Ministry of Health of Mozambique
Local mental health institutions
March 1998 - October 1999
Integrating mental health into general health care at the primary care level, in particular through enhancing psychosocial support.
The national mental health programme in Mozambique has as its main objectives to decrease morbidity for mental and neurological problems with an emphasis on the psychosocial integration of the mentally ill into the community. The strategic elements of this plan are the decentralization of mental health care provision, de-medicalization of intervention through the involvement of the non-health sector, and collaboration with traditional healers.
Many regions in Mozambique are difficult to reach and consequently mental health strategies are either non-existant, weak, or poorly integrated into the community. It is important to create a model for providing mental health care which can then be applied to other 'hard to reach' and neglected regions.
The project will be carried out in Niassa, a region north of the country, which is heavily populated by displaced persons as a result of the war. Within this region the district of Cuamba has been selected as the site for the demonstration project namely because data indicates that it has the highest prevalence of alcohol and cannabis abuse and also because of the excessive demands placed on health care resources due to the existence of a large number of mental health cases but only one rural hospital to serve the community. The specific target population are women and children and the target conditions are violence, somatoform disorders, drug addiction, epilepsy and chronic mental disease.
The objectives of the project are to:
1. Study the social-cultural reality of the district. This will involve undertaking qualitative research to understand better the needs of the local population, social-cultural factors influencing mental health and mental problems, local definitions of mental health suffering and traditional strategies for intervention to deal with mental problems.
2. Train health providers, social workers, community leaders and religious leaders in the recognition of psycho-emotional suffering. 3. Establish a strategy for collaboration with traditional healers.
3. Provide an adequate strategy of intervention, including a regular mental health consultation (rural hospital and 10 health posts) and the displacement of health workers into the community.
4. Improve referral and back-referral mechanisms for mental health care.
The model developed for Cuamba will then be disseminated to other districts of the Niassa region.
These include the number of traditional healers collaborating with the programme; the number of health care providers who received training on mental health; improved skills in identifying persons with mental problems; number of admissions to the rural hospital for mental problems; number of discharges from the hospital; average length of stay in the hospital; and number of health workers and time spent in the community on mental health consultations; eg., home visits.
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