Health care models guiding mental health policy in Kenya 1965-1997
Health care models guiding mental health policy in Kenya 1965-1997
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DOI：
10.1186/1752-4458-4-9
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发表时间：
2010-01-01
影响因子：
3.6
通讯作者：
Jenkins, Rachel
中科院分区：
文献类型：
--
作者：
Muga, Florence A.;Jenkins, Rachel
背景：需要制定精神卫生政策来制定一个国家提供精神卫生服务的战略和方向。然而，政策的制定并不是在真空中进行的，而是受到卫生部门和其他部门的当地和国际因素的影响。 方法：本研究于 1997 年进行，旨在考察在国际卫生和发展概念不断变化的背景下，肯尼亚 1965 年至 1997 年间精神卫生政策的演变。对政策文件的定性内容分析与关键政策制定者的访谈相结合。 结果：研究表明，1965-1997年期间，肯尼亚的通用卫生政策从1960年代和1970年代基于医疗模式的政策转变为1970年代末和1980年代基于初级卫生保健模式的政策，最后转变为基于1990年代卫生保健市场模式的政策。另一方面，精神卫生政策从20世纪60年代基于医疗模式的政策演变为基于20世纪90年代初级卫生保健模式的政策，但并未拥抱医疗保健的市场模式。这导致了 20 世纪 90 年代的情况，即精神卫生政策植根于与本应实施的一般卫生政策不同的概念模型。这种“模范混乱”可能阻碍了肯尼亚精神卫生政策的实施。结论：将国家精神卫生政策与一般卫生政策和其他部门政策相结合是适当的，目前正在进行中。
Background: Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors.Methods: This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers.Results: The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya.Conclusions: Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.