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Current Status of Mental Health Services at the Primary Healthcare Level in Northern Nigeria

Abstract

Mental health services at the primary healthcare level remain critical in most developing countries, especially in resource-poor and crisis-stricken communities. This study explored the erstwhile mental health services, with particular reference to their availability, at the 47 primary healthcare centres in three selected states in northern Nigeria, with a view to drawing for action. Qualitative data were collected from a purposive sample of 13 participants through in-depth interviews. Additional data were also collected from observations during the visits (a checklist based on minimum standards for primary healthcare services) and clinic records at the centres. The data were analysed using content analysis and thematic clustering to indicate the status of the mental health services at the primary healthcare centres. Despite having the mental health units on the service delivery charts of the primary healthcare centres studied, none was providing any formal mental health services. There were only few but uncoordinated services in some centres essentially provided by individual primary healthcare service providers and a non-governmental organization found in one of the 47 primary healthcare centres in one of the three states investigated. In conclusion, mental health services at all primary healthcare centres in all the Local Government Areas in all the states visited are at best scarce, poorly and haphazardly rendered in a few places or completely absent in most centres. There is an urgent need to stimulate the primary healthcare system and other levels of government and their partners, to initiate or activate policies in favour of community-based mental health services to make these important services available at the community (primary healthcare) level for the promotion of mental health and treatment of mental illnesses.

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References

  • Abegunde, D. (2013). Mental health care in Nigeria: Time for change. The Nation Newspaper.

  • Adefuye, D. (2011). Budgetary allocation to health, shame of a Nation, Association of Nigerian Physicians in America Blog. Accessed March 20, 2012, from http://www.anpa.org/blog/2011/03/30/budgetary-allocationtohealth-shame-of-a-nation.

  • Akhtar, R. (1991). Health care patterns and planning in developing countries (p. 264). Greenwood Press.

  • Anyebe, E.E. (2016). Mental health services at the primary health care level in three states in Northern Nigeria; a PhD Thesis Submitted to School of Postgraduate Studies Ahmadu Bello University, Zaria. Accessed November 2, 2018, from http://kubanni.abu.edu.ng.

  • Asuni, T. (1966). Development of mental health in Nigeria with particular reference to western Nigeria. In Proceeding IV world congress of psychiatry, 1067.

  • Asuni, T. (1967). Aro hospital in perspective. American Journal of Psychiatry, 124, 71.

    Article  Google Scholar 

  • Asuzu, J. (2009). The necessity for a health systems reform in Nigeria. Journal of Community Medicine & Primary Health Care, 16(1), 1–3.

    Google Scholar 

  • Asuzu, M. (2008). Nigeria still searching for right formula. Bulletin of the World Health Organization, 86(9), 664–666.

    Google Scholar 

  • Ayonrinde, O., Gureje, O., & Lawal, R. (2004). Psychiatric research in Nigeria: Bridging tradition and modernisation. The British Journal of Psychiatry, 184(6), 536–538.

    Article  PubMed  Google Scholar 

  • Creswell, J. W., Plano, V., & Clark, L. (2011). Designing and conducting mixed methods research. Thousand Oaks: SAGE.

    Google Scholar 

  • Ellen, T. (2003). Analysing qualitative data. Madison: University of Winsconsin.

    Google Scholar 

  • Federal Ministry of Health (FMOH). (1988). National health policy. Lagos: FG Press.

    Google Scholar 

  • Federal Ministry of Health (FMOH). (1991). National mental health policy. Lagos: FG Press.

    Google Scholar 

  • Federal Ministry of Health (FMOH). (2001). DOTS implementation (FMOH). Abuja.

  • Federal Ministry of Health (FMOH). (2007). Integrated maternal, newborn, and child health strategy. Abuja: Government of Nigeria.

    Google Scholar 

  • Federal Ministry of Health (FMOH). (2011). Comprehensive EPI multi-year plan 2011–2015 updated. Abuja: Government of Nigeria.

    Google Scholar 

  • Gureje, O. (2015). Challenges of mental health care in Nigeria. A webinar internet conference held on 15th December 2015.

  • http://www.neuroaro.com. (2014). Community mental health unit. Accessed April 12, 2016, from www.neuroaro.com/index.php/about-us/departments/item/108-community-mentalth-health.

  • Jack-Ide, I. O., & Uys, L. (2012). Barriers to mental health services utilization in Niger Delta region of Nigeria: service users’ perspectives. The Pan African Medical Journal, 13(3), 15–19.

