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What mistakes should be avoided to successfully integrate mental health services into primary health care? Experience in Burundi

par NDAYIKUNDA, Alain;Munezero, Belyse;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: Given the large gap between the prevalence of mental illness and the number of people receiving a treatment, integration of mental health services into primary health care has been tested in Burundi to facilitate access. Non specialized caregivers have been trained to care these patients (diagnosis, referral, treatment delivery and follow-up) as well as community health workers. This study documents the issues faced between 2019 and 2022 during the integration pilot experience. Method: Individual interviews were conducted with 31 peripheral-level mental health caregivers and 3 NGO coordinators involved in that integration process. Interviews were recorded, transcribed and analyzed. Ideas triangulation was used to identify mistakes to avoid. Results: Five major mistakes to avoid were identified: 1) Developing the community aspect before the medical one; 2) Creating too many expectations among patients and providers; 3) Not including in the process aspects aimed at developing ownership by the different stakeholders; 4) Not establishing the basis for effective collaboration between caregivers at different levels of the health pyramid and between caregivers and community health workers; 5) Not dedicating enough time to the process. Despite these challenges, patients, providers, and community health workers are satisfied with the results of the ongoing integration process. Conclusion: A good context and stakeholder analysis will help avoid these mistakes and increase the effectiveness of the integration of mental health services into primary health care.