Maling mental health in resource limited settings

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  • More than 85% of the worlds population lives in the 153 countries classified as low-income and Middle income countries.
  • Territory size shows the proportion of all nurses that work in that territoryTerritory size shows the proportion of all physicians (doctors) that work in that territory
  • The human poverty index uses indicators that capture non-financial elements of poverty, such as life expectancy, adult literacy, water quality, and children that are underweight.The highest human poverty index scores are in Central Africa, the lowest are in Japan
  • Low-income countries have a median of 0·05 psychiatrists and 0·16 psychiatric nurses per 100 000 population. High-income countries have a ratio of psychiatric health-workers to population that is about 200 times higher. These figures show the huge inequities in the distribution of skilled human resources for mental health across the world.
  • The distribution of human resources between the urban and rural areas was disproportionate. Thedensity of psychiatrists in or around the largest city was 11 times greater than the density ofpsychiatrists in the entire country. The density of nurses was 13.4 times greater in the largest citythan the entire country.
  • We propose that the five core indicators be used to assess how well national mental health systems provide services to people with mental disorders,
  • The six secondary indicators be used to assess health systems that have attained expected targets for some or all of the core indicators. Taken together, these 11 indicators address the four most important overarching goals: (1) sufficient planning and investment for mental health care; (2) a sufficient workforce to provide mental health services; (3) consistency of mental health care inputs and processes with best practice and human-rights protection; and (4) improved outcomes for people with mental disorders.
  • Maling mental health in resource limited settings

    1. 1. Global Mental Health: Implications for resource limited settings<br />Samuel Maling<br />Department of Psychiatry<br />Mbarara University<br />
    2. 2. Introduction<br />
    3. 3. World Map: Land Area<br />World Map: population<br />
    4. 4. Nurses <br />Working<br />Physicians <br />working<br />
    5. 5. Poverty <br />
    6. 6. About 14% of the Global burden of disease has been attributed to neuropsychiatric disorders<br />Developing countries tend to place much emphasis on communicable diseases<br />Mental illness are the most neglected of the neglected diseases<br />
    7. 7. “Global health is “an area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide.”<br />Global mental health is the application of these principles to the domain of mental ill health.<br />
    8. 8. Global inequity<br /> Low- and middle-income countries are home to more than 80% of the global population but command less than 20% of the share of the mental health resources. <br />
    9. 9. Resource Limited settings<br />Where materials, personnel, facilities, funds, and anything else that can be used for providing mental health care and services is scarce or not available<br />Policy<br />Infrastructure within countries<br />Mental health services<br />Community resources <br />Human resources <br />
    10. 10. Inequity within a limited resource setting<br />Health expenditure towards mental health <br />Mental health expenditure towards mental hospital<br />
    11. 11. Human resources for mental health in each income group of countries per 100 000 population<br />
    12. 12. Human resources for mental health in Uganda (Per 100,000 population)<br />
    13. 13.
    14. 14.
    15. 15.
    16. 16.
    17. 17.
    18. 18. Global evidence for clinical treatments<br />Less than 1% of Clinical trials are from low-income countries and 10% of trials are from low-income and middle-income countries. <br />
    19. 19. MDGs or ‘GMHDGs’? <br />
    20. 20. Core indicators<br />
    21. 21. Secondary indicators<br />
    22. 22. 1970’s<br />Mental health units in large Regional Referral Hospitals (out-patient and in-patient services offered)<br />

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