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Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme

  • Maya Semrau (a1), Atalay Alem (a2), Jose L. Ayuso-Mateos (a3), Dan Chisholm (a4), Oye Gureje (a5), Charlotte Hanlon (a6), Mark Jordans (a7), Fred Kigozi (a8), Crick Lund (a9), Inge Petersen (a10), Rahul Shidhaye (a11) and Graham Thornicroft (a12)...

Abstract

Background

There is a large treatment gap for mental, neurological or substance use (MNS) disorders. The ‘Emerging mental health systems in low- and middle-income countries (LMICs)’ (Emerald) research programme attempted to identify strategies to work towards reducing this gap through the strengthening of mental health systems.

Aims

To provide a set of proposed recommendations for mental health system strengthening in LMICs.

Method

The Emerald programme was implemented in six LMICs in Africa and Asia (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda) over a 5-year period (2012–2017), and aimed to improve mental health outcomes in the six countries by building capacity and generating evidence to enhance health system strengthening.

Results

The proposed recommendations align closely with the World Health Organization's key health system strengthening ‘building blocks’ of governance, financing, human resource development, service provision and information systems; knowledge transfer is included as an additional cross-cutting component. Specific recommendations are made in the paper for each of these building blocks based on the body of data that were collected and analysed during Emerald.

Conclusions

These recommendations are relevant not only to the six countries in which their evidential basis was generated, but to other LMICs as well; they may also be generalisable to other non-communicable diseases beyond MNS disorders.

Declaration of interest

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Maya Semrau, Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PS, UK. Email: M.Semrau@bsms.ac.uk

References

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Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme

  • Maya Semrau (a1), Atalay Alem (a2), Jose L. Ayuso-Mateos (a3), Dan Chisholm (a4), Oye Gureje (a5), Charlotte Hanlon (a6), Mark Jordans (a7), Fred Kigozi (a8), Crick Lund (a9), Inge Petersen (a10), Rahul Shidhaye (a11) and Graham Thornicroft (a12)...
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