Zambia Forum for Health Research (ZAMFORH).
Int J Technol Assess Health Care. 2012 Jul;28(3):294-300. doi: 10.1017/S0266462312000347.
Mental illness constitutes a large proportion of the burden of disease in Zambia. Yet mental health services at the primary care level are either provided in a fragmented manner or are lacking altogether.
A literature review focused on terms including mental health and primary care and strategic options were analyzed.
From the analysis, two options were considered for integrating mental health into primary health care. An incremental option would start with a pilot project introducing mental health services into primary care with a well-designed evaluation before scaling up. One key advantage of this option is that it is possible to make improvements in the plan, if needed, before scaling up. A comprehensive option would entail introducing mental health services into primary care in all nine provinces of Zambia. In this option, scaling up could occur more rapidly than an incremental approach.
Strategies to implement either option must address several barriers, including insufficient funding for mental health services, inadequate mental health indicators, lack of general public awareness of and social stigma attached to mental illnesses and mental health care not being perceived as cost-effective or affordable.
精神疾病在赞比亚的疾病负担中占很大比例。然而，初级保健层面的精神卫生服务要么提供得支离破碎，要么完全缺乏。
文献综述侧重于包括精神卫生和初级保健在内的术语，并对战略选择进行了分析。
从分析中，考虑了将精神卫生纳入初级卫生保健的两种选择。渐进式选择将从一个试点项目开始，在扩大规模之前，对初级保健中引入精神卫生服务进行精心设计的评估。该选项的一个主要优势是，如果需要，在扩大规模之前可以对计划进行改进。全面的选择将需要在赞比亚的九个省都引入精神卫生服务到初级保健中。在这种选择中，扩大规模的速度可能比渐进式方法更快。
实施任何一种选择的策略都必须解决几个障碍，包括精神卫生服务资金不足、精神卫生指标不足、公众对精神疾病的认识不足和社会污名化、精神卫生保健被认为不具有成本效益或负担得起。
