Information systems for mental health in six low and middle income countries: cross country situation analysis.

Nawaraj Upadhaya,Shalini Ahuja,Crick Lund,Fred Kigozi,Jibril Abdulmalik,Maya Semrau,Charlotte Hanlon,Mark J D Jordans,Atalay Alem,Ivan H Komproe,Graham Thornicroft,Dorothy Kizza,Oye Gureje,Rahul Shidhaye

doi:10.1186/s13033-016-0094-2

Abstract

BackgroundResearch on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided.MethodsWith the aim of informing the development and implementation of a mental health information sub-system that includes reliable and measurable indicators on mental health within the Health Management Information Systems (HMIS), a cross-country situation analysis of HMIS was conducted in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda), participating in the ‘Emerging mental health systems in low and middle income countries’ (Emerald) research programme. A situation analysis tool was developed to obtain and chart information from documents in the public domain. In circumstances when information was inadequate, key government officials were contacted to verify the data collected. In this paper we compare the baseline policy context, human resources situation as well as the processes and mechanisms of collecting, verifying, reporting and disseminating mental health related HMIS data.ResultsThe findings suggest that countries face substantial policy, human resource and health governance challenges for mental health HMIS, many of which are common across sites. In particular, the specific policies and plans for the governance and implementation of mental health data collection, reporting and dissemination are absent. Across sites there is inadequate infrastructure, few HMIS experts, and inadequate technical support and supervision to junior staff, particularly in the area of mental health. Nonetheless there are also strengths in existing HMIS where a few mental health morbidity, mortality, and system level indicators are collected and reported.ConclusionsOur study indicates the need for greater technical and resources input to strengthen routine HMIS and develop standardized HMIS indicators for mental health, focusing in particular on indicators of coverage and quality to facilitate the implementation of the WHO mental health action plan 2013–2020.

Highlights

Research on information systems for mental health in low and middle income countries (LMICs) is scarce
Policy context for mental health and health management information system (HMIS) All six countries have an operational HMIS that is overseen by the respective departments or directorates under the Ministry of Health
Apart from South Africa, none of the countries have specific HMIS policies for general health conditions, health policies and plans of those countries mention HMIS guidelines and standard operating procedures (SOPs) which could be helpful in the development of mental health components within HMIS

Summary

Introduction

Research on information systems for mental health in low and middle income countries (LMICs) is scarce. HMIS is an important tool for the planning and management of health services [6], as well as resource prioritisation. HMIS is of universal importance, in low and middle-income countries (LMICs) that are characterized by poor health outcomes, human resource shortages and limited financial resources. The reality is that the health systems, including the health information systems, of LMICs are often quite weak and fragmented, such that they fail to meet the needs of service providers and policy makers [7]. For example, a large volume of routinely collected HMIS data eventually reaches the national level without being cross-checked, analyzed or utilized [2]

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Results

Discussion

Conclusion