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

Ahuja, Shalini, Hanlon, Charlotte, Chisholm, Dan, Semrau, Maya, Gurung, Dristy, Abdulmalik, Jibril, Mugisha, James, Mntambo, Ntokozo, Kigozi, Fred, Petersen, Inge, Shidhaye, Rahul, Upadhaya, Nawaraj, Lund, Crick, Evans-Lacko, Sara, Thornicroft, Graham, Oye, Gureje and Jordans, Mark (2019) Experience of implementing new mental health indicators within information systems in six low- and middle-income countries. BJPsych Open, 5 (5). e71. ISSN 2056-4724

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Abstract

Background
Successful scale up of integrated primary mental health care 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.

Aims
To 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).

Method
A qualitative study using semi-structured key informant interviews (n=128) was conducted. The ‘Performance of Routine Information Systems’ framework for assessing the performance of the implementation of new forms to measure mental health indicators served as the basis of a coding framework covering three main categories: (1) technical; (2) organisation; and (3) behavioural determinants.

Results
Most 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.

Conclusion
Use 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 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.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups: Brighton and Sussex Centre for Global Health Research
Subjects: R Medicine
Depositing User: Deborah Miller
Date Deposited: 14 May 2019 15:08
Last Modified: 21 Aug 2019 14:30
URI: http://sro.sussex.ac.uk/id/eprint/83554

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