Key influences in the design and implementation of mental health information systems in Ghana and South Africa
Introduction Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is lim...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2016-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425116000030/type/journal_article |
| _version_ | 1811156148349304832 |
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| author | S. Ahuja T. Mirzoev C. Lund A. Ofori-Atta S. Skeen A. Kufuor |
| author_facet | S. Ahuja T. Mirzoev C. Lund A. Ofori-Atta S. Skeen A. Kufuor |
| author_sort | S. Ahuja |
| collection | DOAJ |
| description |
Introduction
Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa.
Methods
We report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews with key stakeholders and reviews of key documents and secondary data from the improved MHIS. We analyzed the qualitative data using a framework approach.
Results
Key components of the MHIS intervention involved the introduction of a redesigned patient registration form, entry into computers for analysis every 2 months by clinical managerial staff, and utilization of data in hospital management meetings in three psychiatric hospitals in Ghana; and the introduction of a new set of mental health indicators and related forms and tally sheets at primary care clinics and district hospitals in five districts in the KwaZulu-Natal and Northern Cape provinces in South Africa. Overall, the key stakeholders perceived the MHIS strengthening as an effective intervention in both countries with an enhanced set of indicators in South Africa and introduction of a computerized system in Ghana.
Discussion
Influences on the design and implementation of MHIS interventions in Ghana and South Africa relate to resources, working approaches (including degree of consultations during the design stage and communication during implementation stage) and the low priority of mental health. Although the influencing factors represent similar categories, more influences were identified on MHIS implementation, compared with the design stage. Different influences appear to be related within, and across, the MHIS design and implementation and may reinforce or negate each other thus leading to the multiplier or minimization effects. The wider context, similar to other studies, is important in ensuring the success of such interventions.
Conclusion
Future MHIS strengthening interventions can consider three policy implications which emerged from our analysis and experience: enhancing consultations during the intervention design, better consideration of implementation challenges during design, and better recognition of relations between different influences.
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| first_indexed | 2024-04-10T04:46:40Z |
| format | Article |
| id | doaj.art-e4aeb8b6c9814e88a0c5244d57290d88 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-04-10T04:46:40Z |
| publishDate | 2016-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-e4aeb8b6c9814e88a0c5244d57290d882023-03-09T12:35:35ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512016-01-01310.1017/gmh.2016.3Key influences in the design and implementation of mental health information systems in Ghana and South AfricaS. Ahuja0T. Mirzoev1C. Lund2A. Ofori-Atta3S. Skeen4A. Kufuor5Public Health Foundation of India, New Delhi, IndiaNuffield Centre for International Health and Development, University of Leeds, UKDepartment of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, South AfricaUniversity of Ghana Medical School, GhanaDepartment of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, South AfricaUniversity of Ghana Medical School, Ghana Introduction Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa. Methods We report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews with key stakeholders and reviews of key documents and secondary data from the improved MHIS. We analyzed the qualitative data using a framework approach. Results Key components of the MHIS intervention involved the introduction of a redesigned patient registration form, entry into computers for analysis every 2 months by clinical managerial staff, and utilization of data in hospital management meetings in three psychiatric hospitals in Ghana; and the introduction of a new set of mental health indicators and related forms and tally sheets at primary care clinics and district hospitals in five districts in the KwaZulu-Natal and Northern Cape provinces in South Africa. Overall, the key stakeholders perceived the MHIS strengthening as an effective intervention in both countries with an enhanced set of indicators in South Africa and introduction of a computerized system in Ghana. Discussion Influences on the design and implementation of MHIS interventions in Ghana and South Africa relate to resources, working approaches (including degree of consultations during the design stage and communication during implementation stage) and the low priority of mental health. Although the influencing factors represent similar categories, more influences were identified on MHIS implementation, compared with the design stage. Different influences appear to be related within, and across, the MHIS design and implementation and may reinforce or negate each other thus leading to the multiplier or minimization effects. The wider context, similar to other studies, is important in ensuring the success of such interventions. Conclusion Future MHIS strengthening interventions can consider three policy implications which emerged from our analysis and experience: enhancing consultations during the intervention design, better consideration of implementation challenges during design, and better recognition of relations between different influences. https://www.cambridge.org/core/product/identifier/S2054425116000030/type/journal_articleDesignGhanahealth management information systemimplementationmental healthmental health information systemSouth Africa |
| spellingShingle | S. Ahuja T. Mirzoev C. Lund A. Ofori-Atta S. Skeen A. Kufuor Key influences in the design and implementation of mental health information systems in Ghana and South Africa Cambridge Prisms: Global Mental Health Design Ghana health management information system implementation mental health mental health information system South Africa |
| title | Key influences in the design and implementation of mental health information systems in Ghana and South Africa |
| title_full | Key influences in the design and implementation of mental health information systems in Ghana and South Africa |
| title_fullStr | Key influences in the design and implementation of mental health information systems in Ghana and South Africa |
| title_full_unstemmed | Key influences in the design and implementation of mental health information systems in Ghana and South Africa |
| title_short | Key influences in the design and implementation of mental health information systems in Ghana and South Africa |
| title_sort | key influences in the design and implementation of mental health information systems in ghana and south africa |
| topic | Design Ghana health management information system implementation mental health mental health information system South Africa |
| url | https://www.cambridge.org/core/product/identifier/S2054425116000030/type/journal_article |
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