ZAMBIA'S MENTAL HEALTH PATIENTS: VICTIMS OF UNSPEAKABLE INFRASTRUCTURE CHALLENGE IN ZAMBIA'S HEALTH SYSTEM
DOI:
https://doi.org/10.47604/gjhs.1489Keywords:
Mental Health, Infrastructure, Communities, Collateral Damage, Integrated, Society.Abstract
Purpose: This article attempts to examine the critical role that physical health infrastructure and associated facilities play in the delivery of effective integrated primary health care services for mental patients in Zambia. The working definition for "˜physical infrastructure' in the paper relates to wider capacities in form of hospital buildings, bed spaces, medical equipment, and professional healthcare personnel, among other elements that facilitate effective operations of a health facility.
Methodology: This study has used both quantitative and qualitative data from various sources to map the debate on the impact of inadequate infrastructure on mental health patients in Zambia's health system.
Findings: Inadequate health infrastructure has had a negative impact on the well-being of mental health patients and other sectors of the Zambian society. The entire country has only one ill-resourced main hospital, offering mental health services and has been overwhelmed by a combination of insufficient infrastructure and effects of COVID-19 pandemic.
Unique contributions to theory, practice, and policy: For the health reforms to be effective, it is recommended that the conceptual integrated health system in Zambia be anchored on universal allocation of adequate resources and operationalization of mental health policies that genuinely connect with social determinants of mental health issues within communities. The involvement of non-governmental organizations providing an interface between communities and governments should be supported by organizational and multi-institution capacity and coordination. A systems theory informed this study and has been elaboratively discussed in the second chapter of this paper
Downloads
References
Academy of Medical Royal Colleges (2008), Managing Urgent Mental Health Needs in the Acute Trust: A guide by practitioners, for managers and commissioners in England and Wales.
Anderson P, Jan-Llopis E, Hosman C (2011), Reducing the Silent Burden of Impaired Mental Health, Health Promotion International, Vol. 26, (S1), 4-9. DOI: https://doi.org/10.1093/heapro/dar051. Chainama Mental Hospital (2021) Annual Statistical Report. Unpublished
Barut J. K, Dietrich M.S, Zanoni P.A, Sheila H. S (2015) Sense of Belonging and Hope in the Lives of Persons with Schizophrenia. Arch Psychiatr Nurs 30(2) 178-184.
Bindman A.B, Grumback K, Osmond, D (1995), Preventable Hospitalizations and Access to Care. Journal of the American Medical Association Vl. 274, (4), 305-311.
Bird P, Omar M, Doku, V, Lund C, Nsereko R. J, Mwanza, J (2011). Increasing the Priority of Mental Health in Africa: Findings from Qualitative Research in Ghana, South Africa, Uganda and Zambia. Health Policy and Planning. Vol. 26 (5) Pages 357-365, Https://Doi.Org/10.1093/Heapol/Czq078.
Boyer L, Millier A, Perthame E, Aballea S, Auquier P, Toumi M (2013), Quality of Life is Predictive of Relapse in Schizophrenia. BMC Psychiatry Vol. 13, (15), 13-15. doi: 10.1186/1471-244x.
Brett A. R (2016), Improving Health Care by embracing Systems Theory: Editorial Commentary. The Journal of Thoracic and Cardiovascular Surgery. Vol. 152, (2), 593-94 http://dx.doi.org/10.1016/j.jtcvs.2016.03.029
Brickell T. A, Nicholls T. L, Procyshyn R. M, McLean C, Dempster R. J, Lavoie J. A, Sahlstrom K. J, Tomita T. M, and Wang E. (2009), Patient Safety in Mental Health, Edmonton Alberta: Canadian Patient Safety Institute and Ontario Hospital Association.
Broni A.O, Aikins I, Asibey O, Agyemang - Duah P (2014), The Contribution of Transport (road) in Health Care Delivery "A Case Study of Mankranso District Hospital in the Ahafo Ano South District of Ashanti region". British Journals of Marketing Studies Vol.2, (4), 30-51, European Centre for Research Training and Development UK (www.eajournals.org)
Chiu F.P, Tsang H.W (2004), Validation of the Chinese General Self-Efficacy Scale among Individuals with Schizophrenia in Hong Kong. International Journal of Rehabilitation Research, Vol. 27(2):159-61.
