Integration of Mental Health into Primary Health Care in a rural district in Uganda
Open accessAbstract
OBJECTIVE: Mental health has been identified as a major priority in the Ugandan Health Sector Strategic Plan. Efforts are currently underway to integrate mental health services into the Primary Health Care system. In this study, we report aspects of the integration of mental health into primary health care in one rural district in Uganda. METHOD: Qualitative methods were used for data collection. Semi-structured interviews and focus group discussions were conducted with various stakeholders within the ministry of health as well as line ministries. Data analysis was done using Nvivo 7, specifically adopting framework analysis approach. RESULTS: Attempts to offer organized mental health services were found to be present in only a few health facilities. The district had only a single mental health nurse, and very few General Health Workers adequately equipped with the knowledge and skills to provide mental health services. The vertical referral system was not being followed as planned and there was no evidence of any organized community interventions for those with mental disorders. The mental health nurse and a few PHC nurses however expressed interest and commitment to providing services for persons with mental illness, despite the challenges. CONCLUSION: Although mental health is expected to be integrated into primary health care, mental health services in this district have not yet achieved the expected level of integration. This implies that this important policy requirement has not yet been effectively realized in this rural district, which could be the case in many other districts of a similar status. There is thus a need to direct more efforts towards realization of this important policy requirement.
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Failure to mobilize and adequately engage the community could be a potential barrier to the successful integration of mental health service into primary care.
“failure to mobilize and adequately engage the community could be a potential barrier to the successful integration of mental health service into primary care [9].”
The availability of psychotropic medicines in this study contrasts with most previous studies where supply of psychotropic medicines was one of the major barriers for integration of mental health services in primary care.
“Psychotropic medicines were available most of the time in the health facilities, which contrasts with most of the previous studies34–36 where supply of psychotropic medicines was one of the major barriers for integration of mental health services in primary care.”
From Process evaluation of a district mental healthcare plan in Nepal: a mixed-methods case study (2020) · cites this paper as [36]
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Background
- Authors
- Ssebunnya, J., Kigozi, F., Kizza, D., & Ndyanabangi, S.
- Affiliations
- Makerere University (UG)
- Butabika Hospital (UG)
- Ministry of Health (UG)
- Venue
- African Journal of Psychiatry
- Publisher
- African Journals Online (AJOL)
- Published
- 2010-05-11
- Volume
- 13
- Issue
- 2
- Pages
- 128-31
- ISSN
- 1994-8220 (ISSN-L)
- OpenAlex
- W2040712973
- Cited by
- 48
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- African Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- University of Leeds
- Department for International Development
- University of Ghana
- University of Cape Town
- Ministry of Health, Uganda
- 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 › Emergency Medical Services › Global Health Workforce Issues
- Keywords
- mental health integration, primary care, rural health care, mental health services, psychiatric nurses, community mental health intervention, mental illness, health policy implementation, Uganda
- MeSH terms
- Health Services Research, Humans, Interview, Psychological, Mental Health Services, Primary Health Care, Uganda, Focus Groups, Rural Health Services, Qualitative Research
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