Health system constraints in integrating mental health services into primary healthcare in rural Uganda: perspectives of primary care providers.

Journal: International journal of mental health systems

Volume: 13

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box , Mbarara, Uganda. Mwanza Intervention Trials Unit, Tanzania National Institute for Medical, Mwanza Centre, Mwanza, Tanzania. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda. Department of Medical Education, California University of Science and Medicine, San Bernardino, CA USA. Department of Pharmacology and Therapeutics and Vice Chancellor, Mbarara University of Science and Technology, Mbarara, Uganda.

Abstract summary 

The World Health Organization issued recommendations to guide the process of integrating mental health services into primary healthcare. However, there has been general as well as context specific shortcomings in the implementation of these recommendations. In Uganda, mental health services are intended to be decentralized and integrated into general healthcare, but, the services are still underutilized especially in rural areas.The purpose of this study was to explore the health systems constraints to the integration of mental health services into PHC in Uganda from the perspective of primary health care providers (PHCPs).This was a cross sectional qualitative study guided by the Supporting the Use of Research Evidence (SURE) framework. We used a semi-structured interview guide to gain insight into the health systems constraints faced by PHCPs in integrating mental health services into PHC.Key health systems constraints to integrating mental health services into PHC identified included inadequate practical experience during training, patient flow processes, facilities, human resources, gender related factors and challenges with accessibility of care.There is need to strengthen the training of healthcare providers as well as improving the health care system that supports health workers. This would include periodic mental healthcare in-service training for PHCPs; the provision of adequate processes for outreach, and receiving, referring and transferring patients with mental health problems; empowering PHCPs at all levels to manage and treat mental health problems and adequately provide the necessary medical supplies; and increase the distribution of health workers across the health facilities to address the issue of high workload and compromised quality of care provided.

Authors & Co-authors:  Wakida Edith K EK Okello Elialilia S ES Rukundo Godfrey Z GZ Akena Dickens D Alele Paul E PE Talib Zohray M ZM Obua Celestino C

Study Outcome 

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Statistics
Citations :  World Health Organization . Declaration of alma-ata. Geneva: World Health Organization, Regional Office for Europe; 2004.
Authors :  7
Identifiers
Doi : 16
SSN : 1752-4458
Study Population
Male,Female
Mesh Terms
Other Terms
Education system;Facilities;Health systems;Human resource;Patient flow processes;Primary healthcare
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
England