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Waterworth CJ, Marella M, Bhutta MF, Dowell R, Khim K, Annear PL. Access to ear and hearing care services in Cambodia: a qualitative enquiry into experiences of key informants. J Laryngol Otol 2024; 138:22-32. [PMID: 36154944 PMCID: PMC10772024 DOI: 10.1017/s0022215122002158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In Cambodia, little is known about the state of ear and hearing care, or the roles providers or key stakeholders play in delivering services. METHOD This was an exploratory study using semi-structured qualitative interviews and a questionnaire addressed to key stakeholders to explore their perceptions and experiences in providing services to people suffering from ear disease or hearing loss in Cambodia. RESULTS Several challenges were described including a lack of hearing services to meet the demand, especially outside Phnom Penh in primary care and aural rehabilitation. Supply-side challenges include a shortage of trained professionals, facilities and resources, poor co-ordination between providers, unclear referral pathways, and long wait times. CONCLUSION Now is an opportune time to build on the positive trend in providing integrated care for non-communicable diseases in Cambodia, through the integration of effective ear and hearing care into primary care and strengthening the package of activities delivered at government facilities.
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Affiliation(s)
- C J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M Marella
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - M F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - R Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Australia
| | - K Khim
- Monitoring, Evaluation and Learning, Access Program, Phnom Penh, Cambodia
| | - P L Annear
- Nossal Institute for Global Health, University of Melbourne, Australia
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Child Mental Health Literacy Among Vietnamese and Cambodian Mothers. PSYCHOLOGICAL STUDIES 2021; 66:62-72. [DOI: 10.1007/s12646-020-00590-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pat P, Richter-Sundberg L, Jegannathan B, Edin K, San Sebastian M. Mental health problems and suicidal expressions among young male prisoners in Cambodia: a cross-sectional study. Glob Health Action 2021; 14:1985229. [PMID: 34643166 PMCID: PMC8519542 DOI: 10.1080/16549716.2021.1985229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background incarceration and mental health problems are known to have a strong empirical association. Many studies have confirmed the high prevalence of mental health problems among young prisoners in particular, yet none has been conducted in Cambodia. Objectives this study aimed to assess the level of mental health problems and suicidal expressions, and determine the associated risk factors among young prisoners in Cambodia. Method this was a cross-sectional study among 572 young prisoners between the ages of 15 and 24 from three prisons. Sociodemographic data and detailed information on participants’ profiles were gathered, and mental health problems and suicidal expressions were assessed using the Youth Self-Report (YSR) and the Attitude Towards Suicide (ATTS) questionnaires, respectively. Results Mental health problems as revealed by the mean YSR scores were: 25.97 for internalizing and 18.12 for externalizing problems; 11.88 for anxiety/depression, 9.97 for aggressive behaviours and 7.53 for somatic complaints. Social problems, attention problems and rule breaking behaviour were in the range of 8.10 to 8.49. Withdrawal depression and thought problems mean scores were 6.55 and 6.66, respectively. Mental health problems were associated with younger age, lower educational background, and shorter duration of incarceration. Around 16% had thought about their own death, and 12% expressed wish to die. Suicide ideation, planning, and attempts were reported by almost 7%, 2%, and 3% of participants respectively. Prior drugs users thought about death significantly more than their counterparts while suicide ideation was significantly lower among prisoners with higher education. Conclusion Mental health problems and suicidal expressions among young prisoners warrant well-planned mental health services that are integrated into the current prison health system. A contextualised intervention that takes into account age, education, duration of incarceration and previous drug use may contribute to improve the mental well-being of young prisoners in Cambodia.
