Barriers and facilitators in the implementation of bio-psychosocial care at the primary healthcare level in South Kivu, Democratic Republic of Congo

Molima, Christian; Karemere, Hermès; Bisimwa, Ghislain; Makali, Samuel; Mwene-Batu, Pacifique; Malembaka, Espoir Bwenge; Macq, Jean

doi:10.4102/phcfm.v13i1.2608

Cited by 6 publications

(12 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bokhour agrees, stressing the efforts that must be made at all levels of the health system on the basis that leadership must be the primum movens (49). To these barriers are added those reported in our previous study (21) namely lack of knowledge of BPS management by caregivers, home visits mainly used for disease control, solidarity initiatives not promoted locally, expected new resources and nancial incentives and accountability summarized in the reporting of speci c indicators.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is a bio-psychosocial approach model possible at the first level of health services in the Democratic Republic of Congo? An organizational analysis of six health centers in South Kivu

Molima

Karemere

Makali

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Efforts to implement a person-centered and/or BPS approach to care may encounter barriers or facilitating factors (21). Disadvantageous factors identi ed included providers' differing understanding of the approach as a mental health program and facilitating factors included home visits and the dynamism and leadership of the care team (21).…”

Section: Introductionmentioning

confidence: 99%

Is a bio-psychosocial approach model possible at the first level of health services in the Democratic Republic of Congo? An organizational analysis of six health centers in South Kivu

Molima

Karemere

Makali

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…It also means caring for the individual according to biopsychosocial considerations and community involvement. (9)(10)(11) To speak of integration of this approach in the care system, particularly at the front line of care, means that the health care team provides quality and safe care in a sustainable way, in its totality, around the health issues of each individual sufferer, offering preventive, curative, promotive, palliative and rehabilitative services. The care provided is juxtaposed with the speci c needs of the person beyond the disease itself, hence, some level of collective coordination would be required to address complex and chronic problems.…”

Section: Introductionmentioning

confidence: 99%

“…In order to improve the quality of care offered at the level of rst-level care structures, a research and development project was implemented in South Kivu in the DRC, nanced by Belgian cooperation (ARES-CCD), with the objective of reorganizing care at the level of health centres according to a new personcentred care approach (10).…”

Section: Introductionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Kasongo

Molima

Makali

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background: The concept of biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it, community involvement is needed to enable its integration into the health sector. For this to happen, the community must first have an understanding of the approach, as a stakeholder and direct beneficiary. The objective of this study is to understand the community's views on the concept of integrated health care according to the biopsychosocial approach (BPS) at the Health Center of a Health District. Methods: We conducted a qualitative study based on individual semi-directive interviews with members of the Health Development Committees of six Health Areas belonging to four Health Districts as well as with some patients met in health facilities. A total of 15 interviews were conducted. The adapted NoMAD tool, derived from the Theory of the Normalization Process of Complex Interventions, allowed us to collect data from November 2017 to February 2018, and then from November 2018 to February 2019. After data extraction and synthesis, we conducted a thematic analysis using the NoMAD tool to build a thematic framework. Results: Initially, community perceptions were diverse in relation to the BPS approach of integrated care in the Health Centre; but later, the concept became clearer with the implementation of the approach, even for the providers with the change in their way of working (interprofessional collaboration, sharing of responsibilities...). Certain practices were encouraged to help the approach, notably the development of financial autonomy and mutual support. According to the community, the BPS model has further strengthened the performance of health workers and should be expanded and sustained. Stakeholders throughout the country were called upon to support the BPS concept in its implementation. Conclusions: The results of our study should encourage the involvement of community participation in any process of integrating the biopsychosocial model of person-centred health care, even at higher levels of care. However, the barriers and enablers to the BPS mechanism identified in our study should be taken into consideration.

show abstract

“…It is known that the spectrum of bio-psychosocial health is critical for person-centered care (i.e., Molima et al, 2021), mainly in chronic conditions and mental health (Wood et al, 2021). Therefore, in parallel to the clinical relevance of misophonia in terms of origin, diagnosis, and treatment, research efforts are needed to address the disorder from a bio-psycho-social perspective.…”

Section: Introductionmentioning

confidence: 99%

On the lack of self-concept and social representation of misophonia and their modulation by an intervention

Ferrer-Torres

Giménez‐Llort

2022

Preprint

View full text Add to dashboard Cite

Misophonia is a poorly understood and underdiagnosed disorder. People who suffer from this condition without knowing it has a notable deterioration in their quality of life, affecting their personal and social relationships. The present study characterized the self-concept of 82 people (women:men, 3:2) attending a medical psychology center in Barcelona before and after their diagnosis of misophonia and intervention to raise awareness. The social representation of misophonia was also studied in their close relatives. A lexicometric analysis using IRaMuTeQ software qualified and quantified the 164 participants' words to describe the patient's behavior (associative cards method) in a list of situations reported but not yet identified as triggers of misophonic responses. The corpus of text, branching, and the word clouds of the most used words showed a high frequency of negative qualifiers (attributed to personality) from relatives [ranking:“irritable” (n=30), “narrow-minded” (n=24) and “anxious” (n=15)] and in the self-concept of patients [ranking: “irritable” (n=34) and “anxious” (n=26), tolerant (n=24) and frank (n=18)], with higher diversification in patients than relatives (14:8 qualifiers n>10), and an increased post-intervention (17:10 qualifiers >10). The intervention strongly modified the corpus since “misophonic” and “disorder” appeared in the self-concept post-intervention, but not the concept, suggesting relatives need substantial efforts to be aware of the nature/impact of the disorder. The distribution of misophonia levels differed among sexes (higher representation of women at level 2 [56%], while men mainly were diagnosed at level 3 [50%]) while age only showed tends. Interestingly, the intervention increased 2.71 points the misophonia score obtained in a self-administered questionnaire repeated seven months later and rescued 13.4% of positive diagnoses, suggesting that for the patients to recognize the diagnosis of misophonia in themselves, they must first be aware of this concept. The individuals with less self-concept stability more frequently recognized themselves as misophonic. Besides, 21% of the variance in the change in self-concept was explained by the change in the concept of a close relative. In summary, the lack of self-concept and social representation of misophonia have strong implications for all the actors and are relevant to design interventions to reduce their impact.

show abstract

Barriers and facilitators in the implementation of bio-psychosocial care at the primary healthcare level in South Kivu, Democratic Republic of Congo

Cited by 6 publications

References 36 publications

Is a bio-psychosocial approach model possible at the first level of health services in the Democratic Republic of Congo? An organizational analysis of six health centers in South Kivu

Is a bio-psychosocial approach model possible at the first level of health services in the Democratic Republic of Congo? An organizational analysis of six health centers in South Kivu

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

On the lack of self-concept and social representation of misophonia and their modulation by an intervention

Contact Info

Product

Resources

About