Collaborative Care for Mental Health in Low- and Middle-Income Countries: A WHO Health Systems Framework Assessment of Three Programs
Collaborative Care for Mental Health in Low- and Middle-Income Countries: A WHO Health Systems Framework Assessment of Three Programs
复制标题
DOI：
10.1176/appi.ps.201700232
复制
发表时间：
2017-09-01
影响因子：
3.8
通讯作者：
Chwastiak, Lydia A.
中科院分区：
文献类型：
--
作者：
Acharya, Bibhav;Ekstrand, Maria;Chwastiak, Lydia A.
协作护理模式是针对行为和其他慢性疾病的循证干预措施，有可能解决全球精神疾病的巨大负担。作者利用世界卫生组织卫生系统框架，提出了在低收入和中等收入国家（LMIC）实施这一模式的挑战，并根据三个大规模项目的经验讨论了应对这些挑战的战略：一项在尼泊尔农村地区一级政府医院进行的实施研究，一项在印度农村50个初级卫生中心进行的临床试验，还有一项在印度的四个糖尿病诊所进行的研究。可以利用几种战略来解决执行方面的挑战，提高中低收入国家的可扩展性，包括调动社区资源，参与宣传，加强整体医疗保健提供系统。
The collaborative care model is an evidence-based intervention for behavioral and other chronic conditions that has the potential to address the large burden of mental illness globally. Using the World Health Organization Health Systems Framework, the authors present challenges in implementing this model in low-and middle-income countries (LMICs) and discuss strategies to address these challenges based on experiences with three large-scale programs: an implementation research study in a district-level government hospital in rural Nepal, one clinical trial in 50 primary health centers in rural India, and one study in four diabetes clinics in India. Several strategies can be utilized to address implementation challenges and enhance scalability in LMICs, including mobilizing community resources, engaging in advocacy, and strengthening the overall health care delivery system.