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Published in: International Journal of Mental Health Systems 1/2010

Open Access 01-12-2010 | Research

An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS)

Authors: Fred Kigozi, Joshua Ssebunnya, Dorothy Kizza, Sara Cooper, Sheila Ndyanabangi, the Mental Health and Poverty Project

Published in: International Journal of Mental Health Systems | Issue 1/2010

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Abstract

Background

The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda.

Methods

A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS) Version 2.2.

Results

Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC). The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health), and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population). Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry.

Conclusion

Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.
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Literature
1.
go back to reference State of Uganda Population Report 2006: Linking Population, Energy and Environment: a critical pathway to poverty eradication and sustainable development. 2006, United Nations Population Fund. Kampala State of Uganda Population Report 2006: Linking Population, Energy and Environment: a critical pathway to poverty eradication and sustainable development. 2006, United Nations Population Fund. Kampala
2.
go back to reference State of Uganda Population Report 2007: Planned Urbanization for Uganda's Growing Population. 2007, United Nations Population Fund. Kampala State of Uganda Population Report 2007: Planned Urbanization for Uganda's Growing Population. 2007, United Nations Population Fund. Kampala
3.
go back to reference Uganda National Household Survey 2005/06: Report on the Socioeconomic Module. 2006, Uganda Bureau of Statistics. Kampala Uganda National Household Survey 2005/06: Report on the Socioeconomic Module. 2006, Uganda Bureau of Statistics. Kampala
4.
go back to reference World Development Report 2007: Development and the next generation. 2007, World Bank, Washington DC World Development Report 2007: Development and the next generation. 2007, World Bank, Washington DC
5.
go back to reference Poverty Eradication Action Plan 2005/6 - 2007/8. Ministry of Finance, Planning and Economic Development. Kampala, Uganda. 2004 Poverty Eradication Action Plan 2005/6 - 2007/8. Ministry of Finance, Planning and Economic Development. Kampala, Uganda. 2004
6.
go back to reference Flisher AJ, Lund C, Funk M, Banda M, Bhana A, Doku V, Drew N, Kigozi FN, Knapp M, Omar M, Petersen I, Green A: Mental health policy development and implementation in four African countries. Journal of Health Psychology. 2007, 12: 505-516. 10.1177/1359105307076237.CrossRefPubMed Flisher AJ, Lund C, Funk M, Banda M, Bhana A, Doku V, Drew N, Kigozi FN, Knapp M, Omar M, Petersen I, Green A: Mental health policy development and implementation in four African countries. Journal of Health Psychology. 2007, 12: 505-516. 10.1177/1359105307076237.CrossRefPubMed
7.
go back to reference Lund C, Breen A, Flisher AJ, Swartz L, Joska J, Corrigall J, et al: Mental health and poverty: A systematic review of the research in low and middle income countries. The Journal of Mental Health Policy and Economics. 2007, 10 (Supplement 1): S26-S27. Lund C, Breen A, Flisher AJ, Swartz L, Joska J, Corrigall J, et al: Mental health and poverty: A systematic review of the research in low and middle income countries. The Journal of Mental Health Policy and Economics. 2007, 10 (Supplement 1): S26-S27.
8.
go back to reference Saraceno B, Levav I, Kohn R: The public mental health significance of research on socio-economic factors in schizophrenia and major depression. World Psychiatry. 2005, 4: 181-185.PubMedCentralPubMed Saraceno B, Levav I, Kohn R: The public mental health significance of research on socio-economic factors in schizophrenia and major depression. World Psychiatry. 2005, 4: 181-185.PubMedCentralPubMed
9.
go back to reference Patel V, Kleinman A: Poverty and common mental disorders in developing countries. Bulletin of World Health Organization. 2003, 81: 609-615. Patel V, Kleinman A: Poverty and common mental disorders in developing countries. Bulletin of World Health Organization. 2003, 81: 609-615.
10.
go back to reference Health Sector Strategic Plan I. 2000, Ministry of Health. Kampala, Uganda Health Sector Strategic Plan I. 2000, Ministry of Health. Kampala, Uganda
11.
go back to reference Health Sector Strategic Plan II. 2005, Ministry of Health. Kampala, Uganda Health Sector Strategic Plan II. 2005, Ministry of Health. Kampala, Uganda
12.
go back to reference Flisher AJ, Lund C: The mental health and poverty project: Some preliminary findings. Mental Health Reforms. 2009, 1: 11-13. Flisher AJ, Lund C: The mental health and poverty project: Some preliminary findings. Mental Health Reforms. 2009, 1: 11-13.
13.
go back to reference Ndyanabangi S, Basangwa D, Lutakome J, Mubiru C: Uganda mental health country profile. International Review of Psychiatry. 2004, 16 (1-2): 54-62. 10.1080/09540260310001635104.CrossRefPubMed Ndyanabangi S, Basangwa D, Lutakome J, Mubiru C: Uganda mental health country profile. International Review of Psychiatry. 2004, 16 (1-2): 54-62. 10.1080/09540260310001635104.CrossRefPubMed
14.
go back to reference World Health Organization: World Health Organization Assessment Instrument for Mental Health Systems. 2005, Geneva: World Health Organization World Health Organization: World Health Organization Assessment Instrument for Mental Health Systems. 2005, Geneva: World Health Organization
