Zambia mental health country profile
Zambia mental health country profile
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DOI：
10.1080/09540260310001635113
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发表时间：
2004-02-01
影响因子：
2.8
通讯作者：
Bowa, AC
中科院分区：
文献类型：
--
作者：
Mayeya, J;Chazulwa, R;Bowa, AC
赞比亚的国家概况是在1998年至2002年间编制的。这项活动的目标首先是使赞比亚的决策者、其他关键决策者和领导人获得有关赞比亚心理健康的信息，以协助制定政策和服务。第二，促进国家间精神卫生服务的比较分析。这项工作包括组成一个专家核心小组，负责协调从赞比亚各组织收集资料的工作。这些信息后来被分享给广泛的利益攸关方，以达成共识。一系列焦点小组讨论（fgd）补充了收集到的信息。在赞比亚，影响心理健康的因素有很多。从赞比亚的角度来看，很明显，社会、人口、经济、政治、环境、文化和宗教影响到人民的心理健康。赞比亚人口1030万，年增长率2.9%，是撒哈拉以南非洲城市化程度最高的国家之一。1998年的贫困水平为72.9%。就失业率而言，城市化程度最高的省份、卢萨卡（首都）和铜带地区受到的影响最大。国内生产总值（GDP）为30.9亿美元，人均收入为300美元。2002年卫生预算拨款总额为15%，而卫生支出占人均国内生产总值的比例为5.6%。艾滋病毒/艾滋病在15-49岁育龄群体中的流行率为20%。邻国的政治不稳定和战争导致难民大量涌入。影响该国的环境因素包括自然灾害和人为灾害，如洪水和干旱、矿难和森林砍伐。在很大程度上，在赞比亚，患有精神疾病的人受到侮辱、恐惧、蔑视、羞辱和谴责。然而，照顾老年人的精神疾病是积极的看法。照顾老人传统上是大家庭的义务和责任。性别暴力（GBV）是另一个问题。经济上完全依赖配偶的妇女由于环境的原因被迫继续生活在受虐待的关系中，损害了她们的精神健康。在赞比亚，家庭被认为是神圣不可侵犯的，家庭成员的事务是私人的。在这种情况下，GB V被视为家庭事务，因此是私人事务，但殴打配偶导致抑郁，在某些情况下导致死亡。在精神病服务方面，全国有近560张精神病患者床位。在赞比亚发现的常见精神障碍是急性精神病发作、精神分裂症、情感障碍、与酒精有关的问题和器质性脑综合征。大约70-80%有精神健康问题的人在向传统健康从业者寻求帮助之前会咨询传统健康从业者。随着时间的推移，一线精神卫生工作者和专业人员的数量一直在下降。这是由于人才流失、退休、死亡和培训机构产出低造成的。对于执业精神科医生，全国只有一个。其他关键的精神卫生工作者，如心理学家、社会工作者和职业治疗师也供不应求。总而言之，赞比亚的精神卫生服务状况可以说是危急的，需要紧急关注。
This country profile for Zambia was compiled between 1998 and 2002. The objectives of the exercise were to first of all avail policymakers, other key decision makers and leaders in Zambia, information about mental health in Zambia in order to assist policy and services development. Secondly, to facilitate comparative analyses of mental health services between countries. The work involved formation of a core group of experts who coordinated the collection of information from the various organizations in Zambia. The information was later shared to a broad spectrum of stakeholders for consensus. A series of focus group discussions (FGDs) supplemented the information collected. There are various factors that contribute to mental health in Zambia. It is clear from the Zambian perspective that social, demographic, economic, political, environmental, cultural and religious influences affect the mental health of the people. With a population of 10.3 million and annual growth rate of 2.9%, Zambia is one of the most urbanized countries in sub-Saharan Africa. Poverty levels stood at 72.9% in 1998. In terms of unemployment, the most urbanized provinces, Lusaka (the capital city), and the copper-belt are the most affected. The gross domestic product (GDP) is US$3.09 billion dollars while per capita income is US$300. The total budget allocation for health in the year 2002 was 15% while the proportion of the GDP per capita expenditure for health was 5.6%. The HIV/AIDS prevalence rates stand at 20% among the reproductive age group 15-49 years. Political instability and wars in neighbouring states has resulted in an influx of refugees. Environmental factors affecting the country include natural and man-made disasters such as floods and drought, mine accidents, and deforestation. To a large extent in Zambia, people who are mentally ill are stigmatized, feared, scorned at, humiliated and condemned. However, caring for mental ill health in old age is positively perceived. It is traditionally the duty and responsibility of the extended family to look after the aged. Gender based violence (GBV) is another issue. Women, who are totally dependent on their spouses economically, are forced by circumstances to continue living in abusive relationships to the detriment of their mental well-being. In Zambia, the family is considered sacrosanct and the affairs of the family members, private. It is within this context that GB V is regarded as a family affair and therefore a private affair, yet spouse beating has led to depression and in some cases death. In terms of psychiatric services, there are close to 560 beds for psychiatric patients across the country. Common mental disorders found in Zambia are acute psychotic episodes, schizophrenia, affective disorders, alcohol related problems and organic brain syndromes. About 70-80% of people with mental health problems consult traditional health practitioners before they seek help from conventional health practitioners. Over time the number of frontline mental health workers and professional staff has been declining. This is due to the 'brain drain, retirement, death and low output from training institutions. For practicing psychiatrists, only one is available for the whole country. Other key mental health workers such as psychologists, social workers and occupational therapists are also in short supply. All in all, the mental health services situation in Zambia could be described as critical, requiring urgent attention.