Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies
| Autor: | Jibril Abdulmalik, Shalini Ahuja, Graham Thornicroft, Catherine O. Egbe, Mark J. D. Jordans, Atalay Alem, Inge Petersen, Charlotte Hanlon, Oye Gureje, Dan Chisholm, Crick Lund, Nawaraj Upadhaya, James Mugisha, Debbie Marais, Rahul Shidhaye, Fred Kigozi |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Mental Health Services Economic growth Asia Population Developing country 03 medical and health sciences Good governance 0302 clinical medicine Health care Humans 030212 general & internal medicine 10. No inequality education Mental health literacy Developing Countries Health policy education.field_of_study Primary Health Care business.industry Corporate governance Health Policy 1. No poverty Original Articles 16. Peace & justice Mental health 3. Good health 030227 psychiatry Government Programs governance Africa Female Business Delivery of Health Care mental health |
| Zdroj: | Health Policy and Planning Petersen, I, Marais, D, Abdulmalik, J, Ahuja, S, Alem, A, Chisholm, D, Egbe, C, Gureje, O, Hanlon, C, Lund, C, Shidhaye, R, Jordans, M, Kigozi, F, Mugisha, J, Upadhaya, N & Thornicroft, G 2017, ' Strengthening mental health system governance in six low-and middle-income countries in Africa and South Asia : challenges, needs and potential strategies ', Health Policy and Planning, vol. 32, no. 5, pp. 699-709 . https://doi.org/10.1093/heapol/czx014 |
| ISSN: | 1460-2237 0268-1080 |
| DOI: | 10.1093/heapol/czx014 |
| Popis: | Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. |
| Databáze: | OpenAIRE |
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