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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Addis Abeba Universty


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. 2 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.



Status of adoption