Department of Social and Behavioural Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Ghana Somubi Dwumadie (Ghana Participation Programme), East Legon, Accra, Ghana.
PLoS One. 2023 May 18;18(5):e0285324. doi: 10.1371/journal.pone.0285324. eCollection 2023.
Access to quality mental health services in Ghana remains poor, yet little is known about the extent of the access gaps and provision of mental health services at the district level in Ghana. We aimed to conduct an analysis of mental health infrastructure and service provision in five districts in Ghana.
A cross-sectional situation analysis was conducted using a standardised tool to collect secondary healthcare data, supplemented by interviews with key informants, across five purposively selected districts in Ghana. The Programme for Improving Mental Health Care (PRIME) situation analysis tool was adapted to the Ghanaian context and used for data collection.
The districts are predominantly rural (>60%). There were severe challenges with the provision of mental healthcare: there were no mental healthcare plans, supervision of the few mental health professionals was weak and unstructured, access to regular supplies of psychotropic medications was a major challenge, and psychological treatments were extremely limited given the lack of trained clinical psychologists. There were no available data on treatment coverage, but we estimate this to be <1% for depression, schizophrenia, and epilepsy across districts. Opportunities for mental health systems strengthening include: the commitment and willingness of leadership, the existence of the District Health Information Management System, a well-established network of community volunteers, and some collaboration with traditional and faith-based mental health service providers.
There is poor mental health infrastructure across the five selected districts of Ghana. There are opportunities for strengthening mental health systems through interventions at the district healthcare organisation, health facility, and community levels. A standardised situation analysis tool is useful for informing district-level mental healthcare planning in low-resource settings in Ghana and potentially other sub-Saharan African countries.
加纳获得优质精神卫生服务的机会仍然很差，但对于加纳地区一级的精神卫生服务提供情况和获取差距的程度知之甚少。我们旨在对加纳五个地区的精神卫生基础设施和服务提供情况进行分析。
使用标准化工具对五个有目的选择的加纳地区进行横断面情况分析，以收集二级保健数据，并辅以关键知情人访谈。改编了改善精神卫生保健方案（PRIME）情况分析工具，以适用于加纳的情况，并用于数据收集。
这些地区主要是农村地区（>60%）。在提供精神卫生保健方面存在严重挑战：没有精神卫生保健计划，对少数精神卫生专业人员的监督薄弱且无组织，定期获得精神药物供应是一个主要挑战，由于缺乏经过培训的临床心理学家，心理治疗极为有限。没有关于治疗覆盖面的数据，但我们估计，在五个地区，抑郁症、精神分裂症和癫痫的治疗覆盖面<1%。加强精神卫生系统的机会包括：领导层的承诺和意愿、地区卫生信息管理系统的存在、成熟的社区志愿者网络以及与传统和信仰为基础的精神卫生服务提供者的一些合作。
加纳五个选定地区的精神卫生基础设施很差。可以通过在地区医疗保健组织、卫生机构和社区各级采取干预措施来加强精神卫生系统。标准化情况分析工具可用于为加纳和可能其他撒哈拉以南非洲国家的低资源环境中的地区一级精神卫生保健规划提供信息。
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