1
|
Pigeon-Gagné É, Hassan G, Yaogo M, Saïas T. Discrimination and Social Exclusion of People Experiencing Mental Disorders in Burkina Faso: A Socio-anthropological Study. Cult Med Psychiatry 2024:10.1007/s11013-024-09860-w. [PMID: 39017776 DOI: 10.1007/s11013-024-09860-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2024] [Indexed: 07/18/2024]
Abstract
Stigma has been pointed out as a barrier to mental healthcare in sub-Saharan Africa. Among the manifestations of stigma, the use of physical restraints is condemned as a form of violation of basic human rights. Research on this phenomenon is limited in West Africa and more particularly in Burkina Faso. This study explores the phenomenon of stigma of individuals experiencing mental disorders in Bobo-Dioulasso (Burkina Faso). As part of 8 months of socio-anthropological fieldwork, we interviewed 94 informants (7 focus groups and 25 individual interviews) to document exclusionary practices, their perceptions, and justifications. Exclusionary practices can be divided in five subgroups: ignoring, physically and sexually abusing, abandoning, banning, and restraining. Some practices were linked to a lack of financial and material resources, while others were justified by an inferior moral status. We observed differences in the type of exclusion experienced between men and women. Restrictive, abusive, and exclusionary measures are common in Bobo-Dioulasso. These practices can either be understood as part of families' adaptative strategies when dealing with chronic conditions, as part of security measures in the case of patients with aggressive behaviors, or as part of punitive measures when transgressions are committed. We conclude the article by addressing the tensions between local and global meanings of stigma.
Collapse
Affiliation(s)
| | - Ghayda Hassan
- Department of Psychology, Université de Québec à Montréal, Montreal, Canada
| | - Maurice Yaogo
- Université Catholique de l'Afrique de l'Ouest, Bobo-Dioulasso, Burkina Faso
| | - Thomas Saïas
- Department of Psychology, Université de Québec à Montréal, Montreal, Canada
| |
Collapse
|
2
|
Duodu PA, Okyere J, Simkhada B, Akrong R, Barker C, Gillibrand W, Simkhada P. Exploration of family caregivers' experiences on coping in dementia care in Ghana: a phenomenological study. BMC Psychol 2024; 12:361. [PMID: 38902797 PMCID: PMC11191216 DOI: 10.1186/s40359-024-01862-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/18/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Dementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers' experiences on coping in dementia care in Ghana. METHODS Adopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun's framework analysis. RESULTS Six themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving. CONCLUSION We conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer's Ghana must raise awareness about the dangers of caregivers' violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.
Collapse
Grants
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
Collapse
Affiliation(s)
- Precious Adade Duodu
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Bibha Simkhada
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Ransford Akrong
- Educational Assessment and Research Center, Osu, Accra, Ghana
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Caroline Barker
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Warren Gillibrand
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Padam Simkhada
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| |
Collapse
|
3
|
Ozota GO, Sabastine RN, Uduji FC, Okonkwo VC. Nigeria mental health law: Challenges and implications for mental health services. S Afr J Psychiatr 2024; 30:2134. [PMID: 38726332 PMCID: PMC11079425 DOI: 10.4102/sajpsychiatry.v30i0.2134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/29/2024] [Indexed: 05/12/2024] Open
Abstract
Background The Nigerian mental health law titled the Lunacy Act of 1958 has been under scrutiny for violating the human rights of people with mental illness. The call to reform the obsolete Lunacy Act has garnered attention from the government, as the law has been unamended for over 60 years. Aim This study presents the challenges and implications of the new mental health law to the mental health services of Nigeria. Methods ScienceDirect, PubMed, and Google Scholar were used to find pertinent material. The implications and difficulties facing the new mental health law examined from the literature were discussed. Recommendations were made following an exploratory search for literature on mental health legislation in Nigeria. Results The new Law in Section 5(6) saw the introduction of mental health services in primary and secondary healthcare. It also addresses critical issues such as non-discrimination, fundamental human rights, standards of treatment, access to information, confidentiality and autonomy, and the employment rights of persons with mental health and substance abuse-related disorders. The Law failed to include mental health services in the country's health insurance system. Conclusion There is a need for legislation to meet people's mental health needs and encourage them to seek treatments, such as regulations that protect against discrimination and harsh treatment of people with mental illness. Contribution Nigerian mental health services would benefit from the new mental health law if the key issues raised in this review are addressed.
