Sparkman Center for Global Health and Department of Health Policy and Organization, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
Research Department, Center for Infectious Disease Research in Zambia, Lusaka, Zambia.
BMJ Glob Health. 2023 Nov;8(Suppl 7). doi: 10.1136/bmjgh-2023-013572.
Over the past two decades there have been major advances in the development of interventions promoting mental health and well-being in low- and middle-income countries (LMIC), including delivery of care by non-specialist providers, incorporation of mobile technologies and development of multilevel community-based interventions. Growing inequities in mental health have led to calls to adopt similar strategies in high-income countries (HIC), learning from LMIC. To overcome shared challenges, it is crucial for projects implementing these strategies in different global settings to learn from one another. Our objective was to examine cases in which mental health and well-being interventions originating in or conceived for LMIC were implemented in the USA. The cases included delivery of psychological interventions by non-specialists, HIV-related stigma reduction programmes, substance use mitigation strategies and interventions to promote parenting skills and family functioning. We summarise commonly used strategies, barriers, benefits and lessons learnt for the transfer of these innovative practices among LMIC and HIC. Common strategies included intervention delivery by non-specialists and use of digital modalities to facilitate training and increase reach. Common barriers included lack of reimbursement mechanisms for care delivered by non-specialists and resistance from professional societies. Despite US investigators' involvement in most of the original research in LMIC, only a few cases directly involved LMIC researchers in US implementation. In order to achieve greater equity in global mental health and well-being, more efforts and targeted funding are needed to develop best practices for global health reciprocal innovation and iterative learning in HIC and LMIC.
在过去的二十年中，在为中低收入国家（LMIC）开发促进心理健康和福祉的干预措施方面取得了重大进展，包括非专业人员提供护理、结合移动技术以及发展多层次基于社区的干预措施。心理健康方面日益加剧的不平等现象促使人们呼吁在高收入国家（HIC）采取类似的策略，从中低收入国家吸取经验。为了克服共同的挑战，在不同的全球环境中实施这些策略的项目必须相互学习。我们的目的是研究起源于或专为中低收入国家设计的心理健康和福祉干预措施在美国实施的案例。这些案例包括非专业人员提供心理干预、减少与艾滋病毒相关的耻辱感计划、减少药物滥用的策略以及促进育儿技能和家庭功能的干预措施。我们总结了在中低收入国家和高收入国家之间转移这些创新实践的常用策略、障碍、益处和经验教训。常用的策略包括非专业人员提供干预措施和使用数字模式来促进培训和扩大覆盖面。常见的障碍包括非专业人员提供的护理缺乏报销机制以及专业协会的抵制。尽管美国调查人员参与了中低收入国家的大部分原始研究，但只有少数案例直接让中低收入国家的研究人员参与了美国的实施。为了在全球范围内实现更公平的精神健康和福祉，需要更多的努力和有针对性的资金来制定针对高收入国家和中低收入国家的全球健康互惠创新和迭代学习的最佳实践。