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Affiliation(s)
- Puthy Pat
- Center for Child and Adolescent Mental Health (Caritas-CCAMH), Cambodia.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | | | - Kerstin Edin
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Parry SJ, Ean N, Sinclair SP, Wilkinson E. Development of mental healthcare in Cambodia: barriers and opportunities. Int J Ment Health Syst 2020; 14:53. [PMID: 32760441 PMCID: PMC7392648 DOI: 10.1186/s13033-020-00385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 07/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Despite the increasing recognition globally of the importance of mental health for sustainable development, significant barriers remain to developing mental health services in low- and middle-income countries. This study explored the particular barriers and opportunities for developing mental health services in Cambodia and how these compared with those described in other low- and middle-income countries. METHODS For this qualitative study, 18 experienced mental health professionals from different disciplines were selected using purposive sampling. Semi-structured interviews were carried out in Phnom Penh and thematic analysis of the data was completed. RESULTS Five key themes were identified: (1) Prioritising mental health in Cambodia, (2) Strengthening collaborations between mental health stakeholders, (3) Developing a mental healthcare model appropriate for the Cambodian culture and context, (4) Increasing the quantity and (5) Improving the quality of mental healthcare. All five themes were referred to by all 18 participants and the two most repeated themes were (2) Strengthening collaborations and (5) Improving the quality of mental healthcare. CONCLUSIONS The themes identified in this study both corroborate previous barriers identified to developing mental health services in low- and middle-income countries and shed new light on opportunities of particular importance in Cambodia. Strengthening collaborations between key stakeholders in mental health and prioritising the quality of mental health education, training and service provision were both cited as being significant opportunities for enhancing the development of mental health services in Cambodia. These have not been widely described before as being important factors.
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Affiliation(s)
- Sarah J. Parry
- OMF International (Cambodia), #3, Street 604, Tuol Kork, PO Box 570, Phnom Penh, Cambodia
| | - Nil Ean
- Department of Psychology, Royal University of Phnom Penh, #110, Russian Federation Boulevard, Phnom Penh, Cambodia
| | - Shirley P. Sinclair
- OMF International (Cambodia), #3, Street 604, Tuol Kork, PO Box 570, Phnom Penh, Cambodia
| | - Ewan Wilkinson
- Institute of Medicine, University of Chester, Parkgate Road, Chester, CH1 4BJ UK
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Turki Y, Saleh S, Albaik S, Barham Y, van de Vrie D, Shahin Y, Hababeh M, Armagan M, Seita A. Assessment of the knowledge, attitudes, and practices (KAP) among UNRWA* health staff in Jordan concerning mental health programme pre-implementation: a cross-sectional study. Int J Ment Health Syst 2020; 14:54. [PMID: 32760442 PMCID: PMC7392824 DOI: 10.1186/s13033-020-00386-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mental health is a major public health priority, especially among refugees. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary healthcare services in Jordan in late 2017. In this study, we aimed to assess of the knowledge, attitudes, and practices (KAP) among UNRWA health staff (HS) in Jordan concerning mental health programme pre-implementation, and their perceived barriers about this MHPSS programme. METHODS A cross-sectional study was conducted among doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan. The assessment was made using a validated self-administered questionnaire. Data analysis was performed using SPSS (version 22). RESULTS Of the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p = 0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220). CONCLUSIONS Most health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation were consistent with the previous studies and need to be tackled with a structured plan of action.