Collapse
Affiliation(s)
- Gerald O Ozota
- Department of Pharmacy, Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, Nsukka, Nigeria
| | | | - Franklin C Uduji
- Department of Pharmacy, Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
| | - Vanessa C Okonkwo
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, Nsukka, Nigeria
| |
Collapse
|
4
|
Lawrence ER, Parekh BJ, Owusu-Antwi R, Newman N, Russell CB, Beyuo TK, Yeboah M, Oppong SA, Moyer CA. "If You Need a Psychiatrist, It's BAD": Stigma Associated with Seeking Mental Health Care Among Obstetric Providers in Ghana. Int J Womens Health 2024; 16:131-141. [PMID: 38283998 PMCID: PMC10822084 DOI: 10.2147/ijwh.s440224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/11/2024] [Indexed: 01/30/2024] Open
Abstract
Purpose Globally, the COVID-19 pandemic has brought attention to the impact of negative patient outcomes on healthcare providers. In Ghana, obstetric providers regularly face maternal and neonatal mortality, yet limited research has focused on provision of mental health support for these providers. This study sought to understand how obstetric providers viewed seeking mental health support after poor clinical outcomes, with a focus on the role of mental health stigma. Patients and Methods Participants were 52 obstetric providers (20 obstetrician/gynecologists and 32 midwives) at two tertiary care hospitals in Ghana. Five focus groups, led by a trained facilitator and lasting approximately two hours, were conducted to explore provider experiences and perceptions of support following poor maternal and neonatal outcomes. Discussions were audiotaped and transcribed verbatim, then analyzed qualitatively using grounded theory methodology. Results Most participants (84.3%, N=43) were finished with training, and 46.2% (N=24) had been in practice more than 10 years. Emerging themes included pervasive stigma associated with seeking mental health care after experiencing poor clinical outcomes, which was derived from two overlapping dimensions. First, societal-level stigma resulted from a cultural norm to keep emotions hidden, and the perception that psychiatry is equated with severe mental illness. Second, provider-level stigma resulted from the belief that healthcare workers should not have mental health problems, a perception that mental health care is acceptable for patients but not for providers, and a fear about lack of confidentiality. Despite many providers acknowledging negative mental health impacts following poor clinical outcomes, these additive layers of stigma limited their willingness to engage in formal mental health care. Conclusion This study demonstrates that stigma creates significant barriers to acceptance of mental health support among obstetric providers. Interventions to support providers will need to respect provider concerns without reinforcing the stigma associated with seeking mental health care.
Collapse
Affiliation(s)
- Emma R Lawrence
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Bela J Parekh
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ruth Owusu-Antwi
- Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology/ Psychiatry Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Noah Newman
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Colin B Russell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Titus K Beyuo
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
- Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana
| | - Michael Yeboah
- Department of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Samuel A Oppong
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
- Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana
| | - Cheryl A Moyer
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
5
|
Omosigho PO, John OO, Musa MB, Aboelhassan YMEI, Olabode ON, Bouaddi O, Mengesha DT, Micheal AS, Modber MAKA, Sow AU, Kheir SGM, Shomuyiwa DO, Adebimpe OT, Manirambona E, Lucero-Prisno DE. Stigma and infectious diseases in Africa: examining impact and strategies for reduction. Ann Med Surg (Lond) 2023; 85:6078-6082. [PMID: 38098545 PMCID: PMC10718398 DOI: 10.1097/ms9.0000000000001470] [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] [Received: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 12/17/2023] Open
Abstract
Stigma poses a significant barrier to accessing care, managing, and preventing infectious diseases in Africa. The authors conducted an extensive search across Scopus, PubMed, ScienceDirect, and Google Scholar to identify relevant English-language articles, with no constraints on publication dates, using the keywords "Stigma," and "Infectious Disease," in conjunction with "Africa." This article explores the multifaceted nature of stigma associated with infectious diseases, highlighting its impact on healthcare access and public health outcomes. It delves into the current situation of infectious disease-related stigma in Africa, emphasizing the various diseases and contexts affected. The article identifies drivers of stigma, including negative attitudes, misinformation, and institutional practices, and discusses their role in perpetuating discrimination. Importantly, it provides recommendations for addressing infectious disease stigma in Africa through comprehensive strategies encompassing health education, contact-based interventions, professionalized counselling and peer support services, and community engagement. The article calls for collaboration among governments, healthcare organizations, NGOs, and community leaders to implement holistic strategies that prioritize inclusivity and stigma reduction. Ultimately, it underscores the urgent need to combat stigma to improve healthcare access and outcomes for individuals affected by infectious diseases in Africa.
Collapse
Affiliation(s)
| | - Okesanya Olalekan John
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta
- Global Health Focus Africa, Abuja
| | | | | | | | - Oumnia Bouaddi
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca
- Mohammed VI Center For Research and Innovation, Rabat, Morocco
| | | | - Abioye Sunday Micheal
- Faculty of Basic Medical Sciences, Department of Public Health, Adeleke University, Ede, Osun State
| | | | - Alhaji Umar Sow
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Research Unit, Global Health Focus, Bujumbura, Burundi
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
6
|
Olatunji G, Faturoti O, Jaiyeoba B, Toluwabori AV, Adefusi T, Olaniyi P, Aderinto N, Abdulbasit MO. Navigating unique challenges and advancing equitable care for children with ADHD in Africa: a review. Ann Med Surg (Lond) 2023; 85:4939-4946. [PMID: 37811061 PMCID: PMC10553014 DOI: 10.1097/ms9.0000000000001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 10/10/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents distinct challenges for African children due to a complex interplay of social, economic and cultural factors. This review examines the various obstacles faced by children with ADHD in Africa, focusing on the lack of awareness and stigma surrounding the disorder, limited access to mental health services, educational system constraints, economic limitations and cultural beliefs and practices. The review underscores the significance of public awareness campaigns and educational initiatives to dispel myths and misconceptions surrounding ADHD. These efforts should target the general public, educators, healthcare professionals, religious leaders and traditional healers. Crucial to addressing this issue is strengthening mental health services, especially in rural and underserved areas, through increased funding and the availability of trained mental health professionals specialised in ADHD diagnosis and treatment. Integrating mental health services into primary healthcare systems is proposed to enhance accessibility for children with ADHD. By training primary care providers to recognise ADHD symptoms and provide initial support and referrals, early identification and intervention can be facilitated. Addressing the affordability and accessibility of ADHD treatment is a priority, with policy recommendations including subsidising medications and therapies and providing financial assistance to families in need. A call for collaborative efforts between governments, nongovernmental organisations and pharmaceutical companies is advocated to ensure that ADHD treatment is affordable and widely available.
