Experience of Trained Primary Health Care Workers in Mental Health Service Delivery across Ogun State Nigeria

Timothy, Adebowale; Umukoro, Onofa Lucky; Ighoroje, Maroh; Gater, Richard; Adegboyega, Ogunwale; Niran, Okewole; Adefolakemi, Ogundele; Samuel, Olarinde; Funmilayo, Olaitan; Modupe, Olopade; Karmodeen, Ogunyomi

doi:10.21767/2471-9854.100035

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…It was probable that some of the scarcely diagnosed disorders were 'somatically disguised' at presentation and sufferers sought help for physical complaints rather than psychological distress. A previous study had shown that 25% to 50% of the THWs reported difficulties in diagnosing depression and OSEC using western diagnostic classification (26). Hence depression remains a major hidden morbidity [27,28].…”

Section: Discussion a Improved Access To Mental Healthcarementioning

confidence: 99%

Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

2018

IJP

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Introduction: Integration of mental health services into Primary Health Care (PHC) is a proven way of reducing the treatment gap in developing countries. A major constraint to scaling up mental health services in developing countries is scarcity of mental health professionals. A practical solution is to adopt task shifting and task sharing strategies involving Primary Health Care Workers (PHW). One of the major challenges of such integrative services is their long term outcomes and sustainability. The Neuropsychiatric Hospital Aro, Abeokuta, Nigeria embarked on mental health services provision across primary health care facilities in Ogun state six (6) years ago. Objective: This report describes the development, challenges of the programme and presents a post-implementation evaluation after 6 years of its commencement. Methods: Applying a population based expansion of pilot- tested integration model of Aro Primary Care Mental Health Programme (APCMHP) for Ogun State, 80 PHC workers were trained using an adapted mental health Gap Action Programme (mhGAP) intervention guide to assess and treat/refer 5 priority conditions: Psychosis, Depression, Epilepsy, Alcohol and Substance abuse and Other Significant Emotional Complaints (OSEC).There was mental health service provision in 40 designated PHC centers across Ogun state. There was support and supervision of the trained health workers by field supervisors, supplementary training and re-training for skill sustenance, periodic stakeholders meeting with Local Government Service Commission, zonal consultants’ review, financial and other resources commitment by the hospital, monthly programme evaluation and monitoring by the faculty members. We reviewed caseload of patients managed by trained PHC Workers since commencement of the programme in November 2011 till October 2017 (6 years period) using descriptive statistics. Appropriate ethical approval was obtained. Results: During the six-year period (November 2011-October 2017), 2194 cases (average of 366 new cases yearly) were identified and treated by Trained Health Workers (THWs). About 90% of cases were Psychosis and Epilepsy. There was a steady attrition of THWs and at the end of the sixth year only 29% of the THWs remained within the programme. Treatment outcomes were fair as over 50% of patients had ≥ 3 follow-up visits, symptom remission of ≥ 30% and a subjective improvement in Global Ratings. Conclusion: Our project has demonstrated that it is feasible, practicable and cost effective with community acceptance to scale up mental health services at primary care setting in Nigeria using adapted mhGAP-IG document. The need to understand the dynamics and econometrics of sustainable primary mental health services is indicated.

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Section: Discussion a Improved Access To Mental Healthcarementioning

confidence: 99%

Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

2018

IJP

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“…37 It has, however, been reported that though women are twice as likely to experience depression and suicidal ideation than men, but men were four times more likely than women to commit suicide. 41…”

Section: Discussionmentioning

confidence: 99%

Depression And Suicidal Ideation: Awareness And Experience Among Students Of Tertiary Institutions In South-South Nigeria

Bodeno,

Esene,

Omuemu

et al. 2024

IJHMR

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AIM: Depression and suicidal ideation: Knowledge, perception and determinant among the students. METHODS: A cross-sectional analytical study was carried out among 406 students of Igbinedion University, Okada, Edo State. The respondents were selected by multistage sampling method; all the students were stratified based on the faculties, departments and year of study. The sampling ratio for each year of study was calculated and a proportional allocation was carried out. Simple random sampling was applied to select the number of students from each college and year of study by using computer generated numbers. Structured, pre-tested, interviewer-administered questionnaire were the tools used for data collection. Data was analyzed using IBM SPSS version 20.0 and level of significance was set at p < 0.05. RESULTS: Almost all, 98.5% and 80.3% of the respondents had good awareness on depression and suicidal ideation respectively, 12.1% had been diagnosed of depression, 11.3% experienced feeling down, depressed or hopeless nearly every day and 7.5% had intention of acting on thoughts about killing themselves. CONCLUSION: Most of the respondents had good awareness about depression, a few diagnosed of depressive illness and about a tenth of them have had intention of acting on thoughts about killing themselves. Therefore, government at all levels and policy-makers should prioritize preventive interventions especially among vulnerable population. The Plan will include nationally agreed strategies relating specifically to depression and suicidal ideation.

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“…A study revealed a high personal fulfillment of the trained Peripheral health centers (PHC) workers in mental health service delivery. There is need for re-training of the PHC workers towards effective service delivery (Timothy et al, 2017). Considering the Global action plan for the prevention and control of NCDs 2013-2020 developed by the World health organization (WHO), will give more significant impact on global NCD mortality, by preventing and well managing NCDs cases (WHO 2017a).…”

Section: Discussionmentioning

confidence: 99%

Untitled

2020

IRJPEH

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Like all non-communicable-diseases in low-income-countries, epilepsy is insufficiently taken into account by health-services. This research aimed to study the knowledge (and related factors) and experiences of health workers regarding epilepsy-management in health-districts from Region of Hauts Bassins (Burkina Faso). Cross-sectional study was conducted from June to September 2015. Health-workers (nurses, care-providers from district-teams and ward supervisors of district-hospitals) were interviewed. Knowledgescore on epilepsy was calculated based on 34 questions, using the median as the threshold. Factors associated (socio-demographic, experiences and organization of services) with good epilepsy-knowledge score were identified by logistic-regressions using SPSS 20.0 software. About 214 health-workers were included. Mean-age of respondents was 36.8 (± 6.2) years; 92.5% were male. Mean epilepsy-knowledge score was 20.5 (95%CI: 20.0-20.9); and 38.8% of respondents had less than the mean epilepsy-knowledge score. Factors influencing the good epilepsy-knowledge score included duration as health worker (p=0.025), having already taken care of an epileptic-seizure (p=0.024), having already sensitized population on epilepsy (p=0.028), and having already prescribed anti-epileptics drugs (p=0.007). Regarding organization and management of health-services for epilepsy cases, our study shows that health-workers were underinformed, untrained and unprepared for epilepsy case management. Health-care services environment was not supportive and not enabled. It is crucial to strengthen the capacity of healthworkers and to improve the health facility environment to become friendly with epilepsy-management.

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Experience of Trained Primary Health Care Workers in Mental Health Service Delivery across Ogun State Nigeria

Cited by 5 publications

References 16 publications

Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

Depression And Suicidal Ideation: Awareness And Experience Among Students Of Tertiary Institutions In South-South Nigeria

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