Donald L, Myers A.I.A, NCARB (2021), Design Guide for Inpatient Mental Health and Residential Rehabilitation Treatment Program Facilities. US, Department of Veteran Affairs.
Draine J, Salzer M, Culhane D, Hadley T (2002), Poverty, Social Problems, and Serious Mental Illness. Psychiatry Services, Vol. 53 (7):899-902.
Edwige F, Michelle F, Kleintjes S, Ofori-Atta A, Ssbunnya J, Mwanza J, Kim C Flisher A (2011), An Assessment of Mental Health Policy in Ghana, South Africa, Uganda and Zambia. Health Research Policy and Systems Vol.9 (17) Http://Www.Health-Policy-Systems.Com/Content/9/1/17.
Esponda M.G, Ryan G.K, Lockwood E.G, Usmani S, Lee L, Murphy J, Qureshi O, Endele, T, Regan M, Eaton J, De Silva M (2021), Lessons From A Theory of Change-Driven Evaluation of A Global Mental Health Funding Portfolio, International Journal of Mental Health Systems Vol.15 (18) Https://Ijmhs.Biomedcentral.Com/Track/Pdf/10.1186/S13033-021-00442-6.Pdf.
Essien B, Asamoah M. K (2020), Reviewing the Common Barriers to the Mental Healthcare Delivery in Africa, Journal of Religion and Health, Vol.59 (5), 2531-2555.
Fiske D. W. (1949), Consistency of The Factorial Structures of Personality Ratings From Different Sources. Journal of Abnormal and Social Psychology, Vol.44 (3), 329-344. DOI: 10.1037/H0057198.
Galderis S, Heinz A, Kastrup M (2015), Toward a New Definition of Mental Health. World Psychiatry, Vol. 14 (2), 231-233.
Galderis S, Heinz A, Kstrup M, Beezhold J, Sartorius N. A (2017), Proposed New Definition of Mental Health, Psychiatria Polska, Vol. 51(3), 407-411.
Government of Zambia (2010). Vision 2030, Ministry of Finance and National Planning.
Government of Zambia (2017), Seventh National Development Plan 2017-2021, Ministry of National Development Planning, https://zambiaembassy.org/sites/default/files/documents/7NDP_final_07-06-17.pdf.
Government of Zambia (2018). National Health in all Policies Strategic Framework 2017-2021. Ministry of Health.
Greenwood R.M, Stefancic A, Tsemberis S (2013), Pathways Housing First For Homeless Persons with Psychiatric Disabilities: Program Innovation, Research, and Advocacy, Journal of Social Issues Vol. 69(4), 645-663.
Hayhurst K.P, Drake R.J, Massie J.A, Dunn G, Barnes T.R, Jones P.B, Lewis S.W (2013), Improved Quality of Life Over One Year Is Associated With Improved Adherence In Patients With Schizophrenia. European Psychiatry, Vol. 29(3) Doi: 10.1016/J.Eurpsy.
Information for Pierce County Residents (2016), Unattended Mental Health's Impact on Society. Tacoma Pierce county Health Department: Healthy people in Healthy communities. Office of assistant, planning and improvement 3629 South D Street, Tacoma, www.tpchd.org.
Jiyao C, Nusrat F, Kechen R, Chen Z.R, Xu W, Yin A, Chen Z.B, Delios A, Miller S, Wan X, Zhang X.S (2021), The Mental Health Under the COVID-19 Crisis in Africa: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health 18(10604) DOI: 10.3390/ijerph182010604.
Kane, J.C (2017), Testing the Effectiveness of A Trans-diagnostic Treatment Approach in Reducing Violence and Alcohol Abuse among Families in Zambia: Study Protocol of the Violence and Alcohol Treatment (VATU) Trial. Global Mental Health, 4, E18, 1-15. Doi:10.1017/Gmh.2017.10.
Kapur, R. (2020). Significance of Health Infrastructure (unpublished), https://www.researchgate.net/publication/342832865_Significance_of_Health_Infrastructure.
Kukla M, Salyers M.P, Lysaker P.H (2013), Levels of Patient Activation among Adults with Schizophrenia: Associations with Hope, Symptoms, Medication Adherence, and Recovery Attitudes, Journal of Nervous and Mental Disease, Vol. 201(4):339-344. Doi: 10.1097/NMD.0b013e318288e253.
