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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A task shifting approach to primary mental health care for adults in South Africa: Human resource requirements and costs for rural settings
Health Policy and Planning, Volume 27, No. 1, Year 2012
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Description
Background A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved.Aim This study aims to calculate and cost a hypothetical human resource mix required to populate a framework for district adult mental health services. This framework embraces the concept of task shifting, where dedicated low cost mental health workers at the community and clinic levels supplement integrated care.Method The expected number and cost of human resources was based on: (a) assumptions of service provision derived from existing services in a sub-district demonstration site and a literature review of evidence-based packages of care in low- and middle-income countries; and (b) assumptions of service needs derived from other studies.Results For a nominal population of 100000, minimal service coverage estimates of 50 for schizophrenia, bipolar affective disorder, major depressive disorder and 30 for post-traumatic stress disorder and maternal depression would require that the primary health care staffing package include one post for a mental health counsellor or equivalent and 7.2 community mental health worker posts. The cost of these personnel amounts to £28457 per 100000 population. This cost can be offset by a reduction in the number of other specialist and non-specialist health personnel required to close service gaps at primary care level.Conclusion The adoption of the concept of task shifting can substantially reduce the expected number of health care providers otherwise needed to close mental health service gaps at primary health care level in South Africa at minimal cost and may serve as a model for other middle-income countries. © 2011 The Author; all rights reserved.
Authors & Co-Authors
Petersen, Inge
South Africa, Durban
University of Kwazulu-natal
Lund, Crick
South Africa, Cape Town
University of Cape Town
Bhana, Arvin
South Africa, Durban
University of Kwazulu-natal
South Africa, Pretoria
Human Sciences Research Council of South Africa
Flisher, Alan J.
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 152
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1093/heapol/czr012
e-ISSN:
14602237
Research Areas
Health System And Policy
Maternal And Child Health
Mental Health
Study Design
Cross Sectional Study
Study Approach
Systematic review
Study Locations
South Africa