Status of adoption and Implementation Level of Integrated Mental Health Service at Primary Health Care Units in Addis Ababa, Ethiopia,2017
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Date
2017-06
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Addis Abeba Universty
Abstract
Background: -In middle and low income countries it is believed that three in four persons with
mental disorder do not receive appropriate treatment. To address this extensive unmet mental
health need in low-income countries. World Health Organization (WHO) recommends
integration of mental health service into primary health care level that is providing mental health
services which involve diagnosing and treating people with common mental disorders within the
general framework of available health services. Ethiopia implemented this program based on
World Health Organization (WHO) scale up program called mental health gap action program
(MH-GAP).
Objective: - The objective of this study was to assess integrated mental health service adoption
status and extent of implementation in primary health care units in Addis Ababa, Ethiopia in
2017.
Methods:-Facility based cross-sectional study was conducted and subjects were selected
randomly using proportional size allocation among health care workers in selected health centers
in 2017. The total sample size for the study was estimated by single proportion population
formula and total sample size was estimated to be 422.Data was collected from selected
participants using self-administered questionnaires. Epi data 3.1 was used to enter and clean the
data. Stata 14.1 was employed for data analysis. Descriptive analysis percentage and summary
measures were conducted for adoption status and implementation level of integrated mental
health service. Bivariate and multivariate logistic regression was calculated to examine
association between general characteristics of respondents, health care provider’s factors and
adoption status of primary health care providers.
Result:-More than half of respondents (61.69%) 238 of health care providers were found to be
under mean score or having poor status of adoption. Majority of respondents 236 (58, 7%) had
stated that there were poor implementation level of mental health integration in their facility.
Work experience more than 11 years [AOR: 12.34.95% CI :( 3.76- 40.56)], pre -service
training[AOR: 2.1.95%CI: (1.249 -3.533)], Presence of discussion with colleagues or higher
supervisor [AOR: 1.82. 95%CI :( 1.066- 3.068)], having role or responsibility to diagnosis and
assessment of mental disorder cases. [AOR: 1.93.95%CI :( 1.021 -3.683)]have found to be
influencing factor for adoption status of integrated mental health service.
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Conclusion and Recommendation: -Status of adoption towards mental health integration
among majority of primary health care providers is poor. The influencing factors for adoption
status of integrated mental health service in primary health care units are work experience, preservice
training, having a role or responsibility to diagnosis and assessment of mental illness,
presence of discussion with colleagues and supervisors in the facility. Majority of primary health
care providers are indicated that there is poor level of implementation in the primary health care
units.
Ministry of health and health science colleges should consider pre-service training to several
field of study. Mental health global action implementers should facilitate consistent support and
supervision after in-service training. In addition several interferences should be used to change
awareness and attitude of health workers towards mental health service integration.
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Keywords
Status of adoption