A5081535706- Mental Health Treatment and Access
- Health Policy Implementation Science
- Child and Adolescent Psychosocial and Emotional Development
- Mental Health and Patient Involvement
- Primary Care and Health Outcomes
- Community Health and Development
- Maternal Mental Health During Pregnancy and Postpartum
- Global Maternal and Child Health
- Evaluation and Performance Assessment
- Adolescent Sexual and Reproductive Health
- Geriatric Care and Nursing Homes
- Family Caregiving in Mental Illness
- Health Systems, Economic Evaluations, Quality of Life
- Health disparities and outcomes
- HIV/AIDS Research and Interventions
- Healthcare innovation and challenges
- Homelessness and Social Issues
- Psychiatric care and mental health services
- Interprofessional Education and Collaboration
- Qualitative Comparative Analysis Research
- Healthcare Systems and Reforms
- HIV, Drug Use, Sexual Risk
- Suicide and Self-Harm Studies
- Reproductive Health and Technologies
- Assisted Reproductive Technology and Twin Pregnancy
University of Newcastle Australia
2019-2025
Heidelberg University
2025
University Hospital Heidelberg
2025
The London College
2023
South African Medical Research Council
2023
New Castle Historical Society
2023
University of Cape Town
2011-2021
Hunter Medical Research Institute
2021
Groote Schuur Hospital
2017
Case Western Reserve University
2009
The Medical Research Councils’ framework for complex interventions has been criticized not including theory-driven approaches to evaluation. Although the does include broad guidance on use of theory, it contains little practical implementers and there have calls develop a more comprehensive approach. A prospective, process intervention design evaluation is required healthcare which are likely be effective, sustainable scalable. We propose approach by adapting integrating programmatic tool,...
Background Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) the diverse settings encountered within between countries. In this paper we compare baseline context, challenges opportunities districts five LMICs (Ethiopia, India, Nepal, South Africa Uganda) participating PRogramme for Improving Mental carE (PRIME). The purpose was inform development a comprehensive district plan integrate into primary care. Methods A...
The integration of maternal mental health into primary care has been advocated to reduce the treatment gap in low- and middle-income countries (LMICs). This study reports findings a cross-country situation analysis on services available five LMICs, inform development integrated care. was conducted districts Ethiopia, India, Nepal, South Africa Uganda, as part Programme for Improving Mental Health Care (PRIME). secondary data prevalence impact priority disorders (perinatal depression, alcohol...
Background In South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to fore need for integrating health into care at district level. Aims To develop a healthcare plan (MHCP) in Africa that integrates depression, alcohol use schizophrenia care. Method Mixed methods using situation analysis, qualitative key informant interviews, theory change workshops piloting one facility informed development MHCP. Results Collaborative packages three...
Background Developing evidence for the implementation and scaling up of mental healthcare in low- middle-income countries (LMIC) like Ethiopia is an urgent priority. Aims To outline a plan (MHCP), as scalable template rural Ethiopia. Method A mixed methods approach was used to develop MHCP three levels district health system (community, facility organisation). Results The community packages were case detection, reintegration inclusion. included capacity building, decision support staff...
As part of a situational analysis for research programme on the integration mental health care into primary (Programme Improving Mental Health Care-PRIME), we conducted baseline study aimed at determining broad indicators population level psychosocial distress in predominantly rural community Ethiopia. The was population-based cross-sectional survey 1497 adults selected through multi-stage random sampling process. Population evaluated by estimating magnitude common disorder symptoms (CMD;...
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 cross-country research methods used to evaluate district-level healthcare plans (MHCPs) Ethiopia, India, Nepal, South Africa Uganda. Method Multidisciplinary conducted community, facility district levels, embedded within a theory change. Results The following designs are employed MHCPs: (a) repeat community-based...
Context A robust evidence base is now emerging that indicates treatment for depression and alcohol use disorders (AUD) delivered in low middle-income countries (LMIC) can be effective. However, the coverage of services these conditions most LMIC settings remains unknown. Objective To describe methods a repeat cross-sectional survey to determine changes contact probable AUD four districts, present baseline findings regarding coverage. Methods Population-based surveys with structured...
There is little practical guidance on how contextually relevant mental healthcare plans (MHCPs) can be developed in low-resource settings.To describe theory of change (ToC) was used to plan the development and evaluation MHCPs as part PRogramme for Improving Mental health carE (PRIME).ToC occurred three stages: (a) a cross-country ToC by 15 PRIME consortium members; (b) country-specific ToCs 13 workshops with median (interquartile range 13-22) stakeholders per workshop; (c) review refinement...
The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way high income countries. Little is known about its use mental care plans low middle countries where services remain inadequate.ToC workshops were held as part formative phase the Programme for Improving Mental Health Care (PRIME) order 1) structured logical evidence-based ToC map basis plan each district; (2) contextualise plans; (3) obtain stakeholder buy-in Ethiopia,...
Background. The prevalence of depression in rural Ugandan communities is high and yet detection treatment the primary care setting suboptimal. Short valid screening measures may improve depression. We describe validation Luganda translated nine- two-item Patient Health Questionnaires (PHQ-9 PHQ-2) as tools for two facilities Eastern Uganda. Methods. A total 1407 adult respondents were screened consecutively using nine-item PHQ. Of these 212 randomly selected to respond Mini International...
The aim of this study was to evaluate outcomes for participants in BasicNeeds' Mental Health and Development programme rural Kenya. All new entrants the Meru South Nyeri North districts were enrolled over a 3-month period (n = 203). Assessments mental health, functioning, economic status quality life conducted at baseline 1-year 2-year follow up, using single group cohort design. Over 2 years there significant improvements scores on General Questionnaire (21.5 [95% CI: 20.2–22.8] 6 4.8–7.2]...
Scaling up mental healthcare through integration into primary care remains the main strategy to address extensive unmet health need in low-income countries. For integrated achieve its goal, a clear understanding of organisational processes that can promote and hinder delivery is essential. Theory Change (ToC), method employed planning, implementation evaluation complex community initiatives, an innovative approach has potential assist development comprehensive plan (MHCP), which inform care....
Injury related to self-harm is one of the leading causes global disease burden. As a formative work for programme implement comprehensive mental healthcare in rural district Ethiopia, we determined 12-month prevalence non-fatal suicidal behaviour as well factors associated with this understand potential burden district. Population-based (n = 1485) and facility-based 1014) cross-sectional surveys adults, using standardised, interview-based measures suicidality (items on suicide from Composite...
Collaborative research partnerships are necessary to answer key questions in global mental health, share expertise, access funding and influence policy. However, between low- middle-income countries (LMIC) high-income have often been inequitable with the provision of technical knowledge flowing unilaterally from high lower income countries. We present experience Programme for Improving Mental Health Care (PRIME), a LMIC-led partnership which provides evidence development, implementation...
Background The PRogramme for Improving Mental Health carE (PRIME) evaluated the process and outcomes of implementation a mental healthcare plan (MHCP) in Chitwan, Nepal. Aims To describe implementation, barriers facilitating factors, to evaluate indicators MHCP. Method A case study design that combined qualitative quantitative methods based on programme theory change (ToC) was used included: (a) district-, community- health-facility profiles; (b) monthly logs; (c) pre- post-training...
In Kenya, approximately one in five girls aged 15–19 years old are pregnant or already a mother. Adolescent and young women experience significant mental health vulnerabilities during the pregnancy postpartum periods, leading to poor antenatal postnatal care attendance inferior infant maternal outcomes. Pregnant adolescents often stigma disenfranchisement due their status at same time lack access support within settings, schools, religious institutions, communities. This paper presents...