Tekola B, Baheretibeb Y, Roth I, Tilahun D, Fekadu A, Hanlon C, Hoekstra R A
Department of Life, Health and Chemical Sciences, The Open University, UK.
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia.
Glob Ment Health (Camb). 2016 Jul 1;3:e21. doi: 10.1017/gmh.2016.17. eCollection 2016.
Little has been reported about service provision for children with autism in low-income countries. This study explored the current service provision for children with autism and their families in Ethiopia, the existing challenges and urgent needs, and stakeholders' views on the best approaches to further develop services.
A situational analysis was conducted based on (i) qualitative interviews with existing service providers; (ii) consultation with a wider group of stakeholders through two stakeholder workshops; and (iii) information available in the public domain. Findings were triangulated where possible.
Existing diagnostic and educational services for children with autism are scarce and largely confined to Ethiopia's capital city, with little provision in rural areas. Families of children with autism experience practical and psychosocial challenges, including severe stigma. Informants further raised the lack of culturally and contextually appropriate autism instruments as an important problem to be addressed. The study informants and local stakeholders provided several approaches for future service provision expansion, including service decentralisation, mental health training and awareness raising initiatives.
Services for children with autism in Ethiopia are extremely limited; appropriate care for these children is further impeded by stigma and lack of awareness. Ethiopia's plans to scale up mental healthcare integrated into primary care provide an opportunity to expand services for children with autism and other developmental disorders. These plans, together with the additional strategies outlined in this paper can help to address the current service provision gaps and may also inform service enhancement approaches in other low-income countries.
关于低收入国家为自闭症儿童提供服务的报道很少。本研究探讨了埃塞俄比亚目前为自闭症儿童及其家庭提供的服务、现有的挑战和迫切需求，以及利益相关者对进一步发展服务的最佳方法的看法。
基于以下方面进行了情境分析：（i）对现有服务提供者进行定性访谈；（ii）通过两次利益相关者研讨会与更广泛的利益相关者群体进行协商；（iii）公开领域的可用信息。在可能的情况下对研究结果进行了三角验证。
埃塞俄比亚现有的自闭症儿童诊断和教育服务稀缺，且主要局限于首都，农村地区几乎没有此类服务。自闭症儿童的家庭面临实际和心理社会方面的挑战，包括严重的污名化。受访者还提出，缺乏适合文化和背景的自闭症评估工具是一个需要解决的重要问题。研究受访者和当地利益相关者提出了几种未来扩大服务提供的方法，包括服务下放、心理健康培训和提高认识倡议。
埃塞俄比亚为自闭症儿童提供的服务极其有限；对这些儿童的适当护理因污名化和缺乏认识而进一步受阻。埃塞俄比亚扩大纳入初级保健的精神卫生保健计划为扩大自闭症儿童和其他发育障碍儿童的服务提供了机会。这些计划以及本文概述的其他策略有助于解决当前的服务提供差距，也可能为其他低收入国家的服务改进方法提供参考。