Collapse
Affiliation(s)
| | - Olamide Faturoti
- Department of Medicine and Surgery, University of Ilorin, Ilorin
| | | | | | | | - Peter Olaniyi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Muili O. Abdulbasit
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| |
Collapse
|
7
|
Llibre-Guerra JJ, Heavener A, Brucki SMD, Marante JPD, Pintado-Caipa M, Chen Y, Behrens MI, Hardi A, Admirall-Sanchez A, Akinyemi R, Alladi S, Dorsman KA, Rodriguez-Salgado AM, Solorzano J, Babulal GM. A call for clinical trial globalization in Alzheimer's disease and related dementia. Alzheimers Dement 2023; 19:3210-3221. [PMID: 36840622 PMCID: PMC10450094 DOI: 10.1002/alz.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND The burden of Alzheimer's disease and related dementia (ADRD) is projected to disproportionally impact low-middle-income countries (LMICs). However, there is a systematic under-representation of LMICs in ADRD clinical trial platforms. METHODS We aimed to determine the global distribution of ADRD clinical trials and identify existing barriers for conducting clinical trials in LMICs. Primary data sources to identify trial distribution in LMICs included ClinicalTrials.gov and the International Trials Registry Platform. An additional systematic review and expert consensus interviews were conducted to identify barriers for conducting clinical trials in LMICs. FINDINGS Among 1237 disease-modifying therapies tested in ADRD clinical trials, only 11.6% have been or are conducted in emerging economies (upper-middle income [9.6%] and low-middle income [2.0%]). We identified several limitations for trial implementation including a lack of financial resources, low industry presence, regulatory obstacles, and operational barriers INTERPRETATION: Although LMICs bear the greatest burden of ADRD globally, substantial development of clinical trial platforms to address this inequity and health disparity is lacking.
Collapse
Affiliation(s)
- Jorge J Llibre-Guerra
- Department of Neurology, Washington University, School of Medicine, St. Louis, Missouri, USA
- Dominantly Inherited Alzheimer's Network Trial Unit, St. Louis, Missouri, USA
- Institute of Public Health, Washington University, St. Louis, Missouri, USA
| | - Anika Heavener
- Department of Global Health and Social Medicine, Harvard Medical School, St. Louis, Missouri, USA
| | - Sonia Maria Dozzi Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Sao Paulo, São Paulo, Brazil
| | | | | | - Yaohua Chen
- Department of Geriatrics, Lille Neurosciences & Cognition, University of Lille, Lille, France
| | - María Isabel Behrens
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Independencia, Santiago, Chile
| | - Angela Hardi
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Rufus Akinyemi
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Suvarna Alladi
- National Institute of Mental Health and Neuroscience, Bangalore, India
| | - Karen A Dorsman
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Joel Solorzano
- Department of Medicine, Hospital Antonio Luaces Iralola, Ciego de Avila, Cuba
| | - Ganesh M Babulal
- Department of Neurology, Washington University, School of Medicine, St. Louis, Missouri, USA
- Institute of Public Health, Washington University, St. Louis, Missouri, USA
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
| |
Collapse
|
8
|
Kwobah EK, Turissini M, Barasa J, Kimaiyo M, Okeyo L, Araka J, Njiriri F, Matundura R, Jaguga F. Mental healthcare services in Kenyan counties: a descriptive survey of four counties in Western Kenya. BMC Health Serv Res 2023; 23:543. [PMID: 37231439 DOI: 10.1186/s12913-023-09481-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/29/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The government of Kenya has made progressive efforts towards improving mental health services in the country. However there is little documentation of mental health services in the counties that would support actualization of the legislative frameworks in the context of a devolved healthcare system. This study sought to document existing mental health services within 4 counties in Western Kenya. METHODS We conducted a cross sectional descriptive survey of four counties using the World Health Organization, Assessment Instrument for Mental Health Systems (WHO-AIMS). Data was collected in 2021, with 2020 being the year of reference. We collected data from the facilities offering mental healthcare within the counties as well as from County health policy makers and leaders. RESULTS Mental healthcare was provided at higher level facilities within the counties, with minimal structures at primary care facilities. No county had a stand-alone policy on mental health services or dedicated budget for mental healthcare. The national referral hospital, within Uasin-Gishu county, had a clear mental health budget for mental health. The national facility in the region had a dedicated inpatient unit while the other three counties admitted patients in general medical wards but had mental health outpatient clinics. The national hospital had a variety of medication for mental health care while the rest of the counties had very few options with antipsychotics being the most available. All the four counties reported submitting data on mental health to Kenya health information system (KHIS). There were no clearly defined mental healthcare structures in the primary care level except for funded projects under the National referral hospital and the referral mechanism was not well defined. There was no established mental health research in the counties except that which was affiliated to the national referral hospital. CONCLUSION In the four counties in Western Kenya, the mental health systems are limited and not well structured, are faced with limited human and financial resources and there is lack of county specific legistrative frameworks to support mental healthcare. We recommend that counties invest in structures to support provision of quality mental healthcare to the people they serve.
