Care delivery in the context of district mental healthcare plans in Ghana: a qualitative study exploring experiences of primary healthcare workers and service users.

Journal: BMJ open

Volume: 14

Issue: 12

Year of Publication: 2024

Affiliated Institutions:  Ghana Somubi Dwumadie (Ghana Participation Programme), PMB Asoyi Crescent, East Legon, Accra Ghana, Accra, Ghana lionelsakyi@gmail.com. Ghana Somubi Dwumadie (Ghana Participation Programme), PMB Asoyi Crescent, East Legon, Accra Ghana, Accra, Ghana. Department of Social and Behavioural Sciences, College of Health Sciences, University of Ghana, Legon, Greater Accra, Ghana. Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, London, UK.

Abstract summary 

To explore the perceptions and experiences of mental health service users and healthcare workers regarding the implementation of district mental healthcare plans (DMHPs) in three district demonstration sites in Ghana.The study employed a qualitative design using reflexive thematic analysis. Interview data were analysed by combining inductive and deductive approaches.The study was conducted in three DMHP districts in Ghana: Anloga (Volta), Asunafo North (Ahafo) and Bongo (Upper East). The districts were selected via national stakeholder consultations, using a DMHP framework. Data were collected between January 2023 and June 2023.In-depth interviews were conducted with 28 primary healthcare workers who played key roles in the delivery of care in the demonstration districts. Thirty-two service users who are 18 years and above and have been receiving healthcare for the past year in the demonstration districts were also interviewed. Participants were purposively sampled.Three main themes were identified: (1) factors supporting DMHP implementation, including capacity building, collaboration, awareness creation and acceptability; (2) challenges affecting DMHP implementation, such as inadequate resources and medication shortages and (3) perceived outcomes of the DMHPs, including improved well-being and daily functioning as well as changing attitudes towards mental health. Some district-level variations were noted in the intensity of challenges and outcomes.The DMHPs have shown promise in improving mental healthcare in primary care settings in Ghana. However, addressing resource constraints and medication shortages and sustaining capacity building and awareness creation efforts will be crucial for successful scale-up. The perspectives of service users and healthcare providers offer valuable insights for policymakers and practitioners aiming to enhance integrated mental healthcare.

Authors & Co-authors:  Sakyi Lionel L Ae-Ngibise Kenneth K Adwan-Kamara Lyla L Weobong Benedict B Lund Crick C

Study Outcome 

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Statistics
Citations : 
Authors :  5
Identifiers
Doi : 10.1136/bmjopen-2024-090711
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Delivery of healthcare, Integrated;Health Services Accessibility;Health policy;MENTAL HEALTH;Primary healthcare;QUALITATIVE RESEARCH
Study Design
Study Approach
Qualitative
Country of Study
Ghana
Publication Country
England