Mental health in Mozambique; a systematic review

Abstract

Context: Neuro-psychiatric disorders are the world's highest cause of incapacity. Mental disease in Africa is taboo and stigmatized, making it a challenge of a silent even hidden epidemy. In Sub-Saharan Africa it is estimated that 20% of patients with mental disorders are treated in primary health care centres and 50-75% are not detected in health facilities. In Mozambique, the prevalence of mental disorders and the frequency with which mental patients are treated at health facilities are not known. Objective: To estimate mental and neurologic disorders burden in Mozambique and evaluate access to mental health care services. Methods: A systematic review of research published in Portuguese, English, French and Spanish during 2017 and 2018 was carried out. We also consulted hospital and outpatient clinical files and yearly reports in the health units of national health system. Quantitative and mixed methods articles were subjected to quantitative meta-analysis and the qualitative and mixed methods articles were submitted to thematic and ethnographic analysis for qualitative meta-synthesis. Results: After selecting 130 articles meeting the search criteria we applied eligibility conditions and reviewed 17 quantitative, 6 mixed-methods and 7 qualitative articles. Population perception about mental illness shows that it is considered a consequence of spiritual problems and patients mainly seek out traditional health practitioners. Epilepsy, a neurologic disorder, is referred in Mozambique as the most prevalent mental disorder. The provision of care for the mentally ill by the national health service is far below the needs. The Mozambican Ministry of Health has a good development program for future mental health services. Discussion: We find scarcity of research in the area of mental health, but progress over time. Studies, though mostly of low quality, show a high burden of mental illness in the Mozambican population, which uses traditional medicine due to lack of conventional health services and cultural adaptation of therapeutic procedures. Conclusion: This study contributes to reveal the beliefs and main mental health problems in the Mozambican population and health system. We propose recommendations for preventive activities and the development of mental health services. This review was registered at www.crd.york.ac.uk/prospero (CRD42018103923).

Psychosocial distress among in-school adolescents in Mozambique: a cross-sectional study using the Global School-Based Health Survey data

“…Currently, there is a paucity of empirical literature on psychosocial distress among in-school adolescents in Mozambique. This is essential because a study has identified children and adolescents in Mozambique as the cohort with high odds of mental disorders, including psychosocial distress [20]. Due to this, the present study examined the prevalence and correlates of psychosocial distress among adolescents in Mozambique.…”

Prevalence and associated factors of common mental disorders in primary care settings in Sofala Province, Mozambique

“…We found that men had a more than six-fold increased odds of substance use and dependence compared with women (aOR = 0.16), which is corroborated by previous research that found that men present a burden of disorders related to the consumption of alcohol and drugs almost six times greater than women. [32][33][34] We also found that HIV-positive serostatus was associated with an almost six-fold increased odds of substance misuse and dependence compared with those who reported being HIV negative (aOR = 0.17). HIV-positive status has a well-established association with substance use and dependence, both inside 35 and outside 36 of primary care settings, and integrated primary care models have sought to address this frequent co-occurrence.…”

The Importance of Positive Factors in Protecting Adverse Mental Health Outcomes and Suicidal Behavior among Citizens of the Community of Portuguese Language Countries

“…As for African Countries with Portuguese as an Official Language (PALOP), there is a scarcity of studies on the influence of these positive factors on mental health and suicidal behavior. Among existing literature, a review from Pires et al (2019) concluded that the Mozambiquan population shows a high burden of mental illness due to the lack of conventional health services and cultural adaptation of therapies.…”