Beyond the biomedical: community resources for mental health care in rural Ethiopia.

Journal: PloS one

Volume: 10

Issue: 5

Year of Publication: 2016

Affiliated Institutions:  Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Centre for Global Mental Health, Institute of Psychiatry, King's College London, London, United Kingdom. Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. Centre for Global Mental Health, Institute of Psychiatry, King's College London, London, United Kingdom. Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Centre for Affective Disorders and Affective Disorders Research Group, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.

Abstract summary 

The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities.The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention.

Authors & Co-authors:  Selamu Medhin M Asher Laura L Hanlon Charlotte C Medhin Girmay G Hailemariam Maji M Patel Vikram V Thornicroft Graham G Fekadu Abebaw A

Study Outcome 

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Statistics
Citations :  Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips M, et al. No health without mental health. Lancet. 2007; 370: 859–877.
Authors :  8
Identifiers
Doi : e0126666
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Delivery of Health Care
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
United States