Development of a scalable mental healthcare plan for a rural district in Ethiopia
Open accessAbstract
Background: Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority. Aims: To outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia. Method: A mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation). Results: The community packages were community case detection, community reintegration and community inclusion. The facility packages included capacity building, decision support and staff well-being. Organisational packages were programme management, supervision and sustainability. Conclusions: The MHCP focused on improving demand and access at the community level, inclusive care at the facility level and sustainability at the organisation level. The MHCP represented an essential framework for the provision of integrated care and may be a useful template for similar LMIC.
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Some studies have reported implementation outcomes, such as feasibility or acceptability, of AUD interventions in general health care settings.
“Some of these studies have further reported on implementation outcomes (e.g., feasibility or acceptability) of interventions for AUD in general health care settings (7, 36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [37]
The review found studies that reported frameworks and plans for integrated interventions for mental health services that also included AUD care as one component.
“In addition to that, we also found studies that reported frameworks and plans for integrated interventions for the mental health services that also included AUD care as one component.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [37]
Various strategies may facilitate the implementation of AUD components of an integrated mental health care program.
“Additionally, these studies also identified various strategies that may facilitate the implementation of AUD components of an integrated mental health care program.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [37]
The strategies identified to facilitate implementation of AUD components of integrated mental health care include methods to improve detection, support decision making, improve staff wellbeing, and ensure proper program management and supportive supervision.
“These strategies included methods to improve detection, support decision making, improve staff wellbeing, and ensure proper program management and supportive supervision (36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [37]
The included studies reported implementation strategies: engaging mental health stakeholders from inception, conducting sensitization workshops, training clinical staff, supervising decision support and supporting staff well-being, and leveraging available resources and existing systems.
“The following implementation strategies were reported: (i) engaging mental health stakeholders from inception to enhance their ownership and commitment, (ii) conducting sensitization workshops (37, 38), (iii) training clinical staff (36–38), (iv) supervising decision support and supporting staff well-being (3–37, 59), and leveraging available resources and existing systems (36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [37]
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References 26 · Cited by 147
Research works printed but not linked: 2
- [17]Fekadu A Alem A Hanlon C Alcohol and drug abuse in Ethiopia: past, present and future. Afr J Drug Alcohol Stud 2007; 6: 39– 53.
- [27]World Health Organization mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings. WHO, 2010. 23741783
- Authors
- Fekadu, A., Hanlon, C., Medhin, G., Alem, A., Selamu, M., Giorgis, T. W., Shibre, T., Teferra, S., Tegegn, T., Breuer, E., Patel, V., Tomlinson, M., Thornicroft, G., Prince, M., & Lund, C.
- Affiliations
- King's College London (GB)
- University of Cape Town (ZA)
- Corresponding author
- Fekadu, Abebaw
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-01
- Volume
- 208
- Issue
- s56
- Pages
- s4-s12
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC4698551
- OpenAlex
- W2179864080
- Cited by
- 147
- References
- 26
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 13 · 2023: 15 · 2022: 17 · 2021: 14 · 2020: 14 · 2019: 18 · 2018: 9 · 2017: 13 · 2016: 5 · 2015: 6
- FWCI
- 18.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The British Journal of Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (091834)
- Government of the United Kingdom
- National Institute for Health and Care Research (NF-SI-0611-10053)
- National Institute on Alcohol Abuse and Alcoholism (R24AA022919)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- scaling up mental health services, rural mental health, district health system, community reintegration, community inclusion, health workforce capacity building, employee well-being, decision support, program management, supervision, sustainability, integrated care, low- and middle-income countries, Ethiopia
- MeSH terms
- Mental Disorders, Community Mental Health Services, Developing Countries, Ethiopia, Health Facility Planning, Health Workforce, Humans, Patient Care Planning, Poverty, Rural Population, Program Evaluation, Qualitative Research
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