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Affiliation(s)
- Yassir Turki
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Suha Saleh
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Shatha Albaik
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Yasmeen Barham
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Dorien van de Vrie
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Yousef Shahin
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Majed Hababeh
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
| | - Merve Armagan
- College of Fine Arts, Humanities and Social Sciences, The University of Massachusetts Lowell, Lowell, United States
| | - Akihiro Seita
- Health Department, United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Amman, Jordan
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Factors Affecting the Help-Seeking Behaviours of Patients with Schizophrenia in Rural Cambodia. Case Rep Psychiatry 2020; 2020:8065058. [PMID: 32566349 PMCID: PMC7293719 DOI: 10.1155/2020/8065058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/25/2020] [Indexed: 11/17/2022] Open
Abstract
In low- and middle-income countries in Asia, the use of supernatural, religious, and magical approaches to mental illness is widespread. We aimed to document the help-seeking behaviours and barriers to effective mental healthcare in the case of a psychiatric patient in rural Cambodia. The present case report describes the pathway that a patient with schizophrenia utilised to receive effective treatment in a rural area. First, the patient was taken by his parents to a pagoda. Subsequently, they took him to the home of a Kru Khmer (a Cambodian traditional healer). Nevertheless, his condition did not improve, and after seeing this, a neighbour suggested to his mother that they visit the provincial hospital. The patient received a diagnosis after an assessment by the hospital psychiatrist. Following several months of treatment with medication, the patient no longer exhibited paranoid behaviour. In this case, the patient's and his family's beliefs are strongly related to help-seeking behaviour toward medical care among psychiatric patients. To promote timely visits to the hospital, it is crucial to clarify and understand the type of beliefs held by psychiatric patients and their families. Besides, an educational approach to the beliefs is essential for shortening the duration of untreated illness.
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Arafa A, Magdi M, Magdy M, Elsharkawy H, Saleh L. Knowledge and attitude of Egyptian parents toward childhood mental disorders. Int J Adolesc Med Health 2019; 34:ijamh-2019-0044. [PMID: 31203258 DOI: 10.1515/ijamh-2019-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 03/15/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parents' awareness of childhood mental disorders can help in early detection and management. This study aimed to assess the knowledge of parents about childhood mental disorders and their attitudes toward children with mental disorders. SUBJECTS AND METHODS Parents of children attending two public primary schools in Beni-Suef city in southern Egypt were invited to participate in this cross-sectional study during the first semester of the academic year 2017/2018. Knowledge and attitude of parents toward childhood mental disorders in addition to their socio-demographic characteristics were evaluated using a self-administered questionnaire. RESULTS A total of 468 parents (41.5% fathers and 58.5% mothers) participated in this study. Only 21.6% of parents had optimal knowledge of risk factors, 33.3% of manifestations/screening, 58.8% of types and 47.6% of treatment, while 42.7% of parents held a positive attitude toward impressions, 43.4% toward social distance, 63.7% toward spiritual treatment, and 59.4% toward chemotherapy and psychotherapy of childhood mental disorders. The multivariable-adjusted regression analyses showed that optimal knowledge associated with urban residence [odds ratio (OR) 1.56, 95% confidence interval (CI) 1.05-2.30)] and knowing someone with a mental disorder (OR 1.62, 95% CI 1.08-2.41). The positive attitude was associated with urban residence (OR 1.80, 95% CI 1.18-2.74) and higher education (OR 2.14, 95% CI 1.32-3.48). Knowledge of parents correlated positively with their attitude toward childhood mental disorders (r = 0.258, p < 0.001). CONCLUSION A significant portion of parents in southern Egypt have suboptimal knowledge of childhood mental disorders and hold a negative attitude toward children with mental disorders. Future studies should focus on the possibility of including parents in screening for childhood mental disorders.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Marwa Magdi
- Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mayar Magdy
- Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | - Lamiaa Saleh