Collapse
Affiliation(s)
| | - Matthew Turissini
- Department of Internal Medicine, Indiana University, Bloomington, USA
| | - Julius Barasa
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Mercy Kimaiyo
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Lily Okeyo
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Joash Araka
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Faith Njiriri
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Richard Matundura
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Florence Jaguga
- Moi Teaching and Referral Hospital, P.O BOX 3-30100, Eldoret, Kenya
| |
Collapse
|
9
|
Byansi W, Ssewamala FM, Neilands TB, Mwebembezi A, Nakigozi G. Patterns of and Factors Associated With Mental Health Service Utilization Among School-Going Adolescent Girls in Southwestern Uganda: A Latent Class Analysis. J Adolesc Health 2023; 72:S24-S32. [PMID: 37062580 PMCID: PMC10270327 DOI: 10.1016/j.jadohealth.2022.09.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 04/18/2023]
Abstract
PURPOSE The study aimed to improve understanding of patterns of multiple family group intervention engagement and associated factors among adolescent girls in a low-resource country, Uganda. METHODS The data used in this analysis were part of a larger cluster randomized controlled trial consisting of 1260 adolescent girls across 47 public secondary schools. The sample in the current study consisted of 317 adolescent girls (ages 14-17 at enrollment) recruited from senior one and senior two classes across 12 secondary schools in the southwestern region of Uganda. Participants in this study participated in the multiple family group intervention-a 16-week manualized intervention. Attendance data from 16 sessions were used to identify the heterogeneity of intervention engagement using latent class analysis modeling. Logistic regression analysis was conducted to assess the association between predisposing, enabling, need factors, and mental health utilization patterns. RESULTS On average, participants attended 10 sessions (standard deviation = 5.90), 34.38% (N = 109) completed all 16 sessions, and 13.56% (N = 43) did not attend any of the sessions. Two attendance groups were identified: low and high attendants using latent class analysis. In addition, two family-level factors, the number of adults and the number of children in the family, were associated with an increase in the utilization of mental health services. DISCUSSION Findings suggest that enhancing family support systems may be useful in promoting mental health utilization among adolescent girls with the potential to improve self-esteem, reduce feelings of inadequacy, and ultimately achieve better mental health outcomes.
Collapse
Affiliation(s)
- William Byansi
- School of Social Work, Boston College, Chesnut Hill, Massachusetts.
| | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Torsten B Neilands
- School of Medicine, University of California San Francisco, San Francisco, California
| | | | | |
Collapse
|
10
|
Xue B, Luo C, Luo X. Attitudes toward dementia screening and influential factors in older adults in China. Psychogeriatrics 2023; 23:211-221. [PMID: 36457142 DOI: 10.1111/psyg.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Dementia will likely be an ongoing concern for future generations, and according to the World Health Organization, two-thirds of dementia cases are missed diagnoses. We aimed to explore the attitudes of older adults toward dementia screening and the related influencing factors. METHODS A multicentre cross-sectional study was conducted. Data were collected using questionnaires between 2020 December and 2021 June from five provinces in China. The study included older adults aged 60 years or older, living in China. A sociodemographic questionnaire and the Perceptions Regarding Investigational Screening for Memory in Primary Care scale were used to assess attitudes toward and influencing factors of dementia screening. RESULTS A total of 279 participants completed the questionnaires. The results revealed housing status as a positive factor in the acceptance dimension, while high income was the primary positive factor in the benefits of screening dimension. Having religious beliefs, low income, and never participating in social activities were positive factors for the stigma dimension. Widowed marital status and participation in social activities were negative factors for the independence dimension, while having religious beliefs positively influenced the suffering dimension. CONCLUSIONS This study showed that participants held a relatively positive attitude toward dementia screening, although they had concerns about stigma and negative impact on independence. Further studies are required to develop intervention strategies to help older adults improve their attitudes and quality of life, promote cognitive health, and facilitate healthy ageing.
