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资源匮乏地区精神卫生保健服务提供中的伙伴关系:在尼泊尔农村建立一个创新网络。

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal.

作者信息

Acharya Bibhav, Maru Duncan, Schwarz Ryan, Citrin David, Tenpa Jasmine, Hirachan Soniya, Basnet Madhur, Thapa Poshan, Swar Sikhar, Halliday Scott, Kohrt Brandon, Luitel Nagendra P, Hung Erick, Gauchan Bikash, Pokharel Rajeev, Ekstrand Maria

机构信息

Bayalpata Hospital, Possible, Sanfebagar-10, Achham, Nepal.

Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Langley Porter, San Francisco, CA, 94143, USA.

出版信息

Global Health. 2017 Jan 13;13(1):2. doi: 10.1186/s12992-016-0226-0.

Abstract

BACKGROUND

Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation.

PARTNERSHIPS NETWORK

We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community.

CONCLUSIONS

We propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal.

摘要

背景

精神疾病是全球非传染性疾病负担的最大成因。然而,获得高质量、具有文化敏感性且符合实际情况的精神卫生保健服务的机会极其有限。尽管存在已证实能改善患者预后的干预措施,但这种情况依然存在。成功的项目调整和实施需要一个伙伴关系网络。

伙伴关系网络

我们将我们的伙伴关系网络作为一个案例进行描述,该案例应对了提供精神卫生保健方面的挑战,并可作为类似环境的典范。我们的观点来自于在尼泊尔一家农村公立医院整合精神卫生保健服务的过程。我们的方法包括由异地的精神科医生对通科卫生工作者进行培训和监督。这通过互补各相关群体的优势和劣势得以实现:公共部门、一个提供一般医疗服务的非营利组织和一个专门从事精神卫生的组织、一个社区咨询委员会、高收入和低收入国家的学术中心,以及来自侨民社区的双文化专业人员。

结论

我们提出一种伙伴关系模式,以协助实施有前景的项目,从而在资源匮乏地区扩大精神卫生保健的可及性。我们描述了我们目前在尼泊尔农村精神卫生项目中的合作伙伴的成功之处和局限性。

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