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Mental health in Burundi, what is the place of the community ?

par Munezero, Belyse;NDAYIKUNDA, Alain;NKURUNZIZA, Edouard;KAMANA, Jeanine;Nimpagaritse, Manassé;Labat, Aline
Référence European Congress on Tropical Medicine and International Health(13: 20-23/11/2023: Utrecht Netherlands)
Publication Non publié, 2023-11-20

Abstract de conférence

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Résumé :

Background: Access to care for patients with mental health disorders is difficult in Burundi. These patients and their relatives, often stigmatized, can quickly sink into poverty. What role does the community play in the initial care seeking and follow-up by the health facilities for these patients?Methodology: To understand the patient’s pathway, a mixte method design was used. 169 patients answered to a questionnaire and among them 31 were also interviewed.Results: The role of families and relatives is very important, as in 81% of cases they are the ones who identify the mental health problem. They are also the motivating factor to consult a health facility for 69% of the patients. Only 41% sought care at the first signs of the disease and nearly a quarter started in the non-conventional system (prayer houses or traditional healers). Patients describ shifts in their pathway between conventional and non-conventional structures. When prayers or traditional practitioners fail, they switch for health facilities. But in the opposite they also change from caregivers to non-conventional for financial or religious reasons, or because of the influence of a relative. Finally, community health workers are identified as leaders to change the attitude of the community about stigma and also to promote treatment adherence. Conclusion: The role of community seems really important to fight stigma, to accelerate the access to health facilities and to keep the patients in the conventional system. The actors involvement of the non-conventional sector should be considered, as well as a better role for community health workers.