Experience of implementing new mental health indicators within information systems in six low- and middle-income countries

BackgroundSuccessful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking.AimsTo assess the acceptability, feasibili...

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Main Authors: Shalini Ahuja, Charlotte Hanlon, Dan Chisholm, Maya Semrau, Dristy Gurung, Jibril Abdulmalik, James Mugisha, Ntokozo Mntambo, Fred Kigozi, Inge Petersen, Rahul Shidhaye, Nawaraj Upadhaya, Crick Lund, Sara Evans-Lacko, Graham Thornicroft, Oye Gureje, Mark Jordans
Format: Article
Language:English
Published: Cambridge University Press 2019-09-01
Series:BJPsych Open
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2056472419000292/type/journal_article
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author Shalini Ahuja
Charlotte Hanlon
Dan Chisholm
Maya Semrau
Dristy Gurung
Jibril Abdulmalik
James Mugisha
Ntokozo Mntambo
Fred Kigozi
Inge Petersen
Rahul Shidhaye
Nawaraj Upadhaya
Crick Lund
Sara Evans-Lacko
Graham Thornicroft
Oye Gureje
Mark Jordans
author_facet Shalini Ahuja
Charlotte Hanlon
Dan Chisholm
Maya Semrau
Dristy Gurung
Jibril Abdulmalik
James Mugisha
Ntokozo Mntambo
Fred Kigozi
Inge Petersen
Rahul Shidhaye
Nawaraj Upadhaya
Crick Lund
Sara Evans-Lacko
Graham Thornicroft
Oye Gureje
Mark Jordans
author_sort Shalini Ahuja
collection DOAJ
description BackgroundSuccessful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking.AimsTo assess the acceptability, feasibility, perceived costs and sustainability of implementing indicators relating to integrated mental health service coverage in six South Asian (India, Nepal) and sub-Saharan African countries (Ethiopia, Nigeria, South Africa, Uganda).MethodA qualitative study using semi-structured key informant interviews (n = 128) was conducted. The ‘Performance of Routine Information Systems’ framework served as the basis for a coding framework covering three main categories related to the performance of new tools introduced to collect data on mental health indicators: (1) technical; (2) organisation; and (3) behavioural determinants.ResultsMost mental health indicators were deemed relevant and potentially useful for improving care, and therefore acceptable to end users. Exceptions were indicators on functionality, cost and severity. The simplicity of the data-capturing formats contributed to the feasibility of using forms to generate data on mental health indicators. Health workers reported increasing confidence in their capacity to record the mental health data and minimal additional cost to initiate mental health reporting. However, overstretched primary care staff and the time-consuming reporting process affected perceived sustainability.ConclusionsUse of the newly developed, contextually appropriate mental health indicators in health facilities providing primary care services was seen largely to be feasible in the six Emerald countries, mainly because of the simplicity of the forms and continued support in the design and implementation stage. However, approaches to implementation of new forms generating data on mental health indicators need to be customised to the specific health system context of different countries. Further work is needed to identify ways to utilise mental health data to monitor and improve the quality of mental health services.Declaration of interestNone.
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spelling doaj.art-4362e1eb889843849e90694affe80f9d2023-03-09T12:28:55ZengCambridge University PressBJPsych Open2056-47242019-09-01510.1192/bjo.2019.29Experience of implementing new mental health indicators within information systems in six low- and middle-income countriesShalini Ahuja0Charlotte Hanlon1https://orcid.org/0000-0002-7937-3226Dan Chisholm2Maya Semrau3Dristy Gurung4https://orcid.org/0000-0003-1839-9382Jibril Abdulmalik5James Mugisha6Ntokozo Mntambo7Fred Kigozi8Inge Petersen9Rahul Shidhaye10Nawaraj Upadhaya11Crick Lund12https://orcid.org/0000-0002-5159-8220Sara Evans-Lacko13Graham Thornicroft14Oye Gureje15Mark Jordans16https://orcid.org/0000-0001-5925-8039Researcher, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKReader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, EthiopiaProgramme Manager, Department of Mental Health and Substance Abuse, World Health Organization, SwitzerlandResearch Fellow, Global Health and Infection Department, Brighton & Sussex Medical School, UK; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKResearcher and Programme Coordinator, Transcultural Psychosocial Organization, NepalResearcher, Department of Psychiatry, University of Ibadan, NigeriaResearcher, Kyambogo University; and Butabika National Referral and Teaching Mental Hospital, UgandaResearcher, School of Applied Human Sciences, University of Kwazulu-Natal, South AfricaSenior Researcher, Butabika National Referral and Teaching Mental Hospital, UgandaResearch Director and Professor, Centre for Rural Health, School of Nursing and Public Health, University of Kwazulu-Natal, South AfricaSenior Researcher, Centre for Mental Health, Public Health Foundation of India, IndiaResearcher, Transcultural Psychosocial Organization, NepalProfessor, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKAssociate Professorial Research Fellow, Personal Social Services Research Unit, London School of Economics and Political Science; and Centre for Global Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKProfessor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKProfessor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South AfricaReader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKBackgroundSuccessful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking.AimsTo assess the acceptability, feasibility, perceived costs and sustainability of implementing indicators relating to integrated mental health service coverage in six South Asian (India, Nepal) and sub-Saharan African countries (Ethiopia, Nigeria, South Africa, Uganda).MethodA qualitative study using semi-structured key informant interviews (n = 128) was conducted. The ‘Performance of Routine Information Systems’ framework served as the basis for a coding framework covering three main categories related to the performance of new tools introduced to collect data on mental health indicators: (1) technical; (2) organisation; and (3) behavioural determinants.ResultsMost mental health indicators were deemed relevant and potentially useful for improving care, and therefore acceptable to end users. Exceptions were indicators on functionality, cost and severity. The simplicity of the data-capturing formats contributed to the feasibility of using forms to generate data on mental health indicators. Health workers reported increasing confidence in their capacity to record the mental health data and minimal additional cost to initiate mental health reporting. However, overstretched primary care staff and the time-consuming reporting process affected perceived sustainability.ConclusionsUse of the newly developed, contextually appropriate mental health indicators in health facilities providing primary care services was seen largely to be feasible in the six Emerald countries, mainly because of the simplicity of the forms and continued support in the design and implementation stage. However, approaches to implementation of new forms generating data on mental health indicators need to be customised to the specific health system context of different countries. Further work is needed to identify ways to utilise mental health data to monitor and improve the quality of mental health services.Declaration of interestNone.https://www.cambridge.org/core/product/identifier/S2056472419000292/type/journal_articleMental healthcareindicatorsprimary healthcarelow- and middle-income settingshealth information system
spellingShingle Shalini Ahuja
Charlotte Hanlon
Dan Chisholm
Maya Semrau
Dristy Gurung
Jibril Abdulmalik
James Mugisha
Ntokozo Mntambo
Fred Kigozi
Inge Petersen
Rahul Shidhaye
Nawaraj Upadhaya
Crick Lund
Sara Evans-Lacko
Graham Thornicroft
Oye Gureje
Mark Jordans
Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
BJPsych Open
Mental healthcare
indicators
primary healthcare
low- and middle-income settings
health information system
title Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
title_full Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
title_fullStr Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
title_full_unstemmed Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
title_short Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
title_sort experience of implementing new mental health indicators within information systems in six low and middle income countries
topic Mental healthcare
indicators
primary healthcare
low- and middle-income settings
health information system
url https://www.cambridge.org/core/product/identifier/S2056472419000292/type/journal_article
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