Equitable access to integrated primary mental healthcare for people with severe mental disorders in Ethiopia: a formative study

• DOI: 10.1186/s12939-016-0410-0
• Publication Date: 2016-07-26T08:43:58Z
• Authors: Maji Hailemariam; Abebaw Fekadu; Medhin Selamu; Girmay Medhin; Martin Prince; Charlotte Hanlon
• Keywords: Mental health care; Health administration; Health Services Research

The provision of mental healthcare through integration into primary care is expected to improve access care, but not all population groups may benefit equally. aim this study was inform delivery a new care-based health service in rural Ethiopia by identifying potential barriers equitable and strategies overcome them. A qualitative conducted as formative work for the PRogramme Improving Mental healthcarE (PRIME), project supporting integrated district south central Ethiopia. In-depth interviews (n = 21) were carried out with stakeholders selected purposively from users, caregivers, community leaders administrators. focus group discussion 12) extension workers. Framework analysis employed using an adapted version framework developed use contexts livelihood insecurity, which considers (1) availability, (2) accessibility affordability. (3) acceptability adequacy dimensions access. Primary considered positive development, would increase affordability treatments. Low levels awareness, general preference traditional religious healing raised challenges healthcare. Participants believed be comprehensive satisfactory quality. However, expectations about effectiveness treatment disorders generally low. Threats identified perinatal women, persons physical disability, those living extreme poverty people severe persistent disability. Establishing affordable within reach, raising awareness financial support families low socioeconomic backgrounds suggested vulnerable including women disabilities. Innovative approaches, such telephone consultations psychiatric nurses based nearby towns home outreach need evaluated.