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Evaluation of district mental healthcare plans: The PRIME consortium methodology

  • Mary J. De Silva (a1), Sujit D. Rathod (a1), Charlotte Hanlon (a2), Erica Breuer (a3), Dan Chisholm (a4), Abebaw Fekadu (a5), Mark Jordans (a6), Fred Kigozi (a7), Inge Petersen (a8), Rahul Shidhaye (a9), Girmay Medhin (a10), Joshua Ssebunnya (a11), Martin Prince (a12), Graham Thornicroft (a13), Mark Tomlinson (a14), Crick Lund (a15) and Vikram Patel (a16)...
Abstract
Background

Few studies have evaluated the implementation and impact of real-world mental health programmes delivered at scale in low-resource settings.

Aims

To describe the cross-country research methods used to evaluate district-level mental healthcare plans (MHCPs) in Ethiopia, India, Nepal, South Africa and Uganda.

Method

Multidisciplinary methods conducted at community, health facility and district levels, embedded within a theory of change.

Results

The following designs are employed to evaluate the MHCPs: (a) repeat community-based cross-sectional surveys to measure change in population-level contact coverage; (b) repeat facility-based surveys to assess change in detection of disorders; (c) disorder-specific cohorts to assess the effect on patient outcomes; and (d) multilevel case studies to evaluate the process of implementation.

Conclusions

To evaluate whether and how a health-system-level intervention is effective, multidisciplinary research methods are required at different population levels. Although challenging, such methods may be replicated across diverse settings.

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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
Mary De Silva, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: mary.desilva@lshtm.ac.uk
Footnotes
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This paper was produced as part of the PRogramme for Improving Mental health carE (PRIME) funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies. The RISE trial of community-based rehabilitation in Ethiopia is supported by the Wellcome Trust (grant number 100142/Z/12/Z). M.J.D.S. is supported by a Wellcome Trust/London School of Hygiene and Tropical Medicine career fellowship. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Declaration of interest

None.

Footnotes
References
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Evaluation of district mental healthcare plans: The PRIME consortium methodology

  • Mary J. De Silva (a1), Sujit D. Rathod (a1), Charlotte Hanlon (a2), Erica Breuer (a3), Dan Chisholm (a4), Abebaw Fekadu (a5), Mark Jordans (a6), Fred Kigozi (a7), Inge Petersen (a8), Rahul Shidhaye (a9), Girmay Medhin (a10), Joshua Ssebunnya (a11), Martin Prince (a12), Graham Thornicroft (a13), Mark Tomlinson (a14), Crick Lund (a15) and Vikram Patel (a16)...
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