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撒哈拉以南非洲部分国家心理健康服务的综合综述:评估进展、挑战及未来方向。

A comprehensive review of mental health services across selected countries in sub-Saharan Africa: assessing progress, challenges, and future direction.

作者信息

Atewologun Faith, Adigun Olaniyi Abideen, Okesanya Olalekan John, Hassan Hakeem Kayode, Olabode Olaleke Noah, Micheal Abioye Sunday, Ahmed Mohamed Mustaf, Ukoaka Bonaventure Michael, Idris Nimat Bola, Oso Tolutope Adebimpe, Lucero-Prisno Don Eliseo

机构信息

Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.

Department of Medical Laboratory Science, University College Hospital, Ibadan, Nigeria.

出版信息

Discov Ment Health. 2025 Apr 7;5(1):49. doi: 10.1007/s44192-025-00177-7.

DOI:10.1007/s44192-025-00177-7
PMID:40195169
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11977099/
Abstract

Mental health is a crucial but frequently neglected aspect of general health and well-being that faces numerous challenges, including underfunding, shortage of trained professionals, pervasive stigma, inadequate infrastructure, and insufficient policies in sub-Saharan Africa. This review reports the significant progress and initiatives that have been made in this region. South Africa, Nigeria, Uganda, Kenya, Tanzania, Ethiopia, Rwanda, and Ghana have developed national policies and integrated mental health services into primary healthcare, marking a shift towards community-based care and reducing stigma through awareness campaigns. Countries such as South Africa and Rwanda have robust infrastructure, while Ethiopia and Kenya emphasize training primary healthcare providers and community-based models. Ghana's Mental Health Act and Uganda's collaboration with NGOs has enhanced awareness and resource mobilization. Mental healthcare-targeted programs, such as Kenya's Friendship Bench and Ethiopia's Health Extension Program, have demonstrated the efficacy of community-based interventions. South Africa has leveraged innovative approaches, such as telepsychiatry, to expand access to holistic mental health services, particularly in rural areas. Partnerships with traditional healers in Uganda and Rwanda have enhanced early identification and referral. Despite these advancements, challenges persist. Common issues include a severe shortage of mental health professionals, inadequate budget allocation, limited access to services in rural areas, and the need for comprehensive policy frameworks that continue to stall the desired goals. Urban-centric services in Nigeria, financial constraints in Tanzania, and resource limitations in Ethiopia and Rwanda have hindered equitable access. While public-private partnerships and technological innovations are emerging, the dominance of institutionalized care in several regions limits community outreach. To chart the path forward, improving mental health services in Sub-Saharan Africa requires increased funding, expanded training programs for mental health professionals, and incorporation of mental health into basic healthcare systems. Utilizing technology such as telemedicine and mobile health applications holds promise for overcoming geographical barriers and supporting ongoing education. Community-based models and advocacy efforts are essential for reducing stigma, promoting sustainable mental healthcare, and enhancing the overall well-being of citizens insub-Saharan Africa.

摘要

心理健康是总体健康和幸福的一个关键但经常被忽视的方面,在撒哈拉以南非洲面临众多挑战,包括资金不足、训练有素的专业人员短缺、普遍存在的污名化、基础设施不足以及政策不完善。本综述报告了该地区已取得的重大进展和举措。南非、尼日利亚、乌干达、肯尼亚、坦桑尼亚、埃塞俄比亚、卢旺达和加纳已制定国家政策,并将心理健康服务纳入初级医疗保健,标志着向基于社区的护理转变,并通过提高认识运动减少污名化。南非和卢旺达等国拥有强大的基础设施,而埃塞俄比亚和肯尼亚则强调培训初级医疗保健提供者和基于社区的模式。加纳的《心理健康法》以及乌干达与非政府组织的合作提高了认识并促进了资源调动。以心理健康护理为目标的项目,如肯尼亚的友谊长椅项目和埃塞俄比亚的健康推广项目,已证明基于社区的干预措施的有效性。南非利用了远程精神病学等创新方法,以扩大获得全面心理健康服务的机会,特别是在农村地区。乌干达和卢旺达与传统治疗师的伙伴关系加强了早期识别和转诊。尽管取得了这些进展,但挑战依然存在。常见问题包括心理健康专业人员严重短缺、预算分配不足、农村地区获得服务的机会有限,以及需要全面的政策框架,这继续阻碍了预期目标的实现。尼日利亚以城市为中心的服务、坦桑尼亚的财政限制以及埃塞俄比亚和卢旺达的资源限制阻碍了公平获得服务。虽然公私伙伴关系和技术创新正在兴起,但几个地区机构化护理的主导地位限制了社区外展。为了规划前进的道路,改善撒哈拉以南非洲的心理健康服务需要增加资金、扩大心理健康专业人员的培训项目,并将心理健康纳入基本医疗保健系统。利用远程医疗和移动健康应用等技术有望克服地理障碍并支持持续教育。基于社区的模式和宣传努力对于减少污名化、促进可持续的心理健康护理以及提高撒哈拉以南非洲公民的整体福祉至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804d/11977099/9cdfc317369e/44192_2025_177_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804d/11977099/dde4efd25158/44192_2025_177_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804d/11977099/9cdfc317369e/44192_2025_177_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804d/11977099/dde4efd25158/44192_2025_177_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/804d/11977099/9cdfc317369e/44192_2025_177_Fig2_HTML.jpg

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