Upadhaya Nawaraj, Jordans Mark J D, Abdulmalik Jibril, Ahuja Shalini, Alem Atalay, Hanlon Charlotte, Kigozi Fred, Kizza Dorothy, Lund Crick, Semrau Maya, Shidhaye Rahul, Thornicroft Graham, Komproe Ivan H, Gureje Oye
Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal.
Department of Research and Development, HealthNet TPO, Amsterdam, The Netherlands.
Int J Ment Health Syst. 2016 Sep 26;10:60. doi: 10.1186/s13033-016-0094-2. eCollection 2016.
Research on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided.
With the aim of informing the development and implementation of a mental health information sub-system that includes reliable and measurable indicators on mental health within the Health Management Information Systems (HMIS), a cross-country situation analysis of HMIS was conducted in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda), participating in the 'Emerging mental health systems in low and middle income countries' (Emerald) research programme. A situation analysis tool was developed to obtain and chart information from documents in the public domain. In circumstances when information was inadequate, key government officials were contacted to verify the data collected. In this paper we compare the baseline policy context, human resources situation as well as the processes and mechanisms of collecting, verifying, reporting and disseminating mental health related HMIS data.
The findings suggest that countries face substantial policy, human resource and health governance challenges for mental health HMIS, many of which are common across sites. In particular, the specific policies and plans for the governance and implementation of mental health data collection, reporting and dissemination are absent. Across sites there is inadequate infrastructure, few HMIS experts, and inadequate technical support and supervision to junior staff, particularly in the area of mental health. Nonetheless there are also strengths in existing HMIS where a few mental health morbidity, mortality, and system level indicators are collected and reported.
Our study indicates the need for greater technical and resources input to strengthen routine HMIS and develop standardized HMIS indicators for mental health, focusing in particular on indicators of coverage and quality to facilitate the implementation of the WHO mental health action plan 2013-2020.
低收入和中等收入国家（LMICs）心理健康信息系统的研究稀缺。因此，缺乏关于心理健康服务需求、治疗覆盖率及所提供服务质量的可靠信息。
为了为心理健康信息子系统的开发与实施提供信息，该子系统包括健康管理信息系统（HMIS）内关于心理健康的可靠且可衡量的指标，在六个低收入和中等收入国家（埃塞俄比亚、印度、尼泊尔、尼日利亚、南非和乌干达）开展了一项HMIS的跨国情况分析，这些国家参与了“低收入和中等收入国家新兴心理健康系统”（Emerald）研究项目。开发了一种情况分析工具，以从公共领域的文件中获取并梳理信息。在信息不足的情况下，联系关键政府官员核实所收集的数据。在本文中，我们比较了基线政策背景、人力资源状况以及收集、核实、报告和传播与心理健康相关的HMIS数据的流程和机制。
研究结果表明，各国在心理健康HMIS方面面临重大的政策、人力资源和卫生治理挑战，其中许多挑战在各地点都很常见。特别是，缺乏心理健康数据收集、报告和传播的治理与实施的具体政策和计划。各地点基础设施不足，HMIS专家很少，对初级工作人员的技术支持和监督不足，特别是在心理健康领域。尽管如此，现有HMIS也有优势，收集并报告了一些心理健康发病率、死亡率和系统层面的指标。
我们的研究表明，需要更多的技术和资源投入，以加强常规HMIS并制定心理健康的标准化HMIS指标，尤其关注覆盖率和质量指标，以促进《2013 - 2020年世界卫生组织心理健康行动计划》的实施。
