Sakyi Lionel, Ae-Ngibise Kenneth, Adwan-Kamara Lyla, Weobong Benedict, Lund Crick
Ghana Somubi Dwumadie (Ghana Participation Programme), PMB 6 Asoyi Crescent, East Legon, Accra Ghana, Accra, Ghana
Ghana Somubi Dwumadie (Ghana Participation Programme), PMB 6 Asoyi Crescent, East Legon, Accra Ghana, Accra, Ghana.
BMJ Open. 2024 Dec 27;14(12):e090711. doi: 10.1136/bmjopen-2024-090711.
To explore the perceptions and experiences of mental health service users and healthcare workers regarding the implementation of district mental healthcare plans (DMHPs) in three district demonstration sites in Ghana.
The study employed a qualitative design using reflexive thematic analysis. Interview data were analysed by combining inductive and deductive approaches.
The study was conducted in three DMHP districts in Ghana: Anloga (Volta), Asunafo North (Ahafo) and Bongo (Upper East). The districts were selected via national stakeholder consultations, using a DMHP framework. Data were collected between January 2023 and June 2023.
In-depth interviews were conducted with 28 primary healthcare workers who played key roles in the delivery of care in the demonstration districts. Thirty-two service users who are 18 years and above and have been receiving healthcare for the past year in the demonstration districts were also interviewed. Participants were purposively sampled.
Three main themes were identified: (1) factors supporting DMHP implementation, including capacity building, collaboration, awareness creation and acceptability; (2) challenges affecting DMHP implementation, such as inadequate resources and medication shortages and (3) perceived outcomes of the DMHPs, including improved well-being and daily functioning as well as changing attitudes towards mental health. Some district-level variations were noted in the intensity of challenges and outcomes.
The DMHPs have shown promise in improving mental healthcare in primary care settings in Ghana. However, addressing resource constraints and medication shortages and sustaining capacity building and awareness creation efforts will be crucial for successful scale-up. The perspectives of service users and healthcare providers offer valuable insights for policymakers and practitioners aiming to enhance integrated mental healthcare.
探讨加纳三个地区示范点的心理健康服务使用者和医护人员对地区精神卫生保健计划（DMHP）实施情况的看法和体验。
本研究采用定性设计，运用反思性主题分析。通过归纳法和演绎法相结合的方式对访谈数据进行分析。
该研究在加纳的三个DMHP地区进行：安洛加（沃尔特）、阿苏纳福北区（阿哈福）和邦戈（上东部）。这些地区是通过全国利益相关者协商，采用DMHP框架选定的。数据收集于2023年1月至2023年6月期间。
对在示范区提供护理方面发挥关键作用的28名初级医护人员进行了深入访谈。还采访了32名18岁及以上、过去一年在示范区接受医疗保健的服务使用者。参与者是有目的地抽样选取的。
确定了三个主要主题：（1）支持DMHP实施的因素，包括能力建设、协作、提高认识和可接受性；（2）影响DMHP实施的挑战，如资源不足和药品短缺；（3）DMHP的感知成果，包括幸福感和日常功能的改善以及对心理健康态度的转变。在挑战和成果的强度方面存在一些地区层面的差异。
DMHP在改善加纳初级保健环境中的精神卫生保健方面显示出了前景。然而，解决资源限制和药品短缺问题，并持续开展能力建设和提高认识的工作，对于成功扩大规模至关重要。服务使用者和医疗保健提供者 的观点为旨在加强综合精神卫生保健的政策制定者和从业者提供了宝贵的见解。
