers is useful in evaluating output of service and restructuring training package. This study was undertaken to determine the experience of trained primary health care (PHC) workers in mental health service delivery across Ogun State South west Nigeria. Methods: Aro Primary Care Mental Health Program (APCMHP) was developed for the training of 80 PHC workers across the state using adapted mhGAP intervention guide to assess and treat/ refer five priority conditions: Psychosis, Depression, Epilepsy, Alcohol & Substance Abuse and Other Significant Emotional Complaint (OSEC). Data was collected on their experience 12 months after commencement of service delivery. Descriptive statistics were used and appropriate ethical approval was obtained. Results: Out of the 80 PHC workers, attrition of 25 (31.3%) was recorded in 12 months period. 54 valid questionnaires were analyzed. There were 52 (96.3%) females and 90.7% were nurses. The mean (SD) age was 42.4 (16.3) years. A total of 473 patients were seen with diagnostic breakdown as follows: Psychosis (45.9%), Epilepsy (38.3%), Depression (10.1%), OSEC (3.2%) and Alcohol & Substance Abuse (2.5%). Diagnostic and treatment difficulty was reported for the following: Psychosis (23.1%), Depression (22.0%), Epilepsy (3.7%), OSEC (52.2 %) and Alcohol & Substance Abuse (57.1%). Personal fulfillment in mental service delivery was reported by 88.5%, while 94.3% reported that the program was helpful to the community. Good attitude of clients and relatives towards the program was identified by 86.8% of the PHC workers. Conclusion: Our study revealed a high personal fulfillment of the trained PHC workers in mental health service delivery. There is need for re-training of the PHC workers towards effective service delivery.

Highlights

Mental, neurological and substance use disorders account for 14% of the global burden of disease [1]
An LMIC, with an estimated population of about 180 million people, has a lifetime prevalence of mental disorders ranging from 12.1-20% [6,7]
The objectives of the study were to describe the sociodemographic profile of primary health care (PHC) workers in Ogun state, South-West, Nigeria, to determine the caseload of patients with mental illness seen over a 12-month period and to document the experience of the trained PHC workers in mental health service delivery

Summary

Introduction

Neurological and substance use disorders account for 14% of the global burden of disease [1]. In terms of human personnel, there are less than 180 psychiatrists in the country (around 1 per 1 million population), around 5 psychiatric nurses per 100,000 population and only very few other mental and neurological health professionals like clinical psychologists, social workers, and occupational therapists [9]. This study was undertaken to determine the experience of trained primary health care (PHC) workers in mental health service delivery across Ogun State South west Nigeria. Methods: Aro Primary Care Mental Health Program (APCMHP) was developed for the training of 80 PHC workers across the state using adapted mhGAP intervention guide to assess and treat/ refer five priority conditions: Psychosis, Depression, Epilepsy, Alcohol & Substance Abuse and Other Significant Emotional Complaint (OSEC). Conclusion: Our study revealed a high personal fulfillment of the trained PHC workers in mental health service

Objectives

Methods

Findings

Conclusion