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Spagnolo J, Champagne F, Leduc N, Rivard M, Piat M, Laporta M, Melki W, Charfi F. Mental health knowledge, attitudes, and self-efficacy among primary care physicians working in the Greater Tunis area of Tunisia. Int J Ment Health Syst 2018; 12:63. [PMID: 30386422 PMCID: PMC6203218 DOI: 10.1186/s13033-018-0243-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-specialists' involvement in mental health care is encouraged in the field of global mental health to address the treatment gap caused by mental illness, especially in low- and middle-income countries. While primary care physicians (PCPs) are involved in mental health care in Tunisia, a lower-middle-income country in North Africa, it is unclear to what extent they are prepared and willing to address mental health problems, substance use disorders, and suicide/self-harm. In this context, we aim (1) to report on mental health knowledge, attitudes, and self-efficacy among a sample of PCPs working in the Greater Tunis area, prior to the implementation of a mental health training program developed by the World Health Organization; and (2) to identify what characteristics are associated with these competencies. METHODS In total, 112 PCPs completed questionnaires related to their socio-demographic and practice characteristics, as well as their mental health knowledge, attitudes, and self-efficacy. Descriptive analyses and regression models were performed. FINDINGS PCPs had more knowledge about depression, symptoms related to psychosis, and best practices after a suicide attempt; had favourable attitudes about distinctions between physical and mental health, learning about mental health, and the acceptance of colleagues with mental health issues; and believed most in their capabilities related to depression and anxiety. However, most PCPs had less knowledge about substance use disorders and myths about suicide attempts; had unfavorable attitudes about the dangerousness of people with mental health problems, personal disclosure of mental illness, non-specialists' role in assessing mental health problems, and personal recovery; and believed the least in their capabilities related to substance use disorders, suicide/self-harm, and psychosis. Participation in previous mental health training, weekly hours (and weekly hours dedicated to mental health), weekly provision of psychoeducation, and certain work locations were associated with better mental health competencies, whereas mental health knowledge was negatively associated with weekly referrals to specialized services. CONCLUSIONS Findings suggest that PCPs in our sample engage in mental health care, but with some gaps in competencies. Mental health training and increased interactions/involvement with people consulting for mental health issues may help further develop non-specialists' mental health competencies, and integrate mental health into primary care settings.
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Affiliation(s)
- Jessica Spagnolo
- School of Public Health, IRSPUM, University of Montreal, Montreal, QC H3N1X9 Canada
| | - François Champagne
- School of Public Health, IRSPUM, University of Montreal, Montreal, QC H3N1X9 Canada
| | - Nicole Leduc
- School of Public Health, University of Montreal, Montreal, QC Canada
| | - Michèle Rivard
- School of Public Health, University of Montreal, Montreal, QC Canada
| | - Myra Piat
- Douglas Mental Health University Institute, McGill University, Montreal, QC Canada
| | - Marc Laporta
- Montreal WHO-PAHO Collaborating Center for Research and Training in Mental Health, McGill University, Montreal, QC Canada
| | - Wahid Melki
- Razi Hospital, University of Tunis El-Manar, Tunis, Tunisia
| | - Fatma Charfi
- Mongi-Slim Hospital, University of Tunis El-Manar, Tunis, Tunisia
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Liu R, Huang L, Yang Q, Hu Q, Huang Q, Jiang X, Zhu H, Xie F, Wen X, Liu X, Yuan Z, Lu Y. Investigation on Task Shifting of HIV/AIDS Follow-Up Management Workers in New Launched Areas, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2132. [PMID: 30274139 PMCID: PMC6210782 DOI: 10.3390/ijerph15102132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/18/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
Abstract
Background: This study aimed to understand attitudes of HIV/AIDS follow-up workers regarding task shifting, reveal the current conditions of this implementation, as well as to find out any challenges of early-stage implementation. Methods: Taking Jiangxi Province as an example, a cross-sectional survey with 102 health professionals in CDCs (Centers for Disease Control and Prevention) and 92 health care providers in primary health institutions was conducted from November 2016 to January 2017. This survey includes the demographic backgrounds of participants, their attitudes towards task shifting, and the main difficulties faced in their work, etc. Results: 60.8% of professionals and 77.2% of providers hold positive attitudes towards task shifting. Both health professionals and providers express their concerns about unclear and undefined funds distribution and lack of confidentiality of PLWHA (people living with HIV) in local primary health institutions. Conclusions: The majority of health workers hold positive attitudes towards task shifting. It also highlights some negative reactions in implementation, and reveals the main difficulties that constitute barriers to follow-up. Findings from this study may provide evidence for enhancing future implementation of task shifting.
