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Evaluation of district mental healthcare plans: The PRIME consortium methodology

Published online by Cambridge University Press:  02 January 2018

Mary J. De Silva ,
Sujit D. Rathod ,
Charlotte Hanlon ,
Erica Breuer ,
Dan Chisholm ,
Abebaw Fekadu ,
Mark Jordans ,
Fred Kigozi ,
Inge Petersen  and
Rahul Shidhaye
...Show all authors
Mary J. De Silva*
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Sujit D. Rathod
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Charlotte Hanlon
Affiliation:
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia and Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Erica Breuer
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Dan Chisholm
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
Abebaw Fekadu
Affiliation:
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia and Department of Psychological Medicine, Centre for Affective Disorders and the Affective Disorders Research Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Mark Jordans
Affiliation:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and HealthNet TPO, Research and Development Department, Amsterdam, The Netherlands
Fred Kigozi
Affiliation:
Butabika National Referral and Teaching Hospital/Makerere University, Kampala Uganda
Inge Petersen
Affiliation:
School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, South Africa
Rahul Shidhaye
Affiliation:
Centre for Mental Health, The Public Health Foundation of India, India and Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
Girmay Medhin
Affiliation:
Department of Psychological Medicine, Centre for Affective Disorders and the Affective Disorders Research Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
Joshua Ssebunnya
Affiliation:
Butabika National Referral and Teaching Hospital/Makerere University, Kampala, Uganda
Martin Prince
Affiliation:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Graham Thornicroft
Affiliation:
Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Mark Tomlinson
Affiliation:
Centre for Public Mental Health, Department of Psychology, Stellenbosch University and Department of Psychiatry and Mental Health, University of Cape Town, Stellenbosch, South Africa
Crick Lund
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Vikram Patel
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, the Public Health Foundation of India, India and Sangath, Goa, India
*
Mary De Silva, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: [email protected]
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Abstract

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Background

Few studies have evaluated the implementation and impact of real-world mental health programmes delivered at scale in low-resource settings.

Aims

To describe the cross-country research methods used to evaluate district-level mental healthcare plans (MHCPs) in Ethiopia, India, Nepal, South Africa and Uganda.

Method

Multidisciplinary methods conducted at community, health facility and district levels, embedded within a theory of change.

Results

The following designs are employed to evaluate the MHCPs: (a) repeat community-based cross-sectional surveys to measure change in population-level contact coverage; (b) repeat facility-based surveys to assess change in detection of disorders; (c) disorder-specific cohorts to assess the effect on patient outcomes; and (d) multilevel case studies to evaluate the process of implementation.

Conclusions

To evaluate whether and how a health-system-level intervention is effective, multidisciplinary research methods are required at different population levels. Although challenging, such methods may be replicated across diverse settings.

Type
Papers
Information
The British Journal of Psychiatry , Volume 208 , Issue s56: Mental health plans in five low- and middle-income countries: PRogramme for Improving Mental health carE (PRIME) , January 2016 , pp. s63 - s70
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Copyright
Copyright © Royal College of Psychiatrists, 2016

Footnotes

This paper was produced as part of the PRogramme for Improving Mental health carE (PRIME) funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies. The RISE trial of community-based rehabilitation in Ethiopia is supported by the Wellcome Trust (grant number 100142/Z/12/Z). M.J.D.S. is supported by a Wellcome Trust/London School of Hygiene and Tropical Medicine career fellowship. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Declaration of interest

None.

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