Lake J (2017), Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care, Special Report, https://doi.org/10.7812/TPP/17-024.
Luxon, Linda (2015), Treasurer Infrastructure - The Key to Healthcare Improvement, Editorial, Future Hospital Journal, Vol. 2, (1), 4-7.
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-96.
Mental Health ATLAS (2011). World Health Organization. Geneva.
Ministry of Health Zambia (2019), Prevention and control of Non-communicable Diseases in Zambia: The case for investment.
Mohamed S, Rosenheck, R, Lyketsos C.G, Schneider L.S (2010), Caregiver Burden in Alzheimer Disease: Cross-Sectional and Longitudinal Patient Correlates, Am J Geriatr Psychiatry, Vol.18(10), 917-927.
Moore K.A, Hair E.C, Vandivere S.M, Cameron B, Thomson L, Mcnamara M (2006), Depression among Moms: Prevalence, Predictors, and Outcomes for Children, Research Brief, Publication #2006-1. Washington, DC: Child Trends. Available At: Http://Www.Childtrends.Org/Wpcontent/Uploads/2013/03/Child_Trends-2006_03_31_RB_MomDepression.pdf.
Mudenda S, Mukosha, M, Chiluba M, Munkombwe D, Daka V, Witika A.B, Kampamba M, Chileshe M (2021), Impact of the Coronavirus Disease (COVID-19) on the Mental Health and Physical Activity of Pharmacy Students at the University of Zambia: A Cross-Sectional Study.
Munakampe M.N (2020), Strengthening Mental Health Systems in Zambia. International Journal of Mental Health Systems, Vol.14 (28).
Mwape L, Mweemba P (2010), Strengthening the Health System for Mental Health in Zambia (Policy Brief), Lusaka, Zambia: The Zambia Forum for Health Research.
Mwape L, Mweemba P, Kasonde J (2012), Strengthening the Health System to Enhance Mental Health in Zambia: A Policy Brief, Cambridge University Press, https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/abs/strengthening-the-health-system-to-enhance-mental-health-in-zambia-a-policy-brief/E84A716AC8C1EDB7E9959EEAFD2EDDB4.
Mwape L. (2010), Integrating Mental Health into Primary Health Care in Zambia: A Care Provider's Perspective, International Journal of Mental Health Systems 4-21, http://www.ijmhs.com/content/4/1/21.
Mwiya I.L and Banda S (2015), Mental Health Problems of Street Children in Residential Care in Zambia: Special Focus on Prediction of Psychiatric Conditions in Street Children, Journal of Clinal Medicine and Research, Vol.7(1), 1-6, DOI:10.5897/JCMR11.025.
Narlawar W. U and Sourav U (2018), Assessment of Physical Infrastructure of Sub-Centres in Central India as per Indian Public Health Standards 2012 Guidelines: A Cross Sectional Study, Journal of Medical Science and Clinical Research 28 DOI: https://dx.doi.org/10.18535/jmscr/v6i3.
National Assembly of Zambia: Mental Health Bill (2019), https://www.parliament.gov.zm/node/7883.
National Assembly of Zambia: Mental Health Act (No.6, 2019), https://www.parliament.gov.zm/sites/default/files/documents/acts/The%20Mental%20Health%20Act%20No.%206%20of%20%202019.pdf.
Nemecek, D (2020), Cigna Standards and Guidelines/Medical Necessity Criteria: Treatment of Mental Health Disorders, https://static.cigna.com/assets/chcp/pdf/resourceLibrary/behavioral/cigna-standards-and-guidelines-medical-necessity-criteria-2020-Edition.pdf.
Ngungu J, and Beezhold J (2009), Mental Health in Zambia: Challenges and way forward. International Psychiatry, Vol. 6(2), 39-40.
Nyashanu M, Karonga T, North G, Mguni M, Nyashanu W (2021), COVID-19 Lockdown and Mental Health: Exploring Triggers of Mental Health Distress among Women in the Copperbelt Province Zambia. International Journal of Mental Health, DOI: 10.1080/00207411.2021.1984127.
Okech C.T (2016), Devolution and Universal Health Coverage in Kenya: Situational Analysis of Health Financing, Infrastructure and Personnel. International Journal of Economics, Commerce and Management, Vol. 4, Issue 5, United Kingdom.
