Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana - structural equation modelling

A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes

Background

Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana.

Methods

A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.

Results

The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds.

Conclusion

Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06993-1.

Supply chain performance in the power distribution sector

Purpose

In today’s highly competitive milieu, many organizations are entering into the international market to gain greater share and take advantage of higher production. However, the introduction of advanced technology has brought a significant amount of competition within the supply chain especially within the bounds of the power distribution sector. This study aims to examine how information and knowledge sharing influence supply chain performance in the power distribution sector.

Design/methodology/approach

The quantitative method and cross-sectional survey design were used in the study. A sample of 200 officers specifically selected from power distribution companies was used for the study. Data was analysed using descriptive, correlation, regression and structural equation models.

Findings

The relationship between information sharing, knowledge sharing and performance of the supply chain are positively mediated by supply chain collaboration. The findings indicate that technological innovation positively moderates the relationship between information sharing, knowledge sharing and supply chain performance.

Practical implications

Information sharing, knowledge sharing and technological innovation are critical indicators driving the supply chain operation of power distribution organizations.

Originality/value

This study presents a contemporary approach towards understanding knowledge and information sharing as antecedents of supply chain performance.

Recovery services and expectation of consumers and mental health professionals in community-based residential facilities of Ghana

BACKGROUND

In the past decades, considerable global attention has been drawn to recovery services that seek to promote the personal recovery journey of consumers with mental illness. However, in most settings, including Ghana, limited empirical studies have attempted to explore, from the perspectives of Mental Health Professionals (MHPs) and consumers, the effectiveness of recovery services and expectation towards the recovery. This study, therefore, explored consumers' and MHPs perspectives concerning recovery services and expectations towards recovery in two community-based residential facilities in Ghana.

METHODS

A qualitative method, involving in-depth interviews and observations, were used to collect data from 24 participants (5 MHPs and 19 consumers). Thematic analysis was used to analyze the data.

RESULTS

The study identified three global themes and nine organizing themes. The global themes were recovery services offered to consumers, expectation regarding personal recovery and challenges in achieving recovery. The study found that recovery services were expected to improve the internal and external recovery processes of consumers. The internal recovery process was independent living whilst the external recovery process were management of illness, economic empowerment and social inclusion. Several systemic and consumer-related factors influenced consumers' and MHPs expectation concerning the recovery journey.

CONCLUSION

The study concludes that the government should prioritize the use of recovery services through policies, financial incentives, infrastructure support, and adequate training of MHPs.