15.
go back to reference World Health Organization: The World Health Report 2001 - Mental Health: new understanding, new hope. 2001, Geneva: World Health Organization World Health Organization: The World Health Report 2001 - Mental Health: new understanding, new hope. 2001, Geneva: World Health Organization
17.
go back to reference World Health Organization: Mental Health Atlas. 2005, Geneva: World Health Organization World Health Organization: Mental Health Atlas. 2005, Geneva: World Health Organization
18.
go back to reference Bossert TJ, Beauvais JC: Decentralization of health systems in Ghana, Zambia, Uganda and Philippines: a comparative analysis of decision space. Health Policy and Planning. 2002, 17 (1): 14-31. 10.1093/heapol/17.1.14.CrossRefPubMed Bossert TJ, Beauvais JC: Decentralization of health systems in Ghana, Zambia, Uganda and Philippines: a comparative analysis of decision space. Health Policy and Planning. 2002, 17 (1): 14-31. 10.1093/heapol/17.1.14.CrossRefPubMed
19.
go back to reference Horton R: Launching a new movement for mental health. Lancet. 2007, 370: 806-10.1016/S0140-6736(07)61243-4.CrossRefPubMed Horton R: Launching a new movement for mental health. Lancet. 2007, 370: 806-10.1016/S0140-6736(07)61243-4.CrossRefPubMed
20.
go back to reference Jacob KS, Sharan P, Mirza I, Garrido-Cumbrera M, Seedat S, Mari JJ, Sreenivas V, Saxena S: Mental health systems in countries: Where are we now?. The Lancet. 2007, 370: 1061-1077. 10.1016/S0140-6736(07)61241-0.CrossRef Jacob KS, Sharan P, Mirza I, Garrido-Cumbrera M, Seedat S, Mari JJ, Sreenivas V, Saxena S: Mental health systems in countries: Where are we now?. The Lancet. 2007, 370: 1061-1077. 10.1016/S0140-6736(07)61241-0.CrossRef
21.
go back to reference Knapp M, Funk M, Curran C, Prince M, Grigg M, McDaid D: Economic barriers to better mental health practice and policy. Health Policy and Planning. 2006, 21 (3): 157-170. 10.1093/heapol/czl003.CrossRefPubMed Knapp M, Funk M, Curran C, Prince M, Grigg M, McDaid D: Economic barriers to better mental health practice and policy. Health Policy and Planning. 2006, 21 (3): 157-170. 10.1093/heapol/czl003.CrossRefPubMed
22.
go back to reference Basic Needs Uganda: Social Stigma and Mental Health in Uganda. 2005, Kampala: Basic Needs U.K in Uganda Basic Needs Uganda: Social Stigma and Mental Health in Uganda. 2005, Kampala: Basic Needs U.K in Uganda
24.
go back to reference McIntyre D, Gilson L: Equitable health care financing and poverty challenges in the African context. 2005, Paper Presented to Forum 9, Global Forum for Health Research, Mumbai McIntyre D, Gilson L: Equitable health care financing and poverty challenges in the African context. 2005, Paper Presented to Forum 9, Global Forum for Health Research, Mumbai
25.
go back to reference Beattie A, Doherty J, Gilson L, Lambo E, Shaw P: Implementing Health Financing Reforms in Southern Africa. Sustainable health care financing in Southern Africa. Edited by: Beattie A, Doherty J, Gilson L, Lambo E, Shaw P. 1998, Washington DC: World Bank, full_text.CrossRef Beattie A, Doherty J, Gilson L, Lambo E, Shaw P: Implementing Health Financing Reforms in Southern Africa. Sustainable health care financing in Southern Africa. Edited by: Beattie A, Doherty J, Gilson L, Lambo E, Shaw P. 1998, Washington DC: World Bank, full_text.CrossRef
26.
go back to reference Kohn R, Saxena S, Levav , Saraceno B: The treatment gap in mental health care. Bulletin of the World Health Organization. 2004, 82: 858-866.PubMedCentralPubMed Kohn R, Saxena S, Levav , Saraceno B: The treatment gap in mental health care. Bulletin of the World Health Organization. 2004, 82: 858-866.PubMedCentralPubMed
27.
go back to reference Saxena S, Thornicroft G, Knapp M, Whiteford HA: Resources for mental health: scarcity, inequity and inefficiency. Lancet. 2007, 370: 878-889. 10.1016/S0140-6736(07)61239-2.CrossRefPubMed Saxena S, Thornicroft G, Knapp M, Whiteford HA: Resources for mental health: scarcity, inequity and inefficiency. Lancet. 2007, 370: 878-889. 10.1016/S0140-6736(07)61239-2.CrossRefPubMed
28.
go back to reference Patel V, Flisher AJ, Hetrick S, McGorry P: Mental Health of Young People: a global public-health challenge. Lancet. 2007, 369 (9569): 1251-1252. 10.1016/S0140-6736(07)60368-7.CrossRef Patel V, Flisher AJ, Hetrick S, McGorry P: Mental Health of Young People: a global public-health challenge. Lancet. 2007, 369 (9569): 1251-1252. 10.1016/S0140-6736(07)60368-7.CrossRef
29.
go back to reference Kleintjes S, Lund C, Flisher AJ: A situational analysis of child and adolescent mental health services in Ghana, Uganda, South Africa and Zambia. African Journal of Psychiatry. Kleintjes S, Lund C, Flisher AJ: A situational analysis of child and adolescent mental health services in Ghana, Uganda, South Africa and Zambia. African Journal of Psychiatry.
31.
go back to reference World Health Organization: Mental health legislation & human rights (Mental health policy and service guidance package). 2003, Geneva: World Health Organization World Health Organization: Mental health legislation & human rights (Mental health policy and service guidance package). 2003, Geneva: World Health Organization
Metadata
Title
An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS)
Authors
Fred Kigozi
Joshua Ssebunnya
Dorothy Kizza
Sara Cooper
Sheila Ndyanabangi
the Mental Health and Poverty Project
Publication date
01-12-2010
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2010
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/1752-4458-4-1

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