Overview of the mental health system in Mozambique: addressing the treatment gap with a task-shifting strategy in primary care.
Overview of the mental health system in Mozambique: addressing the treatment gap with a task-shifting strategy in primary care.
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DOI：
10.1186/s13033-015-0032-8
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发表时间：
2016
影响因子：
3.6
通讯作者：
Mari Jde J
中科院分区：
文献类型：
--
作者：
Dos Santos PF;Wainberg ML;Caldas-de-Almeida JM;Saraceno B;Mari Jde J
莫桑比克已逐渐改变其对心理健康（MH）的行动，从以庇护为中心的长期住院护理转变为社区和初级护理的创新方法。收集有关莫桑比克 MH 系统的重要信息以供决策，提高所提供服务的质量，更新 MH 战略和行动计划。该研究使用 WHO-AIMS 来评估 MH 系统，包括政策和立法、服务组织、初级保健中的 MH、人力资源、公共教育以及与其他部门的联系、监测和研究。通过对比分析，呈现2010年至2014年相关数据的演变。全国有两家精神病医院和综合医院的床位。在此期间，综合医院床位数量保持稳定（203张），精神科医院床位从173张增加到298张。精神卫生门诊设施从83个增加到152个。精神科医生的数量（2010年9人，2014年10人）仍然很低，而心理学家（56-109人）和职业治疗师的数量大幅增加（2-23）。精神科技术人员的数量从 2010 年的 66 名增加到 2014 年的 241 名。这种增加使精神卫生网络从 60 个地区扩大到 135 个地区，这意味着覆盖率从 44% 增加到 100% 的乡村地区。任务转移战略的重点是精神科技术人员和中级专业人员在初级保健中提供的服务，从而扩大了所有乡村地区的精神卫生服务，并缩小了莫桑比克的治疗差距。
Mozambique has gradually changed its action on mental health (MH) from an asylum-centric care with long-term hospitalization to an innovative approach to community and primary care. To collect essential information on Mozambique’s MH system for decision making, to improve quality of services delivered, update MH Strategy and Action Plan. The study used the WHO-AIMS to assess MH systems including policy and legislation, organization of services, MH in primary care, human resources, public education and link with other sectors, monitoring and research. A comparative analysis was conducted to present the evolution of relevant data from 2010 to 2014. There are two psychiatric hospitals in the country and beds in general hospitals. In the period, the number of beds in general hospitals remained stable (203), and the beds in psychiatric hospitals increased from 173 to 298. Mental health outpatient facilities have increased from 83 to 152. The number of psychiatrists (9 in 2010, and 10 in 2014) remained very low, with a significant increase in the number of psychologists (56–109) and occupational therapists (2–23). The number of Psychiatric Technicians has increased from 66 in 2010, to 241 in 2014. This increase allowed the mental health network to expand from 60 to 135 Districts, meaning an increase of coverage from 44 to 100 % of the country districts. The task-shifting strategy focused on services delivered in primary care by psychiatric technicians, mid-level professionals, allowed the expansion of mental health services for all the country districts and the reduction of treatment gap in Mozambique.