Abstract
BackgroundDespite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services.AimsThe aim of this paper was to explore health providers' views about mental health integration into primary health care.MethodsA mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka) and one rural setting (Mumbwa).ResultsThere is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems.RecommendationsIt is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level.ConclusionIntegrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia.
Highlights
Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority
Recommendations: It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level
Such reforms were in response to the government’s growing awareness of the innumerable health challenges afflicting the nation. These reforms were based on a primary health care concept, as it was believed that most diseases in Zambia were either preventable or could be managed at the primary health care level [2]
Summary
Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. Zambia has embarked on a radical transformation process aimed at creating a well functioning, cost effective and equitable district-based health care system [1] Such reforms were in response to the government’s growing awareness of the innumerable health challenges afflicting the nation. The burden of mental disorders is unknown in Zambia, hospital-based figures in Zambia suggest a prevalence rate of 3.61 and 1.8 per 10 000 population served by the hospitals catchment area for acute psychotic states and schizophrenia respectively. Treatment for 200 000 people with mental disorders (of an adult population of 2 million) in Zambia is either lacking or provided in a fragmented and not evidence-based manner [6] It is a cause for concern that mental health has been largely overlooked in Zambia, and not included within the Basic Health Care Package [5]
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