Mutamba Byamah B, Twikirize Gad, Ssemalulu Jimmy, Babirye Roseline, Semakula Lynn, Cappo David
YouBelong Uganda, Kampala, Uganda.
Butabika National Referral Mental Hospital, Kampala, Uganda.
Int J Ment Health Syst. 2024 Jul 15;18(1):26. doi: 10.1186/s13033-024-00643-9.
Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.
将精神、神经和物质使用（MNS）障碍的诊断与治疗纳入初级卫生保健，是低收入和中等收入国家改善服务可及性的一项推荐策略。尽管乌干达有许多将精神卫生保健纳入其中的举措，但尚未对卫生管理信息系统（HMIS）记录进行评估，以确定MNS障碍是否得到常规诊断。我们试图确定乌干达人口最多的地区瓦基索区和坎帕拉区初级卫生设施中MNS障碍的诊断模式。我们走访了较低层级的初级卫生设施，从HMIS登记册中获取记录，记录MNS障碍的诊断情况。我们进行了二次数据分析并报告了描述性统计结果。共走访了40所初级卫生保健设施，占研究地区卫生设施的58.6%。分别走访了瓦基索区和坎帕拉区超过一半（54.8%）和几乎所有（87.5%）的较低层级卫生设施。乌干达较低层级初级卫生设施诊断出的MNS障碍比例非常低，癫痫是记录中最常见的MNS诊断。本文讨论了初级卫生设施诊断数量如此之低的原因以及可能的解决办法。
