Cristin-resultat-ID: 1662612
Sist endret: 6. mars 2019, 15:22
NVI-rapporteringsår: 2018
Resultat
Vitenskapelig artikkel
2018

Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

Bidragsytere:
  • Angela Akol
  • Fredrick Makumbi
  • Juliet Ndimwibo Babirye
  • Joyce Nalugya
  • Sylvia Nshemereirwe og
  • Ingunn Marie S. Engebretsen

Tidsskrift

Global Mental Health (GMH)
ISSN 2054-4251
e-ISSN 2054-4251
NVI-nivå 1

Om resultatet

Vitenskapelig artikkel
Publiseringsår: 2018
Publisert online: 2018
Volum: 5
Sider: e29
Open Access

Beskrivelse Beskrivelse

Tittel

Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

Sammendrag

Background: Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle-income countries, but PHC providers have limited ability to detect CAMH disorders. We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda. Methods: Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n = 18) to control (n = 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher's exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056). Results: Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1-18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics' non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm, p = 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31-4.68); p = 0.005]. Conclusion: In this setting, mhGAP CAMH training of PHC providers increases PHC clinics' identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance.

Bidragsytere

Angela Akol

  • Tilknyttet:
    Forfatter
    ved Institutt for global helse og samfunnsmedisin ved Universitetet i Bergen

Fredrick Makumbi

  • Tilknyttet:
    Forfatter
    ved Makerere University

Juliet Ndimwibo Babirye

  • Tilknyttet:
    Forfatter
    ved Makerere University

Joyce Nalugya

  • Tilknyttet:
    Forfatter
    ved Mulago Hospital

Sylvia Nshemereirwe

  • Tilknyttet:
    Forfatter
    ved Butabika National Psychiatric Referral Hospital
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