Feasibility and effectiveness of nurses and clinical officers in implementing the WHO mhGAP intervention guide: Pilot study in Makueni County, Kenya

Mutiso, Victoria; Pike, Kathleen M.; Musyimi, Christine; Gitonga, Isaiah; Tele, Albert; Rebello, Tahilia J.; Thornicroft, Graham; Ndetei, David M.

doi:10.1016/j.genhosppsych.2019.04.005

Cited by 26 publications

(23 citation statements)

References 32 publications

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“…We decided to conduct a baseline study in the existing health system in Makueni County as an entry point for dialogue with the Government of Makueni County and the various stakeholders as a preliminary step towards the implementation of the mhGAP-IG. The process of implementing that program has been documented [24] and some of the outcomes have been published [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya

Mutiso

Musyimi

Gitonga

et al. 2020

BMC Health Serv Res

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Background: In order to develop a context appropriate in mental health system, there is a need to document relevant existing resources and practices with a view of identifying existing gaps, challenges and opportunities at baseline for purposes of future monitoring and evaluation of emerging systems. The World Health Organization Assessments Instrument for Mental Health Systems (WHO-AIMS) was developed as a suitable tool for this purpose. Our overall objective of this study, around which research questions and specific aims were formulated, was to establish a baseline on mental health system as at the time of the study, at Makueni County in Kenya, using the WHO-AIMS. Methods: To achieve our overall objective, answer our research questions and achieve specific aims, we conducted a mixed methods approach in which we did an audit of DHIS records and county official records, and conducted qualitative interviews with the various officers to establish the fidelity of the data according to their views. The records data was processed via the prescribed WHO-Aims 2.2 excel spreadsheet while the qualitative data was analyzed thematically. This was guided by the six domains stipulated in the WHO AIMS. Results: We found that at the time point of the study, there were no operational governance, policy or administrative structures specific to mental health, despite recognition by the County Government of the importance of mental health. The identified interviewees and policy makers were cooperative and participatory in identifying the gaps, barriers and potential solutions to those barriers. The main barriers and gaps were human and financial resources and low prioritization of mental health in comparison to physical conditions. The solutions lay in bridging of the gaps and addressing the barriers. Conclusion: There is a need to address the identified gaps and barriers and follow up on solutions suggested at the time of the study, if a functional mental health system is to be achieved at Makueni County.

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Section: Introductionmentioning

confidence: 99%

Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya

Mutiso

Musyimi

Gitonga

et al. 2020

BMC Health Serv Res

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“…These FGDs for different IHPs were conducted separately and independently so as not to allow any influence by the other group of their perceptions. We also conducted eight FGDs for service users [18]. We based our number of FGDs on recent evidence that showed that between three and six FGDs are adequate to identify the most prevalent themes within datasets [22].…”

Section: Methodsmentioning

confidence: 99%

“…The recruitment for the FGD participants was from the service users. These included patients with common mental disorders listed in the mhGAP-IG but confirmed for DSM-IV/ICD 10 diagnosis using the MINI-Plus [18]. These are the patients who had taken part in the quantitative phase of the study.…”

Section: Methodsmentioning

confidence: 99%

“…Using this multi-stakeholder approach which included policy makers, we demonstrated the feasibility of implementing the mhGAP-IG using existing and trained community human resources and also the feasibility to transit seamlessly from research to policy and practice uptake [17]. In a different publication, we reported that both nurses and clinical officers as well as CHWs, THs and FHs can be trained to successfully and accurately screen for mental health disorders using the mhGAP-IG symptoms and that they may play a key role in decreasing the mental health treatment gap [18]. There were high concordances in the accuracy of screening by all the service providers for both formal and informal [19].…”

Section: Introductionmentioning

confidence: 99%

“…We have also demonstrated significant increase in mental health related knowledge in people with mental illness using the mhGAP-IG [21]. More recently we demonstrated that a combination of psychoeducation of people with common mental disorders and of nurses and clinical officers who are trained on mhGAP-IG, supported and supervised can lead to improved outcomes in disabilities, quality of life and clinical outcomes in people with common mental disorders [18]. Overall, our above publications on the quantitative phase of TEAM have demonstrated significant and positive outcomes on the mhGAP-IG based interventions.…”

