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Yang JMK, Vaiphei K, Siliya M, Mkandawire T, Dolman C, Heron J, Wilson S, Yaresheemi S, Kitney D, Bailey L, Apsey C, Liwimbi O, Stewart R, Thippeswamy H, Jones I, Chorwe-Sungani G, Chandra P, Di Florio A. Postpartum psychosis: a public involvement perspective across three continents. Arch Womens Ment Health 2023; 26:831-837. [PMID: 37615717 PMCID: PMC10632256 DOI: 10.1007/s00737-023-01347-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/01/2023] [Indexed: 08/25/2023]
Abstract
Postpartum psychosis is a psychiatric emergency that is currently not represented in diagnostic systems, to the detriment of people with lived experience. Engaging with stakeholders offers an important avenue to improve clinical practice and make research more impactful, by providing perspectives based on first-hand, expert experience. There is a paucity of reports on stakeholders' engagement in psychiatry. Activities have thus far been limited to Western countries and there are few reports on postpartum psychosis. We report the results of public involvement activities (in the form of discussion groups) with key stakeholders in India, Malawi and the UK. These discussions centred around the clinical picture of postpartum psychosis and the terminologies used to describe these episodes. Seven major areas were highlighted: how postpartum psychosis is handled within services, common symptoms and characteristics, impact of episode, barriers to care, non-medical approaches, terminology and research areas of interest. According to the discussions, postpartum psychosis presents similarly across countries, although there are differences in access to services, approaches to mental health and terminologies used within and across countries. With this understanding comes the foundation for cross-cultural assessment, service improvement and a stakeholder-informed research agenda.
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Affiliation(s)
- Jessica Mei Kay Yang
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Kimneihat Vaiphei
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | | | | | - Clare Dolman
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Bipolar UK, 32 Cubitt Street, London, UK
| | - Jessica Heron
- Action on Postpartum Psychosis, Institute of Mental Health, University of Birmingham, Birmingham, UK
| | - Sally Wilson
- Action on Postpartum Psychosis, PO Box 137, Swansea, UK
| | - Shivanand Yaresheemi
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Danielle Kitney
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Leah Bailey
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Chloe Apsey
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | | | - Robert Stewart
- Division of Psychiatry, University of Edinburgh, Scotland, UK
| | - Harish Thippeswamy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Ian Jones
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | | | - Prabha Chandra
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Arianna Di Florio
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.
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Merry L, Castiglione SA, Rouleau G, Létourneau D, Larue C, Deschênes MF, Gonsalves DM, Ahmed L. Continuing professional development (CPD) system development, implementation, evaluation and sustainability for healthcare professionals in low- and lower-middle-income countries: a rapid scoping review. BMC Med Educ 2023; 23:498. [PMID: 37415150 DOI: 10.1186/s12909-023-04427-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Policymakers and program developers in low-and lower-middle-income countries (LLMICs) are increasingly seeking evidence-based information and guidance on how to successfully develop and implement continuing professional development (CPD) systems. We conducted a rapid scoping review to map and synthesize what is known regarding the development, implementation, evaluation and sustainability of CPD systems for healthcare professionals in LLMICs. METHODS We searched MEDLINE, CINAHL and Web of Science. Reference lists were screened and a cited reference search of included articles was conducted. Supplementary information on the CPD systems identified in the articles was also identified via an online targeted grey literature search. English, French and Spanish literature published from 2011 to 2021 were considered. Data were extracted and combined and summarized according to country/region and healthcare profession via tables and narrative text. RESULTS We included 15 articles and 23 grey literature sources. Africa was the region most represented followed by South and Southeast Asia and the Middle East. The literature most often referred to CPD systems for nurses and midwives; CPD systems for physicians were frequently referred to as well. Findings show that leadership and buy-in from key stakeholders, including government bodies and healthcare professional organizations, and a framework are essential for the development, implementation and sustainability of a CPD system in a LLMIC. The guiding framework should incorporate a regulatory perspective, as well as a conceptual lens (that informs CPD objectives and methods), and should consider contextual factors (support for CPD, healthcare context and population health needs). In terms of important steps to undertake, these include: a needs assessment; drafting of a policy, which details the regulations (laws/norms), the CPD requirements and an approach for monitoring, including an accreditation mechanism; a financing plan; identification and production of appropriate CPD materials and activities; a communication strategy; and an evaluation process. CONCLUSION Leadership, a framework and a clearly delineated plan that is responsive to the needs and context of the setting, are essential for the development, implementation and sustainability of a CPD system for healthcare professionals in a LLMIC.