Collapse
Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Chang Luo
- School of Artificial Intelligence of Jianghan University, Wuhan, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan, China
| |
Collapse
|
11
|
Breffka E, Jagoe C, Murphy SP, Tsegaw BB. Restricted participation: Drivers, experiences and implications of disability stigma in Ethiopia. Afr J Disabil 2023; 12:1085. [PMID: 36756458 PMCID: PMC9900290 DOI: 10.4102/ajod.v12i0.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023] Open
Abstract
Background Community-based inclusive development (CBID) acknowledges society's critical role in supporting the active participation of persons with disabilities. However, research on how this approach relates to the context-sensitive socially situated barriers of disability stigma is underexplored. Objectives This study aimed to understand the drivers and experiences of disability stigma in Ethiopia, from the perspective of persons with disabilities engaged in CBID programmes, and to establish how disability stigma acts as a barrier to participation. Methods An inductive methodological approach guided the research design. Mixed methods were used including a narrative review of disabilities studies literature, 16 semi-structured interviews with persons with disabilities, and a quantitative survey of 970 persons with disabilities across three communities in Ethiopia. Results Informed by theories of epistemic justice, this study identified specific indicators of meaningful participation and examined how these relate to experiences of disability stigma. The study found that the participation of adults with disabilities in society is restricted across different areas of life. Misconceptions about the causes of disability and social perceptions regarding the capacities of persons with disabilities are found to exacerbate stigma and act as a barrier to participation. Conclusion Targeted efforts to challenge internalised norms and harmful beliefs within CBID approaches are required to address disadvantages arising from embedded disability stigma. Contribution This study makes conceptual, empirical and practical contributions that advance insights into the relationship between disability stigma and participation in Ethiopia and the dimensions of epistemic justice relevant to understanding the nature and drivers of disability stigma.
Collapse
Affiliation(s)
- Esther Breffka
- Department of Clinical Speech and Language Studies, Faculty of Arts, Humanities and Social Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland,Department of Geography, Faculty of Science, Technology, Maths and Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Caroline Jagoe
- Department of Clinical Speech and Language Studies, Faculty of Arts, Humanities and Social Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Susan P. Murphy
- Department of Geography, Faculty of Science, Technology, Maths and Engineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Belestie B. Tsegaw
- Department of Public Health, Faculty of Public Health, Health Care, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia,Department of Psychology, Faculty of Behavioral Science, Social Studies and Humanities, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
12
|
Adebisi AT, Salawu MA. Misconception of dementia-related disorders in Sub-Saharan Africa. Front Neurol 2023; 14:1148076. [PMID: 37139060 PMCID: PMC10149925 DOI: 10.3389/fneur.2023.1148076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Affiliation(s)
- Abdulyekeen T. Adebisi
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu, Republic of Korea
- *Correspondence: Abdulyekeen T. Adebisi
| | | |
Collapse
|
13
|
Ayele BA, Ali S, Anbessie M, Zewde YZ, Yoseph S, Lee S, Valcour V, Miller B. The need for a tailored national dementia plan in Ethiopia: A call for action. Front Neurol 2023; 14:1126531. [PMID: 36925945 PMCID: PMC10011145 DOI: 10.3389/fneur.2023.1126531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
Globally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under 5 years of age. In Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid-century. Older age is considered the most important non-modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non-communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub-Saharan Africa (SSA), including Ethiopia, has developed a standalone or an integrated national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, and economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment.
Collapse
Affiliation(s)
- Biniyam A Ayele
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seid Ali
- Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammed Anbessie
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Yared Z Zewde
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selam Yoseph
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Suzee Lee
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
14
|
Slewa-Younan S, Krstanoska-Blazeska K, Blignault I, Li B, Reavley NJ, Renzaho AMN. Conceptualisations of mental illness and stigma in Congolese, Arabic-speaking and Mandarin-speaking communities: a qualitative study. BMC Public Health 2022; 22:2353. [PMID: 36522660 PMCID: PMC9753024 DOI: 10.1186/s12889-022-14849-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Australia is an ethnically diverse nation. Research has demonstrated an elevated risk of developing a mental illness in culturally and linguistically diverse (CaLD) communities yet uptake of mental health services is low. To improve mental health treatment seeking and outcomes for CaLD individuals in Australia there is an urgent need to deeply understand barriers to treatment such as stigma. Using an exploratory qualitative approach, the aim of the study was to explore how CaLD communities' conceptualise and interpret mental illness and associated beliefs and experiences of stigma. METHODS The study focused on three key CaLD groups: the Congolese, Arabic-speaking and Mandarin-speaking communities residing in Sydney, Australia. A series of eight focus group discussions (n = 51) and 26 key informant interviews were undertaken online using Zoom during the period of November to December 2021. Focus group discussions and key informant interviews were digitally recorded, transcribed, and analysed using NVivo software. RESULTS Three major themes were identified. The first theme related to mental illness terminology used in the three communities. Despite variation in the terms used to refer to 'mental illness' all three communities generally distinguished between 'mental illness', a more severe condition and 'mental health problems', considered to arise due to stressors. The second theme centred on beliefs about mental illness; with all three communities identifying migration-related stressors as contributing to mental illness. Culturally related beliefs were noted for the Congolese participants with the perception of a link between mental illness and supernatural factors, whereas Mandarin-speaking participants highlighted lack of inter and intrapersonal harmony and failure to adhere to values such as filial piety as contributing to mental illness. The final theme related to mental illness related stigma and the various ways it manifested in the three communities including presence of collectivist public stigma felt across all three groups and affiliate (family) stigma reported by the Arabic and Mandarin-speaking groups. CONCLUSIONS We found rich diversity in how these communities view and respond to mental illness. Our findings provide some possible insights on both service provision and the mental health system with a view to building effective engagement and pathways to care.