    Google Scholar 

  • Jegede, A. S. (2010). Mental health. In African culture and health, enlarged edition. Ibadan: Bookwright Publishers.

  • National Bureau of Statistics. (2010). Report of the Nigeria literacy survey June 2010. Nigeriastat.gov.ng.

  • National Strategic Health Development Plan (NSHDP). (2010–2015). Abuja: Federal Ministry of Health (FMOH), Government of Nigeria.

  • National Primary Health Care Development Agency (NPHCDA). (2007). Minimum standards for primary health care in Nigeria. Abuja: PATHS2/Federal Ministry of Health/UKaid.

  • Odejide, A. O., Morakinyo, J. J., Oshiname, F. O., Omigbodun, O., Ajuwon, A. J., & Kola, L. (2010). Integrating mental health into primary health care in Nigeria: Management of depression in a local government (district) area as a paradigm. http://www.ncbi.nlm.nih.gov/pubmed/12607921.

  • Omigbodun, O. O. (2001). A cost-effective model for increasing access to mental health care at the primary care level in Nigeria. The Journal of Mental Health Policy and Economics, 4, 133–139.

    PubMed  Google Scholar 

  • WHO. (1978). Alma-Ata 1978: Primary health care. Report of the international conference on primary health care Alma-Ata, USSR, 6–12 September 1978. Geneva: World Health Organisation.

  • World Health Organisation (WHO). (2005). Country status report 2005. Nigeria: WHO Publications.

    Google Scholar 

  • WHO. (2007). Developing community mental health service. Report of the regional workshop Bangkok, Thailand, 11–14 December 2006: World Health Organization Regional Office for South-East Asia New Delhi, August 2007.

  • WHO. (2008). mhGAP Mental Health Gap Action Programme: Scaling up care for mental, neurological and substance use disorders. Geneva: World Health Organization.

    Google Scholar 

  • WHO. (2009). Need to address mental disorders in children: WHO calls for action on World Autism Awareness Day. Accessed May 16, 2013, from http://www.who.int/mediacentre/news/releases/2009/autism_children_20090402.

  • WHO. (2012). New WHO report: Dementia: A public health priority.

  • WHO. (2018). Nigeria: Life expectancy. Accessed April 5, 2019, from https://www.worldlifeexpectancy.com/nigeria-life-expectancy.

  • WHO-AIMS Report. (2006). Mental health system in Nigeria: A report of the assessment of the mental health system in Nigeria using the World Health Organization—Assessment Instrument for Mental Health Systems (WHO-AIMS). Ibadan, Nigeria.

  • WHO Report. (2011). WHO highlights global underinvestment in mental health care. Accessed May 21, 2013, from http://www.who.int/mediacentre/news/notes/2011/mental_health_20111007.

  • WHO/WFMH. (2009). Integrating mental health into primary care: A global perspective. Geneva: WHO.

    Google Scholar 

  • WHO/Wonca. (2007). Integrating mental health services into primary health care: Mental health policy, planning and service development information sheet, sheet3. Geneva: World Health Organization. Accessed June 12, 2015, from http://www.who.int/mental_health/policy/services/en/index.html.

  • WHO/World Bank. (2004). The cost-effectiveness of primary care services in developing countries: A review of the international literature. Working paper no. 37. Disease Control Priorities Project.

  • World Data Atlas. (2018). Nigeria: Education-literacy. Accessed April 5, 2019, from https://knoema.com/atlas/Nigeria/topics/Education/Literacy/Adult-literacy-rate.

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Correspondence to E. E. Anyebe.

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None declared; there was no source of funding, grant for this study or any tie to any institutional or company interest.

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All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent and assent were obtained from all respondents included in the study, in accordance with the Health Research Ethical Committee (HREC) of the Ahmadu Bello University, Ahmadu Bello University Teaching Hospital (Certificate No: ABUTH/HREC/K028/2014) and the Federal Neuro-psychiatric Hospital, Barnawa Kaduna Nigeria institutional review boards.

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Anyebe, E.E., Olisah, V.O., Garba, S.N. et al. Current Status of Mental Health Services at the Primary Healthcare Level in Northern Nigeria. Adm Policy Ment Health 46, 620–628 (2019). https://doi.org/10.1007/s10488-019-00950-1

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Keywords

  • Mental health services
  • Community health care
  • Northern Nigeria
  • Primary health care