Scaling-up school mental health services in low resource public schools of rural Pakistan: the Theory of Change (ToC) approach.
Scaling-up school mental health services in low resource public schools of rural Pakistan: the Theory of Change (ToC) approach.
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DOI：
10.1186/s13033-021-00435-5
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发表时间：
2021-01-12
影响因子：
3.6
通讯作者：
Wissow LS
中科院分区：
文献类型：
--
作者：
Hamdani SU;Huma ZE;Suleman N;Warraitch A;Muzzafar N;Farzeen M;Minhas FA;Rahman A;Wissow LS
90%有心理健康问题的儿童生活在低收入或中等收入国家。校本课程提供了早期识别和干预的机会，但实施需要跨部门合作，以确保可持续地提供高质量的培训，持续的监督和大规模的成果监测。在巴基斯坦，35%的学龄儿童有情绪和行为问题。与许多其他中低收入国家一样，必须共同努力开展校本项目的政府机构资源有限，合作历史也有限。“变革理论”（ToC）流程为新合作伙伴提供了一种有效制定共同目标和长期可持续合作前景的方法。在巴基斯坦公立学校建立一个扩大学校心理健康服务的模式。我们使用ToC研讨会来开发一个经验支持的“假设途径”，用于在巴基斯坦农村公立学校实施世卫组织的学校心理健康计划。三个讲习班有90个利益攸关方参加，如教育和卫生部门的决策者、心理健康专家、研究人员、校长、教师和包括非政府组织在内的其他社区利益攸关方。ToC过程将学校心理健康服务的实施者、组织、提供者和消费者联系起来，以制定共同目标，并将其与干预措施（培训、监测和监督教师;与家长、教师和初级卫生保健设施和学校合作）联系起来（改善儿童的社会情感健康、成绩和参与活动）。在这一过程中制定的关键可检验假设包括卫生保健提供者、教育官员和专业人员、社区组织和家庭的支持。例如，教师需要掌握处理儿童问题的技能，但他们的动机可能来自寻求改善学校业绩和工作条件。贫困，耻辱和缺乏儿童心理健康素养的教师，行政管理和家长被确定为关键的假设障碍。儿童及其家庭被确定为使这一方案取得成功的关键利益攸关方。ToC研讨会有助于团队建设，并成为利益攸关方参与的工具。他们帮助开发和支持关于结构，合作和知识的可测试的假设，这些假设对扩大巴基斯坦学校的心理健康服务至关重要。
Ninety percent of children with mental health problems live in low or middle-income countries (LMICs). School-based programs offer opportunities for early identification and intervention, however implementation requires cross-sector collaboration to assure sustainable delivery of quality training, ongoing supervision, and outcomes monitoring at scale. In Pakistan, 35% of school-aged children are reported to have emotional and behavioral problems. As in many other LMICs, the government agencies who must work together to mount school-based programs have limited resources and a limited history of collaboration. The “Theory of Change” (ToC) process offers a way for new partners to efficiently develop mutual goals and long-term prospects for sustainable collaboration. Develop a model for scale-up of school based mental health services in public schools of Pakistan. We used ToC workshops to develop an empirically supported, ‘hypothesized pathway’ for the implementation of WHO’s School Mental Health Program in the public schools of rural Pakistan. Three workshops included 90 stakeholders such as policy makers from education and health departments, mental health specialists, researchers, head teachers, teachers and other community stakeholders including non-governmental organizations. The ToC process linked implementers, organizations, providers and consumers of school mental health services to develop common goals and relate them (improved child socioemotional wellbeing, grades and participation in activities) to interventions (training, monitoring and supervision of teachers; collaboration with parents, teachers and primary health care facilities and schools). Key testable assumptions developed in the process included buy-in from health care providers, education officials and professionals, community-based organizations and families. For example, teachers needed skills for managing children’s problems, but their motivation might come from seeking improved school performance and working conditions. Poverty, stigma and lack of child mental health literacy among teachers, administration, and parents were identified as key hypothesized barriers. Children and their families were identified as key stakeholders to make such a program successful. ToC workshops assisted in team building and served as a stakeholders’ engagement tool. They helped to develop and support testable hypotheses about the structures, collaborations, and knowledge most important to scaling-up school based mental health services in Pakistan.
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影响因子：
4.5
作者：
Barry MM;Clarke AM;Jenkins R;Patel V
通讯作者：
Patel V
DOI：
10.1186/1748-5908-8-117
发表时间：
2013-10-02
期刊：
Implementation science : IS
影响因子：
--
作者：
Chambers DA;Glasgow RE;Stange KC
通讯作者：
Stange KC
影响因子：
2.6
作者：
Wissow, Lawrence S.;van Ginneken, Nadja;Rahman, Atif
通讯作者：
Rahman, Atif
影响因子：
1
作者：
Prinsen, Gerard;Nijhof, Saskia
通讯作者：
Nijhof, Saskia
影响因子：
4.3
作者：
Syed, Ehsan Ullah;Hussein, Sajida Abdul;Haidry, Sana-e-Zehra
通讯作者：
Haidry, Sana-e-Zehra