Padgett D.K, Smith B.T, Henwood B.F, Tiderington E (2012), Life Course Adversity in the Lives of Formerly Homeless Persons with Serious Mental Illness: Context and Meaning. Am J Orthopsychiatry, Vol. 82(3),421-30. [Pubmed]
Purgato M, Singh R, Acarturk C, Cuijpers P (2021), Moving Beyond a "˜One Size-Fits-All' Rationale in Global Mental Health: Prospects of a Precision Psychology Paradigm. Epidemiology and Psychiatric Sciences 30 (63), 1-6. https://doi.org/10.1017/ S2045796021000500.
Putri A. K, Gustriawanto N, Rahapsari S, Sholikhah A.R, Prabaswara S, Kusumawardhani A.C, Susi Ari Kristina S.A (2021) Exploring the Perceived Challenges and Support Needs of Indonesian Mental Health Stakeholders: A Qualitative Study. Int J Ment Health Syst 15, 81. Https://Doi.Org/10.1186/S13033-021-00504-9
Sankoh O, Sevalie S, Weston M (2018), Mental Health in Africa. The Lancet Global Health, 6(9), e954-e955. https://doi.org/10.1016/S2214-109X(18)30303-6.
Shook M (2005), Transportation Barriers and Health Access for Patient Attending a Community Health Center, Field Area Paper, June 10.
Shrinivas K. P and Shivaswamy M. S (2017), Assessment of Sub-Centres of Belagavi District According To Indian Public Health Standards 2012 Guidelines: A Cross Sectional Study. International Journal of Community Medicine and Public Health Vol. 4(6),1938-42.
Signa (2011), Levels of Mental Health Care Descriptions (Lowest to Highest). Licensed for use by Cigna Corporation Inc.
The Lancet Global Health (2020). Mental Health Matters. Elsevier Ltd ,Volume 8, (11) E1352, www.thelancet.com/lancetghDOI: https://doi.org/10.1016/S2214-109X(20)30432-0.
Tiemens B, Kloos M, Spijker B, Ingenhoven T, Kampman M, Hendriks G. (2019), Lower Versus Higher Frequency of Sessions in Starting Outpatient Mental Health Care and The Risk of A Chronic Course: A Naturalistic Cohort Study, BMC Psychiatry, Vol. 19(228).
UNDP Policy Brief (2020). Gender-Based Violence and COVID-19. https://www.undp.org/publications/gender-based-violence-and-covid-19.
Von Bertalanffy, Ludwig (1968), General system theory, New York, NY, George Braziller.
Wachira, W. G, Nassiuma B.K (2021), Influence of Physical Resource Infrastructure on Health Sector Service Delivery in Nyeri County, Kenya, African Journal of Education, Science and Technology, Vol. 6(4).
Wahl, F. Otto (2012), Stigma as a Barrier to Recovery from Mental Illness. Trends Cognitive Science, Vol.16(1), 9-10. Doi: 10.1016/J.Tics.2011.11.002.
WHO (2005), The WHO Mental Health Policy and Service Guidance Package, Available at: http://www? who.int/mental_ health/policy/essentialpackage1/en/.
WHO (2017) WHO Mental Health ATLAS. Available at: http://www.who.int/mental_health/evidence/ atlas/mental_health_atlas_2017/en/.
WHO Zambia (2020), WHO Coronavirus Disease (COVID-19) Dashboard | WHO Coronavirus Disease.
WHO Zambia (2021), WHO Coronavirus Disease (COVID-19) Dashboard. WHO Coronavirus Disease, https://covid19.who.int/region/afro/country/zm).
Winkelmann J, Webb E, Williams G.A (2021), European Countries' Responses In Ensuring Sufficient Physical Infrastructure And Workforce Capacity During The First COVID-19 Wave, Health Policy Https://Doi.Org/10.1016/J.Healthpol.2021.06.015.
World Health Organization (2020), Mental Health Atlas report https://www.who.int/news/item/08-10-2021-who-report-highlights-global-shortfall-in-investment-in-mental-health.
World Health Organization and World Organization of Family Doctors (Wonca) (2008), Integrating mental health into primary care: a Global Perspective. WHO Library Cataloguing-in-Publication Data.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Kapumpe Chilufya
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.