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Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia

Author

Listed:
  • Medhin Selamu
  • Laura Asher
  • Charlotte Hanlon
  • Girmay Medhin
  • Maji Hailemariam
  • Vikram Patel
  • Graham Thornicroft
  • Abebaw Fekadu

Abstract

Background: The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. Method: We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. Results: The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. Discussion: The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention.

Suggested Citation

  • Medhin Selamu & Laura Asher & Charlotte Hanlon & Girmay Medhin & Maji Hailemariam & Vikram Patel & Graham Thornicroft & Abebaw Fekadu, 2015. "Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0126666
    DOI: 10.1371/journal.pone.0126666
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    References listed on IDEAS

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    1. Padmanathan, Prianka & De Silva, Mary J., 2013. "The acceptability and feasibility of task-sharing for mental healthcare in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 97(C), pages 82-86.
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    4. Crick Lund & Mark Tomlinson & Mary De Silva & Abebaw Fekadu & Rahul Shidhaye & Mark Jordans & Inge Petersen & Arvin Bhana & Fred Kigozi & Martin Prince & Graham Thornicroft & Charlotte Hanlon & Ritsuk, 2012. "PRIME: A Programme to Reduce the Treatment Gap for Mental Disorders in Five Low- and Middle-Income Countries," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-6, December.
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    1. Mayssa Rekhis & Abir Ben Hamouda & Sami Ouanes & Rym Rafrafi, 2017. "Rights of people with mental disorders: Realities in healthcare facilities in Tunisia," International Journal of Social Psychiatry, , vol. 63(5), pages 439-447, August.
    2. Laura Asher & Abebaw Fekadu & Charlotte Hanlon & Gemechu Mideksa & Julian Eaton & Vikram Patel & Mary J De Silva, 2015. "Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.

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