Yitbarek Kiddus, Birhanu Zewdie, Tucho Gudina Terefe, Anand Susan, Agenagnew Liyew, Ahmed Gutema, Getnet Masrie, Tesfaye Yonas
Departemnt of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
Department of Health Behaviors and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
Risk Manag Healthc Policy. 2021 Mar 19;14:1199-1210. doi: 10.2147/RMHP.S298190. eCollection 2021.
The Ethiopian Ministry of Health has integrated mental health services into the community health service, but it has not yet been implemented. Therefore, this study aimed to explore the barriers and facilitators of mental health service implementation in the Ethiopian community health program.
A qualitative case study was conducted in the Ethiopian primary health care system in 2019. We have conducted about eight key informant interviews with policymakers, service managers, and service providers. The interviews were tape-recorded, transcribed, translated, and analyzed manually using the World Health Organization building blocks framework.
The Health Ministry of Ethiopia has recently included mental health services into the health extension package but not yet implemented as part of integrated services. The identified barriers were low political commitment, shortage of resources, non-functional referral system, lack of interest from private health service organizations, attitudinal problems from both the society and service providers, and lack of consistent reporting system of the mental health problems. However, the well-designed primary health care system, trained health extension workers, changing political commitment and attitude of the community could facilitate the mental health service implementation.
A series of activities are expected, especially from the healthcare system managers to implement, follow, and evaluate mental health services implementation at the health extension programs.
埃塞俄比亚卫生部已将精神卫生服务纳入社区卫生服务，但尚未实施。因此，本研究旨在探讨埃塞俄比亚社区卫生项目中精神卫生服务实施的障碍和促进因素。
2019年在埃塞俄比亚初级卫生保健系统中进行了一项定性案例研究。我们对政策制定者、服务管理者和服务提供者进行了约八次关键 informant 访谈。访谈进行了录音、转录、翻译，并使用世界卫生组织构建模块框架进行人工分析。
埃塞俄比亚卫生部最近已将精神卫生服务纳入卫生推广包，但尚未作为综合服务的一部分实施。确定的障碍包括政治承诺低、资源短缺、转诊系统失灵、私营卫生服务组织缺乏兴趣、社会和服务提供者的态度问题以及精神卫生问题报告系统不一致。然而，精心设计的初级卫生保健系统、训练有素的卫生推广工作者、不断变化的政治承诺和社区态度可以促进精神卫生服务的实施。
预计将开展一系列活动，特别是医疗系统管理者要在卫生推广项目中实施、跟踪和评估精神卫生服务的实施情况。
