Skip to main content
×
×
Home

Development of a district mental healthcare plan in Uganda

  • Fred N. Kigozi (a1), Dorothy Kizza (a1), Juliet Nakku (a1), Joshua Ssebunnya (a1), Sheila Ndyanabangi (a2), Blandina Nakiganda (a3), Crick Lund (a4) and Vikram Patel (a5)...
Abstract
Background

Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda.

Aims

To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care.

Method

Mixed methods using a situational analysis, qualitative studies, theory of change workshops and partial piloting of the plan at two levels informed the MHCP.

Results

A MHCP was developed with packages of care to facilitate integration at the organisational, facility and community levels of the district health system, including a specified human resource mix. The partial embedding period supports its practical application. Key barriers to scaling up the plan were identified.

Conclusions

A real-world plan for the district was developed with involvement of stakeholders. Pilot testing demonstrated its feasibility and implications for future scaling up.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Development of a district mental healthcare plan in Uganda
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Development of a district mental healthcare plan in Uganda
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Development of a district mental healthcare plan in Uganda
      Available formats
      ×
Copyright
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Corresponding author
Fred Kigozi, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda. Email: fredkigozi@yahoo.com
Footnotes
Hide All

This article is an output from a project funded by the UK Department for International Development (DFID) for the benefit of low- and middle-income countries.

Declaration of interest

None.

Footnotes
References
Hide All
1 Prince, M, Patel, V, Saxena, S, Maj, M, Masselko, J, Phillips, MR, et al. No health without mental health. Lancet 2007; 370: 859–77.
2 McBain, R, Norton, DJ, Morris, J, Yasamy, MT, Betancourt, TS. The role of health systems factors in facilitating access to psychotropic medicines: a cross-sectional analysis of the WHO-AIMS in 63 low- and middle-income countries. PLoS Med 2012; 9: e1001166.
3 Roberts, B, Ocaka, KF, Browne, J, Oyok, T, Sondorp, E. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in Northern Uganda. BMC Psychiatry 2008; 8: 38.
4 Ministry of Health, Uganda. Health Sector Strategic and Investment Plan II (2005/6 – 2009/10). Government of Uganda, 2005.
5 Ministry of Health, Uganda. Health Sector Strategic and Investment Plan III (2010/11 – 2014/15). Government of Uganda, 2010.
6 Ssebunnya, J, Kigozi, F, Ndyanabangi, S, Cooper, S. Stakeholders' perceptions of the main challenges facing Uganda's mental health care system: a qualitative analysis. Int J Culture Ment Health 2011; 4: 5467.
7 Lund, C, Tomlinson, M, De Silva, M, Fekadu, A, Shidhaye, R, Jordans, M, et al. PRIME: a programme to reduce the treatment gap for mental disorders in five low and middle-income countries. PLoS Med 2012; 9: e1001359.
8 Uganda Bureau of Statistics. Uganda Demographic and Health Survey. Uganda Bureau of Statistics, 2011.
9 Kamuli District Planning Unit. District Development Plan for 2010/11–2014/15. Kamuli District Planning Unit, 2011.
10 Uganda Bureau of Statistics. Uganda Demographic and Health Survey 2011. Uganda Bureau of Statistics, 2012.
11 The Population Secretariat, Ministry of Finance, Planning and Economic Development. The State of Uganda Population Report 2014. Government of Uganda, 2014.
12 Hanlon, C, Luitel, NP, Kathree, T, Murhar, V, Shrivasta, S, Medhin, G, et al. Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries. PLoS One 2014; 9: e88437.
13 Lacey, A, Luff, D. Trent Focus for Research and Development in Primary Health Care: An Introduction to Qualitative Analysis. Trent Focus, 2001.
14 International Network on Strategic Philanthropy. Theory of Change Tool Manual. International Network on Strategic Philanthropy, 2005. (http://www.dochas.ie/Shared/Files/4/Theory_of_Change_Tool_Manual.pdf).
15 Anderson, AA. A Community Builders Approach to Theory of Change: A Practical Guide to Theory Development. The Aspen Institute, 2006.
16 Breuer, E, De Silva, MJ, Shidaye, R, Petersen, I, Nakku, J, Jordans, MJD, et al. Planning and evaluating mental health services in low- and middle-income countries using theory of change. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153841).
17 Breuer, E, De Silva, MJ, Fekadu, A, Luitel, NP, Murhar, V, Nakku, J, et al. Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). Int J Ment Health Syst 2014; 8: 15.
18 World Health Organization. mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialised Health Settings. WHO, 2010.
19 Chisholm, D, Burman-Roy, S, Fekadu, A, Kathree, T, Kizza, D, Luitel, NP, et al. Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: the PRIME study. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153866).
20 World Health Organization. Mental Health Gap Action Programme. Scaling Up Care for Mental, Neurological and Substance Use Disorders. WHO, 2008.
21 Saxena, S, Thornicroft, G, Knapp, M, Whiteford, H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet 2007; 370: 878–89.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
PDF
Supplementary materials

Kigozi et al. supplementary material
Supplementary Figure S1

 PDF (40 KB)
40 KB

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Development of a district mental healthcare plan in Uganda

  • Fred N. Kigozi (a1), Dorothy Kizza (a1), Juliet Nakku (a1), Joshua Ssebunnya (a1), Sheila Ndyanabangi (a2), Blandina Nakiganda (a3), Crick Lund (a4) and Vikram Patel (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *