Closing the gap: decentralising mental health care to primary care centres in one rural district of Rwanda
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JournalPublic Health Action
AbstractSetting: Programmes that integrate mental health care into primary care settings could reduce the global burden of mental disorders by increasing treatment availability in resource-limited settings, including Rwanda. Objective: We describe patient demographics, service use and retention of patients in care at health centres (HC) participating in an innovative primary care integration programme, compared to patients using existing district hospital-based specialised out-patient care. Design: This was a retrospective cohort study using routinely collected data from six health centres and one district hospital from October 2014 to March 2015. Results: Of 709 patients, 607 were cared for at HCs; HCs accounted for 88% of the total visits for mental disorders. Patients with psychosis used HC services more frequently, while patients with affective disorders were seen more frequently at the district hospital. Of the 68% of patients who returned to care within 90 days of their first visit, 76% had a third visit within a further 90 days. There were no significant differences in follow-up rates between clinical settings. Conclusion: This study suggests that a programme of mentorship for primary care nurses can facilitate the decentralisation of out-patient mental health care from specialised district hospital mental health services to HCs in rural Rwanda.
- Evaluating process and clinical outcomes of a primary care mental health integration project in rural Rwanda: a prospective mixed-methods protocol.
- Authors: Smith SL, Misago CN, Osrow RA, Franke MF, Iyamuremye JD, Dusabeyezu JD, Mohand AA, Anatole M, Kayiteshonga Y, Raviola GJ
- Issue date: 2017 Feb 28
- Impact of a district-wide health center strengthening intervention on healthcare utilization in rural Rwanda: Use of interrupted time series analysis.
- Authors: Iyer HS, Hirschhorn LR, Nisingizwe MP, Kamanzi E, Drobac PC, Rwabukwisi FC, Law MR, Muhire A, Rusanganwa V, Basinga P
- Issue date: 2017
- Reaching rural Africans with eye care services: findings from primary eye care approaches in Rubavu District, Rwanda.
- Authors: Courtright P, Murenzi J, Mathenge W, Munana J, Müller A
- Issue date: 2010 Jun
- The national mental health programme in the United Republic of Tanzania. A report from WHO and DANIDA.
- Authors: Schulsinger F, Jablensky A
- Issue date: 1991
- Baseline assessment of adult and adolescent primary care delivery in Rwanda: an opportunity for quality improvement.
- Authors: Vasan A, Anatole M, Mezzacappa C, Hedt-Gauthier BL, Hirschhorn LR, Nkikabahizi F, Hagenimana M, Ndayisaba A, Cyamatare FR, Nzeyimana B, Drobac P, Gupta N
- Issue date: 2013 Dec 17