Section: Introductionmentioning

confidence: 99%

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Perceived impacts as narrated by service users and providers on practice, policy and mental health system following the implementation of the mhGAP-IG using the TEAM model in a rural setting in Makueni County, Kenya: a qualitative approach

Mutiso

Musyimi

Rebello

et al. 2019

Int J Ment Health Syst

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Background A team approach is key to reduction of the mental health treatment gap. It requires collaborative effort of all formal and informal community based service providers and the consumers of the services. Qualitative evaluations of such an approach add value to the quantitative evaluations. Methods A qualitative study was conducted among 205 participants. These were grouped into a total of 19 focus group discussions for community health workers (CHW), traditional healers (TH), faith healers (FH) and patients. For nurses and clinical officers we held 10 key informant interviews and three key informant discussions. We aimed to document personal perceptions as expressed in narratives on mental health following a community based application of the WHO mental health treatment Gap-intervention guideline (mhGAP-IG) using the TEAM model. We also aimed to document how the narratives corroborated key findings on the quantitative wing of the TEAM model. Results There were three categories of perceptions: (i) patient-related, (ii) health provider-related and, (iii) health system related. The patient related narratives were linked to improvement in their mental and physical health, increased mental health awareness, change in lifestyle and behavior, enhanced social functioning and an increase in family productivity. Health provider perceptions were related to job satisfaction, capacity building and increased interest in mental health training. Mental health system related narratives included effectiveness and efficiency in service delivery and increase in number of referrals at the primary health care facilities. Conclusion The TEAM is a feasible model for the implementation of the mhGAP-IG. It led to positive perceptions and narratives by service provides and service consumers. The qualitative findings corroborated the quantitative findings of TEAM.

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The international league against epilepsy primary healthcare educational curriculum: Assessment of educational needs

Singh,

Braga,

Carrizosa

et al. 2024

Epileptic Disorders

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ObjectiveTo assess the need for an epilepsy educational curriculum for primary healthcare providers formulated by the International League Against Epilepsy (ILAE) and the importance attributed to its competencies by epilepsy specialists and primary care providers and across country‐income settings.MethodsThe ILAE primary care epilepsy curriculum was translated to five languages. A structured questionnaire assessing the importance of its 26 curricular competencies was posted online and publicized widely to an international community. Respondents included epilepsy specialists, primary care providers, and others from three World Bank country‐income categories. Responses from different groups were compared with univariate and ordinal logistic regression analyses.ResultsOf 785 respondents, 60% noted that a primary care epilepsy curriculum did not exist or they were unaware of one in their country. Median ranks of importance for all competencies were high (very important to extremely important) in the entire sample and across different groups. Fewer primary care providers than specialists rated the following competencies as extremely important: definition of epilepsy (p = .03), recognition of seizure mimics (p = .02), interpretation of test results for epilepsy care (p = .001), identification of drug‐resistant epilepsy (0.005) and management of psychiatric comorbidities (0.05). Likewise, fewer respondents from LMICs in comparison to UMICs rated 15 competencies as extremely important.SignificanceThe survey underscores the unmet need for an epilepsy curriculum in primary care and the relevance of its competencies across different vocational and socioeconomic settings. Differences across vocational and country income groups indicate that educational packages should be developed and adapted to needs in different settings.

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Feasibility and effectiveness of nurses and clinical officers in implementing the WHO mhGAP intervention guide: Pilot study in Makueni County, Kenya

Cited by 26 publications

References 32 publications

Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya

Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya

Perceived impacts as narrated by service users and providers on practice, policy and mental health system following the implementation of the mhGAP-IG using the TEAM model in a rural setting in Makueni County, Kenya: a qualitative approach

The international league against epilepsy primary healthcare educational curriculum: Assessment of educational needs

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