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Development of a district mental healthcare plan in Uganda
Fred N Kigozi1, Dorothy Kizza2, Juliet Nakku2
1Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India fredkigozi@yahoo.com.
Background:
Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda.
Aims:
To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care.
Method:
Mixed methods using a situational analysis, qualitative studies, theory of change workshops and partial piloting of the plan at two levels informed the MHCP.
Results:
A MHCP was developed with packages of care to facilitate integration at the organisational, facility and community levels of the district health system, including a specified human resource mix. The partial embedding period supports its practical application. Key barriers to scaling up the plan were identified.
Conclusions:
A real-world plan for the district was developed with involvement of stakeholders. Pilot testing demonstrated its feasibility and implications for future scaling up.
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