Barriers and drivers to capacity-building in global mental health projects.
Barriers and drivers to capacity-building in global mental health projects.
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DOI：
10.1186/s13033-020-00420-4
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发表时间：
2020-12-03
影响因子：
3.6
通讯作者：
Murphy J
中科院分区：
文献类型：
--
作者：
Endale T;Qureshi O;Ryan GK;Esponda GM;Verhey R;Eaton J;De Silva M;Murphy J
全球精神卫生工作者短缺是实施和扩大精神卫生服务的重大障碍。部分由于这种短缺，低收入和中等收入国家大约 85% 患有精神、神经和药物滥用疾病的人无法得到护理。因此，制定和实施可扩展的精神卫生能力建设解决方案已被确定为全球精神卫生的优先事项。为全球心理健康能力建设提供最佳实践的证据仍然有限。作为影响低收入和中等收入国家心理健康项目实施因素的四篇论文系列中的一篇，本文反思了加拿大重大挑战资助的全球心理健康受赠者的经验，重点关注能力建设的障碍和驱动因素。 2014 年 6 月至 2017 年 5 月期间，通过有目的抽样的方式招募了现任或前任加拿大全球心理健康大挑战受资助者。 N = 29 名受资助者参加了半结构化定性访谈，代表中美洲和加勒比地区 (n = 4)、南美洲 (n = 1)、西非 (n = 4)、东非 (n = 6)、南亚 (n = 11) 和东南亚 (n = 3) 的项目。根据使用组合级变革理论框架对项目成果进行定量分析的结果，确定了对实施成功至关重要的六个关键主题。作为更大规模的多方法研究的一部分，本文利用框架分析来探讨与能力建设相关的主题。研究参与者描述了三大主题中能力建设的障碍和促进因素：(1) 培训，(2) 监督，(3) 质量保证。贯穿这些主题领域的是背景理解、人力资源和可持续性等交叉主题。此外，与会者还描述了成功能力建设的方法和机制。这项研究证明了能力建设对全球心理健康研究和实施的重要性、其与利益相关者参与和服务提供的关系，以及对资助者、实施者和研究人员的影响。对形成性研究、背景理解、利益相关者参与、政策影响以及融入现有教育和服务提供系统的投资对于能力建设工作的成功至关重要。
The global shortage of mental health workers is a significant barrier to the implementation and scale-up of mental health services. Partially as a result of this shortage, approximately 85% of people with mental, neurological and substance-use disorders in low- and middle-income countries do not receive care. Consequently, developing and implementing scalable solutions for mental health capacity-building has been identified as a priority in global mental health. There remains limited evidence to inform best practices for capacity building in global mental health. As one in a series of four papers on factors affecting the implementation of mental health projects in low- and middle-income countries, this paper reflects on the experiences of global mental health grantees funded by Grand Challenges Canada, focusing on the barriers to and drivers of capacity-building. Between June 2014 and May 2017, current or former Grand Challenges Canada Global Mental Health grantees were recruited using purposive sampling. N = 29 grantees participated in semi-structured qualitative interviews, representing projects in Central America and the Caribbean (n = 4), South America (n = 1), West Africa (n = 4), East Africa (n = 6), South Asia (n = 11) and Southeast Asia (n = 3). Based on the results of a quantitative analysis of project outcomes using a portfolio-level Theory of Change framework, six key themes were identified as important to implementation success. As part of a larger multi-method study, this paper utilized a framework analysis to explore the themes related to capacity-building. Study participants described barriers and facilitators to capacity building within three broad themes: (1) training, (2) supervision, and (3) quality assurance. Running throughout these thematic areas were the crosscutting themes of contextual understanding, human resources, and sustainability. Additionally, participants described approaches and mechanisms for successful capacity building. This study demonstrates the importance of capacity building to global mental health research and implementation, its relationship to stakeholder engagement and service delivery, and the implications for funders, implementers, and researchers alike. Investment in formative research, contextual understanding, stakeholder engagement, policy influence, and integration into existing systems of education and service delivery is crucial for the success of capacity building efforts.
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影响因子：
3.6
作者：
Epping-Jordan, JoAnne E.;van Ommeren, Mark;Saxena, Shekhar
通讯作者：
Saxena, Shekhar
DOI：
10.1017/gmh.2017.3
发表时间：
2017
期刊：
Global mental health (Cambridge, England)
影响因子：
--
作者：
Davies T;Lund C
通讯作者：
Lund C
影响因子：
168.9
作者：
Kakuma, Ritsuko;Minas, Harry;Scheffler, Richard M.
通讯作者：
Scheffler, Richard M.
影响因子：
2.8
作者：
Kpobi L;Swartz L;Ofori-Atta AL
通讯作者：
Ofori-Atta AL
影响因子：
64.8
作者：
Collins, Pamela Y.;Patel, Vikram;Joestl, Sarah S.;March, Dana;Insel, Thomas R.;Daar, Abdallah S.
通讯作者：
Daar, Abdallah S.