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Affiliation(s)
- Rong Liu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Ling Huang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Qing Yang
- Centers for Disease Control and Prevention of Jiangxi Province, Nanchang 330000, China.
| | - Qiang Hu
- Centers for Disease Control and Prevention of Jiangxi Province, Nanchang 330000, China.
| | - Qing Huang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Xiaoqing Jiang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Hui Zhu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Fei Xie
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Xiaotong Wen
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Xiaojun Liu
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Zhaokang Yuan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
| | - Yuanan Lu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China.
- Department of Public Health Sciences, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
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Murphy J, Corbett KK, Linh DT, Oanh PT, Nguyen VC. Barriers and facilitators to the integration of depression services in primary care in Vietnam: a mixed methods study. BMC Health Serv Res 2018; 18:641. [PMID: 30115050 PMCID: PMC6097413 DOI: 10.1186/s12913-018-3416-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 07/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the prevalence of depression in Vietnam is on par with global rates, services for depression are limited. The government of Vietnam has prioritized enhancing depression care through primary healthcare (PHC) and efforts are currently underway to test and scale-up psychosocial interventions throughout the country. With these initiatives in progress, it is important to understand implementation factors that might influence the successful integration of depression services into PHC. As the implementers of these new interventions, primary care providers (PHPs) are well placed to provide important insight into implementation factors affecting the integration of depression services into PHC. This mixed-methods study examines factors at the individual, organizational and structural levels that may act as barriers and facilitators to the integration of depression services into PHC in Vietnam from the perspective of PHPs. METHODS Data collection took place in Hanoi, Vietnam in 2014. We conducted semi-structured interviews with PHPs (n = 30) at commune health centres and outpatient clinics in one rural and one urban district of Hanoi. Theoretical thematic analysis was used to analyse interview data. We administered an online survey to PHPs at n = 150 randomly selected communes across Hanoi. N = 226 PHPs responded to the survey. We used descriptive statistics to describe the study variables acting as barriers and facilitators and used a chi-square test of independence to indicate statistically significant (p < .05) associations between study variables and the profession, location and gender of PHPs. RESULTS Individual-level barriers include low level of knowledge and familiarity with depression among PHPs. Organizational barriers include low resource availability in PHC and low managerial discretion. Barriers at the structural level include limited mental health training among all PHPs and the existing programmatic structure of PHC in Vietnam, which sets mental health apart from general services. Facilitators at the individual level include positive attitudes among PHPs towards people with depression and interest in undergoing enhanced training in depression service delivery. CONCLUSIONS While facilitating factors at the individual level are encouraging, considerable barriers at the structural level must be addressed to ensure the successful integration of depression services into PHC in Vietnam.
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Affiliation(s)
- Jill Murphy
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Suite 2400, 515 W. Hastings Street, Vancouver, BC, V6B 5K3, Canada.
| | - Kitty K Corbett
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave. West, Waterloo, ON, N2L3G1, Canada
| | - Dang Thuy Linh
- Institute of Population, Health and Development, 18 Lane 132, Hoa Bang, Yen Hoa, Hanoi, 122667, Vietnam
| | - Pham Thi Oanh
- Institute of Population, Health and Development, 18 Lane 132, Hoa Bang, Yen Hoa, Hanoi, 122667, Vietnam
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, 18 Lane 132, Hoa Bang, Yen Hoa, Hanoi, 122667, Vietnam
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Olofsson S, Sebastian MS, Jegannathan B. Mental health in primary health care in a rural district of Cambodia: a situational analysis. Int J Ment Health Syst 2018; 12:7. [PMID: 29410703 PMCID: PMC5782361 DOI: 10.1186/s13033-018-0185-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/15/2018] [Indexed: 12/05/2022] Open
Abstract
Background While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia. Methods A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia. Results Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present. Conclusions There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia overall. There is dire need for scaling up and integrating mental health into primary health care to improve the population’s access to and quality service of Cambodian mental care. Electronic supplementary material The online version of this article (10.1186/s13033-018-0185-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofia Olofsson
- 1Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Miguel San Sebastian
- 1Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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