Collapse
Affiliation(s)
- Shameran Slewa-Younan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia.
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | | | - Ilse Blignault
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Bingqin Li
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Andre M N Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
| |
Collapse
|
15
|
Khumalo IP, Appiah R, Wilson Fadiji A. Measuring Positive Mental Health and Depression in Africa: A Variable-Based and Person-Centred Analysis of the Dual-Continua Model. Front Psychol 2022; 13:885278. [PMID: 35795445 PMCID: PMC9252463 DOI: 10.3389/fpsyg.2022.885278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalising mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis such as confirmatory factor analysis (CFA), or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting data from an African sample to both CFA and latent class analysis (LCA) to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum—Short Form (MHC-SF) and Patient Health Questionnaire—9 (PHQ-9); and LCA on combined item responses. College students (N = 892; average age = 22.74, SD = 4.92; female = 58%) from Ghana (n = 309), Kenya (n = 262), Mozambique (n = 232), and South Africa (n = 89) completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF, and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms (25.9%), flourishing with low endorsement of depressive symptoms (63.7%), and moderate mental health with high endorsement of depressive symptoms (10.4%). These findings further contribute to affirming the evidence for the dual-continua model of mental health, with implications for the assessment of mental health, to inform policy, practise, and future research in community and clinical settings in Africa.
Collapse
Affiliation(s)
- Itumeleng P. Khumalo
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
- *Correspondence: Itumeleng P. Khumalo,
| | - Richard Appiah
- Department of Occupational Therapy, College of Health Sciences, University of Ghana, Accra, Ghana
- Center for African Studies, Harvard University, Cambridge, MA, United States
| | - Angelina Wilson Fadiji
- University of Pretoria, Pretoria, South Africa
- North-West University, Potchefstroom, South Africa
| |
Collapse
|
16
|
George G, Fricker M, Todd O, Makowa D, Tembo C, Dotchin C, Gray WK, Walker RW, Mbwele B, Paddick SM. Screening for delirium and dementia in older hospitalised adults in Zambia. J Neurol Sci 2022; 436:120186. [DOI: 10.1016/j.jns.2022.120186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 10/18/2022]
|
17
|
Akinyemi RO, Yaria J, Ojagbemi A, Guerchet M, Okubadejo N, Njamnshi AK, Sarfo FS, Akpalu A, Ogbole G, Ayantayo T, Adokonou T, Paddick SM, Ndetei D, Bosche J, Ayele B, Damas A, Coker M, Mbakile-Mahlanza L, Ranchod K, Bobrow K, Anazodo U, Damasceno A, Seshadri S, Pericak-Vance M, Lawlor B, Miller BL, Owolabi M, Baiyewu O, Walker R, Gureje O, Kalaria RN, Ogunniyi A. Dementia in Africa: Current evidence, knowledge gaps, and future directions. Alzheimers Dement 2022; 18:790-809. [PMID: 34569714 PMCID: PMC8957626 DOI: 10.1002/alz.12432] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/21/2021] [Accepted: 06/11/2021] [Indexed: 12/19/2022]
Abstract
In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer's disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome-associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes. Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium.
Collapse
Affiliation(s)
- Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Joseph Yaria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Maëlenn Guerchet
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Njideka Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria
| | - Alfred K Njamnshi
- Department of Neurology, Yaoundé Central Hospital/Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
- Brain Research Africa Initiative (BRAIN), Geneva, Switzerland/Yaoundé, Cameroon
| | - Fred S Sarfo
- Department of Medicine, Kwame Nkrumah University of Science & Technology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School/Korle Bu Teaching Hospital, Accra, Ghana
| | - Godwin Ogbole
- Department of Radiology, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temitayo Ayantayo
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Thierry Adokonou
- Department of Neurology, University Teaching Hospital, Parakou, Benin
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute, Newcastle University, UK/Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - David Ndetei
- Department of Psychiatry, University of Nairobi and African Meatal Health and Training Foundation, Nairobi, Kenya
| | - Judith Bosche
- Kilimanjaro Christian Medical College, Moshi, Tanzania
| | - Biniyam Ayele
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrea Damas
- Mirembe Mental Health Hospital, Dodoma, Tanzania
| | - Motunrayo Coker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Lingani Mbakile-Mahlanza
- Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
| | - Kirti Ranchod
- Lufuno Neuropsychiatry Centre, Johannesburg, South Africa
| | - Kirsten Bobrow
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Udunna Anazodo
- Lawson Health Research Institute / Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Albertino Damasceno
- Department of Cardiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Margaret Pericak-Vance
- John T. Hussman Institute for Human Genomics and the Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brian Lawlor
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Bruce L Miller