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Affiliation(s)
- Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, Canada.
- SHERPA University Institute, West-Central Montreal CIUSSS, Montreal, Canada.
| | | | - Geneviève Rouleau
- International Health Unit, School of Public Health, University of Montreal, Montreal, Canada
- University of Montreal Health Centre, Montreal, Canada
| | | | - Caroline Larue
- Faculty of Nursing, University of Montreal, Montreal, Canada
| | | | | | - Lubana Ahmed
- ProNurse Project, Cowater International, Dhaka, Bangladesh
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Allen L, Townsend N, Williams J, Mikkelsen B, Roberts N, Wickramasinghe K. Socioeconomic status and alcohol use in low- and lower-middle income countries: A systematic review. Alcohol 2018; 70:23-31. [PMID: 29723827 DOI: 10.1016/j.alcohol.2017.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Harmful use of alcohol is a major cause of global morbidity and mortality. The role of alcohol as a driver of the unfolding non-communicable disease crisis has led to high-profile calls for better epidemiological data. Despite causing a disproportionate amount of harm in low-income groups, there is a critical dearth of evidence on the intra-national socioeconomic patterning of alcohol use in low- and lower-middle income countries (LLMICs). This review aims to fill the gap, providing evidence on the association between socioeconomic status (SES) and alcohol use in these low-income settings. METHODS We conducted a comprehensive literature search for primary research published between January 1, 1990 and June 30, 2015 using 13 electronic databases, including Embase and Medline. We also hand-searched references and reviewed 'gray literature' - studies that have not been published in peer-reviewed journals. We included studies from LLMICs presenting data on multiple measures of socioeconomic status and alcohol use. No age or language restrictions were applied. Due to high heterogeneity, we used a narrative approach for data synthesis. FINDINGS After reviewing 4242 records and 247 full-text articles, 23 studies met our inclusion criteria, reporting data on 861,295 individuals aged >10 years from 10 countries. Alcohol use was found to be more prevalent in lower socioeconomic groups in the majority of Southeast Asian studies. The association was mixed for African studies, although these tended to have smaller sample sizes and weaker methods. Studies that measured multiple domains of SES found good agreement between different indicators. Definitions of alcohol use and abuse varied widely between studies, as did socioeconomic groupings. CONCLUSIONS The lack of consistency between studies and the abject lack of data from the majority of LLMICs present a major barrier to policymakers tasked with reducing alcohol-related harm in these settings. Adherence to standardized definitions, the publication of WHO survey data on alcohol and SES, and enhanced surveillance is needed to build an accurate picture of the socioeconomic patterning of alcohol use in developing countries.
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Holme F, Kapambwe S, Nessa A, Basu P, Murillo R, Jeronimo J. Scaling up proven innovative cervical cancer screening strategies: Challenges and opportunities in implementation at the population level in low- and lower-middle-income countries. Int J Gynaecol Obstet 2017; 138 Suppl 1:63-68. [PMID: 28691331 DOI: 10.1002/ijgo.12185] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The problem of cervical cancer in low- and lower-middle-income countries (LLMICs) is both urgent and important, and calls for governments to move beyond pilot testing to population-based screening approaches as quickly as possible. Experiences from Zambia, Bangladesh, Guatemala, Honduras, and Nicaragua, where scale-up of evidence-based screening strategies is taking place, may help other countries plan for large-scale implementation. These countries selected screening modalities recommended by the WHO that are within budgetary constraints, improve access for women, and reduce health system bottlenecks. In addition, some common elements such as political will and government investment have facilitated action in these diverse settings. There are several challenges for continued scale-up in these countries, including maintaining trained personnel, overcoming limited follow-up and treatment capacity, and implementing quality assurance measures. Countries considering scale-up should assess their readiness and conduct careful planning, taking into consideration potential obstacles. International organizations can catalyze action by helping governments overcome initial barriers to scale-up.
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Affiliation(s)
| | - Sharon Kapambwe
- Ministry of Health of Zambia and Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Ashrafun Nessa
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Partha Basu
- International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Centro Javeriano de Oncologia, Hospital Universitario San Ignacio, Bogota, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
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