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Integration of mental health in PHC in Uganda: Opportunities, challenges and collaboration <br />A <br />Presentation by<b...
Introduction<br />1935- 1954 – Mental Health services started with Asylum care in Hoima<br />1954 – Services introduced at...
Methodology<br />2001- 2005 & 2008 conducted Country Profile of MH services in partnership with WHO collaborating centre a...
Strengthens and opportunities for integration of mental health<br />Global support – World Report 2001<br />Favorable Nati...
Opportunities <br />Integrated guidelines i.e. <br />              Planning<br />              Clinical Management guideli...
opportunities cntd<br />Family members and relatives provide people with mental illness with food, clothing, bed side care...
Findings ctd<br />Strong political will, translated in acquiring loan and grant from ADB for MH totaling USD 25million ove...
Weaknesses and challenges<br />Big population of vulnerable population including refugees, former IDPs, orphans due to HIV...
Weakness ctd<br />Some communities still have high levels of discrimination and stigma<br />Minimal programmes for suicide...
Weaknesses <br />The current staffing structure does not provide adequate staffing numbers and multidisciplinary teams<br ...
Collaboration <br />Collaboration is a major principle of MH Policy. Examples of collaboration in Uganda:<br />Interasecto...
Collaboration ctd<br />International collaboration and National partners including WHO, UNODC, Basic Needs, Transcultural ...
Priorities for strengthening integration of MH<br />Strategic plan to identify activities to reach vulnerable populations<...
Priorities ctd<br />Develop a strategy for streamlining the role of traditional healers in MH<br />Advocate for quick enac...
Priorities ctd<br />Strengthen intrasectoral and intersectoral collaboration<br />Strengthening existing partnerships and ...
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Ndyanabangi integrating mental health in primary care

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Ndyanabangi integrating mental health in primary care

  1. 1. Integration of mental health in PHC in Uganda: Opportunities, challenges and collaboration <br />A <br />Presentation by<br />Dr. Sheila Ndyanabangi<br />Principal Medical Officer, Mental Health <br />
  2. 2. Introduction<br />1935- 1954 – Mental Health services started with Asylum care in Hoima<br />1954 – Services introduced at Mulago National Referral Hospital with four 4 bed Regional Units<br />1965- Butabika National Mental Referral Hospital (1000 beds)<br />1995 – MH Programme at MoH<br />1999/200- National Health Policy and HSSP I MH part of minimum package<br /> Mandate integration of MH at all levels of care<br />
  3. 3. Methodology<br />2001- 2005 & 2008 conducted Country Profile of MH services in partnership with WHO collaborating centre at King’s College London<br />2008 – Conducted a situation analysis during MHAPP Research Project in partnership with DFID funded consortium<br /> Evaluation of Mental Health Policy, Plan and Legislation using WHO checklists <br />
  4. 4. Strengthens and opportunities for integration of mental health<br />Global support – World Report 2001<br />Favorable National Policy that prioritized integration of MH <br />Inclusion of MH in HSSP I<br />Decentralized system of government <br />
  5. 5. Opportunities <br />Integrated guidelines i.e. <br /> Planning<br /> Clinical Management guidelines<br /> Essential drug list<br /> Integrated planning and support supervision guidelines<br /> Annual performance reports<br /> Annual work plan<br />Review of other general policies and laws<br />Training institutions for psychiatric Nurses and PCos <br />
  6. 6. opportunities cntd<br />Family members and relatives provide people with mental illness with food, clothing, bed side care and financial support<br />All regions attach value to positive mental well being and many people seek care for MH problems<br />Mental health care being free at public health facilities and subsidized at most NGO Hospitals<br />An In- Service training programme to build capacity of general health workers exists<br />
  7. 7. Findings ctd<br />Strong political will, translated in acquiring loan and grant from ADB for MH totaling USD 25million over 10years<br />Mental health conditions included in HMIS. Provides opportunity to collect countrywide data<br />
  8. 8. Weaknesses and challenges<br />Big population of vulnerable population including refugees, former IDPs, orphans due to HIV/AIDS, the poor who need special attention<br />Recurrent political turmoil, natural disasters and endemic diseases such as malaria and parasitic diseases<br />Lack of understanding of the concepts of mental health, causes and nature of mental illness<br />
  9. 9. Weakness ctd<br />Some communities still have high levels of discrimination and stigma<br />Minimal programmes for suicide and homicide reduction<br />In spite of increased availability of MH services people still go to traditional and religious healers because of false beliefs<br />The current legislation for MH is outdated and inadequate and formulating the new law is bureaucratic<br />
  10. 10. Weaknesses <br />The current staffing structure does not provide adequate staffing numbers and multidisciplinary teams<br />Low budget for MH services with concetration on curative services and limited efforts on health promotion and disease prevention<br />Poor facilitation of health facilities for activities such as supervision and outreach<br />Low health worker wages de-motivating<br />No formal mechanism for intersectoral collaboration with inadequate participation in care by other relevant sectors such as police, social welfare, education etc.<br />
  11. 11. Collaboration <br />Collaboration is a major principle of MH Policy. Examples of collaboration in Uganda:<br />Interasectoral collaboration with Planning, Human Resource, HP&E, Quality Assurance and the Resource Centre<br />MoH holds a stakeholders’ forum annually which includes other relevant Government sectors, NGOs, User support groups, Training Institutions, National Referral Hospitals, Prisons and Armed Forces MH staff.<br />
  12. 12. Collaboration ctd<br />International collaboration and National partners including WHO, UNODC, Basic Needs, Transcultural Psychosocial Organization, Peter C. Alderman Foundation<br />Partner in resource mobilization, policy development and service delivery especially psychosocial services<br />Collaboration in research includes WHO collaborating centre at King’s College London, DFID funded research projects e.g. MHAPP and PRIME evaluation of models for integration of MH<br />
  13. 13. Priorities for strengthening integration of MH<br />Strategic plan to identify activities to reach vulnerable populations<br />Build capacity of MH services to respond to emergencies and conflict situations<br />Scale up public education for understanding concepts of MH and mental illness<br />Set up programmes for suicide and homicide prevention<br />
  14. 14. Priorities ctd<br />Develop a strategy for streamlining the role of traditional healers in MH<br />Advocate for quick enactment of the Mental Health Act<br />Lobby for hastening of restructuring exercise to increase number of staff and multidisciplinary team<br />Develop mechanisms for increasing funding to MH by government and other partners<br />
  15. 15. Priorities ctd<br />Strengthen intrasectoral and intersectoral collaboration<br />Strengthening existing partnerships and establishing more international partnerships and collaboration<br />

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