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Mayowa Owolabi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Olusegun Baiyewu
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard Walker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Oye Gureje
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rajesh N Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Adesola Ogunniyi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| |
Collapse
|
18
|
Hovland OJ, Hole AF, Chiduo MG, Johannessen B. Experiences from cross-cultural collaboration in health campaigns in Tanzania: a qualitative study. Arch Public Health 2021; 79:199. [PMID: 34784960 PMCID: PMC8597226 DOI: 10.1186/s13690-021-00730-0] [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] [Received: 06/16/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Health campaigns are an important aspect of preventive health work. They can aim to improve health literacy in rural areas where residents lack access to health information and knowledge, and to improve both local and global health through cross-cultural collaboration. In Tanga District, Tanzania, exchange students and local youths participate together with Tanga International Competence Centre (TICC) to plan and accomplish health campaigns in local communities. The aim of this study was to explore the participants’ experiences with the cross-cultural collaboration in the planning and delivery of TICC’s health campaigns. Methods This study used a focused ethnographic approach. Five weeks of fieldwork included four observations of health campaigns and nine interviews: three individual interviews with employees at TICC (all Tanzanians), two group interviews with nine Norwegian nursing students, two group interviews with five local youths enrolled in TICC’s Youth Program, one interview with a local village leader, and one interview with a local primary school teacher. The interview material was analyzed using systematic text condensation. Results All participants experienced the cross-cultural collaboration as successful. Having enough time, adapting to local conditions, and understanding the needs of the target groups were perceived as essential to the campaigns’ success. Music and role-play, which are dominant within Tanzanian culture but not common among the Norwegian students, created excitement and motivation among the audiences. The interviewees identified changes in people’s health behavior in the aftermath of the campaigns. Conclusion All participants in this study identified positive outcomes from the cross-cultural collaboration within TICC’s health campaigns. The health campaigns were considered beneficial because of the poor access to health information among residents in the local communities.
Collapse
Affiliation(s)
- Olav Johannes Hovland
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Building I, Postbox 422, 4604, Kristiansand, Norway.
| | - Ane Falnes Hole
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Building I, Postbox 422, 4604, Kristiansand, Norway
| | - Mercy Grace Chiduo
- National Institute for Medical Research, Tanga Medical Research Centre, P. O Box 5004, Tanga, United Republic of Tanzania
| | - Berit Johannessen
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Building I, Postbox 422, 4604, Kristiansand, Norway
| |
Collapse
|
19
|
Paddick SM, Yoseph M, Gray WK, Andrea D, Barber R, Colgan A, Dotchin C, Urasa S, Kissima J, Haule I, Kisoli A, Rogathi J, Safic S, Mushi D, Robinson L, Walker RW. Effectiveness of App-Based Cognitive Screening for Dementia by Lay Health Workers in Low Resource Settings. A Validation and Feasibility Study in Rural Tanzania. J Geriatr Psychiatry Neurol 2021; 34:613-621. [PMID: 32964799 PMCID: PMC8600584 DOI: 10.1177/0891988720957105] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The majority of people with dementia live in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA) human-resource shortages in mental health and geriatric medicine are well recognized. Use of technological solutions may improve access to diagnosis. We aimed to assess the diagnostic accuracy of a brief dementia screening mobile application (app) for non-specialist workers in rural Tanzania against blinded gold-standard diagnosis of DSM-5 dementia. The app includes 2 previously-validated culturally appropriate low-literacy screening tools for cognitive (IDEA cognitive screen) and functional impairment (abbreviated IDEA-IADL questionnaire). METHODS This was a 2-stage community-based door-to-door study. In Stage1, rural primary health workers approached all individuals aged ≥60 years for app-based dementia screening in 12 villages in Hai district, Kilimanjaro Tanzania.In Stage 2, a stratified sub-sample were clinically-assessed for dementia blind to app screening score. Assessment included clinical history, neurological and bedside cognitive assessment and collateral history. RESULTS 3011 (of 3122 eligible) older people consented to screening. Of these, 610 were evaluated in Stage 2. For the IDEA cognitive screen, the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% CI 0.74-0.83) for DSM-5 dementia diagnosis (sensitivity 84.8%, specificity 58.4%). For those 358 (44%) completing the full app, AUROC was 0.78 for combined cognitive and informant-reported functional assessment. CONCLUSIONS The pilot dementia screening app had good sensitivity but lacked specificity for dementia when administered by non-specialist rural community workers. This technological approach may be a promising way forward in low-resource settings, specialist onward referral may be prioritized.
Collapse
Affiliation(s)
- Stella-Maria Paddick
- Newcastle University, Newcastle upon
Tyne, United Kingdom,Stella-Maria Paddick, Campus for Ageing and
Vitality Newcastle University, Westgate Road, Newcastle upon Tyne NE4 6BE,
Tanzania.
| | - Marcella Yoseph
- Kilimanjaro Christian Medical University
College, Moshi, Tanzania
| | - William K. Gray
- Northumbria Healthcare NHS Foundation
Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | | | - Robyn Barber
- Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Aofie Colgan
- Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Catherine Dotchin
- Newcastle University, Newcastle upon
Tyne, United Kingdom,Northumbria Healthcare NHS Foundation
Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Sarah Urasa
- Kilimanjaro Christian Medical University
College, Moshi, Tanzania
| | - John Kissima
- Hai District Hospital, Boman’gombe,
Kilimanjaro, Tanzania
| | - Irene Haule
- Hai District Hospital, Boman’gombe,
Kilimanjaro, Tanzania
| | - Aloyce Kisoli
- Kilimanjaro Christian Medical University
College, Moshi, Tanzania
| | - Jane Rogathi
- Kilimanjaro Christian Medical University
College, Moshi, Tanzania
| | | | - Declare Mushi
- Kilimanjaro Christian Medical University
College, Moshi, Tanzania
| | | | - Richard W. Walker
- Newcastle University, Newcastle upon
Tyne, United Kingdom,Northumbria Healthcare NHS Foundation
Trust, North Tyneside General Hospital, North Shields, United Kingdom
| |
Collapse
|
20
|
Fletcher JR. Black knowledges matter: How the suppression of non-white understandings of dementia harms us all and how we can combat it. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1818-1825. [PMID: 34002398 DOI: 10.1111/1467-9566.13280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/06/2020] [Accepted: 10/25/2020] [Indexed: 06/12/2023]
|
21
|
Okumu M, Nyoni T, Byansi W. Alleviating psychological distress and promoting mental wellbeing among adolescents living with HIV in sub-Saharan Africa, during and after COVID-19. Glob Public Health 2021; 16:964-973. [PMID: 33843460 DOI: 10.1080/17441692.2021.1912137] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
COVID-19 social control measures (e.g. physical distancing and lockdowns) can have both immediate (social isolation, loneliness, anxiety, stress) and long-term effects (depression, post-traumatic stress disorder) on individuals' mental health. This may be particularly true of adolescents living with HIV (ALHIV) and their caregivers - populations already overburdened by intersecting stressors (e.g. psychosocial, biomedical, familial, economic, social, or environmental). Addressing the adverse mental health sequelae of COVID-19 among ALHIV requires a multi-dimensional approach that at once (a) economically empowers ALHIV and their households and (b) trains, mentors, and supervises community members as lay mental health services providers. Mental health literacy programming can also be implemented to increase mental health knowledge, reduce stigma, and improve service use among ALHIV. Schools and HIV care clinics offer ideal environments for increasing mental health literacy and improving access to mental health services.
Collapse
Affiliation(s)
- Moses Okumu
- School of Social Work, University of North Carolina, Chapel Hill, NC, USA
| | - Thabani Nyoni
- Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - William Byansi
- Brown School of Social Work, Washington University, St. Louis, MO, USA
| |
Collapse
|
22
|
Miller AP, Ziegel L, Mugamba S, Kyasanku E, Wagman JA, Nkwanzi-Lubega V, Nakigozi G, Kigozi G, Nalugoda F, Kigozi G, Nkale J, Watya S, Ddaaki W. Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework. QUALITATIVE HEALTH RESEARCH 2021; 31:967-982. [PMID: 33451275 PMCID: PMC8628861 DOI: 10.1177/1049732320986164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services.
Collapse
Affiliation(s)
| | - Leo Ziegel
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Centre for Dependency Disorders, Stockholm, Sweden
| | - Stephen Mugamba
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Emmanuel Kyasanku
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | | | | | - Gertrude Nakigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Grace Kigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - James Nkale
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Stephen Watya
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - William Ddaaki
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| |
Collapse
|
23
|
Spittel S, Kraus E, Maier A. Dementia Awareness Challenges in Sub-Saharan Africa: A Cross-Sectional Survey Conducted Among School Students in Ghana. Am J Alzheimers Dis Other Demen 2021; 36:15333175211055315. [PMID: 34985361 PMCID: PMC10581119 DOI: 10.1177/15333175211055315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The survey focuses on identifying dementia awareness challenges among Ghanaian school students. Data were generated in a cross-sectional survey (n = 1137). 9.3% of school students showed dementia awareness whilst the community respondents, representing both higher age and level of education, showed greater awareness (32.2%, P < .001). 45% of respondents believed in witchcraft and 57% were afraid of potentially being harmed by witchcraft. Age and education did not influence people's belief in witchcraft. Moreover, dementia symptoms were often mistaken for witchcraft, especially by those who had encountered a person accused of witchcraft: "swearing at others" (24%), displaying "memory loss" and "confused speech" (22%), "forgetfulness" and who was seen "roaming around" (19%). Lack of dementia awareness was particularly evident among school students whereas belief in witchcraft was similar in both respondent groups. There was a correlation between low dementia awareness rates and misinterpretation of dementia symptoms with attribution to witchcraft.
Collapse
Affiliation(s)
- Susanne Spittel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Neurology, Berlin, Germany
- Universität Bremen, Department of Health Care Research, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Elke Kraus
- Alice-Salomon University of Applied Sciences, Berlin, Germany
| | - André Maier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Neurology, Berlin, Germany
| |
Collapse
|